高温环境适宜劳动强度的评价

实验选用8名男青年作为受试者,年龄20.1±2.0岁。在热暴露前,用直接法测定每个人的o_2max(47.8±2.6ml/kg/min)。然后在高温室内的水平跑步机上负重行走3h,室内干球温度35℃,湿球温度29℃。各个负重行走组的劳动强度为29～52％o_2max。结果表明,生理参数与％o_2max之间呈非线性相关,非线性相关的“转折点”分别为36％和38％o_2max,而且“转折点”前后两条回归线的斜率差别非常显著(P<0.001)。这些变化说明,当劳动强度超过36～38％o_2max时,人体的生理反应急剧增加。因此,我们认为可以把36～38％o_2max作为人在高温环境从事体力劳动的容许上限。     

Exercise as a buffer against organizational stress

This field study was designed to examine the impact of an organizationally sponsored exercise program on attitudes and self-perceptions under shipboard conditions. Pre- and postsurvey data were collected from 245 Navy and Marine Corps men participating in either experimental circuit weight-training (N= 111) or control (N=134) groups. Survey measures included: (1) attitudes towards the organization; (2) perceptions of performance, health, self-esteem and stress; and (3) turnover intent. Results indicate that organizational commitment, satisfaction and internal work motivation declined significantly during the study period. Reported job stress decreased significantly during the study for the exercise group while increasing among control group members. No significant (p<0.05) time or group by time effects for indices of self-perception were observed. Findings suggest that organizationally induced stress: (1) affects attitudes towards the organization in a negative direction; and (2) is attenuated somewhat by involvement in an exercise program.     

The effect of the calcium antagonist, isradipine, on working capacity, pulmonary function, morbidity and survival rate in patients with severe chronic obstructive pulmonary disease (COPD): a randomized, double-blind, placebo-controlled study.

Beneficial effects of calcium antagonists on the pulmonary haemodynamics of patients with chronic obstructive pulmonary disease (COPD) have been observed in several studies. Such effects include a decrease in pulmonary vascular resistance, an increase in cardiac output, and an increase in oxygen delivery. The clinical implications of these effects are uncertain. The randomized, double-blind, placebo-controlled, long-term study described here is the first to investigate the clinical effects of a calcium antagonist on patients with COPD. The aim was to test the hypothesis that the calcium antagonist, isradipine, could increase working capacity and lung function, and decrease morbidity and mortality. Fifty-two patients with COPD were investigated. During a 22-month observation period no statistically significant differences between the isradipine group and the placebo group were found with regard to these parameters. It is concluded that the existing evidence does not justify the introduction of calcium antagonists as part of the routine treatment of COPD.     

小儿骨科“一日病房”工作模式的探讨

在小儿骨科医疗过程中，发现一些特殊情况，有些患儿病情需要连续观察治疗，而家长由于时间、经济条件或其他原因，不能住院治疗，但如果不连续治疗，又会影响治疗效果。为了适应新形势的需要，也方便儿童家长，我科特推出特色服务项目“一日病房”，科室专门腾出几间病房作为“一日病房”，由专门的医师和护士进行管理和治疗，一天多达三、四十人，深受患儿及家长的欢迎。     

Work in pregnancy

Pregnant women in the western world are increasing their part in paid employment. This can be added to their work in the home which, with their leisure and athletic activities, might add up to a considerable load; the possible effects this exertion could have on the woman and her unborn child has been realized only in the last twenty years and many attempts have been made to quantify it. The patterns of work in the home, in employment, and at sporting activity are assessed. There are two distinct areas of possible influence on the fetus: the work with its physical effort might affect respiratory and metabolic acid-base balance and specific teratogens related to activity at work may be encountered and act at nodal points during fetal growth at specific times, causing congenital abnormalities of organs. Potential hazards under chemical, physical, and biological headings are considered, while both the psychological and physical effect of energy expenditure are discussed. Possible measures of outcome are assessed and three recently published studies from the U.S. and U.K. are examined to show the difficulties of making valid measurements about the effect of work on the pregnancy, as well as that of pregnancy on the work. It is probable that ordinary work done by a fit young woman has no serious effect on herself or a healthy fetus. Research will continue, for it may be that with an impaired afferent nutrition and oxygen supply to the fetus, certain specific increases in degrees of work could have an exaggerated effect. © 1993 Wiley-Liss, Inc.     

Work stress, job satisfaction and emotional well-being among Canadian dental assistants

Abstract Although dentistry is considered to be a stressful occupation, few data exist on work stress among dental assistants. In a previous paper, the extent and nature of work stress among this group was described and linked to a behavioural outcome: namely, intentions to change jobs or seek work outside of dentistry. In this paper the psychological outcomes of work stress, in the form of job satisfaction and emotional well-being, are examined. Using data collected by a mail survey, it was revealed that the main sources of dissatisfaction for dental assistants were low incomes, lack of opportunity to develop professionally and a lack of recognition. Almost one-in-live had scores on a standard measure of emotional distress, which indicated a cause for concern. Work stress proved to be a significant predictor of job satisfaction, and work stress and job satisfaction emerged as significant predictors of emotional well-being. Social support while at work showed direct and interactive effects on job satisfaction hut not emotional well-being. Role ambiguity, under-utilization of skills and low self-esteem emerged as important issues. These results are of interest theoretically and have important implications for the way denial practice and dentistry are organized.     

Intervention on occupational stress among teachers in the middle schools in China

The purpose of this study was to evaluate the effectiveness of the interventions on occupational stress among teachers in middle schools. The study group consists of 459 teachers (247 men and 212 women) from four middle schools. The control group consists of 502 teachers (271 men and 231 women). The three dimensions of occupational adjustment (including occupational stress, psychological strain, and coping resources) were measured with the Occupational Stress Inventory‐Revised Edition (OSI‐R) and the work ability was assessed with the Work Ability Index (WAI) among teachers. The integrated interventions (involving organizational and individual level intervention) were taken to the teachers in the study group. The main results were as follows. The scores of some scales of occupational role questionnaire and personal strain questionnaire decreased significantly and the scores of some scales of personal resources questionnaire and WAI increased significantly after intervening. This study suggested that interventions were efficient in reducing the teachers' occupational stressors, increased their coping resources and improved their work ability. Copyright © 2006 John Wiley & Sons, Ltd.     

介入治疗急性心肌梗死术中并发症的观察与护理

目的阐述临床护理工作在急性心肌梗死病人介入治疗中的重要性.方法22例急性心肌梗死病人在介入治疗术中发生的32例次并发症,诸如,低血压、心律失常、心绞痛,造影剂不良反应、以及速走神经反射等均在严密的临床观察与精心的护理下,得到应急处置.结果22例急性心肌梗死病人在介入治疗术中由于得到精心观察与护理,有效地控制了并发症的持续存在,手术成功率达100%.结论护理工作对于急性心肌梗死病人获得理想的介入治疗效果起着保证作用.     

Acute effects of the heavy metal antidotes DMPS and DMSA on circulation,respiration, and blood homoeostasis in dogs

The heavy metal antidotes sodium-2,3-dimercaptopropane-1-sulfonate (DMPS) and meso-2,3-dimercaptosuccinic acid (DMSA) were investigated in anaesthetized dogs for their effects on a variety of physiological variables and parameters. In addition, the influence of both dithiols on oxygen consumption and ferrihaemoglobin production was studied in blood and red blood cells in vitro. DMPS (15 and 75 mg/kg i.v.) did not affect respiration, central venous pressure, left ventricular pressure or cardiac output and showed only marginal, statistically non-significant effects on aortic and effective perfusion pressure. In contrast to the slight, non-significant changes due to DMPS (15 mg/kg i.v.), an equimolar dose of DMSA (12 mg/kg i. v.) led to a slight transient decrease in femoral blood pressure with strong reflex tachycardia and increase in blood flow. The higher DMPS dose (75 mg/kg i.v.), however, caused marked decreases in femoral blood pressure and blood flow, strong changes in blood gases and pH, and lactacidosis. Most of the physiological variables and parameters did not return to the initial level by 60 min. The R-spike of the electrocardiogram decreased, and the T-wave increased. Experiments on the denervated hind leg indicate that DMPS may be a direct vasodilator. The fall of blood pressure due to DMPS was markedly reduced when 30% ferrihaemoglobin had been formed by 4-dimethylaminophenol. HCl (DMAP). The highest DMPS dose (150 mg/kg i.v.) provoked circulatory failure and respiratory arrest. Artificial ventilation with room air restored spontaneous respiration, but one of three animals did not survive this dose for more than 90 min. DMPS and DMSA reacted with oxygen. In phosphate buffer, pH 7.4,1 mol O₂ appears to be taken up by 2 mol DMPS. The consumption of O₂ by DMPS was less in samples of human and canine blood or erythrocyte suspensions than in buffer solution. DMPS caused a greater loss of oxygen than DMSA. DMPS and DMSA alone did not produce ferrihaemoglobin, but the ferrihaemoglobin content of erythrocyte suspensions increased over the time when DMPS was added in the presence of 30% ferrihaemoglobin. Such an action was not observed at the same ferrihaemoglobin content in vivo.     

Health care reform and the transformation of nursing in Hong Kong

Health care reform in Hong Kong in the 1990s has brought about dramatic change to the nursing discipline. This paper reports an ethnographic study which aimed at exploring the transformation of nursing in a regional hospital in Hong Kong during this period of reform. In the study, the restructuring of nursing work, its associated dynamics and resulting impacts upon the nursing profession were examined. A methodological triangulation approach to data collection encompassing interviews, participant observation and review of documents was used. The findings in this study suggest that the majority of nurses working in the case study hospital continue to be subject to medical dominance and are under management control. The emphasis on cost-effective care has however, fostered qualified nurses to claim more ownership of their professional judgement and autonomy. The health care reform has confirmed the status of two newly established groups of nurses, the nurse specialists and nurse managers. The development of the nursing profession is found to be closely connected to its work development. The preparation of the new generation of nurses, as revealed in this study, needs to emphasize the cognitive dimension of the professional competence. Some nurses need to be further educated in specialist practice and clinical management to maximize the contribution of nursing in health care delivery.