Women's alcohol consumption: emerging patterns,problems and public health implications

There is growing awareness of changes in the levels and patterns of women's use of alcohol. Australian and international data suggest that patterns of consumption among younger women are beginning to echo that of their male counterparts. Similarly, alcohol consumption among older women is also increasing in some developed countries. This paper provides an overview of available data sources that address changing patterns of consumption among women in Australia, and explanatory models which may account for these changes are discussed. Particular attention is directed to drinking among younger women and indigenous women. External social factors are explored, including the erosion of traditional values associated with women's consumption of alcohol. Finally, the paper examines the evidence for a long speculated 'convergence' of female and male alcohol consumption and assesses the public health implications of the emerging patterns of alcohol consumption by women. The inconsistent findings regarding brief interventions when applied to women, compared to men, are also highlighted in terms of appropriate future public health strategies.     

Women's knowledge of Pap smears, risk factors for cervical cancer, and cervical cancer

OBJECTIVE: To review the literature on women's knowledge of Pap smears, risk factors for cervical cancer, and cervical cancer. DATA SOURCES: The review was based on a search of the relevant literature over a 10-year period using MEDLINE and CINAHL. DATA EXTRACTION: Articles from relevant, indexed journals and textbooks published within the past decade were included. Seminal articles were included as appropriate. DATA SYNTHESIS: Risk factors for the development of cervical cancer have been reevaluated. The case for human papillomavirus as the cause of cervical neoplasms has been strengthened. CONCLUSIONS: Cervical cancer is associated with early sexual debut, number of lifetime sexual partners, nonuse of condoms, and infection with human papillomavirus. Cigarette smoking facilitates development of cervical cancer.     

医疗事业单位网络安全管理风险研究与思考

阐述了医疗事业单位在网络安全管理方面普遍存在的制度不健全、技术及管理人才缺失、培训教育不及时、管理及应对措施不到位等问题，并根据现行的国家相关政策及法律法规对医疗事业单位的日常网络安全管理工作，提出了完善组织管理，建立健全管理制度；加强人员储备及管理；提高思想认识等有效建议，并对建立监测预警与应急处置体系进行了介绍。     

Effect of the pretest probability of intrauterine growth retardation on the predictiveness of sonographic estimated fetal weight in detecting IUGR: a clinical application of Bayes' theorem

Four hundred and five women with singleton pregnancies and fetal age determination by crown-rump length were classified on the basis of their prenatal clinical findings into four risk categories for intrauterine growth retardation (IUGR), defined as a neonatal weight below the 10th percentile of age-dependent birth weight distribution curve. The incidence of IUGR in these four groups were 3.5% (very low risk), 20.6% (low risk), 49.6% (intermediate risk), and 88.0% (high risk). Severe growth retardation (birth weight less than 2.5th percentile) increased from 0% to 76.0% as the incidence of IUGR increased throughout the risk groups. The effect of these pretest risks on the prediction of severe IUGR by sonographic estimated fetal weight (EFW) was evaluated. The positive predictive value of the test, as well as the probability of having a growth-retarded infant after a normal EFW was obtained were considerably higher when the pretest probability of IUGR increased. In the very low risk group, the probability of severe IUGR was negligible regardless of the EFW. When the EFW was less than 10th percentile of our age-dependent EFW curve, the probability of severe IUGR in the other risk groups was high enough to warrant fetal well-being surveillance and/or timely interruption of gestation as appropriate. However, when the pretest probability was high, the risk of severe IUGR in spite of an EFW within the 10th percentile to 90th percentile remained sufficient to require fetal well-being surveillance as well. The study shows that placing ultrasound results in the context of the pretest risk of IUGR may improve clinical decision making in pregnancies complicated by fetal growth retardation.     

Preventing EMS workplace violence: A mixed-methods analysis of insights from assaulted medics

ObjectiveTo describe measures that assaulted EMS personnel believe will help prevent violence against EMS personnel.MethodsThis mixed- methods study includes a thematic analysis and directed content analysis of one survey question that asked the victims of workplace violence how the incident might have been prevented.ResultsOf 1778 survey respondents, 633 reported being assaulted in the previous 12 months; 203 of them believed the incident could have been prevented and 193 of them (95%) answered this question. Six themes were identified using Haddon’s Matrix as a framework. The themes included: Human factors, including specialized training related to specific populations and de-escalation techniques as well as improved situational awareness; Equipment factors, such as restraint equipment and resources; and, Operational and environment factors, including advanced warning systems. Persons who could have prevented the violence were identified as police, self, other professionals, partners and dispatchers. Restraints and training were suggested as violence-prevention tools and methodsConclusionsThis is the first international study from the perspective of victimized EMS personnel, to report on ways that violence could be prevented. Ambulance agencies should consider these suggestions and work with researchers to evaluate risks at the agency level and to develop, implement and test interventions to reduce the risks of violence against EMS personnel. These teams should work together to both form an evidence-base for prevention and to publish findings so that EMS medical directors, administrators and professionals around the world can learn from each experience.     

城市化迅猛发展对人口健康的隐患

以环境为中介分析了城市化与人口健康之间的关系。城市化发展给我国经济社会发展带来巨大收益的同时给环境带来了巨大压力,并产生了一系列环境问题。文章定性分析了环境污染对人口健康的危害,对城市化发展与环境水平间的关系进行了定量分析,提出了健康城市化的发展路径。     

Polycyclic aromatic hydrocarbon levels in three pelagic fish species from Atlantic Ocean: inter-specific and inter-season comparisons and assessment of potential public health risks

The concentrations of 18 polycyclic aromatic hydrocarbons (PAHs) were determined in three commercially valuable fish species (sardine, Sardina pilchardus; chub mackerel, Scomber japonicus; and horse mackerel, Trachurus trachurus) from the Atlantic Ocean. Specimens were collected seasonally during 2007–2009. Only low molecular weight PAHs were detected, namely, naphthalene, acenaphthene, fluorene and phenanthrene. Chub mackerel (1.80–19.90 μg/kg ww) revealed to be significantly more contaminated than horse mackerel (2.73–10.0 μg/kg ww) and sardine (2.29–14.18 μg/kg ww). Inter-specific and inter-season comparisons of PAHs bioaccumulation were statistically assessed. The more relevant statistical correlations were observed between PAH amounts and total fat content (significant positive relationships, p ? 0.05), and season (sardine displayed higher amounts in autumn–winter while the mackerel species showed globally the inverse behavior). The health risks by consumption of these species were assessed and shown to present no threat to public health concerning PAH intakes.     

Comparison of Various Risk and Protective Factors for Substance Use/Abuse in a Court-Adjudicated Male Population

ABSTRACT

A sample of 350 court-adjudicated adolescent males, labeled as “delinquent,” and referred to a residential treatment center and school, were comprehensively assessed at the time of admission into a prevention/early intervention program for substance use/abuse.

A factor analysis of 20 social behavior/peer relationship variables that had been found significantly related to a summary index measure of substance use/abuse, yielded two factors that neatly separated the risk factors from the protective factors.

Cross-sectional analyses showed the social behavior/peer relationship risk variables to be more strongly related to the degree of substance use/abuse than were the family problem risk variables, accounting for 36% of the variance compared to 12% of the variance, in the degree of substance use/abuse.

In the analyses for predicting to degree of substance use/abuse one year later, at follow-up assessment, in which the family problem risk variables were entered as controls, the fact that the subject's father had a substance abuse problem accounted for 6.2% of the variance in the subject's degree of substance use/abuse; and the factor score for deviant and delinquent social behavior and peer relationships did not account for any additional variance in the later degree of substance use/abuse. On the other hand, the factor score for conforming socially acceptable behavior was found to still account for 8.1% of additional variance in later substance use/abuse, after the initial 6.2% of variance had been accounted for by the fact that the father had a drug problem. Thus, the degree of protective factors (conforming social behavior and conventional bonding) were found to be more powerful than degree of the social behavior risk factors for predicting to either or both of the following: (1) which court-adjudicated male adolescent will improve more with treatment; or (2) which of such adolescents will not develop a more serious substance abuse problem, during a one-year period.     

电子病历档案管理中的安全风险及防范措施

电子病历档案作为医院病历档案管理的新手段,受到国内外学者的广泛关注。电子病历档案的信息安全是其得到有效利用的前提,因此,确保电子病历档案的信息安全是发挥其作用的保障。从电子病历档案保管环境的安全风险入手,对电子病历档案载体安全与信息安全风险两个方面进行分析,并提出针对性的防范措施。