非政府组织(NGO)艾滋病防治工作在转型期的可持续发展

随着国际社会逐渐减少对中国的艾滋病防治工作提供经费支持,云南省防艾工作已逐步进入转型期。在转型期,非政府组织(NGO)防艾工作面临一系列挑战,如:如何继续获得参与的平台;如何促进NGO参与的管理方式、理念转化为政府的工作机制等。为使NGO防艾工作可持续发展,首先应开展一些独立的活动,如技术资料和人力资源及工作网络的整理与利用、经济资源投入促动行动、培训政府相关部门的艾滋病工作管理人员等,以推动目前NGO参与的产出进一步扩大、增值和继续发挥其作用;其次应创造条件,促进政府的认可,扩大NGO自己的生存空间;第三应从服务领域、服务层次、筹资渠道、志愿者发展、组织网络建设等方面努力提高自身专业能力的建构和财政的自主性,谋求长远发展。     

湖北省相关非政府组织参与艾滋病防治工作调查研究

目的了解和掌握湖北省相关非政府组织（NGO）参与艾滋病防治工作的基本情况、活动能力与目前的需求，探索湖北省NGO参与艾滋病防治工作的策略、方法与能力建设模式。方法发放统一调查表格，由各市、州预防医学会组织相关NGO填报，并个别访谈NGO负责人或艾滋病防治专家，对全省资料进行统计分析。结果①全省56个相关NGO主要分布在武汉、襄樊、宜昌、孝感、黄冈、咸宁、随州等地；活动经费来源依次为34％国内NGO、22％政府、16％企业、14％国际NGO、10％会费、4％个人资助。②主要活动领域依次为学术交流、健康教育、技术培训、行为干预、关爱护理等。③主要目标人群依次为大众人群、艾滋病病毒感染者／病人、性乱人群、男男性接触者（MSM）、青少年和孤儿、吸毒人群、妇女和流动人口等。④主要需求依次为活动经费、人力资源、场所设备、政策支持、信息提供、技术支持等。结论全省相关NGO参与艾滋病防治活动体系已初步形成，并在艾滋病防治工作中起到了重要作用。建议加强对NGO人力资源的管理和自身建设，加强对NGO的政策、资金和技术支持，建立参与艾滋病工作的NGO联盟，探索适合湖北省NGO参与艾滋病防治的策略、方法与能力提高模式。     

我院2001年业务收支情况分析

医院业务收支分析,是医院财务活动分析的主要内容,也是医院财务管理的一个重要环节。通过收支分析,找出问题,总结经验,促进医院发展。 一、2001年业务收支基本情况 我院有病床250张,各类人员376人,是一所中等规模的专科医院,2001年业务收支情况如下:全年总收入2991.72万元。其中:医疗收入1085.30万元;药品收入1521.38万元;财政补助收入234万元;其他收入151.04万元;全年总支出3036.95万元。其中:人员经费1294.96万元;药品材料费支出1135.02万元;修购基金提取267.15万元。全年收支结余为-45.23万元。     

经济欠发达艾滋病低流行区防治经费需求分析

目的探讨经济欠发达、艾滋病低流行区的防治成本及今后经费需求,为政府财政决策提供依据。方法核实财务报账数据和档案资料的各项效果指标完成情况,计算各项活动或人均单位成本,再结合未来工作指标和物价因素,应用分析软件,对今后经费需求进行预测。结果2008年艾滋病防治工作经费总额1646892元人民币,人口年平均费用1.38元。对15～49岁人群的宣传教育人年均成本均为0.47元;对女性性服务者、男男性行为者和农民工的人均年宣传干预成本为177.63元、231.78元、0.47元;孕妇和被监管人员HIV筛查人均成本为6.59元、6.09元;HIV感染者/病人CD4检测、抗病毒治疗和管理的费用人年均成本461元、9901元、439元;工作人员培训人均成本为120元;多部门合作、督导评估和日常办公费用分别占总额的34.70%、6.25%、6.74%。预测2009-2012年经费需求分别为140.91万元、130.96万元、128.55万元、128.54万元,人年均约1.10元;多部门合作和大众宣传教育经费需求下降幅度较大,其他15项经费需求均少有增加。结论艾滋病防治经费需求是根据干预人群规模和工作活动覆盖规模要求及物价上涨等因素,计算和预测未来工作单位成本和经费需求,是艾滋病项目成本-效果分析的基础性探讨。     

伊金霍洛旗卫生防疫站1989年至1999年经费资源情况分析

<正>1 十年收支活动情况 伊金霍洛旗卫生防疫站10年来的收入主要来源于财政拔款和业务收入,财政拔款逐年有所增长,从1989年的9、10万元增至1999年的21.50万元。但人员经费的增幅较大,从1989年的6.30万元增至 1999年的 23.40万元。说明财政拔款的增长远远低于人员经费的增长,到1999年已经连人员经费都不能得到保证。而业务收入的增幅较大,从1989年的5,10万元增至1999年的27.00万元。     

四川省中英艾滋病防治项目经费投入现状分析

目的 评价中英项目经费投入的影响因素及在四川省的使用情况.方法 采用分层抽样的原则,从全省32个项目点分层抽取3个项目点作为研究对象,并按项目经费流向收集各项目点的财务数据和财务督导评估报告等资料.结果 中英项目5年投入到3个项目点资金总额为7 893 674元,A、B、C项目点分别占89%、7%和4%,3项目点在项目活动上的总投入比例分别为干预与宣传(34.2%)、项目管理支持(32.6%)、监测及基本能力建设(15.2%)、关怀与治疗(11.1%)、设备购置及其他(6.8%).结论 四川省中英项目点的经费投入和该地区的感染者人数高度相关(r=0.85,P<0.05),而不是依据项目点的财政能力(r=0.086,P>0.05).项目活动的投入重点是干预与宣传和项目管理支持,同时艾滋病防治经费投入的可持续性值得重视.     

卫生九项目／日本社会发展基金赠款 加强新疆非政府组织参与性病艾滋病防治能力建设项目

卫生九项目／日本社会发展基金赠款加强新疆非政府组织参与性病艾滋病防治能力建设项目（简称卫生九新疆NGO项目）于2005年6月启动至2008年6月结束，总投入约66万美元，项目支持新疆维吾尔自治区部分非政府组织开展和实施以社区为基础的艾滋病干预活动，以便更有效地控制性病艾滋病的流行。共启动实施了24个干预子项目，目标干预人群主要包括男男性接触人群、暗娼人群、吸毒人群及其配偶、街头闲散青少年、建筑工人、媒矿工人等。     

夏集镇新型农村合作医疗运行现状分析与思考

1夏集镇3年的农村合作医疗资金运行分析 夏集镇参保人口在4．4万人左右，占农业人口92％，占全镇人口70%左右。现有一家中心卫生院、两家民营医院（王营医院和郭桥医院）和16个村卫生室，其中中心卫生院医疗服务及药品收入3年平均每年220万元，王营医院每年90万元，郭桥医院每年90万元，村卫生室每年150万元。2004年住院实际发生报销金额320万元、2005年住院实际发生报销金额523万元，2006年1—10月份住院资金发生金额345万元（已结报）。     

我国卫生政策与体系研究科研项目及经费现状分析

目的：描述我国卫生政策与体系研究领域科研项目及经费现状,分析存在的问题,为促进研究能力提高提供建议。方法：通过问卷调查和关键人物深度访谈,从科研项目数量及分布、主题情况等方面进行分析。通过公开资料梳理,从项目数量与分布、主题情况等方面对国家自然科学基金的资助情况进行分析。结果：2015—2017年平均每个机构每年开展科研项目26.25项,涉及主题为卫生筹资、服务提供、卫生人力等;平均每个机构每年的科研经费为529.00万元;63.16%的研究机构来自国内的经费资助多于来自国际的经费资助,政府来源经费占全部经费比例为44.23%;财务管理方面,科研经费通常由上一级机构的财务管理部门通过预决算机制进行管理。2008—2017年,共有116家机构获得国家自然科学基金资助,平均每个机构获得项目数为4.81项、所获得资助金额为169.06万元,主要研究为卫生服务提供相关主题。结论：我国卫生政策与体系研究科研项目数量及经费快速增长,但主要集中于发达地区的研究机构,存在地区不平衡现象;国际资助呈现下降趋势,国内来源占比越来越高;经费管理机制在逐步调整,但不同机构落实方面存在差异。     

NG0-战胜艾滋病的重要战略伙伴

NGO，即非政府组织“Non—government Organization”的缩写。在人类近二十年来与艾滋病的战斗中，NGO发挥的作用是非常重要的。它不但能深入到社区最基层的单位开展工作，并且能在相当广泛的领域中活动。从宣教预防知识(包括制作和分发宣传资料、健康讲座、培训、咨询、同伴教育以及开展服务等方面)到护理感染者，NGO都发挥了不可替代的作用，并在很多时候给予其合作伙伴以资金和技术上的支持。     

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.