英国卫生改革的最新组织结构与功能调整

英国卫生改革的最新组织结构与功能调整大连医科大学任苒随着英国国家卫生服务制度（ＮＨＳ）改革的实施，ＮＨＳ的组织结构又有了新变化。最新的变化是自１９９６年４月１日起，大区卫生局的废除，地区卫生局和家庭卫生服务局的合并。目前的ＮＨＳ结构见附图所示。附图：...     

英国地区间国家卫生服务资源配置方法的回顾与展望

英国国家卫生服务卫生资源的地区间发配一直是ＮＨＳ执行机构的重要工作领域。如何实现ＮＨＳ资源地区间分配的公平性目标，研究机构和各级政府进行了大量的研究，探讨和实践，本对英国ＮＨＳ资源配置方法进行了回顾与展望。     

从一个英国医院集团的运营现状看医院集团的发展趋势

当前我国城市大型医疗机构的集团化发展是一个不可阻挡的趋势[1 4 ] 。在其发展过程中 ,借鉴和学习国外的医院集团运作方法 ,正确运用到卫生改革的实践中是医院管理者研究的重要课题。作者结合中国卫生经济网络“旗舰”培训计划所采用的英国伦敦Ｓｍｉｔｈ医院托拉斯 (下文中称集团 )的资料[5] ,分析其运作的主要方法和成败得失 ,探讨在当前形式下有借鉴作用的医院集团化管理模式。一、医院集团基本情况2 0世纪 90年代中期 ,英国卫生行政管理部门(ＮＨＳ)为了提高医院经营效率 ,推动医院之间的竞争 ,采取了一系列有利于医疗机构权力下放的管…     

我院实施ISO9004-2的分析

1999年我们采用ＩＳＯ90 0 4 2建立起符合医院工作实际的医疗服务质量管理体系 ,经近 1年的运行 ,取得明显的效果。现将我们实施ＩＳＯ90 0 4 2的做法和体会进行阐述。一、医院采用ＩＳＯ90 0 4 2质量体系的意义(一 )有利于管理的规范化与制度化和法制化 :通过质量体系文件的建立、批准和发布 ,把ＩＳＯ90 0 4 2标准转化为医院具体执行的标准 ,所有人员必须严格执行 ,因此 ,对服务行为具有规范化的作用。(二 )有利于明确职责 :通过展开ＩＳＯ90 0 4 2标准的要素 ,可以把医院各级领导以及所有与质量有关人员的职责和作用具体化、文件化 …     

国外医院所有制结构演进及启示

当前 ,医疗机构面临着重组和所有制结构改造的现实问题。如何借鉴它国的经验 ,少走弯路 ,是摆在我们面前的一项课题。一、国外医院所有制的演进(一 )英国医院所有制结构的演进及影响 :英国是一个高福利国家。 194 4年在国家卫生服务法白皮书中首次提出实行国家卫生服务制度 (ＮＨＳ)。194 8年将全国医院基本收归国有 ,国有医院占 95 %以上 ,由政府实行计划管理[1] 。医院按人头、床位拨款 ,医务人员领取政府支付的固定工资。 196 4年通过“国家卫生保健法” ,规定所有英国居民都可以免费享受国营医院的医疗服务。在这种政府高度垄断的单一医…     

如何建立ISO9001医院质量管理体系

建立ＩＳＯ90 0 1医院质量管理体系是医院的一项战略性决策。我院从 2 0 0 1年 11月起按照ＩＳＯ90 0 1标准要求建立医院质量管理体系。在贯彻实施ＩＳＯ90 0 1质量管理体系标准 (以下简称贯标 )的过程中 ,我们体会到尽管ＩＳＯ90 0 1质量管理体系标准的科学性和先进性勿容置疑 ,但是 ,由于对医院来说 ,所谓的产品指的是医疗服务 ,具有特殊性和复杂性。因此 ,不能生搬硬套ＩＳＯ90 0 1标准 ,应在实践中勇于探索。即一是从无到有的原创性活动 ;二是结合标准对现有管理的更新。既不能唯条条框框是上 ,也不能完全脱离标准。一、转变观念和统一…     

英国医疗制度及其改革

英国医疗制度及其改革于宗河英国总面积２４．４２万平方公里，人口５６７０多万。１９４４年英国宣布实行＂国家卫生服务制度＂（ＮａｔｉｏｎａｌＨｅａｌｔｈＳｙｓｔｅｍ，ＮＨＳ）并着手从三方面改革：①需要对英国每位公民提供广泛的医疗服务；②国家税收支付大部分...     

高效液相色谱法测定食品中山梨酸等的方法研究

高效液相色谱法 (ＨＰＬＣ)具有灵敏度高、分离效果好的特点。我们采用ＨＰＬＣ法对食品中山梨酸 (ＳＯＡ)、苯甲酸(ＢＡ)、糖精钠 (ＳＡ) [1] 进行了测定。1　材料与方法1 1　仪器　高效液相色谱仪　日本岛津ＬＣ -10Ａ、ＳＰＤ -10Ａ紫外检测器、Ｃ -Ｒ7Ａｅ色谱数据处理机。超声波清洗机、隔膜真空泵、石英亚沸高纯水提纯器、微孔滤膜 ( 0 45 μｍ)。1 2　试剂1 2 1　甲醇 (ＣＨ3 ＯＨＡＲ级 )。 0 0 2ｍｏｌ/Ｌ乙酸铵 (ＣＨ3 ＣＯＯＮＨ4ＡＲ级 ) :称取 1 5 4ｇ乙酸铵 ,加水至 10 0 0ｍｌ溶解。氨水7 0ｍｏｌ/Ｌ (ＮＨ4 ＯＨＡＲ级 )…     

医院信息系统的实施过程及体会

我院是一所二级甲等综合医院 ,拥有病床 40 0余张 ,日均门诊量约 60 0人次。以前医院信息管理采用部分手工部分单机方式 ,这种方式不但不能保证采集数据的客观性准确性 ,还存在数据录入工作量大 ,各部门之间重复劳动多等诸多缺点 ,为了规范医院管理 ,充分利用信息资源 ,提高工作效率 ,对全院的财务、医疗信息、物资及人员进行全方位的管理 ,2 0 0 1年初进行了医院信息系统 (ＨＩＳ)建设改造 ,新系统采用Ｃｌｉｅｎｔ/Ｓｅｒｖｅｒ结构 ,以ＷｉｎｄｏｗｓＮＴＳｅｒｖｅｒ为网络操作平台 ,配以ＭｉｃｒｏｓｏｆｔＳＱＬＳｅｒｖｅｒ数据库管…     

石墨炉AAS法测定蔬菜中Pb、Cd、Cr的研究

本研究根据蔬菜的多种类型 ,采用简易的湿法消化方法处理样品 ,用石墨炉原子吸收光谱法结合应用ＮＨ2 Ｈ2 ＰＯ4 基体改进剂和标准加入法测定Ｐｂ、Ｃｒ、Ｃｄ ,得到准确的测定结果。1　材料与方法1.1　试剂铅、铬、镉标准储备液 :浓度为 10 0 0ｍｇ/Ｌ(标准溶液 ,ＮＣＳＧＳＢＧ6 2 0 71,6 2 0 17,6 2 0 40 ) ;铅、铬、镉的标准使用液 ;分别将标准储备标准用 0 .5 %ＨＮＯ3 经多次稀释 ,配成 10 .0ｍｇ/Ｌ和 1.0ｍｇ/Ｌ标准使用溶液 ;硝酸 (ＧＲ) :0 .2 %ＨＮＯ3 ;ＮＨ4 Ｈ2 ＰＯ4 改进剂溶液 2 5 0ｇ/Ｌ ;分析过程中全部用水为去离子水 ;…     

Trends in meningococcal disease in Italy in 1988

Meningococcal disease in Italy decreased 15% in 1988 from the previous year (290 vs. 342 cases). The decline was particularly evident in military cases (1.7/100,000 in 1988 vs. 5/100,000 in 1987) reflecting the full coverage of bivalent serogroup (A + C) meningococcal polysaccaride vaccine in army recruits, achieved since January 1988. The highest proportion of cases was seen in people older than 25 years of age (25%). Serogroup C constituted 60% of the isolates, while 19% belonged to serogroup B. The proportion of strains resistant to sulphonamides was 45%, while 15% were resistant to Minocycline and none to Rifampin. Out of the five military cases, only one (due to serogroup C) was attributable to the vaccine failure. A single coprimary case, but no secondary cases occurred among civilians. These findings are consistent with the trends reported in Italy in the previous years.     

Benzene in blood and phenol in urine in monitoring benzene exposure in industry

Determinations of benzene concentration in blood and of phenol in urine were made by head-space gas chromatography techniques on samples taken near the end of the work day from two groups of workers potentially exposed to low levels of benzene in the work-place atmosphere. Preliminary results suggest that benzene in blood is more reliable than phenol tests for assessing both exposure and uptake of benzene. Normal values of phenol in urine (10 mg/liter or less) were found in nearly all those cases in which benzene was detected in the blood.     

2015年郑州市饮用水放射性水平状况调查

目的了解郑州市不同地区、不同季节、不同水源类型的放射性水平。方法分别于丰水期和枯水期采集郑州市区黄河水源水、井水源水、丹江口水源水、出厂水和末梢水各一份;以县为单位,每单位采集出厂水、末梢水、水库水、河水、井水各1份,按《生活饮用水生活标准检验方法》(GB/T 5750.13-2006)检测饮用水中总α和总β放射性水平,依据《生活饮用水卫生标准》(GB 5749-2006)进行判定。结果丰水期、枯水期水体总α、总β放射性水平均低于国家标准限值。结论郑州市不同水源类型均处于正常的天然放射性本底水平。     

Occupational stress in nurses in psychiatric institutions in Taiwan

Nurses are known to be exposed to occupational stress. However, occupational stress is not well documented for nurses in psychiatric institutions in Taiwan. A cross-sectional study was conducted to explore the work-related stress and risk factors of nurses in psychiatric institutions in Taiwan. A structured questionnaire was distributed to nurses at five state-owned psychiatric hospitals in Taiwan in 2001. Demographic information, working environment, and personal health status were inquired. Occupational stress was assessed based on the Chinese version of Job Content Questionnaire (JCQ). General health status and mental health were evaluated by the International Quality of Life Assessment Short Form-36 (IQOLA SF-36). A total of 573 questionnaires were disseminated to nurses and 518 (90.4%) were satisfactorily completed by nurses, including 408 female full-time nurses who had been in their current work for more than 6 months. In the past one month, 17.2% of nurses reported being under significant stress often or always. Assault episodes were reported by 45.1% of nurses in the past 6 months. Among the nurses, 16.9%, 25.2%, 50.0%, and 7.8% belong to the "High strain", "Low strain", "Active", and "Passive" groups, respectively. Perceived occupational stress was associated with young age, widowed/divorced/separated marital status, high psychological demand, low workplace support, and threat of assault at work. Lower general health score was associated with low job control, high psychological demand, and perceived occupational stress. A lower mental health score was associated with low job control, high psychological demand, low workplace support, and perceived occupational stress. We concluded that nurses in psychiatric institutions are under significant stress related to work factors.     

Changes in nursing administration in supporting transplantation in Brazil

This historical and bibliographic study aimed to understand how Nursing was organized to support care in transplantation. The HISA, LILACS, BDENF, PERIENF and DEDALUS databases were consulted, and thirteen references were found, ten of which were scientific articles, two were master's dissertations and one was a doctoral thesis. The span of time chosen for study ranges from the date of the first kidney transplant in Brazil (1965), to the date of publication of the last scientific article found in the databases mentioned above (2003). After reading these articles, the ones that were similar in topic were grouped together, thus creating the thematic axis for the presentation of the results. The results showed that the Nursing profession has played an important and active role in transplants ever since the first procedure in 1965.     

2019年中国肿瘤流行病学研究进展

恶性肿瘤已成为中国居民的主要死因之一。近些年来,中国政府积极推进肿瘤预防和控制领域的研究工作,取得了很大的进步。本文简要汇总中国在肿瘤流行病学领域的研究进展,具体包括2019年的肿瘤负担、癌症危险因素及其干预、筛查和早期发现、癌症防治专项行动(2019-2022年)方案等方面,以期为我国肿瘤防治工作的有效开展提供技术支撑和理论依据。     

2012年绵阳市蔬菜中农药残留状况

目的 了解绵阳市2012年市售蔬菜中农药残留情况,为食用蔬菜监管提供依据.方法 全部样品均按照GB/T 5009-2003的方法进行农药的残留检测.依据GB 2763-2005《食品中农药最大残留限量》进行判定.结果 2012年共检测蔬菜165份,农药检出率和超标率分别为72.12％和23.64％.豆类、根茎类、叶菜类、瓜果菜类和食用菌类蔬菜检测农药残留超标率分别为8.00％、23.53％、36.00％、5.26％和27.03％,差异有统计学意义(x2=11.41,P＜0.01).不同种类农药超标率差异有统计学意义(x2 =62.42,P＜0.01).夏季和冬季蔬菜农药超标率差异无统计学意义(x2=3.44,P＞0.05).结论 绵阳市叶菜类蔬菜中农药残留情况较为严重,应采取有效措施,加强蔬菜的监督管理,从源头禁止高毒农药的使用,加大蔬菜种植、销售环节的监测,确保市民食用蔬菜的安全.