主成分分析与因子分析法在医院管理质量综合评价中的应用研究

目的 探讨主成分分析与因子分析法在医院管理工作质量综合评价中的应用.方法 用主成分分析与因子分析法对6所医院的管理工作质量进行综合评价.结果 主成分分析与因子分析法得到的6所医院管理工作质量的综合评价排序结果为（按由好到差的顺序）：B医院、C医院、A医院、D医院、F医院、E医院.结论 理论和实践表明主成分分析与因子分析法适宜于客观地综合评价医院管理工作质量.     

两种方法在医院运行管理质量综合评价中的应用

目的 运用主成分分析法结合加权TOPSIS法对医院运行管理质量做出客观准确评价,探讨这种综合评价方法应用在医院运行管理质量中的科学性和可行性,为医院管理部门制订决策提供依据.方法 选取某肿瘤医院2008至2012年运行基本监测指标中有代表性的15项统计指标,分别运用TOPSIS法和主成分分析法结合加权TOPSIS法对指标进行综合评价和分析.结果 主成分分析法结合加权TOPSIS法的评价结果与医院实际发展情况相符,医院运行管理质量呈逐年上升的趋势,即年份越近,排名越佳.结论 主成分分析法结合加权TOPSIS法灵活实用、科学可靠,适宜在医院运行管理质量评价中推广应用.     

医院护理过程质量综合评价指标研究

目的 建立科学、实用、适应形势发展的医院护理过程质量评价指标体系，为医院护理管理部门合理评价、科学决策提供依据。方法 采用典型调查法，了解医院现行护理过程质量评价内容和方法；会议讨论确定评价指标体系的基本范畴；采用头脑风暴法、特尔斐法对指标进行筛选和论证，确立指标体系；用现场调查法对25个科室的护理过程质量进行评价和分析。结果 建立了医院护理过程质遣综合评价体系，涵盖护理服务、护理管理、护理技术和护理安全4个范畴并分解成不同层次的评价指标，整体结构由1个总目标、4项一级指标、12项二级指标、5项三级指标和290项子指标构成。结论 新指标体系强调护理服务理念、突出以病人为关注焦点的质量管理原则，层次清晰，操作性强，为科学合理评价护理过程质量提供了可靠保证。     

两种改进加权TOPSIS综合评价方法的探讨与实证

目的 探讨卫生决策中TOPSIS相对综合评价方法的两种优化改进途径.方法 根据主成分降维思想,将原始指标体系下的数据矩阵转化为主成分指标下的样本向量形式,消除相关和冗余,优化评价结构;根据信息熵原理体现指标数据分布离散差异信息,并主客观结合组合赋权评价.改进途径作原理分析和算例实证.结果 TOPSIS法与主成分思想结合,适于复杂评价体系问题;加权TOPSIS法综合了熵权组合赋权的优点,评价更客观.结论改进途径可推广应用于卫生综合评价中.     

基于主成分分析的武汉市公立医院综合评价研究

目的 将武汉市市属医院与部、省属医院进行综合评价并进行对比,以发现武汉市属医院薄弱环节,为当地卫生部门提高市属医院综合效率、提供医院管理决策提供依据.方法 选取10个代表性指标,运用主成分分析对位于武汉市的26家医院(市属和部、省属各13家)进行综合评价.结果 确认了第一主成分为反映医院的医疗服务能力的综合指标,第二主...     

医院综合评价科室方案的研究与应用

目的 为医院管理者提供一套综合评价科室的指标方案。方法 采用三维框架和树状结构的方法设置指标内容,根据工作实际设定指标仅重,应用动态区间平移法和静态取值法制订指标计划值,通过计划值比较法、内差法和特尔菲法获取指标积分值;依托医院的信息管理系统采集原始数据;开发计算机程序实现自动积分和报表。结果 生成评价区间以科室为单位的单项评价指标积分表和综合评价指标积分表。结论 针对性强、灵敏度高、操作简便,结果可靠,起到评价作用,收到预期效果。     

主成分分析法在同级医院综合比较中的运用

目的 对深圳市4所三甲综合医院和8所部属同级医院进行定量评价,为我市三甲综合医院找出薄弱环节、提高综合水平提供依据.方法 选取具有代表性的指标共10项,用SPSS软件进行主成分分析.结果 按主成分分析的综合评分值对12所医院进行排名,我市三甲综合医院排名分别为第5、6、7、9位.结论 我市三甲综合医院整体水平与部属同级医院相比存在差距,有待进一步提高,主成分分析方法能较好地反映各医院之间的差距,评价结果客观合理.     

综合评价法在医院管理中的应用

目的探讨综合评价法在医院管理中的应用。方法以我院统计室资料为基础,采用综合评价法建立指标体系,计算综合指数。结果经过综合指标的计算,反映医院的工作效益呈直线上升的态势。结论运用综合评价法科学地分析和评价医院的工作效益,为管理者决策提供科学依据。     

主成分分析与因子分析在医院综合评价中的比较研究

目的探讨主成分分析与因子分析在医院综合评价中的应用,验证2种评价方法的科学性和适用性。方法用主成分分析法与因子分析法对某院1996--2005年的医院管理质量进行综合评价。结果2种方法综合评价结果基本一致、略有不同,与TOPSIS法和综合指数法所得的评价结果也不完全一致。结论主成分分析与因子分析适宜于客观地评价医院的医疗管理质量。     

TOPSIS法和RSR法评价医院综合效益变化的比较研究

本文尝试分别以TOPSIS法和RSR法评价厂矿医院不同年度的综合效益，比较两种方法评价结果的异同。旨在探讨适用于医院综合效益评价的实用方法，以促进基层医院管理水平的提高。研究拟设指标力求全面，评价对象力求具有更好的均衡性，而且评价样本中包含是否改制这一干扰因子，更加有助于进一步考察TOPSIS和RSR两法的稳定性和实用性。     

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.