地下空间空气环境影响因素分析

分析了地下空间温湿度特性,以及放射性污染、微生物、有害气体、固体颗粒物等地下空间空气环境的影响因素,因地制宜采取防潮、通风、除尘、杀菌消毒等措施是改善地下空气环境的有效途径,独立除湿技术、增加空气负离子也是提高空气品质的有效措施。     

以科学发展观为指导 推进军队疗养院全面建设又好又快发展

本文立足当前军队疗养院建设发展实际,深入分析了疗养院发展现状和存在的一些普遍性问题,着眼于深入贯彻落实科学发展观,从5个方面入手,提出了理性的见解与思考,为新形势下进一步开创疗养院全面建设又好又快发展新局面提供借鉴。     

精神损害费若干法律问题探讨

从成功索赔到精神损害费的33例医疗纠纷案件出发，分析了当前精神损害费索赔事由、范围、赔偿金额等现状，讨论了精神赔偿的双重效应，指出完善医疗法规建设是解决医疗纠纷中精神赔偿问题的必要之路。     

室内装饰材料的卫生状况调查

在中国预防医学科学院环境卫生监测所组织和指导下，于1997年11月至1998年4月对某新建小区5家住户，某报社办公楼电脑网络中心及某宾馆的客房、KTV包房进行了卫生学和流行病学调查，采用现场监测环境变量，暴露人群的主诉反应调查及线性可规模拟比例尺进行评分，结果表明上述单位的室内甲醛浓度偏高，而且被调查的暴露人群均不同程度出现了不良建筑物综合征，尤以较多使用装饰材料和新家具的住户为甚，同时也证明线性可视模拟比例尺是一种简便、灵敏、定量地评价室内环境感觉的研究手段。     

Psychosocial factors and gender as predictors of symptoms associated with sick building syndrome

Sick building syndrome (SBS) refers to a cluster of symptoms that typically worsen when employees are at work and diminish when they leave. A higher prevalence of symptoms is frequently observed among female employees. Although its aetiology is debated, evidence suggests that psychosocial factors might be at least as important as features of the working environment in predicting SBS symptoms. Utilizing a sample of 346 office‐based employees (55 per cent female) located in five buildings with no known environmental problems, this study examined job control, job satisfaction, work‐related mood and negative affectivity as predictors of self‐reported symptoms typical of SBS. The role played by gender in symptom‐reporting was also investigated. Findings revealed that employees who experienced more symptoms reported significantly less job control and job satisfaction and more work‐related depression and anxiety. A positive relationship was also observed between symptom‐reporting and negative affectivity. In contrast to previous research, no gender differences were observed in the prevalence of self‐reported symptoms, but men and women differed in the predictors of symptoms and the proportion of variance explained. The findings suggest that demographic and psychosocial factors, as well as features of the objective physical environment, should be considered in future investigations of SBS. Copyright © 2008 John Wiley & Sons, Ltd.     

Sick Building Syndrome. III. Stachybotrys chartarum

Increasingly, physicians are being asked to evaluate patients with putative environmentally associated illnesses. These can include a variety of problems, including infectious illnesses (Legionnaire's disease), chemical exposure in the workplace, and sick building syndromes. The latter has been an issue particularly in asthma because of the association of mold and increased bronchial responsiveness. Recently, attention has been focused on the mold Stachybotrys in human disease. Stachybotrys was first identified more than 60 years ago following an epidemic of stomatitis, rhinitis, conjunctivitis, pancytopenia, neurologic disorders, and death in horses. Since then, Stachybotrys has been identified in several outbreaks of disease in animals. It has also attracted attention as a possible agent in idiopathic pulmonary hemorrhage in infants. Stachybotrys is a relatively uncommon fungus but has been isolated from a variety of sources, including contaminated grains, tobacco, indoor air, insulator foams, and water-damaged buildings with high humidity. This fungus is particularly important because it is one of a series of fungi that produces trichothecenes mycotoxins; these mycotoxins are biologically active and can produce a variety of physiological and pathologic changes in humans and animals, including modulation of inflammation and altered alveolar surfactant phospholipid concentrations. The presence of Stachybotrys in a building does not necessarily imply a cause-and-effect relationship with illness, but should alert physicians and healthcare professionals to do more vigorous environmental testing. Guidelines are presented herein for intervention measures in the maintenance of heating, ventilation, and air-conditioning systems.     

Thinking Beyond ICPD+10: Where Should Our Movement Be Going?

In this roundtable discussion, three long-time international activists in the field of reproductive and sexual rights discuss the challenges facing the feminist women's health movement ten years after the 1994 International Conference on Population and Development in Cairo, and the 1995 Fourth World Conference on Women in Beijing. Their conversation reflects on the nature of the global context in 1994-95 and how that context has changed a decode later, especially in light of growing conservatism and the growing HIV/AIDS epidemic. They consider the successes and limitations of the Cairo agenda and the strategic importance of taking a long-term view. In particular, they emphasise the need for strengthening health systems worldwide, advocating for better and more woman-friendly use of existing resources and building broader coalitions. Much of the conversation explores points of commonality and difference between feminist groups on the one hand, and medical and family planning organisations on the other, as well as ways of utilising such venues as the World Social Forum. Points of greatest promise internationally include the growing youth movement for sexual and reproductive health and rights and the potential for opening up larger alliances around sexual and bodily rights with HIV/AIDS activists, sex workers, people living with HIV and AIDS and human rights organisations.     

Building the capacity for evidence-based clinical nursing leadership: the role of executive co-coaching and group clinical supervision for quality patient services

AIM: The general aims of this article were to facilitate primary care nurses (District Nurse Team Leaders) to link management and leadership theories with clinical practice and to improve the quality of the service provided to their patients. The specific aim was to identify, create and evaluate effective processes for collaborative working so that the nurses' capacity for clinical decision-making could be improved. BACKGROUND: This article, part of a doctoral study on Clinical Leadership in Nursing, has wider application in the workplace of the future where professional standards based on collaboration will be more critical in a world of work that will be increasingly complex and uncertain. This article heralds the type of research and development activities that the nursing and midwifery professions should give premier attention to, particularly given the recent developments within the National Health Service in the United Kingdom. The implications of: Agenda for Change, the Knowledge and Skills Framework, 'Our Health, Our Care, Our Say' and the recent proposals from the article 'Modernising Nursing Career', to name but a few, are the key influences impacting on and demanding new ways of clinical supervision for nurses and midwives to improve the quality of patient management and services. METHOD: The overall approach was based on an action research using a collaborative enquiry within a case study. This was facilitated by a process of executive co-coaching for focused group clinical supervision sessions involving six district nurses as co-researchers and two professional doctoral candidates as the main researchers. The enquiry conducted over a period of two and a half years used evidence-based management and leadership interventions to assist the participants to develop 'actionable knowledge'. Group clinical supervision was not practised in this study as a form of 'therapy' but as a focus for the development of actionable knowledge, knowledge needed for effective clinical management and leadership in the workplace. FINDINGS: 1. Management and leadership interventions and approaches have significantly influenced the participants' capacity to improve the quality of services provided to their patients. 2. Using various techniques, tools, methods and frameworks presented at the sessions increased participants' confidence to perform. 3. A structured approach like the Clinical Nursing Leadership Learning and Action Process (CLINLAP) model makes implementing change more practical and manageable within a turbulent care environment. The process of Stakeholder Mapping and Management made getting agreement to do things differently much easier. Generally it is clear that many nurses and midwives, according to the participants, have to carry out management and leadership activities in their day-to-day practice. The traditional boundary between the private, the public and the voluntary sector management is increasingly becoming blurred. CONCLUSION: It is conclusive that the district nurses on this innovative programme demonstrated how they were making sense of patterns from the past, planning for the future and facilitating the clinical nursing leadership processes today to improve quality patient services tomorrow. Their improved capacity to manage change and lead people was demonstrated, for example, through their questioning attitudes about the dominance of general practitioners. They did this, for example, by initiating and leading case conferences with the multi-disciplinary teams. It became evident from this study that to use group clinical supervision with an executive co-coaching approach for the implementation and to sustain quality service demand that 'good nursing' is accepted as being synonymous with 'good management'. This is the future of 'new nursing'.