新冠肺炎疑似病例集中收治医院的改建与管理

目的：探索新冠疫情下,对作为某三级甲等综合医院临时分院,收治新冠肺炎疑似病例的乡镇卫生院的改建与管理。方法：由指定某三级甲等综合医院派出的医疗、护理及院感组成的管理团队对其进行直接管理,通过改造布局流程、规范运行模式、健全制度建设、合理人员配置、严格质量控制,有效落实新冠肺炎的防控措施,防止疫情扩散。结果：新冠肺炎疑似病例集中收治医院共收治新冠疑似患者91例,其中住院患者71例,留观患者20例,6例核酸检测阳性患者安全转运至定点收治医院治疗,所有患者（包含转出的6名）均康复出院居家隔离观察。结论：规范改建后的新冠肺炎疑似病例集中收治医院,成功收治甄别了近百名疑似患者,有效地落实疫情防控措施,提高了突发公共卫生事件的应对能力;同时还培养了一批专业管理及医护人员。     

思维导图在新冠肺炎疫情下普外科急诊患者应急护理及防护中的应用

目的：探讨思维导图在新冠肺炎疫情下普外科急诊患者护理及防护流程中的应用。方法：自行设计思维导图,将疫情下急诊患者从入院到出院涉及到的各个环节流程化、系统化。结果：护士在工作中能做到思路条理清晰,精准地实施各项护理措施,做好防护,保证了疫情防控期间的护理质量与安全。结论：思维导图在新冠肺炎下普外科急诊患者护理及防护中发挥了重要作用。     

浅谈职业病危害因素苯的识别与化学品安全说明书的关系

新型冠状病毒肺炎（新冠肺炎）对人民的生命健康造成了巨大的威胁。在新冠肺炎疫情下，如何应对肝胆外科肝癌患者的门诊筛查、病房管理以及安全地实施肝癌手术，都是对肝胆外科医师提出的新挑战。我们认为，该病的临床处置应在筛查新冠肺炎的前提下，遵循正规操作流程，做好充分防护。对于需要急诊治疗但无法排除新冠肺炎的肝癌患者，须综合考虑患者的病情严重程度、手术方式及手术室条件，慎重制定个体化治疗方案。整个诊疗过程必须遵从既保证患者的安全及疗效，又要降低医护人员感染风险的原则。     

普通病房住院患者新型冠状病毒肺炎防控策略

新型冠状病毒容易引发医院感染,形成病房聚集性案例,给医疗机构带来灾难性后果。为快速识别住院病房中的新型冠状病毒肺炎(简称新冠肺炎)患者,医疗机构应培训各级医务人员掌握新型冠状病毒相关知识,做好病房场所、诊疗技术和防护物质的准备,修订住院患者新冠肺炎的筛查流程,从而达到防范医院感染新冠肺炎的目的。     

郴州市39例新型冠状病毒肺炎确诊病例病毒核酸检测结果分析

目的 分析郴州市39例新型冠状病毒肺炎(简称新冠肺炎)确诊病例不同时期不同标本的新型冠状病毒核酸检测情况,为新冠肺炎临床诊疗和管理提供科学依据。 方法 以郴州市新冠肺炎疫情期间确诊的39例新冠肺炎病例为研究对象,收集其从确诊、住院诊疗到院后康复管理过程中新型冠状病毒核酸检测的相关信息,描述不同阶段、不同标本的检测结果。 结果 新冠肺炎疫情期间,郴州市共完成了39例新冠肺炎确诊病例301人次核酸检测。新冠肺炎病例均以单独咽拭子标本核酸检测确诊,出院后随访复查采用同一病人不同种类标本联合检测为主。出院后病例新冠病毒核酸检测复阳率为12.82%。 结论 增加病例不同时期标本核酸检测次数和同一时期不同种类标本联合检测可提高阳性检出率,应对出院后病例“复阳”现象开展进一步研究并加强健康管理。     

新型冠状病毒肺炎患者的呼吸康复

正新型冠状病毒肺炎(简称"新冠肺炎")是一种传染性极强的呼吸道传染病,会对患者造成呼吸功能、躯体功能和心理功能的障碍。随着我国抗击新冠肺炎疫情取得阶段性胜利,许多新冠肺炎患者陆续出院,进行居家康复。那么,新冠肺炎患者究竟应该如何进行呼吸康复呢?     

新型冠状病毒肺炎期间急诊手术感控防护的体会

目的探讨新型冠状病毒肺炎期间急诊手术处理流程和各项防护措施。方法通过回顾1例输尿管结石患者按照新冠肺炎疑似患者进行急诊手术处理及术前术中术后各项防控措施。结果手术过程顺利,术后继续按疑似病例隔离处理,术后恢复较快,术后病原体核酸报告阴性,顺利出院,继续居家隔离。结论新型冠状病毒(2019-nCoV)引起的肺炎(简称新冠肺炎)主要传播途径为呼吸道飞沫、接触、气溶胶传播,预防难度大,对于急诊手术的处理,感染控制的细节需要加倍的注意~([1-3]),必须严格遵照相关防护规定,做好医护人员的防护。     

基于新冠肺炎应急状态下快速营养诊疗流程的建立

目的 根据新冠肺炎应急和防护要求,因地制宜建立优化的营养诊疗流程。方法 根据新冠肺炎疫情爆发和防护要求,在四川和湖北参与新冠肺炎临床营养救治工作中,组建多学科团队,对传统临床营养诊疗流程的步骤进行优化改进,建立适合当时实际情况的临床营养诊疗方案。结果 在新冠肺炎流行期间,完成了对509余名患者营养风险筛查,180名患者的营养状况评价,73名患者的个体化肠内或/和肠外营养支持,以及94名患者接受治疗饮食,顺利完成救治任务。结论 在新冠肺炎临床营养救治过程中,改进优化的临床营养诊疗流程能有效保障新冠肺炎的临床营养救治。     

新型冠状病毒肺炎的CT检查流程及隔离防护措施

目的新型冠状病毒肺炎(Coronavirus disease 2019,COVID-19,简称新冠肺炎),是一种新发传染病,该病具有很强的传染性,目前国内疫情已基本得到控制,境外疫情正在蔓延,防控依然严峻。放射诊断是新冠肺炎诊疗过程中的重要一环,具有肺炎影像学特征者已经作为临床诊断病例写入新型冠状病毒肺炎诊疗方案(试行第五版)中。放射科承担着新型冠状病毒肺炎CT检查工作,放射科工作人员尤其是技师成为继发热门诊、感染科和ICU后最危险的一线群体。此文旨在规范放射检查技术,避免院内交叉感染,提高影像学检查质量,指导放射科感控工作,达到放射科技师"零感染"的目标。方法针对解放军总医院第二医学中心放射科新冠肺炎感染防护难点及高龄患者特点进行剖析,科室成立新冠肺炎应对处置组,定期组织防护培训,加强消毒隔离的意识,在保证高质量完成图像扫描的同时,全面体系地控制感染,针对放射科工作人员尤其是技师在新冠肺炎CT检查的操作流程及消毒防护措施,并对高龄危重不能配合呼吸的患者及时调整CT扫描参数,做好危重患者陪护人员的标准预防防护和X线辐射防护。结果面对传染性疾病及高龄患者,通过组织防护培训考核、加强消毒隔离防护措施,规范CT检查流程、调整CT扫描参数,得到了高质量CT影像数据,解决了放射科感控薄弱的问题,预防了院内交叉感染,为有效控制疫情打下了坚实基础。在做好防护的前提下,疑似新冠肺炎患者的CT检查顺利开展。结论 COVID-19是一种高度传染性疾病,不断提升放射科医务人员诊疗技术,加强隔离防护,把CT检查的流程标准化、规范化对进一步做好新型冠状病毒肺炎防控工作至关重要。     

多学科诊疗模式在新型冠状病毒肺炎重症患者诊疗中的实践探索

为落实"提高治愈率、降低病亡率"的新型冠状病毒肺炎(以下简称新冠肺炎)医疗救治目标,作为重症患者收治定点医院的华中科技大学同济医学院附属同济医院光谷院区通过成立多学科诊疗管理团队,在科学的治疗方案指导下,优化多学科诊疗流程,以院区、病区为层级,开展新冠肺炎重症患者多学科联合救治,保证了患者治疗效果.但应注重多学科诊疗内...     

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 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.     

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.     

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.     

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.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

The risk of heat exhaustion at a deep underground metalliferous mine in relation to surface temperatures

The risk of heat exhaustion at a deep underground metalliferous mine was assessed in relation to thermal conditions prevailing on the surface. For each day of a 1-year prospective case series of heat exhaustion, surface 24-h mean wet and dry bulb temperatures were recorded. From this data, 24-h mean wet bulb globe temperatures were derived using certain assumptions. The three surface temperature variables were significantly higher on those days on which heat exhaustion occurred, compared to those days on which it did not occur (P < 0.001). The relative risk of heat exhaustion on days when the 24-h mean wet bulb globe temperature was in the range 26.0-28.0 degrees C was 4.82 (95% confidence interval 2.12-10.96). Surface temperature data could be used at this mine to warn miners about the risk of heat exhaustion.