Risk factors in urban road traffic accidents

INTRODUCTION: The urban road traffic accident (RTA) risks for the city of Zagreb, Croatia, from 1999 through 2000 were analyzed with the aim of reducing the increasing injury incidence. METHOD: Simple and bivariate analysis using chi(2), odds ratio, and confidence interval of 95% was used to determine risks in three outcome groups: killed, severely, and mildly injured. RESULTS: There were 528 RTA victims consisting of 260 severely, 213 mildly injured, and 55 killed at the scene of an accident and during transportation. More fatal accidents occurred during night hours (OR=3.78; 95% CI, 2.08-6.85), on urban road links (OR=2.33; 95% CI, 1.30-4.19), and at exceeding speed limit (OR=2.56; 95% CI, 1.43-4.61). More people were injured than killed on urban junctions (OR=5.27; 95% CI, 2.21-12.57). The highest combined risk of dying or being severely injured was found in males, driving at excessive speed, on urban links, and during bad visibility (OR=16.15; 95% CI, 3.901-66.881). CONCLUSION: These results will influence the urban traffic police enforcement measures, which will change inappropriate behavior of drivers and protect the least experienced road users.     

Balance the Paradox between Limited Health Resources and Growing Demands for Medical Services

Health institutions in the People＇s Republic of China are under considerable challenge. Innovations in management systems may support the challenge to increase both efficiency and effectiveness. The balanced scorecard （BSC） is one such innovation. We have used a model to explore the factors that may impact the diffusion of the BSC in Chinese government hospitals. In particular, we concentrate on three factors - the outer context, the nature of the innovation and the communication and influence. The outer context and the nature of the innovation do provide an inducement to implement a BSC. The strength of the communication and influence may affect the level of take-up. However, we recognise that they may choose ＂the BSC not for any apparent technical excellence but for the legitimation that Western management practices may bring to local managers.     

MBR工艺处理综合医院污水

本文介绍了综合医院污水治理采用的MBR工艺方法.工程核心构筑物——MBR反应器经调试试运行后,达到了预期的安全、高效的设计原则,为我国综合医院污水的治理提供了技术改造要点及可行性经验.     

医疗垃圾焚烧飞灰重金属形态分析

利用原子吸收光谱仪分别对医疗垃圾焚烧飞灰重金属含量和重金属形态及其随颗粒度分布特性进行了分析,结果表明,飞灰中Cd、Zn、Pb等的浸出浓度远超标与这些重金属的可交换态和碳酸盐态含量较高有关;飞灰颗粒度主要在96 μm以下,96～150 μm的颗粒中Cd、Pb含量最高,且Zn、Cd的形态以可交换态为主.     

医疗废物焚烧过程脱硫机理和试验

医疗废物中包括含有硫分的橡胶,焚烧时会产生SO2从而污染环境,因此医疗废物在焚烧处理时需要进行脱硫。应用HSC热力学软件计算可知,医疗废物焚烧炉内喷入脱硫剂在燃烧过程脱硫,脱硫效果最好的脱硫剂是CaO,然后是Ca(OH)2,CaCO3。综合各种因素,选用CaCO3做脱硫剂进行焚烧过程脱硫试验。试验结果表明:温度对脱硫有着重要的影响,最佳脱硫温度为830～870℃左右;随着Ca/S摩尔比的增大脱硫率增大,但增加的速度却趋于平缓,所得最佳Ca/S摩尔比为2.5。     

加压生物接触氧化法处理医院污水

介绍了采用加压生物接触氧化-ClO2消毒工艺处理医院污水的情况,运行结果表明,该工艺装置除污效率高、占地少、运行稳定,处理出水达到了国家污水综合排放一级标准(GB8978-1996)的要求。     

综合性医院建设项目环境影响评价要点分析

综合性医院的医疗废水要分一般废水和特殊废水，在坚持全过程控制原则、减量化原则、就地处理等原则的同时，根据需要进行一级处理和二级处理；按要求将医疗垃圾分类、包装、存放、处理；对水处理污泥应按危险废物进行处理。建设项目的水环境影响评价应进行详细的预测评价、一般专项评价或一般性分析；在医疗废物处理设施的环境影响评价中，医疗废物焚烧应作为评价重点，做到社会效益、环境效益和经济效益相统一。     

An earthquake disaster in Turkey: an overview of the experience of the Israeli Defence Forces Field Hospital in Adapazari

On 17 August 1999 at 3:04 a.m., an earthquake of 7.4 magnitude (Richter scale) struck the Marmara region in Turkey. The city of Adapazari suffered 2,680 fatalities with approximately 5,300 injured. The Israeli Defence Forces (IDF) field hospital arrived at Adapazari, on day four after the quake. The team consisted of 102 personnel. The field hospital acted as a secondary referral centre. A total of 1,205 patients were treated in the field hospital between day four and day 14 of the earthquake. The frequency distribution of the medical problems seen in the field hospital was 32 per cent internal medicine, 13 per cent general surgery including plastic, 21 per cent orthopaedic surgery, 23 per cent paediatric disease, 10 per cent obstetrics and gynaecology and 1 per cent major psychiatric disorders. A mean number of 35 patients per day were hospitalised in the field hospital for between 24 hours to one week. The rapid establishment of the field hospital enabled the local medical facilities to 'buy time' in order to organise and restore surgical and hospitalisation abilities in this disastrous situation.     

医院空调回风口滤网积尘中抗生素抗性基因污染的比较

为了解医院环境中抗生素抗性基因(ARGs)的污染情况与分布特征,于2018年11月至2021年4月期间分批次采集了武汉市两家医院部分病房空调回风口滤网积尘样本127份,对其进行β-内酰胺类ARGs (mecA、bla_TEM、bla_CTX-M、bla_SHV)和碳青霉烯类ARGs (bla_KPC、bla_NDM-1、bla_IMP、bla_VIM、bla_OXA-51)及一类整合酶基因intI 1的定性与定量检测与评价.结果表明,医院不同科室及ICU空调滤网积尘中可检出以上9种β-内酰胺类,碳青霉烯类ARGs及intI 1,平均检出率分别为55.12%、37.64%和81.89%.ICU的β-内酰胺类与碳青霉烯ARGs的平均检出率显著高于外科与内科(P<0.05);4种β-内酰胺类ARGs中的bla_TEM、mecA检出率及其相对丰度在内科、外科最高(P<0.05);ICU的bla_SHV检出率及其相对丰度高于内科、外科(P<0.05).5种碳青霉烯类ARGs中的bla_NDM-1检出率及其相对丰度在内科、外科显著高于bla_KPC、bla_IMP(P<0.05).intI 1与9种ARGs的相对丰度均呈显著正相关(P<0.05).研究结果表明,两家医院不同科室病房空调滤网积尘中存在β-内酰胺类和碳青霉烯类ARGs以及一类整合酶基因intI 1的污染,内科、外科、ICU均以bla_TEM、mecA、bla_NDM-1为主,由此可认为医院不同科室空气及相关环境中可能存在与此等ARGs相关的耐甲氧西林金黄色葡萄球菌、产ESBLs肠杆菌科细菌、耐碳青霉烯大肠埃希菌与鲍曼不动杆菌等耐药菌的现时与既往污染,并且存在ARGs水平转移的风险;ICU空调滤网积尘中β-内酰胺类与碳青霉烯ARGs的污染较内科、外科严重,其中bla_SHV污染高于内科、外科,由此表明,ICU是ARGs及相关耐药菌污染的高风险科室.     

医院污水氯化消毒处理的相关因素及探讨

在医院污水氯化消毒处理中改善污水水质，因地制宜地选择合理的消毒剂和处理工艺流程，限制来苏尔、石炭酸的用量，以降低污水中酚的含量是确保污水消毒效果的重要因素。