护理干预措施对神经内科重症监护患者院内感染控制的影响

目的探讨护理干预措施对神经内科重症监护患者院内感染控制的影响。方法选择本院神经内科重症监护患者144例,分为干预组69例和对照组75例,对照组给予常规护理,观察组在此基础上给予综合护理干预,比较两组院内感染发生率。结果干预组患者发生院内感染12例,感染率16.00%,对照组患者发生院内感染37例,感染率53.62%,两组比较差异有统计学意义（P〈0.01）。两组患者下呼吸道、上呼吸道、泌尿道、颅内及皮肤院内感染发生率比较,差异有统计学意义（P〈0.01）。结论强化综合护理干预措施对预防和控制神经内科重症监护患者院内感染的发生作用显著。     

老年住院患者医院感染率调查及护理对策

目的调查老年住院患者医院感染率并提出护理对策,以减少老年患者医院感染率的发生。方法对医院2008年1~6月年龄≥65岁住院老年患者149例进行回顾性调查。结果老年患者医院感染率与年龄差异无统计学意义;但与住院时间延长相关,住院时间60 d患者医院感染发生率高于住院时间30 d(P0.05);感染部位以呼吸道(63.6%)和泌尿道(13.6%)为主;病原菌以铜绿假单胞菌(31.8%),鲍氏不动杆菌(18.1%)、大肠埃希菌(15.9%)和金黄色葡萄球菌(11.4%)为主。结论在预防与控制医院感染发生中加强护理质量监控和培训不容忽视。     

老年非霍奇金淋巴瘤医院内感染临床分析

目的了解老年非霍奇金淋巴瘤（NHL）患者的医院内感染情况。方法对126例次住院老年NHL患者中发生医院感染的51例次患者进行回顾分析,并与同期非老年组进行比较。结果老年组发生医院感染率为40．5％,高于同期非老年组的12．6％（P〈0．05）。感染部位以呼吸道为主;病原菌以革兰阴性杆菌为主,占43．7％;革兰阳性菌占34．4％;真菌占21．9％。外周血白细胞、化疗疗程、住院天数都是影响院内感染发生的重要因素。结论老年NHL患者医院感染发生率高,应引起重视,加强防护。     

儿童患者EB病毒感染状况分析

目的了解爱泼斯坦巴尔病毒（EB病毒）在住院患者感染及引起的临床症状。方法从2004年10月-2006年4月,对医院儿科住院患者,取咽拭子,用实时荧光定量PCR法检测咽拭中EB病毒-DNA。结果总共检测了3429例,有738例为阳性,阳性率为21.5%;EB病毒感染率随年龄增大而升高,在≤3、4～7、8～11、12～15岁年龄组的感染率分别为18.8%、26.5%、29.0%、31.7%,差异有统计学意义（P〈0.01）;在EB病毒感染的病例中,主要以呼吸道感染为主,急性上呼吸道感染（41.2%）、肺炎（15.3%）、支气管炎（12.6%）等。结论EB病毒是儿科住院感染的重要病原体,主要感染病例为急性上呼吸道感染、肺炎、支气管炎等,而随着年龄的增长,由EB病毒感染所引起比例越大。     

精神科老年住院患者感染情况调查与分析

目的 为了了解精神科老年住院患者的院内感染情况,探寻感染发生的原因,以期降低感染率.方法 采用回顾性的方法,对2009年我院住院老年精神障碍患者(男≥60岁、女≥55岁)中发生医院感染的病历进行统计分析.结果 331例住院老年患者发生感染113例,医院感染率34.1%,以下呼吸道感染为主(52.2%),获感染的患者中老年痴呆例数多(55.75%),医院感染率及感染部位分别与性别具有较显著性差异(P<0.05),男性较女性更易感染,呼吸道感染男性比例高,泌尿道感染女性比例高,感染部位与年龄无显著性差异.结论 老年痴呆症患者是老年精神障碍患者中最易感染的群体,预防呼吸道及泌尿道感染是降低精神科老年患者感染率的关键.     

浦东新区远郊社区卫生服务中心院内感染调查分析

目的了解浦东新区远郊社区卫生服务中心院内感染发生现状,有效预防和控制医院内感染的发生和流行。方法对泥城社区卫生服务中心2012年1月—2014年6月全部病历进行调查,对院内感染情况进行回顾性调查分析。结果院内感染发生率为7.07%,院内感染的发生与患者年龄、疾病和住院时间等都有统计学意义(P<0.01)。年龄越大,发生率越高,90岁以上年龄组感染率为9.03%,75~89岁年龄组感染率为8.45%,60~74岁为5.82%;住院时间越长,发生率越高,住院10天以下的感染率为1.42%,大于60天的入院感染率为48.57%;在所有院内感染病例中,以呼吸系统感染最多,占58.67%;11月、1月和2月是院内感染的高发季节,分别为22.9%、11.1%和11.04%。结论我中心院内感染率高于全国发生的一般水平,社区卫生服务中心应根据院感发生的易感因素,结合服务中心的自身特点,采取有效的干预措施,控制院内感染的发生和流行。     

某妇幼保健院妇科患者HPV亚型感染的研究

目的探讨妇科门诊患者HPV感染率、亚型分布以及不同年龄HPV感染情况,为本地区妇女HPV防制提供基线资料。方法对2009年10月-2011年7月来湘潭市妇幼保健院妇科门诊就诊的9 266例患者进行登记,并采集其阴道、宫颈分泌物作为标本,用导流杂交基因芯片技术进行21种HPV基因型的分型检测。用EXCEl2007和SPSS17.0建立数据库及统计分析,HPV感染率比较采用χ2检验。结果①HPV阳性总检出率为21.07%（1 952/9 266）,高危型别感染率为18.55%（1 719/9 266）,低危型别感染率为2.51%（233/9 266）,单一型别感染率为15.55%（1 441/9 266）,多重型别感染率为5.51%（511/9 266）;②HPV感染数前三位的是HPV52、HPV16、HPV58,且以单一感染和双重感染为主,高危型和低危型感染者在HPV单一及多重感染分布上差异有统计学意义（χ2=68.37,P〈0.01）;③不同年龄检查者的HPV感染率差异有统计学意义（χ2=28.27,P〈0.01）,不同年龄的HPV感染者感染高低亚型的分布上差异有统计学意义（χ2=32.87,P〈0.01）,不同年龄的HPV感染者HPV感染类型的分布上差异有统计学意义（χ2=48.49,P〈0.01）,各年龄均以单一及高危感染为主,但在25岁以下及50岁以上年龄HPV感染者中高低危合并感染、多重感染多于其他年龄段。结论本院妇科门诊患者HPV感染率处于较高水平,HPV感染最常见的亚型为HPV52、16、58。不同年龄患者HPV感染率不同,高低危亚型、单一及多重感染分布在不同的年龄中有差别,在25岁以下及50岁以上年龄患者中高低危合并的多重感染高于25~50岁患者。     

某医院老年患者院内感染因素分析

目的探讨老年患者院内感染的危险因素以及预防对策。方法 调查某医院老年住院患者560例,对60例发生院内感染患者临床资料进行调查,分析院内感染的危险因素。结果某医院院内感染感染发生率为10.71%,阻塞性肺疾病院内感染率最高为12.83%,其次为恶性肿瘤10.58%,糖尿病9.26%,脑血管疾病为6.67%,心血管疾病5.13%。感染部位以呼吸道为主（51.67%）;泌尿道其次（21.67%）。吸氧、静脉留置针、雾化等侵入性操作的院内感染发生率分别为95.00%。、81.67%和43.33%。病原菌培养以革兰阴性杆菌为主（60.94%）。结论 吸氧、静脉留置针、雾化等侵入性操作是院内感染的主要危险,不同基础疾病发生院内感染率不同,严格规范各类侵入性操作,并加强基础性疾病的治疗和合理使用抗生素,预防减少院内感染的发生。     

医院感染化脓性眼内炎临床分析

目的探讨医院感染化脓性眼内炎的临床特点,给预防和治疗提供依据。方法对1996-2005年住院患者进行回顾性研究分析。结果医院感染化脓性眼内炎占手术例数的0.024%,91.00%发生在术后3 d内,送检标本培养以革兰阳性球菌为主;晶状体后囊膜破裂与后囊膜未破裂的眼内炎感染率差异有统计学意义（P〈0.05）;年龄≥60岁与〈60岁感染率差异无统计学意义（χ^2=1.50,P〉0.05）。结论医院感染化脓性眼内炎的致病菌以条件致病菌为主要菌属,危险期为术后3 d内,晶体后囊膜破裂是其危险因素,老年人医院感染相对高发的现象不明显。     

成人急性白血病医院感染危险因素及对策

目的：为了进一步研究导致成人急性白血病患者发生医院感染的危险因素,从而为临床实践提供借鉴和参考。方法：本文以本院2011年12月-2013年1月期间入院治疗的466例成人急性白血病患者为研究对象,针对患者的临床资料进行回顾性分析。结果：本次调查的成人急性白血病医院感染发生率为30.04%;大于或等于60岁患者的感染率（47.22%）显著地高于小于60岁的患者（15.20%）;实施化疗患者的感染率（33.59%）显著地高于未实施化疗的患者（10.00%）;住院时间大于30d患者的感染率（51.65%）显著地高于住院时间小于15d（6.12%）和15～30d（31.41%）的患者,差异均具有统计学意义（P〈0.05）。结论：患者的年龄、实施化疗情况、住院时间是导致急性白血病医院感染的危险因素。     

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.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

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.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.     

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.