护理人员的职业损伤因素及健康维护

作者指出临床一线的护理人员是发生职业损伤的高危群体。产生职业损伤的危险因素包括基础教育和继续教育缺乏职业损伤及其防范知识；影响护理人员身体健康的诸因素，如化疗专用的溶药设备、洁净操作台或相对密闭的溶药环境不健全；乙型肝炎等医院内易感性等疾病增加，被血液、体液等污染的医疗锐器刺伤是护理人员职业感染的主要途径；护理人员工作职业特点对健康不利的影响，护理人员心理压力大。为维护护理人员身心健康，应加入医院感染、职业损伤和健康维护的在校理论教育内容，加强护理人员职业安全教育，采取防范职业损伤的措施，如化疗药物中心配药、使用一次性手套等措施。     

Effects of cadaver dissection on the attitudes of medical students

Summary: Summary. A study was conducted to determine whether the attitudes of medical students to death and caring changed during the 3 months following exposure to cadaver dissection. All first-year students were invited to complete a questionnaire immediately before their initial cadaver dissection experience, after 6 weeks, and after a further 3 months. The questionnaire reflected attitudes to death, violent death, death of someone known to the respondent and caring when someone known to the respondent is seriously injured. Ethnicity and previous exposure to dying has no effect on responses, but overall men students' reactions were significantly less than for women ( P < 0.001). The responses given on the final part of the questionnaire after 3 months were significantly lower than those to most questions in the first part of the questionnaire. The exceptions were those questions where the subject in the given scenario was known to the respondent, where reactions were rated significantly greater ( P < 0.001) in the follow-up questionnaire and can be explained on the basis that they were a personal referent.
Students rapidly develop a coping mechanism which enables them to view cadaver dissection as an occupation quite divorced from living human beings. During these early months of training solicitude decreases for those who die who are unknown to them, but concern for personal referents increases. Educators should be aware of the dramatic change of attitudes among students and the process of professionalization which might influence their caring of future patients.     

Head Start Teaching Center: Differential Training Effects for Head Start Personnel

Driven by research findings regarding the positive relationship between training and enhancement of services, as well as literature on adult learning, the New England Head Start Teaching Center (NEHSTC) was created in 1992 to test the efficacy of participatory, hands-on training. The purpose of this paper is to examine the outcome evaluation results from 4 years of training at the NEHSTC, 1 of 14 federally funded sites, as well as to discuss the implications for delivering this type of participatory training throughout Head Start. Findings suggest that the NEHSTC was successful in implementing high quality, participatory training within the context of an ongoing Head Start program. Head Start staff who participated in the NEHSTC trainings demonstrated gains in knowledge, skills, and expertise compared to similar Head Start employees who did not receive training. Results also reveal a sustained effect of training over time, with NEHSTC participants continuing to demonstrate enhanced knowledge and skills 6 months after training. Similar positive outcomes of training were found for staff with varying levels of experience and holding different Head Start positions. Thus the participatory, hands-on training implemented by the NEHSTC was found to produce positive and lasting outcomes for diverse Head Start staff. An effective and cost efficient model of training Head Start personnel is particularly relevant and timely as Head Start strives to establish universal quality and expansion of services in the 21st Century. The findings are also relevant for improving the quality of all early care and education programs.     

Independent learning among general practice trainees: an initial survey

Self-directed learning is a natural way for adults to learn. Vocational training for general practice is a preparation for unsupervised clinical work that will be supported, in the main, by continuing medical education. This study uses the Self-Directed Learning Readiness Scale to investigate factors influencing readiness for such learning among a sample of general practice trainees. Three principal factors emerged from analysis: enjoyment and enthusiasm for learning; a positive self-concept as a learner and a factor suggesting the possibility of a 'reproducing' orientation to learning. These factors may reflect approaches to learning in general rather than these adopted for professional learning, but offer helpful pointers for the development of both vocational training and of continuing medical education.     

经鼻蝶窦手术动物模型神经内镜手术训练

目的建立一种活体动物的神经内镜经鼻蝶手术模拟训练方法。方法选择大鼠，建立一套训练计划，完成内镜图像导引下的内镜操作，电凝止血、冲洗和吸引、活检等神经内镜经鼻蝶手术的基本技巧。结果利用大鼠颅脑进行模仿内镜经鼻蝶手术，如在内镜图像导引下操作内镜的方法；熟悉内镜系统、电凝系统、冲洗和吸引设备的使用；熟悉了神经内镜经鼻蝶手术的步骤。结论作为神经内镜实验室训练的重要组成部分，通过利用大鼠颅脑进行模拟神经内镜手术，训练者可以从中获得神经内镜操作基本技巧的练习。     

Fire in the operating theatre. Evacuation pre–planning may save lives

An operating theatre fire and the steps taken to deal with it are described; the difficulties encountered in evacuating anaesthetised patients are highlighted. Measures which might be taken to prevent recurrence of these problems, and recommendations on the institution of fire drills for the safety of patients and staff are given.     

对医学工程技术人员岗位培训方式的探讨

本文对如何开展医学工程技术人员的培训进行了分析，并提出了一些具体的办法。     

云南罗平医院员工对医院的认同度分析

通过问卷调查和访谈分析,调查了云南罗平医院194名员工对医院的认同度,调查对象包括行政、临床和后勤人员,从医院管理模式、医院绩效考核、医院薪酬待遇等方面用描述统计方法分析了数据,显示了医院员工的认同度情况及管理中存在的问题,并分析了不同因素对医院员工的认同度影响,为进一步改善医院管理状况,提高管理水平提供了参考。     

Development and evaluation of an allocation committee to distribute community placements on an equitable basis between universities: Our experience with the University Placement Allocation Committee

The present paper outlines the development and evaluation of an allocation committee to distribute community placements on an equitable basis between universities. Although based on our experience in South Australia with the University Placement Allocation Committee (UPAC), the primary goal is to outline the steps that would be useful if placement coordinators at other universities in Australia decided to establish and maintain an allocation committee. A survey of field supervisors was also conducted and field supervisors endorsed UPAC as a constructive mechanism for allocating community placements.     

"11.24"海难援救军人的心理健康状况分析

目的 探讨海难后军队应激援救人员的心理健康特点，为建立特定人群的心理健康评定体系提供科学依据。方法 采用症状自评量表和自行编制的调查表对39名1999－11－24烟台“大禹”海难1mo后的善后援救军人进行了心理健康测试，并将调查结果与对照军人和国内军人常模进行了比较。结果 接受调查的应激人群的SCL－90总分79.5%（31／39）的人评定为正常，总分≥160分为8例，占20.5%。SCL－90总分、射体化、焦虑、恐怖与精神病性因子与国内军人常模比较无显差异，但阳性项目数、强迫症状、人际敏感、抑郁、敌对及偏执因子分均显低于国内军人常模（P＜0.05-0.01）；而阳性症状均分显高于国内军人常模（P＜0.05）。应激人群的阳性项目数明显低于对照人群，而阳性症状的痛苦水平明显高于对照人群（P＜0.01）；阳性症状均分仍显高于对照人群（P＜0.05）。结论 提示受调查的应激人群的阳性症状均分显高于国内军人常模，改善婚姻状况和与同胸关系、完善上级领导工作方法和善后处理可以改善SCL－90结果，减少生活事件的刺激量可望改善其心理健康状况。