产后访视对于产妇围生期生活质量的影响

目的探讨产后访视对于产妇围生期生活质量的影响。方法选取我院产科2011年5月-2012年8月收治健康产妇240例,采用随机数字表法分为对照组和产后访视组,每组各120例;其中对照组产妇出院前进行常规健康宣教干预,产后访视组产妇则在对照组基础上加用产后访视干预;比较两组产妇产褥期生活质量评分,健康知识普及率,母乳喂养情况及产褥期并发症发生情况等。结果产后访视组产妇产褥期生活质量评分明显高于对照组,组间比较差异具有统计学意义（P〈0．05）;产后访视组产妇计划免疫、母乳喂养、产褥期疾病预防及饮食知识普及率均明显高于对照组,组间比较差异具有统计学意义（P〈0．05）;产后访视组产妇乳房肿胀、乳腺炎及乳房裂口发生率均明显高于对照组,组间比较差异有统计学意义（P〈0．05）;同时产后访视组产妇乳房肿胀、乳腺炎及乳房裂口发生率均明显高于对照组,组间比较差异有统计学意义（P〈0．05）。结论产后访视用于产妇围生期可有效改善生活质量,提高产妇卫生水平,促进母婴健康,具有临床应用价值。     

213例产后访视结果分析

目的通过高质量的产后访视来降低产妇产褥期患病率和死亡率及新生儿的发病率,提高母乳喂养率。方法对本镇213名产妇由辖区内乡村医生进行了上门访视,按照产后访视要求给予询问、体格检查、卫生宣教、母乳喂养指导及常见问题处理和转诊并填写产后访视单上交卫生院。结果 213例产后访视中产妇异常10例,新生儿异常27例,纯母乳喂养39.9%,混合喂养36.2%,人工喂养23.9%。结论及时、高质量的产后访视有助于产妇及新生儿顺利度过产褥期和新生儿期,保障母婴健康,并提高母乳喂养率。     

产妇产褥期感染病原菌与产后抑郁的相关性分析

目的 探讨产妇产褥期感染与产后抑郁的相关性,为预防和降低产后抑郁的发生提供数据基础.方法 采用病例对照研究,纳入116例产后抑郁症患者和395例对照,比较两组产妇产褥期感染率、感染部位及病原菌感染情况.结果 抑郁组产褥期感染率为20.7％,显著高于对照组(7.3％),OR值为3.29(95％ CI为1.87～5.79)...     

北航社区272例产后访视情况分析

目的:探讨北航社区教工及居民对产后访视的需求、实际产后访视情况及其与纯母乳喂养的关系。方法:将2007年1月～2009年7月272例在北航社区医院建立的母子健康档案随机分为两组,即:接受产后访视1次或仅接受产后42天检查为A组,接受产后访视2次及以上为B组。通过对档案中登记的产妇文化程度、产后访视情况及纯母乳喂养情况进行分类、统计、电话回访,分析文化程度与保证首次访视时间(产后3～7天内)、保证产后访视2次以上以及自访、外访与纯母乳喂养之间的关系。结果:产妇文化程度与保证首次访视时间和产后访视2次以上无必然联系(P>0.05);保证首次访视时间及产后访视2次以上与纯母乳喂养存在正比例关系(P<0.05);自访、外访与纯母乳喂养之间无必然联系(P>0.05)。结论:高校社区高文化程度人群也是围产保健宣教重点;保证产后访视至少2次和首次访视时间,增加访视内容及保证宣教到位,是达到产后访视效果、确保产妇康复、新生儿健康及母乳喂养的有力措施。     

国内产后家庭访视服务现状

<正>产褥期保健是孕产妇系统保健管理中一个重要的环节,通过访视医生的家庭访视,了解产妇康复、新生儿喂养情况及对产妇、婴儿体检,及时发现产妇、婴儿的一些异常情况,并予以处理及宣教指导,可以有效地提高母乳喂养率和降低产妇产后抑郁,对保护母婴健康安全、降低孕产妇死亡率和围产儿死亡率有重要意义,但目前国内的产后家庭访视服务现状并不十分乐观。     

基于微信平台的延续性护理用于产后抑郁产妇的效果观察

目的 分析基于微信平台的延续性护理对产后抑郁产妇的影响。方法 82例产后抑郁产妇随机分为两组,对照组给予常规护理,延续护理组在常规护理基础上采用基于微信平台的延续性护理,比较两组的负面情绪、自我护理能力、母婴患病情况及纯母乳喂养情况。结果 干预后,延续护理组的SAS、 SDS评分均低于对照组,自我护理态度、自我护理知识、自我护理技能评分均高于对照组,婴儿患病率、产妇患病率均低于对照组,纯母乳喂养率高于对照组（P <0.05）。结论 基于微信平台的延续性护理用于产后抑郁产妇可改善其负面情绪,提高产妇自我护理能力及母乳喂养积极性,降低产褥期母婴患病风险。     

社区产后访视对母婴健康的影响

目的:研究社区产后访视对母婴健康的影响。方法:选择2007～2008年该辖区住院分娩,出院后产后访视产妇780例作为研究对象,分成两组,分别为观察组(社区入户产后访视组)和对照组(电话访视组)各390例。结果:观察组产妇贫血、乳头皲裂、乳腺炎、母乳汁不足、伤口愈合不良、晚期产后出血、产褥感染发生率均明显低于对照组,有统计学差异(P0.01);观察组纯母乳喂养、混合喂养、人工喂养与对照组相比有统计学差异(P0.01);观察组新生儿口腔黏膜感染、脐部感染、黄疸、红臀、湿疹发病率均明显低于对照组,有统计学差异(P0.01)。结论:产后访视可及时发现产妇及新生儿的疾患,降低产褥期及围生儿的发病率,对提高母婴保健水平具有重要意义。     

健康教育在产后访视中的应用

随着整体护理工作不断深入，健康教育已贯穿到病人入院到出院的各个环节。而产后保健对母亲的健康和生存至关重要；产褥期间或产后是分娩过程的一个整体部分。在此期间产妇身体机能恢复的好坏关系到她们一生的健康与幸福；产后访视是住院分娩服务的延续。通过访视可以及时发现影响产妇及婴儿的不良习俗及健康问题，并能促进母乳喂养率。从2006年4月份以来我们开展产后访视，对769例住院分娩的产妇及婴儿进行42天内的访视。重点对产褥期间母婴健康状态影响因素及常见病进行调查。     

产后访视对母乳喂养的影响

目的探讨产后访视对母乳喂养的影响。方法选择在儿科门诊42 d健康体检的母婴240例,已接受1次以上产后访视120例作为访视组,未接受产后访视120例作为对照组,两组间进行纯母乳喂养率比较。结果访视组42 d纯母乳喂养率80.83%;对照组纯母乳喂养率56.67%,两组间纯母乳喂养率比较,访视组高于对照组(P<0.05)。结论加强产后访视,可促进母乳喂养的实施,是提高母乳喂养的有效措施。     

产后访视在实际工作中的体会

目的探讨访视医生在产后访视中是为了全面了解产妇及新生儿的健康问题,促进母婴健康。方法对1656名产妇进行了上门访视,给予产妇及家属进行母乳喂养知识、健康教育及育儿知识进行宣教和指导。结论产后访视对产妇及婴儿实施连续性的健康服务,使产妇和家属掌握母乳喂养知识、新生儿护理、产褥期自我保健,预防疾病,保障母婴健康。     

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 occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

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.     

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.     

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.