野战方舱医院在五官模块抗震救灾中的应用及体会

目的:探讨野战方舱医院五官模块在抗震救灾中的使用。方法:根据野战方舱医院参加抗震救灾五官科遂行的卫勤保障任务,对实际展开工作的特点及遇到的困难,以及针对五官科模块配置装备少、需多渠道筹措等情况进行分析。结果:野战方舱医院配置使用五官模块,在参加汶川抗震救灾和玉树抗震救灾中提高了方舱抗震救灾保障能力。结论:野战方舱医院使用五官模块,适应抗震救灾需要,极大提高了野战方舱医院的救治能力。     

非战争军事行动方舱医院的抽组与部署

结合抗震救灾等非战争军事行动的任务和要求,总结了方舱医院执行非战争军事行动卫勤保障任务的主要特点。从理解行动任务、明确抽组任务,针对现实特点、确立抽组目标,科学抽组力量、适应不同行动要求等方面阐述了方舱医院的抽组方法;从针对任务样式、灵活配置部署,快速优先部署方舱医院、提高救治能力,慎重初次配置、快速机动展开等方面阐述了方舱医院的部署方法。指出正确把握方舱医院的合理抽组和部署方法,赢得了救治时间,提高了救治能力,确保了救治效果。     

方舱医院的建设与保障实践

阐述了方舱医院的建设与保障,指出了方舱医院目前存在的问题,提出了实现野战图像数据快速传输,实现医院方舱内部数据交换、进行硬件设备改造等建议,有效地提高了方舱医院的卫勤保障能力。     

野战方舱医院配备集装箱存放物资的使用与分析

针对抗震救灾卫勤保障的特点和影响野战方舱医院快速出动的因素,提出了将野战医疗所部分物资集装箱化存放。利用集装箱存放野战方舱医院物资装备,既实现了野战方舱医院物资的有序管理和使用,又满足了野战方舱医院紧急出动救治伤员的需要。     

我军方舱医院装备伪装防护的现状与对策

通过运用现代高技术战争的侦察技术理论,归纳总结了方舱医院装备的特点,分析了方舱医院装备伪装防护能力的现状,指出了在伪装防护方面存在的不足及问题,提出了针对性的伪装防护对策,为卫勤装备伪装防护这一难题的研究、提高方舱医院在未来高技术局部战争中的生存能力和卫勤保障能力奠定基础.     

新型野战综合手术救治方舱使用管理探讨

介绍了新型野战综合手术救治方舱的功能及结构特点,通过参与卫勤演练与动物实验、巡回医疗相结合的方式进行人装结合训练,对新型野战综合手术救治方舱使用中的管理流程进行探讨,解决其使用管理中存在的问题,使综合手术救治方舱的综合效能及卫勤保障能力得到提升。     

野战医疗方舱医院参加“5．12”抗震救灾的相关问题探讨

通过汶川抗震救灾接近实战的实践和尝试，对以医疗方舱为依托的野战医院的配置地域、人员编配、物资保障、方舱的保障能力及军地资源整合等方面的问题进行了探讨。提出了地域靠前配置；方舱编配复合型人才；提高人装结合的效能；军地资源及时整合；多渠道获得物资保障等观点。为战时提高卫生营的快速反应和应急救治能力，增强战时卫勤保障能力提供了经验。     

武警方舱医院卫勤保障平台建设特点及应用分析

目的:分析武警方舱医院的显著特点和主要功能,为相关部门提供理论参考.方法:综合应用文献资料分析、实地调研和专家咨询等多种方法,对武警方舱医院保障平台的建设特点及应用展开系统的归纳分析.结果:武警方舱医院具有“功能布局精简-机动性能增强”、“仪器设备精良-诊断与救治水平提高”和“信息系统集成-数据实时传输”等显著特点;可承担武警总部本级卫勤保障、灾害医学救援、卫勤机动力量培训和医疗巡诊等任务.结论:武警方舱医院将在未来非战争军事行动中发挥重要的保障作用.     

卫生方舱卫勤保障训练的实施

卫生方舱以应急机动医院野战卫生装备体制为模式,可根据战时卫勤救治机构的组建和任务,实现单元或模块装备剪裁复合、随机组配,机动应变能力强。我院以卫生方舱为平台,结合历次承担卫勤保障等重大任务,狠抓卫勤机动力量建设与发展,积极研探及构建“快速”卫勤保障训练模式,收到较好效果。     

结合非战争军事行动卫勤保障谈方舱医院药材保障体会

研究了如何做好方舱医院药学保障模块的平时管理和战时保障,解决了方舱医院药学模块存在的药品管理难、人员职责不清、保障能力差的问题,从而确保药学模块适用于野战方舱医院遂行各种任务时药品保障的需要,以提高方舱医院的救治能力.     

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.