Optimal Sterilization Policies in Interdependent Economies

In this paper, a two-country leader-follower model with imperfect asset substitution is used to derive the optimal sterilization coefficients for two-country flexible and fixed exchange rate regimes. It is found that, in general, incomplete sterilization is optimal. However, both the origin and the type of macroeconomic shocks the economies experience are important in determining the appropriate degree of sterilization. We also find that sterilization policies have spill-over effects (strategic complements) in both cases. Thus, in a competitive policy-making environment, greater sterilization by one country leads to greater sterilization by the other country. Further, the impact of increasing capital market integration is examined in particular. We show that greater integration compounds this problem, leading to full sterilization as the optimal outcome under perfect capital mobility

Investigating steam penetration using thermometric methods in dental handpieces with narrow internal lumens during sterilizing processes with non-vacuum or vacuum processes

Background: Dental handpieces are required to be sterilized between patient use. Vacuum steam sterilization processes with fractionated pre/post-vacuum phases or unique cycles for specified medical devices, are required for hollow instruments with internal lumens to assure successful air removal. Entrapped air will compromise achievement of required sterilization conditions. Many countries and professional organisations still advocate non-vacuum sterilization processes for these devices. Aim: To investigate non-vacuum downward/gravity displacement, type-N steam sterilization of dental handpieces, using thermometric methods to measure time to achieve sterilization temperature at different handpiece locations. Methods: Measurements at different positions within air turbines were undertaken with thermocouples and dataloggers. Two examples of commonly used UK benchtop steam sterilizers were tested; a non-vacuum benchtop sterilizer (Little Sister 3, Eschmann, UK) and a vacuum benchtop sterilizer (Lisa, W&H, Austria). Each sterilizer cycle was completed with three handpieces and each cycle in triplicate. Findings: A total of 140 measurements inside dental handpiece lumens were recorded. We demonstrate that the non-vacuum process fails (time range 0-150 seconds) to reliably achieve sterilization temperatures within the time limit specified by the International standard (15 seconds equilibration time). The measurement point at the base of the handpiece failed in all test runs (n=9) to meet the standard. No failures were detected with the vacuum steam sterilization type B process with fractionated pre-vacuum and post-vacuum phases. Conclusion: Non-vacuum downward/gravity displacement, type-N steam sterilization processes are unreliable in achieving sterilization conditions inside dental handpieces and the base of the handpiece is the site most likely to fail

Sterilization of heparinized Cuprophan hemodialysis membranes

The effects of sterilization of dry heparinized Cuprophan hemodialysis membranes by means of ethylene oxide (EtO) exposure, gamma irradiation, or steam on the anticoagulant activity and chemical characteristics of immobilized heparin and the permeability of the membrane were investigated. Sterilization did not result in a release of heparin or heparin fragments from heparinized Cuprophan. Sterilization of heparinized Cuprophan by means of EtO exposure and gamma irradiation induced a slight, insignificant decrease of the anticoagulant activity. In contrast, steam-sterilized heparinized Cuprophan showed a higher anticoagulant activity than unsterilized heparinized Cuprophan, which was most likely caused by cleavage of some of the covalent bonds between heparin and Cupropha. The effects of sterilization on the permeability of unmodified Cuprophan and heparinized Cuprophan were compared. The permeability of unmodified Cuprophan for vitamin B12 (Vit B12) and sulfobromophthalein (SBP) was reduced by 20–35% after EtO exposure and gamma irradiation and was reduced by 90–95% after steam sterilization. The water permeability of unmodified Cuprophan remained the same after EtO exposure and gamma irradiation but also dramatically reduced after steam sterilization. These reductions were ascribed to the collapse of pores of the membrane. The permeability of heparinized Cuprophan was not affected by EtO exposure and gamma irradiation but dramatically reduced after steam sterilization, although to a lesser extent than in the case of unmodified Cuprophan. Apparently, the presence of immobilized heparin (partially) prevented the collapse of pores during sterilization. Gamma irradiation was recommended as the preferred method of sterilization for heparinized Cuprophan.\u

Failure of non-vacuum steam sterilization processes for dental handpieces

Background: Dental handpieces are used in critical and semi-critical operative interventions. Although a number of dental professional bodies recommend that dental handpieces are sterilized between patient use there is a lack of clarity and understanding of the effectiveness of different steam sterilization processes. The internal mechanisms of dental handpieces contain narrow lumens (0·8-2·3mm) which can impede the removal of air and ingress of saturated steam required to achieve sterilization conditions. Aim: To identify the extent of sterilization failure in dental handpieces using a non-vacuum process. Methods: In-vitro and in-vivo investigations were conducted on commonly used UK benchtop steam sterilizers and three different types of dental handpieces. The sterilization process was monitored inside the lumens of dental handpieces using thermometric (TM) methods (dataloggers), chemical indicators (CI) and biological indicators (BI). Findings: All three methods of assessing achievement of sterility within dental handpieces that had been exposed to non-vacuum sterilization conditions demonstrated a significant number of failures (CI=8/3,024(fails/n tests); BI=15/3,024; TM=56/56) compared to vacuum sterilization conditions (CI=2/1,944; BI=0/1,944; TM=0/36). The dental handpiece most likely to fail sterilization in the non-vacuum process was the surgical handpiece. Non-vacuum sterilizers located in general dental practice had a higher rate of sterilization failure (CI=25/1,620; BI=32/1,620; TM=56/56) with no failures in vacuum process. Conclusion: Non-vacuum downward/gravity displacement, type-N steam sterilizers are an unreliable method for sterilization of dental handpieces in general dental practice. The handpiece most likely to fail sterilization is the type most frequently used for surgical interventions

Differential Scanning Calorimetric (DSC) Study of New and Sterilized Nickel-Titanium Rotary Endodontic Instruments

Introduction: Nickel-Titanium (NiTi) files have become popular in endodontic procedures compared to traditional stainless steel hand files owing to their increased flexibility which is especially advantageous in curved canals. Due to the associated costs, endodontic instruments are frequently re-used, which requires sterilization between uses. With the application of temperature NiTi has the ability to undergo phase transformations, altering the properties of the instruments. The purpose of this study was to investigate phase transformations of four brands of NiTi rotary endodontic instruments in the as-received condition and after multiple sterilization cycles under steam sterilization, using differential scanning calorimetry. Materials and Methods: Four brands of nickel-titanium endodontic rotary files size 35, .04 taper were evaluated in this study: ProFile (Dentsply Tulsa Dental Specialties, Tulsa, OK), ProFile Vortex (Dentsply), Vortex Blue (Dentsply), and HyFlex CM (Coltène/Whaledent, Cuyahoga Falls, OH). The transformation temperatures and phase transformations of these files were determined in the as-received condition and after 1, 3, and 5 cycles of steam sterilization by differential scanning calorimetry. Measurements were analyzed using a two-way ANOVA. Results: There were significant differences between file brands in austenite finish temperature (p \u3c 0.05) but the only statistical significant differences in thermal properties when comparing files before and after 1, 3, and 5 cycles of steam sterilization were found with onset heating (p \u3c 0.05). Conclusion: Repeated cycles of steam sterilization do not appear to influence the phase transformations of NiTi endodontic instruments

HUBUNGAN FAKTOR KARAKTERISTIK, TINGKAT PENGETAHUAN DAN SIKAP DENGAN PRAKTEK STERILISASI

RSU Kardinah Tegal pusat pelayanan kesehatan, salah satu jenis pelayanan adalah Sterilisasi pada wanita, dari 105 orang pasca melahirkan perbulan hanya 10,48% yang menjalani sterilisasi, rendahnya angka tersebut bila dibandingkan dengan angka peserta KB baru di kota-kota lain di Jawa Tengah, diduga erat hubungannya dengan faktor predisposing yang meliputi faktor karakteristik, tingkat pengetahuan dan sikap terhadap sterilisasi. Tujuan dari penelitian ini adalah untuk mengetahui hubungan faktor karakteristik, tingkat pengetahuan dan sikap dengan praktek sterilisasi pada ibu pasca melahirkan di RSU Kardinah Tegal tahun 2003. Jenis penelitian yang digunakan adalah explanatory survey dengan pendekatan cross sectional study, sebagai populasi dalam penelitian ini adalah ibu pasca melahirkan di RSU Kardinah Tegal bulan Januari sampai Maret 2003 yang berjumlah 334 orang. dan setelah dilakukan penghitungan diperolah 75 responden sebagai sampel penelitian dengan metode pemilihan sampel secara acak sistematik. Analisa data dilakukan dengan uji Chi Square untuk mengetahui hubungan antar variabel bebas dan variabel terikat karena jenis data berupa nominal. Kesimpulan dari penelitian tersebut yaitu ada hubungan antara umur (p value = 0,0001), jumlah anak (p value = 0,005), pendidikan (p value = 0,0001), tingkat pengetahuan (p value = 0,021), sikap (p value = 0,020) dengan praktek sterilisasi. tidak ada hubungan antara pendapatan (p value = 0,114), agama (p value = 0,146), daerah asal (p value = 0,285), sumber informasi (p value = 0,423) dengan praktek sterilisasi. disarankan pemberian motivasi kepada ibu-ibu yang memenuhi kriteria untuk sterilisasi mengingat masih adanya ibu yang menolak sterilisasi (32%). Kata Kunci: Praktek Sterilisasi, pasca melahirkan RELATION OF CHARACTERISTIC FACTOR, LEVEL OF KNOWLEDGE AND ATTITUDE WITH STERILIZATION PRACTICE RSU Kardinah Tegal as center of health service, one of service type is sterilization of at woman, from 105 people pasca bear month only 10,48% experiencing sterilization, lower the number when compared to by number of new competitor KB in other towns in Central Java, anticipated to by sliver its relation with factor predisposing covering characteristic factor, mount knowledge and attitude to sterilization. Intention of research this is to know relation of characteristic factor, mount knowledge and attitude with sterilization practice of at mother pasca bear in RSU Kardinah Tegal Year 2003. Used by research type is explanatory survey with approach of cross sectional study, as population in this research is mother pasca bear in RSU Kardinah Tegal of January Month until March 2003 amounting to 334 people. And after done by a enumeration obtained by 75 responder as sampel research by method of systematic election sampel at random. Analyse data done with test of Chi Square to know relation usher free variable and the variable trussed by since data type in the form of nominal. Conclusion from the research that is there is relation of between responder age with sterilization practice (p value = 0,00010,05), ther no relation of between religion with sterilization practice (p value = 0,146>0,05), there no relation of between origin district with sterilization practice (p value = 0,285 > 0,05), there no relation of between information sufficiency with sterilization level wilt sterilization practice (p value = 0,021<0,05), there is relation of between attitude with sterilization practice (p value = 0,020<0,05). Suggested by a gift motivate to mothers fulfilling criterion for the sterilization remember there (be) still his/its is mother refusing sterilization (32%). Keyword : Characteristic, Sterilization Practice, Mother Post Partu

Soil Sterilization

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Sterilization costs and exchange rate targeting

This paper examines the movements of exchange rates and capital flows in an environment where an optimizing central bank pursuing the joint goals of inflation and output targeting engages in costly sterilization activities. Our results predict that when faced with increased sterilization costs, the central bank will choose to limit its sterilization activities allowing target variables, such as the nominal exchange rate, to adjust. ; We then test the predictions of a linearized version of the saddle-path solution to the model for a cross-country panel of developing countries. We use IV, GMM and simultaneous equation specifications to allow for the endogeneity of capital inflows. Our results confirm that a monetary policy does respond to sterilization costs.Foreign exchange ; Capital movements

Molar band re-use and decontamination: a survey of specialists

Objective: To determine the pattern of use and re-use of orthodontic molar bands, and examine infection control measures in a sample of UK orthodontists. Design: Questionnaire survey. Subjects and methods: Questionnaires were sent to 204 individuals selected at random from the UK Specialist Orthodontist list. Follow-up questionnaires were sent to those that had not replied within 8 weeks. An overall response rate of 74.5% was achieved. Main outcome measures: Orthodontic band use and re-use and cross-infection control. Results: The reported rates of pre-sterilization cleaning and sterilization of orthodontic instruments were 92 and 100%, respectively. Of the respondents, 90% were using bands for molar teeth with the remainder routinely used bonded attachments. Most clinicians (95%) using bands routinely re-used them after being tried-in with 5% discarding them. Pre-sterilization cleaning of re-used molar bands was carried out by 92% of respondents who reclaimed bands. Sterilization of these bands was then carried out by most specialists apart from 2. Conclusions: The majority of UK specialist orthodontists who responded to the questionnaire are adhering to universal precautions for cross-infection control and are carrying out approved decontamination procedures. The majority are also reusing orthodontic bands that have been tried in the mouth, but found to be the wrong size. The great diversity of reported procedures for decontamination of instruments and bands suggest that more research is required to provide guidelines into the most effective method