《医疗事故处理条例》在医院感染管理中的应用

目的 解决医院感染管理中医疗事故的防范与处理。方法 对照《医疗事故处理条例》(简称《条例》)和《医院感染管理规范》(简称《规范》)进行医院相关规章制度的修订。结果 加强医务人员培训，加强病历资料书写管理和保存，对现有的规章制度进行修订、完善，加强监督，可有效地控制医院感染中医疗事故的发生。结论 加强医院感染管理，提高医务人员预防医院感染的自觉性是现代医疗的保障。     

男性病科医院感染的预防

为做好男性病科医院感染预防与控制工作,我们组织医务人员认真学习了卫生部<医院感染管理办法>、<医院消毒技术规范>和<医疗卫生机构医疗废物管理办法>等法规文件.按要求建立健全了各项预防医院感染的规章制度,抓好各项工作落实,为男性病科预防控制医院感染取得了良好的效果.     

医院感染管理存在的问题及对策

目的 了解医疗机构医院感染管理目前存在的问题,制定相应措施,提高医疗护理质量.方法参照<医院感染管理办法>、<消毒技术规范>、<感染管理规范>等法律、法规,对医疗机构的医院感染管理现状进行调查分析,并提出相应措施.结果通过加强医院感染管理各环节的监督检查,增强医务人员感染管理意识,并有效控制医院感染.结论加强医院感染管理,是提高医疗护理质量的重要保证.     

医院常见的非医疗事故纠纷类型

医疗纠纷．是指医院与患者之间因为医疗活动而发生的纠纷。在这些纠纷中被谈论比较多的是医疗事故纠纷，但随着医院社会福利性质的逐渐减少和医疗服务市场化的逐步施行，其它类型的医患纠纷也在逐渐增多。本文将从实践出发，简要介绍较为常见的几类医院与患者之间的非医疗事故纠纷。医院在日常管理中对这些纠纷．应当加强管理，注意预防和避免。     

基层医院规避医疗风险减少医疗纠纷的治本之策

医疗风险、医疗事故和医疗纠纷长期困扰医院管理者和医务人员。加强制度落实、促进管理到位、做到沟通有效,切实处理好医患关系,是基层医院规避医疗风险、防范医疗事故和减少医疗纠纷的治本之策。     

针灸科医院感染控制与管理

目的 加强针灸科管理,预防与控制医院感染.方法 对针灸科管理过程中可能造成医院感染的问题和原因进行分析,采取有效的控制措施.结果 对诊室的空气、医疗操作、用具、医务人员手及医疗废弃物等加强消毒管理,有效控制医院感染.结论 严格管理是降低及控制医院感染的重要措施.     

谈医疗事故与医护人员职业道德

医疗事故的预防和处置是医院质量管理的重要内容.近几年来,医疗事故困扰了一些医院的发展.检点医疗事故发生的原因,除了社会大环境的诸多因素之外,我们会发现医疗事故中往往隐含着深层次的医疗职业道德上的缺陷.因为医护人员在医疗工作中的失责,激化了医患之间的矛盾.所以,化解医疗纠纷,必须把加强医生护士职业道德建设作为切入点.     

医院防范医疗事故的主要对策

为了正确处理医患矛盾，维护患者和医疗机构及其医务人员的合法权益，保证医疗安全，提高医疗质量，医院应采取以下几方面对策，预防和减少医疗事故(纠纷)的发生。(1)加强学习，提高法律意识；(2)加强医疗环节管理，规范医疗行为，以法治院；(3)加强高危科室管理和急诊急救工作的领导；(4)强化服务意识，提高基础管理和质量；(5)加强对年轻医务人员的管理；(6)设置专门监督管理机构。     

加强医患沟通 和谐医患关系

近年来,患者及家属对医院及医务人员的投诉增加,医疗纠纷有上升趋势,无论是纠纷的规模、范围还是恶性程度都在不断地加大。为了预防医疗差错的产生,减少医疗纠纷,杜绝医疗事故的发生,除应增强医务人员的工作责任心和服务态度,努力提高医护人员的技术水平外,加强医患沟通与交流,增进医患感情,建立起相互信任、相互理解的医患关系是不容忽视的重要问题。     

规范口腔科医院感染管理的做法与体会

目的为了有效预防和控制口腔科医院感染,加大管理力度. 方法从医务人员、诊疗环境设置、消毒设备、消毒方法和程序、卫生学监测等方面,制定相对应的管理制度. 结果逐渐规范了对口腔科预防医院感染管理工作. 结论口腔科预防医院感染管理工作能符合<医院感染管理规范>和<消毒技术规范>的要求.     

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.     

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.     

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.     

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.