Sick Building Syndrome. III. Stachybotrys chartarum

Increasingly, physicians are being asked to evaluate patients with putative environmentally associated illnesses. These can include a variety of problems, including infectious illnesses (Legionnaire's disease), chemical exposure in the workplace, and sick building syndromes. The latter has been an issue particularly in asthma because of the association of mold and increased bronchial responsiveness. Recently, attention has been focused on the mold Stachybotrys in human disease. Stachybotrys was first identified more than 60 years ago following an epidemic of stomatitis, rhinitis, conjunctivitis, pancytopenia, neurologic disorders, and death in horses. Since then, Stachybotrys has been identified in several outbreaks of disease in animals. It has also attracted attention as a possible agent in idiopathic pulmonary hemorrhage in infants. Stachybotrys is a relatively uncommon fungus but has been isolated from a variety of sources, including contaminated grains, tobacco, indoor air, insulator foams, and water-damaged buildings with high humidity. This fungus is particularly important because it is one of a series of fungi that produces trichothecenes mycotoxins; these mycotoxins are biologically active and can produce a variety of physiological and pathologic changes in humans and animals, including modulation of inflammation and altered alveolar surfactant phospholipid concentrations. The presence of Stachybotrys in a building does not necessarily imply a cause-and-effect relationship with illness, but should alert physicians and healthcare professionals to do more vigorous environmental testing. Guidelines are presented herein for intervention measures in the maintenance of heating, ventilation, and air-conditioning systems.     

医院建筑创意的黏性——以两家医院设计实践为例

介绍了创意黏性这一概念,并通过两家医院建设实践案例,阐述了创意产生黏性的原则及在医院建筑设计创作中的应用,赋予了医院建筑作品灵魂.     

高校附属医院文化建设和党建工作的关系研究

断发展,我国卫生管理体制改革也不断深入,在此过程中,对于高校附属医院文化建设和党建工作提出更高水平的要求.从医院层面来看,通过加强文化建设以及发展党建工作,能够有效提高医院的凝聚力,促进医院树立良好的形象、培养优秀的医护人员等.文化建设和党建工作息息相关,在医院管理与发展的过程中,两者之间相辅相成.文章在研究的过程中,...     

Exposure to 17α‐ethinylestradiol decreases motility and ATP in sperm of male fighting fish Betta splendens

The synthetic estrogen 17α‐ethinylestradiol (EE2) is an endocrine‐disrupting chemical released into aquatic environments from sewage treatment facilities. We tested the effects of two environmentally relevant concentrations of waterborne EE2, 10 and 100 ng L^?1, on reproductive endpoints in the teleost fish Betta splendens. In the first experiment, testes were removed from males and sperm were exposed to EE2 directly through the activation water. Direct exposure to EE2 had no effect on any measure of sperm swimming performance. In the second experiment, we exposed sexually mature male B. splendens to EE2 using a semi‐static exposure protocol for 4 weeks. There were no significant treatment effects in the 10 ng L^?1 treatment group, but at the 100 ng L^?1 dose we found that fish had smaller gonads and reduced sperm swimming velocity. When allowed to interact freely with female conspecifics, males exposed to 100 ng L^?1 EE2 built smaller nests and showed a nonsignificant decrease in fertilization success. To investigate further the potential mechanism underlying the decrease in sperm quality, we repeated the chronic exposure experiment and analyzed the ATP content of sperm from fish in each treatment group. We found that males exposed to 100 ng L^?1 of EE2 had fewer moles of ATP per sperm than did fish in the other two treatment groups, suggesting that a decrease in intracellular ATP caused a reduction in sperm swimming velocity. The current study adds to the growing body of literature that indicates the risks to aquatic organisms of exposure to environmentally relevant concentrations of EE2. © 2012 Wiley Periodicals, Inc. Environ Toxicol 29: 243–252, 2014.     

Family-centered Care for Sick Newborns: A Thumbnail View

Family-centered care (FCC) for sick newborns is emerging as a paradigmatic shift in the practice of facility-based newborn care. It seeks to transforming a provider-centered model into a client-centered one and thus build a new therapeutic alliance. FCC is the cornerstone of continuum of care, imparting caregiving competencies to parents/caregivers both within institutions as well as after the discharge. This has potential gains for the newborn, family members, and facility-level staff. The initial model piloted in tertiary-care settings is now undergoing translation at five sites across the country; the outcomes are keenly awaited.     

116所军队三级医院官方网站建设调查

目的通过分析116所全国各地区军队三级医院网站建设情况,提出加强网站建设质量对策。方法拟制调查问卷,使用搜索引擎检索直接访问医院主页进行定性评价,对评价结果进行统计分析。结果存在建站率低、互动性滞后、可信度不高、缺乏信息维护和推广机制、布局和功能设计与实际需求脱节等问题。结论认识网站重要作用,提升网站建设水平;增强交互性内容,实现人性化功能服务;规范信息维护机制,保证信息有效准确;充实网站平台内涵,突出专科特色优势;以信息需求为根本,构建主动服务模式。     

上海市社区临床药师能力提升模式与建设现状

本文从药政管理角度对社区临床药师能力提升模式与建设现状进行总结,以期为进一步优化社区临床药师培养模式提供思路.上海市社区临床药师专业能力提升思路主要从专项培训和结对帮扶两个角度开展工作.目前在社区临床药师数量与素质、执业能力上均有明显改善与提升,逐步形成具有特色的药学联盟和家庭药师服务,但社区临床药师发展仍面临着服务提...     

β-烷基胺基酮类化合物高效液相色谱参数logk'的测定

本文报导了β-烷基胺基酮类化合物HPLC参数logk'的测定方法。简述了logk'与logP的线性关系。经此法间接测得的logP与π加和法估算的logP值相近,结果令人满意。HPLC参数logk'的测定为药物定量构效关系(QSAR)的研究提供一个快速而有效的参数信息。     

The application of the parallel track model in community health promotion: a literature review

The parallel track model is one of the several models that are used in health promotion programmes that focus on community empowerment. It is unique in that it explicitly incorporates an empowerment approach with a top‐down health programme. Since its development in 1999–2000 the model has been used in various health programmes in both developed and developing countries. The aim of this review is to examine the nature and extent of the application of this model and its contribution to promoting health. A review of the literature published between 2000 and 2011 was conducted. Nine results matched the inclusion criteria and revealed that the model has been mostly applied to disadvantaged communities to address health determinants, such as poverty and health literacy. This review found that the model had a positive impact on specific health outcomes such as health literacy and community capacity. We concluded that the parallel track model has the most potential for building capacity for community health promotion and appears to be the least useful for interventions focusing on health behaviour change within a limited time frame.     

Australia

In the context of Australia's land, people, and turbulent social history, this article explores the Australian health care system, the health issues of Aboriginals, and the role of the social worker in health care.