北京市医院感染监控管理系统开发与应用研究

目的研究开发医院感染监控管理信息系统，实现医院感染动态监控，及时发现医院感染流行暴发；分析医院感染相关危险因素，为医院感染的控制提供科学依据。方法采用C／S构架，后台采用SQLSERVER2000大型数据库，前端应用程序使用PowerBuilder7编程，将医院感染报告数据采集的应用软件集成到各个计算机工作站上，构建涉及医院任何部门的医院感染监控网络。结果北京市医院感染监控管理系统实现了对各级医院感染信息进行动态收集、上报、统计、分析、浏览、查询的功能，并为各使用单位自动生成规范化及个性化的监测图表，同时可达到医院感染暴发流行的预警作用。结论北京市医院感染监控管理系统是一个有效的医院医疗质量辅助管理工具，能够使医疗机构和卫生行政部门全面及时了解医院感染管理的基本状况，并为卫生行政部门的领导决策提供循证依据，以达到科学化管理的效果。     

医院感染监控管理系统的网络信息化应用

目的利用计算机网络，应用《医院感染监控管理系统》，提高医院感染管理水平。方法将软件直接安装在临床科室的医生工作站，实现医院感染实时监控以及预警。结果改变了既往医院感染监控以回顾性调查为主的被动局面，实现了医院感染的前瞻与动态监测，使医院感染控制的关口前移，及时发现医院感染流行趋势或暴发的苗头，替代以往手工数据处理、统计分析、上报等操作。结论充分利用医院信息系统，可以提高医院感染管理水平。     

基于大数据的医院真实场景传染病预警系统研究

目的基于大数据,以"被动监测、主动预防、大数据感知"为理念构建适用于医院真实场景下的传染病实时监控及预警系统,描述系统建设背景、整体架构、技术路径、主要功能和实施成效。方法通过开发传染病实时监控及预警系统实现对已知传染病的监测上报,对未知传染病的监测预警、趋势提醒。结果将传统单样本上报的被动监测系统转变为主动监测、大数据智能分析、态势感知异常与多点触发的全方位防控体系。结论结合人工智能等新技术将传染病管理集成、实时共享、动态追踪和可视化展示融入到医院的传染病预警防控中,提升传染病防控、突发传染病事件应急处置能力,为疾病控制、趋势分析、预警和防控策略的制定提供了科学支撑和智能解决方案。     

医院感染实时预警系统的实践与应用

目的通过建立医院感染实时预警系统,并将其应用于医院感染控制工作中,实现医院感染信息化管理,科学控制医院感染。方法通过现有的HIS、EMR、LIS、RIS和物资管理系统,采用数据聚合技术将各种与医院感染相关的数据聚合到统一的数据库系统中,建立一个多因素影响的医院感染模型,实现医院感染病例主动发现机制,利用为多个因素的叠加的数学模型表达方式,从而可以实现对医院感染疑似病例的快速定位。结果建立了医院感染实时预警系统,该系统可将医院感染管理科、临床医师工作站、临床检验科进行连接,将被动监测转化为主动监测,实现了医院感染病例实时预警;实时提醒功能简化上报流程,感染病例网络直报,提高上报依从性;围手术期预防使用抗菌药物动态提醒,规范了抗菌药物使用时间,控制细菌耐药,统计报表功能,避免人工误差。结论利用计算机信息技术改变医院感染管理的模式,逐步实现医院感染管理全面信息化监控,及时有效的采取预防措施,降低医院感染发生率,提高医院医疗质量管理,保障医疗安全。     

医院感染实时监控系统的设计

为加强医院感染管理,建设了医院感染实时监控系统,通过信息技术手段实现医院感染的智能化判别、监测与预警。在医院感染信息实时采集的基础上,采用主动监测、医生上报和医院感染管理科监管相结合的模式,充分利用监控功能来实时监控医院可能发生感染的各种状况,对异常信息进行预警,将医院感染控制在初发状态,降低了感染发生率。     

医院感染的网络系统建设和实时监控

目的提高医院感染实时监控、早期预防和早期治疗等各重要环节的效率,增加临床抢救的成功率,减少死亡率,提高医疗质量。方法在医院信息平台基础上,充分利用患者基本信息、诊疗信息,细菌培养与药敏试验结果,利用网络系统进行医院感染信息追踪与分析,按预先设定的预警参数对医院感染的发生进行预警监控。结果医院感染前瞻性与目标性调查,是有效降低医院感染发病率和漏报率的有效手段,能及时发现散在感染,时时警惕感染的流行与暴发。结论医院感染的网络系统建设和实时监控是现代医院感染控制的必备平台。     

医院感染信息预警监测系统在医院感染管理中的作用

目的探讨医院感染信息预警系统在医院感染管理中的应用方法和效果,实现医院感染管理的自动化及程序化。方法医院在医院信息系统(HIS)的基础上,按照预先设定的预警参数实现了对全院患者的实时监控和动态预警,通过医院感染危险因素提示对患者进行监测、统计、上报工作。结果该系统强化了流程管理,有效提高了工作效率和质量,确保医疗质量和医疗安全。结论医院感染信息预警系统提高了医院感染的管理水平。     

信息化技术在医院感染管理与监控中的应用

目的 将信息化技术应用于医院感染管理与监控,逐步实现医院感染信息化管理.方法 利用医院信息平台,建立医院感染监控管理系统,构建实时预警、报告及监控审核网络.结果 该系统实现了医院感染、传染病、多药耐药菌感染自动预警、网络报告与实时监控等信息化管理,并具有抗菌药物分级管理、合理使用等监管统计功能;通过对住院患者的感染信息及抗菌药物监控与干预,提高了医院感染诊断的及时性和准确性,降低了漏报率;及时掌握多药耐药菌分布和流行趋势,以采取有效的预防控制措施;同时为临床指导抗菌药物合理使用提供了可靠依据.结论 信息化技术应用于医院感染管理与监控,极大地提高了医院感染的科学化、规范化、标准化管理质量与监控水平.     

传染病防治与医院感染管理

目的探讨医院感染管理在医院防治传染病暴发流行过程中的作用. 方法根据国家法律法规及传染病流行特征,分析医院感染管理部门职能和专职人员的职责. 结果医院感染管理科应当根据传染病的流行趋势,做好传染病预防、控制、监测、报告、预警、咨询、指导及监督检查等职能工作;感染管理专职人员应改变过去只注重医院内部常见致病菌的监控,将传染病的监测和预防作为另一项重要工作内容. 结论医院感染管理科是医院防止传染病暴发流行的重要职能科室,加强医院感染管理专业学科建设,对提高医院防治传染病暴发流行的能力,确保医疗质量与安全具有重要意义.     

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.     

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.     

Assessing occupational and environmental exposure

Exposure assessment is a poorly understood component of the science of epidemiology. The relationship between exposure to chemicals and ill-health outcomes is often calculated using crude exposure measures such as ever/never exposed or duration. When investigating subtle effects, exposures need to be characterized much more fully in terms of intensity, frequency, duration and route. While occupational exposures tend to be much greater than those experienced from the wider environment there is a need to remember that, for many chemicals, exposure can occur occupationally, environmentally and through consumer use of products containing the material of interest. Inhalation exposure has generally been the traditional focus for most epidemiological investigations but there is now growing awareness of the importance of the dermal and ingested routes of contact and internalization. Quantification of the exposure also needs to be related to a biological mechanism of action and exposure metrics need to be selected accordingly. Occupational exposures can generally be measured using simple well-validated techniques. Environmental exposures require much more sensitive instruments and are more difficult to assess. Exposure modelling, particularly for the environmental fate of chemicals has undergone many recent developments and Monte Carlo techniques can be used to characterize model uncertainty and variability. This approach to exposure assessment can now be used in the setting of the wider environment and will enable a far better understanding of the relationship between exposure and disease.     

Mercury toxicity due to the smelting of placer gold recovered by mercury amalgam

A 19-year-old man developed tremor in both hands and fatigue after starting work at a placer gold mine where he was exposed to mercury-gold amalgam. Examination revealed an intention tremor, dysdiadochokinesis and mild rigidity. The 24-h urinary mercury concentration reached a peak of 715 nmol/l (143 ug/l) shortly before the clinical examination, after which he was removed from working in the gold room [Mercury No. Adverse Effect Level: 250 nmol/l (50 ug/l)]. On review 7 weeks later his tremor had almost resolved and the dysdiadochokinesis and rigidity had gone. The 24-h urinary mercury concentration had fallen to 160 nmol/l (32 ug/l). The principal exposure to mercury was considered to be the smelting of retorted gold with previously unrecognized residual mercury in it. The peak air concentration of mercury vapour during gold smelting was 0.533 mg/m3 (Mercury Vapour ACGIH TLV: 0.05 mg/m3 TWA). Several engineering and procedural controls were instituted. This episode occurred at another mine site, unrelated to Mount Isa Mines Limited.     

How Adults with Acquired Brain Damage Perceive Computer Training as a Rehabilitation Tool: A Focus-group Study

The aim of this study was to explore and describe how adult outpatients with acquired brain damage and referred to occupational therapy perceive computer training with the RehaCom programs, in order to evaluate the method of treatment as a tool in the rehabilitation of persons with cognitive disorders. By using focus-group discussions as a qualitative method of research when analysing the result, five themes with corresponding categories emerged, describing a development of understanding and learning about capacities. Themes describing how the participants could apply strategies to overcome shortcomings in daily occupations and the therapeutic role of the occupational therapist were identified as well. The result shows that a computer training program such as RehaCom can be used as an educational tool, for example, to guide a person who is trying to adopt compensatory strategies to avoid overload by taking pauses. It was found that anything the participants learned was also applicable to occupational performance in daily life.