Water, Sanitation and Hygiene in Lower-Level Health Care Facilities of Dar es Salaam Region in Tanzania: Status towards Achieving the Sustainable Development Goals and Way Forward

Background: Improving Water, Sanitation and Hygiene in health care settings is a critical prerequisite for achieving national health goals and Sustainable Development Goals (SDGs). The World Health Organization (WHO) has set a target for each United Nations member state to reach by 2030. Each member state is required to reach by 2022, 2025 and 2030 at least 60%, 80% and 100%, respectively of basic level of service of the five elements which are water, sanitation, hygiene, waste management and environmental cleaning. Methods: This study aimed to evaluate and document the current state of basic water, sanitation, and hygiene services in all lower-level health care facilities in the Dar es Salaam region of Tanzania as of July 2022. A cross-sectional study was conducted in 99 public dispensaries in the Dar es Salaam region’s five councils: Ubungo, Kigamboni, Kinondoni and Temeke Municipalities, and Ilala City. The interviewee form and observational checklists were both digitalized using the Kobo tool software. The respondents were health care facility in-charges or nurse in-charges. Data were downloaded, validated, and imported to Stata version 15 for analysis. Results: The basic WASH level per JMP is far below the target in 2022. Each member state by 2022 is required to reach at least 60% of the basic level of service of each element. We found a low coverage of basic WASH in the 99 dispensaries included in this study. The basic WASH coverage was met in only 10 (10.1%) of the dispensaries, while the remaining 89 (89.9%) dispensaries fall on limited WASH services. Conclusion: This study revealed lower coverage of basic WASH services in dispensaries. An urgent need is required to improve the status of WASH in all the dispensaries and facilitate the provision of quality health care services, patient safety and reduce health care associated infections.

Present situation and the countermeasures of health human resources in Guangxi general hospitals at the county - level

[目的] 了解广西县级综合医院卫生人力资源状况,为进一步推进县级医院改革提供建设性意见. [方法]通过问卷调查法、数理统计法等综合分析广西县级综合医院卫生人力资源现状.[结果]广西县级综合 医院在岗人员在编率为41.56%,医护比为1： 1.68, 67.12%的卫生技术人员职称为初级及以下,超七成拥有 大专及以上学历.[结论]广西县级综合医院卫生技术人员在编率较低,医护比、职称及学历结构不合理,整 体年龄偏低,需通过综合措施加以改善.

Assessment of pollution levels and human health risk of heavy metals in dust deposited on Yerevan＇s tree leaves (Armenia)

The total concentrations of Cd,As,Pb,Cr,Ni,Co,Zn,Cu,Ag,Hg,and Mo were determined in the atmospheric dust of the city of Yerevan by atomic absorption spectrometry(AAnalyst PE 800).Heavy metal pollution levels were evaluated by calculating geo-accumulation(I_(geo)) and summary pollution(Z_c) indices.Potential human health risk was assessed using the United States Environmental Protection agency's human health risk assessment model.The results show that mean contents of all elements tested except Ni and Cr were substantially higher than local geochemical background values.According to the I_(geo),Yerevan territory is strongly-to-extremely polluted by As,Ag,Hg,Mo,and Cd.The Z_c assessment indicated that very high pollution was detected in 36%of samples,high in 32%,average in 12%,and low in 20%.The health risk assessment revealed a noncarcinogenic risk(HI >1) for children at 13 samplings sites and for adults at one sampling site.For children the risk was due to elevated levels of Mo,Cd,Co,and As,while for adults,only Mo.Carcinogenic risk(>1:1,000,000) of As and Cr via ingestion pathway was observed in 25 and 14 samples,respectively.This study,therefore,is the base for further detailed investigations to organize problematic site remediation and risk reduction measures.

Practical Experience of Establishing German Standard Level 1 Perinatal Center in Chongqing Health Care for Women and Children

Germany,as a western developed country,has an advanced medical level,especially in the health care of very immature premature infants.We trace the medical history of perinatology to understand the development of perinatal centers in Germany.After analyzing the classification and function,hierarchical management and quality control systems of German perinatal centers,we established a German standard level 1 perinatal center in the Chongqing Health Center for Women and Children(CHCWC).During more than two years of practice,we changed concepts,continuously updated clinical knowledge and skills,developed a series o f high-quality work processes and supervision systems and introduced advanced medical equipment.We believe that the experience of establishing a German standard level 1 perinatal center and perinatal center network in Chongqing is worthy of being promoted to the Chinese maternal and child health care system.

The Effect of Life Skills Training on the Mental Health and Level of Resilience among Teachers of Normal Students and Teachers of Exceptional Students in Zahedan

This is an experimental study conducted on two groups of control and experimental using pretestposttest design, applying psychological intervention on the study sample. The present study aimed to determine the effectiveness of collective education life skills on mental health and resilience of teachers in Zahedan. The population of the study included all teachers at schools with normal students and teachers at schools with exceptional students in Zahedan, among which 60 teachers at normal schools and 20 teachers at exceptional schools were selected and placed in two groups of experimental and control, respectively. Initially, members of the experimental group were taught 10 basic life skills in 10 2-hour sessions. Mental health and resilience questionnaires were distributed and gathered before and after the training sessions. Results indicated the positive effect of life skills training on mental health of teachers at schools with normal students and teachers at schools with exceptional students, which meant that the more the life skills training to teachers at schools with normal students and teachers at schools with exceptional students, the lower their mental health scores would be. Results also indicated the positive effect of life skills training on resilience of teachers at schools with normal students and teachers at schools with exceptional students, which meant that the more the life skills training to teachers at schools with normal students and teachers at schools with exceptional students, the higher their resilience scores would be.

A Theoretical Study on Health Quotient Promotion-based Physical Education Reform at the University Level

This study maintains that university-level physical education does not currently include or implement health education.? As a consequence of this, college and university students have a very weak theoretical understanding of health.? This study maintains that university-level physical education should focus on the state of students’ health, using the principles of the health quotient.? Of particular importance are problems related to mental health, social adaptive ability, and lifestyle.? Physical education should incorporate instruction based on health quotient-related theories and techniques;doing so will lay a strong foundation for students’ lifelong physical education.? In addition to opening up new paths and methods in research related to the all-around health education of college students, this can also enrich and perfect the theoretical system of modern sports science, as well as provide a new line of thinking and perspective to university-level physical education reform.

Health concerns of veterans with high-level lower extremity amputations

Background: To identify health concerns of veterans with high-level lower extremity amputations.Methods: Through a cross-sectional study, general practitioners, an orthopedic specialist, psychologists, psychiatrists,physiotherapist and prosthetists examined 100 veterans using a short-form health-related quality of life questionnaire(SF-36) that assessed their ability to perform activities of daily living(ADL), instrumental activities of daily living(IADL) and life satisfaction(SWLS) after hip disarticulation or hemi-pelvectomy amputations. The assessment tool was designed to gather statistically useful information about their health needs.Results: The means of the Physical Component Summary(PCS), Mental Component Summary(MCS), SWLS, ADL and IADL were 48.58±29.6, 33.33±22.0, 19.30±7.7, 48.10±10.5 and 5.08±1.8, respectively. Somatization, depression, and anxiety were the most prevalent disorders;among the veterans who were visited by psychiatrists, 11.6% had a history of hospitalization in a psychiatry section, and 53.2% had a psychiatric visit. Regardless of their injury in battle, 34% of veterans were hospitalized. Hearing problems were common, and about four-fifths of the participants suffered from at least one orthopedic condition. Neuroma(49%) was the most common stump-related complication during orthopedic evaluations, though the prevalence of phantom pain was 81% during the pain assessment. A total of 87% of the participants had a history of wearing a prosthesis, but only 29% wore a prosthesis at the time of the present study.The Canadian-type of prosthesis was uncomfortable and not useful(27%) and excessively heavy(10%) according to the amputees.Conclusions: Understanding veterans’ characteristics and special needs are important to make sure that enough facilities and services are afforded to them. These findings emphasize the importance of paying close attention to different dimensions of health in veterans and can help health providers identify health needs and make regular assessments.

Physical Activity Level and Adult Saudi Health Related Quality of Life

Purpose: Physical inactivity in Saudi Arabia is a growing challenge to public health. This study aimed to define the relationship between the physical activity level (PAL) and adult Saudi health-related quality of life (HRQoL). Methods: Participants of this study were 100 Saudi adult aged from 18 - 70 years. The 36-Item Short-Form Health Status Survey (SF-36) was used to measure the participant’s HRQoL. The SF-36 is comprised of 8 domains. The electronic version of the General Practice Physical Activity Questionnaire was used to categorize participants in terms of physical activity level into;inactive, moderately inactive, moderately active, and active. Descriptive and inferential statistical tests were used to treat the collected data. Results: Results showed that only 17% of the Saudi adults had active PAL. The PAL had significantly positive relationship with 4 domains of HRQoL including: physical functioning (P = 0.004), role limitations caused by physical health problems (P = 0.048), vitality (P = 0.009), and general health (P = 0.044). Results also confirmed that the younger the subject, the higher the PAL (P = 0.0001) and the better the HRQoL. This is true for all domains except the role limitations caused by emotional problems and emotional wellbeing. Conclusion: The poor physical activity level of adult Saudi negatively impacts their HRQoL.

基于随机森林模型分析共情心理对大学生心理健康的影响

目的运用随机森林算法分析共情心理对大学生心理健康的影响。方法采取方便抽样的方法,以问卷调查的方式于2022年8月对河北省某大学的1383名学生进行在线调查,内容包括调查对象一般情况以及基本共情量表和症状自评量表。使用最小二乘法回归模型分析共情心理是否为大学生心理健康的影响因素,构建随机森林模型分析共情心理对大学生心理健康的重要性。结果共回收问卷1383份,有效问卷1348份,问卷有效率为97.5%。回归模型结果表明,共情心理对大学生心理健康水平的影响具有统计学意义(t=-2.051,P<0.05)。随机森林模型的结果显示,大学生心理健康重要性排名前3位的解释变量分别为共情心理、睡眠质量以及学业压力。结论共情心理是影响大学生心理健康的重要因素。建议合理开展提升共情心理能力的活动,关心学生的睡眠时长,适当减轻学生的学业压力。

当代大学生心理健康素养特点及影响因素分析

采用《国民心理健康素养问卷》和《心理健康自评问卷》(SRQ-20)对大学生进行调查。发现以下几点,①大学生心理健康素养总分均值、对心理疾病的知识和观念优于我国社会水平,但是在对待心理疾病的态度、行为和技能、维护心理健康态度方面,大学生群体回答正确率较低;②大学生心理健康素养存在显著的性别、城乡、学历层次、专业类别差异,担任心理骨干、学习课程和参加活动的学生,其心理健康素养均处于较高水平;③有心理困扰的大学生的心理健康认识观念得分高于无困扰学生,但在应对行为因子上显著低于后者;④心理健康低水平组的心理健康素养低于高水平组;心理健康水平越低,其心理健康素养越差;⑤大学生心理健康素养与“心理/精神障碍患者的接触频率”呈负相关,与“对心理健康服务的熟悉程度”呈正相关。

2016—2021年四川省地表水体中铀的放射性水平及健康风险评价

为调查四川省地表水体中放射性物质铀(U)的含量,评价居民摄入地表水体中U导致的健康风险,在四川省主要地表水系中共设置23个监测断面,于2016—2021年检测了U的放射性水平,并根据健康风险评价模型对居民的健康风险进行评估。结果表明:四川省地表水体中U的质量浓度为0.16~3.6μg/L,参照《生活饮用水卫生标准》(GB 5749—2022),均合格;不同年份、不同地表水体中U的放射性水平间的差异均无统计学意义(P>0.05);不同水期U的放射性水平间的差异有统计学意义(P<0.05)。各年龄组通过饮水、水体浸没途径摄入U所致总年均待积有效剂量均<0.1mSv;对各年龄段居民的总致癌风险为4.18×10^(-9)~2.24×10^(-8),均低于世界卫生组织(WHO)和国际放射防护委员会(ICRP)发布的最严格控制限值。全省主要地表水体中U对各年龄组都是安全的。

健康教育在学校结核病防控中的价值研讨

目的研究学校结核病防控中应用健康教育的效果。方法于2021年1月—2022年12月时间段对某高中学校进行调查,选择该校三年级400名进行研究,其中1~5班采用常规校园疾病防控管理(200名),6~10班采用健康教育疾病防控管理模式(200名),观察指标为健康知识水平、防控措施落实情况、新发结核病发生情况。结果6~10班学生结核病防控知识高于1~5班学生,差异有统计学意义(P<0.05);6~10班学生防控措施落实情况高于1~5班学生,差异有统计学意义(P<0.05);6~10班学生新发结核病发生为0,低于1~5班学生3例(1.50%),但差异无统计学意义(P>0.05);6~10班学生结核病主动汇报15例(7.50%),高于1~5班学生4例(2.00%),差异有统计学意义(P<0.05)。结论学校结核病防治过程中采用健康教育模式可以提升学生的健康知识水平,强化结核病防治措施落实效果,有效预防新发结核病发生,并提高其主动汇报率,改善学生预后效果。

公共服务水平对居民健康的影响研究

本文使用2010—2020年中国家庭追踪调查(CFPS)和中国统计年鉴数据,构建了多层次Logistic回归模型,验证了公共服务水平与居民健康之间的关系。研究发现:公共服务水平提升对居民健康具有明显的促进作用,但在不同群体中,其作用效果有所不同;公共服务可以调节个体属性对居民健康的影响,公共服务削弱了年龄对居民健康的负向影响,并削弱了户籍和收入对居民健康的正向影响,但强化了性别对居民健康的正向影响,有利于促进健康平等;公共服务水平提升有利于居民树立积极健康观,提升健康素养,形成科学的生活方式,合理使用医疗资源做好疾病预防、及时诊治、愈后康复,进而提升居民健康水平。

高职院校辅导员心理育人路径探索

高职院校的学生面临着学业、职业、人际等多方面的压力。面对学生多样化的心理需求,高职院校辅导员的心理育人工作显得尤为重要。辅导员提升自身专业素养,准确把握学生心理需求,为学生提供专业化的帮助和支持是高职院校心理育人工作的关键路径。文章从辅导员心理育人的内涵和特点出发,结合高职院校学生特点,分析高职院校辅导员心理育人领域的路径探索与实施,旨在为高职院校辅导员提供启示,帮助高职院校辅导员更好地开展心理育人工作。

中医馆健康信息平台应用现状与思考

本文基于中医馆健康信息平台应用现场调研和问卷调研结果,发现中医馆健康信息平台推广应用过程中存在后续经费投入不足、与医院信息系统对接困难等一系列问题。笔者基于调研结果,就如何更好地推广应用中医馆健康信息平台提出相关建议,以期更有效地提升基层中医馆信息化水平和诊疗能力。

基于应急管理全过程均衡理论的县级公立医院应对突发公共卫生事件应急管理研究——以资阳市安岳县为例

在面对突发公共卫生事件时,县级公立医院主导的救治体系是应对突发公共卫生事件、保障人民生命安全和身体健康的重要基础,是应对突发公共卫生事件实施医疗救援的主阵地。本文基于应急管理全过程均衡理论的“6+1”框架模型,以四川省安岳县县级公立医院为研究对象,对该县县级公立医院应对突发公共卫生事件应急管理流程进行分析,梳理县级公立医院应对突发公共卫生事件的特点,针对不足和短板提出优化安岳县县级公立医院应对突发公共卫生事件应急管理的路径,以期提升县级公立医院应对突发公共卫生事件应急管理的能力与水平。

基于SERVQUAL模型的基层医疗卫生服务质量评价研究

目的:在县域医共体的建设背景下,评价社区卫生服务中心服务质量及影响因素,提出基层医疗卫生服务质量改善对策。方法:运用SERVQUAL模型,从社区卫生服务中心服务质量的有形性、可靠性、响应性、信任性、移情性方面,形成问卷条目;通过多因素二分类logistic回归探索筛查服务质量差距的影响因素;借助IPA象限图呈现居民对社区卫生服务中心的SERVQUAL模型各维度服务质量重要性的分布情况。结果:问卷各项条目的服务质量差距均为负值,服务保证性和移情性维度的服务质量差距得分最高,分别为-0.47±0.59分和-0.47±0.65分;服务有形性维度的服务质量差距得分最低,为-0.40±0.55分。年龄、收入情况和慢病年限是服务质量差距的影响因素。结论:当前基层医疗卫生服务质量与居民的期望之间存在一定差距,基层医疗卫生服务机构应重视对低年龄、高收入和慢病病程较长的居民的服务需求。

肇庆市老年人口健康水平的人居环境影响因素

基于2020年肇庆市乡镇街道地理尺度的人口普查数据,运用描述性统计方法揭示肇庆市老年人口健康水平的群体差异和空间格局,采用Tobit回归模型识别影响老年人口健康水平的人居环境要素,并探讨了多维人居环境要素对老年人口健康水平可能存在的混杂影响。结果表明:1)肇庆市城镇老年人口的健康水平优于乡村,老年人口健康水平存在性别差异,70岁后呈现女性健康优势被男性反转的特征。2)老年人口的健康水平呈现东南高西北低的特征,在城区、城关镇、建制镇组成的城市内部空间结构中存在等级分异格局。3)PM_(2.5)和地区健康老人比例有显著的负相关关系,年均绿量对健康老人比例的影响并不显著,但却在乡村地区年均绿量可以缓解PM_(2.5)和健康老人比例的负相关关系,污染企业数量和区域贫困剥夺指标则会加剧PM_(2.5)对乡村健康老人比例的负向影响;优质的住房条件有助于提高健康老年人比例,医疗床位数、无主要收入来源、贫困剥夺、高龄对健康老人比例呈负向的预测作用。

压差式光纤光栅静力水准仪的设计与研究

为实现对建筑结构不均匀沉降的有效监测,基于光纤光栅与连通器的基本原理,该文设计了一种压差式光纤光栅静力水准仪,并对该水准仪进行了理论推导、标定试验及静态特性分析。试验结果表明,该水准仪灵敏度为6.5 pm/mm,线性拟合度R^(2)为0.999,非线性误差为1.48%,迟滞性误差为0.74%,重复性误差为5.72%,总精度为5.95%。为增大该水准仪灵敏度特性,对原有的波纹膜片改进与分析,结果表明,改进后的水准仪灵敏度为11.87 pm/mm,较改进前提升了约1.8倍。该结构形式的水准仪可对建筑物的沉降进行有效监测,为建筑物结构健康监测提供有效的技术支持。

大学生心理健康素养现状及其相关因素

目的 了解大学生群体的心理健康素养现状及相关因素。方法 对山东省某医学院大学生,使用心理健康素养问卷、焦虑自评量表、抑郁自评量表和症状自评量表进行调查。结果 在大学生群体中,心理健康素养均分为(79.49±9.73)分,男性均分为(76.69±10.94)分,女性均分为(81.43±8.28)分,女性得分高于男性(t=-5.519,P<0.05);大学生群体不同专业中心理学专业得分最高,均分为(83.29±10.32)分,精神医学专业得分次之,均分为(82.29±7.67)分,临床医学得分最低,均分为(77.34±10.10)分,不同专业的大学生心理健康素养水平存在显著差异(F=11.439,P<0.05);未见明显城乡来源差异。大学生心理健康素养水平与焦虑水平(r=-0.272,P<0.05)、抑郁水平(r=-0.261,P<0.05)评分负相关。焦虑水平、抑郁水平、性别及专业是大学生心理健康素养的独立影响因素(P<0.05)。结论 大学生群体心理健康素养处于较高水平,地域分布上较为均衡,但在性别、专业维度存在显著差异,较高水平的心理健康素养对心理健康有促进作用,我们应重视心理健康素养在性别及专业中的差异,提高大学生群体心理健康素养,从而进一步提高心理健康水平。