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At least 613 records · Page 34Linked to original sources
PubMed2002

Community infection control: what is the evidence?

Evidence-based practice is the conscientious use of current best evidence in decision-making about care or the delivery of health services (National Institute for Public Health, 1996). Evidence-based health care is one aspect of the quality improvement activities of clinical governance as a main component of the programme of quality in the NHS (Hek, 2000). Practitioners working in clinical areas are therefore being required to deliver care that has been shown to be effective. (Playle, 2000).

Bandages↗
PubMed2004

Colostomy products: an update on recent developments.

This article gives the reader an overview of recent developments in appliances for people with a colostomy. After a brief background, the various products that have been brought onto the market in recent years are discussed.

Colonic Pouches↗
PubMedDate not supplied

Strategies for dental clinic infection control.

The application of proper infection control procedures helps to protect practitioners, patients and the community. The goal is to minimize the spread of potentially pathogenic micro-organisms and to remove and/or kill organisms that have contaminated objects and surfaces. Dental practitioners are aided in this process by the generation of rules, guidelines and recommendations by regulatory agencies and professional organizations. Ideally, each office/clinic would generate and maintain a written set of infection control procedures.

Cross Infection↗
PubMed2003

The fate of gallstones: traditional practice questioned.

AIMS: Gallstones are traditionally handed back to patients as a souvenir of their cholecystectomy. The aim of this study was to review the potential hazards of this practice, the final fate of gallstones and the patients' perception of the risks. PATIENTS AND METHODS: A total of 86 consecutive patients undergoing cholecystectomy for cholelithiasis were surveyed prospectively. An unrestricted Medline database search was performed to gather pertinent literature. RESULTS: Of the 86 patients studied, 64% took their gallstones home, out of whom 29% actually handled the stones. In 9%, gallstones were accessible to children. Of all patients surveyed, 19% thought that the stones could be harmful. No patient received any information about the potential risks. Of the study group, 35% had discarded their stones by 6 weeks and 16% were planning to discard them. The rest were unsure or had decided to keep the stones. CONCLUSIONS: Available literature establishes the presence of viable pathogenic bacteria in gallstones, but their infective potential is unknown. These bacteria are possibly more pathogenic than similar gut flora. This study has shown that gallstones are handled by a significant number of patients and are even accessible to children. The majority of patients do not consider them harmful and no information is provided to them. In this age of increasing health awareness, we recommend that patients taking their gallstones home should be informed of the potential risks.

Adolescent↗
PubMed2002

Laboratory evaluation of amalgam separators.

BACKGROUND: Amalgam in dental wastewater is receiving increasing scrutiny from regulators because of national, state and local initiatives to reduce or virtually eliminate the discharge of mercury and mercury-containing items into the environment. Amalgam separators are considered to be one means of reducing the amount of amalgam that dental offices discharge into sewers. The purpose of this study was to evaluate the amalgam removal efficiency of commercially available amalgam separators and the total mercury concentration in the effluent from laboratory testing. METHODS: The authors evaluated the amalgam removal efficiency of 12 amalgam separators according to International Organization for Standardization, or ISO, Standard 11143 for Amalgam Separators. Total mercury concentration in the effluent was calculated using the mass of amalgam particles larger than 1.2 micrometers and the volume of effluent, together with U.S. Environmental Protection Agency, or EPA, Method 245.1 for amalgam particles smaller than 1.2 microm. Total dissolved mercury also was determined. RESULTS: The results show that all 12 amalgam separators exceeded the ISO 11143 requirement of 95 percent amalgam removal efficiency. Statistical differences were found in the efficiencies of the separators. Both the total mercury concentration and total dissolved mercury concentration in the effluent demonstrated large variations. CONCLUSIONS AND CLINICAL IMPLICATIONS: This laboratory evaluation shows that amalgam separators removed at least 96.09 percent of the amalgam in samples with particle-size distribution as specified in ISO 11143. Total mercury concentration and total dissolved mercury concentration in the effluent varied widely for each amalgam separator. Additional research is needed to develop test methods to evaluate the efficiency of amalgam separators in removing small amalgam particles, colloidal amalgam particles and ionic mercury in solution.

Dental Amalgam↗
PubMed2003

Dental mercury hygiene recommendations.

BACKGROUND: The ADA has long recognized the importance of observing proper mercury hygiene practices for the safety of dental professionals. In 1999, the ADA Council on Scientific Affairs adopted mercury hygiene recommendations to provide guidance to dentists and their staff members for safe handling of mercury and dental amalgam. These mercury hygiene recommendations have been developed to update those previously adopted by the Council. OVERVIEW: In addition to discussing sources of mercury in the dental office, this Council report describes office engineering considerations and hygiene recommendations to be used during preparation and placement of dental amalgam restorations. New information included in this report covers the management of mercury spills. PRACTICE IMPLICATIONS: These recommendations are intended to provide guidance to the dental practitioner in ensuring the safety of personnel who handle dental amalgam and in minimizing the release of mercury into the dental office environment.

Air Pollution, Indoor↗
PubMed2003

Purchasing, installing and operating dental amalgam separators: practical issues.

BACKGROUND: Growing environmental concern over the accumulation of mercury in some fish has led some state and local environmental agencies to pursue stricter regulation of mercury in wastewater. Dental offices are an identifiable source of mercury in the form of dental amalgam. Although mercury in dental amalgam is not immediately bioavailable (that is, it has not been shown to contribute significantly to the problem of mercury in fish tissue), environmental agencies in some locales are asking dental offices to install amalgam separators in an effort to reduce amalgam discharges beyond those already achieved through chairside traps and vacuum filters. Field experience indicates that the configuration and operation of the dental office infrastructure can significantly affect the choice of separator, as well as the operation and maintenance of the installed equipment. OVERVIEW: The authors review factors related to office infrastructure and operation that dentists should consider when investing in an amalgam separator. They also provide a cost-analysis worksheet and checklist that may be useful to dentists who are considering purchasing a separator. CONCLUSIONS AND CLINICAL IMPLICATIONS: Before purchasing or installing an amalgam separator, dentists should consider factors specific to the available models, including size and maintenance requirements. In addition, office-specific actors should be considered (such as the plumbing configuration, available space for installation and subsequent access to that space for equipment replacement and maintenance). Dentists also should research whether any local or state regulations exist that might influence product selection or installation. Dentists should consider the effect an amalgam separator could have on existing suction equipment. Finally, dentists will want to consider the short- and long-term costs (including maintenance and parts replacement) of the available options.

Costs and Cost Analysis↗
PubMed2006

Evaluating amalgam separators using an international standard.

BACKGROUND: Most amalgam particles generated during placement and removal of amalgam restorations are captured by chair-side traps and suction system traps and filters. Particles not captured can end up in the wastewater discharged from the dental office. Environmental initiatives to reduce the discharge of mercury-containing products such as dental amalgam waste into the environment have sparked interest in the use of amalgam separators. METHODS: The authors used International Organization for Standardization (ISO) Standard 11,143 for Amalgam Separators in a laboratory test to evaluate the amalgam removal efficiency of 13 commercially available amalgam separators and two commercially available filtration devices not marketed as amalgam separators but that have the potential to be used as such. RESULTS: All 13 amalgam separators and the two filtration devices exceeded the ISO Standard 11,143 requirement of 95 percent amalgam removal efficiency. The authors found statistical differences in the efficiency of the separators and filtration devices. No differences were found between the "empty" and "full" conditions for each separator. CONCLUSION AND CLINICAL IMPLICATIONS: This laboratory evaluation shows that amalgam separators and the filtration devices removed at least 97.05 percent of the amalgam in samples with particle-size distribution as specified in ISO Standard 11,143.

Analysis of Variance↗
PubMed1998

Hospital trash: cleaners speak of their role in disease prevention.

Feminist researchers have contrasted the caring provided by women in hospitals with a more fragmented "curing" approach, which they identify with the predominantly male professions of medicine and surgery. The author spoke with hospital cleaners about their jobs and their health. Several themes emerged: the invisibility of the cleaning function, lack of respect for cleaners, representations of cleaning as undemanding, and assumptions that women's work in cleaning is particularly easy. Cleaners use various strategies to combat these stereotypes but receive little help from administrators or fellow employees. There is a hierarchy in the status of Québec hospital workers with curing (doctors) at the top, followed by caring and healing (nurses, therapists, and attendants), and hygiene (cleaners, sterilizers, and launderers) at the bottom. Authority hierarchies in health care are not related to gender in a simple way, although there is discrimination against women cleaners. The fact that cleaning, especially cleaning performed by women, is invisible to managers, other hospital personnel, and patients has important consequences for cleaners' and for patients' health.

Female↗
PubMedDate not supplied

[Potentially infectious residues at hemotherapy services and interfaces with infectious diseases].

The aim was to identify the processing of potentially infectious residues and of piercing and cutting residues at hemotherapy units and their possible relation with workers' health. No service presented a structured plan for managing health service residues or for the occupational safety program. We found an occupational accident rate of 32.82% and that 9.16% of the workers did not have a complete plan of vaccination against hepatitis B. In-service training in handling residues and in occupational health are not standardized. The rate of serum conversion for HBV and HCV after occupational exposure was 11.63%. We concluded that the processing of potentially infectious residues and of piercing and cutting residues at the examined hemotherapy units has exposed workers to the acquisition of infectious diseases.

Accidents, Occupational↗
PubMedDate not supplied

[Criteria for definition of environmental contamination indicators related to solid waste from health care facilities: a proposal for evaluation].

The objective of this study was to identify target microorganisms as indicators of environmental contamination. The study evaluates the main environmental aspects and epidemiological chain related to such agents. Microorganisms were selected through key information about microbiological characterization of health care facilities' solid waste and evaluation of risk of infection from discarded sharps. The form of evaluation proposed for criteria adopted in the selection of contamination indicators included prior submission of a structured questionnaire to a network of specialists from the Federal District of Brazil. The specialists' multidisciplinary background, including professionals from the health field and an environmental microbiologist, helped define environmental contamination indicators by consensus. Pathogens such as Mycobacterium tuberculosis and hepatitis A and B viruses were specifically identified as capable of environmental survival or resistance.

Environmental Health↗
PubMed2004

[Health services waste management: a biosafety issue].

The subject of "health services waste" is controversial and widely discussed. Biosafety, the principles of which include safeguarding occupational health, community health, and environmental safety, is directly involved in the issue of medical waste management. There are controversies as to the risks posed by medical waste, as evidenced by diverging opinions among authors: some advocate severe approaches on the basis that medical waste is hazardous, while others contend that the potential for infection from medical waste is nonexistent. The Brazilian National Health Surveillance Agency (ANVISA) has published resolution RDC 33/2003 to standardize medical waste management nationwide. There is an evident need to implement biosafety procedures in this area, including heath care workers' training and provision of information to the general population.

Communicable Diseases↗