Do patients receive adequate pain control after discharge from the ED?

Studies on the effectiveness of pain management have uniformly concluded that health care providers underestimate or undertreat pain. In the emergency department (ED) in which this study was conducted, physicians receive formal didactic and bedside teaching on pain recognition and management in order to heighten the awareness of patient's need for pain control. The purpose of this study was to determine if this outpatient pain management of patients with acute, painful conditions is better than that reported in the medical literature. In this prospective study, 110 adult patients who had an acute, painful diagnosis were telephoned 48 hours after discharge from the ED and asked if they felt their pain at home was well controlled. Patient satisfaction with pain control was higher (91%) than that reported in the medical literature. Also, pain medication was provided more frequently by this study's ED (95%). Education on pain awareness and treatment is a way to improve pain management.     

Drug Education: Supporting Parents to Support Children

Such research evidence as exists on effective drug strategies in prevention and education draws attention to the importance of involving parents along with other community agencies and school governors. Much depends nevertheless on the way in which 'involvement' is interpreted and the assumptions that are made about parents' knowledge of drugs and drug education as well as their attitudes to drug issues. As the age of initial experimentation and contact with drugs continues to fall, the importance of enskilling parents to support drug education programmes for 5 year olds and upwards continues to rise. This paper reports the first wide ranging survey of parents' knowledge of drugs and drug issues across an entire English county embracing younger as well as older children. The need for more coordinated, informed and systematic guidance to parents is established.     

Some practical perspectives for educating gifted children

This article identifies common characteristics of educationally related programs that form a common basis for understanding and working with gifted programs. Special approaches and programs for educational enrichment as well as specific activities that have been successful are discussed.     

A combined course of primary health care practice and family medicine at the University of Gezira

The community-based course presented is a longitudinal course running through four semesters in the Faculty of Medicine, University of Gezira, Sudan. Students combine their regular work in primary health care centres with attachments to a number of families in Wad Medani town. They continue to visit these families regularly throughout their entire medical course with the aim of studying them and helping them with some of their medical and psychosocial problems.     

Drug related hospital admissions

Summary As part of a high-intensity monitoring study of drug events as the cause of admission to departments of internal medicine, the effect of an educational intervention programme was studied. Two departments were included, one specialising in geriatrics and one that received patients by non-selected referral. The series consisted of 607 consecutive admissions studied before and 703 after the intervention. The drug events considered were adverse drug reactions and dose-related therapeutic failures, mainly due to non-compliance.A modest, statistically non-significant decrease in drug related hospital admissions (DRH) was seen, from 14% before to 13% after the intervention period. However, DRHs classified as definitely avoidable showed the significant decrease of 83%.There was no apparent relationship between the topics selected for the intervention programme and changes in the pattern of DRHs. No relationship between alterations in sales data and hospital admissions caused by a given drug could be demonstrated. A blinded external evaluation of case abstracts did not disclose any significant shift in the investigators' assessments.The intervention may have had an non-specific effect on avoidable DRHs.     

福建省部分县市健康人群发铬调查

本文用气相色谱法对居住福州、长乐、宁化三个地区270名健康人群发铬含量进行调查。结果表明:福州地区发铬值高于其它两地区,并有非常显著性差异。总体发铬算术平均数与国内外部分地区所报导的结果比较接近,但在性别及年龄间差异不明显。对三个地区发铬值与当地土壤铬含量进行相关分析,r=0.9978,二者呈正相关,并有非常显著性意义。     

The short-term stability of student ratings of instruction in medical school

The purpose of this study was to assess the degree of consistency in student ratings of teacher effectiveness during the first year of medical school. Student ratings of teaching effectiveness represent a commonly used source of information that enters into the academic decision-making process. In medical school, student evaluations often represent a major source of information that is used in promotion and tenure decisions. It is essential that the precision of such ratings be ascertained so that decision-makers will know how much confidence to place in this source of information on teaching effectiveness. In this study, each member of a first-year medical school class was randomly assigned a two-digit identification number at the beginning of the spring semester, 1986. As the semester progressed students were asked to evaluate each full-time teacher in three major courses. Multiple instructors were utilized in each course (n = 10). Each teacher was evaluated immediately after lectures during the first (T1) and second (T2) halves of the course. Students evaluated the teacher a third time (T3) as part of the end-of-semester overall course evaluation. The teachers were evaluated on a short eight-item Likert-type scale that identified several key indicators of effective teaching. Students attached their anonymous identification numbers to individual ratings so that their responses could be matched in the analysis. The results indicate that medical students are only moderately consistent in the extent to which they evaluate teachers. This inconsistency varied by course and by instructors within courses.(ABSTRACT TRUNCATED AT 250 WORDS)     

Occupational therapy in rural India

India is called the land of villages. In 1951, 82.7% of the Indian population lived in rural areas. Sanskritisation and urbanisation have changed the pattern. It is expected that by the year 2020 this percentage would come down to 55%. These villagers are relocating in urban slums. Thus from the rehabilitation point of view both problems pose challenges. An Indian village community is a political, economic and cultural unit. At the urban slum area at Malwani and in small villages near Juchandra, community rehabilitation programmes were found to be most pragmatic. Community education and preventive occupational therapy are found to be essential steps in rural rehabilitation. Therapists have to work on ‘disability, attitude and beliefs’ and change the behaviour to deal with the grass root (basic) causes. It is felt that for longer sustainment, community-based rehabilitation should originate within the community. Heath professionals must recognise the capabilities of individuals within the support structure of the family and community, while helping individuals to improve the quality of their lives.     

Teaching of medical ethics

Teaching medical ethics in Manchester within the introductory course of obstetrics and gynaecology is a joint activity with the Centre for Social Ethics and Policy. This interdisciplinary teaching has evolved through lecture sessions with small-group discussions dealing with topics of interest in human reproduction. The small-group discussion have been replaced by an open debate conducted by the students. Their own involvement and participation and an exposure to the disciplines of the humanities has broadened their approach to different ways of problem-solving of these real issues.     

花都区职业性健康体检面临的困境及对策探讨

通过对花都区职业性健康体检工作现状的分析，探讨职业性健康检查面临的困境，包括监督执法力度不足，部门之间不够协调、用人单位领导及劳动者职业卫生意识差、管理制度不完善以及经济因素等，继而提出一些对策：建立健全监督体制、完善管理制度、加强队伍建设、加大宣传和健康教育力度、建立相应的社会保险制度等。