The diluting effect of medical work groups on feedback efficacy in changing physician's practice

Feedback intervention has been advocated as a successful method to modify the way that physicians practice medicine. However, most studies concerned with modifying physician profiles have focused on interns and residents. The results presented here concern regular staff and therefore provide a better basis for generalization. Over a 2.5-year period, we analyzed the use of clinical resoucces by physicians practicing in four medical specialties in two hospitals. Hierarchical multiple regression models were used to control case mix in order to identify the specific effects attributable to feedback. The information failed to modify the physicians' practice profiles. Our results suggest that this failure is related to the organization of inpatient medical practice as a group effort. This mode of practice has a negative effect on feedback efficacy. First, it weakens one of the main feedback mechanisms, that is personal identification with the data. Second, it probably generates mutual adjustment among physicians, thus eliminating practice variations at the source.     

三种补肾方对老年大鼠下丘神经递质的影响

目的：观察三种补肾方对24个月龄老年大鼠下丘氨基酸类神经递质的影响.方法：采用反相高效液相色谱(HPLC)荧光法、受体放射分析法、RT PCR法测定大鼠下丘的氨基酸递质含量、受体特异性结合量及受体亚单位的mRNA表达.结果：24个月龄大鼠下丘存在兴奋/抑制失衡,表现为下丘γ 氨基丁酸(GABA)能抑制作用减弱,可能与耳鸣发病率随年龄增长而增加有关.补肾息鸣经验方使24个月龄大鼠下丘氨基酸类神经递质介导的抑制作用上调和兴奋作用下调；左归丸及右归丸使24个月龄大鼠下丘兴奋性与抑制性氨基酸类神经递质(Asp、Tau、GABA)含量均有明显上升.结论：对肾虚耳鸣的治疗应在补肾的基础上结合开窍活血等药物.     

民族药臭灵丹的生药学研究

目的：为研究和开发菊科四棱峰属植物臭灵丹laggera pterodonta(D．C)benth提供依据。方法：采用来源鉴定、性状鉴定、显微及理化鉴定的方法作系统的生药学研究。结果：证明其主要化学成分为黄酮类化合物、倍半萜类化合物等，组织特征为茎维管束23～29个；叶中脉维管束5～8个；全体密被非腺毛。结论：为制定药材质量标准、研究和开发利用该药资源提供了理伦依据。     

Socioeconomic status and cancers of the female breast and reproductive organs: a comparison across racial/ethnic populations in Los Angeles County, California (United States)

Objectives: Despite the fact that socioeconomic status (SES) has been shown to have important implications in health related issues, population-based cancer registries in the United States do not routinely collect SES information. This study presents a model to estimate the SES of cancer patients in the registry database.Methods: At the Los Angeles Cancer Surveillance Program (CSP), we developed a model to estimate each cancer patient's SES from aggregate measurements of the census tract of residence (n = 1,640) at time of diagnosis. We then applied the SES estimates to observe the relationship between SES and risk of cancers of the female breast and reproductive organs including cancers of the ovary, cervix uteri, and corpus uteri. The analyses were performed on the cumulative records (n = 127,819) of cancer patients diagnosed between 1972 and 1992 in Los Angeles County, California, for the mutually exclusive racial/ethnic groups of non-Hispanic Whites, Hispanic Whites, Blacks, Asians, and persons of other ethnic groups.Results: We found SES is positively associated with female breast cancer, ovarian cancer, and cancer of the corpus uteri, but inversely associated with cervical cancer. These SES trends were quite consistent across age groups among non-Hispanic White women. Variations by race/ethnicity in the SES patterns were also found, with Asians exhibiting little association.Conclusions: Our model of measuring SES is sufficiently sensitive to capture the trends. Adopting the aggregate approach to measure SES in population-based registry data appears to be useful.     

Evolution of atherogenic diets in South Asian and Italian women after migration to a higher risk region

BACKGROUND: To identify differences in the evolution of the diets of South Asian and Italian migrants, a cross-sectional, multiethnic study was undertaken in Glasgow, Scotland. METHODS: Five groups of women aged 20-42 years comprising general population (n = 35), South Asian migrants (n = 35) British-born controls (n = 37), Italian migrants (n = 30) and British-born (n = 38) participated in an interviewer administered structured questionnaire on issues relating to health, diet and food selection. Anthropometric measurements were made and subjects completed a 7-day weighed diet inventory. RESULTS: Compared with the general population, dietary differences were greatest amongst first generation migrant groups. There were major differences between the two migrant groups. South Asian migrants tended to display a more atherogenic profile (fat 42.4% energy, saturated fat 15.0% energy, vitamin C 5.1 mg per 1000 kJ) than the general population (fat 39.1% energy, saturated fat 13.5% energy, vitamin C 6.8 mg per 1000 kJ), and Italian migrants (fat 35.7% energy, saturated fat 12.1% energy, vitamin C 10.9 mg per 1000 kJ). However, South Asian groups had higher intakes of polyunsaturated fatty acids which may be cardioprotective. CONCLUSIONS: South Asian migrants to Scotland appear to develop adverse dietary elements in the first generation, which are modified in subsequent generations, whereas Italians' diets remain cardioprotective in the migrant generation but deteriorate in subsequent generations.     

凉山农村彝族人群HIV/AIDS知识及相关行为特征分析

目的　了解农村彝族一般人群的HIV/AIDS知识知晓情况及相关行为特征 ,为开展综合干预提供依据。方法　随机抽取 3个彝族聚居的行政村 ,使用自行设计的问卷进行面对面的访谈调查 ,共调查到 15～ 4 9岁彝族村民 10 0 8人。用SPSS软件进行统计分析。结果　村民普遍缺乏HIV/AIDS防制知识 ;8 4 %的村民曾尝试过吸毒 ;13 5 %的人有多性伴现象 ;外出者中近 4 0 %为盲流 ,为吸毒贩毒创造了条件。结论　该地区农村彝族人群存在多种艾滋病相关危险因素 ,缺乏知识和贫困导致的盲流是该地HIV传播流行的主要原因。应及时开展形式多样的HIV/AIDS相关知识的宣传教育工作 ,同时开展扶贫工作 ,使艾滋病防制工作获得可持续性的发展     

福建省畲族中学生心理健康状况

目的了解畲族中学生心理健康状况,以便为少数民族中学生的心理健康教育提供依据.方法以症状自评量表(SCL-90)为测试工具,以当地汉族中学生为对照组,采用随机整群分层抽样研究方法,调查福建省部分畲族中学生的心理健康状况.结果汉畲族中学生在抑郁、恐怖等因子中差异均有显著性,与对照组不同,调查对象的心理健康状况差异不存在显著性.结论畲族中学生总体心理健康水平低于汉族学生.应针对畲族中学生的心理特点进行心理健康的指导和干预工作.     

湖北民族学院土家族医学生心理健康状况

目的研究分析土家族医学生心理健康状况,为开展少数民族大学生心理健康教育提供依据.方法采用症状自评量表(SCL-90)对湖北民族学院医学院1997～1999级医学生中的土家族学生509人的心理健康状况进行测评,并进行比较分析.结果被试中至少有1项SCL-90因子分≥3分的学生占21.41%,男、女及不同年级学生间比较,差异均无显著性.总体上,土家族医学生的心理健康水平优于国内其他地区大学生.结论土家族医学生心理问题不容忽视,且女生的心理卫生问题相对较为突出,应根据土家族人的心理特性对土家族医学生进行心理卫生教育.     

GROWTH STATUS OF CHILDREN IN NORTH WEST SYRIA: A COMPARISON OF THREE RURAL LIVELIHOOD GROUPS

Undernutrition, a multifactorial phenomenon, has severe consequences. A study was conducted in Syria to compare nutritional differences in children from three rural livelihood groups: a “barley-livestock” group in the southeast (Khanasser), and an “olive/fruit tree” group and an “irrigation” group in the northwest of Aleppo province (Afrin). An anthropometric assessment was conducted on 541 rural children from 207 rural households and 199 urban children (2-10 years) from a middle income urban group. Comparisons were made with the 1978 NCHS/WHO (National Center for Health Statistics/ World Health Organization) international growth reference (WHO, 1995) and a -2 SD Z-score was used as a cut-off. Prevalence rates and mean Z-scores were calculated and independent sample t-tests used to compare totals and age-group disaggregated children (both boys and girls). Total stunting prevalence was highest in the barley-livestock group (23%) and lowest in the irrigation group (12.5%). Girls in the barley-livestock group displayed the highest rates of stunting (28.3%), followed by the boys (22%) and the girls (21.08%) in the olive/fruit tree group. The prevalence of underweight children was highest in the barley-livestock and olive/fruit tree livelihood groups (14.29% and 13.25%, respectively). Wasting rates were very low. The rates of stunting and underweight were higher in the barley-livestock and olive/fruit tree groups, as compared with the country-level estimates of 20.8 percent and 12.9 percent respectively, in children under five. A comparison of rates and mean scores indicates that, amongst rural groups, there was considerable variation: the barley-livestock and olive/fruit tree group, belonging to drier and poorer areas, exhibited higher rates and lower mean scores.     

在沪就读藏族初中学生情绪和自我意识相关性研究

目的了解在沪读书藏族中学生情绪和自我意识之间的关系,以便为藏族学生心理咨询提供依据。方法应用流调用抑郁量表、PiersHarris儿童自我意识量表(PHSS)对藏族中学生672名进行调查。结果藏族中学生抑郁情绪的检出率为14.4%。男生在行为分量表、合群分量表的得分低于女生;躯体外貌分量表得分为男生高女生低。有抑郁情绪学生的PHSS总分和各分量表得分均低于无抑郁情绪的学生,差别有统计学意义。抑郁情绪与自我意识总分及各分量表得分呈负相关。结论在沪就读藏族中学生的情绪状态与自我意识有关,且相互影响。