妊娠期口服葡萄糖负荷试验合理血糖界值的探讨

目的 探讨目前适合我国卫生经济条件的妊娠期葡萄糖负荷试验(GCT)的筛查界值.方法 资料来源于2006年4月1日至2006年9月30日在全国18个城市25家医院保健并进行首次50 g GCT的16 286例孕妇,对其GCT结果进行统计和分析.结果 以NDDG标准诊断妊娠期糖尿病(GDM),50 g GCT的界值选取7.2 mmol/L时的敏感度和特异度分别为98.2%和59.0%,选取7.8 mmol/L时分别为96.0%和73.0%,选取8.3 mmol/L时分别为90.2%和81.5%;以ADA标准诊断GDM,选取GCT界值为7.2 mmol/L时敏感度为97.9%,特异度为60.4%;选取7.8 mmol/L时分别为96.2%和74.7%;而选取8.3 mmol/L则分别为87.0%和83.1%.以NDDG标准诊断妊娠期糖代谢异常(包括GDM及妊娠期糖耐量受损),选取7.2 mmol/L时敏感度和特异度分别为97.7%和61.4%,选取7.8 mmol/L时分别为95.4%和75.8%,选取8.3 mmol/L时分别为84.9%和84.1%.结论 据我国目前的卫生经济情况,以7.8 mmol/L作为50 g GCT的界值是合理的.     

手工搬举作业的最大可接受搬举重量

目的对手工搬举作业的最大可接受搬举重量（MAWL）进行研究,为我国制订手工搬举作业劳动负荷的标准提供依据.方法 用心理物理学方法对13名男性和10名女性受试者的MAWL进行了研究,并与推荐搬举重量限值进行比较.结果 男女受试者的MAWL均随着搬举高度的上升逐渐降低.当搬举高度超过肩关节时,MAWL急剧下降.男性受试者在水平距离25 cm处,其推荐搬举重量均大于MAWL,但在水平距离45、63cm处,推荐值均小于MAWL.男性受试者的平均MAWL比女性受试者高30.8%.在同一高度,随着水平距离的增加,MAWL逐渐下降,男女受试者结果一致.男性受试者不对称搬举时,扭转的角度越大,MAWL越低.扭转角度和搬举能力呈负相关（r=-0.996 6,P＜0.01）.不同扭转角度的推荐搬举重量限值均比MAWL低,且差异有统计学意义（P＜0.01）.结论 美国国家职业安全卫生研究所（NIOSH）搬举方程对于水平距离和不对称的校正是充分的,但对于高度的校正是不足的,尤其是对于过肩的搬举作业是不适合的,对于过肩搬举作业的推荐搬举重量限值还应降低.NIOSH搬举方程应考虑性别因素的影响,可加入性别常数项S;如果性别为男性,则S=1;如果性别为女性,则S=0.692.     

信息时代实施个人知识管理的思考

信息时代,面对海量的信息和繁多的信息渠道,如何有效获取信息、吸收信息和运用信息成为每个人所必须面对的问题。个人知识管理作为知识管理思想在个人层面的应用为解决这个问题提供了思路和方法。文章就信息时代个人如何实施知识管理做了探讨,总结了个人知识管理的实施框架、详细阐述了个人知识管理的实施过程和所需技能,并对个人知识管理系统的发展做了分析。     

药学高职教育的价值取向与课程设计

以执业药师岗位群为目标,确立药学高职教育的专业方向并设计相关课程;以高职教育特征和学历层次定位为依据,指导课程大纲的制定;依照现代高职人才的通用价值标准设立技能拓展和素质培养课程。在专业定位、学历层次定位和高职教育通用价值标准的三维坐标中确立药学高职教育的价值取向,并引领教育改革的方向。     

Bioactive nutrients - Time for tolerable upper intake levels to address safety

There is increasing interest by consumers, researchers, and regulators into the roles that certain bioactive compounds, derived from plants and other natural sources, can play in health maintenance and promotion, and even prolonging a productive quality of life. Research has rapidly emerged suggesting that a wide range of compounds and mixtures in and from plants (such as fruits and vegetables, tea and cocoa) and animals (such as fish and probiotics) may exert substantial health benefits. There is interest in exploring the possibility of establishing recommended intakes or dietary guidance for certain bioactive substances to help educate consumers. A key aspect of establishing dietary guidance is the assessment of safety/toxicity of these substances. Toxicologists need to be involved in both the development of the safety framework and in the evaluation of the science to establish maximum intake/upper limits.     

A New Approach to Study the Physical Stability of Monoclonal Antibody Formulations—Dilution From a Denaturant

The early-stage assessment of the physical stability of new monoclonal antibodies in different formulations is often based on high-throughput techniques that suffer from various drawbacks. Accordingly, new approaches that facilitate the protein formulation development can be of high value to the industry. In this study, a dynamic light scattering plate reader is used to measure the aggregation (by means of the increase in the hydrodynamic radius [R_h]) of monoclonal antibody samples that were subject to incubation and subsequent dilution from different concentrations of a denaturing agent, that is, guanidine hydrochloride. The increase in the R_h of the protein samples is dependent not only on the denaturant concentration used but also on the buffer in which the incubation/dilution was performed. We also compare the aggregation after dilution from a denaturant with other high-throughput stability-indicating methods and find good agreement between the techniques. The proposed approach to probe the physical stability of monoclonal antibodies in different formulation conditions offers a unique combination of features—it is isothermal, probes both the resistance to denaturant-induced unfolding and the colloidal protein stability, it is entirely label-free, does not rely on complex data evaluation, and requires very short instrument measurement time on standard equipment.     

Trends in listening to personal stereos

Abstract

Long term use of personal stereo players (PSP) is now established as a potential risk to hearing health if exposure levels are not maintained at what are accepted as safe levels. Comparison of PSP user test results indicate that mean listening levels (L_Aeq) have decreased from 86.1 dB in 2002/03 to 81.3 dB in 2008 and mean exposure levels (L_Aeq,8h) have decreased from 79.8 dB to 74.7 dB over the same time period, in a user population whose mean age has increased from 23.6 years (SD = 5.7) to 26.0 years (SD = 10.5). This reduction in exposure level of 5 dB also means that the percentage of user population at risk of noise injury and subsequent hearing loss has decreased from 25% to 17% when judged by criterion commonly used for workplace occupational noise exposure standards.

Sumario

Está bien establecido que el uso prolongado de estéreos personales (PSP) es un riesgo potencial para la salud auditiva, si los niveles de exposición no se mantienen en los niveles aceptados como seguros. La comparación de los resultados de pruebas a usuarios de PSP indican que los niveles de escucha medios (L_Aeq) han disminuido de 86.1 dB en 2002/03, a 81.3 dB en 2008 y que los niveles medios de exposición (L_Aeq,8h) han disminuido de 79.8 dB a 74.7 dB en el mismo período de tiempo, en una población de usuarios cuya edad media se ha incrementado de 23.6 años (SD=5.7) a 26 años (SD= 10.5). Esta reducción de 5 dB en el nivel de exposición, también significa que el porcentaje de población de usuarios con riesgo de daño por ruido y subse-cuente pérdida auditiva, ha disminuido de 25% a 17%, cuando se juzgan con el criterio comúnmente usado para los estándares de exposición en lugares de trabajo con ruido ocupacional.     

From a Social Issue to Policy

Summary

This paper outlines a 22 year campaign to introduce openness into the arena of donor conception in the UK. It identifies key aspects of the development of an advocacy based approach to such work and argues that social work values and principles can prove key to identifying structural inequalities which are not necessarily based in socio-economic disadvantage. Donor conceived people may find themselves in families which enjoy material privilege but whose exposure to a legislative framework and dominant professional cultures within the treatment centres encourages secrecy around genetic origins. Social workers' experience of adoption and family work leads them to recognise the danger of such secrets within families. Turning such social issues into policy changes requires vision, strategic long term advocacy and partnership with those directly affected.     

Professional Burnout:

This paper attempts to answer the question of why social caseworkers have ongoing supervision by exploring the historical evolution of social work supervision. Supervision has withstood the many changes in the field since its beginning in the late 1800s and has been reinterpreted to fit the prevailing theories guiding practice, thus avoiding obsolescence. Supervision began as an educational device, then evolved into a practice tool, later became a therapeutic method, and then became a separate entity from therapy.