高原铜矿建设项目职业病危害因素识别与评价

目的识别与评价高原铜矿建设项目可能产生的职业病危害因素。方法依据《工业企业设计卫生标准》采用类比法和经验法等进行评价。结果该建设项目的选址与总体布局、生产设备布局等基本符合国家有关规定，生产过程中可能存在粉尘（0．33～2．90mg／m^3）、砷及其无机化合物（0．003～0．008mg／m^3）、氟及其化合物（0．1～1．1mg／m^3）、硫化氢（0．3—0．5mg／m^3）、二硫化碳（0．20～1．30mg／m^3）、噪声、高温热辐射等主要职业病危害因素，属于职业病危害严重的建设项目。结论该项目生产过程中可能产生的职业病危害是可以预防的，从职业卫生角度分析该项目是可行的。     

怀宁县结核病控制项目实施效果评价

目的评价怀宁县实施结核病项目效果，为控制结核病提供依据。方法对2002-2006年结核病控制项目资料进行评价分析。结果5年共接诊可疑肺结核症状者6416例，发现新发涂阳肺结核病人1212例，新发涂阳病人登记率由2002年的10．13／10万上升到2006年的46．31／10万，初治涂阳病人的治愈率从2002年的71．0％提高到2006年的89．8％。结论怀宁县结核病控制项目取得显著成效。     

某公司四阳极熔盐电解制钠技术改造项目职业病危害控制效果评价

[目的]确定某公司四阳极熔盐电解制钠技术改造项目主要的职业病危害因素及危害程度,评价职业病危害防护措施的效果。[方法]2007年11~12月,对该技改项目进行职业病危害控制效果评价。[结果]该技改项目主要职业病危害因素是氯气、氨、烧碱、石蜡烟及噪声。在正常满负荷生产的情况下,工人接触各种职业病危害因素浓度(强度)均符合国家职业卫生标准;但总体布局不尽合理,辅助生产区会对二期工程生产车间产生影响;未设置报警装置、事故通风设施、泄险区与应急撤离通道,高毒作业场所未设置红色区域警示设施,厂区无紧急救援组织、药品、器材、设备。[结论]该项目属于严重职业病危害建设项目,在可行性研究阶段未进行职业病危害预评价,导致平面布局不合理,应急救援设施亟待完善。     

某兽药饲料监察所建设项目职业病危害预评价

目的识别、评价、控制某兽药饲料监察所建设项目可能产生的职业病危害因素。方法采用类比、定量等方法综合分析进行预评价。结果该项目选址、总体布局、生产工艺布局及设备选型、职业病防护设施设计、卫生辅助用室等符合国家有关规定。对类比企业监测结果显示，生产过程中可能产生的职业病危害因素有甲苯、硫酸、盐酸、氢氧化钠、丙酮、乙酸乙酯、甲醇。分别检测了TWA、STEL硫酸均〈0．13mg／m^3，丙酮均〈6．7mg／m^3，甲苯均〈3．3mg／m^3的浓度（强度），符合国家卫生标准的要求。结论该项目为职业病危害一般的建设项目，生产过程中可能产生的职业病危害是可以预防的，从职业卫生角度分析该项目是可行的。     

Care systematization in psychiatric nursing within the psychiatric reform context

The aim of this study was to approach care systematization in psychiatric nursing in two psychiatric disorder patients who attended ‘Nossa Casa’, São Lourenço do Sul, RS, Brazil. Nossa Casa services psychiatric patients in the community, focussing on: (i) permanence in their environment, allowing patients to remain close to their families and social spheres; (ii) integral attendance to meet individual needs; (iii) respecting individual differences; (iv) rehabilitation practices; and (v) social reinsertion. Concepts and assumptions of the psychiatric reform and the Irving’s nursing process were used as theoretical–methodological references to elaborate this systematization. A therapeutic project for the psychiatric patient was elaborated, in accordance with the interdisciplinary proposal accepted by Nossa Casa. Interdisciplinary team intervention, guided by a previously discussed common orientation and defined through an individualized therapeutic project, allowed for an effective process of psychosocial rehabilitation. The authors concluded that a therapeutic project based on the mentioned premises leads to consistent, comprehensive, dialectical and ethical assistance in mental health, thereby reinstating the citizenship of psychiatric patients.     

Ethical issues arising from a research, technology and development project to support frail older people and their family carers at home

The present paper provides an overview of the application of the key ethical issues which arose in an EU-funded research, technology and development project, Assisting Carers using Telematics Interventions to meet Older Persons' Needs (ACTION). The primary aim of the ACTION project was to support frail older people and their family carers in their own homes across England, Northern Ireland, the Republic of Ireland, Sweden and Portugal via the use of user-friendly information and communication technology. Ethical guidelines were developed in the project and used as a tool to enable the multidisciplinary project team to increase their awareness of ethical issues in their everyday work, and to act as a useful ethical framework for regular team discussions at international and local meetings across the partner countries. A range of ethical issues arose during the field-study phases of the project when the ACTION services were introduced into a number of families' own homes. It can be argued that these ethical issues reflect factors relating both to the application of research into practice, as well as those relating more directly to the use of new technology by families and care professionals. Key issues centre upon the ethical concepts of autonomy, independence, quality of life, beneficence, non-maleficence and justice, and more specifically, on ethical issues of security, privacy and confidentiality, increased expectations, and withdrawal of the service. This paper is intended to facilitate dialogue and debate in the area of enabling (assistive) technology in home care for older people and their families.     

Evaluation of the Thai-Lao Collaborating Nursing Manpower Development Project using the Context Input Process Product model

Abstract The purpose of this article was to describe, monitor and evaluate the Thai–Lao Collaborating Nursing Manpower Development Project using Stufflebeam's Context Input Process Product model. The study found that the project had great success in personnel development according to the six activities of the project. It helped develop two nurses with Masters degrees, 24 senior nurses and 283 diploma and auxiliary nurses. There were visible changes in the discipline and in terms of nursing care, nursing process was utilized. The Lao nursing system was developed to the point where white uniforms were used as the symbol of nurses who previously went unrecognized. There was a change in the structure of nursing organization. Moreover, nursing activities moved torwards the goal of health promotion and prevention. The study recommended that a periodic supervisory activity be implemented to enhance the training of trainers. In addition, a 2-year continuation program for Bachelor degrees in nursing should be developed initially in Laos, then a 4-year program should be developed. The nursing education program for Masters degrees should initially be obtained through neighboring countries.     

Low-Back Pain in Morbidly Obese Patients and the Effect of Weight Loss Following Surgery

Background: Although low-back pain (LBP) is a common health problem and a source of significant discomfort, disability and work absences, its incidence, severity and outcome have not been extensively investigated in morbidly obese patients undergoing bariatric surgery. Methods: 50 morbidly obese candidates for vertical banded gastroplasty (VBG) were asked to fill in a questionnaire, to assess the incidence and severity of any existing LBP symptoms. 50 non-obese patients, admitted to our surgical unit for management of several benign conditions, were also asked to fill in the same questionnaire and served as controls. 24 months after VBG, the morbidly obese patients were again evaluated for their LBP symptoms. Results: LBP was identified in 29 morbidly obese patients (58%) preoperatively and in only 12 (24%) of the lean controls (P<0.01). 2 years after VBG, with a significant excess weight loss (P<0.0001), only 10 patients continued to have LBP but less frequently and requiring reduced doses of medications compared with the preoperative condition. In the remaining 19 patients with preoperative positive LBP history, the postoperative weight loss was associated with complete resolution of the symptoms. Conclusion: The frequency of LBP is significantly higher in morbidly obese patients than in lean subjects. Surgical weight reduction results in significant improvement and even disappearance of this obesity co-morbidity.     

Quality indicators for health promotion programmes

Methods for systematically following up and auditing health promotion have been in demand for a considerable period of time. Quality assurance as an auditing method has opened up new opportunities in this area. On the basis of Donabedian's 'triad' of structure, process and outcome, the theoretical preconditions for and implementation of a number of successful health promotion programmes/ projects have been analysed with regard to their common characteristics. These characteristics have been generalized and then transformed into indicators of a successful health promotion programme/project. To ensure the practical applicability of the quality indicators, they were operationalized in what we call a 'question pro-forma'. Any negative response to a question on the pro-forma indicates quality defects in a programme, and any positive response the opposite. The 'template' can be employed for both the planning and auditing for quality assurance on health promotion programmes and projects. The question pro-forma has been tested successfully on a number of programmes and projects. The results from one study are shown in the article.