贵州省县级疾控机构人力资源现状及公平性分析

目的 分析贵州省县级疾控中心（以下简称“县级疾控”）现有人力资源现状及公平性,为疾控人才队伍建设提供参考依据。方法 采用多阶段分层随机抽样的方法,抽取贵州省18所县级疾控,通过调查表收集机构编制和人员数量、职称、学历等情况,用构成比对卫生资源配置情况进行描述性分析;运用洛伦兹曲线和基尼系数从人口/面积/经济维度对卫生资源配置的公平性进行分析。结果 贵州省被调查县级疾控每万人实有编制0.97个;每万人常住人口拥有在编疾控人员0.84人;学历以本科为主（43.71%）;职称以初级及以下职称为主（71.01%）;不同地区间人员在编情况（χ²= 30.143,P＜0.001）、性别（χ²= 24.248,P＜0.001）、年龄（χ²= 25.896,P = 0.004）、职称（χ² = 26.952,P = 0.001）、学历（χ²= 32.874,P＜0.001）和专业（χ²= 109.208,P＜0.001）分布差异有统计学意义（P＜0.05）。编制、在职人员及在编人员按人口、面积配置公平性相对较好,按经济配置公平性有待进一步提高。结论 政府应加大对疾控的经费和政策支持,完善人才准入机制和培养机制,提高疾控人员待遇;在进行疾控人力资源配置时,应综合考虑人口、地理面积和经济3个方面,以促进疾控人员配置更加公平和合理。     

罗湖区疾控中心2011—2020年人力资源发展状况分析

目的 以深圳市罗湖区为例,通过对2011—2020年罗湖区疾控中心人力资源发展状况进行分析,为进一步提高区级疾控中心人才队伍建设水平提出建议。方法 本研究系统整理分析2011—2020年罗湖区疾控中心人员数量、人员类型、性别比例、专业、年龄、学历、职称等情况,并进行汇总分析,结合服务人口、检验检测工作量等研究区级疾控中心人力资源发展状况,用Excel 2013软件建立历年人力资源数据库,使用SPSS 18.0软件进行统计学分析。结果 2011—2020年罗湖区疾控中心工作人员数与年份之间的相关性无统计学意义(r=0.433,P=0.211),检验检测人均工作量与年份之间呈正相关(r=0.952,P<0.001),性别比例与年份之间的关联无统计学意义(χ_线性趋势²=1.568,P=0.210),年龄分组人员比例与年份之间存在显著性关联(χ_线性趋势²=14.382,P<0.001),学历分组人员比例与年份之间存在显著性关联(χ_线性趋势²=24.09...     

中老年慢性病患者卫生服务利用影响因素分析——基于CHARLS数据实证分析

目的 分析中老年慢性病患者卫生服务利用及其影响因素,为其制定个性化医疗服务提供依据。方法 使用2018年中国健康与养老追踪调查数据(China Health and Retirement Longitudinal Study,CHARLS),以Anderson模型为理论框架,采用χ²检验和两部模型对卫生服务利用影响因素进行实证分析。结果 在6 227例中老年慢性病患者中,最近一个月利用门诊服务的患者占比22.90%,最近一年接受过住院服务的患者占比26.19%。不同年龄(χ²=11.543,P<0.01)、慢性病数量(χ²=35.007,P<0.001)、自评健康水平(χ²=123.305,P<0.001)、吸烟(χ²=8.637,P<0.01)在门诊服务利用方面的差异具有统计学意义。不同性别(χ²=20.773,P<0.001)、年龄(χ²=101.908,P<0.001)、居住地(χ^2...     

陕西省男男同性性行为人群HIV暴露前预防知识知晓及用药意愿调查

目的 调查分析陕西省男男同性性行为人群(men who have sex with men, MSM)对人类免疫缺陷病毒(human immunodeficiency virus,HIV)暴露前预防用药(pre-exposure prophylaxis,PrEP)的知晓情况和用药意愿。方法 采用横断面调查方法，2021年6—12月采用网络填写问卷的方法对陕西省MSM状况进行问卷调查并分析。结果 共获得有效问卷820份。PrEP知识知晓率为54.88%，陕西省不同学历(χ²=29.188, P<0.01)、婚姻状态(χ²=11.984, P=0.017)、性取向(χ²=9.460, P<0.01)、性伴类别(χ²=17.530, P<0.01)、与性伴的安全套使用情况(χ²=12.220, P<0.01)的MSM之间PrEP知识知晓率差异有统计学意义。PrEP使用意愿为47.56%，不同学历(χ²=11.083,P=0.011)、职业...     

某医院工作人员职业性伤害现况分析

调查毕节市某三甲医院工作人员职业性伤害现况。制定《职业暴露报告登记表》,收集2017年1月-2021年12月工作人员职业暴露资料,共176人次,采用χ²检验、连续性校正的χ²检验进行分析。结果显示,职业暴露方式以锐器伤为主,发生锐器伤的主要部位是手,非锐器伤的主要部位是眼(χ²=58.874,P<0.01);不同职业类别人员发生锐器伤的构成比以医生、护士和实习生为主(χ²=14.286,P<0.01);不同职称人员发生锐器伤的构成比以初级以下职称人员为主(χ²=9.140,P<0.05);不同年龄发生锐器伤的构成比以≤25岁人员为主(χ²=26.767,P<0.01);不同性别人员发生锐器伤的构成比以女性为主(χ²=8.062,P<0.01);职业暴露环节以手术过程发生最多(χ²=83.447,P<0.01);职业暴露的场所以病房为主(χ²=168.571...     

2017-2021年连云港市职业健康检查结果分析

对2017-2021年连云港市职业病监测数据进行收集分析,为制定连云港市职业病防治策略提供科学依据。结果显示,5年间开展职业健康检查的企业数不断增多,粉尘危害企业所占比重最大。上岗前职业禁忌证检出率分别为0、1.56%、2.64%、4.57%、3.26%,呈逐年增长趋势(χ²趋势=13.710,P<0.01),差异有统计学意义(χ²=100.552,P<0.01);在岗期间职业健康检查职业禁忌证检出率分别为0、1.56%、2.64%、4.57%、3.26%,呈逐年增长趋势(χ²趋势=116.047,P<0.01),差异有统计学意义(χ²=129.248,P<0.01),2019-2021年疑似职业病检出率分别为0.01%、0.04%、0.1%,呈逐年增长趋势(χ²趋势=24.353,P<0.01),差异有统计学意义(χ²=30.995,P<0.01)。接触不同职业病危害因素劳动者职业禁忌证检出率前三位分别为噪声2.10%...     

深圳市疾控系统新型冠状病毒肺炎应急防控人力资源分析

目的 了解深圳市疾控系统的新型冠状病毒肺炎（新冠肺炎）疫情防控的人力资源配置现状。方法 收集深圳市、区2级疾控中心的人员信息,对应急防控相关人员的数量和质量现状进行统计描述与分析。结果 深圳市、区2级疾控中心在编人员共855名,实际在岗人数共1 408名,共计937（占66.5%）人参与新冠肺炎疫情防控。疫情发生后,应急防控相关人员中的公共卫生专业人员占比大幅提高（从40.9%提高至48.8%）;市、区对比发现,市疾控中心的人员编制比例、参与新冠肺炎疫情防控的人员素质构成高于区级疾控中心。结论 深圳市疾控系统新冠肺炎疫情防控人力投入占比不低于66.5%,市、区2级疫情应急防控人员构成存在一定差异。建议建立和完善公共卫生应急人力资源配置机制,充实专业技术人员,最终形成长效发展的疾控机构人力资源建设机制。     

福州市区县级疾控机构基础建设和人力资源状况比较分析

目的 评价福州市区县级疾病预防控制体系基础建设和人力资源状况。方法 2020 年 5—7 月调查福州市区县级 12 家疾病预防控制机构的基础设施和人员。结果 各区县级疾病预防控制机构应配备用房建筑面积为 48 750 m²,现有建筑面积 35 252 m²,平均建筑面积 2 937.65 m²,总达标比例为 72.31%,实验室占建筑面积比例为 28.33%,五区实验室面积比例高于七县,差异有统计学意义(χ²=399.97,P < 0.01)。共有核编人员 473 人,在岗人员 415 人,在岗比例为 87.74%。按照人口计算每 10 万常住人口疾病预防控制机构核编人数仅为 7.14 人。五区核编人员比例高于七县,差异有统计学意义(χ²=7.95,P < 0.01),七县专技人员比例高于五区,差异有统计学意义(χ²=44.39,P < 0.01),五区和七县人员职称比例和学历比例差异有统计学意义(P < 0.01)。结论 当前...     

吉林省西部重点地区2020年华支睾吸虫病感染状况分析

目的 对2020年吉林省西部重点地区人群华支睾吸虫感染情况进行分析,为下一阶段制订华支睾吸虫病防治措施提供科学依据。方法 选取吉林省西部地区华支睾吸虫感染率较高的县(市、区)作为华支睾吸虫病监测点,对人群感染情况、中间宿主和保虫宿主感染情况进行检测和分析。结果 2020年,吉林省西部重点地区镇赉县、大安市、扶余市、前郭县、松原市宁江区5个监测点共检查5 000人,华支睾吸虫感染人数416人,平均感染率为8.32%。其中,镇赉县、扶余市两个地区感染率达10%以上,其他地区感染率由高到低分别为大安市、宁江区、前郭县,差异有统计学意义(χ²=184.05,P<0.01)。男性感染率高于女性,差异有统计学意义(χ²=17.36,P<0.01),职业分布以农牧民为主,各职业间差异有统计学意义(χ²=28.66,P<0.01),高年龄组人群感染率高于低年龄组人群,各年龄组间差异有统计学意义(χ²=39.48,P<0.01)。初中学历人群感染率最高,各组间差异有统计学意义(χ^2<...     

2017—2021年上海市奉贤区养老机构消毒质量监测分析

【目的】了解上海市奉贤区养老机构消毒工作质量，为养老机构消毒与感染控制工作提供依据。【方法】2017—2021年选择奉贤区54家养老机构开展消毒质量监测，采集室内空气、物体表面、餐饮具及工作人员手，开展菌落总数和大肠菌群检测，评价养老机构消毒效果。【结果】2017—2021年奉贤区养老机构消毒合格率为84.85%～100.00%，不同年份消毒质量监测的总体合格率差异有统计学意义(χ²=51.73,P<0.01)。不同类型的养老机构中乡镇敬老院消毒合格率最低，为88.80%，不同类型养老机构消毒合格率差异有统计学意义(χ²=25.83,P<0.01)。养老机构室内空气消毒质量的合格率为100%，环境物体表面、餐饮具、工作人员手的消毒合格率分别为93.21%、92.59%及86.73%(χ²=22.97,P<0.01)；不同类型工作人员手消毒合格率为79.17%～92.71%，保洁人员和护理人员消毒合格率低于保健医生(χ²=6.53,P<0.05)；各种物体表面消毒监测结果中水龙...     

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.