OUTCOMES OF ORDINARY HOUSING SERVICES IN WALES: OBJECTIVE INDICATORS

Outcome data were collected on fourteen, recently provided staffed houses for people with mild, moderate, severe or profound learning disabilities in order to assess the quality of service provided. Quality indicators reflected the quality of the housing provision, social and community integration, social relationships within the houses, resident engagement in activity, developmental progress over time and opportunities for autonomy and choice. The data show that the quality of the houses investigated was broadly similar to that reported for other housing services in British research which has accompanied deinstitutionalisation. Quality levels on many indicators were related to the ability of residents and the data illustrate the difficulty in providing services for people with more severe or profound learning disabilities, which are capable of achieving outcomes comparable with those attained in services for more able residents. This research provides further evidence that the extent of staff support for resident activity is critical to how much residents are able to participate fully in the everyday activities which arise in the conduct of their lives.     

我国实施基本公共卫生服务项目的效果分析

目的完善基本公共卫生服务项目,促进基本公共卫生服务均等化。方法采用资料收集法,对6省基本公共卫生服务项目的完成率、实施效果得分、项目组织管理得分进行评测。结果基本公共卫服务项目的完成情况各省差别较大,6省实施效果和项目组织管理的平均得分分别为18.9分和9.2分。结论基本公共卫生服务项目的开展改善了基本公共卫生服务的公平性,进一步提高了群众的健康水平。     

THE EFFECT OF RHEUMATOID FACTORS AND OF ANTIGLOBULINS ON IMMUNE HEMOLYSIS IN VIVO

Studies were undertaken in man and in the rat comparing the effects of rheumatoid factors and immune antiglobulins on red cells sensitized with incomplete antibodies. The interaction of immune antiglobulins with sensitized red cells produced (a) agglutination in vitro and (b) an accelerated sequestration of the sensitized cells in vivo. In contrast, rheumatoid macroglobulins, although capable of agglutinating Rh-sensitized red cells in vitro, did not modify their destruction in vivo. The failure of rheumatoid factors to function as antiglobulins in vivo appears to reflect their non-reactivity with sensitized cells in whole serum. It is suggested: (a) that the native (7S) gamma globulins of plasma competitively inhibit rheumatoid factors from reacting with fixed antibody in the blood stream; (b) that if these macroglobulins do indeed have pathogenetic activity, this may be limited to body fluids of low protein content.     

异丙酚与咪达唑仑用于胃窥镜检查术的临床观察

目的：研究三种不同给药方法在纤维胃镜中的镇静作用及对循环呼吸的影响。方法：选择自愿接受门诊无痛胃镜的患者如例(ASAⅠ—Ⅱ级)，随机分为3组：A组(异丙酚2mg／kg)，B组(咪达唑仑0．08mg/kg)，C组(异丙酚1．2kg／kg 咪达唑仑0．04mg/kg)各30例。观察术中HR，MAP，Spo2及镇静分级、苏醒时间、术中不适、记忆缺失、自我感觉等情况。结果：MAP，SpO2下降(注药后l一3min)A组与B，C两组比较有显著性差异(P＜0．05);C组MAP(注药后l-3min)虽有下降趋势，但与B组比较无显著性差异(P＞0．05)。镇静分级、苏醒时间、记忆缺失、术中不适及自我感觉A，C两组组问无差异，但均明显优于B组(P＜0．05)。结论：异丙酚1．2mg／kg，复合咪达唑仑0．04mg／kg用于胃窥镜检查是安全有效的。     

THE EFFECT OF AMINOMETHYLPTEROYLGLUTAMIC ACID ON THE DEVELOPMENT OF SKIN HYPERSENSITIVITY AND ON ANTIBODY FORMATION IN GUINEA PIGS

1. In guinea pigs, aminomethylpteroylglutamic acid (methotrexate) is capable of blocking the development of delayed skin hypersensitivity, the primary antibody response, and the specific febrile response to ovalbumin and diphtheria toxoid. The primary antibody response is more easily inhibited than is the development of delayed skin hypersensitivity. 2. The effect of methotrexate on immunologic responses depended upon the dose of methotrexate employed and the strength of the antigenic stimulus.     

THE EFFECT OF HEMATIN ON THE CIRCULATION AND RESPIRATION

1. Doses of less than six milligrams of hematin and, under certain conditions, larger doses may cause a slight rise of blood pressure. 2. Large doses of hematin cause a profound and prolonged fall of blood pressure. The principal factor in this fall of blood pressure is the marked dilatation of the splanchnic vessels. The splanchnic dilatation either does not occur at all or but very slightly if the splanchnic nerves are cut. The splanchnic dilatation is partly compensated for by a marked constriction of cutaneous vessels and it seems probable that the cutaneous constriction is active and not simply passive to the splanchnic engorgement. 3. Hematin acts upon the cardio-inhibitory center causing a marked slowing of the rate of heart-beat, and in large doses produces a typical vagal pulse or even marked irregularities in the amplitude and rhythm of the pulse. Under hematin the heart at first shows great loss of tone but later the tone increases beyond the normal. The cardiac output for a time is greatly diminished. 4. In the large doses employed by us, hematin depresses the respiratory center and death under hematin is due to paralysis of this center.