济南市农村集中式供水水质卫生状况

目的调查分析济南市农村不同集中式供水水质卫生状况。方法采用分层抽样的方法对济南市10个区县农村集中式供水工程进行基本卫生状况调查,并对2011和2012两年度丰水期和枯水期出厂水进行分析。结果农村集中式供水枯水期和丰水期合格率分别为56．79％和42．55％。浅井水、深井水、泉水和地表水枯水期合格率分别为38．64％、60．08％、23．53％和65．38％,丰水期合格率分别为20．45％、45．64％、27．27％和57．69％,枯水期和丰水期不同水源合格率总体上差异有统计学意义（P〈0．05）。菌落总数、大肠菌群是影响济南市农村饮用水水质的主要指标,硝酸盐和氟化物分别是浅井水和深井水的主要超标指标。水样经消毒处理和不经消毒处理的微生物合格率分别为56．9％和75．0％（X^2=36．37,P=0．000）。结论济南市农村集中式供水卫生状况较差,需进一步完善。     

商丘市无烟医疗卫生机构创建工作调查

目的了解商丘市创建无烟医疗卫生机构情况,了解医务人员、疾控人员吸烟情况,为进一步加强控烟工作提供依据。方法采用暗访和座谈相结合的方法对无烟医疗卫生机构创建情况进行调查;对医务人员、疾控人员吸烟情况调查采用调查问卷的方法。调查问卷采用商丘市疾控中心制定的《医务人员吸烟情况调查表》。结果 38家医疗卫生机构均设置有禁烟标志,37家机构张贴有控烟海报、标语或设置了宣传栏,26家机构设置了室外吸烟区,11家医疗机构设置了戒烟门诊或戒烟咨询电话,23家机构存在室内吸烟现象,15家有销售卷烟现象。调查医疗卫生工作人员556人,吸烟者141人,吸烟率25.40%,410人(73.70%)认为医务人员应该不吸烟,329人(59.20%)认为医院应设立吸烟区,在调查的人群中赞同控烟的有521人,占93.70%,不赞同控烟的有35人,占6.30%。结论商丘市医务人员吸烟率偏高,创建无烟医疗卫生机构工作需要进一步加强。     

南京市职业人群健康状况调查

目的了解南京市2家企业不同岗位职业人群健康状况,为职业人群的健康促进提供依据。方法采用分层整群随机抽样方法,从南京2家企业抽取2 141人,并按工作岗位分为行政管理、技术服务、一线工人3组。对调查人群进行问卷调查及体格检查,运用SPSS统计软件分析数据。结果被调查人群中慢性病患病率以高血压最高(32.8%),超重和肥胖分别为35.5%、10.0%,血脂异常率为11.1%。行政管理组高血压患病率、超重和肥胖者率、血脂异常率均高于其他两组职业人群(P0.05)。3组职业人群水果每日适宜摄入量比例差异有统计意义,一线工人组最低(43.0%)。25.4%的调查人群体育运动适量,3组差异无统计学意义。总体吸烟率为40.7%,以一线工人组最高(49.8%),3组间差异有统计学意义(P0.001)。结论高血压、超重与肥胖及血脂异常是受调查职业人群的主要健康问题,对不同岗位的职业人群应采取有针对性的健康干预措施。     

六安市2008～2012年城区生活饮用水监测结果分析

目的了解六安市城区生活饮用水卫生状况,为改进市政供水卫生质量和卫生监督工作提供科学依据。方法按国家标准对水样进行采集、检测和评价,对六安市城区2008~2012年生活饮用水进行抽样监测,共采集水样697份,分别对感官性状、一般化学指标、毒理学指标、微生物指标和消毒剂指标进行检测。结果六安市2008~2012年城区生活饮用水水质合格率分别为81.06%、88.64%、91.08%、93.45%、99.07%;主要不合格指标是浑浊度、硝酸盐氮、游离余氯、总大肠菌群、耐热大肠菌群等;丰水期与枯水期水质合格率差异无统计学意义（χ2=0.325,P〉0.05）;新水厂与老水厂水质合格率分别为95.90%和87.64%,差异有统计学意义（χ2=12.633,P〈0.01）。结论六安市城区生活饮用水卫生状况趋于良好,但有部分指标超标,饮用水水质存在一定卫生安全隐患,应加强对供水单位的监督管理。     

野战环境下医用x线图像数字化装备研究现状与进展

介绍了野战条件下医用x线图像数字化的主要方式,包括前数字化中的野战化改造方案以及后数字化中的扫描和摄影方式,分析了现有方案应用于野战环境时在维护成本和结构上的不足,最后根据军队的装备现状和实际需求,提出了改进的思路,为设计适用于野战应用的医用X线图像数字化系统提供了合理的依据。     

野外条件下手术物品无纺布包装的储存期限研究

目的：探讨野外自然环境下手术无菌物品无纺布包装的有效储存期限.方法：选择无纺布与棉布包装,随机分为试验组和对照组,将手术器械、物品分类包装,尖锐器械采用器械保护卡保护后进行高压灭菌,并存放在战备仓库（自然环境）,每月进行一次装载转运,进行7 d～6个月的微生物抽检.结果：无纺布包装方法在野外环境下有效期可达到5个月.结论：采用无纺布包装并使用自制的器械保护卡保护器械尖端,能有效延长野外无菌手术包的储存期限,满足野外救援装载转运需求,保证野外救援无菌物品的存储供应,提高野外救援综合能力.     

我国实施家庭医生制度支撑条件研究

建立家庭医生制度是国家新医改的重要内容,从技术、政策、经济和社会4个方面对家庭医生制度的内涵及支撑条件进行探讨,主要分析家庭医生人才队伍、社区卫生服务体系、医疗保险政策支持、转诊机制、绩效考核与激励机制、补偿机制以及社区网络支持等重要支撑条件,最终为制定适合我国目前发展情况的家庭医生制度政策提出建议,即完善家庭医生相关标准建设、加强家庭医生与辅助人员的人才队伍建设、加快信息化建设以及积极推进多部门协作。     

Mental health of patients with human immunodeficiency virus in Japan: a comparative analysis of employed and unemployed patients

In developed countries, human immunodeficiency virus (HIV) has become a chronic disease. The aims of this study were to clarify the physical, social, and psychological factors affecting Japanese HIV patients in a stable condition and to identify factors related to mental health of employed and unemployed HIV patients. The target subjects were people with HIV infection who were treated as outpatients at core hospitals for acquired immune deficiency syndrome (AIDS) treatment in Japan. A questionnaire including items from the Hospital Anxiety and Depression Scale (HADS) was sent to each medical facility with a request for participation from the HIV-infected outpatients. Responses from 1199 patients were analyzed. Mental health was reportedly better in the employed patients than in the unemployed patients. The unemployed patients were more likely to have resigned from their jobs because of poor health, to have resigned voluntarily, or to have been unfairly dismissed. Once the patients stopped working because of HIV, returning to work became difficult. In the employed patients, a good workplace environment was strongly related to lower scores on HADS. Higher HADS scores were recorded for employed patients infected with HIV for six years or more. For the unemployed patients, a relationship was observed between strong feelings of stigmatization and HADS scores. Quitting a job because of an experience related to HIV status may be related to feelings of stigmatization.     

Emergency department revisits for nontraumatic dental conditions in Massachusetts

BackgroundInadequate access to oral health care and palliative care provided in the emergency department (ED) creates a pattern of repeat nontraumatic dental condition (NTDC) ED visits. The authors examined NTDC ED revisits and assessed the determinants associated with these visits in Massachusetts.MethodsThe authors examined NTDC ED revisits in Massachusetts during 2013 using the Massachusetts All-Payer Claims Database. The authors report patient characteristics of those who made a single NTDC ED visit and of those who made NTDC ED revisits within 30 days of the index NTDC ED visit. The authors used a multilevel logistic regression model to examine the determinants associated with NTDC ED repeat visits.ResultsIn 2013, 21.5% of NTDC ED visits were revisits. Men from 26 through 35 years of age who were enrolled in Medicaid and who did not make an outpatient dental office visit within 30 days of the index NTDC ED visit had increased odds of repeat visits.ConclusionsThe sizable proportion of NTDC ED repeat visits indicates that certain patients in Massachusetts experience consistent and systematic barriers in accessing appropriate and timely oral health care.Practical ImplicationsPrioritizing young adults and Medicaid enrollees for ED diversion programs and setting up a formal referral process via connecting patients to dental offices and community health centers after an NTDC ED visit may reduce NTDC ED revisits and provide appropriate oral health care to these patients.     

Economic evaluation of meningococcal serogroup B childhood vaccination in Ontario,Canada

Objective

Invasive Neisseria meningitidis serogroup B (MenB) disease is a low incidence but severe infection (mean annual incidence 0.19/100,000/year, case fatality 11%, major long-term sequelae 10%) in Ontario, Canada. This study assesses the cost-effectiveness of a novel MenB vaccine from the Ontario healthcare payer perspective.

Methods

A Markov cohort model of invasive MenB disease based on high quality local data and data from the literature was developed. A 4-dose vaccination schedule, 97% coverage, 90% effectiveness, 66% strain coverage, 10-year duration of protection, and vaccine cost of C$75/dose were assumed. A hypothetical Ontario birth cohort (n = 150,000) was simulated to estimate expected lifetime health outcomes, quality-adjusted life years (QALYs), and costs, discounted at 5%.

Results

A MenB infant vaccination program is expected to prevent 4.6 invasive MenB disease cases over the lifetime of an Ontario birth cohort, equivalent to 10 QALYs gained. The estimated program cost of C$46.6 million per cohort (including C$318,383 for treatment of vaccine-associated adverse events) were not offset by healthcare cost savings of C$150,522 from preventing MenB cases, resulting in an incremental cost of C$4.76 million per QALY gained. Sensitivity analyses showed the findings to be robust.

Conclusions

An infant MenB vaccination program significantly exceeds commonly used cost-effectiveness thresholds and thus is unlikely to be considered economically attractive in Ontario and comparable jurisdictions.