卫生监督稽查工作探讨

卫生监督稽查是卫生行政部门根据依法行政的要求,以落实行政执法责任制为核心,以卫生行政执法行为合法、规范、公正、高效为基本要求,以卫生行政执法监督和过错责任追究为保障的执法监督工作。日常卫生法律事务中,卫生行政部门通常采用依法限制卫生行政相对人的权利或义务的方式,     

卫生科普摄影宣传画的创作技巧

传统的卫生科普宣传画以手工绘画为手段,传播卫生科普知识,为卫生防病做出了不可估量的贡献。随着照相机的普及和计算机在平面设计的广泛应用,以卫生摄影为主体的卫生科普宣传画创作速度快且效果好,大有取替传统卫生宣传画的趋势。     

基于健康档案的区域卫生信息平台建设方案

1方案分析 1．1方案目标 本方案以技术平台为主,兼顾区域应用平台;面向健康档案,以卫生服务为中心;以卫生和行业外资源信息为支撑,提升卫生服务,辅助卫生管理和决策。     

北方三省2013年卫生监督与疾控机构中学校卫生人力资源现状

目的了解我国北方地区卫生监督与疾控机构中学校卫生人力资源配置现状,为学校卫生人才队伍的建设提供科学依据。方法采用判断抽样和整群抽样相结合的方法,选取北京、辽宁、甘肃三省卫生监督机构与疾控机构中学校卫生相关科室作为调查对象,通过问卷调查,收集学校卫生人力资源相关信息,对人员的年龄、学历、专业、职称和工作情况等进行描述性分析。结果卫生监督机构和疾控机构中,设独立学校卫生科室的机构比例分别为48.48%和23.53%,学校卫生工作人员专职比例分别为43.23%和42.91%,年龄分布均以30～50岁为主,专业均以预防医学和临床医学为主,学历以大专和本科为主,职称以初级和中级职称为主,但半数以上学校卫生工作人员从事学校卫生工作的时间不足5年。三省学校卫生人力资源配置不同。结论设独立学校卫生科室的机构较少,学校卫生工作人员整体配备不足,素质参差不齐,应加强对学校卫生人才队伍的建设。     

2019年全国医疗机构医务人员诊疗过程手卫生监测报告

 目的 建立医务人员诊疗过程手卫生监测数据的评价体系。方法 2019年9月1—30日采用手卫生观察员现场调查方法获取综合重症监护病房（ICU）、呼吸内科病区、骨科病区、感染科病区、儿科门急诊、血液透析室医生和护士手卫生执行情况,并统计同期调查科室工作量、手卫生用品消耗量以及医疗机构实际开放床位数,计算手卫生依从率和手卫生用品床日消耗量。结果 共有1 480所医疗机构手卫生调查资料审核合格,应执行手卫生1 353 531次,执行手卫生1 076 639次,正确执行手卫生891 185次,手卫生依从率为79.54%,手卫生执行正确率为82.77%。不同规模医疗机构手卫生依从率为76.26%~82.84%,以实际开放床位数600~899张者手卫生依从率最低;手卫生正确率为81.87%~84.01%,以实际开放床位数≥900张者手卫生正确率最低。调查科室手卫生依从率为76.80%~84.44%,以儿科门急诊手卫生依从率最低;手卫生正确率为81.19%~84.98%,以骨科手卫生正确率最低。五个手卫生时机手卫生依从率为67.59%~89.84%,以接触患者周围环境后手卫生依从率最低;手卫生执行正确率为81.51%~86.76%,以接触患者周围环境后手卫生执行正确率最低。综合ICU、呼吸内科、骨科、感染科手卫生用品消耗量分别为56.62、10.76、9.50、14.54 mL/床日,儿科门急诊、血液透析室手卫生用品消耗量分别为2.02、9.06 mL/人次。不同规模医疗机构中,综合ICU以实际开放床位数600~899张者手卫生用品消耗量最多（61.15 mL/床日）,呼吸内科、骨科、感染科均以实际开放床位数>900张者手卫生用品消耗量最多（分别为13.61、10.96、16.55 mL/床日）,儿科门急诊、血液透析室均以实际开放床位数300~599张者手卫生用品消耗量最多（分别为2.53、10.76 mL/人次）。结论 此次调查获取的不同规模医疗机构手卫生依从率及手卫生用品床日消耗量可作为标杆,为各医院机构提供手卫生执行情况的对照体系,以促进全国医疗机构手卫生持续改进。     

打牢联勤基础提高保障能力--沈阳军区部队卫生装备检修保障工作纪实

部队卫生装备是部队卫勤保障的重要物质基础。在科学合理利用有限的卫生装备资源的同时,延长卫生装备使用寿命,提高卫生装备完好率,是提高部队卫勤综合保障能力的有效途径。近年来,沈阳军区卫生部以军委关于联勤保障决策为统揽,以《军队卫生装备检修管理办法》等法规为依据,以保证部队卫生装备运行质量为目的,以提高部队卫勤保障能力为己任,在总部的指导下,从加强部队卫生装备检修机构建设入手,强化管理,突出服务,积极探索联勤体制下部队卫生装备检修保障模式,建立和完善了以军区联勤检修机构、区域性检修站、部队卫生机构为技术保障框架的…     

本期导读

我国党和政府历来十分重视儿童青少年的健康成长,通过建立健全学校卫生工作网络,成立各级中小学卫生保健机构,壮大了学校卫生保健队伍,推动了学校卫生工作。《中国学校卫生》杂志社以《中国学校卫生》杂志为载体,经过多年的努力探索与创新,通过与全国知名专家和学者、高等院校、科研院所、各级卫生与教育机构的互动与交流,逐步形成了"以安徽医科大学公共卫生学院为主的科研技术支撑平台,以各地中小学卫生保健所为主的科研现场支撑平台,以《中国学校卫生》杂志为主的科研成果发布支撑     

浙江省放射卫生监督员培训现状与对策建议

目的了解浙江省放射卫生监督员培训现状,分析存在的问题,为今后开展放射卫生专业知识培训和放射卫生监督岗位人才队伍建设提供科学依据。方法采用事先设计的《浙江省放射卫生监督员培训现状与需求调查问卷表》,对省内91名从事放射卫生监督的人员进行问卷调查,对调查结果进行统计分析。结果从事放射卫生监督的男性占61.54%,女性占38.46%,男性多于女性;学历构成以本科为主,占78.02%;专业以预防医学为主,占71.43%;未独立设置放射卫生科的监督机构占95.65%;兼职从事放射卫生监督的人员占85.71%;97.80%的人员未进修过放射卫生专业知识;98.90%的人员有意愿参加培训;在培训形式方面有72.53%的人员选择培训班;培训内容以放射卫生基础和放射卫生执法知识为主;84.06%人员认为有必要对参加的培训班进行效果评价。结论各级卫生监督机构应按照卫生部《2011~2015年全国卫生监督员培训规划》,制定切合实际的培训计划,落实放射卫生监督员培训学时数,提高培训率;市县级卫生监督机构应加强人员进修学习,以适应快速发展的核技术;各级卫生监督机构应尽可能固定放射卫生监督人员,以确保放射卫生监督工作的开展;开展培训效果评价,能改进培训方法,提高培训效果。     

宁波市新一轮卫生援疆工作的实践与思考

新一轮对口援疆工作开展以来,宁波市卫生局高度重视卫生援疆工作,以规划为先导,科学实施卫生援疆工作;以项目为抓手,强化医疗卫生基础设施建设;以培训为手段,稳步推进卫生智力支援工作;以支医为载体,有力保障各族群众健康,取得了卫生援疆工作良好开局。在推进卫生援疆工作过程中,还需要进一步提高认识,创新援疆模式,完善工作协调机制,确保卫生援疆工作取得长期和扎实的成效。     

卫生监督执法工作职业道德特点与对策

认真研究卫生监督执法工作职业道德特点,加强卫生监督执法工作职业道德建设,全面提高卫生监督执法队伍的整体素质,是卫生监督体制改革后迫切需要探讨和解决的问题。1卫生监督执法工作职业道德的特点医学伦理道德是以“病人为中心”,以“救死扶伤、忠于职守、精益求精、文明行医     

An activity week for children with cancer: who wants to go and why?

Many children now live with cancer rather than die from it, and such children need both to continue their social, emotional and cognitive development and to make long-term psychological adjustments. This paper presents the findings of a research project set up to explore issues pertinent to the current provision of an activity week experience for a group of British paediatric cancer patients. The aims of the study included finding out which factors discriminate between families who apply for a place to attend the week for their child and families who do not, and to develop a knowledge of what factors are considered by parents and children. The findings suggest that the week appeals to children who are confident, active and able to separate from parents and whose parents are keen to encourage independence and new experiences. Children diagnosed and treated at a younger age and further away from treatment were more likely to express concerns about being homesick and safety and to not apply for the week. Issues of protection, independence and disability are discussed with reference to the importance of parental attitude on children's psychological accommodation to disease and treatment and to the experiences of adult survivors of childhood cancer.     

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.     

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.     

物理研究人员投稿和阅读习惯调查与分析

【目的】 从选择投稿期刊、阅读文献等维度调查物理学相关领域研究人员对期刊服务的需求,为国内物理类期刊进一步优化工作重点提供帮助。【方法】 设计调查问卷,以《物理学报》采编系统人员库中7000多位活跃作者、专家为主要调查对象,对研究人员投稿和阅读的习惯进行统计分析,结合《物理学报》的办刊实践,总结物理类期刊吸引优质稿源、扩大影响力的有效措施。【结果】 期刊声誉、收录情况、出版周期、评价政策、审稿质量和影响因子是物理类研究人员选择期刊的重要参考因素;文献检索和电子版阅读是研究人员获取学术信息、学习科研成果的主要方式;研究人员普遍认为同行邮件推送和评选封面文章、优秀论文是论文宣传的有效途径。【结论】 物理类期刊应努力缩短出版周期、提高审稿质量;应密切关注检索技术和数字出版的相关动态,积极提升文章显示度和读者阅读体验;需要重视对已发表论文进行分类、遴选和再加工,为研究人员提供精准和个性化的学术服务。     

Augmented Reality Farm MAPPER Development: Lessons Learned from an App Designed to Improve Rural Emergency Response

Fire departments have right-of-entry to most commercial industrial sites and preemptively map them to identify the onsite resources and hazards they need to promptly and safely respond to an emergency event. This is not the case for private farms. Emergency responders are blind to resources and hazards prior to arrival and must spend critical minutes locating them during an emergency response at a farm location. The original 2013 Farm Mapping to Assist, Protect and Prepare Emergency Responders (Farm MAPPER) project was undertaken to develop a method to give emergency responders an up-to-date view of on-farm hazard information to safely and efficiently conduct emergency response activities on private agricultural operations. In 2017, an augmented reality version of Farm MAPPER was developed to combine the technological advantages of geographic information system-based data points with a heads-up display and graphical overlay of superimposed hazard imagery and informative icons. The development and testing of this iOS- and Android-ready prototype uncovered lessons learned applicable to other mobile-based apps targeting farmers, ranchers, and rural populations faced with limited or inconsistent mobile internet connectivity.     

Implementation of Health and Mental Health Evidence-Based Practices in Safety Net Settings

Implementation of evidence-based practices (EBP) in health and mental health settings has not been as successful as anticipated. Patients in safety net settings have even less opportunity to receive evidence-based care. Translation research has been dominated by efficacy trials, which often do not translate to the complexity of safety net settings. Implementation research to date seems to focus mostly on provider and organizational contextual factors more than macro and patient factors crucial to outcomes in safety net settings. Focus on translation and adaptation of interventions to safety net settings, and use of qualitative methods to flesh out complex processes and involve more stakeholders will help give safety net patients access to state of the art care. This issue is important for social workers to understand due to their ethical obligation to advocate for social justice and access to care for vulnerable and oppressed populations.     

Advice given to patients about return to work and driving following surgery

BACKGROUND: The post-operative advice given to patients by health care practitioners regarding return to work and return to driving may have an impact upon their absence duration. The only guidance that is readily available to assist health care practitioners give this advice is provided by the Department of Work and Pensions (DWP). AIMS: To identify what advice local consultant surgeons, occupational physicians and general practitioners give to patients about return to work and driving, following benign abdominal hysterectomy (BAH) and Birmingham hip resurfacing (BHR). To explore health care practitioners' awareness of the DWP evidence-based return to work guidelines. METHOD: A questionnaire was administered to 216 health care practitioners, asking them about the advice they would give to patients undergoing BAH or BHR, regarding return to driving and return to work. RESULTS: Fifty-eight per cent of all health care practitioners that responded were unaware of the DWP evidence-based guidance. Seventy-four per cent of occupational physicians were aware of this guidance but only 32% of general practitioners and 0% of hospital specialists. The advice given regarding expected duration of sickness absence was very variable, ranging between 2 weeks and >12 weeks for both BAH and BHR procedures. Twenty-one different operative 'patient information sheets' were examined and these included only very brief and very general advice about return to work. CONCLUSION: National guidance on post-operative return to work advice could be beneficial. The guidance should be supported by health care practitioners and provide advice about normal ranges of time to return to driving and to return to work.     

社区产后访视健康教育对母乳喂养的影响

目的:通过社区产后访视健康教育知识宣传让产妇和家属了解和接受母乳喂养知识和技能,提高母乳喂养率.方法:社区产后访视人员在产妇及新生儿出院后3天、28天各进行上门访视一次,先了解产妇及新生儿健康状况、母乳喂养知识了解程度和喂养技能掌握情况,再根据当前存在的问题给予纠正.对可能发生的问题给予预防措施指导.利用健康教育宣传母乳喂养知识,使产妇及家属了解和接受母乳喂养知识.结果:社区产后访视健康教育宣传指导使产妇及家属接受和正确实施母乳喂养,从而提高了母乳喂养率.结论:社区产后访视利用健康教育宣传和指导母乳喂养知识和技能对提高母乳喂养率有很大的促进作用.     

加快推进继续医学教育工作 为卫生事业发展奠定基础

探讨继续医学教育工作。结合我国继续医学教育工作的实际，应在以下方面加快推进继续医学教育工作：进一步提高认识，切实加强对继续医学教育工作的领导；进一步完善继续医学教育相关制度，加强和规范继续医学教育的监督管理；加大对农村和基层继续医学教育工作的支持力度；突出重点，加快推进医学继续教育工作：加强继续医学教育管理干部队伍建设。     

Development of prevention programmes for HIV, hepatitis and sexually transmitted infections among migrants consulting in the doctors of the World French centers

The French Doctors of the World centers have as objective to facilitate access to care and to rights in the law system for vulnerable populations and to keep the global population informed. The objective of the project was to ensure daily actions of prevention: to bring people to HIV and hepatitis screening as well as to offer full access to treatment for the populations consulting in Reception centers of care and orientation (Caso). The screening is proposed systematically to all new patients (90% of them are migrants) after a medical consultation or a special prevention consultation. Among the patients screened in 2007, the prevalence of HIV, hepatitis B and C was respectively 15, 10,5 and seven times greater than the national average. The centers of Doctors of the World are privileged places to inform, prevent, offer screening and bring to healthcare these people particularly exposed to risks.