某市三级甲等医院重大节假日急诊就诊情况分析

[目的]对某市重大节假日急诊就诊情况进行分析,为有关部门决策提供科学依据. [方法]通过对2000～2005年重大节假日期间急诊就诊登记的22014例资料进行分析,揭示发病的年龄、性别和昼夜时间的分布规律以及疾病构成梯次.[结果]急诊就诊的男性病例普遍多于女性,并且10岁以下年龄组就诊人数居多;其中.发热、外伤及腹痛是最为常见的就诊原因;每日的午后至凌晨存在"驼峰型"分布的就诊高峰期. [结论]探讨重大节假日期间急诊就诊情况,有助干急诊工作的改进,合理调配卫生资源.     

Holidays,ozone and skin cancer

Summary The estimates of a dose-response model for human skin cancer (non-melanotic) incidence have been compared with the observed records for the Bristol area over the period 1952–1972.In general the model appears to respond more slowly than the real population. The trend of the model expectations agrees qualitatively with the observed data and correlation of annual incidences, although negligible in the first decade, is very good in the second (corr. factor=0.74).The results indicate that an increase of 1% in dose might eventually lead to an increase of between 2% and 3% in skin cancer incidence.     

Christmas and New Year as risk factors for death

This paper poses three questions: (1) Does mortality from natural causes spike around Christmas and New Year? (2) If so, does this spike exist for all major disease groups or only specialized groups? (3) If twin holiday spikes exist, need this imply that Christmas and New Year are risk factors for death? To answer these questions, we used all official U.S. death certificates, 1979–2004 (n = 57,451,944) in various hospital settings to examine daily mortality levels around Christmas and New Year. We measured the Christmas increase by comparing observed deaths with expected deaths in the week starting on Christmas. The New Year increase was measured similarly. The expected number of deaths was determined by locally weighted regression, given the null hypothesis that mortality is affected by seasons and trend but not by holidays. On Christmas and New Year, mortality from natural causes spikes in dead-on-arrival (DOA) and emergency department (ED) settings. There are more DOA/ED deaths on 12/25, 12/26, and 1/1 than on any other day. In contrast, deaths in non-DOA/ED settings display no holiday spikes. For DOA/ED settings, there are holiday spikes for each of the top five disease groups (circulatory diseases; neoplasms; respiratory diseases; endocrine/nutritional/metabolic diseases; digestive diseases). For all settings combined, there are holiday spikes for most major disease groups and for all demographic groups, except children. In the two weeks starting with Christmas, there is an excess of 42,325 deaths from natural causes above and beyond the normal winter increase. Christmas and New Year appear to be risk factors for deaths from many diseases. We tested nine possible explanations for these risk factors, but further research is needed.     

Epidemiology and severity of paediatric burn injuries occurring during camping and caravanning holidays

Background

Due to its unique location, the South West England Paediatric Burns Service based in Bristol admits an interesting cohort of holiday-makers, who have sustained their burns whilst on camping and caravanning holidays.

Aim

We aimed to establish whether burns sustained during camping and caravanning holidays are more severe and require more extensive intervention compared to burns sustained in other situations.

Methods

We undertook a retrospective, observational study of admissions to the South West Paediatric Burns Service between June, and August from 2003 to 2005. Our primary outcome was to assess the severity of the burns as defined by percentage total body surface area of partial and full thickness burns. We used secondary outcomes of indirect indicators of burn severity: length of hospital stay, number of general anaesthetics, and need for surgical debridement, artificial skin dressing and/or skin grafting. Analysis of the data was undertaken using Mann–Whitney test, Fisher's exact test, and Chi-squared test.

Results

151 patients were included in the study, 30 (20%) of which were campers. Our results show that burns sustained during camping and caravanning holidays are significantly more likely to be of larger surface area than burns sustained in other environments. Campers’ burns also required more frequent surgical intervention (in 87% versus 66%) and had longer inpatient admissions (5.3 days versus 3.8 days).

Conclusions

Our results have implications for clinicians and campsite owners. Access to free flowing water is often not immediately available on campsites and time taken to reach the nearest Emergency Department is often prolonged with a further delay before reaching the tertiary centre. The general public needs to be aware of the risks of burn during camping and caravanning holidays. Campsite owners should consider improving first aid facilities and clinicians need to be aware of the need for early referral and timely transfer to tertiary facilities.     

某高校医学生假期日常行为调查

目的了解医学生日常行为,为医学生今后假期学习生活提供指导,增强医学生自主学习能力。 方法以河北某医学院的医学生为调查对象,调查其基本情况、睡眠状况、学习情况、娱乐及运动情况,随机抽取本科生及硕士生共960人。 结果（1）假期期间仅8.12%的医学生睡眠质量差,且硕士生明显多于本科生,本科生的睡眠障碍得分高于硕士生,硕士生的入睡时间、睡眠时间得分明显高于本科生;（2）硕士生假期自主学习的能力优于本科生,硕士生的自我效能、学习控制、学习意义、制定学习计划及学习评价得分明显高于本科生;（3）医学生主要通过电子设备学习专业知识,本科生多通过书籍（83.43%）及观看相关教学视频（72.93%）学习,硕士生学习专业知识的途径多为文献阅读（78.46%）及论文撰写（56.15%）,硕士生学习专业性突出;本科生英语学习多为背单词（80.63%）,硕士生以英文文献阅读（59.62%）为主;78.44%的医学生按时听网络直播课程,其中51.39%的学生认为其效果不如课堂授课;（4）58.13%的医学生每天使用电子设备娱乐时间超过4 h,不同年级间无明显差异;（5）每日运动时间超过30 min的医学生占22.19%,其中硕士生明显多于本科生。 结论假期医学生睡眠质量一般,硕士生的睡眠质量明显差于本科生。硕士生假期自主学习能力优于本科生;本科生、硕士生对于专业知识和英语学习重点不同。本科生及硕士生每日使用电子设备娱乐时间均较长。每日运动时间超过30 min的硕士生明显多于本科生。