National Survey of Korean Dentists' Knowledge and Opinions: Dental Caries Etiology and Prevention

Objectives : Dentists have the potential to influence what their patients know and do regarding dental caries prevention. The practices of dentists and what they tell their patients are influenced, in part, by their own knowledge and opinions. The purposes of this study were to determine the level of knowledge and opinions about caries etiology and prevention among Korean dentists and to describe related factors. Methods : A pretested, 27-item questionnaire was mailed to 2,047 dentists, selected by a stratified random sampling allocated proportionately. A postcard reminder was sent to all dentists after one week. Nonrespondents were sent additional complete mailings after three, seven, and nine weeks. The response rate was 83 percent (n=1,700 dentists). Results : Analysis of six factors thought to be related to knowledge about caries etiology and prevention showed that recent graduates and dentists who worked in public health centers were likely to be more knowledgeable about caries etiology and prevention than their counterparts (P<.05). In regression analysis of perceived effectiveness of caries-preventive procedures for children, recent graduates, males, and dentists who worked in public health centers tended to rate caries-preventive procedures more effective than other dentists (P<.05). Dentists who had experience with school-based preventive programs and dentists in rural areas were likely to rate caries-preventive procedures for adults more effective than other dentists (P<.05). Conclusion : Overall, results of this study suggest that the majority of dentists do not know current information concerning etiology and prevention of dental caries, mechanisms of action of fluoride, and effectiveness of preventive procedures for children and adults. Efforts to enhance the level of knowledge and practices of Korean dentists about caries prevention should focus on strategies to educate older graduates and female dentists, especially those in private practice.     

A computerised bronchoscopy database providing reporting and auditing facilities

The bronchoscopy reporting and auditing procedure has been computerised using dBASE IV software on a portable microcomputer and printer system. Although entering the data into the computer tends to prolong the reporting procedure slightly, the additional effort is rewarded by a more comprehensive, attractive and accurately documented report; together with rapid access to correct clinical and medical audit statistics. The ease of access to the patient data is proving useful at clinical review meetings and in the production of quality assurance statistics of operator technique.     

运动性蛋白尿及其类型的强度依赖性

本文研究探讨了不同强度负荷(50%,70%,90% VO_(2max))跑台运动后尿总蛋白(TP)及其各组份白蛋白(Alb)、β_2—微球蛋白(β_2—mG)、溶菌酶(Lys)、淀粉酶(Amy)、乳酸脱氢酶(LDH)、磷酸肌酸激酶(CPK)排泄率变化及尿蛋白各组份排泄率与HR、LA.VO_2、%VO_(2max)的相关性;运动性蛋白尿类型与运动强度的依赖性;观察了运动强度对肾小球滤过选择性和肾小管重吸收功能某些指标的影响。结果表明不同强度运动后即刻尿蛋白排泄率不同;当LA≥5.4mmol.L~(-1)时上述各组份排泄率才有显著增加;其中β_2—mG和Lys排泄率是指示大强度运动灵敏的生化指示;TP、Alb、β_2—mG、Lys、LDH与各强度指标均呈指数函数相关;Alb/TP与HR、LA、VO_2呈直线相关。HPLC研究表明中大强度运动后SI有显著下降(P<0.05);大强度运动后β_2-mG/Alb排泄率显著增加。小到中等强度运动后尿蛋白呈肾小球型,大强度运动后呈肾小球—肾小管混合型。     

A 3-month survey of enteral tube feeding and parenteral feeding: a baseline for improvement

This paper presents the results of a 3-month survey of tube feeding and parenteral nutrition in hospital in-patients, undertaken to provide information for the development of guidelines by the Hospitals Nutritional Advisory Group and a baseline for future monitoring. This represents the first steps in the audit cycle. The results highlighted the following problems.

• 1. 

  Total parenteral nutrition is often continued after bowel sounds have returned.
• 2. 

  Enteral tube feeding is often instituted for only a very short period of time and may be of little nutritional benefit to the patient.
• 3. 

  Significantly lower amounts of energy and nitrogen are received by the patients in the enterally tube-fed group than is indicated by their estimated energy and nitrogen requirements.
• 4. 

  The medical staff noted the start of feeding in 60% of the case notes, however, the aims of feeding and the reason for commencing feeding were never documented. Nutritional aims were defined in the case notes by dietitians for all tube-fed and 18 of the 20 patients who were parenterally fed.

     

人类与病毒共存和斗争的历史: 我国人民卫生健康基本状况

人类社会的发展历史，就是一部人类与病毒不断抗争，并通过知识创新和技术进步战胜各种病毒的历史；建国50余年的历史，也是一部不断战胜传染病魔的历史，且仅用占世界很小比重卫生支出有效地提高了中国近13亿人口的健康水平。因此，我们应辩证地、历史地面对SARS给中国带来的巨大冲击，并正确对付和处理好这场危机。     

From research and development to practice-based evidence: clinical governance initiatives in a service for adults with mild intellectual disability and mental health needs

Background Practice‐based evidence represents the contribution of practitioners who utilize research methodologies to examine the quality of their clinical practice and service provision. Methods The present paper describes the evolution of a routine practice‐based evidence system (PBES) via four phases of research and development. The four phases are described, as is their relevance to assessment and intervention with regard to the mental health problems of people with mild intellectual disability. Phase four describes the development of a routine PBES. Results The PBES is capable of profiling the individual mental health needs of service users and examining service effectiveness and quality at an organizational level. Conclusions The PBES is discussed according to its current utility and possible directions for future development. The system is presented as an example of clinical governance that could be utilized by multidisciplinary teams to develop and maintain an organizational culture of quality.     

INITIAL PARATHYROID EXPLORATION: CURRENT TRENDS IN AUSTRALIA

Background: An Australia-wide multicentre prospective study was undertaken to audit cases of initial parathyroid exploration between 1 January and 31 December 1992. One hundred and sixty-two cases were audited. The audit was designed to study pre-operative biochemical assessment, localization techniques and the technique of exploration. Method: A pro forma audit form was circulated to all Australian surgeons known to perform parathyroid surgery. Eleven responded. Results: Free serum ionized calcium (iCa) was measured in 30% of cases, with the majority of pre-operative calcium assays being performed using total serum calcium (tCa). In 40 cases (29%) pre-operative localization techniques were used. These proved inaccurate in 10 cases. The intra-operative technique of localization with methylene blue infusion was used in 11% of cases. All four glands were biopsied in 11 % of cases. No deaths were reported and a postoperative morbidity rate of 3.1 % was noted. Eighty-eight per cent of patients were discharged within 5 days of surgery with a third going home within 48 h of neck exploration surgery. Only one patient (0.6%) required re-exploration for persistent hypercalcaemia due to a second adenoma. Conclusions: The surgical treatment of hyperparathyroidism can be regarded as safe, with minimum morbidity in experienced hands. Pre-operative localization studies in initial parathyroid exploration are not indicated.     

张謇与晚清社会变迁

作为近代中国的杰出人物，张謇在晚清社会变迁中充当了重要角色。他由实业而教育，由教育而政治。几乎参与了晚清社会的重大活动。无论是甲午战争，戊戌变法，还是“东南互保”，清末宪政，抑或辛亥革命，乃至民主共和政治的创建、清帝退位等等，无不看到他的身影和他所起的重大作用。他追踪时代’，顺应潮流，与时俱进，致力于谋求民族独立，国家富强，社会进步。不失为近代中国的一位爱国政治家。张謇的人生事业是近代社会变迁的留痕，带有强烈的民族特性。他的政治理念及其实践活动直到今天仍不失其借鉴和启示。