区域军队中心医院学科建设对策

分部所属医院都是中心医院,编制床位都在200张左右;各医院学科实力、品牌影响、技术水平和教学科研能力不断提升,建设发展成绩喜人。但按照科学发展观规律、广大官兵健康需求和医院现代化建设标准来衡量,各医院学科建设还存在人才队伍不够整齐、制度落实不够严格、学科发展不够平衡、医教研发展不协调等矛盾。中心医院学科建设要坚持创新发展,增强学科建设的动力;坚持规范管理,挖掘学科建设的潜力;坚持人才为先,激发学科建设的活力;坚持文化推动,提升学科建设软实力。     

军队医院大型医疗设备管理的现实性问题探讨

伴随着科学技术的进步和军队现代化建设的不断推进,大型医疗设备的引进促进了军队医院医学科学技术的发展和卫勤保障水平的提高,使医院质量、内涵建设和核心竞争力得以加强,形成了技术促进设备更新、设备为人才和学科建设提供物质基础保障和健康发展的良性循环。针对军队医院大型医疗设备管理现状,指出了军队医院医疗设备在引进、使用、维护和监管等方面存在的问题,探讨了应对的策略和方法,以提高医院医疗设备管理水平。     

浅论提高科研管理水平与医院学科建设发展的关系

1认真论证学科方向,制定科学合理的学科学科建设是医院建设的重要组成部分,它贯穿于整个医院的发展、建设过程。医院要发展,学科是关键[1]。加强学科建设主要从培育人才、建立研究方向、加强科技创新、创立学科精神、开展交流与合作、构筑硬件设施等途径来实现。     

基于复旦学科评估模型的军队医院疾病预防控制学科建设评估

目的 通过对军队医院疾控科学科发展现状进行评估,总结学科建设的成效和问题,分析优势和短板原因,探讨改进措施。方法 对标复旦大学医院管理研究所《医院学科评估指标体系》,构建“四横三纵”学科综合评估模型,评估军队医院疾控科面临的现状和问题。结果 评估结果显示,军队医院疾控科具有三方面优势：高层次人才队伍相对稳定、科研平台建设具备一定基础、为部队服务工作优先开展。存在问题：人才建设方面,高质量的后备人才明显缺乏、人才内部主动培育有待加强;教学工作方面,教学经验总结不足、教员队伍建设参差不齐;学科科研方面,科研氛围不够浓厚、实验室建设严重缺失;服务保障方面,“医”“防”尚未深度融合、政策制度尚不健全、配套设施尚不完善、技术发展尚无突破。基于评估模型得出结果,给出持续改进建议。结论 该学科评估理论框架及指标体系遵循了系统性、科学性、客观性及可操作性的原则,变经验评估为循证评估,结果相对公平客观,可以为新时期军队医院疾控学科建设发展提供一定前瞻性思路和实用性对策。     

基于高质量发展的某省级区域医疗中心学科建设的实践探讨

目的 分析某省级区域医疗中心在高质量发展过程中的学科建设实践与效果,为其他医疗卫生机构学科建设工作提供参考。方法 综合分析某省级区域医疗中心近年来学科建设实践与效果,总结优化学科建设以实现医院高质量发展的具体经验,深入探讨相关影响因素和改进措施。结果 各项学科建设工作初见成效,学科中心化有序推进,科技创新能力水平显著提高。结论 明确学科发展定位,做好学科发展规划,重视医院运营管理,加强人才团队建设,增强对外交流合作,搭建科技创新研究平台,促进科技创新成果转化,能够显著提升省级区域医疗中心在高质量发展过程中的学科建设水平。     

新医改形势下公立医院高质量发展策略思考△

针对当前公立医院高质量发展面临政府财政投入力度不足、收入增幅趋缓、人才学科建设有待加强、运行效率有待提升等问题,本文提出要聚焦当前发展不平衡、不充分的主要矛盾,按照五大发展理念制定医院发展战略,加强医院运营精细化管理,提升医院内涵质量,以人才学科建设与技术项目开展为抓手增强医院核心竞争力,积极推进医疗联合体建设,进一步优化医疗服务供给等,在此基础上推动医院高质量发展。     

三级医院创新发展的探讨与实践

创新型管理必将取代常规型管理。南京市第一医院不断加强管理创新:一是创新发展思路,形成特色办院模式;二是创新管理理念,提升医疗服务水平;三是创新激励机制,推进人才学科建设;四是创新内涵建设,强化医疗安全管理。通过以上措施,提升了医院资源的整体运行功效,取得了良好的经济和社会效益。     

加强内涵建设 推进军队医院全面发展

为谋求新时期军队医院又好又快发展,本文阐述在确保姓军为兵服务方向,完成部队保障任务的同时,军队医院要以内涵建设为导向,突出抓好医疗质量管理;以观念更新为突破,提高服务意识;以人才学科建设为根本,强化加快推进发展意识。     

军兵种总医院优势学科体系发展的策略

在总结医院优势学科体系建设经验基础上,全面分析联勤体制下军兵种总医院学科建设面临的形势和任务,提出了加强军兵种总医院学科建设的总体思路、通用学科建设的策略、特勤学科建设的模式及学科支撑体系建设的具体方法,提出了＂设备加人才等于技术、技术加市场等于效益、效益加和谐等于发展＂的学科建设理论,创新了医院学科建设理论。     

军队医院学科建设发展趋势及对策

本文通过综合分析军队医院学科建设所处环境和未来发展趋势,指出当前军事医学特色不突出、学科发展方向多元化、学科建设基础不稳固、科研综合能力不全面、学科效率增长不明显等主要问题,提出应突出军事保障重点、着力提升学科特色性,突出疾病诊疗导向、着力提升医疗服务力,突出基础质量建设、着力提升学科竞争力,突出创新转化驱动、着力提升学科前沿性,突出评估体系建立、着力提升分配合理性等建议,不断推动军队医院学科建设又快又好发展。     

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.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

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.