基于大集中模式的省级新型农村合作医疗信息系统的建设

本文针对海南省新型农村合作医疗信息系统建设的实际情况，提出了一套基于大集中模式的省级新型农村合作医疗新系统的建设方案，重点讨论了该方案的设计要点、系统技术架构、功能结构等方面的问题，并对实现的系统进行了综合评价，以作为对我国建立省级新型农村合作医疗信息系统的初步探讨。     

基于SaaS模式的省级新型农村合作医疗信息平台建设

目的：探讨建立一体化的省级新型农村合作医疗业务管理平台及信息系统。方法：针对海南省新型农村合作医疗信息系统建设的实际情况,提出了基于SaaS模式的省级新型农村合作医疗信息新系统的建设方案。结果：建设完成的系统覆盖了全海南省,是全国唯一实现了以省为单位进行集中管理的新农合信息处理平台。结论：该系统在国内新型农村合作医疗系统的建设中有极大的推广价值。     

湖北省新农合“直补”问题及应对策略

新型农村合作医疗"直补"已经成为新型农村合作医疗乃至整个医疗保险行业发展的必然趋势。通过交流湖北省新型农村合作医疗"直补"的现状,分析在"直补"政策的宣传落实、制度管理及操作规范、网络结算方式等方面出现的问题,针对性提出了加强宣传和指导落实"直补"政策;完善新型农村合作医疗"直补"信息管理及实行一人一卡制度;统一实现省级平台"直补"结算,提高效率,减少纠纷等具体建议,期望能对进一步完善新农合"直补"工作有所裨益。     

新农合信息系统与HIS接口的设计与实现

介绍了医院HIS和新型农村合作医疗系统的接口系统开发设计原理，分析了采用Web Service来实现的接口方案，确保了数据传输的安全，提高了医院新农合病人的结算效率。     

新型农村合作医疗病人医药费用补偿数据的管理方法

新型农村合作医疗的实施给医院管理提出了新的问题,如何高效地开展新型农村合作医疗病人医药费用补偿工作和补偿数据的管理工作,随时掌握新型农村合作医疗病人的医药费用补偿数据,做到心中有数是医院管理工作者的任务.本文利用Excel强大的数据管理功能,对新型农村合作医疗病人门诊费用补偿的数据管理方法进行了探索,它提高了结算工作的速度和准确性;便于集中统一管理病人结算数据和快速查询统计,有利于加强病人费用的监督管理.     

福建新型农村合作医疗即时结算报销的实践

新型农村合作医疗制度是新时期政府关心民生问题的重大突破点,为了更好地完善该制度,进一步促进社会经济发展,新型农村合作医疗即时结算报销模式应运而生.文章介绍了福建省开展省市级定点医疗机构即时结算报销模式的实施背景、实施情况,分析了该报销模式给广大农民带来的好处以及初步成效,并对该模式存在的问题进行探讨从而提出建议,以促进新型农村合作医疗制度的完善.     

公平与创新—谈初级卫生保健与新型农村合作医疗

2005年3月28-29日，江苏省政府召开全省新型农村合作医疗和农村改水工作经验交流会。在会上，卫生部新型农村合作医疗技术指导组组长李长明同志做了重要讲话。讲话对初级卫生保健与新型农村合作医疗的关系、政府在卫生公平上致力达到的目标以及创新是新型农村合作医疗可持续发展的核心问题等进行了深入的阐述。现经本人同意，刊发李长明同志的讲话，供读者学习参考。     

四川省新型农村合作医疗信息系统开发及运行情况分析

四川省新型农村合作医疗管理信息系统按照国家卫生部《新型农村合作医疗信息系统基本规范》和《卫生部关于新型农村合作医疗信息系统建设指导意见》进行规划建设。该系统的县级平台开发成功后，已有三个县安装使用．经历了6个补偿结算周期（六个月），1次网上年度筹资录入和跨年度数据结转，运行情况良好，目前该系统的县级平台正在全省进一步推广应用。     

跨医疗保险药品报销目录整合研究与实现

目的:分析新型农村合作医疗药品报销目录存在的问题,提出整合技术路线,整合多来源词表,生成国家新型农村合作医疗药品一体化目录。方法:采用一体化医学语言UMLS整合多来源词表的技术路线,整合了国家基本药物目录、社保药品报销目录及新型农村合作医疗药品报销目录等12个来源药品目录,形成国家一体化药品目录。结果:该目录包括了以上12个来源目录的所有药品条目,并最大程度保留了来源药品目录的属性。结论:解决了构建国家新型农村合作医疗药品目录编码中多来源字典集成问题,已经用于国家新型农村合作医疗信息平台的数据分析中,下一步将用于基本医疗保险的跨省就医即时结算中。     

农民对新型农村合作医疗及先住院后结算模式的认知情况调查探析

在新型农村合作医疗的不断改革过程中,出现了一些新的问题,尤其是步住院后结算模式的问题,这就使得相关部门不得不重视起农村的合作医疗。本文通过调查农民对新型农村合作医疗及先住院后结算模式的认知情况,并对此进行分析和探讨,最后提出相应的改革和优化。     

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.