我国餐厨垃圾、餐厨废弃油脂规范管理运行机制研究

介绍了餐厨垃圾、餐厨废弃油脂定义,论证了餐厨垃圾、餐厨废弃油脂分开管理的必要性;分析了上海市餐厨垃圾、餐厨废弃油脂规范管理经验、运行机制,针对餐厨垃圾、餐厨废弃油脂源头管理、收运和处理管理,提出了相应的建议。     

利用微生物处理餐厨垃圾

我国餐厨垃圾数量十分巨大，并呈快速上升趋势。一般的大城市每天产生生活垃圾3000吨以上，其中餐厨垃圾约占50％。如何高效快捷地处置餐厨垃圾，一直是政府和社会普遍关切的问题。近年来，微生物处理餐厨垃圾逐渐成为热门话题。     

杭州市加强餐厨垃圾管理

杭州市餐厨垃圾管理以政府引导、统一管理、集中收运、定点处置、社会参与、市场化运作的方式进行。杭州市市政市容管理局负责餐厨垃圾产生、收集、运输、处置和利用的监督管理。新设餐饮业单位在对外营业前 1 5日内向所在区市容环卫管理部门办理申报手续 ,告知餐厨垃圾预产生量。餐饮业单位地址和产生量发生变更 ,应重新办理申报手续。餐饮业、企事业单位食堂、宾馆等产生的餐厨垃圾由专业部门定时定点统一密封收运、集中处置 ,并按产生量支付收运、处置费。居民住宅小区餐厨垃圾由居民投放到社区餐厨垃圾处理机进行生化处理。杭州市加强餐…     

北京市餐厨垃圾的处理现状及发展趋势

介绍了北京市餐厨垃圾现状,分析了北京市餐厨垃圾处理中存在的主要问题,并阐述餐厨垃圾主要资源化的处理技术及发展前景,旨在为北京市餐厨垃圾管理及资源化提供参考。     

“无废城市”建设背景下我国餐厨垃圾管理现状、问题与建议

在垃圾分类开展及"无废城市"试点建设的背景下,对餐厨垃圾管理现状、存在问题进行系统梳理和深入分析。采用政府统计数据采集和中英文文献数据提取等方法,估算2017年我国产生餐厨垃圾约1.58×108 t,其中餐饮垃圾约0.63×108t。结果表明各地区餐厨垃圾产生量、理化特性、处理能力和水平等存在时空差异。我国餐厨垃圾资源化利用能力与水平虽得到明显发展,但仍存在源头减量重视不足、处理能力缺口明显、水平效率有待提升、绩效评估缺乏方法等问题。建议各地区应因地制宜,结合垃圾分类和"无废城市"建设,不断提升餐厨垃圾减量化和资源化水平,弥补分类处理缺口。政府、企事业单位、居民等多方共同参与餐厨垃圾全过程管理。通过规范评估主流处理工艺和监管餐厨垃圾处理项目实际运行效果,建立多维度评价方法学体系,实现餐厨垃圾管理全过程和全周期环境—资源—成本等多维度效益的定量分析研究,为未来政府和行业有效决策提供科学依据。     

国内外餐厨垃圾的生物处理及资源化技术进展

分析了美国、日本、韩国、中国的餐厨垃圾产生、处理现状,重点介绍了这些国家在餐厨垃圾生物处理方面的研究进展。蚯蚓堆肥、容器式堆肥成为目前美国、中国的研究及应用热点;韩国、日本则重点着手于非传统方式的餐厨垃圾资源化技术研究,如利用餐厨垃圾生产动物饲料,厌氧消化一生物气回收,浆状好氧降解法处理餐厨垃圾。简述了部分国家关于餐厨垃圾资源化利用方面所制定的相应法规,并提出了今后的工作及研究方向。     

北京城区餐饮业餐厨垃圾卫生状况调查

目的对北京市城区餐饮服务业餐厨垃圾的产量、处理等进行调查,为制定餐厨垃圾管理措施提供科学依据。方法对北京市某社区街道的218家餐饮单位进行全面调查。结果 218家餐饮服务单位每日餐厨垃圾总产量为14 822.9kg,其产量与餐饮单位的类别、规模、餐次有关,大型餐饮单位餐厨垃圾产量最高,快餐店和小吃店最低;晚餐餐厨垃圾产量最高,早餐最低。一年中餐厨垃圾产量在11月至次年2月较低,6-9月最高。只有42.2%的餐饮单位对餐厨垃圾进行了分类,厨余垃圾与废弃油脂所占比例分别为85.9%和14.1%。无害化处理的餐厨垃圾占总量的54.1%,其中资源化利用的比例为28.7%。结论北京市某城区的餐饮服务业餐厨垃圾产量较高;餐厨垃圾的无害化处理及资源化利用有待进一步发展。建议从宣传、立法、餐饮业的准入和监管等方面加强餐厨垃圾的源头减量化、分类收集和无害化处理以及资源化利用的目标。     

上海市餐厨垃圾管理沿革及处置能力发展浅析

分析了上海市餐厨垃圾的产生状况,在阐述其管理体系沿革的基础上,探讨了上海市不同阶段对于餐厨垃圾管理的不同政策,论述上海市餐厨垃圾处置能力和基础设施的发展状况;并以浦东新区为例,分析了目前上海市餐厨垃圾管理中存在的问题,提出相应对策。     

某高速公路服务区餐厨垃圾就地资源化技术研究与示范

针对高速公路服务区地域分散、餐厨垃圾产生量小的特点，采用就地资源化技术开发出一套高效环保、绿色节能、产出优质的餐厨垃圾智能一体化处理设备并进行示范。该技术采用绿色循环理念，融合微生物一体化设备及云平台管理，产出有机肥基质及毛油，减量率达85%以上，运行成本约为130元/t，成规模后单位产品经济附加值约为40元/t。该技术的成功示范每年可有效处理该高速服务区餐厨垃圾182.5 t，实现了餐厨垃圾就地无害化处理和资源化利用，可在我国具有分散性、不便集中处理的餐厨垃圾处理市场进行复制推广。     

中小型城市餐厨垃圾收运和处理模式探讨

分析中小城市餐厨垃圾收运和处理现状,以及传统收运和处理模式存在的问题;以宜昌为例,提出了在餐厨垃圾收运和处理过程中融入网格化管理思路,即将传统餐厨垃圾处理重心由处理场转移到网格片区,针对不同餐厨垃圾采用不同的收运和处理模式。这种处理模式可有效实现餐厨废物收运和处理物联网控制,从源头上杜绝“地沟油”、“潲水猪”的出现。     

Study of Rogi Kalyan Samitis in Strengthening Health Systems Under National Rural Health Mission,District Pune,Maharashtra

Background:

With objective of health systems strengthening, as visualized under National Rural Health Mission (NRHM); one key strategic intervention is up-gradation of health service delivery facilities so as to provide sustainable quality care with accountability and people''s participation, which required the development of a proper management structure called Rogi Kalyan Samitis (RKS). It is the State''s attempt to make health everyone''s business by de-mystifying health-care delivery at district and sub-district levels with reference to facility based health-care delivery by encouraging citizen''s participation in management bodies.

Objective:

The study was an attempt to define ‘functional Health Systems’ with a focus on strategic issues concerning RKS operations.

Materials and Methods:

A mixed-method, multi-site, collective case study approach was adopted. In-depth interviews of key-stakeholders were conducted. Qualitative data were analyzed thematically and coded inductively.

Results:

RKS is yet to bring out quality component to the health services being provided through facilities. This can be attributed to structural and managerial weakness in the system; however, certainly NRHM has been consistent in creating a road-map for benefitting local community and their participation through RKS.

Conclusion:

The progress of the RKS can further be enhanced by giving due priority to critical areas. Furthermore, the results emphasize an urgent need for devising strategies and actions to overcome significant systemic constraints as highlighted in the present study.     

Does decentralization influence efficiency of health units? A study of opinion and perception of health workers in Odisha

Background

Health systems in low and middle income countries are struggling to improve efficiency in the functioning of health units of which workforce is one of the most critical building blocks. In India, Rogi Kalyan Samiti (RKS) was established at every health unit as institutions of local decision making in order to improve productive efficiency and quality. Measuring efficiency of health units is a complex task. This study aimed at assessing the perception (opinion and satisfaction) of health workers about influence of RKS on improving efficiency of peripheral decision making health units (DMHU); examining differences between priority and non-priority set-ups; identifying predictors of satisfaction at work; and discussing suggestions to improve performance.

Methods

Following a cross-sectional, comparative study design, 130 health workers from 30 institutions were selected through a multi-stage stratified random sampling. A semi-structured questionnaire was administered to assess perception and opinion of health workers about influence of RKS on efficiency of decision making at local level, motivation and performance of staff, and availability of funds; improvement of quality of services, and coordination among co-workers; and participation of community in local decision making. Three districts with highest infant mortality rate (IMR), one each, from 3 zones of Odisha and 3 with lowest IMR were selected on the basis of IMR estimates of 2011. The former constituted priority districts (PD) and the latter, non-priority districts (NPD). Composite scores were developed and compared between PD and NPD. Adjusted linear regression was conducted to identify predictors of satisfaction at work.

Results

A majority of respondents felt that RKS was efficient in decision making that resulted in improvement of all critical parameters of health service delivery, including quality; this was significantly higher in PD. Further, higher proportion of respondents from PD was highly satisfied with the current set of provisions and manners of functioning of the sample health units. Active community engagement, participation of elected representatives, selection of a pro-active Chairman, and training to RKS members were suggested as the immediate priority action points for the state government. Mean scores differed significantly between PD and NPD with regard to: influence of RKS on individual-centric, organizational-centric and patient-centric performance, and the responsibilities to be entrusted with RKS. Absenteeism was strongly associated with satisfaction and local self-governance. Work-related factors, systemic factors, local accountability and patients’ involvement were found to be the key predictors of satisfaction of health workforce.

Conclusion

The understanding on quality improvement strategies was found to be very poor among the health workers. Tailor-made capacity building measures at district and sub-district levels could be critical to equip the peripheral health units to achieve the universal health coverage goals. Work environment, systemic factors and accountability need to be addressed on priority for retention of health workforce. The hypothesized link between efficient local decision making, perception of health workers about efficiency of health units and the health status of population needs further investigation.

     

Reactogenicity and immunogenicity of live attenuated Salmonella enterica serovar Paratyphi A enteric fever vaccine candidates

Eight Salmonella enterica serovar Paratyphi A strains were screened as candidates to create a live attenuated paratyphoid vaccine. Based on biochemical and phenotypic criteria, four strains, RKS2900, MGN9772, MGN9773 and MGN9779, were selected as progenitors for the construction of ΔphoPQ mutant derivatives. All strains were evaluated in vitro for auxotrophic phenotypes and sensitivity to deoxycholate and polymyxin B. All ΔphoPQ mutants were more sensitive to deoxycholate and polymyxin B than their wild-type progenitors, however MGN10028, MGN10044 and MGN10048, required exogenous purine for optimal growth. Purine requiring strains had acquired point mutations in purB during strain construction. All four mutants were evaluated for reactogenicity and immunogenicity in an oral rabbit model. Three strains were reactogenic in a dose-dependent manner, while one strain, MGN10028, was well-tolerated at all doses administered. All ΔphoPQ strains were immunogenic following a single oral dose. The in vitro profile coupled with the favorable reactogenicity and immunogenicity profiles render MGN10028 a suitable live attenuated Paratyphi A vaccine candidate.     

Determinants of utilization of services under MMJSSA scheme in Jharkhand 'Client Perspective': a qualitative study in a low performing state of India

Preventing maternal death associated with pregnancy and child birth is one of the greatest challenges for India. Approximately 55,000 women die in India due to pregnancy- and childbirth- related conditions each year. Increasing the coverage of maternal and newborn interventions is essential if Millennium Development Goals (MDG) 4 and 5 are to be reached. With a view to accelerate the reduction in maternal and neonatal mortality through institutional deliveries, Government of India initiated a scheme in 2005 called Janani Suraksha Yojna (JSY) under its National Rural Health Mission (NRHM). In Jharkhand the scheme is called the Mukhya Mantri Janani Shishu Swasthya Abhiyan (MMJSSA). This paper focuses on community perspectives, for indentifying key areas that require improvement for proper implementation of the MMJSSA in Jharkhand. Qualitative research method was used to collect data through in-depth interviews (IDIs) and focus group discussions (FGDs) in six districts of Jharkhand- Gumla, West Singhbhum, Koderma, Deoghar, Garhwa, and Ranchi. Total 300 IDIs (24 IDIs each from mother given birth at home and institution respectively; two IDIs each with members of Village Health and Sanitation Committees (VHSC) / Rogi Kalyan Samitis (RKS) from each district) and 24 FGDs (four FGDs were conducted from pools of husbands, mothers-in-law and fathers-in-law in each district) were conducted. Although people indicated willingness for institutional deliveries (generally perceived to be safe deliveries), several barriers emerged as critical obstacles. These included poor infrastructure, lack of quality of care, difficulties while availing incentives, corruption in disbursement of incentives, behavior of the healthcare personnel and lack of information about MMJSSA. Poor (and expensive) transport facilities and difficult terrain made geographical access difficult. The level of utilization of maternal healthcare among women in Jharkhand is low. There was an overwhelming demand for energizing sub-centers (including for deliveries) in order to increase access to maternal and child health services. Having second ANMs will go a long way in achieving this end. The MMJSSA scheme will thus have to re-invent itself within the overall framework of the NRHM.     

中西医结合治疗多形性红斑临床研究

目的探讨中西医结合治疗多形性红斑临床效果及安全性。方法选取该院2010年3月—2012年12月收治多形性红斑患者120例,采用随机数字表法分为对照组和中西医结合治疗组,每组各60例;其中对照组患者采用单纯西药治疗;中西医结合治疗组患者在对照组治疗基础上加用当归四逆汤治疗;比较两组患者临床治疗总有效率、复发率、治疗前后临床症状积分及不良反应发生情况等。结果对照组和中西医结合治疗组患者临床治疗总有效率分别为73.3%,96.7%;中西医结合治疗组患者临床治疗总有效率明显高于对照组,组间比较差异显著(P<0.05);对照组和中西医结合治疗组患者治疗前临床症状积分组间比较无显著差异(P>0.05);两组患者治疗后临床症状积分较治疗前均显著降低,且中西医结合治疗组患者降低程度明显高于对照组,组间比较差异具有统计学意义(P<0.05);中西医结合治疗组患者复发率明显低于对照组,组间比较差异具有统计学意义(P<0.05)。结论与单纯西医治疗相比,中西医结合治疗多形性红斑可有效改善临床症状,降低复发率,且无明显不良反应具有临床使用价值。     

生长抑素对急性胰腺炎患者血清抵抗素的影响

[目的]观察生长抑素对急性胰腺炎(AP)患者血清抵抗素水平的影响。[方法]选择AP患者54例,随机分为基础治疗亚组(28例)和生长抑素治疗亚组(26例),以正常健康人40例为正常对照组。基础治疗亚组给予包括重症监护,应用抗生素,改善脏器微循环,加强对症、支持等治疗;生长抑素治疗亚组在基础治疗的同时加用生长抑素针。所有入选研究者分别于治疗前、治疗后d3、d7测定APACHEⅡ积分、血清高敏C-反应蛋白(hs-CRP)和抵抗素水平。[结果]①治疗前MAP与SAP患者的血清抵抗素水平与hs-CRP浓度均较正常对照组显著升高(P﹤0.01),但SAP患者升高较MAP更为明显(P﹤0.01)。②治疗后d3,基础治疗亚组和生长抑素治疗亚组的抵抗素水平较治疗前进一步增加(P﹤0.01),但是APACHEⅡ积分与治疗前对比无明显差异(P﹥0.05)。③治疗后d7时,基础治疗亚组和生长抑素治疗亚组的抵抗素水平和APACHEⅡ积分均较治疗d3时明显下降(P﹤0.05),且与基础治疗亚组比较,生长抑素治疗亚组降低更为显著(P﹤0.05)。[结论]生长抑素能够降低血清抵抗素水平,减轻炎症反应,改善AP患者的病情严重程度。     

重症急性胰腺炎应用短期腹腔灌洗治疗效果观察．

目的：观察和分析短期腹腔灌洗治疗重症急性胰腺炎患者的临床效果。方法：选取2012年12月-2014年4月收治的96例重症急性胰腺炎患者,按照患者住院时间先后顺序分为对照组和治疗组。对照组：采用常规治疗,但未实施灌洗。治疗组：在常规治疗基础上实施短期腹腔灌洗治疗。观察两组患者治疗前后APACHEII变化及血清CRP水平变化、临床指标改善、并发症等情况。结果：治疗前,治疗组APACHEII积分和CRP分别为（14．38±6．47）分、（269．79±52．01）mg／L,与对照组的（14．42±6．51）分、（269．87±51．96）mg／L比较差异无统计学意义（P〉0．05）;治疗后,治疗组APACHEII积分和CRP分别为（6．64±2．17）分、（64．27±10．61）mg／L,与对照组的（9．65±2．47）分、（127．61±32．21）mg／L比较差异有统计学意义（P〈0．05）。治疗组患者临床指标改善和并发症发生率与对照组比较差异有统计学意义（P〈0．05）。结论：采用短期腹腔灌洗治疗重症急性胰腺炎,可有效改善患者临床各项指标,降低患者APACHEII积分和CRP水平,减少并发症发生,促进患者康复。     

80例小儿先天性泪道阻塞临床治疗观察

目的 研究先天性泪道阻塞合适的临床治疗方式及时机.方法 选择在某院就诊的先天性泪道阻塞患儿,根据年龄分为1～3月组、3～8月组以及8～15月组,依次给予手法按摩、泪道冲洗、泪道探通治疗,观察治疗后的效果.结果 手法按摩治愈12例；手法按摩+泪道冲洗治愈48例；手法按摩+泪道冲洗+泪道探通治愈69例；其中年龄1～3月的患者治愈率65.38％；年龄3～8月的患者治愈率97.12％;年龄8～15月的患者治愈率63.16％,3～8月患者的总治愈率明显高于其余两组患者、且经泪道冲洗、泪道探通的治愈率也高于其余两组.另外,年龄1～3月患者通过手法按摩的治愈率明显高于其余两组.结论 3～8月是泪道冲洗、泪道探通治疗的最佳时机；对于1～3月的患者宜采用手法按摩,若不能取得良好疗效应在3～8月时进行泪道冲洗、探通治疗.