Appealing to the ''experience'' of the patient in the care of the dying

The care of dying patients in hospital is characterized by the copresence of four different frames: practical, medical, lay and psychological. Within the psychological frame, the staff define the patient as an experiencing subject, exposed to the staff members' knowledge and involvement. The psychological frame is used in two different circumstances. First, it is used by the staff members when the patient deviates from an expected identity within some other frame. The deviation creates a threat to the working conditions and moral order at the ward. The threat is managed through a shift into the psychological frame. Second, the psychological frame is used spontaneously in the accounts of their work given by staff members to the sociological field researcher. The image of care associated with the field researcher is characterized by a special awareness of the psychological issues. Thus the field researcher is inevitably a part of the functioning of the new kind of surveillance working through the psychological frame.     

A perceptual study of the role of the president of the medical staff

This study examines how medical staff presidents and hospital administrators perceive the president's role. The perceived role of the president is compared to hospital typology as measured by hospital size, technology, and form of ownership. Overall, there is little difference between how hospital administrators and presidents view the president's role. There is substantial agreement on steps that should be taken to increase the effectiveness of the president. A widespread view is that the president should receive formal management training and be an active member of the hospital's board of trustees.     

Centenary of the Health Council of the Netherlands. VI. Coordination mechanisms and the authority of the Health Council of the Netherlands

What do scientific advisory boards such as the Health Council of the Netherlands get their authority from? How does the Council ensure that its advice is incorporated into policy and into the practices at which the advice is directed? A frequently heard answer to this question is: by describing 'the state of knowledge' as optimally as possible. However, case studies on advisory work by the Health Council have shown that this explanation is too simplistic. It is more likely that the explanation lies in the use of 'co-ordination tools'--such as problem definition, the committee process and a specific use of language--that enable the Council to both separate and bridge science and policy. The authority of the Council is based on the hybrid nature of its work.     

彩色多普勒技术分析穿静脉形态与功能变化

目的探讨彩色多普勒技术评估下肢穿静脉曲张患者穿静脉形态与功能变化的相关性。方法从2017年10月-2019年9月于本院治疗的下肢穿静脉曲张患者中筛选出62例患者,对其进行彩色多普勒技术诊断。分析穿静脉形态与功能变化的相关性。结果62例患者中,彩色多普勒检查显示有115支穿静脉开放。其中显示有77支出现反流。大腿下部和小腿下部内径比较,有统计学意义(t=6.432,P=0.000)。穿静脉反流随着穿静脉的内径增加而增加(r=0.712,P=0.000)。结论小腿是下肢穿静脉血栓的多发部位,大腿穿静脉内径大于小腿穿静脉内径,小腿穿静脉更容易形成反流。穿静脉开放的数量,与穿静脉内径成正比,穿静脉反流与穿静脉内径密切相关。反流静脉的内径越宽,其反流情况越严重。     

乳腺癌的流行现状分析

乳腺癌是女性最常见的恶性肿瘤,也是患病人数最多的恶性肿瘤,而且患病人数呈持续增加趋势,不仅严重威胁着女性的健康和生活质量,而且给全球卫生系统带来沉重的负担。根据近几十年来全球及各地区乳腺癌的统计资料,分析乳腺癌在世界范围内的流行现状和流行趋势,并阐述乳腺癌发病危险的研究进展。     

Healthy community indicators: the perils of the search and the paucity of the find

The Canadian Healthy Communities Project (CHCP) is an ambitiousattempt to implement principles of health promotion and healthypublic policy at the municipal level. The aim of CHCP is tofoster local community organization and action around issueswhich threaten or may enhance residents' well-being. To participatein the project, communities must be prepared to monitor andevaluate their progress using indicators that are relevant,sensitive and easy to collect, and that will facilitate comparisonswith other communities. The perils of the search for indicatorswhich meet the criteria above coalesce around five main issuesincluding lack of guidance about how to proceed; lack of expertise;gathering the data itself; lack of resources and finally theconcern about how the results will be used. The paucity of thefind is not isolated to the Canadian Healthy Communities Project,but experienced by WHO Healthy Cities Europe project participantsas well. Finding one-size-fits-all indicators is doubtful giventhat the contextual dependence of relations are unique to eachlocal community. This paper addresses practical and theoreticalquestions about the role of indicators in the CHCP.     

外周静脉留置针不同封管液封管效果的研究

目的 比较外周静脉留置针两种封管液的封管效果。以选择更有效的封管液封管。减少临床上由于封管液选用不当而致堵管情况的发生，避免由于堵管而不得不再次穿刺给患者带来的痛苦。方法 将68例患者按随机抽样的方法分为对照组和实验组，每组均34例，对照组用0．9％生理盐水5ml封管。实验组用肝素盐水（50u／m1）5ml封管，两组均采用正压封管方法，进行留置效果比较。结果 实验组用肝素盐水（50u／ml）5ml封管。有效率为93．10％。对照组用0.9％生理盐水5ml封管，有效率为64．93％。经统计学处理χ^2=20．16．P〈0．01两组封管方法有显著性差异。肝素盐水封管优于生理盐水。结论 对外周静脉留置针而言．主张用肝素盐水封管。     

高校女性教职工健康状况分析

目的了解高校女性教职工健康状况,探讨女性知识分子保健工作的服务模式,提高她们的健康水平和生活质量。方法对我校2005年860名女性教职工健康体检和妇科疾病检查结果进行统计分析。结果高血压、高血脂、高血糖、心电图异常、妇科疾病的检出率分别为13·83%,15·23%,7·20%,15·93%,65·47%。结论我校女性教职工的健康状况值得重视,心血管病、三高症(高血糖、高血脂、高血压)、妇科疾病的患病率较高,对她们进行定期体检和健康指导,是当前女性教职工保健的主要任务。     

Relationship of the clinician and the pathologist at the turn of the millennium

The autopsy, once a fundamental and familiar component of medical practice based on the good cooperation of clinicians and pathologist, is now infrequently used. Recent data indicate that autopsies are performed only about one third of the cases in Hungary and less that 1 of 10 inpatients death in the united States. Explanation for this decrease is multifactorial, involving changing professional and patients attitudes, the advent of sophisticated antemortem diagnostic methods, socioeconomic factors, and medicolegal concerns as well. Teaching institutions need to reevaluate concerning the need and practice of the autopsy. "The final audit" not always reflect well on clinical diagnoses and management of patients. Many facts proves that our modern tools still not enough to reach always a correct and safe diagnoses. Errors are still common in medicine. About 10% of necropsies indicate a clinical managements different from what the patients received, 20% reveal additional diagnoses, and 60% of cases have teaching point. Though autopsy is expensive and time consuming, moreover the shortage of pathologist is evident, necropsy should remain the cornerstone of medicine in the new millennium as well. There are a broad range of different fields where pathologist and clinicians should work together in an everyday--setting--e.g. evaluate biopsy- or cytology-samples. Clinicopathological conferences are also important to discuss cases mainly for teaching purposes. Without maintaining the traditionally good cooperation neither clinicians nor pathologists will be able to give proper answers to the challenges and professional questions of the new era.     

The importance of the insertion of the nutritionist on the Family Health Strategy

The Family Health Strategy has as its main purpose to reorganize the practice of attention to health in new bases and to substitute the traditional model existing in Brazil. The new curriculum guidelines to graduate health professionals propose a general formation as well as ethics, having as its main focus the largest approach to the local health services. However, Nutrition still does not present a regulation for an active participation in the Family Health Strategy. Considering this fact, the Family Health Strategy is directly linked to people's welfare in many aspects (social, nutritional, psychological, etc). Therefore, this work intends to present the importance of the insertion of a nutritionist in the Family Health Strategy for the integrality of health actions. The conclusion is that nutritionist is fully qualified to work in the Family Health Strategy, because the absence of this professional is against the principle of the integrality of the health actions, as it is evident that no other health professional possesses education to work with food and nutrition within the communities and this presence would contribute to promote people's health.     

A model of the development of the brain as a construct of the thyroid system

Thyroid hormone is essential for normal brain development. However, little is known about the molecular and cellular mechanisms that mediate thyroid hormone action on the developing brain or the developmental events selectively affected. Consequently, although a large number of environmental chemicals interfere with the thyroid system, there are few neurodevelopmental end points to recruit for toxicological studies. Therefore, my goal here is to review what is known about the relative timing of normal brain construction and thyroid system development, with special focus on the period of in utero development in humans and the comparable developmental period in laboratory rats. These data are presented as a timeline to aid in the identification of thyroid-sensitive end points in brain development and to highlight important data gaps. I discuss the known influence of certain synthetic chemicals on the thyroid system and include a brief review of the effects of developmental exposure to chemicals on thyroid system function. The relationship between the thyroid hormone and retinoic acid systems, as well as the thyroid hormone sensitivity of the developing cochlea, is also discussed.     

大力推进以德治院 促进医院精神文明建设

推进“以德治院”,促进医院精神文明建设,必须抓好以下4个方面的工作：一是坚定理想信念,夯实思想根基。要抓好理想信念的灌输引导,强化“军魂”意识,抓好领导干部的“官德”。二是加强医德医风建设,提高职业道德水平。要加强医德教育,完善规章制度,强化监督管理。三是坚持以病人为中心,深化优质服务。要进行持续质量改进,开拓服务创新,加大硬件投入。四是加强医院文化建设,充分发挥文化的熏陶教育功能。通过弘扬“总医院精神”,开展各种文化活动,优化文化建设环境。     

Variation of the Occupancy of Two Medical Units with the Amount of Sharing Between the Units

Prediction of gain in occupancy and reduction of overflow effected by sharing beds between two previously disjoint medical units is related to the number of beds in each unit and to a variable number of beds that each unit makes available to the other when not in use. The methodology, here applied to two wards at the Johns Hopkins Hospital, is applicable wherever it is desired to estimate the effect of making beds interchangeable between wards or services.     

Hygienic assessment of the impact of the lettering of text-books

The study has established the parameters of lettering of text-books, which has a positive effect on the memory function of schoolchildren of different age. It is expedient to use color prints and their varying sizes in the text-books for junior pupils. Two types of page lettering may be used in secondary school text-books, moreover, the application of color prints is justifiable to a lesser extent than that of back-and-white one. Equitypes used in the text-books for senior schoolchildren are adequate to memory functions. The san-serif type is optimal for effective material learning in junior classes while the Times type is in middle and senior classes.     

On the abolishment of the case manager.

Stabilizing clients in the midst of a psychotic episode in the hospital can be a difficult task that requires a multidisciplinary team. The task of helping those persons to live stable lives of decent quality after they leave the hospital is at least as difficult, and much more complex. Thus, it is not surprising that the case management model, which is not multidisciplinary and is available only on weekdays, is inadequate to deliver well-integrated, constantly available services to difficult clients. The effect on clients is that few are receiving adequate rehabilitation, and many are unstable and frequently rehospitalized. The effect on the system is that a large portion of the mental health budget goes to hospital care, frustrating attempts to reallocate dollars to develop comprehensive services in the community.     

X线机电源电缆横截面积的计算

分析了X线机电源电路阻抗，由电源阻抗产生的电压降计算电缆横截面积．最后给出不同长度电缆对应的电缆横截面积。     

对医疗事故技术鉴定程序规范化的探讨

对１９９５年１２月～１９９８年５月受理的４２起医疗事故技术鉴定工作进行分析和总结，认为建立和完善科学化、规范化的鉴定工作程序，是保证鉴定质量的有效措施。要建立规范化的受理工作程序、准备工作程序和鉴定会议程序。     

Estimation of birth weight by measuring the height of the uterus in the parturient women in the Islamic Federal Republic of the Comoro Islands

This study aims at evaluating the measurement of fundal height in labor as a mean of estimating birth weight in singleton pregnancies. The delivery records of the 1983 Grande Comore Island, Indian Ocean, maternal health care centers were reviewed (n = 730). Weight and fundal height were found in 412 delivery records. The mean weight is 3,108 +/- 533 g. The linear correlation coefficient is 0.59 and the square of the correlation coefficient is 0.35. The best cut-off point of fundal height for the detection of a low birth weight newborn (less than 2,500 g) is 31 cm, which correspond to the 19th percentile. The linear regression model is not strong enough to predict birth weight. As a diagnostic test, fundal height can be usefull on an individual basis. For a mass screening utilisation, this procedure would have to be integrated to a complete program of maternal and child health care.     

长沙铁路旅客列车广播员艾滋病相关知识及态度现况调查

目的 了解长沙铁路旅客列车广播员艾滋病相关知识和态度,为在铁路旅客列车广播宣传艾滋病防治知识工作的顺利开展提供科学依据.方法 以长沙客运段所有的96名广播员为调查对象,采取问卷调查的方法,调查问卷自行设计,题型为选择题形式.结果 广播员对艾滋病主要传播途径血液、性、母婴知晓率较高,在84.38%～95.83%之间,对普...     

An investigation into the effects of breathing upon the aspiration efficiency of the human head

A mathematical investigation is undertaken into the effects of the breathing pattern upon the aspiration efficiency of the human head. It is assumed that all the fluid inhaled by the head is subsequently exhaled and that the two stages of the breathing pattern last for an equal length of time. The particles are taken to be spherical and are assumed to be suspended without sedimentation in an ideal fluid which is flowing towards the head. A model for the head is proposed and the case of breathing through the mouth is studied. An analytical approach is adopted to determine the behaviour of the particles near the mouth, and the sampling efficiency of the head is investigated. Results are obtained for various situations, and comparisons are made with existing experimental results. It is shown that, in many cases, the effect of the breathing pattern is insignificant but for normal human breathing rates, it becomes significant as the velocity of the flow increases.