The Dangerous Middle: Situational Awareness and Worker Perception of Beetle Kill

ABSTRACT

Forest workers, including loggers, foresters, and wildland firefighters, are regularly exposed to some of the most fatal occupational environments in the United States. These hazardous work environments may become even more complex and dynamic when subject to bark beetle outbreaks that have resulted in significant tree mortality. The impacts of tree death from bark beetles are significant, with the cumulative 17-year (2000–2016) footprint for bark beetle caused tree mortality estimated at 54 million acres. However, how workers think about and act in these environments is understudied. This study, therefore, approaches the issue of beetle kill and forest worker safety by examining the perspectives or workers themselves. Its contribution is to leverage ethnographic research to provide insights that can generate new research questions, better inform outreach, and ultimately improve worker safety outcomes. The resulting insights show that beetle kill was understood by workers as a hazard that increased the complexity and dynamism of the work environment, making situational awareness both more necessary and more difficult to maintain. While much research about situational awareness focuses on hazardous situations, it is suggested that building adequate situational awareness should also include broader considerations of organizational communication, as well as training and experience considered over the course of entire careers.     

我对子午流注阴阳盛衰转换的认识

阐述了时相与阴阳的关系，阴阳昼夜的盛衰转换与经脉循行、气血流注密切相关；对传统流注说和任督为主的阴阳循环说进行了分析，认为子午流注阴阳盛衰转换在妇科学中有重要意义，子午流注所指出的4个较重要的时期与月经周期中的4期(行经期、经后期、经间排卵期、经前期)相关。重视研究日相阴阳太极钟的变化，将能更加深入地认识月经周期中阴阳消长转化的规律变化，从而推动中医妇科学向前发展。     

Lead poisoning in precious metals refinery assayers: A failure to notify workers at high risk

Lead poisoning in a precious metals refinery fire assayer and a routine OSHA inspection prompted an investigation of the index facility, a survey of the industry, and efforts to notify assayers of this previously unrecognized hazard. Air and blood samples were obtained at the index facility. Management personnel from all fire assay laboratories in Rhode Island and southern Massachusetts were interviewed. The industry's trade association, OSHA, NIOSH, trade unions, and the media were asked to assist in a nationwide notification effort. Assayers at the index facility had excessive exposures to lead due to an age-old, lead-based assaying method that remains the industry gold standard. Blood lead levels of the three assayers (mean 61.3 μ/dl, range 48–86 μg/dl) were considerably higher than those of 16 other refinery workers (mean 27.4 μg/dl, range 13–49 μg/dl). The industry survey revealed inadequate knowledge of both the lead hazard and the applicability of the OSHA lead standard. Notification efforts failed in large part due to economic obstacles. The notification of workers at high risk of lead exposure and the eradication of occupational lead poisoning will require greater attention to economic forces. © 1994 Wiley-Liss, Inc.     

从脾胃论秋冬养阴——凌耀星教授的膏方经验一隅

冬令膏方是依据“秋冬养阴”为原则的养生和疾病防治方法。凌耀星教授在膏方辨证施治的过程中,尤重脾胃,从《内经》理论出发证实了“脾胃”在“秋冬养阴”中占有主导地位。     

火针刺血疗法的临床应用心得

目的:探讨火针刺血疗法在临床的应用价值。方法:对实践经验和临床资料进行分析。结果:火针刺血疗法疗效快无不良反应。结论:火针刺血疗法对寒凝血瘀证疗效较好。     

Fire in the operating theatre. Evacuation pre–planning may save lives

An operating theatre fire and the steps taken to deal with it are described; the difficulties encountered in evacuating anaesthetised patients are highlighted. Measures which might be taken to prevent recurrence of these problems, and recommendations on the institution of fire drills for the safety of patients and staff are given.     

养阴清热、宣痹通络法治疗类风湿性关节炎的临床研究

目的 观察清络通痹颗粒治疗类风湿性关节炎阴虚络热证的临床疗效。方法 将118例患者随机分为清络通痹颗粒治疗组63例和雷公藤多甙片对照组55例，观察用药前后主要症状、体征和实验室检测指标的变化。结果 治疗组的临床治愈率为9．52％，临床治愈显效率为38．10％，总有效率为90．48％，疗效明显优于对照组的0％、20％、83．64％（P＜0．05）；治疗组的类风湿因子滴度、血沉、C反应蛋白、免疫球蛋白也明显降低，与对照组相比差异显著（P＜0．05或P＜0．01）。结论 清络通痹颗粒具有抗炎镇痛、调节免疫紊乱等作用，从而达到控制病情的治疗效果。     

从热、虚、瘀辨证论治小儿过敏性紫癜

从热、虚、瘀三个方面论述了小儿过敏性紫癜的病因病机特点，抓住病因病机的核心，确定了热伤血络、阴虚火旺、气不摄血三个本证证型和风热、热毒、湿热、血瘀四个标证证型。采用本证和标证相结合的方法对小儿过敏性紫癜进行辨证论治，并从理论上探讨了该方法的科学性和实用性。     

机体阴阳交感现象的熵变分析

借用非平衡热力学理论,分析自然界水火运动的规律,得出结论——阴阳交感过程是熵减少过程,阴阳反作过程是熵增加过程;机体的许多阴阳变化也遵循同一规律。并在此基础上论证了新陈代谢过程是机体从外界输入负熵以抵消体内正熵产生的过程,从而推知阴阳交感现象发生的原因是新陈代谢。     

益气养阴活血法治疗冠心病心律失常有效性和安全性的Meta分析*

[摘要]目的 系统评价益气养阴活血法治疗冠心病心律失常的有效性及安全性。方法 检索中国知网数据库（CNKI）、维普中文科技期刊全文数据库（VIP）、中国学术期刊数据库（万方）、Cochrane图书馆、Web of Science和PubMed中有关益气养阴活血法治疗冠心病心律失常的临床随机对照试验研究,提取纳入研究的相关数据并进行方法学质量评价。应用RevMan5.3软件进行Meta分析。结果 共纳入26个研究。Meta分析结果显示,益气养阴活血法治疗组在临床总有效率[OR=3.47,95%CI（2.68, 4.48）,P<0.00001]、24h心律失常事件数[WMD=-204.82,95%CI（-228.78, -180.86）,P<0.00001]、中医症候疗效[OR=3.08,95%CI（2.04,4.66）,P<0.00001]、心电图疗效[OR=2.50,95%CI（1.63,3.83）,P<0.0001]、血液流变学指标：全血高切黏度[WMD=-1.02,95%CI（-1.18,-0.85）,P < 0.00001]、全血低切黏度值[WMD=-1.66,95%CI（-2.00,-1.33）,P< 0.00001]、血浆比黏度[WMD=-0.42,95%CI（-0.50,-0.35）,P < 0.00001]、纤维蛋白原[SMD=-1.67,95%CI（-2.06,-1.28）,P <0.00001]及安全性[OR=0.41,95%CI（0.27,0.61）,P<0.001]方面均优于常规西医治疗组。结论 益气养阴活血法治疗冠心病心律失常具有更好的有效性及安全性。由于目前纳入文献数量及质量的限制,期望今后有更多高质量的随机对照试验支持。