Short- and long-lasting consequences of novelty,deviance and surprise on brain and cognition

When one encounters a novel stimulus this sets off a cascade of brain responses, activating several neuromodulatory systems. As a consequence novelty has a wide range of effects on cognition; improving perception and action, increasing motivation, eliciting exploratory behavior, and promoting learning. Here, we review these benefits and how they may arise in the brain. We propose a framework that organizes novelty's effects on brain and cognition into three groups. First, novelty can transiently enhance perception. This effect is proposed to be mediated by novel stimuli activating the amygdala and enhancing early sensory processing. Second, novel stimuli can increase arousal, leading to short-lived effects on action in the first hundreds of milliseconds after presentation. We argue that these effects are related to deviance, rather than to novelty per se, and link them to activation of the locus-coeruleus norepinephrine system. Third, spatial novelty may trigger the dopaminergic mesolimbic system, promoting dopamine release in the hippocampus, having longer-lasting effects, up to tens of minutes, on motivation, reward processing, and learning and memory.     

无陪护模式病房不同能级护理人员承担工作项目调查

目的了解山东省三级综合性医院无陪护模式病房不同能级护理人员承担工作项目情况,为实现护理人力资源优化管理提供基础和依据。方法自行设计无陪护模式病房临床护理人员能级对应相关情况调查表,对山东省6所三级医院无陪护模式病房551名护理人员承担部分工作项目情况进行调查。结果不同能级护理人员承担各护理工作项目有所侧重(均P<0.01),但均承担所有工作项目;基础护理、执行治疗是主要的临床护理工作,分别占23.81%、22.00%;临床教学及科研所占的比重最少,分别占8.17%、2.51%;无陪护模式病房护理工作的主力是大专学历、初级职称及工龄不足3年的护士。结论护理人力资源配置的不合理及利用低效率并存,护理管理者应制定科学的护理人力资源配置标准,并根据不同岗位的专业技术要求配备相应能力的护士,从而优化护理人力资源管理。     

正常中晚期孕妇的凝血四项和D-二聚体结果分析及其临床意义

目的检测正常中晚期孕妇的凝血四项及D-二聚体指标,了解正常中晚期孕妇的凝血与纤溶功能状态及临床意义。方法凝血四项测定均为凝固法,D-二聚体为免疫比浊法。在Sysmex CA7000全自动血凝仪上进行检测。结果正常妊娠中晚期孕妇与正常非孕妇女对照组比较,PT、APTT时间明显缩短(P<0.05);FIB显著增高(P<0.01);TT差异不明显(P>0.05);D-二聚体水平差异有统计学意义(P<0.05)。结论妊娠中晚期由于凝血功能增强,抗凝及纤溶功能减弱,出现妊娠期高凝状态,有利于产后快速有效止血。产前凝血功能的检测,对预防产科并发症(如DIC及羊水栓塞等)有重要的临床意义。     

社区健康服务中心医用灭菌物品下收下送流程管理

目的探讨社区健康服务中心医用灭菌物品下收下送的供应流程,确保医用灭菌物品质量。方法对下收下送车辆、下送护士、领用计划信息和交接换物实施流程化管理。结果医用灭菌物品的质量得到保证,未发生过消毒质量安全问题;对需求供应及时,连续3年下送无差错。结论对下收下送流程适度调整,加强管理,能保证社康中心医用灭菌物品消毒质量和供给,对防范医院感染、保障患者安全起着重要的作用。     

Examining the Effectiveness of Action Plans Derived from the Root Cause Analysis of Incidents Occurring in a Radiation Therapy Department

PurposeIn 2011, the Canadian Partnership for Quality Radiotherapy developed guidelines for quality improvement. In the same year, a large academic cancer centre initiated a program of root cause analysis (RCA) and incident learning for major incidents. RCAs were performed on seven incidents; more than 40 action items were developed with the intent to prevent these incidents from recurring. The aim of this study was to determine the efficacy of implementation of the six action items, evaluate radiation therapists' (RTTs') awareness of these new action items, and determine whether communication among staff members was satisfactory.Methods and MaterialsThe study consisted of two components. Part one examined four action items using a questionnaire distributed to all RTTs at the cancer centre. Part two examined two action items by auditing the radiation treatment software, MOSAIQ.ResultsStaff communication and RTTs' awareness of the action items ranged from 71% to 98%. For the first four action items, although most RTTs were aware of them, only 40%–70% of RTTs always or often used these action items and considered them effective. The fifth action item, implementation of the new breast tolerance setting, had 51% more overrides after implementation. Further investigation indicated only 40% of the tangent breast setups had new tolerance settings applied.ConclusionsCommunication plays an important role in the dissemination and application of interventions identified from an RCA. A standardized route of communication is required to ensure that all RTTs fully understand an action item. A follow-up program and continuous monitoring of the action items are key to an effective RCA program.     

河南省新农合不同支付方式参合农民满意度调查

[目的]评价河南省新农合支付方式改革试点县和非试点县不同支付方式的参舍农民满意度,为政策制定、评价提供参考。[方法]选择河南省新农合支付改革试点县和非试点县各一个,调查参合农民对不同支付方式的满意度,比较二者差异。[结果]选择河南省南阳市镇平县（试点县）和开封市开封县（非试点县）为调查点,两地各发放问卷500份,合计回收问卷912份,两地参合农民的住院天数、住院花费、报销金额差异无统计学意义,住院报销比例差异有统计学意义;在新农合满意度各指标上,除对新农合办理人员业务熟练程度、报销程序等上差异无统计学意义外,其余各项两地差异均有统计学意义（尸〈0．05）。[结论]以按病种支付的新农合支付方式较按项目付费的支付方式,参合农民的实际报销比例增加,满意度提高。     

标本溶血对生化检验结果的影响分析

目的探讨标本溶血对生化检验结果的影响。方法采用日立7600生化分析仪检测50例正常人血液标本溶血前后血清中的肝功能6项（ALT、AST、TP、ALB、TBiL、DBiL）,肾功能3项（BUN、Cr、UA）、心肌酶谱（LDH、CK、CK-MB、α-HBDH）以及血脂4项（TG、TC、HDL-C、LDL-C）的值。结果发现溶血标本对肝功能6项、心肌酶谱以及TC影响较大,差异显著（P〈0.05）;而对肾功能的指标几乎没有影响,对TG、HDL-C、LDL-C的影响也较小（P〉0.05）。结论标本溶血对一些常用生化检测项目有明显的干扰作用。     

Increased levels of extracellular noradrenaline in the frontal cortex of rats exposed to naturalistic environmental stimuli: modulation by acute systemic administration of diazepam or buspirone

In vivo microdialysis was used to investigate the effects of an IP injection of diazepam or buspirone (each at 3 mg/kg) on spontaneous efflux of noradrenaline in rat frontal cortex, and on changes in efflux induced by naturalistic stress. After drug administration, rats either remained in their home cages or were transferred individually to a novel cage, 1 h later. The novel cage was brightly lit (1500 lux) and contained another, unfamiliar rat. After transfer to the novel cage, noradrenaline efflux was lower in diazepam-injected rats than in their vehicle-injected counterparts. However, in both case, stress caused a significant increase in efflux and the net increase was not affected by diazepam. Similarly, buspirone, which increased spontaneous efflux of noradrenaline, did not affect the net increase in efflux during stress. Neither compound modified locomotor activity in the novel cage. This suggests that any changes in noradrenaline efflux are unrelated to drug effects on non-specific arousal. It is concluded that generically unrelated anxiolytic agents can have different effects on spontaneous efflux of noradrenaline but do not modify the noradrenergic response to naturalistic stimuli.     

妇幼卫生服务项目成本测算探讨

采用成本法，以福建省和黑龙江省为现场，测算2001年妇幼保健机构妇幼卫生服务项目实际消耗，并对测算结果进行分析讨论。得出重医疗、轻保健的现状导致了妇幼卫生服务工作数量和质量的下降，妇幼保健服务与人群健康水平提高的关系等，并提出保持妇幼保健机构的独立性，调整卫生资源配置方向等建议和意见。     

The effects of novelty,isolation, light and ethanol on the social behavior of mice

The social behavior of pairs of male NIH Swiss mice was assessed under a variety of experimental conditions. Increasing periods of isolation increased both the total time spent in social interaction and also increased the incidence of aggressive behavior. Familiarity with the testing arena tended to increase social behavior, but the magnitude of this effect was considerably less than that previously observed in rats. High light levels reduced social interaction. Ethanol (0.8–2.4 g/kg) caused a dose-related decrease in the total time spent in social interaction, a biphasic effect on aggressive behavior and a dose-related increase in locomotor activity. While the social interaction test in this form may not be a suitable model of anxiety in NIH Swiss mice, it should provide a useful method of assessing drug effects and investigating genetic influences on social and aggressive behavior.