OUTLOOK 0.23T磁共振梯度系统的故障检修2例

OUTLOOK0．23T是低场强常导开放式磁共振。它的梯度子系统（gradient subsystem或gradients）是MRI系统的重点部位。由于它长期工作在高电压大电流条件下，受电流、电压波动及环境温度、湿度变化的影响较大，所以它是整台设备的“高危地带”，极易发生故障。因此，研究如何分析排除这方面的故障，有很重要的现实意义。为此．本文对OUTLOOK0．23T磁共振梯度子系统典型故障的分析和检修做一简要的介绍，供同行参考。     

Multi-platform mediation: U.S. mothers’ and fathers’ mediation of teens’ media use

This study attempts to solidify a predictive model of parental mediation across four media platforms (television, video games, internet, and cellphones). The analysis compares U.S. mothers’ and fathers’ mediation, specifically within the larger context of parenting behaviors and media attitudes. Results indicate that there are only a few, small gender differences in parental mediation. Across media, parental mediation was largely predicted by the child’s age, parents’ attitudes about media effects, and levels of parent–child involvement and communication. More involved parents were more frequent mediators for television, video games, and the Internet. Parents who reported frequent talks with children more frequently mediated all four media. The results are discussed within the context of research on parenting.     

Exploring U.S. Men’s Birth Intentions

While recently there have been renewed interest in women’s childbearing intentions, the authors sought to bring needed research attention to understanding men’s childbearing intentions. Nationally representative data from the 2006–2010 National Survey of Family Growth (NSFG) was used to examine pregnancy intentions and happiness for all births reported by men in the 5 years preceding the interview. We used bivariate statistical tests of associations between intention status, happiness about the pregnancy, and fathers’ demographic characteristics, including joint race/ethnicity and union status subgroups. Multivariate logistic regressions were used to calculate adjusted odds ratios of a birth being intended, estimated separately by father’s union status at birth. Using comparable data and measures from the male and female NSFG surveys, we tested for gender differences intentions and happiness, and examined the sensitivity of our results to potential underreporting of births by men. Nearly four out of ten of births to men were reported as unintended, with significant variation by men’s demographic traits. Non-marital childbearing was more likely to be intended among Hispanic and black men. Sixty-two percent of births received a 10 on the happiness scale. Happiness about the pregnancy varied significantly by intention status. Men were significantly happier than women about the pregnancies, with no significant difference in intention status. Potential underreporting of births by men had little impact on these patterns. This study brings needed focus to men’s childbearing intentions and improves our understanding of the context of their role as fathers. Men need to be included in strategies to prevent unintended pregnancy.     

妊娠剧吐致Wernick’S脑病2例

妊娠剧吐致Wemick’s脑病非常罕见，该病起病急，病情重，临床上多因诊断不及时，治疗不当而预后差。笔者所在医院在近两年中收治2例，报道如下。     

保守治疗外阴Paget’S病3例分析

目的探讨乳房外Paget’s病的保守治疗方法。方法对3例乳房外Paget’s病患者的临床特点、病理资料以及治疗随访情况进行总结。结果3例Paget’s病均行药物保守治疗，随访1年，1例复发外阴瘙痒，2例无特殊不适。结论老年、不能耐受手术、病理类型为早期上皮内病变的Paget’s病患者，可以尝试药物保守治疗。     

U.S. women physicians’ residential radon testing practices

Introduction: These analyses were designed to elucidate U.S. physicians’ perception of residential radon risk, as measured by the prevalence of residential radon testing using a representative sample of U.S. women physicians from the Women Physicians’ Health Study database. In addition, characteristics of women physicians who were more likely to have conducted a residential radon test were identified.Methods: A random sample (n = 4,501 respondents) of U.S. women physicians aged 30 to 70 was obtained in the Women Physicians’ Health Study. Analyses were conducted using SUDAAN.Results: The overall prevalence of residential radon testing among respondents was 18%, 2- to 6-fold higher than any estimate of residential radon testing in the general population. The strongest relationship with radon testing observed through logistic regression was with marital status; age, ethnicity, and region of residence were also related.Conclusion: This study demonstrates that although U.S. women physicians are more likely to have conducted a personal residential radon test than the general population, 82% report not having done so. Increasing the awareness of physicians about the health risks associated with prolonged radon exposure will be essential if they are to play a role in addressing this important public health problem.     

THE VIEW FROM SOMEWHERE: LOCATING LESBIAN EXPERIENCE IN WOMEN’S HEALTH

In some circles of nursing practice and research, “women’s health” is seen to stand for “women’s reproductive and heterosexual health.” In this article we offer a view of women’s health that makes central the contexualized reality of the material, social, and discursive experiences of women’s lives. We suggest that the barriers to adopting broader conceptualizations of health are grounded in pervasive ideologies that privilege biology and a traditional model of health over nonmedical determinants of health. Lesbian disclosure is a central experience in lesbian life, and, as such, is seen as an exemplar of research questions that challenges our taken-for-granted ideologies and contextualizes women’s health experiences.     

U.S. clinicians’ and pharmacists’ reported barriers to implementation of the Standards for Adult Immunization Practice

BackgroundThe Standards for Adult Immunization Practice (Standards), revised in 2014, emphasize that adult-care providers assess vaccination status of adult patients at every visit, recommend vaccination, administer needed vaccines or refer to a vaccinating provider, and document vaccinations administered in state/local immunization information systems (IIS). Providers report numerous systems- and provider-level barriers to vaccinating adults, such as billing, payment issues, lower prioritization of vaccines due to competing demands, and lack of information about the use and utility of IIS. Barriers to vaccination result in missed opportunities to vaccinate adults and contribute to low vaccination coverage. Clinicians’ (physicians, physician assistants, nurse practitioners) and pharmacists’ reported barriers to assessment, recommendation, administration, referral, and documentation, provider vaccination practices, and perceptions regarding their adult patients’ attitudes toward vaccines were evaluated.MethodsData from non-probability-based Internet panel surveys of U.S. clinicians (n = 1714) and pharmacists (n = 261) conducted in February-March 2017 were analyzed using SUDAAN. Weighted proportion of reported barriers to assessment, recommendation, administration, referral, and documentation in IIS were calculated.ResultsHigh percentages (70.0%−97.4%) of clinicians and pharmacists reported they routinely assessed, recommended, administered, and/or referred adults for vaccination. Among those who administered vaccines, 31.6% clinicians’ and 38.4% pharmacists’ submitted records to IIS. Reported barriers included: (a) assessment barriers: vaccination of adults is not within their scope of practice, inadequate reimbursement for vaccinations; (b) administration barriers: lack of staff to manage/administer vaccines, absence of necessary vaccine storage and handling equipment and provisions; and (c) documentation barriers: unaware if state/city has IIS that includes adults or not sure how their electronic system would link to IIS.ConclusionAlthough many clinicians and pharmacists reported implementing most of the individual components of the Standards, with the exception of IIS use, there are discrepancies in providers’ reported actual practices and their beliefs/perceptions, and barriers to vaccinating adults remain.