大连市区医疗服务热点调查及信息利用分析

目的 收集了大连市区群众对市内医院的服务需求情况及其满意度资料，评估市民对市内医院的信任感和忠诚度，为持续改进医院服务提供依据。方法 利用市医师协会组织市内20余家医院为市内居民义诊的机会，采用单纯随机抽样的方法，向4975名参加义诊的群众随机发放问卷500份。运用卫生经济学相关理论，从需方角度，对医疗服务涉及的看病难、看病贵、医疗质量问题，解析曾就诊过的医院、印象最深的医院、不选择某医院就诊的原因、全年支付健康费用、服务环境设施等5个方面，与调查对象现场沟通，针对主要因素对其结果进行分析并讨论与医院管理的相关性。结果 医疗服务需求者个体，对非营利性国家医院抱有较大的热情与期望。医护人员在医疗服务中的人文关怀给服务对象留下的深刻印象，是评价医疗服务质量的重要因素，就近择医、为服务对象提供相适宜的医疗技术服务、合理的流程、舒适便捷的就诊环境也为需求者所关心。医疗服务价格在本组资料中不是需方选择就医的首要条件，就诊者从社会学群体及个人角度对此有较全面的认识。496份调查结果还表明，作为提供医疗服务的医院方的责任在于规范医疗行为、提高技术水平，在医疗护理过程中加入人文关怀，在医疗决策中考虑各方利益，努力减少资源消耗。结论 本文报告496份调查结果作为信息资源被利用，通过与2003年3月-2006年3月3年实践结合，取得较好的效益。     

在医疗服务中彰显人文关怀

医学人文关怀,是人文精神在医疗活动中的体现。通过医疗服务中建立人文关怀的有关制度,可促进医学科学精神与人文精神的交融。最终提高医疗服务质量,构建和谐医患关系。本文介绍了该院在医疗服务中注重人文关怀的实践与体会,如创立"以病人为中心"的人性化服务模式,保障患者的隐私权、知情权等合法权利,优化医院服务流程,改善医院服务环境等。并就如何培养医务人员的人文精神,在医疗服务中彰显人文关怀进行了讨论。     

在医疗服务中彰显人文关怀

医学人文关怀,是人文精神在医疗活动中的体现。通过医疗服务中建立人文关怀的有关制度,可促进医学科学精神与人文精神的交融。最终提高医疗服务质量,构建和谐医患关系。本文介绍了该院在医疗服务中注重人文关怀的实践与体会,如创立“以病人为中心”的人性化服务模式,保障患者的隐私权、知情权等合法权利,优化医院服务流程,改善医院服务环境等。并就如何培养医务人员的人文精神,在医疗服务中彰显人文关怀进行了讨论。     

我驻刚果（金）维和二级医院人文关怀做法与体会

人文关怀在现代护理学中占据着举足轻重的位置。在非洲执行维和任务的二级医院,由于任务区的环境、文化差异等因素,在一定程度上影响了护理服务的质量。本文针对影响服务质量的因素,提出相应的方法措施,充分发挥人文关怀的作用,更好地将人文关怀运用于维和二级医院医疗服务工作中。     

县级医疗机构服务利用及满意度调研 ——以浙江省玉环市为例

目的以浙江省玉环市为例,分析居民选择就医地点的影响因素,为全面提高国内各县级地区的县域内就诊率提供参考借鉴。方法采取整群抽样的方法,进行入户调查,对所抽取的家庭进行医疗服务利用与服务满意度调查。结果玉环市居民日常市内就诊率为91.42%,最近一次市内基层就诊率为74.20%。距离近和价格低是引导居民在市内就诊的重要因素,而优质的医疗服务质量是吸引居民前往市外就医的重要因素。居民对基层医疗机构的满意度高于县级医院,其中就诊感受为主要影响因素。结论医保政策对居民的就医流向作用有限,县级医疗机构仍需不断改善自身医疗服务质量和患者服务体验,以提高县域内就诊率。     

某军队大型综合医院手术科室医疗医学人文关怀实践

目的：通过对某军队大型综合医院手术科室医疗实践中医学人文关怀的应用状况进行研究,发现手术科室医学人文关怀在医疗实践中存在的问题并进行原因分析,从而为医学人文关怀在医疗实践中的拓展途径探究提供支持。方法通过调查问卷,复习国内外有关文献以及深度访谈,利用SPSS 13．0统计软件对问卷进行统计学处理。结果72．6％的医务人员认为患者大部分能接受医院高新技术应用及服务项目,53％的医务人员比较重视与患者的交流与沟通,62．1％的患者对医院手术科室的服务比较满意,56．5％的医务人员认为医院文化对工作影响程度较大。结论医疗新技术设备的普及率、知晓率不高;医疗服务流程仍存在手续繁多、环节复杂的现象;医院就医环境未做到全程、全方位的“以人为本”;医院管理规章制度较少涉及人文关怀．     

某三级综合医院门诊患者满意度调查研究

[目的]了解安徽省某三级综合医院门诊患者满意度情况,探讨影响门诊患者满意度的主要因素,为改善医患关系、提高医疗服务质量提供参考依据。[方法]采用横断面调查法。在门诊科室中随机抽取10个科室,对2009年5~6月份来就诊的18～69岁患者随机发放自行设计的满意度调查问卷,由经过统一培训的调查员进行面对面调查。采用χ2检验和非条件Logistic回归模型,分析门诊患者满意度情况及其影响因素。[结果]调查对象对医院提供的医疗服务的总体满意度为43.5%(158/363)。多因素Logistic回归模型结果显示收费水平、就诊环境、在就诊过程中患者是否被尊重、医生的技术水平、在就诊过程中护士是否及时地引导患者与门诊患者满意度的关系有统计学意义。[结论]患者对医院门诊医疗服务满意度不高,需要在就诊环境、降低医疗费用、尊重患者等方面进一步改善。     

做好药房窗口服务 促进高校医院医患和谐

<正>药房是医院直接面对患者,与患者直接接触、提供药学服务的窗口,高校医院服务对象主要为在校师生员工。在高校高度注重人文关怀的氛围中,药房作为特殊的窗口服务部门,在注重提供专业服务的同时,能否同时重视完善"以人为本"的服务理念,决定了药房服务质量的优劣,关系到就诊师生对药物治疗的依从性、用药的安全有效,也直接影响到师生员工     

北京市医疗机构患者就医体验现状及其影响因素分析

目的了解北京市医疗机构患者就医体验现状,并探究患者就医体验的影响因素,为提高医疗服务质量提供科学依据。方法在41所北京地区三级和二级公立医院中,按方便抽样方法选取2 460名门诊和住院患者作为调查对象,开展问卷调查,回收有效问卷1 617份。使用SPSS 26.0统计软件对患者的基本信息进行描述性分析,运用因子分析计算出患者的就医体验评分,运用均值检验进行患者就医体验单因素分析,并以最终分数为因变量,患者的人口学因素和医院自身条件为自变量进行多因素回归分析。结果患者就医体验包含医院服务、医疗质量、医院环境3个维度,其中医院服务评分(4.81±0.76)最高,其次是医院环境评分(3.78±0.34),最低为医疗质量评分(3.23±0.28)。多元回归结果显示,患者就诊类型、医院所在区域是影响患者就医体验的主要因素。结论为持续提高患者就医体验,应当从医院服务技能、医疗质量和医院环境3个方面提升医疗服务质量。     

新疆某三甲医院儿科人性化服务满意度调查研究

目的：了解儿科患儿家属对人性化服务的满意度情况,为医院在儿科人性化服务方面的建设提供依据。方法选取新疆某三甲医院儿科住院患儿家属150人作为调查对象,自行编制调查表对患者家属进行满意度调查分析。结果患儿家属总体满意度较高;不同性别的患儿家属对医院儿科提供人性化服务的服务效率、态度及就诊环境存在差异（P 〈0.05）;不同年龄的患儿家属对就诊环境满意度存在差异（P 〈0.05）。结论儿科人性化服务意识在伴随医院发展过程中有所提高,患者家属满意度较高,但仍需通过加强医疗服务环境建设、改善医疗护理模式、重视医院管理环境建设及加强医护人员素质的建设等方面来进一步提高满意程度。     

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.