军队医院医务工作者潜在的心理问题及影响因素分析*

摘要目的：近年来医务人员工作压力过重而引起的心理疾病日益突出,引起社会各界的关注。本研究针对军队医院医务人员的 心理压力及工作满意度情况展开调查,分析影响该群体心理健康的因素,探讨改善心理环境的有效方法,为提升军队医院管理提 供参考。方法：对我院312 名医务人员的基本资料、心理应激及工作满意度情况进行问卷调查,分析影响军队医院医务人员心理 健康的危险因素。结果：医务人员的心理压力主要表现为焦虑、抑郁、敏感和偏执,工作中普遍不满的是工资福利、工作负荷、晋升 及人际关系。医务人员所处的岗位和职称等级不同,其心理压力与工作满意度也不同。临床医师与护理人员的心理压力均较高, 医技与行政人员的工作满意度较高(P<0.05);初级职称与中级职称医务人员的心理压力较高,副高级职称与高级职称人员的工作 满意度较高,组间数据比较差异显著(P<0.05)。结论：军队医院的管理人员应完善管理机制,创造良好的发展平台,改善军队医院 医务人员的心理环境,促进医院的发展。     

紫苏对医院绿地土真菌群落组成及生态功能群结构的影响

医院绿地土壤是医院人体病原真菌或潜在人体病原真菌重要的物种储存库.这些携带真菌孢子的土粒和灰尘在空气中的传播增加了医院院内真菌感染的风险,已成为一个日趋严重的公共卫生问题.现研究表明,不少高等植物,尤其是药用植物具很强的抗真菌特性.基于高通量测序及模拟盆栽试验,本研究观察了种植药用植物紫苏Perilla frutesc...     

新疆拟橙衣属地衣研究

报道新疆拟橙衣属地衣的6个分类单位。其中南方拟橙衣Fulgensia australis,荒漠拟橙衣F.desertorum和苔生拟橙衣F.schistidii为中国新记录种。在形态学、解剖学、化学及生态学方面对它们进行了简短的论述。此外,还提供了形态特征和内部解剖特征照片以及新疆种类的分种检索表。研究所用的标本采自托木尔峰、铁力买提达坂、阿尔金山和准葛尔盆地等,保存于新疆大学生命科学与技术学院地衣标本室。     

Factors influencing eating ability of old in-patients in a rehabilitation hospital in Japan

Objectives: This study was designed to determine the factors influencing eating ability of old in‐patients in a rehabilitation hospital. Design: Cross‐sectional investigation. Setting: Forty‐six in‐patients in the rehabilitation ward of Hashimoto Hospital in Kagawa Prefecture in Japan were investigated using a multi‐disciplinary approach. Main outcome measures: Age, gender, state of dentition, muscle activity of lip, cheek and tongue, biting force, salivary flow rate per a minute (SFR), masticatory ability for gummy jelly, swallowing ability, texture of meal, independency of walking (Functional Independence Measure=FIM) and ability to communicate. Results: Bivariate analysis for the relationship between surveyed items and masticatory ability (chi‐square test) identified that better masticatory ability for gummy jelly was associated with age (<85 years), gender (male), state of dentition (dentate), SFR (high), activity of lip (good), biting force (high), swallowing ability (good) and activity of communication (high). Among these items, SFR (p=0.001), gender (p=0.004), ability to communicate (p=0.005) and age (p=0.012) were found having an influence on the masticatory ability (logistic regression analysis). On the other hand, age (<85years), gender (male), SFR (high), activity of lip (good), activity of cheek (good), biting force (high), masticatory ability (good) and swallowing ability (good) had a relationship with normal texture of meal. In regression analysis, only two items, activity of lip (p=0.003) and swallowing ability (p=0.024) emerged as factors on texture of meal. Conclusions: Masticatory ability for gummy jelly was influenced by cognitive function and was excluded from the factors on the state of meal. These results suggested the limitation of evaluation using test food, so dentists should observe eating behaviour of in‐patients. In addition, dentists should pay attention to the activity of the lip and swallowing ability as well as dentition and prostheses in the rehabilitation of eating ability. As SFR was the most significant factor on masticatory ability, this emphasizes the necessity of care for dry mouth caused by side effects of multi‐medication     

Exposing hidden endemism in a Neotropical forest raptor using citizen science

Gaps in our knowledge of the geographical distribution of species represent a fundamental challenge to biogeographers and conservation biologists alike, and are particularly pervasive in the tropics. Here we highlight the case of the Rufous‐thighed Kite Harpagus diodon, a South American raptor commonly mapped as resident across half the continent. Recent observations at migration watch points have indicated it may be partially migratory in the southernmost parts of its range. To investigate this possibility, we collated contemporary and historical specimen records, published sight records and ‘digital vouchers’ – photographs and sound‐recordings archived online (from citizen science initiatives) – and explored the spatiotemporal distribution of records. We were unable to trace any documented records of this species from Amazonia during the austral summer (October–March), or records from the Atlantic Forest biome during the peak of the Austral winter (June–August), and all proven breeding records stem from the Atlantic Forest region. We compared this pattern with that of a ‘control’ species, the congeneric Double‐toothed Kite H. bidentatus, again using specimens and digital vouchers. For this species we found no evidence of seasonality between biomes and can disregard spatiotemporal variation in observer effort as a cause of seasonal biases. We consider that all populations of Rufous‐thighed Kites are fully migratory, wintering in Equatorial forests in the Amazonian basin. We provide evidence that this pattern was previously obscured by erroneous undocumented records and poor or erroneous specimen metadata, and its discovery was primarily facilitated by digital vouchers. This discovery requires a reassessment of the species’ global conservation status as an Atlantic Forest breeding endemic, threatened by habitat loss and degradation, as it was previously considered to be resident across large swathes of undisturbed Amazonian Forest on the Guiana Shield. The bulk of the digital voucher data used to elucidate this pattern were extracted from a Brazilian citizen science initiative WikiAves, which may serve as a model for collating biodiversity data in megadiverse countries and help catalyse environmental awareness.     

卫生信息化背景下电子健康档案建设的法律思考

在卫生信息化日快速发展的背景下, 电子健康档案日益被重视并开始逐步推广,但是其中存在的法律问题也同时显现。在分析我国电子健康档案信息安全的基础上,对电子健康档案的法律地位、患者的隐私权、医师注意义务以及政府的公共行政权利等方面进行了探讨。     

工作月报制在现代医疗管理中的应用与探索

“痕迹管理”是现代医院管理工作客观要求,北京大学第一医院建立了医疗管理工作月度报告制度,以《医疗管理工作日度报告》为载体,加强医疗管理处室内部组织以及医疗管理团队间的协作,提升了医院医疗管理水平。     

贵州发现毛翼管鼻蝠和华南菊头蝠及其回声定位声波特征

2017年5月分别在贵州省兴义市和安龙县用雾网采集到1只大体型雌性管鼻蝠和2只小体型雄性菊头蝠,经鉴定为毛翼管鼻蝠(Harpiocephalus harpia)和华南菊头蝠(Rhinolophus huananus),属贵州省翼手目新分布记录。所采集的毛翼管鼻蝠雌性个体可能为怀孕个体,故测量相关数据并鉴定后原地放归野外。华南菊头蝠标本保存于东北师范大学环境学院。毛翼管鼻蝠(1♀):鼻部呈短管状,全身被毛厚密而柔软,后足、翼膜和尾膜均被覆黄褐色绒毛;体重14.01 g,前臂长48.23 mm;回声定位声波为调频(FM)型,静止状态下声波峰频为(56.04±4.52)k Hz。华南菊头蝠(2♂):耳大,对耳屏相对较小;鼻叶之蹄状叶宽大,完全覆盖吻部;鞍状叶小,其高略超过其宽,近乎矩形;体毛烟褐色;2只样本体重分别为4.52 g、4.12 g,前臂长40.70 mm、40.00 mm;头骨狭长,颅全长16.35 mm、16.46 mm,颅宽8.11 mm、8.14 mm;回声定位声波属调频-恒频-调频(FM-CF-FM)型,静止状态下峰频分别为(68.48±0.08)k Hz、(67.18±0.06)k Hz。2种蝙蝠物种在贵州省为首次发现,扩大了其在国内的分布范围,丰富了生态资料,为进一步的研究和保护提供了基础资料。     

A Revision of South American Austroperlidae (Plecoptera)

The South American Austroperlidae are revised. Klapopteryx kuscheli and Penturoperla barbata are redescribed. The male and nymph of K. armillata are described and figured for the first time and the female genitalia redescribed. K. costalis is declared a junior synonym of K. armillata. K. barilochensis is transferred to Andesobius new genus and redescribed. New family and generic diagnoses and keys to genera and species are given.     

Spatio-temporal analysis of infra-specific genetic variations among a Pseudomonas aeruginosa water network hospital population: invasion and selection of clonal complexes

Aims: To investigate infra-specific spatio-temporal dynamics of a hospital water network Pseudomonas aeruginosa population. To infer the origin of water network isolates and assess their potential health hazard. Methods and Results: 168 P. aeruginosa strains were isolated from tap waters and swabs of tap nozzle aerators of a hospital unit, over 2 years, and from rectal swabs and nosocomial infections. Genetic diversity among this collection was assessed by pulsed field gel electrophoresis of SpeI restricted genomic DNA. Virulence gene sets, biofilm properties, and hypochlorite resistance were analysed. Exactly 68% of the water samples and 74% of the tap nozzle aerators harboured P. aeruginosa. The strains were divided into 22 clonal lineages, with one dominant clone shown to have been involved in a nosocomial infection. Conclusions: An important turnover among the P. aeruginosa hospital population was observed. Some clonal lineages were found to persist, spread in the unit, and diversify into clonal complexes. Rectal carriage appeared an important source of contamination of the water network. Significance and Impact of the Study: High P. aeruginosa infra-specific population diversity suggested a broad ability in colonizing water networks but persistence analysis indicated a strong selection leading to the emergence of dominant clones.