图书馆伦理建设的制度安排

分析图书馆制度安排对图书馆伦理建设的重要意义,以及当前我国图书馆伦理建设制度安排中存在的制度缺位、制度虚设和伦理功能不够协调等问题,提出图书馆制度安排应坚持人文化、公正、权益、系统化和可操作性等基本原则。     

中国六城市烟草广告及促销手段相关因素分析

目的 了解中国城市烟草广告、促销现状以及相关因素.方法 在北京、上海、沈阳、长沙、广州和银川6个城市,采用累计概率比例抽样和简单随机抽样方法,对4815名18岁以上的吸烟者进行问卷调查.结果 烟草广告覆盖吸烟人群最广的2种途径分别为广告牌(35.6%)、电视(34.4%).商家最爱使用的促销手段是赠送礼品(23.1%),其次为赠送香烟(13.9%).长沙市的吸烟者通过广告牌(X2=562.474,P<0.001)以及电视(X2=265.570,P<0.001)途径获取烟草广告的比例较高.长沙市吸烟者中可看到烟草相关新闻的比例较高(X2=58.314,P<0.001).多因素logistic同归分析结果显示,生活所在城市及学历情况与"使想吸烟事物"的关注度有关.结论 中国城市烟草制品广告及促销活动较为普遍,各地控烟法律法规执行效果不一,尽快完善并统一相关立法势在必行.     

《军队医疗机构电子病历管理办法》相关问题的处理

军队医院全面运行医院信息系统已有10多年历史,电子病历更是得到了长足发展。但相关的规章制度并没有及时作出调整。因此,建立电子病历应用管理规范成为军队医院信息化发展和医疗管理的迫切要求。在此背景下。总后卫生部组织制订了《军队医疗机构电子病历管理办法》并已发布实施;介绍了该管理办法对电子病历应用中一些具体问题的处理,以及如何进一步完善相关制度。     

抓医德建设工程 促医院全面发展

介绍了同济医院医德建设工程的内容和从抓教育、抓组织、抓制度、抓专项治理方面入手抓落实,并以“活动”为载体,促进了医院全面发展和医院综合实力提高的经验和做法。     

The single case format: Proposal for a structured message for the telematic transmission of information on individual case reports in pharmacovigilance

The development of telematic exchange of information in pharmacovigilance has as a consequence the necessary development of the messages used to transmit the information. The first of these messages is the one used to transmit information on individual case reports. Common formats exist on paper, but these have not been applied to electronic transmission. A structured message for the transmission of single case information has been developed within the ENS European research programme, by three National Pharmacovigilance administrations, and reviewed by the relevant European bodies. It has been submitted to the Western European Edifact Board MD9 for admission as an EDIFACT message, so that it will be possible to exchange information concerning these single cases, using standard EDI methodology.     

安徽省21家工业企业职业卫生现况调查与分析

目的　对我省《职业病防治法》实施后工业企业职业卫生现况进行首次基线调查。方法　分层随机选择 2 1家工业企业采用现场检查、查阅资料、询问核实情况、填写调查表的方法进行。结果　国有企业职业病防治工作开展较好 ,职业病防护设施岗位配置率 98.7% ,职业病危害因素检测合格率 74 .6 % ,均高于境外投资企业和股份制企业 ;职业卫生专业人员配置率和规章制度健全率达 4 2 .9% ;分析了存在的主要问题。结论　从加强宣传、完善制度、源头把关、规范行为、以点带面、加大监督力度等方面提出了措施和意见 ,以提高工业企业职业卫生的水平和质量 ;特别要重视境外投资企业的职业卫生工作。     

Appropriate working hours for surgical training according to Australasian trainees

Background: The demands of surgical training, learning and service delivery compete with the need to minimize fatigue and maintain an acceptable lifestyle. The optimal balance of working hours is uncertain. This study aimed to define the appropriate hours to meet these requirements according to trainees. Methods: All Australian and New Zealand surgical trainees were surveyed. Roster structures, weekly working hours and weekly ‘sleep loss hours’ (<8 per night) because of 24‐h calls were defined. These work practices were then correlated with sufficiency of training time, time for study, fatigue and its impacts, and work–life balance preferences. Multivariate and univariate analyses were performed. Results: The response rate was 55.3% with responders representative of the total trainee body. Trainees who worked median 60 h/week (interquartile range: 55–65) considered their work hours to be appropriate for ‘technical’ and ‘non‐technical’ training needs compared with 55 h/week (interquartile range: 50–60) regarded as appropriate for study/research needs. Working ≥65 h/week, or accruing ≥5.5 weekly ‘sleep loss hours’, was associated with increased fatigue, reduced ability to study, more frequent dozing while driving and impaired concentration at work. Trainees who considered they had an appropriate work–life balance worked median 55 h/week. Conclusions: Approximately, 60 h/week proved an appropriate balance of working hours for surgical training, although study and lifestyle demands are better met at around 55 h/week. Sleep loss is an important determinant of fatigue and its impacts, and work hours should not be considered in isolation.     

The Artificial Pancreas on the Threshold of Ambulatory Use: Setting the Stage for a Critical Transition: Artificial Pancreas: Model Predictive Control Design from Clinical Experience

Background

The objective of this research is to develop a new artificial pancreas that takes into account the experience accumulated during more than 5000 h of closed-loop control in several clinical research centers. The main objective is to reduce the mean glucose value without exacerbating hypo phenomena. Controller design and in silico testing were performed on a new virtual population of the University of Virginia/Padova simulator.

Methods

A new sensor model was developed based on the Comparison of Two Artificial Pancreas Systems for Closed-Loop Blood Glucose Control versus Open-Loop Control in Patients with Type 1 Diabetes trial AP@home data. The Kalman filter incorporated in the controller has been tuned using plasma and pump insulin as well as plasma and continuous glucose monitoring measures collected in clinical research centers. New constraints describing clinical knowledge not incorporated in the simulator but very critical in real patients (e.g., pump shutoff) have been introduced. The proposed model predictive control (MPC) is characterized by a low computational burden and memory requirements, and it is ready for an embedded implementation.

Results

The new MPC was tested with an intensive simulation study on the University of Virginia/Padova simulator equipped with a new virtual population. It was also used in some preliminary outpatient pilot trials. The obtained results are very promising in terms of mean glucose and number of patients in the critical zone of the control variability grid analysis.

Conclusions

The proposed MPC improves on the performance of a previous controller already tested in several experiments in the AP@home and JDRF projects. This algorithm complemented with a safety supervision module is a significant step toward deploying artificial pancreases into outpatient environments for extended periods of time.J Diabetes Sci Technol 2013;7(6):1470-1483     

The practice of occupational and environmental health in Belgium

Occupational medicine and occupational health regulations in Belgium are succinctly presented. Since 1970 a minimum level of appropriate training has been required for conferral of a certificate in occupational medicine. At some universities this training is integrated into a larger programme which meets the requirements of EEC Directive 89/594. The current Belgian legislation relating to the prevention of occupational diseases and injuries is detailed in the Règlement pour la Protection du Travail, first published in 1946 and constantly updated. The occupational physician is supposed to provide advice on the risks to which workers are exposed and the adaptation of working conditions in accordance with the state of health or the abilities of the worker. Employers are obliged by law to cover the risks of accident by subscribing to a private insurance policy which covers any related costs. They also contribute financially to the Fonds des Accidents du Travail (Occupational Accidents Fund) and the Fonds des Maladies Professionnelles (Occupational Diseases Fund). Occupational diseases are recognised and may be financially compensated by the Fonds des Maladies Professionnelles.