重庆市区县妇幼保健院产后康复服务现状调查及思考

目的:了解区县妇幼保健院产后康复服务现状,为制定政策、规范和标准提供决策参考。方法:采用自行设计的结构式问卷调查收集相关数据,进行统计分析。结果:区县妇幼保健院普遍开展产后康复服务,但开展规模、科室设置、科室管理、服务项目与收费标准等各异,存在诸多问题和隐患。结论:产后康复行业尚无统一规范和标准,严重影响产后康复服务的开展和发展,应及时制定、完善相关政策、规范与标准,加强监管和保障安全。     

妇幼保健机构成本效益评价体系的研究

目的:建立妇幼保健机构成本效益评价体系。方法:通过专家咨询等方法确立指标体系,用特尔雯法确定指标权重,用综合指数法建立妇幼保健院经营效益评价模型。结果:确立了以发展能力、保值增值能力、运营能力、患者费用负担以及偿债能力5类18个指标构成的妇幼保健机构成本效益评价指标体系,采用综合指数法进行定性评价。结论:研究建立的妇幼保健院成本效益指标体系结构简单,各项指标内涵明确,具有较强的普遍性。指标体系不仅适用于妇幼保健院自身纵向、横向间全面综合评价妇幼保健院总体经营情况,也可以分别根据各类指数大小评价妇幼保健机构发展能力、保值增值能力、运营能力、患者疾病负担以及偿债能力等。     

重庆市区县级妇幼保健机构资源配置综合评价与分析

目的:了解重庆市区县级妇幼保健机构资源配置的差异,为卫生行政部门制定政策提供依据和建议。方法:采用统一的问卷调查,应用秩和比法进行综合评价,用SPSS11.0软件进行统计分析。结果:万州、涪陵等5个区县妇幼保健院(所)资源配置最好,铜梁、江津、荣昌等24个区县妇幼保健院(所)资源配置中等,武隆、双桥、酉阳等11个区县妇幼保健机构资源配置最差。结论:重庆市区县级妇幼保健机构发展不平衡,在制定妇幼保健机构资源配置扶持政策时,应分类指导、因地制宜,重点扶持配置最差机构,实现全市妇幼保健机构的协调发展。     

妇幼保健院儿科急诊室医患纠纷预防措施的探讨

妇幼保健院作为我国公共卫生服务体系的重要组成部分,是直接关系着妇女儿童的生命安全和出生人口的健康素质的重要机构.近些年来,我国多数的妇幼保健院在运营过程中频繁发生的医患纠纷事故严重阻碍了妇幼保健院的正常运行和发展.据相关的调查资料显示,儿科急诊室作为妇幼保健院的重要组成部分,是医院纠纷发生几率较高的科室之一.如何提高妇幼保健院儿科急诊室的服务质量,降低儿科急诊室医患纠纷的发生几率成为妇幼保健院在发展和建设过程中亟待解决的问题.     

综合分析方法在妇幼保健机构效率和绩效评估中的应用

目的:应用综合分析方法对广东省地级市妇幼保健机构的运营效率和综合绩效进行评估,对综合分析方法的适用性和绩效评价体系进行验证。方法:采用数据包络分析方法对21所地级市妇幼保健院的投入、产出指标进行分析,评价其效率。采用TOPSIS法与RSR法相结合对21所地级市妇幼保健院进行综合绩效评价和分档。结果:数据包络法分析显示,14所的效率值为1,DEA有效;7所的效率值小于1,DEA无效。TOPSIS法结合RSR法分档,6所机构被评为上档,9所被评为中档,6所被评为下档。结论:数据包络分析方法特别适合多输入、多输出的评价系统,适用于保健机构投入、产出效率的分析。采用TOPSIS法评价结果与实际情况较为符合,评价指标体系较为合理。     

妇幼医院VS综合医院 你生孩儿时会去哪儿?

<正>怀孕分娩,是选择妇幼保健院,还是去大型综合性医院,对于准妈妈来说确实是个问题。通常,每个区县只有一家专业的妇幼保健院,如果离家较近,多数准妈妈自然会毫不犹豫地选择:但如果妇幼保健院离家较远,且交通又不方便,为了检查、分娩方便,有些准妈妈就会选择居家附近的大型综合性医院了。     

省地县3级妇幼保健机构2004年度绩效状况分析

目的:通过调查掌握省地县3级妇幼保健机构的资源与运营情况,对3级妇幼保健机构的绩效进行分析。方法:基于现代化的网络传输系统开发《全国妇幼卫生机构管理信息网络报告系统》,实现信息网络实时直报。结果:妇幼保健机构级别越高绩效状况越好,县级机构的绩效状况较差。同时,与综合性医院相比较,妇幼保健机构尤其是县级妇幼保健机构,配置结构和经济效益较综合性医院为差。结论:应加强对县级妇幼保健机构的建设,在人力和物力方面给与在一定政策倾斜,以提高其绩效水平。同时,妇幼保健机构应在确保妇幼保健院的“保健”强项的前提下,发挥自身特色和优势,积极拓宽业务,做到保健与临床的有机结合,适当提高产出效益,保持妇幼保健院的发展活力。     

四川省妇幼保健机构等级评审结果分析

目的:了解和分析四川省妇幼保健院机构管理和临床、保健管理方面现状。方法:组织专家按照统一的评审标准对申请评审机构进行评审,对机构管理、保健管理和临床管理评审得分情况结合专家评审报告进行分析。结果:机构管理方面业务用房面积、实有床位数和卫生专业人员数与标准的差距较大,科教管理得分率较低;二、三级妇幼保健院保健管理平均得分率分别为92.0%和88.8%,相关内容从高到低依次为:公共卫生、妇女保健和儿童保健;临床管理平均得分率分别为89.53%和84.19%,其中二级妇幼保健院医院感染管理和药事管理得分率较低,而三级乙等妇幼保健院医学影像得分率最低。结论:等级评审促进了妇幼保健院的建设和发展,但普遍在硬件及人才队伍建设、科研工作、医疗保健亚专业发展、医院感染管理和医疗质量管理以及辅助科室服务能力方面还亟待提高。     

妇幼保健院优质护理服务质量管理评价研究

目的:明确妇幼保健院优质护理服务质量管理现状及问题,针对薄弱环节,持续改进护理质量管理.方法:利用2011年“医疗质量万里行”活动收集的数据及资料,采用定性与定量分析相结合的方法,对妇幼保健院的优质护理服务质量管理进行分析与评价.结果:妇幼保健院优质护理服务管理总体良好,但在依法依规执业、护理人员培训及相关体制机制改进方面仍需加强.结论:继续加强妇幼保健院优质护理服务质量管理,形成护理质量持续改进的长效机制.     

四川省市级妇幼保健机构发展能力分析

目的:探讨四川省20所市级妇幼保健机构的发展能力。方法:利用网络直报的方法,对全省保健机构资源与运营情况进行调查。用总资产增长率、人均业务收入增长率和净资产增长率3个指标进行综合评价。结果:T妇幼保健院在同级机构中发展能力综合评价最高,H、G、L、A4所机构发展能力处强势地位,K、P、M3所机构发展能力有限。结论:20所市级妇幼保健机构发展能力不平衡,少数机构发展能力较好,大部分机构发展能力相对较低。     

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.     

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.     

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.     

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.     

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.     

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.