嘉兴外来人员生活环境与肠道传染病相关知信行现况调查分析

目的了解城郊结合部外来人员聚集地生活环境现况和霍乱等肠道传染病健康知信行情况,进一步明确肠道传染病防治健康教育与健康促进工作的重点开展方向。方法采用随机抽样的方法,运用统一设计的调查问卷对嘉兴市5县2区城郊结合部等外来人员聚集地进行流行病学调查。结果93.06%的调查对象以租房为主,90.61%的生活用水来源于自来水,9.25%用井水;78.61%的人知道霍乱传播途径,21.53%的人知道霍乱主要临床症状,28.03%的人知道肠道传染病全部预防措施;77.31%的知识来源于电视,其他顺位依次为书刊、广播、家人或朋友处;希望获得宣传资料形式:传单占46.68%,墙报占31.21%。结论外来人员租房人数居多,有部分人使用井水;肠道传染病相关知识了解的较少。应采取多部门齐抓共管来改善外来人员聚集地的生活环境,因地制宜地对外来人员开展有针对性的预防肠道传染病健康教育。     

少数民族女大学生性与避孕行为调查

目的:了解少数民族女大学生性与避孕行为状况。方法:在武汉地区,对各大学的少数民族女大学生进行了抽样调查。结果:调查了286名少数民族女大学生,其性行为率为14.68%,不同专业和不同年级的女大学生性行为率有统计学差异。女大学生性行为的原因以一时感情冲动、好奇、为了加强与男友的关系、生理需要为主,还有迫于暴力等原因。性伴侣以自己的男朋友为主(占95.23%以上),但也有一般熟人和一夜情对象;另有多性伴现象存在。发生性行为者中,初次性行为有42.85%未采取任何避孕措施;在近1年内有性行为者中,有54.54%的人每次性行为都采取了避孕措施。在性行为者中,有23.81%的学生怀孕,另有19.05%的学生患生殖系统炎症或性病。结论:少数民族女大学生中的性行为发生率较高,她们中存在性滥、怀孕和性传播疾病等问题。     

Demand patterns for HIV-tests in general practice: Information collected by sentinel networks in 5 European countries

This study describes a p. year international data collection on the demand pattern for HIV-antibody tests in general practice recorded by 6 sentinel networks in 5 European countries. The purpose of the recording was to evaluate the use of HIV-antibody testing by general practitioners and the demand for testing among the general population. Sentinel networks of general practitioners are a possible and available instrument for monitoring the perception of the HIV-test, and indirectly of the threat of the HIV-epidemic by the public and by the general practitioners (GPs). Differences were found between the countries in the frequency of testing, the person asking the test and the reason for testing. Possible explanatory factors, such as differences in the routine testing of specific groups, differences in the training and in the role of the GP, differences in the characteristics of prevention policy, are discussed. The European comparison also offers the opportunity to reflect on common medical practice in dealing with demands for HIV-tests.     

元认知能力在医学生临床实习中的培养

元认知能力在医学生临床实习过程中起着非常重要的作用。培养医学生的元认知能力 ,必须丰富医学生的元认知知识 ,强化医学生的元认知体验 ,促进医学生加强元认知监控 ,从而使他们成为独立自主、有创造力的学习者。     

Learning and retention of movement sequences in Parkinson's disease.

The purpose of this study was to examine motor learning and retention given extensive practice in two fundamentally different movement sequences. One sequence was a memory-driven task (performing a series of whole body positions from memory) and the other a context-driven task (buttoning). Practice took place over 3 weeks, with performance measured weekly; retention was measured weekly for 3 weeks after practice. There were 7 people with Parkinson's disease (PD) and 7 age-matched neurologically healthy people who participated in this study. Both groups improved performance on both tasks with practice, with the majority of the change for the PD group occurring between 1 and 2 weeks of practice. Although those with PD did not necessarily perform as well as age-matched controls, they learned both sequences in a manner similar to age-matched controls, and exhibited retention across the 3-week retention interval. If people with PD are given sufficient practice they can learn and retain both memory-based and context-driven movement sequences as well as age-matched controls. The results provide support for maintaining physical activity and for intervention through movement therapy.     

Routinely collected general practice data aids identification of people with hyperglycaemia and metabolic syndrome.

AIMS: To assess the performance of a risk score comprising data routinely available in general practice records (age, gender, body mass index, family history of diabetes, smoking habits and prescribed anti-hypertensive drugs or steroids) in detecting diabetes, impaired glucose tolerance and metabolic syndrome. METHODS: In a population-based, cross-sectional study in a semi-rural general practice in Jutland, Denmark, Cambridge Risk Scores were calculated for 1355 patients without known diabetes (69% response rate) who completed questionnaires and underwent anthropometric measurement and an oral glucose tolerance test. RESULTS: Prevalences of diabetes, impaired glucose tolerance and metabolic syndrome were 2.29% (95% CI: 1.56-3.23), 6.64% (95% CI: 5.38-8.10) and 13.4% (95% CI: 11.5-15.2), respectively. Area under the ROC curve for the risk score and diabetes was 83.8% (75.9-91.7) and for metabolic syndrome [European Group for the Study of Insulin Resistance (EGIR)] was 78.1% (74.6-81.6). Twenty per cent of the population had a risk score above 0.246; at this threshold the sensitivity to detect diabetes was 71.0% (53.4-83.9), the specificity 81.2% (79.0-83.2), positive predictive value 8.1% (6.6-10.0) and likelihood ratio 3.77 (2.94-4.85). For metabolic syndrome (EGIR) corresponding values for sensitivity were 50.3% (43.1-57.5), specificity 84.7% (82.5-85.6), positive predictive value 33.6% (28.2-39.4), and likelihood ratio 3.28 (2.69-4.00). CONCLUSIONS: Undiagnosed hyperglycaemia and metabolic syndrome are common. The Cambridge Risk Score is a practical first step in a screening procedure to identify individuals with these disorders who might benefit from diagnostic testing or to direct preventive interventions.     

Day-to-day variations in serum iron,serum iron binding capacity,serum ferritin and erythrocyte protoporphyrin concentrations in anaemic subjects

Day-to-day variations in serum iron, serum iron binding capacity, serum ferritin and erythrocyte protoporphyrin were determined on 2 successive days in 48 patients with anaemia. The correlation coefficients between the paired determinations were 0.86, 0.89, 0.95 and 0.95, and the day-to-day coefficients of variation (in per cent) were 33, 11, 12 and 13 for serum iron, serum iron binding capacity, erythrocyte protoporphyrin and serum ferritin, respectively. Thus, in patients with anaemia, day-to-day variations in serum iron, serum iron binding capacity, erythrocyte protoporphyrin and serum ferritin are at least as high as in healthy controls. The results indicate important limitations in the use, particularly, of serum iron in the clinical investigation of anaemia.     

Physician assistants in academic radiology: the harborview experience

We describe a model of how physician assistants can be used in an academic medical center to expand radiologist productivity, and to enhance the departmental academic and educational missions. At Harborview Medical Center, following a training program and graduated responsibility under supervision, physician assistants provide initial interpretation of radiology studies, consultation to referring physicians, and perform less complicated interventional procedures. Acceptance of physician assistants by the radiologists, radiology residents, and referring physicians has been high. Although the impact of physician assistants on departmental clinical productivity is difficult to measure, our data suggest that radiologists are more efficient when physician assistants are assigned to service, both in terms of numbers of studies interpreted, and timeliness of reporting and billing. As a result of the success of our program, we believe that physician assistants can have an important role in radiology practice.     

Practice standards for optometry and optometric practice accreditation

Background: To assist optometrists to deliver care more efficiently and effectively, in 1995 Optometrists Association Australia decided to develop standards that would assist optometrists in better managing their practices. Existing practice management standards for health professionals were thought to be either not specific enough for optometric practice or to have shortcomings in the context of optometric practice in Australia. Methods: Following a literature search, material previously developed by Optometrists Association Australia to assist practitioners with management of their practices and standards from other professions were used to assist with the development of a draft set of standards for optometric practices in Australia. Successive drafts were circulated for comment to optometrists in practice, non‐optometrists with experience in the development of practice standards for other health professions and to Australian General Practice Accreditation Limited. The comments were used to refine the standards and the accreditation guidelines to their final form. Results: Optometric Practice Standards suitable for use in a practice accreditation program were developed. The standards comprise seven sections—Practice administration, Quality assurance, Rights and needs of the patient, Practice services, Practice facilities, Communication and Patient records. These sections are divided into criteria that provide the detail of the requirements of the standard. Indicators describing how criteria can be assessed accompany the criteria.