27所医院医院感染现患率调查分析

目的了解全市医院感染现状,寻找发生原因,改进工作方法。方法采用床旁调查和查阅病例相结合的方法,调查全市27所二级以上医院2009年9月2日所有住院患者(包括当日出院、转科和死亡病例,不包括当日新入院患者)的医院感染情况。结果调查病例11 650例,实查11 493例,实查率98.65%,医院感染171例,现患率1.49%,例次现患率1.71%。结论全市医院感染现患率普遍较低,但重点科室仍较高,应加强重点科室医院感染控制。     

肿瘤专科医院医院感染现患率调查

目的了解某肿瘤医院医院感染现患率及抗菌药物的使用情况,为提高医院感染管理水平提供科学依据。方法采取床旁询问病史、体格检查与病历调查相结合的方法,对该院2011年9月15日0∶00-24∶00的所有住院患者进行调查。结果调查当日应查住院患者325例,实查321例,实查率98.77%。发生医院感染15例,16例次,医院感染现患率为4.67%,例次现患率为4.98%。现患率较高的科室有化疗一科(19.05%)、妇瘤科(14.29%)、中医科(10.00%)和呼吸科(4.44%)。抗菌药物当日使用率为47.98%（154/321）。医院感染部位以下呼吸道居首位,占37.50%;其次为皮肤软组织(18.75%)和胃肠道(12.50%)。结论医院感染现患率调查有利于了解医院感染发生情况,加强对高危科室的目标性监测和进一步规范抗菌药物的使用。     

医院感染现患率调查

[目的]了解和掌握医院感染现状,为制定医院感染控制措施提供科学依据.[方法]采用横断面调查方法,采用床旁与住院病历调查相结合.调查2009年11月18日全天的住院患者进行医院感染现患率调查.[结果]实查373人,医院感染14例次,医院感染例次现患率为3.75%.感染部位以下呼吸道居首位,颅脑外科为高发科室,侵入性操作为易感因素.[结论]做好重点人群、重点科室的目标监测,合理使用抗菌药物,降低医院感染率.     

医院感染现患率调查分析

目的了解医院感染现患率,评价医院感染日常监测资料的可靠性和准确性,为医院感染预防与控制工作提供科学依据。方法采取横断面调查方法,对调查日0:00-24:00的所有住院患者进行医院感染现患率调查,填写统一的个案调查表,并对调查当日处于医院感染的病例进行统计分析。结果 2009年4月21日及11月4日连续两次共调查住院患者1243例,实查率为99.68%;医院感染现患率分别为2.30%和1.86%,医院感染高发科室为神经内科;医院感染部位以上呼吸道为主,其次为下呼吸道和胃肠道。结论针对医院感染发生率较高的科室进行重点监测及干预,加强感染病例标本送检,规范手术科室抗菌药物使用,降低使用率。     

二级中医院医院感染现患率调查分析

目的了解医院感染现患率、危险因素和横断面抗菌药物的使用情况,为医院感染控制工作提供依据。方法于2010年9月28日0∶00-24∶00采用横断面调查方法,床边与病例调查相结合,对全院住院患者进行医院感染现患率调查。结果实查住院患者585例,实查率100.00%,发生医院感染18例,现患率3.08%,例次感染19例,例次感染率3.25%;呼吸科占9.25%,肿瘤科占7.50%,是医院感染的高发科室;感染部位以下呼吸道居首位占63.16%;老年患者、住院时间长是医院感染的危险因素;抗菌药物使用率偏高,治疗用药前微生物送检率低。结论应加强对感染高危科室的感染监控和下呼吸道感染的干预,加强抗菌药物合理使用的管理,减低医院感染率。     

医院感染现患率调查分析

目的 了解湖北省医院感染现患率及医院感染的实际状况.方法 采用横断面调查方法,床旁调查与查看病历相结合,对调查日处于医院感染状态的病例进行统计分析.结果 调查住院患者44 273例,实查43 646例,实查率98.58％,发生医院感染1494例,现患率3.42％,1756例次,例次感染率为4.02％;感染率最高科室为综合ICU;医院感染部位以下呼吸道感染为首位,占49.53％;抗菌药物使用率为54.50％.结论 通过医院感染现患率调查,全面了解湖北省医院感染现状,同时为制定全省医院感染预防控制措施及目标性监测提供科学依据.     

我院医院感染现患率调查分析

目的了解某院医院感染现患率,发现医院感染管理中存在的问题和医院感染发生的特点,以改进预防控制措施.方法统一培训调查人员,床旁询问病史、体格检查与在架病历调查相结合,填写统一的个案调查表.对调查日处于医院感染状态的病例进行统计分析.结果应查病例512人,实查495人,实查率96.68%.发生医院感染40例,41例次,医院感染现患率为8.08%、例次现患率为8.28%,高于日常连续性调查结果.医院感染部位以下呼吸道居首位.结论医院感染现患率调查有利于发现医院感染管理工作中存在的问题,为制定医院感染监控措施提供可靠依据.     

沈阳市四所综合性医院3年医院感染现患率调查

目的通过对2013年-2015年沈阳市4所综合医院开展三次医院感染现患率调查工作,描述医院感染分布情况,分析医院感染的流行病学特征,为制定预防和控制医院感染措施和进一步研究提供依据。方法于2013年12月18日、2014年12月17日、2015年12月16日在四所医院开展医院感染现患率调查工作,每所医院均按照50张病床配备一名调查员的比例从本院各临床科室抽调主治医师以上医生参加调查工作,调查当日各组均采用床旁调查与查阅病历相结合的方法,同时填写床旁调查表和个案调查表,应用SPSS20.0进行数据处理。结果本次调查应查病例14987例,实查病例14883例,实查率为99.31%;3年共发现医院感染392例,426例次,医院感染现患率为2.63%,感染例次率为2.86%;医院感染部位排名占前三位的依次为下呼吸道、上呼吸道、泌尿道;医院感染病原菌分布中革兰阴性菌中排名前三位的是铜绿假单胞菌、鲍氏不动杆菌、大肠埃希菌,革兰阳性菌排名前三位的是金黄色葡萄球菌、凝固酶阴性葡萄球菌、肠球菌属;抗菌药物使用率为37.04%。结论以连续三年的医院感染现患率调查资料为证据,为调整医院感染控制策略,开展针对性、前瞻性的目标性监测提供科学依据,对降低医院感染率具有重要意义。     

河北宽城县医院感染状况调查结果与分析

目的了解医院感染现状、抗菌药物使用情况及重要病原菌检出率,为提高医院感染管理水平提供科学依据,更好地预防与控制医院感染。方法按全国医院感染监控网要求,采用床旁座谈和查阅运行病历相结合的方法,调查2012-12-25所有住院患者的医院感染情况,包括当日出院、转科和死亡病例,不包括当日新入院患者。结果全院住院患者438例,调查432例,实查率98.6%,医院感染28例,医院感染现患率为6.48%,例次现患率为6.94%。其中:ICU室33.3%,骨一科21.43%,脑外科19.35%,骨二科12.82%;医院感染高发部位主要以上呼吸道、下呼吸道、泌尿道为主,分别为42.86%、46.43%、7.14%;应用抗菌药物274人,日抗菌药物使用率为63.43%;一联233例,使用率85%,二联37例,使用率13.5%,三联以上4例,使用率1.46%。感染病例分离出病原菌7株,以革兰阴性杆菌为主。结论本次全院性的医院感染现患率调查较好地反映了宽城县医院的医院感染实际发生、抗菌药物使用情况。     

医院感染现患率调查及分析

目的 了解医院感染发生情况与影响因素,以改进医院感染发病率监测方法及医院感染预防与控制措施.方法 以专职人员为主,临床医院感染管理小组人员配合,以科室为单位调查前1 d零时至当日零时,所有住院患者均计入调查范围内,按现患率调查要求统一设计床旁调查表和个案病史调查表,将所有调查患者进行统计、分析.结果 应调查住院患者653例,实际调查638例,实查率97.7%,发生医院感染38例、47例次,医院感染现患率6.0%、例次现患率7.4%;感染部位以呼吸道为首位.结论 此方法节省人力、调查标准统一,为进一步开展医院感染发病率监测方法的改进和制定医院感染预防与控制措施提供了可靠依据.     

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.     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

Fatigue and health in a seafaring population

Background Occupational fatigue is relatively common withinthe general population and has been linked to reduced performance,injury and longer term ill-health. Despite growing acknowledgementof this problem in the maritime sector, little research hasbeen conducted into the risk factors, prevalence and consequencesof seafarers' fatigue. Aims To examine the prevalence of fatigue among seafarers, identifypotential risk factors and assess possible links with poor performanceand ill-health. Methods Cross-sectional questionnaire survey of seafarers workingin the offshore oil support, short-sea and deep-sea shippingindustries. A number of tools were used including the fatiguesubscale of the profile of fatigue-related symptoms, the CognitiveFailures Questionnaire, the General Health Questionnaire andthe SF36 General Health scale. Results In all, 1855 questionnaires were completed giving anoverall response rate of 20%. Fatigue symptoms were associatedwith a range of occupational and environmental factors, manyunique to seafaring. Reporting a greater number of risk factorswas associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35)for those with three or four risk factors and OR = 9.54 (6.95–13.09)for those with five or more risk factors]. There was also astrong link between fatigue and poorer cognitive and healthoutcomes, with fatigue the most important of a number of riskfactors, accounting for 10–14% of the variance. Conclusions Seafarers' fatigue could impact on safety withinthe industry and may be linked to longer term individual ill-health.It can only be addressed by considering how multiple factorscombine to contribute to fatigue.     

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.