Dog noise as a risk factor for hearing loss among police dog handlers

AIM: To determine the sources of noise exposure among police dog handlers and to examine whether these levels might lead to noise-induced hearing loss. METHODS: We conducted a cross-sectional study at four Royal Air Force bases using a noise survey, a postal questionnaire and medical record review. The noise survey was conducted following task analysis. We surveyed police dog handlers and a comparison group of police who had never been dog handlers, using a postal questionnaire on noise exposures and confounders. Audiometric and otological data were extracted from medical records. RESULTS: The noise survey revealed significant exposures due to dogs, travelling in vans and aircraft noise during foot patrol. The overall response rate to the questionnaire was 56% (29 police dog handlers, 24 police officers). Five subjects (9.4%) had age-corrected hearing loss exceeding 10 dB, averaged over the 4 and 6 kHz frequencies, affecting the left ear only, but there were no differences between dog handlers and controls. CONCLUSION: Although the measured noise exposures of police dog handlers did not exceed current legal limits, the noise levels at times are such that the proposed Physical Agents (Noise) Directive has implications for employers who use dogs for security purposes.     

Quantitative Noise Analysis in a Modern Hospital

Quantitative noise analysis of a general surgical ward in a modern hospital showed that the level of noise was in excess of recommended levels and of sufficient intensity to disturb sleep. Individual noises in excess of 50 dB(A) were recorded in every area at all times of the day. Internal hospital sounds were responsible for most noise; staff and audible warning devices were the main sources of noise over 70 dB(A). Octave waveband analysis showed that both the general ward noise and the noise of the air conditioning were in excess of recommended levels.     

护理风险管理在精神科封闭病房中的应用效果分析

目的 探讨护理风险管理在精神科封闭病房中的应用效果。方法 选取2014年1月至2015年12月我院精神科封闭病房收治的60例患者作为对照组,行常规护理管理;另选取2019年1月至2020年12月我院精神科封闭病房收治的60例患者作为观察组,在对照组基础上行护理风险管理。比较两组的护理质量及医疗安全不良事件发生率。结果 观察组的护理文书书写、基础管理、安全管理及消毒隔离评分均显著高于对照组（P <0.05）。观察组的医疗安全不良事件发生率为6.67%,显著低于对照组的21.67%(P <0.05)。结论 护理风险管理可提高精神科封闭病房的护理质量,降低医疗安全不良事件发生率。     

某农机厂噪声作业男工健康状况的动态分析

目的调查分析职业性噪声对工人心血管系统的动态影响。方法以常州某农机厂150名接触噪声的作业男工为噪声组,以企业行政、后勤及不接触噪声男工125人为对照组。采用现场环境噪声测试和班前班后职业性健康检查等方法进行调查研究,比较其血压、心率、心电图的变化情况。结果噪声组班前班后动态收缩压改变差异有统计学意义(P0.05),噪声组与对照组班前收缩压、舒张压、心率比较,差异均有统计学意义(P0.01)。结论噪声对作业工人的动态血压、脉率、心电图有一定影响,需进一步采取措施预防。     

新生儿病区噪声暴露现状及对策

目的：分析医院新生儿病区噪声暴露现状,提出相应的干预措施。方法：应用噪声统计分析仪连续24h监测新生儿病区噪声强度,记录暖箱内外噪声水平。结果：暖箱内外噪声的等效声级（Leq）分别为55.40±3.67 dB（A）和59.56±3.04 dB（A）,差异有统计学意义（P〈0.05）;夜间最大声级（Lm ax）分别为75.51±10.81dB（A）和83.04±8.50 dB（A）;昼间的等效声级和最大声级均高于夜间,差异有统计学意义（P〈0.05）。结论：新生儿病区噪声水平远高于WHO和我国制定的标准。噪声主要来源于医护人员行为和医疗设施。     

Occupational exposure to noise and hypertension in pilots

The role of occupational exposure to noise as a hypertension risk factor has not been established sufficiently. The aim of the study is to evaluate whether chronic exposure to different levels of noise in two groups of pilots, operating with two types of aircraft, could be a risk for hypertension, what relevance the parameters (intensity, duration and type) of exposure can have and, lastly, whether there are any links between hearing impairment and hypertension. After excluding pilots with confounding factors, a study was made of 77 male pilots of turboprop planes (group A) and 224 male pilots of jet aircraft (group B), matched by age and working life. Blood pressure (supine and standing positions) and heart rate were measured. Electrocardiogram, stress tests on a cycle ergometer, sound-level measurement and audiometric tests were also done. Pilots of group A were exposed to Leq of 93 dBA while pilots of group B were exposed to the Leq of 79 dBA. Significant results in group A compared to group B were found between heart rate, blood pressure, drop in blood pressure, parameters (intensity, duration and type) of exposure to noise and between hearing damage and hypertension. The findings suggest that chronic exposure to noise is a risk factor for blood hypertension in pilots exposed to high noise levels, and that the drop in blood pressure may be a sign of more sensitive effect of noise on blood pressure, according to other studies in literature.     

开放式与密闭式吸痰对机械通气患者监护指标的影响

目的 探讨开放式吸痰与密闭式吸痰对机械通气患者监护指标(SPO2,心率,收缩压)的影响.方法 将80例行机械通气的患者随机分为实验组(密闭式吸痰48例)和对照组(开放式吸痰32例).观察两组患者吸痰前5 min、吸痰过程中及吸痰后5 min监护指标(SPO2,心率,收缩压)的变化情况.结果 实验组与对照组吸痰前5min...     

Effects of low intensity noise from aircraft or from neighbourhood on cognitive learning and electrophysiological stress responses

The effects of low intensity noise on cognitive learning and autonomous physiological processes are of high practical relevance but are rarely addressed in empirical investigations. This study investigated the impact of neighbourhood noise (of 45 dB[A], n=20) and of noise coming from passing aircraft (of 48 dB[A] peak amplitude presented once per minute; n=19) during computer based learning of different texts (with three types of text structure, i.e. linear text, hierarchic hypertext, and network hypertext) in relation to a control group (35 dB[A], n=20). Using a between subjects design, reproduction scores, heart rate, and spontaneous skin conductance fluctuations were compared. Results showed impairments of reproduction in both noise conditions. Additionally, whereas in the control group and the neighbourhood noise group scores were better for network hypertext structure than for hierarchic hypertext, no effect of text structure on reproduction appeared in the aircraft noise group. Compared to the control group, for most of the learning period the number of spontaneous skin conductance fluctuations was higher for the aircraft noise group. For the neighbourhood noise group, fluctuations were higher during pre- and post task periods when noise stimulation was still present. Additionally, during the last 5 min of the 15 min learning period, an increased heart rate was found in the aircraft noise group. Data indicate remarkable cognitive and physiological effects of low intensity background noise. Some aspects of reproduction were impaired in the two noise groups. Cognitive learning, as indicated by reproduction scores, was changed structurally in the aircraft noise group and was accompanied by higher sympathetic activity. An additional cardiovascular load appeared for aircraft noise when combined with time pressure as indicated by heart rate for the announced last 5 min of the learning period during aircraft noise with a peak SPL of even 48 dB(A). Attentional mechanisms (attentional control) like being threatened by passing aircraft approaching the airport, higher demands of selective filtering, and difficulties in changing cognitive strategies during noise are discussed as underlying mechanisms.     

Effect of acute exposure to loud occupational noise during daytime on the nocturnal sleep architecture, heart rate, and cortisol secretion in healthy volunteers

OBJECTIVES: Noise is one of the commonest physical stressors to which industrial workers are exposed. Many workers complain of symptoms associated with a non-specific generalized stress response, including disturbed sleep. However, industrial workers may be exposed to more than one source of stress and it is not possible to completely attribute the disturbed nocturnal sleep and changes in heart rate to the effects of loud noise alone. This study was done to find out whether acute exposure of healthy individuals to loud occupational noise during the daytime would cause changes in their nocturnal sleep architecture, heart rate during sleep and serum cortisol levels. METHODS: Baseline polysomnography was done on ten subjects who were exposed for eight hours either to continuous occupational background noise levels of >75dB(A), or a quiet environment. Sleep polysomnography was done on the night prior to and after exposure. Blood was collected for serum cortisol estimation at night prior to sleep and in the morning after waking up. Statistical analysis was done by repeated measures ANOVA with Tukey's post test. RESULTS: The sleep efficiency was less than 80% and the total time spent in Rapid Eye Movement (REM) sleep, Slow Wave Sleep (SWS) and the REM onset latency were significantly decreased on the night after exposure to noise. There was a significant increase in stage shifts. The percentage fall in heart rate during sleep was decreased compared to the baseline values. The serum cortisol levels in the morning after exposure to noise was significantly increased. CONCLUSION: Workers exposed to loud background occupational noise react to the stress and show changes in nocturnal sleep architecture and heart rate which may be contributed to the exposure to noise.     

人性化管理模式在小儿内科病房护理管理中的运用

目的分析人性化管理模式在小儿内科病房护理管理中的运用效果。方法选取该院小儿内科病房在2018年1-12月收治的100例患儿参与该次试验,其中1-6月收治的50例患儿为对照组,实施常规护理管理,7-12月收治的50例患儿为试验组,实施人性化管理模式,就其不良事件发生率、治疗依从性、家属护理满意度进行分析和比较。结果试验组患儿不良事件发生率(4.0%)较之对照组(20.0%)更低,治疗依从率(94.0%)较之对照组(76.0%)更高,家属护理满意度较之更高,两组对比差异有统计学意义(P<0.05)。结论在小儿内科病房实施人性化护理管理有助于降低护理风险,预防各类不良反应的发生,并提升患儿治疗依从性和家属护理满意度。     

Nosocomial infections in a children's hospital in Argentina: impact of a unique infection control intervention program.

OBJECTIVE: To assess the efficacy of parental education and use of parents as nursing assistants on reducing nosocomial infections. DESIGN: Prospective study. METHODS: Active surveillance for nosocomial infections was performed on two wards. On ward A, parents were educated about infection control practices and assisted nursing staff with routine tasks, so that nursing personnel could focus their efforts on procedures with higher risk of infection. Parental assistance was not sought on ward B, the comparison ward. RESULTS: From October 1990 through September 1991, 1,081 patients were admitted to wards A (470) or B (611). The over-all nosocomial infection rate was 7.1 per 100 admissions; the nosocomial infection rate was significantly higher on ward B than ward A (63/611 vs 14/470; P<.001). Multivariate analysis identified risk factors for nosocomial infection on the two wards as age <2 years (P=.01), malnutrition (P=.005), duration of hospitalization (P<.001), ward B hospitalization (P=.003), and ward cleanliness score (P=.009); the distribution of patients with these factors was similar on the two wards. CONCLUSIONS: Our data suggest that parental infection control education and recruitment to relieve nursing staff of routine low-risk procedures are economical and easily implemented measures to reduce nosocomial infections in hospitals with limited personnel resources in the developing world.     

背景音乐联合改良式拉玛择呼吸法对初产妇活跃期的影响简

目的：观察100例初产妇第一产程活跃期应用背景音乐联合改良式拉玛择呼吸法的效果。方法2012年12月至2013年12月间临产的初产妇200例,随机分为研究组和常规组各100例。研究组活跃期进入待产室开始使用改良式拉玛择呼吸法,常规组活跃期进入待产室常规观察照护。观察两组疼痛强度、血压差、心率差及活跃期所需时间。结果研究组疼痛程度明显减轻,血压差和心率差显著低于常规组（ P＜0．05）,活跃期所需时间明显缩短,差异有统计学意义（P＜0．05）。结论背景音乐联合改良式拉玛择呼吸法在初产妇活跃期的应用中镇痛效果显著,可以稳定血压、心率,缩短活跃期。     

Occupational Group Therapy in a Psychiatric Day Care Unit for Long-term Mentally Ill Patients

The outcomes of 20 patients participating in occupational group therapy at a psychiatric outpatient unit were explored and related to perceptions of the ward atmosphere and the treatment process. The outcome variables—psychiatric symptoms, global mental health, quality of life and occupational functioning—were measured at admission, at discharge and 1 year after discharge. The ward atmosphere was rated twice a year and the treatment process once a month. The study used a combined within-group and between-group design. The ward atmosphere showed stability over a period of 5 years and was rated by patients and staff as beneficial for both psychotic and non-psychotic patients. Low levels of anger and aggression and staff control and high levels of support and order and organization were the most prominent features of the unit. Several characteristics of the ward atmosphere were related to outcome, e.g. an optimal level of anger and aggression as perceived by the patients initially in treatment was significantly related to improvement in global mental health and occupational functioning. The patients improved from admission to discharge on all the outcome variables except for quality of life. Contrasted with a matched comparison group, the patients' improvement was significantly higher regarding a measure of global functioning. Thirteen of the twenty patients were judged as having attained clinically significant change. With respect to the treatment process, patient ratings of a better working relationship vis à vis the main therapist compared to the other occupational therapists were significantly related to improvement in global mental health and occupational functioning, as well as to a principal component accounting for a large proportion of the variance in the outcome measures used. Furthermore, patient participation, especially in a psychological sense, was related to a better performance in everyday occupations and to the principal component reflecting outcome. In-depth analyses of three representative case studies illustrated the relationships that were established at a group level and mediated specific patient experiences. A percept-genetic test (PORT) revealed that the patients' external life situations and psychiatric problems were reflected in their internal object representations, and vice versa. A more benign picture testing at a 1–year follow-up indicated that the therapy had influenced the patients' internal object representations.     

Hearing status among aircraft maintenance personnel in a commercial airline company

The aim was to study subjective and objective hearing loss in a population of aircraft maintenance workers and identify predictors. A total of 327 aircraft maintenance personnel answered a self-administered work environment questionnaire (response rate 76%) and underwent audiometric test. The mean values for the hearing threshold at 3, 4, and 6 kHz for the ear with the most hearing loss were compared with a Swedish population database of persons not occupationally exposed to noise. Equivalent noise exposure during a working day was measured. Relationships between subjective and objective hearing loss and possible predictors (age, years of employment, self-reported exposure to solvents, blood pressure, and psycho-social factors) were analyzed by multiple logistic regression. At younger ages (<40 years), aircraft maintenance workers had higher hearing thresholds (1-3 dB) compared to the reference group, but such a difference was not found in older employees. Relationships were found between age and objective hearing loss, and between exposure to solvents and reported subjective hearing loss. Equivalent noise exposure during working days were 70-91 dB(A) with a maximal noise level of 119 dB(A). Aircraft maintenance workers are exposed to equivalent noise levels above the Swedish occupational standard, including some very high peak exposures. Younger employees have a higher age-matched hearing threshold level compared with a reference group. Thus, there is a need for further preventive measures.     

高温噪声作业人员血脂水平的调查分析

目的探讨高温+噪声和单纯噪声的职业病危害因素对劳动者血脂水平的影响,为预防和减轻高温及噪声对作业人员健康的影响提供依据,同时探讨血脂是否可作为噪声、高温作业人员职业健康检查的必检项目。方法选择某工厂的冶炼工、浇铸工、热处理工60名为高温、噪声接触对象;选取该厂的原料工、打磨工、制模工60名为单纯噪声接触对象;选取该厂不接触噪声、常温作业的财务人员、销售人员、采购人员72名为对照组。用方差分析、秩和检验的方法进行统计分析。结果高温+噪声组、单纯噪声组和对照组工人的血脂成分中总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平(x珋±s)和甘油三酯(TG)中位数水平的差异无统计学意义,高密度脂蛋白胆固醇(HDL-C)中位数水平,3组间差异有统计学意义(P0.05)。3组工人HDL-C水平多重比较显示,高温+噪声组与噪声组之间差异有统计学意义(P0.05);高温+噪声组与对照组、噪声组与对照组之间差异有统计学意义(P0.01);3组工人血脂增高率比较,TC、LDL、TG,均P0.05,HDL-C增高率P0.05。TC、TG、LDL水平不高于对照组,差异无统计学意义,高温+噪声组、单纯噪声组的血脂异常检出率(除HDL-C外)均比对照组高,但差异无统计学意义。结论血脂检查不应做为噪声、高温作业人员职业健康检查的必检项目。     

PDCA持续质量改进在病区药品管理中的应用

目的研究对病区药品管理过程中实施PDCA持续质量改进措施产生的药学管理应用价值。方法选择我院2018年病区检查相关药品资料,根据PDCA持续质量改进实施前后分组,将药品资料分为两组,2018年3月-2018年6月阶段资料为PDCA持续质量改进实施前组、2018年9月-2018年12月阶段资料为PDCA持续质量改进实施后组,各50份药品,对比两组药品基数管理、效期管理以及正确贮存数据。结果 (1)应用PDCA持续质量改进,实施前组病区药品备用药品基数、效期管理以及正确贮存合格率明显低于实施后组,可见明显组间差异性(P <0.05)。(2)应用PDCA持续质量改进,实施前组管理缺陷总有效率(60.00%)低于实施后组管理缺陷总有效率(90.00%),两者差异明显(P <0.05)。结论实施PDCA持续质量改进措施,降低药品管理缺陷,保证药品贮存质量,提高病区药品管理水平。     

Delivery of Enteral Nutrition after the Introduction of Practice Guidelines and Participation of Dietitians in Pediatric Critical Care Clinical Teams

Provision of optimal nutrition is often difficult to achieve in the critically ill child, but can improve with better nutritional support practices. This study evaluated the joint impact of the introduction of enteral feeding practice guidelines and participation of dietitians in daily ward rounds on enteral nutrition (EN) intake and practices in children in intensive care. Nutritional intake and EN practices were audited before (period A) and after (period B) the introduction of enteral feeding practice guidelines and participation of dietitians in daily ward rounds in a pediatric intensive care unit. Information was collected on a daily basis and nutritional intake was compared with predefined targets and the United Kingdom dietary reference values. There were 65 patients and 477 nutritional support days in period A and 65 patients and 410 nutritional support days in period B. Basal metabolic rate (BMR) energy requirements were achieved in a larger proportion of nutritional support days in period B (BMR achieved [% nutritional support days]; period A: 27% vs period B: 48.9%; P<0.001). In patients admitted for nonsurgical reasons, median energy, protein, and micronutrient intake improved significantly. In the same group, the percentage of daily fluid intake delivered as EN increased post implementation (period A: median=66.8%; interquartile range=40.9 vs period B: median=79.6%; interquartile range=35.2; P<0.001). No significant changes were seen in patients admitted for corrective heart surgery. Implementation of better EN support practice can improve nutritional intake in some patients in critical care, but can have limited benefit for children admitted for corrective heart surgery.     

太原市某卷烟厂噪声对作业工人心血管系统的影响调查

[目的]探讨噪声对作业工人心功能的影响,制定更合理的防护措施。[方法]2008年5月。对太原市某卷烟厂125名噪声作业工人进行心脏健康监护。并与对照比较。[结果]高血压患病率噪声组125人为10．40％,对照组125人为6．40％（P〉0．05）;心电图异常率,噪声组为47．20％,对照组为20．80％（P〈0．01）。[结论]本次调查调查对象的样本量较少,有待扩大样本量进一步确定噪声对卷烟厂作业工人心血管系统的影响程度。