医务人员健康教育专业知识掌握及运用情况调查

目的了解义乌市医务人员健康教育专业知识掌握及运用情况,分析医务人员健康教育工作中存在的问题.方法 采用多阶段抽样方法,运用自编问卷对6家单位的281名医务人员进行调查.结果 三级医疗单位的医务人员健康教育知识的平均知晓率高于一级医疗单位,医生的知晓率高于护士与医技人员.281名被调查者中, 99.3%的被调查者认为在医护活动中实施健康教育很重要,对病人有帮助;53.4 %的被调查者在日常医护工作中进行双方的交流并注重病人的理解接受程度;一级医疗单位的医务人员接受健康教育专业培训的比例明显高于三级医院.结论 不同学历、职业、医疗单位对医务人员的健康教育知识知晓率及运用情况有影响,高级别医疗单位的健康教育工作较低级别的医疗单位开展得差.     

北京市顺义区医务人员中东呼吸综合征健康教育短期效果评价

目的评价顺义区医务人员中东呼吸综合征健康教育效果,为防控政策的制定提供科学依据。方法采用多阶段分层随机抽样方法,应用自行设计顺义区医务人员中东呼吸综合征知识调查表,被调查者自填问卷,发放调查问卷共167份,对问卷结果进行统计分析。结果 167名医务人员对中东呼吸综合征知识的知晓率健康教育前在32.9%～71.9%之间,平均知晓率为48.02%。健康教育后在69.5%～100%之间,平均知晓率提高到81.32%,与健康教育前相比差异有统计学意义（P〈0.05）;对疑似病例各项措施知晓率健康教育前在43.1%～86.2%之间,平均知晓率为62.4%。健康教育后在74.3%～100%之间,平均知晓率提高到92.2%,与健康教育前相比差异有统计学意义（P〈0.05）;医务人员接诊发热病人口罩佩戴率健康教育前为89.2%,在采集疑似病人标本时采取防护级别正确率仅为51.5%。健康教育后口罩佩戴率为达100%,采集疑似病人标本时采取防护级别正确率增长至95.2%,与健康教育前相比差异均有统计学意义（P〈0.05）。结论顺义区医务人员中东呼吸综合征防控知识、信念、行为方面具有一定基础,经过短期健康教育效果明显,应继续加强医务人员在日常工作中自我防护意识和防护行为。     

宝山区医务人员性病艾滋病防治培训现状调查

目的 了解宝山区医疗单位组织医务人员性病艾滋病防治知识培训情况和对性病艾滋病病人的态度。方法 区疾控中心传染病防制科对21家医疗单位137名医务人员作现况调查。调查问卷由被调查者自身,资料输入微机进行统计分析。结果 近3aⅢ级医院的性病艾滋病知识培训率低于Ⅰ、Ⅱ级医院。医务人员对性病传播途径的知晓率为74．45％;对艾滋病传播途径的知晓率为88．59％;对性病疑似病例的处理原则和感染HIV到抗体出现检出率时间答对率仅为27％;66．42％的医务人员对艾滋病感染者和病人持不歧视的态度。结论 对医务人员的性病、艾滋病防治的培训还有待加强。     

潮州市医务人员艾滋病及职业暴露防护知识及影响因素

目的了解潮州市医务人员艾滋病及职业暴露防护知识知晓情况,为培训工作提供依据。方法对潮州市县区和市级的8家医院399名医务人员进行问卷调查。结果潮州市医务人员艾滋病基本知识知晓率为93.2%,职业暴露防护知识知晓率为37.8%;学历、关注艾滋病疫情及治疗过艾滋病病毒(HIV)感染者/病人为艾滋病基本知识知晓率的影响因素;而影响艾滋病职业暴露防护知识知晓率的主要因素为工作年限及是否接受过培训,工龄越长,知晓率越高,接受过培训的医务人员知晓率高于未接受培训者。结论潮州市医务人员艾滋病基本知识知晓率较高,但职业暴露防护知识知晓率较低,应加强对医务人员的职业暴露防护知识培训。     

江苏省扬州市部分医务人员吸烟行为及控烟知识现状调查

目的对江苏省扬州市医务人员的吸烟行为和控烟知识现状进行调查,为今后在医务人员群体中实施控烟干预提供依据。方法采用问卷调查的方法,对扬州市4家医疗机构605名直接从事医务工作的人员进行问卷调查。结果医务人员人群总吸烟率为16.03%,现在吸烟率为11.57%;烟草危害的知晓率为73.61%,7种吸烟相关疾病的知晓率为71.00%,6种被动吸烟相关疾病的知晓率为77.60%;对医疗机构控烟认同率为83.63%;43.46%的医务人员获得过控烟方面的知识培训,能为病人制定戒烟计划的有1.69%;能对病人在门诊和病房提供健康教育的有31.40%。结论医务人员人群烟草相关知识掌握相对不足,应当进一步加强医务人员控烟知识和技能的健康教育和培训,改变其吸烟行为,同时也更好地推动社会控烟工作。     

甘肃省三级医院护理人员医院健康教育知信行分析

目的了解甘肃省医院护理人员医院健康教育知信行现状,为制定医院健康教育策略提供科学依据。方法采用分层随机抽样的方法,利用自制调查问卷对该省20家三级医院的护士进行医院健康教育知信行调查。结果回收有效问卷1945份,其中10个健康教育基本理论知识知晓率最高为78.65%,最低为16.20%。不同职称、文化程度的被调查者知晓率差异有统计学意义(P0.05)。86.59%以上的被调查者认为医院有必要开展健康教育、医院有必要对医护人员进行健康教育和培训;医院有必要设立独立的健康咨询门诊;认为医院应该设立专门的科室负责全院健康教育和健康促进工作。59.89%的被调查者认为医护人员对患者开展健康教育时间应在5~10 min。25.06%的被调查者1年内未接受过健康教育理论及技能培训;49.18%的被调查者缺乏烟草危害健康教育相关技能。20.12%的被调查者在日常工作中,没有充足的时间进行健康教育。结论甘肃省三级医院护理人员健康教育理论知识知晓率较低,护理人员对医院健康教育的重要性明确,医疗卫生机构在医院健康教育方面有待加强。     

当涂县医务人员艾滋病职业暴露知识与针刺伤状况调查

目的了解当涂县医务人员对艾滋病职业暴露知识的知晓情况和医护过程中锐器刺伤暴露情况。方法采用整群抽样方法选择当涂县1家县级医院和13家乡镇卫生院及25家村卫生室,于2010年11月~2011年1月对其中的307名医务人员进行问卷调查。结果 307名医务人员艾滋病职业暴露相关知识总体知晓率为52.4%,其中对发生HIV职业暴露后的报告单位知晓率为90.9%;不同医院级别、职业和科室以及是否曾参加过相关培训的医务人员之间掌握艾滋病职业暴露相关知识的程度不同(均有P<0.05);57.3%的调查对象承认在最近1年医疗护理过程中有曾经被针具利器刺破皮肤的经历,不同职业、职称和科室医务人员之间针刺伤发生率不同(均有P<0.05)。结论当涂县医务人员对艾滋病职业暴露相关知识知晓程度较低,发生锐器刺伤等职业暴露率较高,有必要加强培训,提高医务人员艾滋病职业暴露相关知识和自我防护能力。     

医务人员疑似预防接种异常反应知识知晓率调查

目的了解平湖市医务人员对疑似预防接种异常反应(AEFI)知识知晓情况。方法采用单纯随机抽样方法,抽取平湖市3家县级和10家乡镇医疗单位医务人员共280人,进行问卷调查。结果调查274名医务人员,其中267人(97.45%)听说过AEFI。对AEFI的分类、报告、诊断和补偿的知晓率分别为63.67%、26.59%、20.22%和12.36%;不同性别、学历、职称医务人员知晓率差异均无统计学意义(P0.05);公共卫生管理人员对AEFI补偿知识的知晓率高于其他岗位人员(P0.05)。结论医务人员对AEFI诊断、报告、补偿等政策的知晓率相对较低。应加强培训,不断提高医务人员AEFL知晓率,提升免疫规划工作质量。     

丽水市初中生艾滋病知识、态度及健康教育需求调查

目的了解丽水市初中生艾滋病知识掌握情况及艾滋病相关态度,为进一步开展学校艾滋病健康教育工作提供依据。方法采用匿名问卷调查方式收集数据进行统计分析。结果丽水市初中学生对HIV传播途径等基本知识的知晓率较高,但是非传播途径知识知晓率偏低;初三学生的艾滋病知识平均得分高于初一学生,对艾滋病病人的态度更为积极;被调查者中,愿意和HIV/AIDS在一个教室里学习的占47.45%。结论应加强丽水市初中学生艾滋病健康教育工作,完善艾滋病宣传内容,促进学生掌握防艾知识。     

我国移动医疗及相关APP使用的现状研究

目的分析目前移动医疗发展存在的问题并提出相关的政策建议。方法采用自制的调查表调查不同职业人群对移动医疗的使用、需求情况。结果357位被调查者中有63.03%下载了移动医疗相关APP但未使用;参与调查的63名医务人员中仅15.87%对移动医疗的使用满意;医务人员对"门诊教育与互动"的需求性高于其他人群,不同职业人群对"在线医疗资源信息""药物提醒""远程医疗与诊断""健康管理"等功能的需求率均大于50%;分别有85.71%、62.75%、58.54%的被调查者期望移动医疗应用于健康监测、高血压控制、糖尿病管理;医务人员最期望研发的移动医疗技术主要是药房管理、疾病管理、远程医疗等。结论目前移动医疗的使用率较低,应加大宣传力度,提高移动医疗的使用率;提高医务人员对移动医疗使用的满意度,根据不同职业人群的需求开发移动医疗技术。     

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.