以培养目标定位医学生核心能力标准

根据社会需要，以Bloom教育目标分类理论为指导，研究和制定医学生培养目标在世界医学教育界日益广泛受到重视。国际医学教育组织以医学生培养目标定位，制定了“全球医学教育最基本要求”的医学生核心能力标准。     

受教育程度和职业对80后新生代生育子女数量的影响

目的:了解受教育程度和职业对80后新生代生育孩子数量选择的影响。方法:按照学历教育和职业分类,分析各学历和职业人群意愿生育孩子数量构成。结果:不同受教育程度者打算不要孩子比例有明显差异(χ2=84.80,P<0.01);意愿生育多子女(≥3个)的比例也有差异(χ2=69.42,P<0.01)。不同职业者打算不要孩子的比例有差异(χ2=95.44,P<0.01),意愿生育多子女(≥3个)的比例没有差异(χ2=10.88,P>0.05)。不同学历和不同职业人群均不愿意多生育孩子,96%以上的调查对象认为生育1～2个孩子为好,意愿生育2个孩子者多于生育1个者(10%)。打算不要孩子和多要孩子的均以高学历的研究生居多,分别占4.12%和4.84%。结论:受教育程度和职业对80后新生代生育子女数量选择的影响已逐渐降低。     

Foot‐and‐Mouth Disease in Tanzania from 2001 to 2006

Foot‐and‐mouth disease (FMD) is endemic in Tanzania, with outbreaks occurring almost each year in different parts of the country. There is now a strong political desire to control animal diseases as part of national poverty alleviation strategies. However, FMD control requires improving the current knowledge on the disease dynamics and factors related to FMD occurrence so control measures can be implemented more efficiently. The objectives of this study were to describe the FMD dynamics in Tanzania from 2001 to 2006 and investigate the spatiotemporal patterns of transmission. Extraction maps, the space‐time K‐function and space‐time permutation models based on scan statistics were calculated for each year to evaluate the spatial distribution, the spatiotemporal interaction and the spatiotemporal clustering of FMD‐affected villages. From 2001 to 2006, 878 FMD outbreaks were reported in 605 different villages of 5815 populated places included in the database. The spatial distribution of FMD outbreaks was concentrated along the Tanzania‐Kenya, Tanzania‐Zambia borders, and the Kagera basin bordering Uganda, Rwanda and Tanzania. The spatiotemporal interaction among FMD‐affected villages was statistically significant (P ≤ 0.01) and 12 local spatiotemporal clusters were detected; however, the extent and intensity varied across the study period. Dividing the country in zones according to their epidemiological status will allow improving the control of FMD and delimiting potential FMD‐free areas.     

Development and testing of a sustainable environmental restoration policy on eradicating the poverty trap in China's Changting County

It is widely accepted that environmental degradation and poverty are linked and that conservation and poverty reduction should be tackled together. However, success with integrated strategies has been elusive. Here, we present the results of a study that illustrates how development that combines environmental and economic perspectives and that provides appropriate compensation to affected populations can improve both nature and society, thereby eradicating the “poverty trap.” The results show that if we cannot improve the livelihood of local residents, we will be unable to restore degraded environments when state-owned property is transferred to private ownership to encourage better management by residents. In contrast, measures to eliminate poverty, combined with the development of green enterprises that improve the livelihoods of private land owners in the long term, is the precondition for successful ecological restoration.     

我校护理专科生实践教学体系的构建与实施

目的建立新的实践教学体系，旨在提高学生的职业能力，使培养的人才更加符合社会及职业岗位需求。方法自2005年始，采用新的教学理念和教学方法设计培养方案，使实践教学体系贯穿整个培养过程。学生临床实习结束后，我们分别到河南省南阳市的几家医院，对该年级学生的实习情况作了跟踪调查。结果93．0％的临床带教老师认为．该届学生和往届学生相比整体素质较高、工作能力较强。结论新的实践教学体系突出了教学过程的实践性、开放性和职业性，使培养的人才更加符合社会需求。     

ADDRESS TO THE INSTITUTE

The fire control problem deals with intensively managed softwood forest areas. The early use of the fire fighting truck in South Australia was associated with good access conditions in plantation areas. Improvement of truck performance in loose sand has been obtained by changes in gear ratio (to low gear of 8 to 1). and the size of wheels (reduced to 18 inches) and tyres (increased to 9 inches). Power pump equipment has changed from plunger pumps of low rate of delivery (5 gallons per minute) to centrifugal pumps, which are driven direct from high speed engines, and have an outlet of up to about 25 gallons pev minute.

The 4-ton truck is the standard fire fighting vehicle. This is equipped with a 500 gallon tank, power pump with outlet through two “live” reels, and a hand pump, all fixed to a steel frame. The latest power pump has a flexible performance, with a range of delivery from 2.5 to 28.8 gallons per minute, and a stream distance up to 80 feel. The assembly of this unit, loading methods and the small equipment of the truck are described.

Smaller trucks arc equipped in accordance with their capacity in the district they have to work. The water supply of the trucks depends on a system of 1,000 gallon overhead tanks, which are located at accessible and strategic places throughout the plantations. The truck tank can be filled from these at a rate of 80 gallons per minute. The gang on the truck usually consists of 8 men, each of whom has special duties.

The fire fighting truck has four main uses. These are the direct suppression of small fires, the holding of a back fire, the provision of water supplies for knapsacks, and mopping up. The scope of the equipment and the methods of its use arc described.

Possible future development of trucks and equipment and the organisation of their use are briefly outlined.     

Broader perspective on ecosystem sustainability: Consequences for decision making

Although the concept of ecosystem sustainability has a long-term focus, it is often viewed from a static system perspective. Because most ecosystems are dynamic, we explore sustainability assessments from three additional perspectives: resilient systems; systems where tipping points occur; and systems subject to episodic resetting. Whereas foundations of ecosystem resilience originated in ecology, recent discussions have focused on geophysical attributes, and it is recognized that dynamic system components may not return to their former state following perturbations. Tipping points emerge when chronic changes (typically anthropogenic, but sometimes natural) push ecosystems to thresholds that cause collapse of process and function and may become permanent. Ecosystem resetting occurs when episodic natural disasters breach thresholds with little or no warning, resulting in long-term changes to environmental attributes or ecosystem function. An example of sustainability assessment of ecosystem goods and services along the Gulf Coast (USA) demonstrates the need to include both the resilient and dynamic nature of biogeomorphic components. Mountain road development in northwest Yunnan, China, makes rivers and related habitat vulnerable to tipping points. Ecosystems reset by natural disasters are also presented, emphasizing the need to understand the magnitude frequency and interrelationships among major disturbances, as shown by (i) the 2011 Great East Japan Earthquake and resulting tsunami, including how unsustainable urban development exacerbates geodisaster propagation, and (ii) repeated major earthquakes and associated geomorphic and vegetation disturbances in Papua New Guinea. Although all of these ecosystem perturbations and shifts are individually recognized, they are not embraced in contemporary sustainable decision making.     

Using the Jigsaw Cooperative Learning Method to Teach Medical Students About Long-Term and Postacute Care

Since many of the frailest and most vulnerable Americans reside in nursing homes, medical students need focused education and training pertaining to this setting. A unique cooperative learning experience utilizing the jigsaw method was developed to engage and expose students to the institutional long-term and postacute care (LTPAC) setting and the roles of personnel there. To accomplish these goals, small groups of medical students interviewed LTPAC personnel about their role, generally, and in relation to a specific patient case. These groups were then rearranged into new groups containing 1 student from each of the original groups plus a faculty facilitator. Each student in the new groups taught about the role of the LTPAC professional they interviewed. To assess the effectiveness of this learning experience, students and LTPAC personnel provided written feedback and rated the activity using a 5-point Likert scale (1 = worst; 5 = best). Students also took a knowledge test. The activity received ratings from students of 3.65 to 4.12 (mean = 3.91). The knowledge test results indicated that students understood the roles of the LTPAC personnel. In general, the jigsaw exercise was well-received by participants and provided an effective means of introducing medical students to the nursing home environment.     

236例死亡孕产妇文化程度与保健服务情况分析

目的了解妇女受教育程度与孕产妇死亡之间的关系,为制定降低孕产妇死亡率的措施提供依据。方法1999~2003年信阳市孕产妇死亡监测报告卡,核对无误后,进行汇总分析。结果1999~2003年孕产妇死亡率为64.88/10万,其中小学以下文化程度占64.41%;236例死亡孕产妇进行孕早期检查的只有19.07%,而合格产前检查率仅有13.98%,其中小学以下文化程度只有6.35%,与高中以上文化程度相比存在明显差异(χ2=5.52,P<0.05);随着文化程度的提高,产前检查率、孕早期检查率、合格产前检查率都呈明显上升趋势。文化程度越低,接受保健服务的意识越差。结论各级政府要把重视教育尤其是女童的教育落实到行动上;提高育龄妇女的自我保健意识和医疗保健单位的服务水平;提高领导责任意识,制定相应的干预措施,有效降低该市孕产妇死亡率。     

河北省867个农村自然村预防艾滋病教育现状调查

[目的]调查农村预防艾滋病教育现状,针对具体问题研究做好农村预防艾滋病宣传教育工作的对策。[方法]采用随机抽样的方法,对874名家庭所在地为农村,熟悉农村情况并直接参与农村居民防艾宣传教育工作的大学生进行问卷调查。[结果]农村防艾教育宣传方式、教育形式单一;农村居民对我国艾滋病的流行状况有一些了解的为35.9%;对预防艾滋病基本知识比较了解的为11.8%;对艾滋病的严重危害性缺乏认识的为43.3%;缺乏预防艾滋病自我防护意识的为47.6%;希望了解更多的防艾知识的农村居民为89.6%。[结论]该省农村预防艾滋病宣传教育应针对所存在的具体问题,采取相应的对策。同时应加强提高农村居民、农民工和流动人口的防范意识和个人行为的规范与约束。