Functional Confirmation Using a Medical X-Ray System of a Semiconductor Survey Meter

In recent years, semiconductor survey meters have been developed and are in increasing demand worldwide. This study determined if it is possible to use the X-ray system installed in each medical facility to calculate the time constant of a semiconductor survey meter and confirm the meter’s function. An additional filter was attached to the medical X-ray system to satisfy the standards of N-60 to N-120, more copper plates were added as needed, and the first and second half-value layers were calculated to enable comparisons of the facility’s X-ray system quality with the N-60 to N-120 quality values. Next, we used a medical X-ray system to measure the leakage dose and calculate the time constant of the survey meter. The functionality of the meter was then checked and compared with the energy characteristics of the meter. The experimental results showed that it was possible to use a medical X-ray system to reproduce the N-60 to N-120 radiation quality values and to calculate the time constant from the measured results, assuming actual leakage dosimetry for that radiation quality. We also found that the calibration factor was equivalent to that of the energy characteristics of the survey meter.

Interest of Systematic Chest Radiography during Periodic Medical Visits in Workers

Background: Systematic chest X-ray is the most prescribed examination by occupational physicians during periodic medical check-ups in our context, unlike in most countries where this practice has been discontinued. Objective: The objective was to determine the diagnostic yield and cost-effectiveness of chest radiography during periodic medical check-ups of workers in Ngaoundere. Materials and Methods: A cross-sectional and descriptive study was carried out in Ngaoundere Regional Hospital from January to December 2018, concerning all persons coming to perform a systematic chest X-ray in the context of the periodic medical check-up having been consented to participate in the study. Posteroanterior (PA) chest radiographs were obtained from all workers during this periodic medical check-up. The variables studied were: age, sex, clinical manifestations, antecedents, job type, cost, and chest X-ray results. Statistical analysis was performed using the Sphinx Plus2-Lexica-V5 Edition software. Results: 753 workers were selected for this study, of whom 88.04% were men and 11.96% were women, a sex ratio H/F is of 7.4, the average age was 39 ± 7.89 years with extremes of 24 and 56 years, the most frequent job type was the administration (38.37%), the storekeepers (17.92) and the drivers (15.27%), most of them were asymptomatic (97.47%), some had cough (2.52%), chest pain (2.12%), dyspnea (0.26%) and fever (0.13%). History was dominated by lung infection (2.39%), pleurisy (1.06%) and tuberculosis (0.79%). 7.43% of workers occasionally smoked tobacco and consumed alcohol. 41 cases of pathologies (5.44%) were found on the chest X-ray, including 1 case (0.13%) of evolutionary pathology, 40 cases (5.31%) of sequelae pathologies. When the results of the chest X-ray are compared with the clinical signs and the pathological history of the workers, it is found that the only case with evolutionary abnormalities on the chest X-ray showed clinical signs and that the other cases with sequelae abnormalities had either clinical signs or antecedents related to these abnormalities. The cost of a chest X-ray at the time of our study was 5,000 FCFA ($8.59), for a total of 3,765,000 FCFA ($6473.74) for all the X-rays performed. Conclusion: In view of the low rate of abnormalities on the chest X-ray and the sequelae nature of the pathologies, it can be said that the routine X-ray of the chest during the periodic medical check-ups has a low diagnostic yield and a low cost-effectiveness ratio and is not profitable. It should be non-systematic and case-by-case based on the clinical context and background of workers.

Issues concerning Migrant Workers' Participation in the New Rural Cooperative Medical System and Countermeasures——Based on the Survey in Wenjiang District and Jintang County, Chengdu City

We conduct questionnaire survey of migrant workers in Wenjiang District and Jintang County of Chengdu City,respectively,using the method of key-point investigation and the sampling survey. We describe the status quo of the sample migrant workers' participation in the New Rural Cooperative Medical System,analyze the issues concerning migrant workers' participation in the New Rural Cooperative Medical System,and put forward the countermeasures and recommendations as follows: using many types of medical insurance; establishing universal reimbursement points in strange land and premium-paying system for migrant workers; making the proportion of reimbursement open and transparent; establishing and improving medicare security system for migrant workers.

Analysis of Health Workers’ Perceptions on Medical Waste Management in Tanzanian Hospitals

This paper presents the perceptions of health workers (HWs) on medical waste management (MWM) issues in Tanzanian hospitals. The perceived total waste generation rates were lower than the actual measurements. Administrators perceived lower rates than implementers. The results indicated three categories of medical waste which are given due attention, that is, sharps waste, pathological and infectious waste. Other wastes like radioactive, chemical, pharmaceutical, pressurized containers receive very little attention. Container colour coding and labelling was negligible, while improvised containers are still in use. Medical waste is transported within hospitals manually, with little efforts on mechanized transportation. Poor waste storage was observed, while the prominent medical waste treatment technologies are medium temperature incinerators. Off-site transportation of medical waste is practiced, where the waste is finally dumped or buried. The hospitals are currently utilizing public-private partnership schemes for MWM in only one aspect of off-site transportation. Three main problems which require high attention include: Weaknesses in hospital management, poor MWM infrastructure, and lack of skills and knowledge on MWM among HWs. Knowledge and awareness among HWs on health hazards associated with poor MWM is low (with exception of cholera, HIV and typhoid). Few PPE types are supplied and used in the hospitals, leading to poor diseases prevention. There is also low knowledge among HWs on administrative issues related to MWM in Tanzanian hospitals.

Investigation and Countermeasures of Medical Staff’s Demand for Nursing Workers in Chifeng

In order to understand the current demand of the medical staffs for nursing workers in Chifeng and to explore the practical management mode of nursing workers,150 doctors and nurses were randomly selected from general tertiary hospitals in Chifeng to participate in a questionnaire survey.The objective of this study was to investigate the demand of nursing workers in tertiary hospitals in Chifeng and the satisfaction of medical staffs toward the existing nursing work.The results of the investigation were analyzed to provide countermeasures and suggestions for the nursing work in Chifeng.

Non-equilibrium Analysis of Migrant Workers ' Medical Insurance System under the Background of Citizenization

The participation of migrant workers in medical insurance of urban workers is a formal institutional arrangement. However,in reality,the insurance participation rate of migrant workers is low and the medical insurance taken by the migrant workers is not sufficient,which seriously hinders the process of the citizenization of migrant workers. The main reason lies in the unbalanced supply and demand of the current system. With the continuous advancement of the citizenization process,the rural migrant workers' demand for medical insurance has changed.However,our research found that the supply of medical insurance system for migrant workers is seriously inadequate,the system and the institutional environment are disconnected,the internal contradictions of the system are increasing,and a large amount of potential profits are accumulated under the current system. Potential profit is the motive force to promote institutional innovation and promote the reform of current system to strike a balance.

Medical assistance in fighting against COVID-19 in Wuhan,China:A frontline nurse’s experience and lessons learned

This article shared personal experiences of encountering challenges during the work at the frontline fighting against COVID-19 in Wuhan,China,and found solutions and suggestions to overcome the challenges during the period,including solutions to address challenges encountered during work,suggestions for smooth communication among different parties,and suggestions for optimizing work regulations and workflow and establishing behavior habits and professional knowledge and practices.These experiences would be helpful for health‑care workers to fight against the pandemic.

Efficient Deep-Learning-Based Autoencoder Denoising Approach for Medical Image Diagnosis

Effective medical diagnosis is dramatically expensive,especially in third-world countries.One of the common diseases is pneumonia,and because of the remarkable similarity between its types and the limited number of medical images for recent diseases related to pneumonia,themedical diagnosis of these diseases is a significant challenge.Hence,transfer learning represents a promising solution in transferring knowledge from generic tasks to specific tasks.Unfortunately,experimentation and utilization of different models of transfer learning do not achieve satisfactory results.In this study,we suggest the implementation of an automatic detectionmodel,namelyCADTra,to efficiently diagnose pneumonia-related diseases.This model is based on classification,denoising autoencoder,and transfer learning.Firstly,pre-processing is employed to prepare the medical images.It depends on an autoencoder denoising(AD)algorithm with a modified loss function depending on a Gaussian distribution for decoder output to maximize the chances for recovering inputs and clearly demonstrate their features,in order to improve the diagnosis process.Then,classification is performed using a transfer learning model and a four-layer convolution neural network(FCNN)to detect pneumonia.The proposed model supports binary classification of chest computed tomography(CT)images and multi-class classification of chest X-ray images.Finally,a comparative study is introduced for the classification performance with and without the denoising process.The proposed model achieves precisions of 98%and 99%for binary classification and multi-class classification,respectively,with the different ratios for training and testing.To demonstrate the efficiency and superiority of the proposed CADTra model,it is compared with some recent state-of-the-art CNN models.The achieved outcomes prove that the suggested model can help radiologists to detect pneumonia-related diseases and improve the diagnostic efficiency compared to the existing diagnosis models.

An Assessment of Both Patients and Medical Staff Awareness of the Risks of Ionizing Radiation from CT Scan in Cameroon

Objectives: To assess the patients and health personnel’s level of awareness on risks related to ionizing radiation during CT scan. Materials and methods: Three questionnaires were addressed to patients, prescribing physicians, and the medical imaging staff for three hospitals respectively. This permitted us to assess their knowledge on the benefits and risks of the required medical exam, based on the dangers of being exposed to X-rays, especially induced-radiation cancer following the amount of X-rays received during a CT scan and the possibility of not receiving radiation as tools of diagnosis. Results: 150 patients, 84 referring doctors of CT scan tests and 60 medical imaging personnel were retained. For patients, only 7.1% received information on the benefits and risks of their exams, and 34.4% believed that x-rays were harmful to their health. For the prescribers, 46.7% took into account the benefits/risk ratio before prescribing a test and only 16.7% of the referring doctors have informed the patient of the risks related to X-ray. 90% of the medical imaging staff ensures that the required test is justified, and 50% informed the patient on the risks associated with their radiation exposure, and the increased risk of developing cancer. 65% of the imaging staff could not estimate the dose that the patient will receive during the medical test. 25% mentioned the dose received during the acquisition in the patient’s exam report. Conclusion: This study confirms that the referring doctors, the patients, and the radiologists have a low knowledge concerning the risks associated with radiation exposure during a CT scan assessment. We will therefore say that patients and prescribers are not aware of the doses of radiation on CT and their possible risks, even though there is a risk of developing cancer.

广州市基层医务工作者工作资源对离职意愿的影响研究

目的基于资源保存理论、工作要求-工作资源理论以及自我决定理论分析工作资源对离职意愿的影响,以及要求-能力匹配的调节作用,为降低基层医务工作者的离职意愿提供实证依据。方法采用多阶段分层随机抽样法选取广州市600名基层医务工作者,利用工作资源量表、离职意愿量表和要求-能力匹配量表进行问卷调查,运用SPSS 22.0进行描述性统计、相关和多元线性回归分析。结果广州市基层医务工作者工作资源的3个维度:社会支持(β=-0.296,P=0.017)、工作控制(β=-0.392,P=0.001)和工作发展机会(β=-0.362,P=0.001)与离职意愿呈负相关;要求-能力匹配起调节作用,增强了社会支持(β=-0.211,P<0.01)、工作控制(β=-0.313,P<0.01)和工作发展机会(β=-0.158,P<0.01)与离职意愿间的负相关关系。结论基层医务工作者感知到工作资源水平越高,则离职意愿越低,要求-能力匹配起增效作用。建议提升基层医务工作者的社会支持,适度保证基层医务工作者在工作中的自主权,给予他们更多的上升通道,增加相应的培训以提升其要求-能力匹配度,从而降低其离职意愿。

行为和社会驱动因素影响医务人员疫苗态度的机理与对策研究

本文梳理了医务人员疫苗态度的现状,基于世界卫生组织推荐使用的行为和社会驱动因素(BeSD)模型以及我国实际情况构建医务人员疫苗态度和行为的决策模型,从想法和感受、现实问题、社会过程、动机方面分析医务人员接种和推荐疫苗的动因和阻碍因素,提出了增强疫苗医务人员对免疫接种的认知和信心、开展科学研究落实服务提供方的激励政策、提升疫苗及其接种服务的可及性与便利性、多举措保障医务人员与儿童家长的有效沟通等方面的对策建议。

新型冠状病毒感染疫情常态化防控背景下社区医务人员心理健康状况及影响因素分析

背景自新型冠状病毒感染(简称新冠感染)疫情发生以来,身处防控一线的社区医务人员面临着直接接触病毒的风险,存在工作强度大、工作时间长、心理压力大等问题,因此探究社区医务人员的心理健康状况及其内在联系对精准实施心理干预具有重要意义。目的了解新冠感染疫情常态化防控期间社区医务人员心理健康状况并探讨其影响因素。方法于2021年12月,采用多阶段随机抽样法,选取296名中山市社区医务人员作为调查对象,采用一般资料调查表、自行编制的社区医务人员新型冠状病毒感染疫情防控工作压力调查问卷、广泛性焦虑量表(GAD-7)和患者健康问卷抑郁症状群量表(PHQ-9)对其进行网络问卷调查,采用多因素Logistic回归分析探讨社区医务人员新冠感染疫情防控工作感知压力水平及焦虑、抑郁情绪状态存在情况的影响因素。结果中山市社区医务人员新冠感染疫情防控工作高感知压力的检出率为10.1%(30/296);中度及以上焦虑和抑郁的检出率分别为7.1%(21/296)和9.5%(28/296);性别、抑郁情绪状态存在情况和新冠感染疫情防控工作感知压力水平是社区医务人员焦虑情绪状态存在情况的影响因素(P<0.05);疫情期间从事日常诊疗工作情况、疫情期间从事“三人小组”上门排查工作情况、焦虑情绪状态存在情况和新冠感染疫情防控工作感知压力水平是社区医务人员抑郁情绪状态存在情况的影响因素(P<0.05);焦虑、抑郁情绪状态存在情况是社区医务人员新冠感染疫情防控工作感知压力水平的影响因素(P<0.05)。结论社区医务人员新冠感染疫情防控工作压力与焦虑和抑郁负性情绪之间彼此关联、相互影响、相互作用,且疫情防控工作任务与人力资源的相对不足等因素加剧了社区医务人员负性情绪的叠加效应,卫生健康行政部门应结合疫情常态化防控阶段社区卫生服务机构的发展特点及暴露出的突出问题,着力构建新形势下社区卫生服务机构的长效投入和发展机制,加强对医务人员的心理干预指导。

一线医务工作者的心理应激反应、影响因素及干预策略的研究进展:以新冠感染疫情为例

通过检索国内外新型冠状病毒感染疫情防控一线医务工作者心理健康相关文献,系统总结并分析一线医务工作者的心理应激反应、影响因素及干预策略。疫情防控一线医务工作者呈现出急慢性心理应激反应,包括失眠、疲劳等躯体症状,以及抑郁、焦虑、创伤后应激等心理症状。个体、工作和社会3个层面的风险和保护因素影响心理应激反应。线上和线下心理干预有助于缓解一线医务工作者压力。目前研究多聚焦于疫情暴发期,关于疫情长期影响的追踪研究较为匮乏;干预研究更多报道方案的开发和执行,而较少涉及干预效果的循证检验,未来可考虑结合数字化技术开发干预方案并检验干预效果。

青年医务工作者在传染病防控中的积极实践及对协同治理机制发展的推动作用

由传染病引发的突发公共卫生事件一直以来都严重威胁着人民群众的生命健康安全。广大青年医务工作者在每一次传染病疫情防控工作中,充分发挥了生力军和突击队作用。在新型冠状病毒感染疫情防控中,广大青年医务工作者在医疗救治、筛查转运、志愿服务等各项工作中承担着重要工作任务。本文将围绕北京市相关医疗卫生机构青年医务工作者参与传染病疫情防控工作的协同治理机制构建展开探讨,并提出要从构建协同落实机制、信息共享机制、分工协作机制和服务保障机制四个层次的制度体系来推动协同治理。

工作自主性和医疗体系的工作支持度:医务社会工作者留职意愿的影响因素研究

留职意愿是影响医务社会工作人才队伍稳定性的重要因素。基于2019年“中国社会工作动态调查(CSWLS)”数据,分析全国216名医务社会工作者的留职意愿情况,探讨工作自主性和医疗体系的工作支持度对留职意愿的影响。研究发现,工作自主性和医疗体系的工作支持度会显著正向影响医务社会工作者的留职意愿,同时医疗体系的工作支持度在医务社会工作者的工作自主性和留职意愿的关系中起到完全中介效应。建议从明确医务社会工作者的职责分工、提高专业自主性、加强跨职业和跨学科的合作与沟通、构建紧密的医疗团队支持网络等方面增强医务社会工作者的留职意愿,保证医务社会工作者人才队伍的稳定性,促进医务社会工作可持续发展。

智慧医院建设实践中的问题及解决对策

近年来,医院建设与发展正在努力适应“变局”,创立“新局”。5G新基建、智慧医院建设、多院区运行等决策的落实都是为了更加以患者为中心,更加高效与精准地提供医疗服务。让多院区运行能够有条不紊地开展以及确保管理与医疗在最短的时间内实现同质化,一院多区智慧医院建设任重道远。在技术和政策的推动下,以智慧医疗、智慧服务和智慧管理为中心的智慧医院的构建架构越来越清晰。但是,目前我国在建设智慧医院时,还面临一些问题,如建设标准难以统一、思路不清等。文章针对这些问题提出了相关策略,将智慧医院建设与“一院多区”的科学发展紧密连接起来,能促进医院的良性发展。

曲靖市医务社会工作基层实践及完善路径探讨

目的探讨医务社会工作在基层的实践困境与发展路径。方法本文以曲靖市第一人民医院的医务社会工作为样本,以医患关系为切入点,从医患协作机制、院内管理机制、院外社会支持、医务社会工作宏观环境四个维度,深度剖析该院医务社会工作在医疗服务中面临的困难和价值体现。结果医务社工在介入服务对象心理减压、健康促进以及资源链接等方面效果显著,进一步促进了医务社会工作与医疗卫生事业的紧密结合与融合发展。结论医务社会工作是完善院内外服务体系建设、创新服务模式、拓展本土化职业空间及推动基层卫生健康服务工作快速发展的重要举措。