突发事件中成建制抽组医疗队的优越性

某联勤分部在抗击 SARS的战斗中 ,启动应急机动作战任务程序和应急机动卫勤力量抽组预案 ,从两所应急机动医院成建制抽组 ,组建小汤山医院第九、十病区。从接到军区命令后 7小时完成动员和抽组 ,4 8小时整装待发。××名医疗队员以顽强的意志 ,拚搏的精神、科学的态度和过硬的技术 ,圆满完成任务 ,被授予首都防治 SARS工作先进集体荣誉称号。分部应急机动作战部队的卫勤力量又一次经受了实战考验 ,显示了成建制抽组单位在应对突发事件中的优越性。1　用“首战用我 ,用我必胜”的精神做好成建制应急抽组的动员教育抽组命令下达后 ,某驻军…     

医疗机构名称管理刍议

目前,一些医疗机构的名称出现了混乱现象。一是以大冠小、哗众取宠。如有些单位挂出“东北××医院”、“华北××医院”、“北方××医院”、“南方××医院”的招牌。二是名实不符、“中心”繁多。技术实力和固定资产寥寥无几的小单位竟称为“××中心”,甚至一个城市、一个地区出现了好几个内容相同的中心。三是越权命名。一些非卫生行政主管部门擅自越权审批成立医疗     

一种阻断SARS传播方法及其应用效果研究

“阻断SARS传播法”是羊城铁路总公司2003年在预防和控制严重急性呼吸道综合征(severe a-cute respiratory syndrome,SARS)方面的科学总结,它运用3×3管理体系,不断地获取SARS这一全新的传染性疾病的传播特征,并采取相应的阻断措施,是推行现代化管理的创新成果。1阻断SARS传播法的含义在阻断SARS的传播中运用现代管理科学中3×3管理体系的原理和方法,由运作保障、决策牵引和激励驱动三大核心框架来完成,最大限度地提高阻断SARS传播的整体效果,控制SARS通过铁路运输传播。2采用的基本原理2.1运作保障框架的采用阻断SARS传播涉及…     

提高三级医师查房质量的探讨

在日常的医疗工作中 ,最能够反映医院医疗质量水平的是最常见的三级医师查房。笔者参加了对全国2 2所三级甲等医院创建“百佳”的验收工作 ,检查中发现所有被检医院的三级医师查房质量均不同程度地存在一些问题。1　存在的问题1.1　主任 (副主任 )医师查房情况查房记录中 ,内容比较单调 ,知识面不够宽 ,流于形式 ,没有反映出查房者的真实水平。多数查房记录内容苍白 ,就事论事 ,既无对所查疾病的鉴别诊断 ,又无当前国内、外对该病的最新疗法和检查手段等。最常见的是“×××主任看病人”,或“×××主任同意目前诊断及治疗”。1.2　主治医…     

运用综合指数参与医院管理

当前在社会经济开放形势要求下,医院统计管理工作逐步向多层次、多目标、系统化发展,从单纯依靠病床使用率和实际占用床日来评价医疗工作效率,用治疗有效率、病死率和出院者住院日等指标反映医疗效果,已不能综合反映医院医疗管理工作的总体水平,近年来我院运用综合指数方法参与医院统计管理工作来全面衡量医院管理水平.1 资料来源我院是所区级综合性医院,编制床位200张,在编职工360人,床位与人员之比1:1.8,资料采用1989～1993年五年统计报表.2 统计方法综合指数评价方法定量地反映多个指数的综合变动程度,对医院工作从医疗质量、工作效率、经济效益三方面系统地加以评价,计算公式为;医院工作综合指数=(医院质量指数×工作效率指数×经济效益指数)~(3/1)医疗质量指数=(入出院诊断符合率×手术前后诊断符合率×三日确诊率×治疗有效率)~(4/1)工作效率指数=(实际病床使用率/应完成床位使用率×实际病床周转次数/应完成床位周转次数×实际门诊人次/应完成门诊人次)~(3/1)式中“应完成床位使用率“、“床位周转次数”使用二级甲等医院验收标准分别为85%、年14次.     

以信息化建设促进武警部队医院全面发展

武警部队医院信息化建设以武警部队后勤信息化标准建设实施方案为指导,以提高现代化建设和卫勤保障能力为重点,以统筹规划、整体推进、突出重点、规范建设为原则,下大力解决标准规范、技术支持、队伍建设、系统应用等关键问题,全面推广应用了军字一、二号工程。目前,武警部队96%的医院应用了“军字一号工程”信息系统,建成了××个双向卫星地面站、××个单向卫星地面站、××个移动卫星地面站,部分医院建立了远程医疗会诊网,实现了卫生信息资源共享,在较短时间推动了医院信息化建设跨越式发展,为向数字化医院过渡打下了坚实的基础。     

医院信息系统下统计基础工作的质量保证

当前医院管理正从过去的经验管理向现代科学管理过渡 ,如果说医疗技术是医院赖以生存的基础 ,那么管理则是医院发展的动力。而现代科学管理的实质就是要充分发挥信息的功能和效用 ,以其为依据从事医院的医疗经营管理活动。随着科学技术的发展 ,信息高速公路的建立 ,卫生信息化建设已成为现代医院管理的重要基础工作 ,同时也是检验医院管理是否现代化的重要标志。×××工程医院信息系统ＨＩＳ(ＨｏｓｐｉｔａｌＩｎｆｏｒｍａｔｉｏｎＳｙｓｔｅｍ)的开发与应用为医院信息管理现代化奠定了基础 ,创造了条件 ,同时也对医院基础统计工作提出了…     

对一起暴力抗击食品卫生执法案的反思

1　案件简介1 999年 1 1月 1 4日福建省××市×区 5名食品卫生监督员在辖区巡回检查时 ,发现某饮食店无有效的卫生许可证 ,厨房墙壁沾满油污 ,无抽油烟机、防蝇、防尘、防鼠设施 ,也没有餐饮具消毒设备。于是决定对该店采取临时控制措施 ,限期整改。同时对该店 4种餐具进行采样检测。但该店主杨××、韩××拒绝缴纳检测费 ,并与执法人员发生冲突。在冲突中 ,韩××操起一把剔骨刀砍了监督员刘×× 2刀 ,伤及左手臂。刘××立即被送医院进行抢救 ,其伤口共缝合 30针 ,事后经当地公安局法医鉴定属轻伤。凶手被公安部门拘留并立案 ,移送当地…     

综合指数在评价县级综合医院效益中的运用

目前,医院工作的指标体系有:医疗质量、工作效率、经济效益3个体系,分别评价医院工作的3个方面,但不能全面衡量医院的管理水平。本文拟运用综合指数法来评价、衡量医院的综合管理水平。 医院工作综合指数=(医疗质量指数×工作效率指数×经济效益指数)×1/3……(1) 医疗质量指数:反映医疗质量的指标有三日确诊率、治疗有效率、死亡率、入院与出院诊断符合率、手术前后诊断符合率等,根据其具体情况,我们选用入院与出院诊断符合率、手术前后诊断符合率、3日确诊率、治疗有效率等确定医疗质量指数。     

医疗固体废物处置方法探讨与研究

目的了解我市医疗固体废物排放量,考核使用后的一次性医疗用品集中消毒的效果,评价我市医疗固体废物管理试点工作. 方法对杭州市部分医院的医疗固体废物排放量进行跟踪调查;采用环氧乙烷(EO)对使用后的一次性医疗物品进行集中消毒处理,并进行效果监测,开展医疗固体废物管理试点工作,进一步规范SARS固体废物的管理. 结果杭州市医疗单位医疗固体废物的平均排放量为每日0.64kg/床;对使用后的一次性医疗用品采取EO集中消毒的方法是有效的、可行的;试点医院的结果表明,标准预防、隔离转移、单位计量技术的应用,对预防医院感染发生具有积极作用,杭州市实现了SARS固体废物的零排放. 结论杭州市的医疗固体废物处置方法是有效的、可行的,建议有关部门取消一次性医疗用品后毁形、浸泡消毒和"一对一"对换的做法.     

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.     

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.