绵阳市涪城区基层医疗卫生机构人力资源调查

目的了解绵阳市涪城区社区卫生服务中心和乡镇卫生院人力资源现状,为合理建设基层医疗卫生机构提供依据。方法通过问卷调查的方式对绵阳市涪城区全部社区卫生服务中心和乡镇卫生院的人力资源情况进行调查,采用统计软件SPSS13.0对数据进行统计分析。结果绵阳市涪城区社区卫生服务中心卫生人员平均55名,乡镇卫生院卫生人员平均21名。社区卫生服务中心、乡镇卫生院卫生人员主要以女性为主占62.8%,25～35岁卫生人员占35.6%。结论绵阳市涪城区基层医疗卫生机构人力资源缺乏、专业结构需要调整、学历有待提高、配置需要改善。     

山东省基层医疗卫生机构人员满意度调查研究

[目的]了解山东省基层医疗卫生机构人员满意度。[方法]采用问卷调查,对基层医疗卫生机构人员进行调查,共调查社区卫生服务中心71人,乡镇卫生院276人。[结果]基层医疗卫生机构人员不满意比例较高的是培训机会和晋升标准,对于医院的设备条件满意度较高。[结论]相关部门应当加强和改善基层医疗卫生机构人员的激励因素,提高基层医疗卫生机构人员的满意度。     

山东省乡镇卫生院卫生人力资源配置现状分析

[目的]了解分析山东省乡镇卫生院卫生人力资源现状,为加强基层人才队伍建设提供依据。[方法]从2015年山东省乡镇卫生院信息统计报表中收集相关数据,对山东省乡镇卫生院卫生人力资源的规模、分布、性别、年龄、学历和专业技术资格构成进行描述性分析。[结果]全省乡镇卫生院院均拥有卫技人员61人,男女比为4∶6,25~44岁年龄段占41.90%,本科以下学历占96.11%,初级及以下专业技术资格卫生人员占52.43%,注册护士和医技人员院均16.8人和11.2人。[结论]全省乡镇卫生人员总量充足,卫生技术人员性别比例和年龄结构趋于合理,但学历和专业技术水平总体较低。     

四川省乡镇卫生院卫生人员培训目的需求及其影响因素调查分析

[目的]调查分析四川省乡镇卫生院卫生人员参加培训目的需求及其影响因素,为进一步探索乡镇卫生院卫生人员培训方式提供依据。[方法]采用问卷调查的方法,对四川省宝兴县、彭州市29个乡镇卫生院679名乡镇卫生院卫生人员进行调查,并采用单因素和多因素Logistic回归分析相结合的统计方法进行分析,探讨乡镇卫生院卫生人员参加培训目的需求及其影响因素,并进行模型拟合与诊断。[结果]调查的乡镇卫生院卫生人员中,希望通过参加培训提高临床能力的占53.5%,提高理论水平的占34.0%,其他目的的占12.5%;通过拟合多项Logit模型表明对乡镇卫生院卫生人员参加培训目的有意义的影响因素分别为职业、职称、月收入和学历。[结论]对于乡镇卫生院卫生人员的培训,可以根据职业、职称、学历等多层次结构,建立灵活的多形式相结合的培训模式。     

云南省乡镇卫生院发展现状及对策分析

[目的]分析云南省乡镇卫生院发展现状、当前存在的主要问题与不足,并针对性提出对策建议。[方法]采用文献法查阅相关资料,开展实地调查,最后进行描述性统计分析。[结果]云南省基层医疗卫生机构服务基础仍然薄弱,农村居民选择乡镇卫生院就诊的比例降低,乡镇卫生院基本医疗服务功能弱化,国家和省级利好政策没有用好用足。[结论]党委政府要依法履行发展医疗卫生健康事业的职能职责,配强配齐县级卫生健康行政部门和乡镇卫生院领导班子及其“一把手”,切实提升乡镇卫生院医疗卫生人员服务能力和水平,推行乡镇卫生院差异化功能定位和分类管理。     

云南省玉龙县乡镇卫生院医疗卫生服务能力调查

[目的]通过对玉龙县下属的乡镇卫生院的综合调查,了解基层卫生院卫生服务的能力,为政策制定提供资料和建议。[方法]运用现有资料,通过描述性分析和对乡镇卫生院工作人员进行访谈,评价基层卫生院卫生服务能力及影响因素。[结果]由于经济、地理条件的制约,致使玉龙县乡镇卫生院的卫生服务能力尚处于比较落后的水平;许多诊疗项目未能开展,在很大程度上影响了当地农村居民的健康水平;仪器配备不齐全、医疗卫生人员的匮乏使得基层卫生院目前无法达到国家标准。[结论]相关部门应进一步增加对基层卫生院重视程度,在财政方面给予大量支持,在政策上给予相应倾斜,同时应了解基层的实际需求加大政策的实用性。     

江苏省乡镇卫生院卫生人力资源现况调查与分析

目的 了解江苏省乡镇卫生院卫生人力资源现状,发现存在的问题并提出对策建议.方法 采用普查法搜集江苏乡镇卫生院卫生人力资源的相关信息,对性别、年龄、学历、职称以及各类卫技人员的配置情况进行描述性统计分析.结果 江苏乡镇卫生院卫生、卫技人员数量相对充足;卫技人员年龄机构比较合理,中青年居多,本科及以上学历占比较低,技术职称普遍不高,以中级以下职称为主;口腔类医师以及B超、心电图等类别医技人员的配备率相对较低.结论 主管部门应该科学合理地对卫生人力资源进行配置,重点应放到提高卫技人员的专业素质、优化职称结构和进一步完善各类卫技人员的配置结构上.     

吉林省基层医疗卫生机构卫生资源配置情况分析

目的分析2011~2015年吉林省基层医疗卫生机构卫生资源配置现状,发现当前存在的问题、不足,为建立系统完善、高效灵活的基层医疗卫生机构资源配置体系提供理论依据。方法采用普查的方法,对吉林省基层医疗卫生机构2011~2015年卫生资源配置现状展开调查,利用Excel2010进行数据二次处理,通过SPSS18.0软件进行统计分析。结果物力资源配置方面,各类基层医疗卫生机构数、平均床位数趋于平稳。平均万元以上设备数量中,社区卫生服务中心(站)和乡镇(街道)卫生院逐年增长;人力资源配置方面,社区卫生服务中心和乡镇(街道)卫生院及各类人员配置较多,增长明显;卫生经费配置方面,社区卫生服务中心(站)和乡镇(街道)卫生院财政补助和上级补助中最多且逐年增长,村卫生室上级补助增长明显。结论卫生资源配置情况2012年明显增长,2013年至2015年平稳增长。社区卫生服务中心(站)和乡镇(街道)卫生院在物力资源配置、人力资源配置、卫生经费配置方面明显优于其他基层医疗卫生机构。村卫生室卫生服务工作量大,卫生资源配置尚不能满足卫生服务需求。     

云南省边境地区基层卫生服务人力配置现状分析

[目的]了解云南省边境地区基层卫生服务人力配置现状。[方法]采用分层随机抽样方法,共计抽取11个县,并结合定性访谈展开调查。[结果] 11个边境县每千人口卫生技术人员,平均数为2. 63人,低于云南省平均水平。有7个县的医疗卫生人员超编,临聘人员占现有职工的1/3左右,但也有4个县的编制未招满; 11个县级医疗机构卫技人员中,本科及以上学历低于70%,乡镇卫生院本科及以上学历大部分占20%,村级卫生人员约50%无文凭;有83个乡镇(61. 9%)存在人才流失现象,5年间共计流失了439人。[结论]边境基层地区存在"编制少、临时聘、人才缺、流失多"等问题,需要尽快补齐边境地区医疗卫生服务人才紧缺的短板。     

山西省农村乡镇卫生院卫生人力资源现状分析

[目的]通过分析山西省农村乡镇卫生院卫生人力资源现状,找出其存在的问题和解决问题的对策与措施,为进一步探讨如何建设乡镇卫生院人才队伍、提高乡镇卫生院人员的工作效率和工作积极性,以及充分发挥乡镇卫生院卫生人力资源的作用提供参考依据。[方法]采用普查的方法收集资料。向山西省11个地市的1238个乡镇卫生院相关人员统一发放问卷,在调查人员指导下,由被调查机构负责人现场填写并统一收回。用Excel建立数据库,用SPSS13．O软件进行统计分析。[结果]山西省1238个乡镇卫生院的人员配置状况不合理,具体表现为：乡镇卫生院人员数量不足,整体素质不高;人员学历偏低,具有中专学历的卫生人员占50％gZ上,而具有本科学历的卫生人员仅占0．84％;职称结构不合理,具有高级职称的人数仅占0．23％,呈现出初级人才为主,高级人才短缺的现象;每千人口拥有的卫生人员数1．28人;每千人口拥有的病床数为0．95张;政府财政投入直接影响乡镇卫生院的发展。[结论]卫生人员学历偏低是限制乡镇卫生院发展的重要因素,要重视乡镇卫生院卫生人员的能力建设,提高卫生人员的待遇。政府应加大对乡镇卫生院的投入,制定出有利于乡镇卫生院卫生人员合理配置的政策,有效利用卫生人员,提高卫生服务的水平。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.