以问题为基础的学习方法在ICU护理查房中的应用

目的：提高ICU护理查房质量和护士综合素质，方法：采用以问题为基础的学习方法（PBL）进行护理查房，并与传统查房模式相比较。结果：PBL模式在查房压力，查房前准备，上网查资料，查房前与病人沟通，关注病人体语，参与科研及前赡性选题方面显著优于传统模式（均P＜0．01），PBL模式以心理学，医学，人文学和知识需求为主，传统模式则以医学，护理学知识需求为主，结论：采用PBL模式查房拓展ICU护士的知识面和知识深度，提高其发现，解决问题的能力，提高查房质量。     

How to solve the N-bit parity problem with two hidden units

We construct a three-layer feedforward network (one hidden layer) which can solve the N-bit parity problem employing just two hidden units. We discuss the implications of employing problem constraints into transfer functions for general pattern classification problems.     

Loitering by patients on methadone maintenance: a perception or a problem

Loitering has become an increasing matter of concern to both communities and staff involved in drug treatment programs. In order to determine the prevalence of this problem a retrospective two-year study was performed among clients enrolled in a community methadone maintenance treatment program (MM). Of 1064 persons enrolled in MM during this time, 190 (17.8%) were identified as loiterers with 121 (63.7%) loiterers actively enrolled in MM. No significant differences between loiterers and a matched group of MM clients were seen with respect to time in treatment, presence of drug abuse or excessive alcohol intake. Differences between loiterers and non-loiterers were observed with respect to criminal activity (29% vs. 11%, respectively, P less than 0.001), non-opioid drug abuse (78% vs. 67%, respectively, P less than 0.01) and productive activity (44% vs. 61%, respectively, P less than 0.01). Excessive alcohol intake was seen in 15.4% of the study group. No relationship existed between excessive consumption of alcohol and loitering, arrests, and use of mood altering drugs as determined by urinalysis. No relationship could be demonstrated between loitering and residence in the community surrounding the program. Only 11 (6%) of all loiterers lived within two blocks of the program boundaries, and only 59 (31%) resided within East Harlem. These findings suggest that loitering is a real cause for concern being engaged in mainly by individuals who are neither socially productive nor residents of the immediate community surrounding the program. It is therefore important to develop strategies for dealing with this problem not only to reassure the community but to facilitate rehabilitation.     

Variation in length of time to development of alcoholism by family history of problem drinking

Patients hospitalized for treatment of alcoholism were asked to provide information on family history of drinking problems, age at onset of drinking, and timing of the occurrence of problems due to use of alcohol in their lives, using a time scale. Analysis of data from 256 male patients indicated a strong association between a family history of problem drinking and development of alcoholism at a young age. Mean age at the time the patients could be defined as alcoholic, based on the chronological history of the time of occurrence of symptoms, ranged from 27.2 years for bilineal family history positive patients to 38.5 years for those with negative family history, and the difference could not be explained by differences in age at onset of drinking. The results indicate that the increased risk of alcoholism among individuals with family history of problem drinking, which has been postulated on the basis of many cross-sectional studies, is likely to be overestimated.     

中学生问题行为的问卷编制和聚类分析

目的：研究中学生问题行为多症状的群体规律。方法：自编中学生问题行为自陈问卷，经信度和效度检验后，对男、女生问题行为高分组(总分27％的最高分段)被试分别进行六因子聚类分析。结果：男生分成六种多症状类型：外倾．高学业不良型，内倾．高学业不适型，内倾．低学业不适型，退缩．神经质．攻击型，学业不适型，多种问题型。女生也分成六种多症状类型：外倾．高学业不良型，神经质．退缩．低学业不适型，焦虑．退缩．高学业不适型，神经质．攻击型，退缩．攻击．学业不适型，多种问题型。女生内倾问题发生的比率高于男生，男生外倾问题的比率高于女生；外倾问题的学生同时伴有学业适应不良的问题，而内倾型问题的学生不一定伴有学业适应不良的问题。结论：中学生问题行为往往呈多发性的特点。     

切入社会敏感问题 促进医院跨跃发展

经调查,环境、服务、价格这三大问题是百姓关心的敏感、热点问题。以社会最关注的敏感、热点问题为医院管理切入点,通过治理整顿,医疗质量、服务质量得到了飞速提高,社会效益、经济效益日益增长,促进了医院跨越式发展。     

设备普查中发现的几个问题

设备的档案管理在医院管理中有极其重要的地位,为了保证档案数据准确,我院每年都会进行一次设备普查。普查中总会或多或少的发现一些问题。本文就在普查中发现的问题阐述了相应的处理意见。     

Problem solving and diabetes self-care

An important objective of diabetes care is to provide patients with self-regulation skills. For patients to assume responsibility for their own regimens, they need to have good problem-solving skills to cope with ongoing personal, social, and environmental barriers to adherence. Therefore, a Diabetes Problem Solving Interview for adults was developed and evaluated with 126 non-insulin-dependent outpatients. Interviewers elicited problem-solving strategies patients would use to cope with a variety of situations potentially interfering with dietary, exercise, and glucose testing adherence. Interviews were tape recorded and coded by trained raters to produce scores on both overall problem-solving skill ratings and frequency of use of different types of strategies. Results revealed only minor influences of patient characteristics on problem-solving measures. Prospective analyses revealed that problem-solving measures were significant and independent predictors of levels of dietary and exercise self-care at a 6-month follow-up.This research was supported by Grant DK 35524 from the National Institute of Diabetes, Digestive and Kidney Diseases.     

The use of the singular value decomposition in electrocardiography

In the paper it is shown that singular value decomposition (s.v.d.) is an excellent tool for studying the limit properties of a feasible solution for the inverse problem in electrocardiography. When s.v.d. is applied to the transfer matrix, relating equivalent heart sources to the skin potentials, it provides a measure of the observability. In an example presented, a series of orthonormal potential patterns on a pericardial surface are found in an order of decreasing observability. When s.v.d. is applied to a data matrix, consisting of skin potentials as a function of time and position, one finds the normalised principal components both in time and space. An appropriate use of the singular values leads to a noise filtering algorithm, which at the same time results in useful data reduction. Comparison of spatial potential patterns derived from both the transfer matrix and the data matrix may, finally, be used to evaluate the assumptions on the transfer.