某特种兵大队新兵下肢军事训练伤情况调查

[目的]了解某特种兵部队新兵在入伍基础军事训练中发生的各种下肢训练伤的特点,为部队制定相应的预防措施提供科学依据。[方法]调查了该部队2006年度281名新兵的入伍训练情况(1~3个月),设计训练伤调查表,通过问卷调查了解训练伤发病情况,并进行分类调查统计。[结果]该部队2006年度入伍新兵在基础军事训练中发生下肢损伤75人,发生率为26.69%,发生下肢伤75人中,以小腿部位损伤最多,共35例,占下肢损伤的46.67%。踝关节损伤17例,占22.67%。足部损伤11例,占14.67%。下肢伤中急性损伤为20例,占26.67%,过劳性损伤55例,占73.33%。下肢损伤中骨与关节损伤38例,占50.67%,软组织损伤37例,占49.33%。损伤的原因:场地等外部环境因素18人次,训练负荷过大61人次,损伤所发生的训练项目:大部分为3 km跑,达64人次。[结论]下肢运动损伤是军事训练的常见病和多发病,其发病特点和发生规律各不相同且相当复杂。在该调查中,训练负荷过大所导致的软组织过劳性损伤最为重要。因此,在平常的军事训练中,应该加强健康宣教工作,在新兵训练过程中要注意战士的身体承受情况,循序渐进,减少下肢训练伤的发生。     

呼吸电刺激训练对肺功能康复的作用

通过电流和声、光信号刺激，对２０例慢性阻塞性肺疾患（ＣＯＰＤ）患者进行呼吸电刺激训练（ＲＥＴ），结果在ＲＥＴ时呼吸频率和平均吸气流速明显下降，潮气量和吸气间期明显增加，跨膈压增大，氧耗量和能量代谢无明显变化；于ＲＥＴ１５天后ＰａＣＯ２明显下降，ＰａＯ２和运动能力明显增高，肺勇气功能明显改善。表明ＲＥＴ１５天后ＰａＣＯ２明显下降，ＰａＯ２和运动能力明显增高，肺通气功能明显改善。表明ＲＥＴ能使ＣＯＰＤ     

Procedural memory stimulation in Alzheimer's disease: impact of a training programme

The study evaluates the efficacy of a procedural memory stimulation programme in mild and mild-moderate Alzheimer's disease (AD). Twenty basic and instrumental activities of daily living have been selected, and divided into two groups, comparable for difficulty. Ten normal elderly subjects (age 68.0±4.8 years; MMSE score: 28.7±0.9; education: 7.6±3.5 years) were asked to perform the two groups of daily activities and the time required to perform the tasks of each group was recorded and used as a reference. Ten mild and mild-moderate AD patients (age 77.2±5.3 years; MMSE score: 19.8±3.5; education: 7.3±4.7 years) without major behavioural disturbances constituted the experimental group. Patients were evaluated in all 20 daily activities and the time employed was recorded at baseline and after a 3-week training (1 h/d, 5 d/week) period. Five patients were trained during the 3 weeks on half of the 20 daily activities and the other five patients were trained on the remainder. This procedure was adopted in order to detect separately the improvement in "trained" and "not trained" activities, allowing to control better the effects of the intervention. The assessment of the functional impact of the training was directly measured, through the variation of time employed to perform tasks before and after training. After 3 weeks of training a significant improvement was observed for the trained activities, from 3.6 to 1.9 standard deviations below the performance of the normal elderly controls ( P <0.05). AD patients improved also in not-trained activities from 3.5 to 2.7 standard deviations below the controls'performance ( P <0.05). The rehabilitation of activities of daily living through developing procedural memory strategies may be effective in mild and mild-moderate AD patients.     

Sexuality Training,Education and Therapy in the Healthcare Environment: Taboo,Avoidance, Discomfort or Ignorance?

Multiple sources of resistance are present in the healthcare environment to comprehensive assessment and intervention efforts in regard to sexuality. The authors survey both the diversity of needs and values presented by consumers, and encourage providers to equip themselves educationally, emotionally and ethically so that they can deliver relevant, holistic services to consumers.     

The efficacy of sports vision practice and its role in clinical optometry*

For years it has been recognised that many sports place demands on vision and particular visual skills. There is much evidence to show that the correction of visual dysfunction such as ametropia and binocular and accommodative anomalies results in improved sporting performance for those sports. More controversial and of special interest is the suggestion that it is possible to train visual abilities of subjects who do not present with traditionally recognised functional disorders of vision. It has been proposed that sporting performance can be improved as a result of this training. However, this review found the evidence to be inconclusive. In addition, there are studies that suggest athletes have better visual abilities than non-athletes and good athletes have better abilities than less skilled athletes. However, it has not been determined whether these superior abilities are innate to the athlete or have developed through practice. A review of the available literature was unable to prove (or disprove) either of these proposals. However, there appears to be enough evidence to warrant further investigation of these questions, in order that the area of sports vision and vision training can be more fully understood. This will enable clinicians to take full advantage of the potential of sports vision practice to assist athletes. (Clin Exp Optom 1995; 78: 3: 98–105)     

Teaching Culturally Appropriate Care: A Review of Educational Models and Methods

The disparities in health care and health outcomes between the majority population and cultural and racial minorities in the United States are a problem that likely is influenced by the lack of culturally competent care. Emergency medicine and other primary-care specialties remain on the front lines of this struggle because of the nature of their open-door practice. To provide culturally appropriate care, health care providers must recognize the factors impeding cultural awareness, seek to understand the biases and traditions in medical education potentially fueling this phenomenon, and create a health care community that is open to individuals' otherness, thus leading to better communication of ideas and information between patients and their health care providers. This article highlights the rationale for and current problems in teaching cultural competency and examines several different models implemented to teach and promote cultural competency along the continuum of emergency medicine learners. However, the literature addressing the true efficacy of such programs in leading to long-lasting change and improvement in minority patients' clinical outcomes remains insufficient.     

Monitoring maternity mortality in Botswana

This paper describes the maternity monitoring system in Botswana, developed in 1998, and the main methods used: maternal death and morbidity reviews at service delivery level, analysis by the National Maternal Mortality Audit Committee of data from the reviews as reported on two forms, perinatal reviews and surveys using process indicators. We carried out a study of these findings to examine whether the system was working well. Surveys using process indicators in 2001 and 2006 were analysed. Other data examined were from 2004-2006 and early 2007. The Maternal Death Notification Form was found to be comprehensive but not all health facilities were submitting them and some gave incomplete information. In 2001, 70% of pregnant women attended antenatal care but access to emergency obstetric care was uneven. In 2006, 28 facilities with maternity services surveyed were providing 24-hour delivery care, but laboratory, theatre and blood supplies were more limited, and only 50% of doctors and 67% of midwives had life-saving skills. Antibiotics were widely available, but there were shortages of magnesium sulphate, diazepam, oxytocics and manual vacuum aspiration kits. Recommendations for improvements have been made, training for skilled attendants is ongoing and a medical school has just opened at the University of Botswana.     

The Effect of Acute and Chronic Exercise on Thyroid Hormones in Obesity

Abstract Thyroid hormones were measured before, during and after acute exercise (60 min) or physical training (3 months) in obese women. Thyroid stimulating hormone concentration increased during acute work and decreased immediately after. No changes were seen during the two following days. An increase was seen after ten days as well as after three months of physical training. Thyroxine concentrations showed no changes. 3,5,3′-Triiodothyronine decreased slightly immediately after acute exercise, and after three months of physical training, 3,3′,5′-triiodothyronine (reverse triiodothyronine) increased slowly during and after acute exercise. A negative correlation was found between changes in fasting insulin and thyroxine and a positive correlation between changes in blood pressure and triiodothyronine after training. Lack of agreement in previous reports is probably due to methodological differences such as methods more or less susceptible to fatty acid interference, and thyroid hormones changing differently during acute work and before and after physical training. The duration of the study may also be of importance, even 3 months possibly being too short for attaining equilibrium in thyroid homeostasis.     

心理训练对高特质焦虑新兵生理指标和考核成绩的影响

目的研究心理训练对高特质焦虑新兵考核时生理指标和成绩的影响。方法采用个人评价问卷（PEI）、状态．特质焦虑问卷（STAI）和简易应对方式问卷对参加考核的新兵实施团体测试。将被试者分为对照组、低特质焦虑组、高特质焦虑组和干预组，对干预组进行自我评价、潜能开发、团队精神强化、应对方式的心理训练。测试考核前后生理指标差值及考核成绩的变化。结果干预组新兵军事考核前后收缩压、舒张压和脉搏三项生理差值与考核成绩明显优于高特质焦虑组（P〈0．05）。结论系统的心理训练可有效改善新兵对应激情景的生理和心理反应，提高作业绩效。