心电图走纸电机故障检修1例

心电图机是医院广泛应用的设备之一．患者体检、住院、手术时都需要进行心电图检测。它也是一种具有较高技术指标和精密度的医用电子诊断仪器．但在临床使用中．常因一些小故障致使该机工作异常．延误了正常的诊疗工作。本文介绍1例心电图机的跳齿故障．供同行参考．     

ECG-6511型心电图机故障分析与检修2例

ECG-6511型心电图机是由日本光电厂研制的单导心电图机,现在生产线在上海光电厂。该机操作简单、无机械转换干扰、性价比较高,在部队配发与购置的心电图机中占有很大的比重,现将2例故障维修经验介绍如下。1故障一1.1故障现象交流供电工作正常,电池供电无法     

ECG-6951D型心电图机定标原理分析与故障解决方案

心电图机的定标在临床中主要用于测量心电信号幅度大小和校正机器灵敏度。通过对ECG-6951D型数字心电图机定标的原理、技术流程以及电路进行分析,归纳总结定标电路常见的3种故障现象和故障处理方法,为数字心电图机维修提出解决方案。     

三导心电图机维修的对策与方法

随着医院医疗事业的蓬勃发展,三导心电图机在日常的医疗诊疗中被频繁地使用.因此,切实加强三导心电图机日常维护保养,能大大减小故障率,保障临床的正常使用,提高为患者服务的诊疗水平.现结合我院工作实践,归纳如下：     

ECG-101G型数字心电图机原理及维修案例分析

目的：介绍ECG—101G型数字单通道式心电图机的工作原理,探讨心电图机的常见故障维修案例。方法：简要介绍心电图机的工作原理,分析其故障现象,选择合理的故障测试点完成故障排除。结果：通过分析心电图机常见故障案例,提出了相应的解决办法,提炼了分析思路。结论：通过对心电图机案例分析、维修操作,能够锻炼和提高临床工程师排除故障的能力,确保心电图机的安全使用。     

ECG-6511型心电图机走纸故障检修二例

临床使用的心电图机由于使用频率高，极易发生故障。根据笔者在日常检定、检修心电图机时的体会，心电图机走纸机构的故障发生频率较高。下面是笔者在检修时遇到的二例故障。     

心电图机导联线故障的快速判断及维修

心电图机在使用过程中由于导联线经常受到牵拉、拧劲等因素出现某一导联线的接触不良或断路影响了心电图的正常描记，是心电图机故障中较为常见的一种。现总结出利用心电图机自身来判断故障的方法。     

XDH-3D心电图机多种故障的处理

上海产的3D单道心电图机线路基本上是6511日本光电的图纸,机壳外形与6511机型也相似.在多年维修心电图机的过程中,多种故障集于一机的情况比较少见,现将XDH-3D心电图机的故障现象与维修与同行交流.     

ECG -6511心电图机维修实例

心电图机是指用来记录心脏活动时所产生的生理电信号的仪器。由于心电图机诊断技术成熟、可靠,操作简便,价格适中,对病人无损伤等优点,已成为各级医院中最普及的医用电子仪器之一。 ECG-6511心电图机在使用过程中无法正常运行,经分析发现此故障非常见性故障,较为典型。本文主要描述该设备出现的故障及详细的电路分析处理方法。     

心电图机的舰用化改进对策分析

针对心电图机在各型舰船上使用时故障频出的实际问题，结合舰船环境特点，分析了此环境下各种干扰源对心电图机故障成因的影响，提出了采取增配电源滤波器、电磁屏蔽以及电路板三防处理等舰用化改进措施，确保了心电图机适应舰船环境的使用要求。     

"Can you spare an organ?": exploring Hispanic Americans' willingness to discuss living organ donation with loved ones

Living organ donation offers a means of overcoming the shortage of viable organs available for transplant: a shortage particularly problematic among Hispanics. One barrier standing between those in need of a kidney and a successful transplant operation is an inability, and often lack of desire, to talk to loved ones about the need for a living donation. With an eye on future intervention approaches, and guided in part by the theory of planned behavior, this research effort sought to explore the factors associated with a willingness to engage in a conversation about a living donation with loved ones. Study 1, a phone survey of Hispanic Americans drawn from a Hispanic surname list, reveals that while upward of 90% of respondents would be willing to offer a kidney to a family member in need, and a similar percentage would be willing to accept a living donation if offered, only about half of respondents would feel comfortable initiating a conversation with family members if the respondent was in need of a living donation. Study 2, a survey of Hispanic American patients currently in need of a living kidney donation, revealed that perceived behavioral control accounted for 60% of the variance in future intentions to initiate a conversation among those who have yet to speak to a family member about becoming a living donor. Moreover, perceived behavioral control mediated the relationship between perceived asking appropriateness and future intentions to initiate a conversation. Lastly, recipient outcome expectations, asking appropriateness, and subjective norms were revealed to be predictive of perceived behavioral control. Implications for future living donor interventions focusing on increasing recipient-initiated conversations are discussed.     

Courage: A neglected virtue in the patient-physician relationship

The contribution that the virtues can make to the moral life in general and to the moral community constituted in the patient-physician relationship more specifically is gaining increased scholarly attention. This paper explores the meaning and relevance of the virtue of courage for patients and physicians. Courage is presented as a virtue for physicians in addition to the excellences of competence and compassion and a virtue for patients in addition to the excellences of compliance and gratitude. In agreement with Alasdair MacIntyre, courage is held to be necessary, at times, to our expression of care and concern for one another. The patient-physician relationship is shown to be a context in which care and concern is expressed, a context in which courage can be a relevant virtue.Certain conditions are listed as necessary to courage: freedom, fear, risk, uncertainty, an endangered good and a morally worthy end. Equivalents to these necessary conditions are discussed and held to be potentially present in patient-physician encounters. Physicians are pictured as a ‘sustaining presence’ who have duties toward patients of ‘encouragement’ that can be fulfilled in ways relative to the requirements of each circumstance. Patients are held to have a duty to learn about the nature of human existence and to develop the character necessary to its negotiation. Patients and physicians can be agents of courage who come together in a context of care and concern where certain goods are preserved even, at times, in the midst of loss. Thus, courage is presented as a relevant and important moral virtue for the patient-physician relationship in which those qualities that define who we are as a moral community are expressed and sustained.     

The nursing shortage: is it really about image?

A poor public "image" of the nurse is believed to contribute to nurse shortages. We surveyed more than 3,000 college students in science and math courses in a seven-county region of California's Central Valley to assess their perceptions of a career as a nurse in relation to a career as a physical therapist, a high school teacher, or a physician. Students generally had favorable perceptions of nursing, with two-thirds agreeing that nursing has good income potential, job security, and interesting work. However, nursing lagged behind the other occupations in perceptions of independence at work and was more likely to be perceived as a "women's" occupation. Our findings suggest that these college students have generally gotten the message that nursing is a financially rewarding and desirable career, although they also perceive nursing to be less attractive on some important occupational characteristics such as job independence. Unless nursing training capacity expands substantially, the projected nurse shortage will occur. With continued aggressive marketing of nursing as a career, there is a risk of engendering a backlash from prospective students frustrated in their effort to find a slot in a nursing training program. Much work remains to be done to alter the image of nursing as a women's occupation and to transform the work environment of nurses to make a career in nursing more attractive.     

Increasing response to mailed questionnaires by including a pencil/pen

Nonmonetary incentives lead to small increases in response rates to mailed questionnaires. However, inclusion of a pen or pencil, which may be a facilitating factor as well as a reward, has not been shown to improve response to health surveys in prior trials. In 2001 and 2002, the authors conducted two US trials in which a study-logo pen or pencil was randomly included in a second questionnaire mailed to nonresponders to a first mailing. In the first study, of 10,686 nonresponders to a cohort recruitment mailing, response to the second mailing was 55% with inclusion of a pen versus 40% without one (p < 0.001). In the second study, of 141 nonresponders to a pilot follow-up survey conducted 2 years after entry into a cohort, response was 43% with inclusion of a pencil versus 24% without one (p = 0.02). This 15-19 percentage point increase for mailing 2 translated to a 5-6 percentage point increase after the two mailings combined. In a simulated study of three mailings based on these studies, the overall response rate increased by 4 percentage points at no added cost through inclusion of a pencil in the second mailing. The additional cost of the pencil was compensated for by the reduced number of nonrespondents sent packets at the third mailing. This study supports including a study-logo pen or pencil in a second questionnaire mailing to nonrespondents as a cost-effective method of increasing response rates.     

Enuresis in childhood

Enuresis is a frequent reason for consultation in the primary care centres. Although its natural evolution in the majority of cases is towards spontaneous resolution, the negative consequences that can be occasioned in the life of the child and the discomforts that it creates for the family justify our interest in dealing with the question. Our aim is to define the concept of enuresis and its types; to contribute a protocol based on a careful anamnesis and an exploration and a basic analysis of urine to enable us to make an initial selection of those cases that might have a pathological background and thus be susceptible to a more exhaustive study and that in some cases will require a specific treatment depending on the cause. On the other hand, we aim to present a work methodology that is applicable in the great majority of types of enuresis, and which, besides being free of the undesirable effects of some classic treatments, obtains a high percentage of success. Similarly, we aim to contribute a series of basic norms for a correct apprenticeship in starting to control micturition and that could be incorporated in the program of a healthy child.     

Competence in Mental Health Care: A Hermeneutic Perspective

In this paper we develop a hermeneutic approach to the concept of competence. Patient competence, according to a hermeneutic approach, is not primarily a matter of being able to reason, but of being able to interpret the world and respond to it. Capacity should then not be seen as theoretical, but as practical. From the perspective of practical rationality, competence and capacity are two sides of the same coin. If a person has the capacity to understand the world and give meaning to the situation, he or she is able to make decisions, and is thus competent. People can fail in the area of practical rationality. They can feel ill at ease, uncomfortable or not at home in the situation. Under such conditions, they appear as incompetent, and urge caregivers to respond in such a way that their competence can be raised. The issue is not how to measure their incompetence, but how to help them to become more competent, that is to get a practical grip on their situation and to be able to live out their lives in such a way that they develop their identity in relations with others. From a hermeneutic point of view, assessing a patient's capacity implies focusing on the patient's way of meaning making and regarding her behavior from the perspective of practical rationality. The focus should not be on the assessment as a matter of fact, but on improving capacity. This requires allowing the patient to experience the world meaningfully and affording her, in the context of a supportive and trustful institutional environment, the possibility of developing a personal narrative where her choices are expressed verbally or non-verbally.     

Prophylactic oophorectomy: a historical perspective

Removal of a woman's ovaries (known as bilateral oophorectomy, ovariectomy or, historically, ovariotomy) is undertaken in a number of countries. An estimated 19,000 women aged <60 years had a bilateral prophylactic oophorectomy in the UK in 2003, either as a planned response to an increased specific genetic risk of ovarian or breast cancer or, more frequently, as a prophylactic measure to prevent ovarian cancer. Despite its popularity, however, a full evaluation of the risks, costs and benefits of prophylactic oophorectomy in the absence of genetic markers and at the time of hysterectomy has not yet been undertaken. This paper seeks to provide a historical perspective on current practice by outlining approaches to the ovary in Britain from the 19th century onwards. Historically, ovarian removal has raised many questions about the costs and benefits of surgery. The aim of this article is to highlight the issues, and in so doing, to contribute to a more informed assessment of current practice.     

The analysis of neuronal discharge sequences: change-point estimation and comparison of variances

A key problem in neurophysiology is to determine whether, after presentation of a stimulus, there has been a modification in the discharge of a recorded neuron and if so, an attempt is made to estimate the latency of the response. The estimation problem can be considered as that of the estimation of a change-point in a sequence of random variables. The gamma distribution is adequate to model the distribution of intervals between action potentials for different types of neurons. Simulations show that the maximum likelihood estimator based on this model is efficient and robust. An additional problem, in the case of experiments in which a movement follows the stimulus, is to determine whether a response is related to the stimulus or to the movement. A test based on the comparison of marginal scales of a bivariate distribution is proposed. The whole procedure has been tested in simulation and with real examples.     

Risk society and epidemiological risk

The concept of risk entails a broad discussion, ranging from a more general approach, seeking to contextualize it in the dynamic of societal change, to a more specific approach in the field of health, particularly in epidemiological studies on associations. The term "risk" has appeared with increasing frequency in medical journals in the last three decades, but the phenomenon is not exclusive to health and is permeated by the diversity of a notion that hides a conceptual gap. Given this diversity, the current paper begins with a literature review to systematize the discussion of risk. The result is organized in three sections: 1) an overview of the discussion on risk within the debate on societal change in the transition from modernity to a new phase of social organization; 2) a summary of various uses of the risk notion in health knowledge; and 3) the establishment of the epidemiological concept of risk and its link to clinical medicine.     

Depressive Symptoms,Relational Turbulence,and the Reintegration Difficulty of Military Couples Following Wartime Deployment

Living organ donation offers a means of overcoming the shortage of viable organs available for transplant: a shortage particularly problematic among Hispanics. One barrier standing between those in need of a kidney and a successful transplant operation is an inability, and often lack of desire, to talk to loved ones about the need for a living donation. With an eye on future intervention approaches, and guided in part by the theory of planned behavior, this research effort sought to explore the factors associated with a willingness to engage in a conversation about a living donation with loved ones. Study 1, a phone survey of Hispanic Americans drawn from a Hispanic surname list, reveals that while upward of 90% of respondents would be willing to offer a kidney to a family member in need, and a similar percentage would be willing to accept a living donation if offered, only about half of respondents would feel comfortable initiating a conversation with family members if the respondent was in need of a living donation. Study 2, a survey of Hispanic American patients currently in need of a living kidney donation, revealed that perceived behavioral control accounted for 60% of the variance in future intentions to initiate a conversation among those who have yet to speak to a family member about becoming a living donor. Moreover, perceived behavioral control mediated the relationship between perceived asking appropriateness and future intentions to initiate a conversation. Lastly, recipient outcome expectations, asking appropriateness, and subjective norms were revealed to be predictive of perceived behavioral control. Implications for future living donor interventions focusing on increasing recipient-initiated conversations are discussed.