2007～2011年沈阳市皇姑区公共场所从业人员预防性健康体检资料分析

目的 了解沈阳市皇姑区2007~2011年公共场所从业人员传染病的发病趋势,加强对从业人员的卫生监督管理,为防止传染病的爆发与流行提供科学依据.方法 对皇姑区疾病预防控制中心体检中心2007~2011年公共场所从业人员预防性健康体检结果 进行统计分析.结果 5年间共检出6种传染病666例,检出率为1.54%.以传染期乙型肝炎检出率最高,为0.83%,检出人数占总检出人数的54.05%;其次为其他型肝炎占17.12%,肺结核占9.00% 结论 除肺结核检出率呈逐年上升趋势外,其他传染病的检出率处于波动状态.卫生监督部门应加强对公共所场所从业人员的卫生监督,增加监督频次,严把"两证"(健康合格证、卫生许可证)发放关,加大监督执法力度.相关部门应加强预防接种和卫生知识科普宣传,增强自我防病意识,将传染病控制在一定水平.     

乡镇预防保健机构人员现状分析

目的 了解和掌握乡镇卫生防保队伍人员状况,以便合理配置人力资源.方法 通过对乡镇防保机构年报资料进行汇总分析.结果 在145名预防保健人员中:以中专为主,占68.27%,大专以上学历只占8.28%,高中、初中学历分别占12.41%、11.04%;中级职称的占15.86%,初级职称的占83.45%,无职称的占0.69%;年龄在20～29岁的占29.66%,30～49岁的占45.52%,50岁以上的占24.83%.结论 根据我市卫生人力资源现状,必须尽快提高全市预防保健队伍人员的整体素质,有计划的引进高学历、高职称的人才,实现卫生事业持续、快速、健康发展.     

2006年广饶县部分食品从业人员卫生知识、态度和行为调查

目的了解食品从业人员的卫生知识、态度和行为情况,为开展行业健康教育工作提供依据。方法2006年7至10月.在广饶县疾病预防控制中心接受体检的食品从业人员中抽取1923人进行问卷调查。结果答卷及格率为83.52%.好占45.45%.中占38.07%.差占16.48%。答卷及格率城区高于农村,餐饮业较高,岗位工龄长的较高,文化程度高者较高.28岁以上者较高。卫生知识水平高的卫生态度与行为好于卫生知识水平低的。结论广饶县食品从业人员卫生知识水平较高,相关态度和行为较好。     

加强移民体检肺结核的监控管理

美国、加拿大、澳大利亚、新西兰等几个主要移民国家,均发现近年来结核病发病率有上升趋势,根据联合国健康卫生署(UNHCR)和世界卫生组织(WHO)的调查报告,全球每天有将近五千人死于肺结核,每年则有高达200万的肺结核病人死亡。移民体检部门应重视对出国移民体检人员的胸片检查,加强活动性肺结核的监测和卫生控制,从而有效防止肺结核在国际间的传播。1资料与方法1.1一般资料:2003~2006年经福建省立医院出国体检部体检的移民人员中,美国、加拿大、澳大利亚、新西兰的中国公民有70857名,其中男32814名,占46%;女38043占54%。1.2检查方法:常规…     

健康体检1800名心电图分析

我们对2005年1月至6月我院门诊健康体检1 800名心电图资料进行分析总结，以了解心血管病状况，做到早发现、早治疗。 1 资料和方法 1．1 一般资料：受检人员为部分行业从业人员及离退休人员共1800名，其中男性1177名，女性623名，年龄22～106岁，平均64岁。     

2002～2004年度盐城市区食品公共场所从业人员健康体检结果分析

饮食业、服务业作为特殊行业，其从业人员必须经健康体检合格领取个人健康证明后方可从事相关工作，这一点在《食品卫生法》和《公共场所卫生管理条例》中都作了明确的规定。为进一步了解我市近年来从事饮服业从业人员的健康体检状况，减少因从业人员原因引起的相关疾病的传播，保障服务人群的身体建康，现将我市2002～2004年度市区饮服业食品、公共场所从业人员健康体检情况分析报告如下：     

食品从业人员乙肝病毒感染现状分析

目的了解本区食品从业人员的乙肝病毒感染情况,为乙肝防治提供科学依据。方法选取2011年8月至2014年8月在我院进行健康体检的食品从业人员18267名作为研究对象,对其体检资料进行收集、整理、分类,并把食品行业人员乙肝表面抗原的阳性检出情况作为观察组,把全国的乙肝病毒感染情况作为对照组,比较两组乙肝表面抗原的阳性检出率并进行描述性分析。结果本次累计检测食品从业人员18267名,其中乙肝表面抗原(HBs Ag)阳性646名,总阳性率为3.5%,明显低于全国平均阳性检出率4.1%,观察组阳性检出率从2010年8月至2014年7月由高到低依次为4.1%>3.7%>3.3%>2.8%,呈逐年下降趋势,差异比较有统计学意义(P<0.05)。结论食品从业人员乙肝病毒感染状况不严重,感染率明显低于全国平均水平,且呈逐年下降趋势,说明每年均加强对食品从业人员的预防性健康体检,对保障人员的身体健康极为重要。     

新疆维吾尔自治区卫生人力资源配置现况研究

目的：了解新疆维吾尔自治区医疗卫生机构人力资源配置现状,发现存在的问题及差距,并提出相应的政策建议,为今后新疆医疗卫生机构规范化建设提供理论依据。方法对所收集数据采用excel电子表格建立数据库,应用SPSS 17．0软件对有关指标的变化情况进行不同类型的统计分析。结果2008-2012年新疆卫生机构数及卫生人员数呈增长趋势;新疆每千人口卫生技术人员、职业（助理）医师及注册护士数均高于全国平均水平。卫生人员中卫生技术人员所占比例最高;医护比例明显增高为1.1．04;卫生技术人员职称以初级为主占72．39％,高级人员占6．83％,学历以大专及以下学历人员所占比例最高占50％以上,研究生学历仅占2．34％。结论新疆医疗卫生人力资源结构欠合理,医护比例失衡,卫生技术人员整体素质偏低、结构有待调整,人才队伍需要进一步加强。     

北京市宣武区流动人群从业人员HBsAg检测情况分析

目的了解外地来京务工人群肝炎病毒健康携带情况,为相关行业部门的管理提供科学依据。方法对2008年在北京宣武区疾病控制中心健康体检的各类从业人员肝功能检测进行分析。结果在61285人次外地来京从业人员体检中,携带肝炎病毒的职业禁异者2535例,占4．14％（61285／2535）;本地占2．30％（24315／560）;其中HBsAg阳性人数为2153例,占职业禁异者84．93％,ALT升高者291例,占11．48％;HBsAg和ALT均阳性者91例,占3．59％;两地肝炎病毒携带率差异显著X^2=266．37,P〈0．01。结论相关部门应加强对流动人群中从事饮食、公共场所服务人员的管理,做好从业人员健康体检工作,普及乙肝防治知识,提倡乙肝疫苗接种,以达到减少和控制HBV感染的目的。     

凌云县2009年食品从业人员卫生知识水平调查分析

为了解我县食品从业人员的卫生知识水平状况,为今后健康教育与卫生监督提供科学依据。我们在2009年612月食品从业人员健康体检的同时,对其进行了卫生知识水平调查。现将调查结果报道并分析如下：     

国内常用合理用药软件的综合评价

目的：介绍、评价国内应用较多的七款合理用药软件,为医疗机构选择合理用药软件提供参考。方法：通过文献检索和用户使用调查,从合理用药软件的数据库来源、功能模块、优势特点、版本更新和用户数量及使用体验等几个方面进行综合评价。结果：美德医系统较为先进,兼具专业性和灵活性的特点;美康、大通和逸曜国内用户最多;美康数据库信息全面并提供详细的更新说明;大通拥有庞大的循证医学信息资源,数据更新快,但售后服务不及时;逸曜由药师自主编程,采用智能推理技术,操作简单,售后服务及时;普华和诚、天际健康、慧药通在处方审核模块各有特色。结论：国内的合理用药软件具有相似的基本功能,并日趋完善,同时又有各自的特点和优势,提供了较为完备的市场选择。美康数据库完善,价格适中,适合大部分医院;天际健康能够提供个性化定制服务,逸曜能够实现药师自主编程,操作简单,这两款适合想建立自己特色数据库的医院。普华和诚运行速度块,能够实现专科化和中成药的审核,适合专科化审核要求高的医院;美德医具有针对医保和商保的智能审核系统,适合医院医保用来控费。     

湖北省孝感市农村地区基本药物可获得性研究

目的:了解湖北省孝感市农村地区基本药物的可获得性和价格情况。方法:参考世界卫生组织和欧洲国际健康行动组织推荐的标准化药品价格调查方法,对湖北省孝感市农村地区4家医疗机构和3家药店的基本药物配备情况和价格水平进行调查。结果:该地区医疗机构和药店的基本药物可获得性均较低;药店的药品价格较医疗机构低;与国际参考价格相比,药店的价格较低,医疗机构则相对较高。除1家医疗机构的加成率远高于15.0%之外,其余2家基本控制在15.0%之内。结论:湖北省孝感市农村地区药品可获得性有待提高,药品价格还有降低的空间。     

广州市35家三甲综合医院急诊分诊模式调查研究

目的：了解广州市三甲综合医院急诊科的分诊模式,为完善广州市三甲综合医院急诊科的分诊体系提供依据。方法：通过自行设计的广州市三甲综合医院急诊分诊模式调查表,对广州市35家三甲综合医院急诊科进行调查。结果：54.3%的医院有参照卫生部的分诊指导原则统一分诊标准;74.3%的医院制定分诊流程;65.7%的医院有分诊护士准入制度;48.6%的医院对分诊质量进行评价;各大医院对急诊设施的配备欠统一。结论：我们应在卫生部公布的《急诊病人病情分级试点指导原则》的指导下,结合本地区的具体情况,借鉴国内外先进经验,进一步完善分诊体系,统一标准,为患者提供便捷、高效、安全的急诊护理服务。     

Book Reviews

Book reviewed in this article: Addiction: Questions and Answers for Counsellors and Therapists BILL READING & MICHAEL JACOBS, eds Substance Misuse in Psychosis: Approaches to Treatment and Service Delivery HERMINE L. GRAHAM, ALEX COPELLO, MAX J. BIRCHWOOD & KIM T. MUESER Managing the Dually Diagnosed Patient , 2nd edn DAVID O'CONNELL & EILEEN BEYER, eds International Handbook of Alcohol Dependence and Problems NICK HEATHER, TIMOTHY J. PETERS & TIM STOCKWELL, eds Beyond Advice: 1. Becoming a motivational practitioner 2. Developing motivational skills R. BOTELHO Parental Substance Misuse and Child Welfare BRYANNA KROLL & ANDY TAYLOR Straight Talk About Your Mental Health JAMES MORRISON     

Medicines information services in a resource-limited setting

IntroductionIn resource-limited settings, it is particularly important to explore the priorities for, as well as barriers to, development of health services. There has been limited development of medicines information (MI) services in Vietnam despite national guidelines.ObjectivesTo explore the current status of MI services for healthcare professionals and patients in Vietnamese hospitals.MethodsIn 2018, all hospitals which were under the direct administration of the Ministry of Health and all 63 Provincial Health Bureaus were invited to participate (n = 1359). All national, provincial and district hospitals, as well as private hospitals and hospitals from other Ministries in Vietnam, were included. An online questionnaire about MI facilities, workforce, and activities was used.ResultsThere were 560 eligible responses from pharmacists in hospitals. The most common MI service was pharmacovigilance (provided in 91% of hospitals), and the least common was providing MI for clinical case management (30%), nurse training (31%), and MI provision to patients (27%). Multivariate logistic regression analysis showed that the number of pharmacists and the geographical-economical area where hospitals were based had the strongest impact on the likelihood of offering more MI services in hospitals. While the type of hospital (traditional medicine vs. other hospitals) had some impact, hospital size, level, and specialization of hospital (general vs. specialized) did not have a significant impact on the provision of MI services.ConclusionThe differences in workforce and location may contribute to differences in MI practices between hospitals. These findings are relevant for the implementation of a national MI strategy in Vietnam and other developing countries.     

长沙地区县级医院中年慢性病患者健康商数及其影响因素的研究

目的 了解长沙地区县级医院中年慢性病患者健康商数指数及其影响因素,帮助中年人群提升健康自我管理能力.方法 采用随机抽样的方法对长沙地区4所县级医院的808名中年慢性疾病患者进行一般情况和健商问卷调查,所有资料均采用SPSS 13.0统计软件进行分析.结果 （1）健康商数状况调查结果中各维度得分均较低,在相应临界值水平左右,其中自我保健、生活方式、精神状态维度未低于相应临界值,精神状态维度得分相对较高,为（24.73±5.49） 健康知识维度的得分较低,为（21.47±5.89）,甚至低于安全健康商数维度的临界值.（2）不同年龄段、不同家庭住址、不同文化程度、不同体检频度患者在健康商数四个维度的得分均具有统计学意义（P＜0.05） 不同体质指数的患者在健康知识和精神状态维度的得分有统计学意义（P＜0.05）.结论 （1）长沙地区县级医院中年慢性病患者健康商数状况总体不容乐观,尤其是健康知识维度较为薄弱,提示此类患者应成为护理工作针对性健康教育的重点对象,而健康知识普及应成为健康教育的重点内容.（2）年龄段、家庭住址、文化程度和体检频度是住院中年慢性病患者健康商数的重要影响因素,据此可为护理工作中开展个体化的干预策略提供参考依据.     

新冠肺炎疫情期间医院人力资源调配策略

2020年2月,世界卫生组织(WHO)宣布新型冠状病毒肺炎(COVID-19)成为国际关注的突发公共卫生事件.中国应对新型冠状病毒肺炎疫情工作已经到了关键时期,如何做好疫情期间人力资源调度工作,特别是医疗、护理人员医院内部、外部人力资源调配平衡问题是战胜此次疫情重要因素之一.本研究针对在疫情期间医院人力资源调配问题进行浅析,为疫情防控期间各医院人力资源调配提供参考.     

Physicians’ attitudes towards treatment guidelines: differences between teaching and nonteaching hospitals

Objective To investigate whether physicians’ attitudes towards treatment guidelines for primary and secondary care differ between teaching and nonteaching hospitals shortly before and 4 years after the guidelines’ introduction. Methods Possible barriers and facilitators of joint treatment guidelines were obtained by self-administered questionnaires twice during the study period. Questionnaires were distributed among all internists and cardiologists in the Groningen region of The Netherlands. Results Physicians from teaching and nonteaching hospitals differed in attitude regarding the content and usefulness of the guidelines. Physicians from nonteaching hospitals more often believed that the guidelines are too restrictive (64% vs. 18%) and too rigid to apply to individual patients (14% vs. 6%) and that they oversimplify medical practice (79% vs. 35%). Physicians from teaching hospitals more often agreed that good recommendations for first-choice drugs had been made (76% vs. 50%) and that these guidelines are a convenient source of advice (94% vs. 57%), can facilitate communication with general practitioners (94% vs. 71%), and can improve the quality of pharmacotherapeutic care (88% vs. 43%). Four years later, a larger proportion of physicians from both hospital settings had a negative attitude towards the usefulness of the guidelines, but the difference in attitude between teaching and nonteaching hospitals remained the same. Conclusion Physicians from nonteaching hospitals were less positive about the usefulness of joint treatment guidelines than physicians from teaching hospitals were. Results from studies on the implementation of guidelines in teaching hospitals can therefore not be transferred to nonteaching settings. This research project was financed by an unconditional research grant from the Health Care Efficiency Programme of university hospitals of the Health Care Insurance Board, The Netherlands.     

Operation, formulary decision-making activities of a P & T Committee in a managed care setting

Managing drug benefits in a Health Maintenance Organization (HMO) is perhaps best accomplished through a formulary, as demonstrated by Kaiser Permanente of Colorado. According to Dr. Jim Adams and Ms. Jackie Richardson, the Chairman and Secretary, respectively, of Kaiser Permanente's P & T Committee, since the advent of their formulary only a few years ago, the cost of drugs has been kept well under control, without jeopardizing the quality of care. Both physician and patient education are critical to the success of a formulary in a managed care system--both monumental tasks for Kaiser Permanente of Colorado considering that prescribers exceed 300 and the number of patients they treat approaches 250,000. What is clear in this exclusive Hospital Formulary interview is that HMOs--long recognized for their ability to control costs--can also provide quality health care for patients who use their facilities.     

Substance abuse counselors' implementation of tobacco cessation guidelines

This study assessed the extent of implementation of the Public Health Service tobacco cessation guidelines among a national sample of counselors working in five different types of substance abuse treatment programs. Further, we identified implementation patterns among counselors using cluster analysis and considered differences in counselor characteristics based on their cluster membership. Data were obtained from the 2008 Managing Effective Relationships in Treatment Services (MERITS I) project. Counselors (N = 615) working in Clinical Trials Network (CTN) affiliated community treatment programs completed paper-and-pencil surveys. Implementation of the guidelines was inconsistent and selective. Counselors could be grouped into low versus high implementers. Some counselor characteristics differed based on their implementation cluster membership.