The organizational context of non-lethal workplace violence: its interpersonal, temporal, and spatial correlates.

This article examines 993 violent incidents involving faculty, students, and staff that occurred at a highly ranked teaching and research university and its affiliated medical center. Violent incidents were included in the sample if they involved faculty, students, or staff, regardless of their specific location or context (i.e., whether they occurred on campus and/or off-campus and whether they occurred within the context of work or some other activity). The theoretical goal of the project was to compare work-related incidents with non-work-related incidents of interpersonal violence occurring in a single, multifunctioning, and professionally hierarchical organization. Data were collected over a 7-year period from three police departments (city, county, and university), university records, and criminal history records obtained from the state police. The coding protocol was developed to capture crime-scene information pertinent to each of the incidents. This included information about the victim, the perpetrator, the relationship between the victim and perpetrator, and the violent incident. The data were examined using nonparametric statistics and logistic regression to model predictive differences between the workplace and non-workplace incidents. The results suggest that the workplace incidents of violence differ from the non-workplace incidents according to their time, victim age, degree of victim injury, and whether the workplace is a medical location. The authors conclude that these differences are better explained by the movement of people in and out of the workplace who bring societal violence with them, rather than by a category or type of workplace violence.     

Factors associated with use of community support services in an older Australian population

OBJECTIVE: To assess prevalence and risk factors associated with use of community support services in a representative older Australian population. METHODS: The Blue Mountains Eye Study surveyed 3,654 people aged > or = 49 years, 82.4% of eligible residents from an area west of Sydney during 1992-94. Questions about use of community support services were asked during face-to-face interview. Information on marital and living status, socio-economic status measures, past medical history and self-ranked health status were also collected. RESULTS: 186 (5.4%) persons including 124 women (6.3%) and 62 men (4.2%) reported regular use of community support services, including Meals-on-Wheels (n = 52), Home Care (n = 147) or visits from a community nurse (n = 63). All three services were used by 17 persons and two services by 42 persons. There was a marked age-related increase in use of services from 1.8% in persons aged < 60 years to 25.3% in persons aged 80+ years. Factors significantly associated with use of community services in a multivariate model were: age (OR 1.7 per age decade), living alone (OR 2.5), walking disability (OR 4.1), visual impairment (OR 3.0), stroke history (OR 2.2), arthritis history (OR 1.8), low perceived health status (OR 1.7), cancer history (OR 1.7) and a history of any falls in the past 12 months (OR 1.6). CONCLUSIONS: Our study has found a wide range of health-related factors that impact on the use of community support services, particularly conditions causing difficulty in walking. IMPLICATIONS: These data may assist health planners in identifying target populations for the provision of community support services.     

5%声振人血白蛋白空气微球蛋白含量测定

采用高效液相凝胶色谱法（ＧＣ－ＨＰＬＣ）、醋酸纤维膜电泳和半微量定氮法测定５０％声振人血白蛋白空气微球制剂中球壁蛋白的含量。ＧＣ－ＨＰＬＣ确证了球壁蛋白主要成分为人血白蛋白;醋酸纤维膜电泳测定空气人血白蛋白微球制剂中人血白蛋白纯度＞９０％;半微量定氮法测出球壁蛋白含量平均值为３．５６％左右,９９％正常值范围为２．５２％－４．６０％。     

Public involvement in health care priority setting: an economic perspective

Background  Public involvement in health care decision making and priority setting in the UK is being promoted by recent policy initiatives. In 1993, the British Medical Association called for public consultation where rationing of services was to be undertaken. The approach to priority setting advocated by many health economists is the maximization of quality adjusted life years (QALYs). Typically, for a particular health care programme, the QALY calculation takes account of four features: (1) the number of patients receiving the programme, (2) the survival gain, (3) the gain in quality of life and, (4) the probability of treatment success. Only one feature, that relating to quality of life, is based upon public preferences. If the QALY is to be used as a tool for health care resource allocation at a societal level then it should incorporate broader societal preferences.
Methods  This study used an interview-based survey of 91 members of the general public to explore whether the traditional QALY maximization model is a good predictor of public responses to health care priority setting choices.
Results and conclusions  Many respondents did not choose consistently in line with a QALY maximization objective and were most influenced by quality of life concerns. There was little support for health care programmes that provided a prognostic improvement but left patients in relatively poor states of health. The level of respondent engagement in the survey exercise was not sensitive to the provision of supporting clinical information.     

Diagnostic criteria for malignancy in bile cytology and its usefulness

Fifty three bile specimens from 42 patients were reviewed to assess the diagnostic role of the bile cytology and to define more reliable cytologic indicators of malignancy. Forty three bile specimens came from 34 patients with malignant biliary strictures and 10 bile specimens were from eight patients with benign conditions. There were no false positives. The diagnostic specificity of bile cytology was 100% while diagnostic sensitivity was 55.8%. Overall diagnostic accuracy was 64.2%. We identified four key criteria as cytologic indicators of malignancy among 20 variables by using multiple regression analysis: loss of honeycomb arrangement, hyperchromatism, increased N/C ratio, and coarse chromatin. When bile specimens with three or more of these four criteria are thought to represent malignancy, the sensitivity of diagnosis of malignancy was 65.2%, specificity was 90% and diagnostic accuracy was 69.8%.     

介入栓塞治疗用电解脱弹簧圈的电化学研究

本文研究了用 于介入栓塞颅内 动脉瘤的不锈 钢弹簧圈在 生理盐 水中阳 极溶解 电化 学过程, 确定 了溶断弹簧圈的 电流范围。分析 了不同材料及 表面预处理 对不锈 钢孔蚀 电位的 影响, 为电解 脱离 弹簧圈的选择提 供了依据     

灰关联聚类方法及其应用研究

本文以灰色系统理论中的关联分析方法为基础,建立了评价医院的聚类方法,并应用该方法对某市地区十一所医院的经营效益和管理水平进行了评价分析,获得较高的信度和效度。     

胰腺癌 P16、 P53及 PCNA 的表达及其临床意义

目的：研究胰腺癌中 Ｐ１６和 Ｐ５３基因产物的表达及其临床意义。方法：应用免疫组化 Ｌ Ｓ Ａ Ｂ法研究２８例胰腺癌组织中 Ｐ１６蛋白和 Ｐ５３蛋白的表达情况,并进行增殖细胞核抗原（ Ｐ Ｃ Ｎ Ａ）检测,计算细胞增殖指数（ Ｐｒｏｌｉｆｅｒａｔｉｏｎ ｉｎｄｅｘ, Ｐ Ｉ）。结果： Ｐ１６蛋白低表达和 Ｐ５３蛋白过表达均有促进胰腺癌细胞增殖的作用。 Ｐ１６蛋白表达与淋巴结转移无关; Ｐ５３蛋白高表达者具有较高的淋巴结转移率,预后较差。 Ｐ１６蛋白低表达与 Ｐ５３蛋白高表达共存者,其恶性度最高,预后最差。结论：联合检测 Ｐ１６和 Ｐ５３蛋白表达情况,更能充分反映胰腺癌的生物学行为,对胰腺癌患者预后判断及临床治疗有指导意义。     

脂质过氧化在肺炎衣原体促进巨噬细胞泡沫化过程中的作用

目的：探讨肺炎衣原体（ Ｃｐｎ） 促进 Ｃ５７ Ｂ Ｌ／６ Ｊ 小鼠腹膜巨噬细胞泡沫化的机制。方法：取 Ｃ５７ Ｂ Ｌ／６ Ｊ小鼠腹膜巨噬细胞培养２４ ｈ 让其贴壁后分为对照组、 Ｌ Ｄ Ｌ 组和 Ｌ Ｄ Ｌ 加 Ｃｐｎ 组３ 组培养,然后测反应液中自由基、 Ｍ Ｄ Ａ 及 Ｓ Ｏ Ｄ 含量。结果：反应液中自由基、 Ｍ Ｄ Ａ、 Ｓ Ｏ Ｄ 含量 Ｌ Ｄ Ｌ 加 Ｃｐｎ 组比 Ｌ Ｄ Ｌ 组高,存在显著性差异。结论：脂质过氧化是肺炎衣原体促进巨噬细胞泡沫化的机制之一。