卫生防疫站药品材料管理探讨

一、转变观念，适应市场经济和卫生防疫体制改革、发展的需要，建立健全药品材料管理体系 为适应改革与发展的需要，首先要求卫生防疫部门各级领导和管理人员要转变观念，必须从事业型管理观念中解放出来，树立管理、效益观念，提高药品材料的管理；     

试论医院药剂工作改革

我们对市场经济体制下医院药剂科工作改革进行了探讨，指出药剂科工作职能转变要服从于医院药学的发展，坚持面向临床药学、临床药剂、新药研究、药品管理，以及微机应用的方向；在市场经济条件下，医院在讲社会效益的同时也要积极面向市场，敢于讲经济效益，树立价值观念，经营观念，效益观念。     

医患人员对医院经济行为认知程度的调查

随着医疗制度改革的深入,医院的经济行为成为医院管理的重要元素.合理有效的经营管理能提高医院的效率,促使医院创造更好的效益."经营"的观念,不仅医院管理者应具备,医院的全体人员都应树立此观念,只有人人注重"成本效益",按经济规律办事,医院才能在激烈的市场竞争中生存并发展.     

医院在“医改”环境下面临的挑战与对策

全国城镇职工基本医疗保险制度改革已全面启动，医院作为医疗服务的提供方在新环境下面临的巨大的挑战，如何在医改中抓住机遇深化医院改革，谋求自我发展，文章提出了采取的对策与措施：进一步解放思想，更新观念２走优势，高效，低耗的路子。一是增强市场意识，拓展生存与发展空间；二是增强质量意识，三是增强科技意识，提高技术水平；四是增强服务意识，提供优质服务；五是增强效益意识，加强经营管理，六是增强公关意识，营造良     

新世纪医院管理的探讨

作者阐述了医院在新世纪所面临的外部和内部环境的变化,强调医院管理者必须用新的理念和方式来管理医院,以适应时代的要求。重点论述了10种管理方式,即知识管理、人力资本管理、经营管理、效率效益管理、新医疗质量内涵管理、模糊管理、信息管理、形象管理、人本管理和医院文化管理。     

知识经济与医院经营管理创新

知识经济作为建立在知识和信息的生产、分配和使用基础上的经济,对医院经营管理具有深远的影响.本文从三方面探讨了为适应知识经济要求的医院经营管理创新.医院经营管理观念的创新体现在知识经营管理观念、信息观念、风险管理观念、现金流量管理观念等方面的创新.筹资、投资及分配管理的创新体现了医院经营管理内容的创新.医院经营管理制度创新包含财务分析制度、监督制度及经营管理者的激励制度三方面内容.     

实行成本核算强化经济管理

实行成本核算是医院适应市场经济的必然选择。医院面对日益严峻的挑战 ,只有通过包括成本核算在内的经济管理手段 ,降低成本、提高效益才能提高其生存能力 ,才能在激烈的市场竞争中求得发展。我院开展以全成本核算为最终目标的准成本核算已有７年 ,本文将结合我院的实践 ,探讨医院成本核算问题 ,并就促进医院成本核算提出一些初浅的看法。一、实行成本核算 ,促进医院管理与效益提高相一致我院自１９９４年７月开始实行以全成本核算为最终目标、以增收节支为原则的过渡方案以来，在准成本核算基础上将效益与院内津贴挂钩 ,形成医院经济管理的…     

基于管理效能提升的大部制改革探讨

随着医药卫生体制改革进一步推进,医院传统的组织架构设置已不适应医院内部运行机制改革的需要。根据医院管理职能的变化,事业单位的大部制改革通过归并职能相近的部门,整合了有效的管理资源,促进了管理效能的提高,较好地契合了改革形势的需要。同时,怎样完善大部制的管理体系,需要进一步进行探索。     

强化医院内审工作适应医改形势要求

在卫生系统改革的严峻形势下，医院只有加强内部审计工作，充分发挥内审职能，进一步优化经营管理，才能提高医院的社会效益和经济效益，使其在改革的浪潮中立于不败之地。     

试论医院药房在医疗体制改革中的职能转变

讨论了医疗改革中的医院药房职能的变化，分析了改革对医院药房转变服务意识的要求；强调了完善监督机制的必要性；讨论了服务环境的优化以及服务功能的增强。认为医院药房只有不断增强自身的素为服务方式、才能适应市场变革的需求。     

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.