公立医院改革中门诊服务中心工作探讨

我院在推行北京市公立医院改革中,按照北京市医院管理局统一安排,设置门诊服务中心。门诊服务中心通过统一标识、统一服务内容、统一服务规范,落实便民举措,优化服务流程等方法,使门诊服务得到规范化管理。门诊服务中心对初次到医院就诊的患者起到直接的指导作用,能够提高服务质量和服务水平,展现医院良好服务形象,提升患者就医感受。     

北京市医院管理局首试“公立医院托管”改革试点

继去年备受关注的"医药分开"等公立医院改革试点之后,今年北京市医院管理局认真贯彻国家及北京市医改精神,在深入探索基础上再推新举,"公立医院托管"改革试点开始实施。     

公立医院治理结构中医院经营者代理问题的博弈分析

公立医院治理结构中存在经营者代理问题,在分析公立医院经营者代理问题产生原因的基础上,通过建立公立医院经营者与卫生行政部门、内部监督组织的博弈模型,对医院经营者是否追求医院价值最大化,以及卫生行政部门、内部监督组织是否认真监督的行为选择进行分析,求解模型的均衡条件,据此提出实现多方激励、建立纵向内部监督机制、强化信息披露等治理建议。     

加快区县级医院人才梯队建设 增强应对突发公共卫生事件能力

目的了解目前区县级医院在应对突发公共卫生事件中人才状况,分析存在的问题,从而提高应对突发事件的能力和水平。方法对区县级4家医院2012年从事突发事件管理的人员情况进行分析。结果 (1)管理人员严重不足,4所医院之间从事突发事件管理人员无统计学差异(P≥0.05)。(2)专业技术水平较低,高级职称人员为0。(3)4所医院从事突发事件管理者均为兼职,无专职人员。(4)经过专业培训的人员少,缺乏高素质的多学科复合型人才。结论应加强区县级医院公共卫生管理人才梯队建设,提高他们应对突发公共卫生事件的能力。     

公共场所从业人员沙门氏菌携带情况分析

目的掌握公共场所从业人员的沙门氏菌感染情况,为切实有效防治措施的制定提供理论依据。方法采取广东省江门市新会区2011年公共场所从业的18956名人员的肛拭子,培养并分离细菌,然后鉴定沙门氏菌。结果 18956名公共场所从业人员中检出的沙门氏菌菌株为63株,检出率最高为0.53%,检出率最低为0.13%。平均检出率为0.33%。结论广东省江门市新会区内公共场所从业人员的沙门氏菌平均检出率为0.33%,应加强管理工作,确保公共场从业人员的身体健康,降低在公共场所沙门氏菌的携带及发病情况。     

我国公立医院人力资源管理的思考

目的:伴随着我国医疗改革政策的逐步落实,我国的医疗市场将逐步呈现公立医院、民营医院及其他合资医院同时并存、相互竞争的状况。方法:就我国目前医疗市场的发展状况来看,医疗市场的竞争,从本质上来看,仍旧是人力资源的竞争,公立医院的内部人力资源能够最大限度的发挥其效能,关系到公立医院生存与发展。结果:因此本文着重指出目前公立医院人力资源管理中存在的问题及解决问题的对策。结论:以期能够对我国当前人力资源管理的加强提供一点借鉴。     

2006-2010年长葛市公共场所卫生检测结果分析

目的:了解长葛市公共场所卫生状况,提高公共场所卫生质量。方法:按照GB9663～9673-1996《公共场所卫生标准》和GB/T18204.1～30-2000《公共场所卫生标准检验方法》,对毛巾、卧具、杯具、拖鞋、美容美发工具进行检验。结果:2006年至2010年共检测公共场所用品用具3 743件,总合格率90.5%;2006年合格率最低,为86.3%。公共场所用品用具金黄色葡萄球菌、大肠菌群、细菌总数和霉菌的检测合格率分别为99.7%、99.0%、97.9%和83.5%,金黄色葡萄球菌和大肠菌群的合格率显著高于细菌总数和霉菌的合格率。结论:公共卫生场所要加强卫生监管力度,提高卫生质量。     

二陈汤对吗啡依赖小鼠位置偏爱效应的影响

目的：探讨二陈汤对吗啡诱导的小鼠条件性位置偏爱（CPP）的影响。方法：连续给予小鼠吗啡（9 mg/kg,sc,7 d）,使小鼠产生显著的条件性位置偏爱效应。将小鼠随机分为正常对照组、吗啡组、二陈汤低剂量、中剂量、高剂量五组,正常对照组注射等体积生理盐水,吗啡组注射吗啡,二陈汤组注射吗啡,同时给予三种不同剂量的二陈汤灌胃,并且检测对小鼠的奖赏效应或厌恶效应。结果：吗啡组小鼠在伴药箱中停留的时间明显延长,二陈汤可抑制吗啡引起的小鼠位置偏爱的形成。结论：二陈汤能在一定程度上抑制吗啡诱导的小鼠条件性位置偏爱效应。     

Self-consciousness as a moderator of the effect of social drinking motives on alcohol use

This study evaluated self-consciousness as a moderator of the relationship between social drinking motives and alcohol use. Participants included 243 undergraduate students who reported alcohol use, alcohol-related problems, self-consciousness, and social motives. We expected that social drinking motives, private self-consciousness, and public self-consciousness would be positively associated with drinking and that this relationship would be moderated by self-consciousness. Specifically, we expected this relationship to be stronger for people lower in private self-consciousness, based on decreased awareness about their internal states. In addition, we expected that the relationship between social motives and drinking would be stronger among those who were higher in public self-consciousness, given their focus on the self as a social object. Consistent with expectations, the associations between social motives and peak drinking and drinks per week were more strongly associated among those lower in private self-consciousness. However, inconsistent with expectations, the relationship between social motives and drinking was stronger among those who were lower, rather than higher, in public self-consciousness. Overall implications of these research findings extend previous research emphasizing the importance of considering social influences in etiology and prevention of drinking. Moreover, while social motives are a consistent predictor of drinking among young adults, this is not universally true. This study contributes to social cognitive literature seeking to understand and identify individual factors related to drinking and their application to the adaptation of existing intervention approaches.     

Public health strategies for prevention and control of HSV-2 in persons who use drugs in the United States

Background

Herpes simplex virus type 2 (HSV-2) affects HIV acquisition, transmission, and disease progression. Effective medications for genital herpes and for HIV/AIDS exist. Parenteral transmission of HIV among persons who inject drugs is decreasing. Reducing sexual transmission of HIV and HSV-2 among persons who use drugs (PWUD; i.e., heroin, cocaine, “speedball”, crack, methamphetamine through injection or non-injection) necessitates relevant services.

Methods

We reviewed HSV-2 sero-epidemiology and HSV-2/HIV associations in U.S.-based studies with PWUD and the general literature on HSV-2 prevention and treatment published between 1995 and 2012. We used the 6-factor Kass framework to assess relevant HSV-2 public health strategies and services in terms of their goals and effectiveness; identification of, and minimization of burdens and concerns; fair implementation; and fair balancing of benefits, burdens, and concerns.

Results

Eleven studies provided HSV-2 serologic test results. High HSV-2 sero-prevalence (range across studies 38–75%) and higher sero-prevalence in HIV-infected PWUD (97–100% in females; 61–74% in males) were reported. Public health strategies for HSV-2 prevention and control in PWUD can include screening or testing; knowledge of HSV-2 status and partner disclosure; education, counseling, and psychosocial risk-reduction interventions; treatment for genital herpes; and HIV antiretroviral medications for HSV-2/HIV co-infected PWUD.

Conclusions

HSV-2 sero-prevalence is high among PWUD, necessitating research on development and implementation of science-based public health interventions for HSV-2 infection and HSV-2/HIV co-infections, including research on effectiveness and cost-effectiveness of such interventions, to inform development and implementation of services for PWUD.