Improvement of heat－tolerance by training Ⅱ．Evaluation of effects of cross－country race and heat－bath training on heat－tolera

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Self-directed learning in anatomy: incorporation of case-based studies into a conventional medical curriculum

This paper reports an attempt to develop self-directed learning skills in second-year medical students by introducing case-based projects into the gross anatomy course at a long-established medical school. The programme and students' responses to a questionnaire completed at the end of the year are presented. Information on the various resources used by students to find information is given. The performance of students in the case-based components of the course has been evaluated and also in the more traditional end-of-year written examination. The data confirm that students have recognized that the projects were about obtaining a deeper understanding of the anatomy, and the programme appears to have promoted the use and study of library texts.     

Tension neck and evaluation of a physical training course among office workers in a bank corporation

The purpose of this study was to investigate the effects of a physical training course in a group of patients (n=74) suffering from chronic tension neck. All participants in the course were employed by a bank corporation in Helsinki, Finland. A comparable control group (n=77) consisted of office workers with tension neck from the same bank corporation who did not attend any training course. The outcome was analysed 6 months after the course. Pain and disability in the neck and shoulder region did not vary significantly between the group which participated in the training course and the control group. The experimental group had increased the amount of physical workout compared to the control group (83.7% vs 69.0%, P = 0.0448). Also, regarding the frequency of relaxation and stretching exercises the two groups differed significantly: the experimental group had continued to perform exercises more often (P= 0.0434). The frequency of sick leave days did not significantly differ between the groups, but the office workers in the experimental group had more periods of extended sick leave (> 10 days) and the controls had more frequent short sick leaves. The experimental group did increase their physical workout significantly compared with the controls, but no differences were detected regarding pain and disability. In order to gain more benefit more attention should be paid to the educational part of the training courses in order to enhance the patients'self-care abilities. Also, strategies to alleviate psychosocial problems and organized relaxation exercises could decrease muscle tension in the neck in office workers.     

广西射击运动员血清脂质水平分析

目的：了解射击运动员高脂血症的发生情况和可能的引发因素，为预防高脂血症提供依据。方法：对从事专业训练半年以上，无急慢性疾病的53名省级优秀射击运动员进行膳食调查和血清脂质水平检测。结果：运动员的高脂血症检出率为28．3％，全部为高甘油三脂血症；膳食中 运动员除了摄入维生素B1、B2不足和维生素A缺乏外，其他各类营养素基本能满足机体需要，属基本合理膳食。结论：以抗阻训练和静力运动为运动特征的射击运动，可能会对机体血脂代谢产生不利的影响。     

女性飞行学员高空飞行生理生化耐受能力研究

为从高空缺氧耐力训练前后生理、生化角度探讨中国女飞行员驾驶战斗机的可行性,在地面模拟高空缺氧及高空飞行训练前后行心电图、心率、血氧饱和度、血压、血尿酸(BUA)、肌酸激酶(CK)、血红蛋白(Hb)、乳酸(BLA)、肌酐(Cr)和天冬氨酸转氨酶(AST)测定,并与男飞行学员的测定结果比较.发现男女飞行学员的心电图、心率、血氧饱和度、血压、Cr、CK、BUA和AST均无显著性差异;女飞行学员在高空耐缺氧Hb代偿反应高于男飞行学员(P<0.05),而BLA水平低于男飞行学员(P<0.05).认为中国女飞行学员在生理生化耐受能力上能胜任飞战斗机.     

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.