A fluorescent amplified fragment length polymorphism study of Salmonella enterica serovar Sofia, the major Salmonella serovar isolated from chickens in Australia

Fluorescent amplified fragment length polymorphism (FAFLP) analysis was performed on 68 isolates of Salmonella enterica subsp. salamae serovar Sofia (S. Sofia). Fifty eight isolates were obtained over a period of approximately 15 years from a range of human, chicken industry and environmental sources throughout Australia. A further ten isolates were identified from human and poultry sources in Israel from 1972 to 1987. Analysis of FAFLP profiles for fragments between 50 to 500 base pairs in length indicated distinct clusters of isolates. All but seven isolates clustered into four groups of >90% similarity and all isolates displayed at least 70% similarity with each other. No cluster could be attributed to a particular geographical, temporal or source-of-isolation origin. It is concluded that S. Sofia is genetically variable with certain clones persisting over time but no group appears unique to Australia.     

Influence of exposure mode on vinyl chloride action

Rats were subjected to 4 h continuous or intermittent exposure to vinyl chloride (VC) at different time-weighted average concentrations (15, 50, 150, 500 and 15,000 mg/m³). Hepatic non-protein sulfhydryl content (NPSH) and excretion of thiodiglycolic acid (TdGA) in urine were determined. VC at concentrations from 50 mg/m³ to 15,000 mg/m³ caused a dose-dependent depression of NPSH, but no difference in the magnitude of this depression induced by continuous or intermittent exposure at the same average concentration of VC was noted. At average concentrations of 50 mg/m³ and 150 mg/m³, the urinary excretion of TdGA under continuous exposure did not differ from that under intermittent exposure, whereas at VC concentrations of 500 mg/m³ and 15,000 mg/m³ it was higher following continuous exposure.     

A qualitative exploration of the mechanisms,pathways and public health outcomes of a city centre 20mph speed limit intervention: The case of Belfast,United Kingdom

Twenty miles per hour (mph) speed limits can impact the health of the public (e.g., road safety, active travel). However, a better understanding of how individuals experience 20mph limits is required, to ensure interventions are cognisant of perceptions and potential un/intended outcomes. Focus groups (n = 9, 60 participants) to explore the Belfast 20mph intervention highlighted divergent perspectives and experiences including: 12 mechanisms (e.g., limited awareness), 15 pathways (e.g., reduced driving speed→improved liveability) and 10 public health outcomes (e.g., increased cyclist safety). Future interventions should consider un/intended outcomes and implement strategies to enhance effectiveness and mitigate harms (e.g., through training, enforcement).     

基于疾病诊断相关组的医院内专科评价指标探讨

目的通常疾病诊断相关组(DRGs)指标用于评价综合医院的能力,当用于医院内部评价时,因专科差异较大,现有指标不宜直接用于临床专科比较。本文拟探讨DRGs指标体系应用于医院内评价的问题,并提出专科能力指数及其计算方法。方法以某院2018年DRGs分组结果及该院所在省份DRGs数据,论证现有DRGs指标体系应用于医院内专科评价存在的问题,并提出新评价指标——专科能力指数以对临床科室进行比较与评价。结果新指标能有效地弥补DRGs指标体系在医院内评价临床科室时存在“不可比”的问题,能在一定程度上反映临床科室的专科能力。结论基于DRGs的专科能力指数不仅使得各临床科室具有可比性,且能在一定程度上反映临床科室的医疗服务综合能力。     

广西壮族人群血清HBsAg阳性与 ABO血型相关性研究

目的 探讨广西壮族人群血清HBsAg与ABO血型分布之关系。方法 采用卡方（x^2）检验方法与Woolf统计方法对578例HBsAg阳性携带者血清的ABO血型分布及男女性别的关系进行系统分析。结果 男性携带者血型呈O＞B＞A＞AB型分布,女性携带者呈O＞A＞B＞AB型分布。A、B、O和AB血型人相对危险率分别为1．1531、1．0458、0．9238和0．7365。结论：血清HBsAg阳性携带者与ABO血型间存在一定关系且与性别有关,尤以A型血女性感染乙肝病毒的危险性更大,具有重要流行病学意义。     

Repercusiones del confinamiento por COVID-19 en pacientes crónicos de Andalucía

ObjectiveTo understand the consequences of the COVID-19 pandemic lockdown on the self-care of people living with chronic diseases and on their self-perceived health, and to identify factors that may influence the management of their disease in emergency situations.MethodA qualitative study conducted in 2020 (March and April) in Andalusia (Spain) during the COVID-19 pandemic lockdown, through virtual focus groups, using the Zoom telematics tool. Three virtual focus groups were conducted, including 34 patients from Andalusia with different chronic conditions such as arthritis, diabetes, cardiovascular disease, inflammatory bowel disease, breast cancer and fibromyalgia.ResultsPeople with chronic diseases reported effects of the lockdown in relation to their emotional experience, their coping resources, the information they received, the difficulties to manage self-care, and the contact or access to health services. They also suggested some lessons learned for the future. The need for more and better information, patient training, involving patient associations, and improving telematics access to health services are the main areas for improvement to minimize the impact of future quarantines on the self-care and the health of people with chronic diseases.ConclusionsBesides the risk of contracting COVID-19, the difficulties encountered by people with chronic diseases during the lockdown include interferences in the self-care and the health care received. Health crisis situations demand more information, training for patients and improvements in the health services accessibility for patients with chronic conditions.     

Percepción de profesionales de la salud sobre la intervención grupal socioeducativa con mujeres que presentan síntomas somáticos sin causa orgánica

ObjectiveTo know the perception and opinion of primary care health professionals on the impact of non-medicalizing group educational intervention (GRUSE) with women who present somatic symptoms without organic cause.DesignQualitative phenomenological study.SettingPrimary care health centers in Andalusia, during 2017 and 2018.Participants and/or contextsTwenty-four health professionals, selected according to their level of involvement in the GRUSE strategy (socio-educational groups).MethodA qualitative methodology is applied, through the phenomenological method. The technique used to collect the information is the discussion group, and a content analysis is carried out on it. The software Atlas.ti 8.0 is used as a support resource for the analysis.ResultsHealth professionals highlight group work as a means of achieving change, and point to the importance of intervention as a non-medicalizing strategy. They perceive that the participants obtain some benefits: the improvement of their personal well-being, the increase of their self-esteem and self-determination, and the generation of social networks, benefits that also affect their immediate surroundings.ConclusionsIn the opinion of the professionals, the strategy has positive effects on women and does not mean an increase in resources for the health system. In addition, they express the importance of provide women with tools to cope with daily life problems derivates mostly from gender mandates of a patriarchal society.     

Soledad no deseada,salud y desigualdades sociales a lo largo del ciclo vital

ObjectiveTo analyse the prevalence of unwanted loneliness in our context and its association with health from a life cycle and social inequalities perspective.MethodCross-sectional study based on data from the Health Survey of the Basque Country (n = 7.228; response rate 79%). The prevalence of unwanted loneliness, its association with perceived health and mental health, and social inequalities according to social class were analysed. To analyse the association, age-adjusted prevalence ratios (PR) calculated from robust Poisson models were calculated.ResultsThe feeling of unwanted loneliness affects 23.3% of men and 29.7% of women, being higher in older people and young adults, and in the most disadvantaged social classes. Feeling alone is associated with worse health, both general (PRa men 2.11, 95% confidence interval [95%CI] 1.77-2.51; PRa women 2.10, 95%CI 1.83-2.41) and mental (PRa men 3.95, 95%CI 3.15-4.95; RPa women 3.50, 95%CI 2.99-4.12). Social inequalities in loneliness, as well as the association between it and poor health, was greater among young adults.ConclusionsThe results of the study have important implications for intervention in the reduction and prevention of unwanted loneliness, underlining the importance of the life cycle and social inequalities.     

Effects of participatory workplace improvement program on stress-related biomarkers and self-reported stress among university hospital nurses: a preliminary study

Although participatory workplace improvement programs are known to provide favorable effects on high stress occupations like nursing, no studies have confirmed its effect using biomarkers. The aim of this study was to determine whether a participatory workplace improvement program would decrease stress-related symptoms as evaluated by biomarkers and self-reported stress among hospital nurses. Three actions to alleviate job stress, which were determined through focus group interviews and voting, were undertaken for two months. A total of 31 female Japanese nurses underwent measurement of inflammatory markers, autonomic nervous activity (ANA), and perceived job stress (PJS) at three-time points; before the program (T1), within a week after the completion of the program (T2), and three months after the program (T3). A series of inflammatory markers (Interferon-γ, Interleukin (IL)-6, and IL-12/23p40) decreased significantly at T2, and IL-12/23p40 and IL-15 significantly decreased at T3 compared to T1, while ANA and PJS remained unchanged. Our participatory program exerted beneficial effects in reducing inflammatory responses, but not for ANA and PJS. Further investigations with a better study design, i.e., a randomized controlled trial, and a larger sample size are warranted to determine what exerted beneficial effects on inflammatory markers and why other outcomes remained unchanged.     

基于床位效能评价优化综合医院床位配置的应用研究

目的 运用疾病诊断相关组（diagnosis related groups） DRG指标作为医院医疗服务能力评价指标,结合病床运行效率综合评价单位病床利用效能,为医院床位合理配置提供决策依据。方法 以某三级甲等医院2019年运行数据及DRG数据为基础,以病床周转次数及病床占用率绘制科室病床运行效率散点图;以单床年DRG权重为产出指标,结合科室病例组合指数（case mix index）CMI值绘制病床产出效能散点图; 结合运行效率及产出效率综合评价科室病床利用效能并将其分为A、B、C、D、E五类。分别利用病床工作效率指标及病床产出效率指标95%CI计算各科室病床数的合理区间。结果 39个临床科室中,病床利用效能综合评价为A类有5个科室、B类科室14个、C类科室3个、D类科室10个、E类科室7 个。 有6个科室实际开放床位较为合理,病床工作效率与病床产出效率判定结果均为合适,14个科室的判定结果均为偏多,5个科室的判定结果均为偏少,余14个科室的床位配置判定结果发生了变化。 结论 结合DRG指标与传统运行效率指标对医院科室床位利用效能进行综合评价兼顾了效率和质量,其结果更为全面、客观;可为医院调整内部结构,优化床位配置提供科学依据,助力医院精细化管理。