广西乡镇卫生院免疫规划工作机构设置及人员配备现状调查

目的了解乡镇卫生院免疫规划工作机构设置及人员配备现状,为制定政策提供依据。方法采用现况调查方法收集分析相关数据。结果100．0％的卫生院设置有免疫规划工作机构（防保组）。防保人员配备为1．22人／万人,平均每个乡镇有防保人员4．73人。与2008年相比,11．5％乡镇卫生院防保人员减少,32．0％维持在原来水平,56．5％乡镇卫生院防保人员增加。中专及以下学历占47．8％,31．7％的防保人员无职称,初级职称占49-3％。结论广西乡镇卫生院免疫规划工作机构设置完整,但防保人员不足,学历学位均较低,需要不断增加补充乡级防保人员,进一步提高他们的工作技能。     

广东省乡镇卫生院医生人力资源现状分析及政策建议

目的：了解广东省乡镇卫生院医生人力资源的现状．探索发展对策。方法：采用现场问卷调查的方法，对全省随机抽样的18家乡镇卫生院的486名医生年龄、性别、文化程度、科室和职称情况等进行调查。结果：广东省乡镇卫生院医生学历以大专和中专为主，职称以初级为主．占62．0％，珠江三角洲地区医生学历层次和职称水平明显高于东西两翼和粤北山区；临床医生的学历和职称水平明显高于防保人员。结论：广东省乡镇卫生院医生总体素质偏低，同区域医生发展不平衡．综合素质差别很大．临床医生的素质高于防保医生。建议加强乡镇卫生院医生的继续教育．提高素质，改善结构．采取有力措施缩小区域差距，适当增加防保人员数量，采取对策提高防保人员的质量。     

佛山市疾病预防控制体系人力资源现状分析

目的：了解佛山地区市、区、镇三级从事疾病预防控制工作人力资源现状，为疾病控制机构人力资源的舍理配置提建设性意见。方法：收集2005年佛山市及五区疫病预防控制中心、37个镇（街道）59问医院防保中心的工作人员基本信息以及辖区面积、人口等指标，应用EXCEL和SPSS12．0对数据进行统计分析。结果：全市疾控人员在学历方面，中专及以下学历占46．2％；在职称方面，以初、中级为主，其中初级占64％，中级占28．7％；在专业方面，市区级人员专业构成以预防医学和检验为主，镇（街道）人员所学专业以临床和护理为主。结论：佛山市、区、镇（街道）痰控机构人员总量不足，重医轻防现象相当严重。提出疾控机构人员配置比例至少为2．5人／万的建议，为促进乡镇、村级基层公共卫生网底建设可在村委会（社区居委会）聘用卫生协管员。     

某市疾控机构环境相关疾病预防与控制的人力资源配置现况

[目的]了解环境相关疾病预防与控制人力资源配置状况,为制定市、县（区）级疾病预防控制中心环境相关疾病防制的人力资源配置标准提供依据。[方法]采用回顾性研究和现况研究方法调查某地市疾病预防控制中心环境相关疾病防制的人力资源配置状况,分析其公共卫生职能执行情况。[结果]某市各级疾病预防控制中心从事．环境相关疾病防制的专业人员共118人（其中31．36％为兼职人员）,年龄（37．95±9．01）岁。全市人口中环境相关疾病预防与控制专业人员拥有率为1．92人／10万。专业人员学历以本科为主,占50．85％,研究生及以上学历占9．32％;研究生、本科、大专、中专人数的比例约为1：6：2：2。中级职称以上占61．02％;高级、中级、初级职称的比例为2：5：4。另外,过去5年有15．71％本科以上学历和（或）中级以上职称的专业人员调离了本岗位。该地区公共卫生职能落实程度为40％～60％。[结论]该地区从事环境相关疾病预防与控制的专职人员明显偏少,相应的公共卫生职能有所削弱。建议各级疾病预防控制中心要合理配置环境相关疾病防制的人力资源。     

经济欠发达地区乡村卫生人力资源现状分析

受城乡二元经济的影响,经济欠发达地区乡村卫生人力资源严重缺乏,人员数量每千人仅为0．88人,人力结构大龄化（45岁以上卫生人员占46．71％）、学历结构低（中专学历占81．04％）、专业结构不合理（缺乏预防、医技和护理人才）、职称结构不协调（初级职称占38．13％）,卫生体制不健全和培训机制不完善是导致经济欠发达地区乡村卫生人力资源严重缺乏的直接原因。     

四省基层医疗卫生机构传染病监测人力资源现状调查

目的了解基层医疗卫生机构传染病监测岗位人力资源现状,为相关部门制定卫生规划提供依据。方法对4个省基层医疗卫生机构采用分层抽样的方法抽取调查单位,对抽取的单位所有传染病监测人员全部自填问卷进行调查。结果4个省基层医疗卫生机构传染病预防控制和防保人员746人,传染病诊疗医生285人,检验人员166人。县级疾控机构、县级医院和乡镇卫生院／社区卫生服务机构的传染病监测人员中有专业学历者分别占94．6％、97．8％、89．5％;县级疾控机构传染病预防控制人员中,公共卫生专业的人员占42．7％,县级医院和乡镇卫生院／卒土区卫生服务机构传染病诊疗医生中,临床医学或中医学／中西医结合专业的人员分别占88．8％和79．3％,检验人员中医学检验（或临床检验）和卫生检验专业分别占30．7％和30．1％,无专业学历人员占13．3％（22／166）;职称以初级为主,占48．5％;其次为中级职称占39．9％;各类传染病监测人员具备执业证书者占81．2％,13．3％的人员无任何执业证书。结论4省基层医疗卫生机构传染病监测人员中,学历、职称、专业构成不合理,部分人员没有学历、不具备执业医师（助理医师）或执业护士资格。     

福州市2007年不同经济水平地区接种门诊信息化管理现状

目的了解福州市目前免疫规划信息化管理的基本情况，为运行预防接种信息化管理系统提供依据。方法按照各地经济水平对该市13个区、县（市）182个接种点进行调查，资料使用SPSS13．0进行统计分析。结果该市拟参加信息管理人员482人，Ⅰ、Ⅱ、Ⅲ类地区每个接种门诊拟参加信息管理的平均人员数为3．80、2．46和2．12人，方差分析显示3类地区差异有统计学意义（F=23．822，P〈0．01）；该市计划免疫信息化人员电脑水平，以低级电脑水平人员占较大比例，达50．4％；全市共有132个乡镇接种门诊配备了电脑，其中能够通过宽带或拨号上网的有124个接种门诊，Ⅰ类地区有电脑及能上网比例均高于Ⅱ、Ⅲ类地区。结论福州市已初步具备开展儿童预防接种信息化管理的条件，但各地预防接种信息化管理工作发展不平衡，应逐步建立适合我市各种经济水平地区的信息化管理模式。     

宁夏各市县疾控机构艾滋病防制人力资源现状及公平性研究

目的了解疾控机构艾滋病防制人力资源现状及人口和地理分布配置的公平性。方法于2012年采用问卷调查宁夏5个市级、19个县级疾控机构艾滋病防制人员的年龄、职称、学历及11项艾滋病工作项目开展情况等信息,并采用基尼系数测算公平性。结果共调查艾滋病防制人员82人,以女性为主占67．1％（55／82）,平均年龄（38．61±8．31）岁,学历以本科为主51．2％（42／82）,艾滋病防制人员正高、副高、中级、初级职称的比例为1：2．8：6．2：6．4。11项艾滋病防制工作7项均已开展（机构开展率均为100．0％）,其他艾滋病综合示范区、母婴阻断、哨点监测及疫情报告和处理4项内容,机构开展率分别为25．0％（6／24）、37．5％（9／24）、54．2％（13／24）和91．7％（22／24）。人口分布的公平性基尼系数为0．1375,地理面积分布的公平性基尼系数为0．3251,艾滋病疫情中防制人员分布的公平性基尼系数为0．3166。结论艾滋病防制人力资源数量从地理、人口及疫情分布的配置公平性较好,但人力资源的职称、学历等构成及分布仍需优化调整。     

北京某郊区县卫生防疫系统现况调查

目的了解基层卫生防疫系统的现状，为完善卫生防疫体系以应对今后可能的突发公共卫生事件提供依据。方法采用机构考察、个人访谈、问卷调查等定性与定量研究相结合的方法，于2003年5—6月，对北京市某郊区县疾病控制中心(CDC)及17所乡级卫生院的卫生防疫系统现状进行调查。结果防保科承担本辖区内的儿童保健、计划免疫、精神卫生、传染病防治、流行病学调查、卫生宣教等日常工作；防保人员70％左右的工资需单位自筹。防保人员占总业务人员比例5％及以下的占41．2％；各乡卫生院防保人员占服务人口的比例为平原乡平均1．7人／万人，少或半山乡1．6人／万人，山区乡2．6人／万人；平原乡防保人员年纪轻、学历高、多受过相关专业训练．山区乡防保人员年龄偏大、均为中专学历，57．1％为非预防医学专业毕业、42．9％为非医学专业毕业人员经培训后从事防保工作。结论该地需要进一步明确区、乡两级预防保健系统的职能，工作中急需得到政府部门的理解与配合；区、乡两级预防保健系统资金及防保人员不足、专业人才匮乏问题有待解决。     

安徽省乡镇卫生院卫技人员专业结构与质量的研究报告

该研究抽样调查了安徽省５７８所乡镇卫生院。卫技人员占职工总数８９．０％：中西师（士）占３７．８％、检验占４．７％、放射占３．６％，均基本达到一级医院基本标准。但医护之比＝１∶０．４，严重失调、卫技人员质量低下，无专业学历者占３９．７％，其中３５岁以下占４８．７％，医生中具有大专及以上学历仅占１１．７％，无专业学历占３１．９％；师级以上技术职务中不具备大专及以上学历占８４．２％，在士级不具备中专学历的占２６．３％。预测将有６０．３％的卫技人员需要接受正规化、系统化教育。防保人员每院２．８人，但分布不均，仅有４８．５％乡镇卫生院拥有专职防疫人员，无专业学历占４４．８％，明显低于其他类别卫技人员。该研究认为，要把医学教育重点放到乡镇卫生院在岗人员的培训上，采用“学历教育与专业证书教育”并重策略；调整医护比例，调整专业结构；发展合作医疗制度，理顺卫生体制与运行机制，使农村卫生人力开发与卫生系统之间协调发展。     

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.     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

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.     

Fatigue and health in a seafaring population

Background Occupational fatigue is relatively common withinthe general population and has been linked to reduced performance,injury and longer term ill-health. Despite growing acknowledgementof this problem in the maritime sector, little research hasbeen conducted into the risk factors, prevalence and consequencesof seafarers' fatigue. Aims To examine the prevalence of fatigue among seafarers, identifypotential risk factors and assess possible links with poor performanceand ill-health. Methods Cross-sectional questionnaire survey of seafarers workingin the offshore oil support, short-sea and deep-sea shippingindustries. A number of tools were used including the fatiguesubscale of the profile of fatigue-related symptoms, the CognitiveFailures Questionnaire, the General Health Questionnaire andthe SF36 General Health scale. Results In all, 1855 questionnaires were completed giving anoverall response rate of 20%. Fatigue symptoms were associatedwith a range of occupational and environmental factors, manyunique to seafaring. Reporting a greater number of risk factorswas associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35)for those with three or four risk factors and OR = 9.54 (6.95–13.09)for those with five or more risk factors]. There was also astrong link between fatigue and poorer cognitive and healthoutcomes, with fatigue the most important of a number of riskfactors, accounting for 10–14% of the variance. Conclusions Seafarers' fatigue could impact on safety withinthe industry and may be linked to longer term individual ill-health.It can only be addressed by considering how multiple factorscombine to contribute to fatigue.     

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.     

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.     

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.