郑州某校高三住校生和走读生心理状况与考试焦虑的调查研究

目的 调查分析郑州某校高三住校生及走读生心理状况与考试焦虑情况,为提高高三学生心理应对能力、制定相应的心理卫生保健措施提供依据.方法 通过症状自评量表(SCL-90)和考试焦虑量表(TAI)分别对郑州某中学高三312名住校生、72名走读生进行心理测评,应用SPSS软件对测评结果进行统计学分析.结果 高三学生心理问题总检出率为32.6%,其中住校生检出率为34.9%,走读生检出率为22.2%;住校生在强迫、人际关系、抑郁、焦虑、偏执症状因子上得分高于走读生,差异有统计学意义(P<0.05);住校生TAI总分、TAI/W得分、TAI/E得分均高于走读生,差异有统计学意义(P<0.05);高三学生心理健康状况与考试焦虑具有较高的相关性.结论 高三学生存在一定的心理问题和考试焦虑的现象,其中住校生考试焦虑情况和心理健康问题比走读生严重,需要进行针对性的心理辅导.     

医学专业微生物学标准化考试体系的建立和使用

目前,各医学院校逐步建立各自的试题库,以求获得高信度,高效度的考试。关于试题库建立已有较多报道,但对整个考试体系的建立报道较少,现将我们的工作总结如下。1 标准化考试体系的建立1.1 基本原则1.1.1 性质与目的:是以大专医师专业微生物学教学大纲为质量标准的课终结业常模参照考试。其目的在于区别学生是否达到教学大纲要求和学业成绩的差异。     

湖区武警部队官兵血吸虫病防治认知调查

目的了解湖区武警部队官兵血吸虫病认知现状,为制定武警部队血吸虫病防治措施提供参考依据。方法采用分层整群抽样的方法,对湖南、湖北、江西、安徽及江苏5省武警部队官兵进行问卷调查,调查内容包括官兵社会人口学信息、血吸虫病防治知识、防治态度和接触疫水行为方式,根据答题结果将防治知识判定为及格和不及格,防治态度分为积极和消极。结果 201个调查点22 606份有效问卷中,血防知识总及格率43.2%,其中年龄≤20岁组及格率41.7%,21～29岁组45.1%,≥30岁组42.1%;干部、战士及格率分别为42.5%、43.3%;入伍地为血吸虫病流行疫区官兵的及格率为48.2%,非疫区为39.7%;69.9%的官兵防治态度积极,30.1%消极;接触疫水的行为方式中,湖水浇菜地行为12 188人（53.9%）,参加疫区抗洪抢险8 139人（36.0%）;防治知识及格组与防治态度积极组在接触疫水的行为上明显低于不及格组和消极组。结论湖区武警部队官兵血吸虫病防治知识整体水平有待提高,加强血吸虫病健康教育及推行行为干预是部队血吸虫病防治工作的关键之一。     

招飞受检学生肾脏触诊及鉴定分析

1261名招飞受检学生的肾脏触诊结果表明,平均触及率为15.9％,平均淘汰率为5.1％。淘汰者中,低于标准体重的占76.2％。分析主要原因是受检学生学习紧张营养相对不足、体重轻、肾脂肪囊消减,肾脏移动度增大;体育锻炼少,肌肉不发达,腹壁松软而易于触诊。在鉴定肾下垂是否超出招飞体格条件时,不仅要注意肾下移的距离,还要结合受检学生体质、B超和尿常规检查结果及是否有相关症状,综合评定。     

评《泌尿生殖系统疾病影像鉴别诊断图谱》

放射学或影像学主要依靠图像来说话.在诊断疾病时,如果没有过硬的图像,你作出的诊断只能视为臆断,即使诊断正确,也可能是猜对的.写论文向杂志投稿,如果图像不过硬或质量不高,即使文字修辞很好,也难逃退稿的厄运;撰写一部著作,如果不附大量有价值的图片,不能做到图文并茂,评价不会太高;编写一部图谱,对图片质量要求更高,涉及的领域是否广泛和深入,能否达到普及与提高,图像是否清晰,印刷质量是否精良,如果这些方面达不到,读者也不会很满意.是否可以这样认为:从某种意义上讲,图像是放射学的生命.     

评《泌尿生殖系统疾病影像鉴别诊断图谱》

放射学或影像学主要依靠图像来说话.在诊断疾病时,如果没有过硬的图像,你作出的诊断只能视为臆断,即使诊断正确,也可能是猜对的.写论文向杂志投稿,如果图像不过硬或质量不高,即使文字修辞很好,也难逃退稿的厄运;撰写一部著作,如果不附大量有价值的图片,不能做到图文并茂,评价不会太高;编写一部图谱,对图片质量要求更高,涉及的领域是否广泛和深入,能否达到普及与提高,图像是否清晰,印刷质量是否精良,如果这些方面达不到,读者也不会很满意.是否可以这样认为:从某种意义上讲,图像是放射学的生命.     

四肢战创伤并发急性肾衰竭危险因素的logistic回归分析

目的探讨四肢战创伤并发急性肾衰竭(ARF)的危险因素。方法回顾性分析1968-2002年收治的352例四肢战创伤患者,根据是否发生ARF将患者分为ARF组(9例)和非ARF组(343例)并进行病例对照研究,选择可能影响患者死亡的10个因素(致伤物、伤后是否休克、伤后入院时间、受伤部位、有无合并伤、手术次数、有否异物存留、骨折性质、是否截肢、止血带时间)进行logistic回归分析,筛查导致ARF的危险因素。结果 352例患者中共死亡15例,死亡原因包括ARF 7例(46.7%)、肺栓塞3例(20.0%)、气性坏疽3例(20.0%)、多器官功能衰竭2例(13.3%)。单因素分析显示,伤后是否休克、伤后入院时间、是否截肢、止血带时间为四肢战创伤后ARF的危险因素(P<0.05);多因素logistic回归分析显示,ARF发生的主要危险因素为截肢(P<0.05)。结论四肢战创伤的主要死亡原因为ARF。对肢体严重毁损、缺血坏死的患者,及时正确的处理及选择合适的截肢时机有利于降低ARF的发生率和死亡率。     

晚上喝牛奶易得结石吗

正编辑同志:我习惯每天晚上喝一杯牛奶,可最近听说晚上吃高钙食品容易得肾结石。请问:真是这样吗?某部士官陈龙陈龙同志:膳食中的钙是否会形成肾结石,首先要看自身的健康状况。如果是肾结石病人,则需要控制钙的摄入量,特别是血钙指数比较高的病人更应该严格控制;还有就是要看是什么原因导致的结石,如果是草酸结晶导致的结石则要着重控制蔬菜和面食中草酸和植酸的摄入。     

射频消融术后复发原因的临床分析

目的　对射频消融治疗各种心律失常复发原因进行临床分析总结。方法　通过 110 8例射频消融治疗病例进行回顾性总结 ,对其中 4 0例复发患者从诊断 ,消融部位 ,靶点图形 ,功率 ,即刻成功时间 ,术中是否诱发心动过速及术后心电生理情况 ,消融技术开展时间等方面进行临床分析 ,并总结其复发原因。结果　①总复发率为 3.7% ,其中AVRT3.1% ,AVN RT2 .6 % ;②对诊断复杂 ,右侧旁道 ,靶点V Q间期 <10ms ,消融功率 >2 5W ,即刻成功 >5s,消融时AV波稳定性差及术中未诱发心动过速的AVRT患者容易复发 (P <0 .0 1) ;③对消融功率 >30w才出现结性心律 ,术中未诱发心动过速及术后仍存在心房回波和A H跳跃现象的AVNRT也容易复发 (P <0 .0 1) ;④对V Q <2 0ms的PVB也易复发 ;⑤复发病例多集中在消融技术开展的第 2～ 5年。结论　诊断是否明确 ,消融靶点的掌握 ,消融部位及功率的选择 ,即刻成功时间 ,术中是否诱发心动过速及消融技术开展时间是心律失常消融治疗复发的主要原因。     

卫生板报

首先要判断伤情。是开放型伤口(有破口的),还是非开放型的?是否有皮下淤血?关节功能是否受到影响?局部是否出现肢体畸形?关节活动是否受到影响?其次是及时采取有效的急救。如果是开放型伤口,不论伤口大小,必须送医院进行治疗,并注射破伤风抗毒素。医务人员到来前,要及时止血,有条件的,可用消毒后的纱布包扎;如果没有条件,可用干净的布对伤口进行包扎,然后迅速送医院进行治疗。对于此类受伤,6～8小时是处理缝合伤口的最佳时机,千万不能耽误。如果摔伤的同时有异物刺入,切忌不要自行拔除,要保持异物与身体相对固定,送医院进行处理。如果没有出…     

家庭结构对大学生心理健康的影响

目的:了解高校中具有特殊家庭结构的大学生的心理健康状况,分析特殊家庭结构对大学生心理健康的影响,为院校心理健康教育提供参考.方法:采用UPI对分校2001～2003年入学的有特殊家庭结构的大学生的心理健康状况进行抽样调查和配对分析.结果:有特殊家庭结构的大学生90.91%可能存在心理问题需要咨询和关注;其心理健康状况远比正常大学生的心理健康状况差.结论:有特殊家庭结构背景的学生,易形成孤僻、自卑、多疑、偏激等灰暗心理,是大学生中心理问题的高危人群,应引起院校心理卫生机构的高度重视.     

氧化铝玻璃渗透陶瓷材料生物相容性的研究

目的：对研制的氧化铝玻璃渗透陶瓷材料的生物学性能进行初步评估。方法：采用体外生物学实验方法，对研制的氧化铝及Vit Inceram Alumina的溶血度进行检测。结果：两种材料的溶血度分别为0．7356％、0．441％，均低于5．0％。结论：两种陶瓷材料均不会发生溶血，被步认为具有良好的生物相容性。     

Player sensitivity to changes in string tension in a tennis racket

Forty-one advanced recreational tennis players were tested to determine their ability to detect differences in string tension in a tennis racket. Subjects were given pairs of rackets that varied in tension by up to 98 N (10 kg) and were asked whether they noticed a difference in tension and if so, which racket was strung at a higher tension. Only 11 (27%) of those tested could correctly identify a tension difference of 5 kg (11 lb) or less. Fifteen (37%) could not pick a difference of 10 kg (22 lb). To examine the importance of sound as a means of discrimination, an additional test was undertaken where participants wore earplugs. Of the 26 subjects undertaking this additional test, only 6 (23%) were successful. It was concluded that advanced recreational tennis players demonstrated limited ability to correctly identify differences in string tension and that impact sound was an important factor for those participants who were successful at various levels of discrimination.     

A tale of two CRs: hospital conducts side-by-side test

While we elected to install a digital radiography system in the busiest exam room in emergency room (ER) suite at our 535-bed hospital, we selected computed radiography as the primary platform for digital capture throughout the facility because of its flexibility, productivity and cost-effectiveness. We now use CR systems to handle six exam rooms and portable exams conducted by the radiology department, as well as imaging studies conducted in two ER exam rooms. Before committing to a CR vendor, we conducted an eight-week, side-by-side pilot study with two vendors' systems. One CR system was located in the emergency room and the other unit was located in the main radiology department. Our staff received education and training from both vendors. I led an evaluation team that included representatives from the radiology group, the information services (IS) department, biomedical engineering, staff physicians, ER physicians, pulmonologists and orthopedic specialists. Our team met to design the trial and develop a list of factors that technologists would use to evaluate the two systems. The team met after installation and again after the trial was complete to provide verbal input on each vendor for each category and to review feedback from the technologists' survey. Categories included image quality, interactions with each vendor's sales and service staff, workflow, time studies, durability of cassettes and plates, entry of John Doe patients for ER, and other factors. After the trial, we chose a system by unanimous vote. We learned a lot about CR technology throughout this process. Overall we are extremely satisfied with the platform we selected and with this method of evaluating the two systems prior to making this important decision.     

A new concept in radiology QA in a large setting

Determining film quality has traditionally been carried out through review and evaluation of exam retakes. At best, such a system will tell which exam areas the technologist repeated most. Kaiser Permanente Northwest has 80 radiologic technologists and 30 radiologists who rotate through film reading. The program developed at Kaiser is directed toward general diagnostic film quality only and uses the services of two full-time quality assurance (QA) technologists. Working together, the radiologist and QA staff have created a standard of diagnostic image quality. A QA radiologist representative is available to work with the QA technologist if inconsistencies are raised. Every other month, a QA technologist makes a random selection for review of 50 exams performed by each technologist. These evaluations cover view rather than exam, with each view judged on its own merit. The purpose is to look for recurring problems in the technologist's performance. Copies of the review sheet go to each technologist's supervisor who forwards a copy to the technologist. Technologists can request help to understand why certain films meet or fail to meet quality standards. The QA technologists are available to give one-on-one help, and they also offer classes and demonstrations. In turn, radiologist fill out quality control (QC) slips as they read exams. The slips help to educate and correct specific problems, and are a direct communication link between radiologist and technologist. The QA program places importance on having the proper tools for taking quality films. The program also provides several levels of accountability although QA technologists are not responsible for its enforcement. Instead, they give feedback to supervisors who enforce performance levels. An appeals process is also in place. The program helps keep image quality acceptable to both hospital radiologists and customer requirements in the industry. In turn, the technologists use it to further their professional development.     

Increasing radiographer productivity by an incentive point system

Because of a very low technologist productivity in their Radiology Department, the authors describe a Productive Point System they developed and implemented to solve this personnel problem. After establishing the average time required to perform all exams, point credits (one point for every ten minutes utilized) were assigned to each exam performed, thereby determining an index of production. A Productive Index of 80% was considered realistic and was the equivalent of 192 points for a 40-hour work week. From 1975 to 1978 personal productivity increased from 79% to 113%. This resulted in an average yearly fiscal savings of over $20,000.00 for this three-year period. There was also a significant improvement in exam efficiency and quality, job attitude, personnel morale, and public relations. This program was highly successful because technologist acceptance and cooperation was complete, and this occurred mainly because the system supports the normal occupational goals and expectations of technologists.     

A history and overview of the certification exam for medical dosimetrists.

During the last century, the creation and implementation of board certification has had a powerful impact on the medical community. Board certification has helped to shape the scope and practice of medical professionals and the care they provide, as well as to influence the way the health insurance industry sets standards for reimbursement. One profession that offers board certification to its members is medical dosimetry. The Medical Dosimetrist Certification Board exam has been administered since 1988 and its content covers a broad spectrum of information from the radiation therapy sciences. The exam has strict application requirements and is rather difficult to pass. Those who pass the exam can then call themselves Certified Medical Dosimetrists. For data purposes of this study, several members of the dosimetry community were solicited to participate in a survey regarding the exam's content and history, and to provide relevant statistical data. Currently 2,177 medical dosimetrists are board certified, with an additional 1,500 estimated to be working without certification. Although board certification is not currently required to practice medical dosimetry, new legislation known as the CARE Bill could change this. The CARE Bill, if passed, would mandate nationwide compulsory licensure and/or certification for medical dosimetrists and other medical professionals who want to work in radiation-related health care. Health maintenance organizations and other insurance carriers may likewise require certification for reimbursement purposes.     

Sharing De-identified Medical Images Electronically for Research: A Survey of Patients' Opinion Regarding Data Management

PurposeSecondary usage of patient data has recently become of increasing interest for the development and application of computer analytic techniques. Strict oversight of these data is required and the individual patients themselves are integral to providing guidance. We sought to understand patients' attitudes to sharing their imaging data for research purposes. These images could provide a great wealth of information for researchers.MethodsPatients from the Greater Toronto Area attending Sunnybrook Health Sciences Centre for imaging (magnetic resonance imagining, computed tomography, or ultrasound) examination areas were invited to participate in an electronic survey.ResultsOf the 1083 patients who were approached (computed tomography 609, ultrasound 314, and magnetic resonance imaging 160), 798 (74%) agreed to take the survey. Overall median age was 60 (interquartile range = 18, Q1 = 52, Q3 = 70), 52% were women, 42% had a university degree, and 7% had no high school diploma. In terms of willingness to share de-identified medical images for research, 76% were willing (agreed and strongly agreed), while 7% refused. Most participants gave their family physicians (73%) and other physicians (57%) unconditional data access. Participants chose hospitals/research institutions to regulate electronic images databases (70%), 89% wanted safeguards against unauthorized access to their data, and over 70% wanted control over who will be permitted, for how long, and the ability to revoke that permission.ConclusionsOur study found that people are willing to share their clinically acquired de-identified medical images for research studies provided that they have control over permissions and duration of access.     

The effect of quality assurance on flight nurse documentation

This study was developed to evaluate if a structured quality assurance program has an effect on nursing documentation. A randomized, retrospective audit of records was conducted from 1985 to 1989, and in November 1987, a structured QA program was initiated for flight nurses. Each chart was audited for completeness of 69 elements from seven categories: administrative information, patient history, physical exam, management plan, vital signs, medications and intravenous access. A comparison of audit results was conducted before and after the QA program was initiated. A total of 224 charts were audited, 123 before the QA program and 101 after. There was statistically significant improvement in 4 of 13 administrative, 5 of 7 history, 21 of 31 physical exam, 2 of 6 management, 2 of 2 vital signs, 0 of 4 medication, and 0 of 6 intravenous access elements. Twenty-five of 35 categories that did not show improvement had initial completion rates greater than 90 percent. The significant improvement in documentation by flight nurses after a formal QA program was initiated lead the authors to conclude that QA benefits air medical programs by providing a mechanism to improve documentation.