Linguistic Validation of the US Spanish Work Productivity and Activity Impairment Questionnaire, General Health Version

INTRODUCTION: There are no measures of health-related absenteeism and presenteeism validated for use in the large and increasing US Spanish-speaking population. Before using a Spanish translation of an available English-language questionnaire, the linguistic validity of the Spanish version must be established to ensure its conceptual equivalence to the original and its cultural appropriateness. OBJECTIVE: The objective of this study was to evaluate the linguistic validity of the US Spanish version of the Work Productivity and Activity Impairment questionnaire, General Health Version (WPAI:GH). METHODS: A US Spanish translation of the US English WPAI:GH was created through a reiterative process of creating harmonized forward and back translations by independent translators. Spanish-speaking and English-speaking subjects residing in the US self-administered the WPAI:GH in their primary language and were subsequently debriefed by a bilingual (Spanish-English) interviewer. RESULTS: US Spanish subjects (N = 31) and English subjects (N = 35), stratified equally by educational level, with and without a high school degree participated in the study. The WPAI-GH item comprehension rate was 98.6% for Spanish and 99.6% for English. Response revision rates during debriefing were 1.6% for Spanish and 0.5% for English. Responses to hypothetical scenarios indicated that both language versions adequately differentiate sick time taken for health and non-health reasons and between absenteeism and presenteeism. CONCLUSION: Linguistic validity of the US Spanish translation of the WPAI:GH was established among a diverse US Spanish-speaking population, including those with minimal education.     

关于高等医学教育管理体制与学制改革的思考

高等医学教育管理体制与学制改革是二十一世纪社会发展的需要。文章阐述了医学教育小规模、长学制、高投入的基本特征,强调了遵循医学教育规律的重要性,分析了医学院在综合性大学的重要地位,医学院与附属医院以及相关院系的关系。文章还依据社会发展的需要和医学教育国际化的趋势,分析了医学教育学制调整的必要性以及学制调整思路。     

上海市农村合作医疗筹资与补偿调查分析

目的：为改革和完善上海市农村合作医疗的政策，制度，规划，计划，措施提供科学依据。方法：使用调查研究，比较研究，描述性统计及SAS统计分析等方法。结果：调查分析了上海市1997－1999年8区（县）合作医疗资金来源，数量，比例，补偿等。结论：1997年以来，上海市农村合作医疗得到了快速发展，仍存在保障水平，补偿比例，投保率低下及发展不平衡，资金使用不合理等问题。     

Sensitization to green coffee bean (GCB) and castor bean (CB) allergens among dock workers

Summary Dock workers (n = 218) occupationally exposed to green coffee beans (GCB) were studied, using a specific questionnaire for allergic symptoms and skin tests for common and occupational allergens. Thirty-one workers (14.3%) complained of allergic symptoms of the eye, nose and bronchial system at the workplace. The prick tests, using both commercial allergens and specific extracts prepared from the most common types of coffee and their corresponding sacks, confirmed a sensitization in 21 workers (9.6%). A positive skin reaction to castor beans (CB) was found in nearly all these cases; in ten workers there was also a positive reaction to GCB allergens and in 14 cases prick tests were positive to extracts of sacks. There was a good concordance between prick tests and specific IgE for CB (95.0%) and also, but to a lesser extent, for GCB. The authors concluded that there is a significant risk of sensitization to CB and GCB allergens in dock workers occupied in handling green coffee bean, despite the fact that the exposure is not continuous. CB emerged as a common contaminant of GCB from various countries. For effective prevention, a modification of the methods of transport is required to avoid CB contamination to other products. Eliminating environmental dust during shipping operations is the most important preventive measure and it can be achieved by the use of containers, as some exporting countries are already doing.     

Teaching psychiatric ethics

In the last decade, we have witnessed a burgeoning of interest in ethical issues amongst psychiatrists. Teaching of the subject, however, remains at a rudimentary stage. Various approaches to such instruction are available, particularly modelling (students observe their experienced counterpart), the case method (examining specific clinical situations which involve a need for ethical decision-making), and the seminar approach (trainees are exposed to a core body of knowledge, mainly theoretical in nature). Faced with these different teaching models, the University of Oxford Department of Psychiatry has opted for a blend of all three approaches, which incorporates two goals: an increase in the trainees' sensitivity to the many intricate moral dilemmas facing the psychiatric profession; and their familiarity with salient concepts in moral philosophy which constitute a basis for ethical reasoning and which have a bearing on clinical practice. The teaching programme comprises the following: a pair of trainees prepares a presentation on an aspect of psychiatric ethics under the supervision of a senior psychiatrist. A moral philosopher assumes the role of discussant of the ethical problems raised by the trainees; this is followed by a general discussion. Topics have included involuntary hospitalization, dual loyalty, suicide, psychiatric diagnosis, and ethical issues in various spheres of psychiatric practice such as sex therapy, psychotherapy and child psychiatry. The approach has worked effectively and proved rewarding to all participants involved.     

Respiratory function and bronchial reactivity in mill workers

Professional exposure to vegetable dusts affect the respiratory function of the exposed subjects. A previous survey conducted in an industrial flour-mill demonstrated a higher frequency of respiratory symptoms in workers compared to a control group. Ten subjects employed in a work site particularly exposed to dust were studied. Each subject answered a questionnaire and performed on Mondays and Fridays, at the begenning and end of his work shift, a flow volume curve and an isocapnic hyperventilation test. The aerobiology of the professional environment was also measured. We noted: 1) in the flow volume curves: a drop in the FEV₁ during the Monday morning shift, a significant difference between the FEV₁ (p<0.05) and the MMEFR 25–75 (p<0.05) measured at 6 am on Monday and Friday, and between the MMEFR 25–75 values obtained at 12 noon on Monday and Friday (p<0.05). 2) after isocapnic hyperventilation, a significant drop in the MMEFR 25–75 at 6 am on Monday (p<0.01) and in the FEV₁ and MMEFR 25–75 at 12 noon on Mondays (p<0.05), a significant drop in the FEV₁ at 1 pm on Monday (p<0.01).     

Gestion des risques et choix de maintenance à l'hôpitalRisks management and maintenance choices at the hospital

Regulations evolve and risks management becomes one of the biomedical engineers' preoccupations. Thus, risks are various, and consequently it is difficult to identify, to manage and to bring them under control. Furthermore, regulations exist for sectors like healthcare technology monitoring, but it is not the same thing for instance for the risks linked to the maintenance. Thus regulation in the sector of maintenance evolves and the decree of the 1^st July law of health safety is going to modify the biomedical environment. The goal of this work is to study the tools and the methods of risks management that have been used for several years in the industrial field and to use them for some biomedical equipment like monitors or IV pumps. These methods adapted to these equipment will allow us to determine some appropriate rules of maintenance.     

A follow‐up study of electromagnetic interference of cellular phones on electronic medical equipment in the emergency department

Objective: Considering the growing use of cellular phones and the fast appearance of new phone models, the electromagnetic interference of currently popular cellular phones on electronic medical equipment was tested. Methods: Three Personal Communication System cellular phones were put at different distances from multiple electronic medical devices, the interference effect was observed and the electromagnetic field strength measured with a spectrum analyser. Results: Only two small pieces of equipment, the CO₂ airway adapter and the haemoglucostix meter were affected and then only when the phone was in very close proximity. Conclusion: Compared to the results of our study in 1997 testing Global System for Mobile Communication phones, the Personal Communication System phones generated less electromagnetic interference. However a much larger scaled study and an accurate international electromagnetic interference standard are recommended before any change in the current restrictive hospital policy on mobile phone usage could be recommended.     

以军事斗争卫勤准备为牵引 努力提高海上医疗救护能力

作者总结了医院开展海上卫勤战备训练的做法，在针对海上医疗救护的使命任务不断增强做好卫勤准备的责任感，紧扣海上医疗救护平台的特殊要求努力提高医院船医疗队救治能力，突破海上医疗救护技术的瓶颈制约积极开展海战伤救治技术及应用研究等方面，取得了明显效果。     

性服务工作者性病和艾滋病的干预研究

目的 了解性工作者的性病/艾滋病知识、态度、信念、行为等现状,积极探索对该人群进行预防性病、艾滋病及行为干预的有效办法,为今后在更大范围的高危人群中进行干预提供科学依据.方法 成立专职高危干预队伍,设计借鉴其他地区经验,深入目标人群进行系列外展服务,利用干预前后封闭式调查问卷评价干预效果.结果 发放干预前后问卷各522份,收回前后有效问卷387份.通过外展服务,娱乐场所从业人员对性病史滋病预防知识知晓率明显提高,对安全套及安全性行为预防性病艾滋病的传播的信念和态度有明显转变.结论 对娱乐场所从业人群开展系列专业外展服务可以提高该人群的防病意识,提升对性病史滋痛的知晓率,是高危人群干预的有效方法.