龙里县医疗单位五年消毒质量监测的动态观察

为了认真贯彻《消毒管理办法》提高我县医疗卫生单位的消毒质量,笔者于1995～2000年对我县63家医疗卫生单位的细菌污染情况进行了调查监测,现将结果报道如下。     

曲阜市医疗机构1996～2OOO年消毒质量监测结果与分析

<正> 为贯彻《消毒管理办法》,强化消毒工作管理,1996～2000年,对辖区市的医疗卫生单位的消毒工作质量进行了监测,现将结果报告如下:     

曲阜市医疗机构1996～2000年消毒质量监测结果与分析

为贯彻&lt;消毒管理办法&gt;,强化消毒工作管理,1996～2000年,对辖区市的医疗卫生单位的消毒工作质量进行了监测,现将结果报告如下:……     

医疗机构消毒监测结果分析

<正> 为了解我市医疗机构的消毒质量,同时对我市医疗卫生机构的卫生状况进行调查分析,从而为做好我市医疗卫生机构消毒管理工作提供可靠的依据。我们于1998～2000年,在全市范围内对各类医疗卫生机构消毒灭菌情况进行     

长葛市2001-2010年医疗单位消毒效果监测分析

目的:了解长葛市各级医疗卫生单位消毒效果,为科学指导医院消毒工作、预防和控制医院感染提供科学依据。方法:按卫生部《消毒技术规范》、《医院消毒卫生标准》(GB15982-1995)和《消毒与灭菌效果的评价方法与标准》(GB15981-1995)的方法和要求,从2001年开始对辖区内的7所市级医疗单位、11所乡(镇)级卫生院、206个村卫生室及个体诊所等不同规模医疗卫生单位的消毒灭菌质量进行了10年的动态监测。结果:监测使用中的消毒剂、医务人员手、器械表面、操作台面、室内空气等各种样品共4 481件,合格3 916件,平均合格率为87.4%;市乡村三级医疗单位的综合合格率依次为96.3%、92.2%和81.4%,3者差异有显著性(P<0.01);5类监测样品中合格率最高的是消毒剂(95.5%),最低的是室内空气(66.3%)。结论:长葛市各级医疗卫生单位消毒效果不平衡,消毒合格率一般,乡村级医疗单位是以后消毒监测的重点,应加强医疗单位消毒质量管理,提高医疗单位消毒工作质量。     

田阳县2000年县、乡村级医疗卫生机构消毒效果分析

医疗卫生质量的好坏直接关系到人民群众的身体健康。为了探讨和改进我县各级医疗卫生单位的消毒基本情况 ,以便及早发现问题 ,提高消毒质量 ,防止医源性感染和医院内感染 ,进一步提高我县各级医疗卫生机构的服务质量 ,我站消杀灭科于 2 0 0 0年对全县 12 9家县、乡村级医疗卫生单位进行消毒效果监测 ,现将监测结果分析报告如下 :材料与方法　　 1.监测对象　 3个县级医疗卫生机构 ,15个乡镇卫生院和 111个村卫生所及个体医 ,共 12 9个医疗卫生单位。2 .样品采集和检测(1)物体表面　用 5ｃｍ× 5ｃｍ的标准灭菌规格板放在被检物体表面 ,用浸…     

色达县2001～2003年医疗卫生单位消毒质量监测结果分析

为进一步贯彻落实《消毒管理办法》、《消毒技术规范》和《四川省消毒管理条例》，提高消毒工作质量，有效地控制院内感染，我站于2001-2003年对色达县县级医疗卫生单位进行了消毒质量监测，结果如下：     

云龙县2001-2010年医疗单位消毒效果监测分析

目的了解云龙县各级医疗卫生单位消毒效果,为科学指导医院消毒工作、预防和控制医院感染提供科学依据.方法 按卫生部<消毒技术规范>、<医院消毒卫生标准>(GB15982-1995)和<消毒与灭菌效果的评价方法与标准>(GB15981-1995)的方法和要求,从2001年开始对辖区内的4所县级医疗单位、14所乡(镇)级卫生院、86个村卫生室及个体诊所和4个校医室等不同规模医疗卫生单位的消毒灭菌质量进行了十年的动态监测.结果 监测使用中的消毒剂、医务人员手、器械表面、操作台面、室内空气等各种样品共3267件,合格3000件,平均合格率为91.8%;县乡村三级医疗单位的综合合格率依次为94.1%、91.7%和88.0%,三者差异有显著性(P＜0.05);5类监测样品中合格率最高的是操作台面(95.5%),最低的是空气中的细菌含量(64.1%).结论云龙县各级医疗卫生单位消毒效果不平衡,消毒合格率一般,乡村级医疗单位是今后消毒监测的重点,应加强医疗单位消毒质量管理,增 强医护人员的无菌意识,提高医疗单位消毒合格率,有效防止医院感染.     

1998～2000年汕头市医疗卫生单位消毒质量监测报告

目前我国医疗卫生单位医源性感染的报道并不少见。消毒工作是防止医源性感染的重要措施 ,但目前在各级医疗机构仍存在不少隐患[1]。消毒质量不过关 ,可增加医源性感染的发生率 ,甚至可导致发生严重的医院感染暴发事件[2 ]。为促进我市消毒管理工作水平的提高 ,降低医院感染的发生率 ,现将我站 1 998～ 2 0 0 0年对我市各级医疗卫生单位的消毒质量监测结果报告如下。1　对象与方法1 1　监测对象与内容 :监测对象为我市各市级、县 (区 )级医疗卫生单位。监测内容包括使用中消毒剂、灭菌医疗用品、压力蒸汽灭菌效果、医务人员手、物体表面及空…     

大兴安岭呼中区医疗单位消毒质量监测结果分析

为了解我区医疗单位消毒状况，预防和控制医源性感染的发生和传播，保证病人及医务人员的安全，根据卫生部《医院感染管理规范》我们于2005年5-11月对区里21家医疗卫生单位进行了消毒质量监测。     

A study on the use of car occupant restraint in Selangor

A survey was conducted in December 1995 to study car occupant restraint usage in Selangor. A total of 1082 car occupants were observed in 536 cars. The results of the study shows that only 57.3% of the car occupants observed were protected by any form of restraints. Most of the cars (99.8%) examined had front seat belts but only 44.2% had rear seat belts. Only 0.6% of the cars were found to have child restraints in the cars. 80.2% of drivers used restraints and only 65.4% of front seat passengers used any forms of restraints. In the case of the rear seat passengers, only 0.42% used an available restraint. More people in the urban areas (84.42%) than in the rural areas (66.51%) used seat belts. Usage of seat belts by car drivers influenced the use of seat belts by front seat passengers. Type of seat belts fitted was associated with usage rate. It is sad to note that 21.9% of the drivers used seat belts incorrectly.     

The prevalence of seat belt use in Kingston, Jamaica: a follow-up observational study five years after the introduction of legislation

An observational cross-sectional study conducted in Kingston in 2004 showed that seat belts were used by 81.2% of private motor vehicle drivers and 74.0% offront seat passengers. This was significantly improved compared to 21.1% and 13.6% respectively in 1996 before the introduction of legislation in 1999 (p < 0.001). Females were significantly more likely than males to wear seat belts, both when driving (92.5% vs 77.3%; p < 0. 001) and as front seat passengers (79.9% vs 66.3%; p < 0.001). Of the 2289 motor vehicles examined, all except one were equipped with seat belts. Rear passenger utilization of seat belts was not examined. Drivers of new vehicles were more likely than other drivers to use seat belts (p < 0.001). Male drivers, drivers of older vehicles and all passengers may require specific targeting in an educational and enforcement campaign if the maximum benefits of seat belt use are to be realized     

Effect of seat belts on injuries to front and rear seat passengers

Data on 2520 occupants of cars involved in accidents were analysed in relation to injury and the severity of the crash to investigate the effect of rear seat passengers on injury to restrained and unrestrained front seat occupants and vice versa. Unrestrained front seat occupants showed a higher incidence of serious injury when there were rear seat passengers. The presence of a rear seat passenger did not affect significantly the overall incidence of injury among restrained front seat occupants within the range of crash severity considered. Unrestrained rear seat passengers behind unrestrained front seat occupants showed a higher incidence of moderate injury and a lower incidence of no injury than those behind restrained front seat occupants. It is concluded that legislation on seat belts has not greatly increased the risk of person to person injury.     

The performance of seat belts in severe crashes.

This paper reports an intensive follow-up study of persons injured while wearing seat belts in crashes. Examinations of both vehicles and persons were carried out after the crash, and 30 out of 54 (55.5%) persons were judged to have been wearing seat belts at impact. Eight received injuries from the seat belt, only four of these injuries being severe, and none was fatal. A roadside survey showed that half of the occupants wearing seat belts had them adjusted incorrectly. This compared with nearly 90% of the crash cases having incorrectly adjusted belts. There is therefore an association between incorrectly worn seat belts and injury. The seat belt buckle seems to be a possible cause of injury in this situation, especially when worn in from of the hip, and with a loose belt. Comparison of police reports of belt wearing for the study cases suggests an underestimate of about 10% in the wearing rate if police data are used.     

An analysis of factors associated with seat belt use: prevention opportunities for the medical community

Motor vehicle collisions are a significant cause of morbidity and mortality in the Oklahoma population. The cost associated with this morbidity and mortality is exacerbated by the failure of individuals to use seat belts. Numerous organizations believe that seat belt compliance can be improved through physician counseling. This would allow medical resources to be redirected towards other health problems. Analysis was performed using the Oklahoma Department of Public Safety (ODPS) crash file and the hospital in-patient data discharge file from the Oklahoma State Department of Health (OSDH). These provide a profile of Oklahoma drivers who do not use seat belts. This analysis allows physicians to pinpoint and advise those individuals most likely to not utilize seat belts about the benefits of seat belt use. The results of the analysis show that non-seat belt-users tend to be young and male. Significant predictors of seat belt use are age, gender, alcohol use, time of day (day versus night), driver location (urban versus rural), vehicle type (pick up versus passenger car), and decreased hospital charges. These results show that increased seat belt use can lead to significant decreases in fatalities related to motor vehicle crashes and a decline in associated hospital charges for those who survive. Physicians should encourage seat belt use by their patients and inform them of the risks associated with failure to use seat belts.     

Pacemaker discomfort induced by the wearing of seat belts

A survey was made of 100 consecutive pacemaker recipients to examine problems they may have experienced with seat belts whilst travelling by car, either as drivers (29 patients) or front seat passengers (50 patients). Twenty-one per cent of the drivers and 30% of the front seat passengers had experienced symptoms, usually of a mild nature. Re-siting of the generator was only necessary in 1 patient and no example of electrode displacement was observed. Suggestions are made as to how this problem might be overcome.     

Association between exposure/non-exposure to the mandatory seat belt law with regards to compliance in vehicle accident victims--a hospital review

OBJECTIVE: Injuries sustained in motor vehicle accidents (MVAs) are a major challenge to the Jamaican healthcare system. In November 1999, Jamaica enacted legislation to make seat belt usage in motor vehicles compulsory. The effect of this policy change on seat belt usage is unclear. This study therefore sought to determine the prevalence of seat belt usage and to determine the association between exposure/non-exposure to the mandatory seat belt law and seat belt use in subjects who presented to the Accident and Emergency Department (A&E) of the University Hospital of the West Indies (UHWI) as a result of motor vehicle accidents. METHODS: Subjects were recruited from June to November 2003, post-seat belt law (POBL) period, and May to October 1999, pre-seat belt law (PRBL) period. Data collected included demographic variables, seat belt use and position of the occupants in the vehicle. RESULTS: Of the 277 patients who were eligible for inclusion, data were complete in 258 subjects, 87 in the PRBL period and 171 in the POBL period. The prevalence of seat belt use was 47% (PRBL) and 63% (POBL) respectively. There was no significant gender difference at each period. The odds of wearing seat belt in the rear of a motor vehicle were significantly lower than that of a driver (Table 3, OR 0.19, 95% CI 0.07, 0.48). Adjusting for age, gender and position in vehicle exposure, there was about 100% increase in the odds of seat belt use during the post seat belt law era (OR = 2.09, 95% CI 1.21, 3.61). CONCLUSION: It is concluded from this hospital-based study that the mandatory seat belt law legislature was associated with increased seat belt use in motor vehicle accident victims. However, current data from the Road Traffic Agency indicate that there is still an alarming number of fatalities. This clearly suggests that additional public health measures are needed to address the epidemic of motor vehicle trauma in Jamaica.     

Motor vehicle crash injury patterns and the Virginia seat belt law

Injuries to front seat occupants in tow-away crashes in the Charlottesville, Va, area were compared for 1 year before and 1 year after Virginia's seat belt use law took effect. Vehicle and occupant data were combined to examine crash and injury patterns. Reported seat belt use in crashes increased after the law, and there were substantial decreases in injuries. Front seat occupants were less likely to receive medical treatment following a crash in the postlaw period. The reduction in the number of injuries was greater for passengers in the right front seat than for drivers and for frontal crashes than for other types of crashes. The injury reduction effects occurred primarily through reductions in the number of head and face injuries, particularly those that occur from contact with windshields and instrument panels.     

大客车正面碰撞车内乘员损伤AIS评分的个案分析

目的 基于大客车正面碰撞事故车内乘员损伤AIS (abbreviated injury scale) 评分, 分析损伤的影响因素和特征, 探讨预防措施.方法 采用事故深度调查方法, 对人体损伤及相关因素进行统计和回归分析.结果性别对损伤AIS值影响无显著性差异, 乘员损伤部位主要是头部 (AIS均值=3.7647) 和胸部 (AIS均值=4.000) , t检验无显著性差异 (t=-0.275, P=0.785>0.05) ;前3排乘员平均损伤 (AIS=4.750) 显著大于3排后的损伤 (AIS=1.706) (t=-4.819, P<0.05) ;座椅连接牢固、使用安全带可显著减轻乘员损伤程度;单因素方差分析表明年龄、第几排和安全带是乘员损伤的显著影响因素;二分类项Logistic回归模型表明前两排位置死亡与非死亡概率比达311倍.结论 影响损伤程度的显著性因素有年龄、第几排和安全带;车身前两排死亡与非死亡概率比过高, 两点式安全带对头部和胸部保护作用不足.应改善车身前部安全性结构设计提倡使用用三点式安全带.     

Design and milling manufacture of polyurethane custom contoured cushions for wheelchair users

Background

The design of custom contoured cushions manufactured in flexible polyurethane foams is an option to improve positioning and comfort for people with disabilities that spend most of the day seated in the same position. These surfaces increase the contact area between the seat and the user. This fact contributes to minimise the local pressures that can generate problems like decubitus ulcers. The present research aims at establishing development routes for custom cushion production to wheelchair users. This study also contributes to the investigation of Computer Numerical Control (CNC) machining of flexible polyurethane foams.

Method

The proposed route to obtain the customised seat began with acquiring the user''s contour in adequate posture through plaster cast. To collect the surface geometry, the cast was three-dimensionally scanned and manipulated in CAD/CAM software. CNC milling parameters such as tools, spindle speeds and feed rates to machine flexible polyurethane foams were tested. These parameters were analysed regarding the surface quality. The best parameters were then tested in a customised seat. The possible dimensional changes generated during foam cutting were analysed through 3D scanning. Also, the customised seat pressure and temperature distribution was tested.

Results

The best parameters found for foams with a density of 50kg/cm³ were high spindle speeds (24000 rpm) and feed rates between 2400–4000mm/min. Those parameters did not generate significant deformities in the machined cushions. The custom contoured cushion satisfactorily increased the contact area between wheelchair and user, as it distributed pressure and heat evenly.

Conclusion

Through this study it was possible to define routes for the development and manufacturing of customised seats using direct CNC milling in flexible polyurethane foams. It also showed that custom contoured cushions efficiently distribute pressure and temperature, which is believed to minimise tissue lesions such as pressure ulcers.