2004年莱芜市部分口腔诊疗机构消毒质量调查

[目的]了解莱芜市各级口腔诊疗机构消毒质量,加强口腔诊疗器械的消毒工作的监督管理,预防和控制医院性感染。[方法]2004年10~11月,对莱芜市开展口腔诊疗工作的综合医院、口腔专科医院进行了抽查。调查各单位消毒剂、消毒器械两证持有情况,器械消毒、灭菌程序执行情况,人员消毒知识掌握情况;各类口腔诊疗器械消毒、灭菌效果,诊室空气、物体表面、工作人员手消毒效果。[结果]共抽查15家医疗机构,其中市级综合性医院3家、厂矿综合医院5家、市直专科医院2家、乡镇卫生院3家、个体口腔诊所2家。各单位均持有两证,器械的消毒、灭菌基本按照“去污染-清洗-消毒灭菌”的程序进行,综合医院执行较好,1家卫生院、2家个体诊所执行不严。共抽查各类样本400份,合格率为84.50%,其中无菌器械合格率最高(98.75%),室内空气合格率最低(72.50%)。[结论]莱芜市各级开展口腔诊疗工作的医疗机构消毒质量存在不少问题,应加强监督管理及业务指导。     

口腔科诊疗器械消毒灭菌存在的问题及对策

目的规范口腔科诊疗器械清洗、消毒、灭菌工作,预防与控制口腔医院感染。方法对市直8所医院及11个县直医院口腔科进行全面检查,找出口腔科诊疗器械清洗、消毒、灭菌中存在的问题,提出改进措施。结果大部分县直医院消毒灭菌不规范,有些医务人员在诊疗操作及器械清洗、消毒、灭菌过程中,不按规范要求去做,对造成医院感染的危害性认识不足。结论加强口腔科诊疗器械清洗、消毒、灭菌工作,严格预防与控制医院感染。     

口腔科门诊医院感染因素分析与管理对策

[目的]为了降低口腔科门诊血源性感染发生,探讨口腔科门诊医院感染的发生因素及控制措施。[方法]针对口腔科门诊发生医院感染原因,采取相应的管理对策。[结果]通过建立健全口腔科门诊各项管理规章制度,严格执行技术操作规程,实行标准预防隔离原则,确保口腔器械的清洗、消毒、灭菌质量等综合方法的实施,就能降低口腔科门诊血源性感染发生。[结论]医务人员严格自身职业防护、增强消毒隔离无菌观念意识、规范诊疗操作,对预防口腔科的医院感染非常必要。     

医疗机构消毒灭菌工作存在的问题及对策

[目的]调查我市医疗机构消毒灭菌工作存在的问题,提出管理对策。[方法]对30所二级以上医院的《医院感染管理规范》、《消毒技术规范》、《医疗废物管理条例》、《内镜清洗消毒技术操作规范》、《医疗机构口腔诊疗器械消毒技术操作规范》的执行情况进行逐项调查。[结果]部分医院的医院感染管理机构不健全、消毒技术规范的执行不严格、内镜室布局改造及消毒管理工作不到位、口腔科诊疗器械消毒工作不规范。[结论]各医院要进一步建立健全医院感染管理组织机构,严格按照规范开展消毒、灭菌工作,各级卫生行政部门应加强对医疗机构医院感染工作的监督管理,以提高消毒工作质量,达到控制医源性感染的目的。     

消毒供应中心集中处理口腔诊疗器械调查

目的 探讨消毒供应中心对口腔诊疗器械实施集中式管理的处理效果,杜绝因其管理不当引起的医院感染.方法 按照《医院感染管理办法》及《医疗机构口腔诊疗器械消毒技术规范》,将口腔诊疗器械集中回收处理,制定有效科学的管理方法,对2009年1月-2010年12月处理的口腔诊疗器械进行回顾性调查与分析.结果 确保了口腔诊疗器械的清洗、消毒、灭菌质量与患者的医疗安全,2009年1-12月清洗合格率为96.55％,2010年1-12月清洗合格率98.88％,两者合格率比较差异有统计学意义(x2=4.5,P＜0.05).结论 加强口腔诊疗器械管理,规范处理流程,完善感染控制制度与措施,是有效地预防和控制口腔诊疗操作过程中医院感染发生的重要途径.     

口腔诊疗器械的清洗与消毒、灭菌方法的最佳选择

目的:为了保证口腔诊疗器械的使用安全,研究探讨口腔诊疗器械的清洗与消毒、灭菌方法的最佳选择,降低口腔诊疗中的医源性感染.方法:有条件的医院可将所有可重复使用的诊疗器械和医疗用品,由消毒供应中心统一回收-分类-超声酶洗-终末漂洗-包装-灭菌-配送的一体化管理.无条件的口腔诊疗机构必须建立具备口腔诊疗器械使用后的回收处置、清洗消毒和灭菌储存的独立区域,且工作流程合理,清洗设备齐全,并有严格的强制性的清洗质检及登记和质量监测监控体系,工作程序严格按照消毒供应中心技术操作规范执行并管理.结果:口腔诊疗器械的清洗消毒与灭菌很重要,如去污不彻底就会影响灭菌效果,符合要求的器械管理模式,为各类器械处于良性循环、保证质量要求和保障及时供应打下良好的基础,确保诊疗安全,加强监测管理督查与监管有利于器械清洗与消毒灭菌质量的可持续改进.结论:口腔诊疗器械的清洗与消毒灭菌方法,采取集中式管理的消毒供应中心,形成规范的操作流程,由经专业培训的专业人员来完成是最佳选择,最终达到有效降低成本,资源共享,延长器械使用寿命,提高口腔诊疗器械的清洗消毒与灭菌质量,确保就诊安全和医务工作者的医疗安全.     

加强口腔科清洗区的管理

口腔科清洗区承担着口腔诊疗器械的回收和清洗工作,器械清洗是否彻底关系到下一步消毒灭菌的质量,清洗区的管理是控制口腔科医院感染的重点环节之一,其管理措施:(1)布局合理人性化:布局合理,操作更方便,效率更高.回收分类区为相对污染区,清洗后物品放置区为相对清洁区,两区应彻底分开.各种清洗设备及设施均放在合理位置.(2)设施、设备符合规范要求:严格执行回收清洗工作程序和标准,熟悉各诊疗器械的操作使用规范.配有污物分类回收的器具、手工清洗池、压力水枪、牙科手机自动清洗注油设备、超声清洗机、相应的消毒用品、个人防护用品等,均应符合国家相关标准,保证水、电、压缩空气的供给.(3)及时清理:使用过的口腔诊疗用物回收到清洗区后及时进行清理、垃圾分类.诊疗器械进行分检后,初步清洗,以待集中彻底清洗,减少污染扩散.(4)掌握正确的清洗方法:清洗是否彻     

上海市宝山区医疗机构口腔诊疗器械消毒灭菌现状调查

<正>由于口腔诊疗技术多样、临床侵入性操作多、诊疗器械结构复杂、使用频繁等因素,如果诊疗过程中,消毒隔离不严格,极易造成交叉感染。口腔科器械容易被血液和口腔分泌物污染,携带多种血液传播性疾病因子,如乙型肝炎病毒、丙型肝炎病毒,艾滋病病毒等[1]。因此,对口腔诊疗器械清洗、消毒与灭菌要求严格。为进一步了解本区医疗机构口腔诊疗器械消毒灭菌现状,提出相应的医疗机构口腔诊疗器械消毒灭菌监管对策,我们于2013年7—9月对宝山区51     

莱芜市莱城区个体口腔诊所消毒工作现状调查

[目的 ]了解莱芜市莱城区个体口腔诊所消毒工作现状。 [方法 ] 2 0 0 2年 10～ 12月 ,对莱城区个体口腔诊所工作人员的基本情况 ,口腔诊疗器械的配备情况、消毒方法与效果进行调查。 [结果 ]调查 2 8家个体口腔诊所 ,消毒设施不完善 ,消毒工作开展较差 ;检测口腔诊疗器械、医生手细菌总数合格率分别为 74 17%、82 14 %,HBsAg阳性率分别为7 2 8%、3 5 7%。 [结论 ]莱城区个体口腔诊所消毒工作存在不少问题 ,应加强监督指导。     

2005年宝鸡市口腔诊疗机构消毒工作状况调查

[目的]了解宝鸡市口腔诊疗消毒工作的现状，提出加强口腔诊疗消毒工作的对策。[方法]对宝鸡市市区内开展口腔诊疗活动的个体诊所、职工医院进行监督检查，并对口腔诊疗器械消毒效果进行检测。[结果]45家医疗机构中，超核准诊疗科目范围开展口腔诊疗活动的占59．26％，使用过期消毒剂的医疗机构占到15．56％，采购消毒剂时索取产品生产企业卫生许可证及有效卫生许可批件复印件者占4．44％，口腔诊疗器械消毒效果检测合格率为76．75％。[结论]宝鸡市口腔诊疗消毒工作状况令人担忧，应加大监督检查力度，促进医疗机构提高口腔诊疗消毒工作质量。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Fatigue and health in a seafaring population

Background Occupational fatigue is relatively common withinthe general population and has been linked to reduced performance,injury and longer term ill-health. Despite growing acknowledgementof this problem in the maritime sector, little research hasbeen conducted into the risk factors, prevalence and consequencesof seafarers' fatigue. Aims To examine the prevalence of fatigue among seafarers, identifypotential risk factors and assess possible links with poor performanceand ill-health. Methods Cross-sectional questionnaire survey of seafarers workingin the offshore oil support, short-sea and deep-sea shippingindustries. A number of tools were used including the fatiguesubscale of the profile of fatigue-related symptoms, the CognitiveFailures Questionnaire, the General Health Questionnaire andthe SF36 General Health scale. Results In all, 1855 questionnaires were completed giving anoverall response rate of 20%. Fatigue symptoms were associatedwith a range of occupational and environmental factors, manyunique to seafaring. Reporting a greater number of risk factorswas associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35)for those with three or four risk factors and OR = 9.54 (6.95–13.09)for those with five or more risk factors]. There was also astrong link between fatigue and poorer cognitive and healthoutcomes, with fatigue the most important of a number of riskfactors, accounting for 10–14% of the variance. Conclusions Seafarers' fatigue could impact on safety withinthe industry and may be linked to longer term individual ill-health.It can only be addressed by considering how multiple factorscombine to contribute to fatigue.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.