汶川抗震救灾对医院机动卫勤分队建设的启示

作者总结了医院机动卫勤分队在汶川地震医疗救援行动中的主要经验,分析了医院机动卫勤分队建设在此次救援行动中的重要作用,指出了机动卫勤分队建设中存在的不足,提出了改进意见,为机动卫勤分队建设有所帮助。     

军队医院机动卫勤分队建设与管理

军队医院机动卫勤分队建设与管理作为当前军事斗争卫勤准备的一项重要而紧迫的任务,值得大家深入分析研究。本文指出认真抓好组织领导,是军队医院搞好机动卫勤分队建设和管理的前提;认真抓好制度建设,是军队医院搞好机动卫勤分队建设与管理的保证;认真抓好装备建设,是军队医院搞好机动卫勤分队建设与管理的基础;认真抓好战备训练,是军队医院搞好机动卫勤分队建设与管理的关键。     

军队医院机动卫勤分队建设思考

本文剖析机动卫勤分队建设中存在的现实问题.对在现有水平上抓好机动卫勤分队建设,进行思考与分析,为持续推进卫勤分队建设提供相应依据.     

建设全面过硬的机动卫勤分队

本文阐述了应急机动卫勤分队的基本情况，回顾总结了应急机动卫勤分队近年来建设的主要做法，提出了搞好应急机动卫勤分队建设必须提高认识、强化领导、舍得投入、刻苦训练和严格管理。     

“5．12”抗震救灾工作对军队机动卫勤分队建设的启示

作者结合抗震救灾实践，针对机动卫勤分队的实际情况，提出了加强机动卫勤分队的信息化建设；建立适应不同地域和作战环境的机动卫勤分队；分队的快速机动要坚持人装一体化的投送原则；建立军地联合指挥部，整合各方力量统一指挥、科学安排等建议，对推动军队机动卫勤分队保障水平具有借鉴意义。     

机动卫勤分队人才队伍建设体会

介绍了基层单位机动卫勤分队人才队伍建设方面存在的主要问题,总结了军队中心医院机动卫勤分队人才队伍建设方面的基本方法和措施。实践证明,这些方法和措施提高了机动卫勤分队训练的效果,形成了可持续发展的机制。     

军队医院机动卫勤分队建设现状的SWOT分析

本文通过采用SWOT分析,对军队医院机动卫勤分队建设的外部环境和内部环境进行阐述,以期从中发现机动卫勤分队建设和发展的外部机会和威胁,找出自身的优势与劣势,为加强卫勤分队建设,提高卫勤保障能力提供建议。     

机动卫勤分队战备工作管理系统的开发与应用

目的：加强军队医院机动卫勤分队的信息化建设,提高机动卫勤分队战备工作管理的自动化水平和保障能力．方法：根据医院几年来战备训练工作实践体会,以“军区机动卫勤分队管理系统”为基础,利用有线局域网络技术．采用VB汇编程序实现卫勤分队以及战备库各类数据的共享和管理。增加适应机动卫勤分队战备管理工作需要的功能模块。结果：该系统经过机动卫勤分队多方应用．使管理工作更加规范化．更具有科学性．有效地提高了人员和物资管理的效率。结论：该战备工作管理系统符合当前医院机动卫勤分队信息化管理的使用要求,进一步完善了机动卫勤分队的信息化管理．为科学的决策和管理提供了一个方便快捷的平台,     

机动卫勤分队建设探析

目的研究当前机动卫勤分队建设需解决的主要问题。方法查阅2000--2007年国内10余种主要医学方面杂志,运用边界分析,归纳机动卫勤分队建设现存的各类问题,并进一步运用专家咨询法明确当前的主要问题。结果归纳机动卫勤分队建设存在问题12个方面,其中,真打实备意识不够和战备训练机制不明是当前机动卫勤分队建设当前面临的主要问题。结论针对主要问题,从两个方面采取有力措施。     

应急机动卫勤分队协同训练模式探讨

本文初步界定了机动卫勤分队协同训练的概念,阐述了协同训练的主要内容,并从协同训练对象和组训方式两个方面深入探讨了机动卫勤分队协同训练模式,结合目前机动卫勤分队建设情况提出了对策建议。     

Cultivating a worldly repose: the contribution of Sally Gadow's work to interpretive inquiry

This paper discusses the contribution that the work of Sally Gadow makes to understandings of interpretive inquiry and it's potential to inform and influence nursing practice, research, and education. The discussion draws on several of Gadow's published works that make explicit her understandings of what it means to be interpretive, to be open to multiple truths, to hear multiple voices, to have a history, to be experienced, and to recognize agency in language. Situating this discussion of Gadow's contribution in opposition to a metaphysics of genius is intended to move our understanding of particular work past the subjectivity that produced it, past the subjectivized responses to the work, past the reporting on myself – my thoughts, my perspectives, my experiences – to explore, to see the worthwhileness or even the possibilities of exploring the work itself and the worlds it evokes. This paper is a deliberate attempt to disrupt the call to the author to save us from the task of interpreting the questions that the work itself places us under. Gadow's work itself points us away from a valorization of the voice of the author of the work, a single voice, and towards a cultivation of a worldly repose where each interpretive account points us to some longstanding whole to which the work belongs and from which it gains its sense and significance.     

Factors related to outcome following a work hardening program

The purpose of this study was to determine factors related to a return to work following the completion of a work hardening program. Data from the Workers' Compensation Board of Alberta Millard Rehabilitation Centre for 1527 discharges, collected over 22 months, were examined retrospectively. Factors related to return to work were compared bivariately using logistic regression procedures. A multiple logistic regression model for return to work was also determined. The principle predictor of return to work was job-attached status to the pre-injury employer. Other factors related to return to work were education, primary diagnosis, injury to admission time, job attachment to the pre-accident employer, employer's annual payroll, and vocational direction. Due to the strength of the association between job-attached status to the pre-injury employer and a return to work, it was concluded that attempts to maintain this relationship should be a priority for rehabilitation providers and insurance carriers.     

Working ‘off the record’: polio eradication and state immunity in Chad

The reappearance of polio in Chad generates anxieties about governance as well as public health. Since Chad was declared polio-free in 2003, at least 180 cases of paralytic polio have been linked to importations of wild poliovirus from Nigeria. In efforts to eradicate polio through house-to-house vaccination campaigns, international agencies have aggressively implicated political leaders, placing those authorities in a bind. On the one hand, governments are required to demonstrate compliance in the form of universal vaccination. On the other hand, the legitimacy of political leaders and of local authorities in particular depends upon their ability to show compassion for their populations and to be responsive to individual circumstances and concerns about the drops. This article looks at how the obligation of the African state to adopt global public health policy as its own becomes problematic when the goals and protocols of international agencies rely on the assumption that the state controls its population. Under pressure to render account to international agencies, state officials deploy high-level politicians to enforce vaccination mandates at critical moments, create administrative forms to record campaign progress that conceal difficulties in vaccinating children, and use statistics to portray the campaigns as success stories. Local authorities, who feel the bind most acutely, grant exceptions to the mandate of universal vaccination to certain subjects and work with local vaccinators and supervisors to keep cases of unvaccinated children ‘off the record’. These efforts allow the vaccination campaigns to be carried out without incident even as they work against the goal of polio eradication.     

Reducing occupational exposure to chemical carcinogens

Strategies for controlling occupational exposure to chemicalcarcinogens are set out in the European Union Carcinogens Directiveand in national legislation such as the British Control of SubstancesHazardous to Health Regulations. While such legislative requirementsmust apply to all occupational chemical carcinogens, it is arguedthat priority should be given to controlling those agents thatcontribute most to the cancer burden. Examples of possible strategiesto reduce exposure to two agents (diesel exhaust particulateand paint emissions) are discussed. It is concluded that thereare no real technical difficulties in controlling exposuresto chemical carcinogens; however, for many of the key agents,we need to change attitudes to the potential risks and clearlydemonstrate to employers and employees how to reduce the exposures.     

Timing of steps and reasons for delays in obtaining abortions in the United States

OBJECTIVE: We studied the steps in the process of obtaining abortions and women's reported delays in order to help understand difficulties in accessing abortion services. METHODS: In 2004, a structured survey was completed by 1209 abortion patients at 11 large providers, and in-depth interviews were conducted with 38 women at four sites. RESULTS: The median time from the last menstrual period to suspecting pregnancy was 33 days; the median time from suspecting pregnancy to confirming the pregnancy was 4 days; the median time from confirming the pregnancy to deciding to have an abortion was 0 day; the median time from deciding to have an abortion to first attempting to obtain abortion services was 2 days; and the median time from first attempting to obtain abortion services to obtaining the abortion was 7 days. Minors took a week longer to suspect pregnancy than adults did. Fifty-eight percent of women reported that they would have liked to have had the abortion earlier. The most common reasons for delay were that it took a long time to make arrangements (59%), to decide (39%) and to find out about the pregnancy (36%). Poor women were about twice as likely to be delayed by difficulties in making arrangements. CONCLUSIONS: Financial limitations and lack of knowledge about pregnancy may make it more difficult for some women to obtain early abortion.     

Leptin and Insulin Action in the Central Nervous System

Body adiposity is known to be carefully regulated and to remain relatively stable for long periods of time in most mammalian species. This review summarizes old and recent data implicating insulin and leptin as key circulating signals to the central nervous system, particularly the ventral hypothalamus, in communicating thesizeand thedistribution of body fat stores.This input ultimately alters food intake and energy expenditure to maintain constancy of the adipose depot. The key primary neurons in the arcuate nucleus containing NPY/AgRP and POMC/CART appear be critical constituents of the CNS regulating system, and are shown to contribute to anabolic and catabolic signaling systems to complete the feedback loop. New data to indicate shared intracellular signaling from leptin and insulin is provided. The satiety system for meals, consisting of neural afferents to the hind-brain from the gastrointestinal tract, is described and its effectiveness is shown to vary with the strength of the insulin and leptin signals. This provides anefferent mechanism that plays a key role in a complex feedback system that allows intermittent meals to vary from day to day, but provides appropriate long-term adjustment to need. Recently described contributions of this system to obesity are described and potential therapeutic implications are discussed.     

Toward a Healthy and Environmentally Sustainable Campus Food Environment: A Scoping Review of Postsecondary Food Interventions

Interventions are urgently needed to transform the food system and shift population eating patterns toward those consistent with human health and environmental sustainability. Postsecondary campuses offer a naturalistic setting to trial interventions to improve the health of students and provide insight into interventions that could be scaled up in other settings. However, the current state of the evidence on interventions to support healthy and environmentally sustainable eating within postsecondary settings is not well understood. A scoping review of food- and nutrition-related interventions implemented and evaluated on postsecondary campuses was conducted to determine the extent to which they integrate considerations related to human health and/or environmental sustainability, as well as to synthesize the nature and effectiveness of interventions and to identify knowledge gaps in the literature. MEDLINE (via PubMed), CINAHL, Scopus, and ERIC were searched to identify articles describing naturalistic campus food interventions published in English from January 2015 to December 2019. Data were extracted from 38 peer-reviewed articles, representing 37 unique interventions, and synthesized according to policy domains within the World Cancer Research Foundation''s NOURISHING framework. Most interventions were focused on supporting human health, whereas considerations related to environmental sustainability were minimal. Interventions to support human health primarily sought to increase nutrition knowledge or to make complementary shifts in food environments, such as through nutrition labeling at point of purchase. Interventions to support environmental sustainability often focused on reducing food waste and few emphasized consumption patterns with lower environmental impacts. The implementation of integrated approaches considering the complexity and interconnectivity of human and planetary health is needed. Such approaches must go beyond the individual to alter the structural determinants that shape our food system and eating patterns.     

On the stability of stigmatization: The case of ex-homosexual males

We undertook to empirically identify variables that influence the stigmatization of ex-homosexuals by analyzing the relationship between stigmatization and seven variables held to influence negative attitudes toward members of other ex-deviant groups: the stimatizer's age, highest achieved educational level, amount of interaction the stigmatizer has had with an ex-homosexual, degree of effectiveness attributed to treatment in changing the homosexual to a heterosexual orientation, degree of responsibility that the stigmatizer attributes to ex-homosexuals for their prior homosexual behavior, degree of dangerousness attributed to ex-homosexuals, and degree of seriousness attributed to homosexuality. Analysis of data obtained by questionnaire from 281 respondents showed that the variable most strongly related to stigmatization of ex-homosexuals was the degree of dangerousness attributed to them. There was a profound direct relationship between these variables. Further, educational level, belief in the effectiveness of treatment, and amount of interaction with ex-homosexuals were inversely related to stigmatization, while degree of seriousness attributed to homosexuality was directly related to stigmatization. Respondents' tendency to stigmatize was not found to be related to age or to their attribution of responsibility to the ex-homosexual for his previous sexual orientation.Paper presented at the 1979 Annual Meeting of the Southern Sociological Society, Atlanta, Georgia.     

Perceptions of the first family physicians to adopt advanced access in the province of Quebec,Canada

In Quebec, several primary care physicians have made the transition to the advanced access model to address the crisis of limited access to primary care. The objectives are to describe the implementation of the advanced access model, as perceived by the first family physicians; to analyze the factors influencing the implementation of its principles; and to document the physicians' perceptions of its effects on their practice, colleagues and patients. Qualitative methods were used to explore, through semi‐structured interviews, the experiences of 21 family physicians who had made the transition to advanced access. Of the 21 physicians, 16 succeeded in adopting all five advanced access principles to varying degrees. Core implementation issues revolved around the dynamics of collaboration between physicians, nurses and other colleagues. Secretaries' functions, in particular, had to be expanded. Facilitating factors were mainly related to the physicians' leadership and the professional resources available in the organizations. Impediments related to resource availability and team functioning were also encountered. This is the first exploratory study to examine the factors influencing the adoption of the advanced access model conducted with early‐adopter family physicians. The lessons drawn will inform discussions on scaling up to other settings experiencing the same problems. Copyright © 2016 John Wiley & Sons, Ltd.     

Charging for NHSPlus: an inferential study based on the internal provision of occupational health services within the National Health Service

BACKGROUND: 'NHSPlus' was conceived as a national agency that would provide occupational health services to organizations, for a fee, without imposing any financial burden on the taxpayer. This self-funding requirement brings into focus the resource implications for such a service and the determination of the charges to be made to external clients. AIM: The existing provision of occupational health services to >100000 National Health Service (NHS) staff by 13 NHS occupational health services of various sizes was analysed, with the objective of determining an appropriate charge-out rate to third parties. METHOD: Two focus groups were questioned on their work external to the NHS. Data collected on the allocation of doctors and nurses to occupational health services in relation to the number of NHS clients serviced were used to investigate the nature of the resourcing relationship using regression analysis. RESULTS: The relationship was found to be stable enough to provide a good estimate of staff requirements (the key resource requirement). Combining this with costing information allowed inferences to be drawn concerning the economic cost and hence the break-even rate of charge for the service. This was then compared with the employer charge rates in the NHSPlus published case studies. CONCLUSIONS: The results suggest that the per capita charges to external clients are lower than the per capita cost of internal occupational health provision within the NHS, raising questions about the viability of the service.