牙科医生对口腔卫生服务体系的评价

目的 :分析牙科医生的日常工作量和牙医对口腔卫生服务的态度评价 ,有助于口腔卫生服务体系的制定和评价。方法 :根据武汉市卫生部门登记在册的牙科医生 ,采用整群抽样的方法随机选择 2 5 0名牙科医生进行开放式问卷调查。结果 :所调查的 2 5 0名样本中 ,5 2 %为女性 ,牙科医生平均工作年限为 11.6年 ,平均使用 0 .8台牙椅 ,每位牙医平均每天看 15个病人。主要工作时间用于充填治疗和拔牙。 93 %的牙医认为中国口腔卫生服务强调治疗而忽视预防保健。结论 :口腔卫生服务应重视口腔预防保健     

A health comparison of Alabama nurses versus US, UK, and Canadian normative populations

This article is one of a two part series examining the people and environment associated with patient handling. The approach used was that of an occupational injury investigation of a job class, which incorporates defining in the task, environment, tools, and worker health status. Hence, the objective of this portion of the research was to develop a method and use it to compare the physical and mental health of Alabama nurses with known normative populations to determine a baseline of overall health. For this purpose, the validated SF-36© survey was used to collect data on Alabama nurses who had been registered in the state for at least one year. The potential participant pool included 1000 nurses randomly selected from more than 49,000 registered. Physical mailers with a pre-paid return envelope and a follow-up reminder post-card were used. A return rate of 10% was expected based on nursing literature. One hundred and one surveys were returned with 87 being complete. Results confirmed that nursing in the US is a female dominated profession with the survey matching both the Alabama and US national average of 92%. Comparisons of the sample data to general populations yielded significant differences in 3 of the 8 outcome measures: social functioning; physical functioning; bodily pain. In each of these measures, Alabama nurses had a reduced health status compared to at least one comparative population. Additionally, data related to body mass index (BMI) for Alabama nurses were stratified by gender and age. Results indicated 28% had a “healthy” BMI with 37% and 35% of the nurses being “overweight” or “obese”, respectively. Consequently, results suggest Alabama nurses have a reduced health status compared to normative populations and show similar but not identical BMI trends to the general populations for the state of Alabama and the US, which warrants concerns about potential declines in health status among caregivers.

Significance to healthcare

Nurses constitute the largest proportion of the healthcare industry’s workforce. Understanding the perceptions of health status of this employee group is essential to gain further information about possible influences of health on nurses’ ability to continue to perform their jobs.     

Satellite and Mobile Wireless Transmission of Focused Assessment with Sonography in Trauma

Objectives: Focused assessment with sonography in trauma (FAST) can define life‐threatening injuries in austere settings with remote real‐time review by experienced physicians. This study evaluates vest‐mounted microwave, satellite, and LifeLink communications technology for image clarity and diagnostic accuracy during remote transmission of FAST examinations. Methods: Using a SonoSite, FAST was obtained on three patients with pericardial and intraperitoneal effusions and two control subjects in a remotely located U.S. Army Combat Support Hospital. A miniature vest‐mounted video transmitter attached to the SonoSite sent wireless ultrasound video 20 m to a receiving antenna. The signal was then transferred over VSAT satellite systems at 512 kilobaud per second (kbps), INMARSAT satellite systems at 64 kbps, and over LifeLink on a moving ambulance through a metropolitan wireless traffic–management network. Clarity and absence or presence of effusions were recorded by 15 staff emergency physicians. Results: Average sensitivity, specificity, and accuracy were 87% (95% confidence interval [CI] = 79% to 95%), 85% (95% CI = 81% to 89%), and 86% (95% CI = 82% to 90%) for the Premier Wireless Vest; 98% (95% CI = 97% to 99%), 83% (95% CI = 75% to 91%), and 86% (95% CI = 82% to 90%) for VSAT; 95% (95% CI = 94% to 96%), 70% (95% CI = 58% to 82%), and 75% (95% CI = 70% to 80%) for INMARSAT; and 82% (95% CI = 73% to 91%), 83% (95% CI = 74% to 92%), and 82% (95% CI = 78% to 86%) for LifeLink with clarity of 3.0 (95% CI = 2.7 to 3.3), 2.9 (95% CI = 2.6 to 3.2), 1.3 (95% CI = 1.2 to 1.4), and 2.1 (95% CI = 1.8 to 2.4), respectively. Conclusions: Accuracy correlated with clarity. Roaming vest transmission of FAST provides interpretable, diagnostic imagery at the distances used in this study. VSAT provided the best clarity and diagnostic value with the lighter, more portable INMARSAT serving a lesser role for remote clinical interpretation. LifeLink performed well, and further infrastructure improvements may increase clarity and accuracy.     

Cross‐sector emergency planning for water supply utilities and healthcare facilities

The purpose of this article is to outline the criticality of water supply in sustained operations of healthcare facilities, particularly during community emergencies, and to advocate for enhanced cross‐sector support from the water utilities in meeting this need. Information and ideas presented here were developed in the course of a regional project sponsored by the Metropolitan Washington Council of Governments (MWCOG) for development of emergency water supply operations plans for critical water uses in the Washington, DC, area.     

Properties of Vero cytotoxin-producing Escherichia coli of human origin of O serogroups other than O157.

The 48 Vero cytotoxin-producing Escherichia coli (VTEC) examined for properties associated with virulence were of human origin and represented 17 O serogroups other than O157 and O26. Only Vero cytotoxin production was common to all the strains. About 60% produced enterohemolysin and hybridized with the CVD419 probe derived from plasmid sequences of E. coli O157. Thirteen strains gave localized adherence (LA) to HEp-2 cells. All of these hybridized with the E. coli attaching and effacing (eae) gene probe and were positive in the fluorescence actin staining test, properties characteristic of strains that efface intestinal microvilli. A further 5 strains were eae probe-positive but did not give LA. None of the VTEC hybridized with a probe specific for the enteropathogenic E. coli adherence factor. Seven strains adhered to HEp-2 cells in a diffuse or aggregative pattern but did not hybridize with probes for these phenotypes. Non-O157 E. coli strains are diverse in their properties, although some may share virulence mechanisms with other diarrheogenic E. coli.     

Native associations of early hematopoietic stem cells and stromal cells isolated in bone marrow cell aggregates

In suspensions of murine bone marrow, many stromal cells are tightly entwined with hematopoietic cells. These cellular aggregations appear to exist normally within the marrow. Previous studies showed that lymphocytes and stem cells adhered to stromal cells via vascular cell adhesion molecule 1 (VCAM1). Injection of anti-VCAM1 antibody into mice disrupts the aggregates, showing the importance of VCAM1 in the adhesion between stromal cells and hematopoietic cells in vivo. Early hematopoietic stem cells were shown to be enriched in aggregates by using a limiting-dilution culture assay. Myeloid progenitors responsive to WEHI-3CM in combination with stem cell factor (c-kit ligand) and B220- B-cell progenitors responsive to insulin-like growth factor-1 in combination with interleukin-7 are not enriched. We propose a scheme of stromal cell-hematopoietic cell interactions based on the cell types selectively retained within the aggregates. The existence of these aggregates as native elements of bone marrow organization presents a novel means to study in vivo stem cell-stromal cell interaction.