The Pattern of Intact and Impaired Memory Functions in Autism

A battery of tests of auditory and visual memory was used to investigate memory function in 52 high-functioning adolescents and young adults with autism and 40 group-matched normal controls. It was hypothesized that memory dysfunction is present in autism but is not modality specific and is produced by poor utilization of organizing strategies. It was therefore hypothesized that memory impairment in autism would become more prominent as task complexity was increased. The participants with autism performed as well as controls on short-term memory and paired-associate learning tasks, but performed significantly less well than controls on a list learning task. They also performed significantly more poorly on immediate and delayed recall of a story and of a complex geometric figure. On a maze learning task, their performance became progressively worse relative to controls as the complexity of the maze increased. On a series of span tasks, they did not differ from controls on letter span, but did significantly worse on word span and sentences of increasing complexity. These findings indicate a lack of modality specificity and a failure to initiate organizing strategies as evidenced by inefficiency in new learning, poor utilization of contextual cues in story and complex pattern recall, and greater impairment with increasing complexity of the material.     

New approaches to spatially analyse primary health care usage patterns in rural South Africa

OBJECTIVE: To develop indices to quantitatively assess and understand the spatial usage patterns of health facilities in the Hlabisa district of South Africa. METHODOLOGY: We mapped and interviewed more than 23 000 homesteads (approximately 200 000 people) in Hlabisa district, South Africa and spatially analysed their modal primary health usage patterns using a geographical information system. We generated contour maps of health service use and quantified the relationship between clinic catchments and distance-defined catchments using inclusion and exclusion error. We propose the distance usage index (DUI) as an overall spatial measure of clinic usage. This index is the sum of the distances from clinic to all client homesteads divided by the sum of the distances from clinic to all homesteads within its distance-defined catchment. The index encompasses inclusion, exclusion, and strength of patient attraction for each clinic. RESULTS: Eighty-seven per cent of homesteads use the nearest clinic. Residents of homesteads travel an average Euclidean distance of 4.72 km to attend clinics. There is a significant logarithmic relationship between distance from clinic and their use by homesteads (r(2)=0.774, P < 0.0001). The DUI values range between 31 and 198% (mean=110%, SD=43.7) for 12 clinics and highlight clinic usage patterns across the district. CONCLUSIONS: The DUI is a powerful and informative composite measure of clinic usage. The results of the study have important implications for health care provision in developing countries.     

影响医院信息系统质量建设的几个环节

医院信息系统的建设是一个较为复杂的系统工程，它涉及多个学科领域和医院各个方面。确保系统建设与运行质量并发挥其作用，必须抓好３个主要环节：一是总体方案设计合理；二是应用软件选择要适当；三是基础数据字典开发要规范。     

高等院校护理教师信息素质及其培养方法

分析了高等院校护理教师的信息素质状况,提出了高等院校护理教师信息素质培养的方向和方法.     

Bug reactions: Considering US government and UK government Y2K operations in light of media coverage and public opinion polls

This paper considers the manner and extent to which the media and public opinion influenced the US government's and the UK government's reaction to the Y2K computer bug. The data concerning Y2K come largely from primary and secondary government documents and newspaper articles and public opinion polls from the period as well as semi-structured interviews conducted with civil servants, representatives from the IT sector, and IT journalists. The paper concludes that during the early phases of Y2K planning there was anxiety among a professional elite, which included the media, the legislatures, and private industry, and this anxiety influenced the timing and magnitude of both governments' responses. With respect to public opinion, however, the governments were more concerned about shaping it rather than following it. Both governments raised the profile of Y2K as a strategy to minimize the impact of the bug in a complex and interdependent infrastructure. After having raised awareness and anxiety levels for over a year, however, the US government, in particular, was worried that it had done too good a job, and that public overreaction became a distinct possibility. They therefore embarked on a strategy of bringing public anxiety down. As New Year's Day 2000 approached, the governments' Y2K operations were no longer in line with public perception about the risk, but in light of the potential consequences of a public overreaction, this deviation seemed acceptable.     

Gatekeeping versus direct‐access when patient information matters

We develop a principal‐agent model in which the health authority acts as a principal for both a patient and a general practitioner (GP). The goal of the paper is to weigh the merits of gatekeeping versus non‐gatekeeping approaches to health care when patient self‐health information and patient pressure on GPs to provide referrals for specialized care are considered. We find that, when GPs incentives matter, a non‐gatekeeping system is preferable only when (i) patient pressure to refer is sufficiently high and (ii) the quality of the patient's self‐health information is neither highly inaccurate (in which case the patient's self‐referral will be very inefficient) nor highly accurate (in which case the GP's agency problem will be very costly). Copyright © 2009 John Wiley & Sons, Ltd.     

Medical tests: women's reported and preferred decision-making roles and preferences for information on benefits, side-effects and false results

Objective To determine women's preferences for and reported experience with medical test decision‐making. Design Computer‐assisted telephone survey. Setting and participants Six hundred and fifty‐two women resident in households randomly selected from the New South Wales electronic white pages. Main outcome measures Reported and preferred test and treatment (for comparison) decision‐making, satisfaction with and anxiety about information on false results and side‐effects; and effect of anxiety on desire for such information. Results Overall most women preferred to share test (94.6%) and treatment (91.2%) decision‐making equally with their doctor, or to take a more active role, with only 5.4–8.9% reporting they wanted the doctor to make these decisions on their behalf. This pattern was consistent across all age groups. In general, women reported experiencing a decision‐making role that was consistent with their preference. Women who had a usual doctor were more likely to report experiencing an active role in decision‐making. More women reported receiving as much information as they wanted about the benefits of tests and treatment than about the side‐effects of tests and treatment. Most women wanted information about the possibility of false test results (91.5%) and test side‐effects (95.6%), but many reported the doctor never provided this information (false results = 40.0% and side‐effects = 31.3%). A substantial proportion said this information would make them anxious (false results = 56.6% and side‐effects = 43.1%), but reported they wanted the information anyway (false results = 77.6% and side‐effects = 88.1%). Conclusions Women prefer an active role in test and treatment decision‐making. Many women reported receiving inadequate information. If so, this may jeopardize informed decision‐making.     

胎儿肝脏生命元素与发育参数的关系及其环境生物学信息

目的 :探讨胎儿肝脏生命元素与发育参数的关系及其环境生物学信息。方法 :分析 4～1 0月龄胎儿肝脏 2 1个生命元素的含量 ,并与胎儿整体发育、身长、体重和肝重 4个发育参数做单相关和多元逐步回归分析。结果 :发现生命元素在胎儿生长发育过程中有明显的量变规律 ,依此可对环境—母体系统元素与胎儿营养的关系进行分类。结论 :Zn、K、Na、Mg、Sr、Mn、Cr和 Cu是影响胎儿生长发育的主要因子 ,为进一步研究生命元素在胎儿期的生物化学和生理功能 ,与胚胎期、新生儿、儿童发育的关系及妇幼保健和优生学 ,环境监测提供环境生物信息     

Implementation of an advanced clinical and administrative hospital information system

Summary Over the last six years since University Hospital opened, the University Hospital Information System (UHIS) has continued to evolve to what is today an advanced administrative and clinical information system. At University Hospital UHIS is the way of conducting business. A wide range of patient care applications are operational including Patient Registration, ADT for Inpatient/Outpatient/Emergency Room visits, Advanced Order Entry/Result Reporting, Medical Records, Lab Automated Data Acquisition/Quality Control, Pharmacy, Radiology, Dietary, Respiratory Therapy, ECG, EEG, Cardiology, Physical/Occupational Therapy and Nursing. These systems and numerous financial systems have been installed in a highly tuned, efficient computer system. All applications are real-time, on-line, and data base oriented. Each system is provided with multiple data security levels, forward file recovery, and dynamic transaction backout of in-flight tasks. Sensitive medical information is safeguarded by job function passwords, identification codes, need-to-know master screens and terminal keylocks.University Hospital has an IBM 3083 CPU with five 3380 disk drives, four dual density tape drives, and a 3705 network controller. The network of 300 terminals and 100 printers is connected to the computer center by an RF broadband cable. The software is configured around the IBM/MVS operating system using CICS as the telecommunication monitor, IMS as the data base management system and PCS/ADS as the application enabling tool.The most extensive clinical system added to UHIS is the Physiological Monitoring/Patient Data Management System with serves 92 critical care beds. In keeping with the Hospital's philosophy of integrated computing, the PMS/PDMS with its network of minicomputers was linked to the UHIS system.In a pilot program, remote access to UHIS through the IBM personal computer has been implemented in several physician offices in the local community, further extending the communications horizons of University Hospital's Information System. The implications of remote access to PDMS through the IBM PC emulating a Siemens Model 420 Patient Data Management Terminal are being examined.