关于吉林大学口腔医院设备维修管理的工作体会

本文对医院设备维修工作从管理层面进行了总结,提出行之有效的管理方法,对医院设备维修管理有一定借鉴意义。     

创新财务管理手段 提高公立医院财务管理水平

卫生部等五部委颁发的《关于公立医院改革试点的指导意见》中,强调完善医院财务会计管理制度,严格预算管理和收支管理。然而在贯彻实施过程中,一般公立医院对财务会计工作往往停留在传统的管理层面上,只是在建立健全财务管理制度、严格财务收支标准、履行设备和药品统一招标采购制度、坚持重大经济事项申请审批程序以及财务会计内部控制制度的完善等方面进行修修补补。     

数字化医院信息系统的安全问题

随着医院信息化建设的深入,信息系统安全性问题日益突出。为了保障医院信息系统安全、稳定运行,本文从网络边界模糊、设备脆弱性、人员管理不当、技术支持缺乏等4个层面进行深入分析,并提出相应的安全策略。     

医疗设备技术保障企业化管理的研究

现代医院从技术层面上看对医疗设备的依赖性越来越大,而如何对医疗设备做好技术保障愈显凸出.本文作者提出了医院医疗设备企业化管理的要求、目标和过程,为现代化医院管理在医疗设备方面做了有益的探索.     

香港医疗卫生管理体制特点及其启示

通过专题报告、座谈交流和实地走访,分析香港医疗卫生管理体制,特别是香港医院管理局的问责机制,发现香港医疗卫生管理体制的特点包括问责清晰、公益性质明确、疾病预防控制体系高效统一、医院服务效率较高、医疗资源配置合理、注重战略规划和绩效管理等.     

医院设备工作的职业风险与对策

本文根据医院设备工作的实践体会，分析其职业风险的原因与对策。建议从管理层面和执行层面同时进行风险控制。     

医疗设备安全应急管理探索

医疗设备作为医院正常诊疗功能中不可或缺的一部分,其协助诊疗功能发挥的正常与否关系着医院医疗服务质量的高低。作为医院管理不可或缺的一部分,医院医疗设备管理的安全有效具有十分重要的意义。本文通过分析设备安全管理的分类、医疗设备应急安全管理事件的来源、医疗设备应急安全管理的理论基础、医疗设备应急安全管理的应用需求四个层面,在设备全生命周期的日常管理的基础上,针对现有的研究现状与笔者所在的医院设备管理的实际情况,建立起一系列能够面对各种突发事件和设备安全应急管理的相关制度、措施,以期达到对医疗设备突发性事件进行有效、规范、标准的应急管理的目的。这不仅对于指导设备科的应急安全管理工作,起着十分重要的作用,而且有助于医院医疗正常诊疗活动的进行和医疗安全的可持续性发展。     

上海市医养结合高质量发展评价指标体系构建：基于世界卫生组织《老年人综合照护实施框架》

目的 构建上海市医养结合高质量发展评价指标体系，以评价医养结合现状，推动医养结合实现高质量发展。方法 以世界卫生组织《老年人综合照护实施框架》为指导，通过文献归纳分析法查阅国内外与医养结合及评价相关的期刊文献、政策文件等，结合专家咨询与论证，明确医养结合高质量发展的理念、评价框架、指标在实践中的可行性等。结果 在基于《老年人综合照护实施框架》明确医养结合高质量发展框架和国内医养结合高质量发展概念的基础上，构建涉及7个维度的指标体系：宏观层面包含加强管理和问责制度、加强体系建设；中观层面包含促使居民和社区参与并提升其能力、支持并协调多学科人员提供服务、面向社区的定向照护服务；微观层面包含对个人需求、偏好和目标进行评估，制定个性化的照护计划。结论 研究构建的指标体系可为上海市医养结合高质量发展的评价工作提供参考。     

我院医疗设备精益化使用管理的思考

本文通过分析我院医疗设备使用管理的现状,从精益化管理的层面阐述了医疗设备使用管理应重视的几个问题,以提高设备使用率,降低安全风险。     

我国医疗服务质量问责研究

为了探索我国医疗服务质量的问责关系变化,本文以文献分析和模型构建为基础,从“谁应负责、对谁负责、负责什么”三个维度对我国医疗服务质量中不同参与者进行分析。研究发现,在出现管理者质量感知差距和患者质量感知差距时,需要启动患者问责;出现质量标准差距和服务传递差距时,需要启动医疗机构内部问责;出现市场沟通差距时,需要启动社会问责。在整个问责体系当中,如何提升患者满意度,进一步改善医疗服务质量,患者问责起到关键的作用,是整个问责体系的核心部分。     

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.