一次性无纺布和全棉布包装灭菌效果及成本比较

目的对一次性无纺布与全棉布的灭菌、阻菌效果和成本进行比较,为医院选择经济适用的灭菌包装材料提供依据。方法设实验组与对照组。实验组灭菌包采用一次性无纺布包装,对照组灭菌包采用全棉布包装,两组灭菌包在同一锅次中灭菌。分别于灭菌当天和不同保存时间采样、细菌培养,同时比较两组的包装成本。结果全棉布包装的灭菌包在保存第30天后开始有细菌生长,一次性无纺布包装的灭菌包6个月内未发现细菌生长。50 cm×50 cm规格的一次性无纺布单包包装成本价格为2.6元,全棉布为4元;一次性无纺布单包包装成本每月每包比全棉布少42元。结论灭菌包装材料一次性无纺布与传统全棉布相比,具有理想的灭菌和阻菌效果,且能降低包装成本,节省医疗资源,可替代全棉布应用于临床。     

集中供应手术器械灭菌湿包原因分析及对策

目的 探索供应室集中供应手术器械和敷料灭菌包湿包的原因,并讨论解决方法以保证灭菌质量.方法 将使用纺织棉布或无纺布包装的手术器械包和敷料包称重随后放人灭菌器,按脉动真空压力蒸汽灭菌器的正常操作流程运行1个灭菌周期,观察灭菌后的器械包和敷料包是否有水渍、水珠、水印后,立即、放置10、20 min分别进行称重,连续检测3d.结果 器械包中有两包出现边角湿,敷料包中有两包外有水珠存在;灭菌前后称重发现,超重的敷料包和器械包易产生湿包;灭菌包使用无纺布比纺织棉布包装易湿包;灭菌后立即称重约73.0％超重;放置10 min后17.3％超重;放置20 min后无超重.结论 可通过减轻灭菌包重量,使用棉布代替无纺布包装可缓解湿包现象;灭菌包在灭菌器内延长放置时间等也可缓解湿包现象.     

纸塑包装高压灭菌包的临床应用

目前使用的双层棉布包由于棉布带有微粒、保存有效期短等缺点,已远远不能满足临床需要.近两年来,我院开展了纸塑包装灭菌包,投入临床使用,取得较为满意的效果.     

一次性无纺布不同包装方式对器械包无菌屏障系统的影响

目的观察一次性无纺布包装器械包破损情况,分析包装破损的原因,通过改进包装方法提高包装完好性。方法选取2017年10月—2018年12月某院5 000个相同规格的手术器械包作为研究对象,按照不同的包装形式分为A—E组(A组:普通篮筐+一次性无纺布;B组:普通篮筐+一次性吸水衬纸+一次性无纺布;C组:平底篮筐+一次性无纺布;D组:平底篮筐+一次性吸水衬纸+一次性无纺布;E组:提篮+平底篮筐+一次性吸水衬纸+一次性无纺布),每组数量1 000个,观察记录自包装完成至使用前的七个环节(①包装操作完成;②装载至灭菌架;③灭菌后卸载至存储架;④装入运输车;⑤卸载至手术室存储架;⑥使用前放置在操作台;⑦使用前打开)器械包的破损情况。结果 A—E组包装破损率分别为21.7%、13.5%、8.8%、5.2%、0.1%,A组破损率最高,E组破损率最低,各组比较,差异均有统计学意义(均P0.001)。①—⑦转运环节中包装破损率分别为0、0.24%(12件)、1.04%(52件)、1.44%(72件)、3.44%(167件)、0.30%(15件)、0.46%(23件),除环节①包装破损数量为0以外,各个环节均发生了包装破损,环节⑤破损率最高,器械包进入使用科室直至使用前,破损情况均在持续发生。结论与使用普通篮筐比较,使用平底篮筐进行器械包装破损率更低,增加一次性吸水纸的保护可以进一步改善包装破损情况,器械包转运提篮的使用可以有效减少包装在转运、搬运过程中的损伤。     

供应室棉布包装材料使用次数记录方法

为了落实2009年卫生部颁布《医院消毒供应室管理规范》中,对纺织品包装材料质量要求,我院供应室对所有诊疗器械及物品所使用的棉布包装材料进行使用次数记录,提高了棉布包装材料阻菌、屏障作用,保证无菌物品有效、安全使用,取得了良好效果。     

一次性无纺布不同包装方式对器械包无菌屏障系统的影响

目的 观察一次性无纺布包装器械包破损情况，分析包装破损的原因，通过改进包装方法提高包装完好性。方法 选取2017年10月—2018年12月某院5 000个相同规格的手术器械包作为研究对象，按照不同的包装形式分为A—E组（A组：普通篮筐+一次性无纺布；B组：普通篮筐+一次性吸水衬纸+一次性无纺布；C组：平底篮筐+一次性无纺布；D组：平底篮筐+一次性吸水衬纸+一次性无纺布；E组：提篮+平底篮筐+一次性吸水衬纸+一次性无纺布），每组数量1 000个，观察记录自包装完成至使用前的七个环节（①包装操作完成；②装载至灭菌架；③灭菌后卸载至存储架；④装入运输车；⑤卸载至手术室存储架；⑥使用前放置在操作台；⑦使用前打开）器械包的破损情况。结果 A—E组包装破损率分别为21.7%、13.5%、8.8%、5.2%、0.1%，A组破损率最高，E组破损率最低，各组比较，差异均有统计学意义（均P<0.001）。①—⑦转运环节中包装破损率分别为0、0.24%（12件）、1.04%（52件）、1.44%（72件）、3.44%（167件）、0.30%（15件）、0.46%（23件），除环节①包装破损数量为0以外，各个环节均发生了包装破损，环节⑤破损率最高，器械包进入使用科室直至使用前，破损情况均在持续发生。结论 与使用普通篮筐比较，使用平底篮筐进行器械包装破损率更低，增加一次性吸水纸的保护可以进一步改善包装破损情况，器械包转运提篮的使用可以有效减少包装在转运、搬运过程中的损伤。     

不同灭菌包装材料使用成本与效率的卫生经济学研究

目的:探讨硬质灭菌容器、棉布和无纺布3种灭菌包装材料在医院消毒灭菌使用的经济性,为医院制定相关管理决策提供科学参考。方法:使用结构化问卷,采用Delphi专家调查法,对医院内使用硬质灭菌容器、棉布和无纺布在器械再处理流程中的效率、成本和医患感染风险开展调查,并对调查结果进行统计分析,在MS Excel中建立经济学分析模型,计算评估不同灭菌材料的经济性。结果:硬质灭菌容器、棉布灭菌包和无纺布灭菌包的平均总成本分别为20.56元、25.45元和31.47元。硬质灭菌容器、棉布灭菌包和无纺布灭菌包单次消毒工作时间分别为4.78 min、6.42 min和2.95 min。硬质灭菌容器医患感染风险最低,其次为无纺布灭菌包。敏感性分析结果验证基础分析结果的稳健性。结论:消毒灭菌工作中硬质灭菌容器平均总成本最低,感染风险最小,无纺布灭菌包的消毒时间消耗最低,在器械消毒处理流程中应合理选择使用。     

不同装载方式高压蒸汽灭菌的湿包控制探讨

目的控制灭菌包湿包的发生,提高灭菌质量。方法进行灭菌湿包试验,对比各种灭菌装载技术与灭菌包湿包情况。结果单独纸塑包装物品在各种载装方式灭菌中使用网筐装放、纸面对塑面竖放隔疏单层装载方式的灭菌包湿包率最低;外层棉布包装的有孔金属容器在各种载装方式灭菌中使用单层装载方式的灭菌包湿包率最低。结论不同载方式灭菌,灭菌包湿包率有很大的差异,应用合理的装载技术灭菌可大大减少灭菌包湿包的发生。     

一次性材料包装干镊子容器的实践与效果

无菌干镊子容器其传统包装方法是采用双层棉布包装.由于棉布易破损,使用中回收、清洗成本高,耗费人力物力,且阻菌效果差.因此,我科在实践中通过反复试验,采用一次性皱纹纸加无纺布包装干镊子容器,取得良好的效果.     

一起~(137)Cs固体放射源包壳破损事故

随着科学技术的发展,已将辐射源大量应用于国民经济的各个部门。但是,如果使用方法不当,管理不善,很可能发生固体源包壳破损。本文报道的是一起~(137)CS固体封闭源包壳破损导致的污染事故。     

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.     

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.     

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.     

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.     

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.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.