出国留学对医院科技人员职业设计的影响

目的：了解出国留学对医院科技人员职业设计的影响。方法：采用对某医院有留学经历的科技人员随机发放问卷调查的方法。结果：出国前46．8％和55．9％的人认为通过留学可以增加个人收入和获得晋升技术职称或行政职务;回国后23．4％的人获得晋升技术职称,11．7％的人获得晋升行政职务;29．9％的人发表3篇以上英文论文,27．3％和54．6％的人分别获国家和军队科研基金、科研成果或学术称号,61．0％的人开展了一项以上临床新业务或新技术;90．9％和94．8％的人认为自己所取得的成就及个人综合素质的提高与出国留学相关或密切相关;94．8％的人对自己目前的工作满意或比较满意,5．2％和14．3％的人不甚满意和认为没有人尽其才,11．7％的人曾经有过或目前仍有离开医院的想法。结论：出国留学对留学人员在职称、职务的晋升,学术成果的取得,综合能力的提高和个人职业的重新设计等方面产生明显影响。     

福建师大学生择偶与家庭调查

目的：了解大学生的择偶及家庭观。方法：采用分层整群抽样的方法，对福建师范大学900名大学生进行无记名问卷调查，获得有效问卷876份。结果：有93．7％的男生选择妻子的首要条件是温柔和宽容，女生择偶的条件则主要是会关心体贴人，正直诚实、有正义感，有才干和有事业心；绝大多数学生认为当婚姻破裂时，会选择离婚；77．1％左右的学生选择晚婚，按婚姻法办；有71．8％的大学生选择生育1个孩子或不要孩子。结论：大学生择偶注重的是对方的个人品质、两人的和谐生活和感情，对家庭背景不看重；在生育观念上有较大转变，这将对我国的计划生育政策产生积极的推动作用。此外，女大学生的自主意识逐渐加强。     

公费医疗体制改革的社会、经济效益分析

为了探讨公费医疗体制改革的社会、经济效益，统计分析217名、224名两次参加健康体检的职工身体健康状况和医疗费用支出情况。结果发现参加医疗保险的240名职工，接受健康检查两年后，有关疾病指标的异常率与检出率由10．79％下降至7．63％；个人医疗支出下降了43．08％。可见，公费医疗体制改革对职工有明显的健康促进作用，减少了个人医疗费用，有明显的经济效益和社会效益。     

临产前干预措施对产后抑郁症的发病及疗效的影响

目的观察临产前干预措施对产后抑郁症发生率及疗效的影响。方法选择在我院产检和分娩的孕妇2868例，平均随机分成对照组和干预组（各1434例）。对两组孕妇于孕期行医院焦虑-抑郁情绪自评量表（HAD）测试（≥11分诊断为焦虑抑郁情绪），产后行艾迪产后抑郁量表（EPDS）测试（≥13分诊断为产后抑郁症）。对干预组孕妇临产前行6项干预措施，对照组无干预措施。观察两组的产后抑郁症的发生率及疗效。结果①HAD≥11分：对照组135例（9．41％），其中产后抑郁症发病70例（51．85％）；干预组139例（9．69％），其中产后抑郁症发症31例，31例（22．30％），两组比较，差异有极显著性（P〈0．01）。②EPD5≥13分，对照组211例，占14．71％，干预组85例，占5．93％，两组比较，差异有极显著性（P〈0．01）。③治愈率比较，对照组半年治愈率及一年治愈率分别为51例（24．17％）和139例（65．88％）；干预组半年治愈率及一年治愈率分别为42例（49．41％）和78例（91．76％）。两组比较，差异有极显著性P〈0．01。结论产后抑郁症发生率14．71％，对母婴的影响较大；孕妇临产前焦虑、抑郁情绪是产后抑郁症的高危因素，临产前采用干预措施能够显著降低产后抑郁症的发生率，提高治愈率，值得推广。     

全程结核病健康教育模式的效果观察

目的：探讨全程结核病健康教育模式对结核病患者的结核病知识知晓率、规范治疗完成率、治愈率、复发率的影响。方法：采取随机分组方法。将结核一科和结核二科800例结核病患者分别作为教育组和传统组的研究对象。运用医院结核病门诊-住院-出院全程健康教育模式。对患者结核病知识、治疗依从性、规范治疗完成率、治愈率、复发率进行评价和统计。结果：教育前两组患者结核病知识得分均较低。t值为2．49，P〉0．05．差异无显著性；教育后两组患者知识得分有明显提高，但教育组比传统组提高幅度更快，t值为16．39。P〈0．05。有显著差异；两组患者随访半年后治疗依从性得分测定，教育组明显高于传统组，t值为9．64。P〈0．05；教育组和传统组化疗规范治疗完成率分别为97．6％、87．5％，治愈率分别为98．1％、88．0％，复发率分别为0．5％和4．7％。经统计学处理，Χ^2值分别为30．26、32．08、14．12。P〈0．01。结论：全程结核病健康教育模式干预结核病患者及家属的依从性是有效的，可提高患者自我管理能力及治愈率。具有显著的社会效益。     

动态随机化在临床试验中的应用

从理论上讲，在样本量很大的临床试验中简单随机化即可以保证各组的例数不会相差很大，且各种可能影响预后的因素在组问的分布均衡可比。但通常临床试验的例数有限，随机分组的结果可能各组的例数和预后因素相差较大，例如，总例数为50时，有5．9％的机会出现两组例数相差达到19：31或更极端的情况；当总数为1000时，仍有5．3％的机会出现474：526或更极端的情况。     

农三师妇幼保健队伍建设探讨

随着社会的不断进步和人民生活水平的逐步提高，广大妇女、儿童对医疗保健的需求日益增长。为此，妇幼保健管理上出台了一些与之相适应的措施，在服务质量上发生了很大的变化。提高住院分娩率就是服务指标中变化较大的一项。我师1990年住院分娩率为51．14％，2000年为73．93％，2002年为63．99％，递减了9．94％。住院分娩率的降低，使农牧团场近两年妇幼专干职能有了变化，团妇幼保健队伍的组成随之发生了变化，由于改革精减人员，第一个     

彩色多普勒血流显像诊断胆囊息肉样病变价值探讨

目的探讨彩色多普勒血流显像（CDFI）对胆囊息肉样病变（〈2．5cm）的诊断价值。方法分析72例胆囊息肉样病变（息肉48例，腺瘤7例，腺肌增生2例，小结节型胆囊癌15例）CDFI的声像图特征。结果胆囊息肉为多发、有蒂、乳头状高回声结节，CDFI血流分级以0～1级为主（占85．4％）；胆囊腺瘤为单发、中或高回声结节，大多有蒂，CDFI血流分级以1-2级为主（占85．7％）；胆囊腺肌增生常为基底较宽、低回声结节，病灶内无血流信号；小结节型胆囊癌常为基底较宽、中或低回声结节，CDFI血流分级以2—3级为主（占73．3％）；恶性组RI明显大于良性组，如以RI≥0．6作为诊断恶性肿瘤的指标，其敏感性为91．7％（11／12），特异性为93．8％（30／32），准确性为93．2％（41／44）。结论CDFI是诊断胆囊息肉样病变的有效方法。     

护理程序在肱骨骨折患者中的应用研究

目的：探讨护理程序在肱骨骨折围手术期中的应用。方法：60例肱骨骨折患者随机分为护理程序组和对照组各30例，对照组采用传统的护理措施，护理程序组在传统护理方法的基础上给予心理护理、术前护理、术后护理、功能锻炼、出院指导等。结果：护理程序组患者的并发症发生率明显低于对照组，住院天数明显缩短，功能优良率93．3％，对照组66．7％，两组比较差异有统计学意义（P〈0．001）。结论：护理程序在肱骨骨折的治疗和护理中有重要意义，有较好的社会效益。     

慢性萎缩性胃炎采用规范方案治疗体会

目的：对采用规范方案进行慢性萎缩性胃炎治疗的临床效果进行观察，分析和总结体会。方法：选取2012年1月-2013年1月，我院收治的慢性萎缩性胃炎患者88例，随机分成两组，每组44例。其中，采用常规用药结合替普瑞酮治疗一组，设为观察组；采用常规用药治疗的一组，设为比对组。观察两组患者的临床疗效，比较分析。结果：经治疗后，观察组Hp转阴率为95．45％，总有效率为97．73％，治疗后胃镜检查总有效率为93．18％；比对组患者Hp转阴率为63．64％，总有效率为77．27％，治疗后胃镜检查总有效率为65．91％；两组相比较，差异显著，P〈O．05，具有统计学意义。随访12个月，观察组患者有1例复发，比对组有4例。结论：对慢性萎缩性胃炎患者的治疗，以常规治疗为基础，配合使用替普瑞酮，能够有效提高临床治疗效果，减少复发，不良反应不明显，具有临床推广和应用价值。     

临床医师留学期间临床与基础研究工作情况分析

目的：了解我院临床医师在国外参与临床与基础研究工作情况。方法：对有留学经历的临床医师随机问卷调查,内容包括留学人员在国外从事临床或基础研究分布情况及归国后取得的效益。结果：在调查的91名留学人员中,有33人从事临床研究工作,占调查总人数的36．3％,有58人从事基础研究工作,占调查总人数的63．7％;90．9％的从事临床研究的人员归国后开展了临床新技术方面的工作,31％的从事基础研究的人员归国后发表了3篇以上英语论文。结论：临床医师留学期间多数从事基础研究工作,如何做到按需派遣,学用一致值得深思。     

Absence of nonresponse bias in a study of sport-caught Great Lakes fish consumption and conception failure

INTRODUCTION: We have reported that men's lifetime sport-caught Great Lakes fish consumption was associated with lifetime prevalence of conception delay or failure. Those cross-sectional data were based on responses to a postal questionnaire. The present study was conducted to evaluate whether nonresponse bias could explain the cross-sectional findings. METHODS: We conducted telephone interviews with 230 men and 38 women who did not respond to the original survey, and compared these individuals to the original responders with respect to key demographic, behavioral, and reproductive characteristics. RESULTS: Nonresponders were approximately 1.5 years older at interview, were more likely to be Caucasian, and reported higher incomes than responders. Among men, nonresponders had fished fewer days in the past year (12% reported no fishing, compared to 4. 3% of responders). Almost one half of nonresponders reported no fish consumption in the past year, compared to one quarter of responders. Nonresponders were more likely than responders to have ever conceived a live-born child, had more children, and were less likely to intend to have additional children in the next 5 years. Among both responders and nonresponders there was an increased prevalence of a period of conception failure among men who reported consuming greater quantities of sport-caught Great Lakes fish. DISCUSSION: Our study provides support for the cross-sectional analyses presented previously, insofar as nonresponse bias is unlikely to have a major role in the observed association.     

A method to determine if consenters to population surveys are representative of the target study population

BACKGROUND: Searching medical records of study non-responders to investigate selection bias is no longer acceptable. We explore an alternative by comparing consultation rates in survey responders who consented to medical record review, with anonymized consultation rates for the total practice populations. METHODS: Anonymized aggregated consultation rates for the year following a population-based survey were calculated for headache and a number of other conditions (chosen to reflect a mixture of chronic and episodic conditions). These rates were compared across two groups of adults: (i) responders to the survey who consented to medical record review and (ii) a 'population group' created from records of the general practices participating in the survey to represent all patients aged 18 years and over at the mid-point in the study year. The consultation rates for the conditions were compared across the two groups using direct standardization. RESULTS: Adjusted consultation rates were similar but generally higher in the responders. CONCLUSIONS: This alternative method applied here offers one potential approach to determine whether study respondents are representative of the population from which they were sampled with respect to general practice consultations.     

Participants who left a multiple-wave cohort study had similar baseline characteristics to participants who returned

PURPOSE: Research on determinants of an individual's pattern of response, considered as a profile across time, for cohort studies with multiple waves is limited. In this prospective population-based pregnancy cohort, we investigated baseline characteristics of participants after partitioning them according to their history of response to different interview waves. METHODS: Data are from the Mater-University of Queensland Study of Pregnancy 1981 to 1983 cohort, Brisbane, Australia. Complete baseline information was collected for 7223 of 7535 eligible individuals (95.9%). Follow-up occurred at 6 months, 5 years, and 14 years. Response rates were 93.0%, 72.5%, and 71.8%. Participants were allowed to leave and reenter the study. Participants were categorized as always, intermittent, or never responders. Intermittent responders were categorized further as leavers (responded at least once before leaving the study) or returners (left the study before reentering). RESULTS: Participants who always responded were older, more educated, married, Caucasian, and nonsmokers and had higher incomes. Intermittent responders shared similar baseline characteristics. Relative risk for being an intermittent responder was located between risks for always or never responding. CONCLUSIONS: Participants who left and reentered the study had baseline characteristics similar to participants who responded at least once and then left the study.     

Frequency and determinants of formal respite service use among caregivers of children with cerebral palsy in Ontario

OBJECTIVE: To describe the use of formal respite services among caregivers of children with cerebral palsy in Ontario and discuss the factors that may contribute to respite use and non-use. METHODS: A total of 468 caregivers were interviewed about their experience with formal respite services. Interviews were part of a larger cross-sectional study on caregiver health. Caregivers were asked about their knowledge of formal respite services; their use of formal respite services in the past year; financial implications relating to formal respite use; perceived barriers to formal respite service use; and reasons for not using formal respite services (if applicable). RESULTS: Nearly half (46%) of caregivers in the sample reported using respite services in the past year. Most of the caregivers who used respite services used more than one source of respite, had services provided in their home, often for less than 1 day, and reported using them more than six times. The most commonly cited reason for using formal respite services was for a planned break. Many factors influenced caregivers' use of formal respite services. Caregivers who had a child with a lower level of function, with multiple additional conditions, or who was male, were more likely to use formal respite services. Although over 90% of caregivers indicated that respite use is beneficial for both their family and child, over 60% reported facing many barriers while attempting to access respite services. CONCLUSION: Results from this cross-sectional study indicate that caregivers who used respite services used them frequently for breaks from caregiving. Caregivers described facing many barriers while attempting to access respite services therefore to improve caregiver's experience with respite services, strategies are suggested.     

Return to work after first myocardial infarction in 1991-1996 in Finland

BACKGROUND: A substantial number of myocardial infarctions (MI) occur at working age. It is, however, insufficiently well known how many of these patients return to work after their MI. METHODS: Sources of information were the Hospital Discharge Register, the Causes of Death Register and the registers for social security benefits. Availability for the labour market was used as the return to work criterion. Altogether 10,244 persons (8,733 men, 1,511 women) aged 35-59 years had their first MI or coronary death during 1991-1994 in Finland. Persons who survived for 28 days and were not on pension at the time of MI were included in a two-year follow-up. RESULTS: Twenty-nine per cent of patients were already pensioned at the time of their first MI. Of the patients not pensioned at the time of their MI, 4,929 were alive two years after the event. Of them, 38% of men and 40% of women received disability pension, 3% of both genders were on sick leave and 1% of both genders were on unemployment pension. The remainder, 58% of men and 56% of women, did not receive any of these benefits, thus, being available to the labour force. CONCLUSIONS: Nearly one-third of persons having their first MI at working age were already out of the labour force at the time of their MI. Of those who were not pensioned and who survived the event, slightly more than half were available to the labour market two years later.     

Pilot study of testicular cancer awareness and testicular self-examination in men attending two South London general practices

BACKGROUND: Testicular cancer (TC) awareness and testicular self-examination (TSE) have never been evaluated adequately in UK general practice. TC has a 96% cure rate if detected early. OBJECTIVES: Our aim was to estimate awareness of TC and practice of TSE in a general practice population. METHOD: A cross-sectional questionnaire survey was carried out in 250 consecutive male attenders aged 18-50 years in two general practices, one inner city, and one suburban. After obtaining informed consent, male patients in the waiting room were asked to complete a brief confidential questionnaire about TC and TSE. RESULTS: The response rate was 81%. Mean age was 32 years (range 18-50). Seventy-five per cent of responders described themselves as white, 12% Asian, 6% black and 7% other ethnic groups. Ninety-one per cent were aware of TC but only 26% knew both the age group most affected (25-34 years) and that TC can be curable if detected early. Although 49% of responders had carried out TSE in the past year, only 22% were practising according to recommendations: feeling for lumps at least monthly. TSE was associated with age >35 years, white ethnicity, knowing someone with TC, having attended a Men's Health Clinic and having heard of the 'Everyman' TC awareness campaign. CONCLUSION: Although awareness of TC in this GP population was reasonable, less than half were practising TSE. Further public health campaigns may be needed.     

Stability and change in career choices of junior doctors: postal questionnaire surveys of the United Kingdom qualifiers of 1993

OBJECTIVE: To report on stability and change in career choices of doctors, between 1 and 3 years after qualification. DESIGN: Postal questionnaire surveys. SETTING: United Kingdom. SUBJECTS: All doctors who qualified in the United Kingdom in 1993. MAIN OUTCOME MEASURES: Choices of eventual career expressed 1 and 3 years after qualifying. RESULTS: The overall pattern of career choices at year 3 differed a little from that at year 1. For example, choices for general practice increased from 26% to 29%, choices for medical specialties fell from 22% to 18%, and for surgical specialties they fell from 17% to 14%. However, because changes of choice between specialties tended to 'cancel out', the aggregated data masked much larger changes when considered at the level of individual doctors. Overall, 74% of respondents retained their year 1 career choice in year 3 (78% of men, 70% of women). Of doctors who chose a hospital specialty in year 1, 71% chose the same specialty in year 3, 18% had switched choice to another hospital specialty, and 9% had switched choice to general practice. The percentage who changed choice from hospital specialties to general practice between years 1 and 3 was lower in the 1993 cohort than in all previous cohorts. Of those whose year 1 choice of long-term career was general practice, 89% retained that choice in year 3 and 11% switched to other branches of medicine. Even by year 3, less than half of all respondents (and a smaller percentage of women than men) signified that their long-term choice of specialty was definite. In year 3, 78% of all respondents, and 79% of doctors from homes in the United Kingdom, intended definitely or probably to practise medicine in the United Kingdom for the foreseeable future, which represented little change from the figures in year 1. CONCLUSIONS: About a quarter of doctors change their career choice between years 1 and 3 after qualification, and less than half regard their choice in year 3 as definite. Flexibility is therefore needed, well beyond the first post-qualification year, to accommodate changes of choice. Where training opportunities in a hospital specialty are limited, doctors are now inclining, more than in the past, to switch to an alternative hospital specialty rather than to general practice.