推拿手法安全性的研究进展

中医推拿疗法是一种传统的、有效的理疗方法。在临床实践中具有独特的优势。它可以弥补许多疾病和损伤的药物治疗的不足,具有不可替代的疗效。推拿是部位和手法的综合作用,意外事件的发生主要是因为有的医者求效心切,不关注治疗部位和手法,疗效不明显,而且增加了患者的痛苦并危及患者的健康。本文试从施术部位和手法的不同,分析推拿操作中的意外事件,总结产生损伤的原因,并厘清操作要点,以期指导临床推拿操作的安全实施。     

省级辐射事故应急演习存在问题及对策研究

本文概述了2014年以来全国各省开展省级辐射事故应急演习的基本情况和特点，对演习中在预案修订、实战性、规范性、应急准备能力等方面存在问题进行了分析，并提出了针对性对策建议，为今后各省改进演习工作提供参考和借鉴。     

Characteristics of drowning deaths in an inner city river

A study was undertaken of all drowning deaths that occurred over a 30-year period from 1988 to 2017 in the urban section of the River Torrens, Adelaide, South Australia, an augmented waterway that runs through the central business district. Autopsy records from Forensic Science South Australia (FSSA) were reviewed. There were 34 drownings (0–5 cases/yr) with 28 males and 6 females (M;F = 4.6:1), with an age range for males of 18-76yrs (mean 42.0; SD 18.0) and for females of 20-84yrs (mean 69.3; SD 24.5). There were 15 (44%) accidents, 11 (32%) suicides, 1 (3%) homicide and 7 (21%) undetermined. Of the 22 cases during or after 1994 with complete toxicology reports, 10 (45%) had a blood alcohol concentration (BAC) of greater than 0.05% (g/100 mL) with an illicit substance detected in 4 (18%) cases: (MDMA (3,4-methylenedioxymethamphetamine), methylamphetamine and THC (delta-9-tetrahydrocannabinol) acid). The presence of various therapeutic drugs was also detected in 10 cases (45%) including temazepam, fluoxetine, diazepam, olanzapine, amitriptyline, carbamazepine, codeine, citalopram and valproate. Although the numbers of cases were not high, the urban portion of the River Torrens had a much higher number of drowning events per kilometre compared to other inland waterways in South Australia such as the Murray River. This is most likely due to the vulnerability that exists for intoxicated individuals in the city from falls into the water and to the availability of the river as a means of suicide to members of the adjacent urban population.     

Facteurs associés au burnout en anesthésie–réanimation. Enquête 2009 de la Société française d’anesthésie et de réanimation

Objective

To assess factors related to burnout in anesthesia and intensive care.

Design

National prospective observational study.

Materials and methods

Questionnaire posted on the French Society of anesthesia website from 3rd June 2009 to 27th August 2009: Maslach Burnout Inventory (MBI), Fast Alcohol Consumption Evaluation (FACE) and The Harvard National Depression Screening Day Scale (HANDS) scales and questions to assess health, work and personal life.

Results

One thousand six hundred and three questionnaires returned: 1091 anesthetists (67.6%), 241 intensivists (14.9%), 204 nurses (12.6%), emergency physicians (2.8%), supervisor nurses (0.9%). Seven hundred and sixty three in a university hospital (47.3%), 259 in a regional hospital (16.1%), 405 in a private structure (25.1%), 71 in a non-lucrative private structure (4.4%), 75 in a military hospital (4.6%). Rest of safety: 69.2% of institutions. Depression: 38.7%. Drug or chemicals addicted: 10.6%. Alcohol addicts: 10.6%. Among them, 62.3% of individuals were in burnout. Burnout was linked to fragmented sleep (P < 0.00001), interpersonal conflicts (P < 0.00001), perception of rest of safety (P < 0.02), mental history (P < 0.00001), suicidal ideations (P < 0.00001), depression (P = 0.00001), alcohol (P < 0.002), drug consumption (P < 0.00002), and accidents after a nightshift (P < 0.05). Subjects in burnout intended more frequently to leave the profession (P < 0.00001). Leaving in couple had a protective effect (P < 0.005). The logistic regression model retained seven covariates independently associated with burnout: quality of work, of personal life, of fatigue, depression, conflicts with colleagues and patients, regretting the choice of specialty.

Conclusion

This study of the largest cohort of anesthesia personnel performed in France detects a high proportion of burnout. It highlights links with tensors that may constitute possibilities of prevention of the burnout syndrome.     

心理危机干预技术在急诊意外伤害患者中的应用研究

目的：研究心理危机干预技术在急诊意外伤害患者中的应用。方法：将122例急诊意外伤害患者随机分成两组，在负性心理干预方面，对照组给予一般的心理护理。实验组应用心理危机干预技术进行心理干预。测评两组患者的负性心理干预效果及对急诊护理工作的评价。结果：实验组优于对照组，更能缓解患者的焦虑、抑郁及恐惧情绪，同时，提高了患者对急诊护理工作的满意度，差异均具有统计学意义（P〈0.01）。结论：心理危机干预技术适合在急诊意外伤害患者中应用，是一项有利于意外伤害患者的心理护理新技术。     

无人机事故中人的因素

目的 综述美军军用无人机事故中人的各种因素所起的相关作用及针对性预防措施的研究情况. 资料来源与选择 无人机事故中人的因素研究领域相关文献. 资料引用 引用文献27篇. 资料综合 在介绍军用无人机简要发展概况和与人的因素相关问题的基础上,回顾了近15年来美国陆、海、空军所发生的与人的因素有关的无人机事故,介绍了该领域正在和拟开展的针对性预防研究工作. 结论 军用无人机正处于飞速发展的阶段,在无人机所发生的事故中人的因素占有相当的比重,涉及到人机工效、操作人员心理生理、人员选拔培训和管理使用等方面.国内此方面的工作基本处于空白.吸取国外的经验教训和研究结果,有助于减少因设计原因,或使用过程中由于人的因素所导致的无人机事故,促进我军无人机的发展,并拓展航空医学的研究领域.