某高校新生军训期间伤病情况及防治对策

目的了解高校新生军训的伤病情况,为制订合理的防治措施提供科学依据。方法统计军训期间在医疗服务站点和校医院门诊疾病情况统计,并针对性的提出防治措施。结果新生军训期间伤病有着一定的规律和特点,女生就诊率高于男生,排在首位的是上呼吸道感染,其次为胃肠炎和急性结膜炎;2004年就诊率29.76%,2005年就诊率25.50%,2006年就诊率22.20%。结论新生军训期间的伤病情况不容乐观,加强健康教育,做好军训期间的医疗保健和卫生监督工作十分必要。     

湖北省卫生人力资源情境分析

目的 对湖北省卫生人力资源的现状进行分析和评估，探讨改善卫生人力质量及分布结构的对策。方法 采用回顾性分析方法，对湖北省1952－2000年卫生人力状况进行描述性分析，并采用聚类分析和秩和比评价法对卫生人力资源进行综合评价。结果 1952－2000年湖北省卫生人员数量由3．57万增至30．14万，卫生人员及卫技人员数平均年递增2．41％和2．44％；2000年千人口拥有卫技人员，医生及护师（士）数分别为4．02人，1．74人和1．03人，医生护士比为1．32，医生防疫人员比为9．91；武汉市，黄石市等6个城市卫生人力资源综合评价较优。结论 湖北省卫生人力资源呈增长趋势，总体数量趋于饱和，但存在素质不高，卫生人力地区间及专业间结构分布不均衡等问题。     

Assessment of the humane aspects of electric lancing of whales by measurement of current densities in the brain and heart of dead animals

The potential physiological effects of the electric lance are assessed, as used in Japanese whaling operations. Current densities are measured in the brains and hearts of six whales to which a controlled current of 5 A is applied by two electrodes inserted at various sites in the carcasses. The whales vary in size from 1.8 m (200 kg) to 16 m (40 t). The minimum current density in the brain necessary to cause depolarisation of neurones is estimated to be 10 mA cm⁻² and to cause ventricular fibrillation is estimated to be 0.5 mA cm⁻². No current densities exceeding 4.8 mA cm⁻² are recorded in the brain. Very few recordings of current density from the heart are above 0.5 mA cm⁻², and they occurr only when electrodes are in optimal positions. When electrodes are placed as in whaling operations, no whale over 3 m in length would receive current densities in the heart or brain sufficient to cause permanent dysfunction. It is concluded that electric lancing is ineffective as a secondary method of killing whales and that the current densities recorded could cause pain and suffering to an already distressed animal.     

Stiff-man syndrome and dementia

Stiff-man syndrome is characterized clinically by fluctuating muscular stiffness and spasm, and electromyographically by continuous motor unit activity at rest, which is abolished by sleep, general anesthesia, nerve block, curare, and several centrally-acting medications. A spinal or supraspinal origin has been proposed for this disorder. Some clinical and electrophysiologic features, along with an occasional association with encephalopathy, may support a proposed supraspinal cause. An elderly man with progressive dementia and concomitant development of stiff-man syndrome is described. He had not had stiff-man syndrome one year earlier, when he had only mild dementia. An association between stiff-man syndrome and dementia has not been previously described. Increased muscle tone and muscular rigidity is frequently encountered in patients with dementia, however, and pathologic reflexes involving neck and proximal musculature have been described in dementia. It is possible that this patient represents an exaggerated form of such motor disturbances in dementia, and that clinical and electromyographic features of stiff-man syndrome may be present with increased incidence in patients with dementia.     

SQUARE-WAVE ANALYSIS OF SKIN IMPEDANCE

A method is described for studying skin impedance phenomena, based on analysis of waveforms of current through the skin produced by square voltage pulses. In several experiments, the method is used to provide data relevant to the choice of an appropriate equivalent circuit for skin. Removal of the stratum corneum eliminates the parallel resistive and capacitative elements, and slightly reduces the series or ‘ohmic’ resistance. During healing the source of skin potential recovers before the other electrodermal parameters have returned to normal. The relationship of these parameters to electrode area, current density, and site temperature is studied. It is argued that the capacitance of skin may not vary with the frequency of the measuring current, in contrast to traditional views. The main purpose of the paper is to illustrate and advocate the square-wave method of analysis.     

The effect of living in flats on mental health A general practice survey

Summary From the literature it appears that most people prefer not to live in flats. That there, however, a high prevalence of psychological problems among flat dwellers does not come out clearly. The present study describes a cross-sectional survey carried out to determine the effect of living in flats on the general practice.It turns out that in flats the contact rate with the general practitioner is higher than in regular houses. The difference in contact rate cannot be explained by an increased contact rate for psychological or psychosomatic problems. However, in flats twice as many women contact their general practitioner for contraceptive advise. The two groups investigated have been matched in age, sex, family situation and profession. After the matching procedure the prevalence of psychological problems and the use of sedatives and hypnotics appeared surprisingly to be lower among flatdwellers. In psychosomatic problems no differences were found.     

Testing the individualized care model

BACKGROUND: Although there has been some research to identify the dimensions on which individualized care should be measured, the indicators that constitute individualized care remain unclear. OBJECTIVES: To describe briefly the maintenance of individualized care and to test a hypothetical model of individualized care in a sample of surgical patients. DESIGN AND METHODS: A correlational survey design was used. Data were collected with questionnaires from adult patients (n = 454) discharged from surgical wards in one Finnish hospital district (response rate 91%). Structural equation modelling LISREL SIMPLIS using maximum likelihood estimation was used to estimate and test the parameters of the hypothesized model derived deductively from the previous literature. RESULTS: The goodness-of-fit statistics supported the basic solution of the Individualized Care Model, although two additional paths indicating error covariances between the sub-concepts were identified in the revised model. In this model individualized care is defined in terms of patients' views of nursing activities aimed at supporting individuality in care and in terms of perceptions of individuality in their own care. CONCLUSIONS: The model has been found to capture attributes that characterize individualized care. It can be used as a basis for evaluation in clinical nursing practice from patients' point of view. The study highlights the importance of patients' clinical situation, personal life situation and decisional control as predictors of individualized care. The results also confirm the construct validity of the previously developed Individualized Care Scale.     

浙江省布鲁氏菌病流行现状及防治对策探讨

目的：了解浙江省布鲁氏菌病防治现状。探讨今后布病防治对策。方法：对存栏牲畜采血作血清学检查，对重点人群采用布病皮试、血清学及流行病学调查等方法进行检测。以及时发现人畜布病疫情，采取防控对策。结果：1983-1995年间全面开展了畜间布病普查。共查11个地市的86个县（市、区）的奶牛、山羊和猪等家畜共计238403头，检出布病阳性326头，阳性率为0．14％。人间布病共监测11个地市42个县（市、区）18098人，皮试阳性355人，阳性率1．96％，血清学阳性7人，阳性率为0．04％。控制达标后的1996-2005年中。共检查奶牛、耕牛、羊和猪等牲畜180675头，检出阳性奶牛和山羊1245头，阳性率为0．69％。对职业人群监测18262人，其中皮试5182人，阳性28人，阳性率为0．54％；直接血清学检查12897人，阳性110人，阳性率为0．85％，发现布病病人31例，人畜布病阳性率有逐年增高趋势。结论：应做好牲畜检疫，建立牲畜健康证制度，加强对牲畜养殖、屠宰、生皮毛加工等重点人群的布病监测，以控制疫情蔓延。     

Varied and Principled Understandings of Autonomy in English Law: Justifiable Inconsistency or Blinkered Moralism?

Autonomy is a concept that holds much appeal to social and legal philosophers. Within a medical context, it is often argued that it should be afforded supremacy over other concepts and interests. When respect for autonomy merely requires non-intervention, an adult's right to refuse treatment is held at law to be absolute. This apparently simple statement of principle does not hold true in practice. This is in part because an individual must be found to be competent to make a valid refusal of consent to medical treatment, and capacity to decide is not an absolute concept. But further to this, I argue that there are three relevant understandings of autonomy within our society, and each can demand in differing cases that different courses of action be followed. Judges, perhaps inadvertently, have been able to take advantage of the equivocal nature of the concept to come tacitly to decisions that reflect their own moral judgments of patients or decisions made in particular cases. The result is the inconsistent application of principle. I ask whether this is an unforeseen outcome or if it reflects a wilful disregard for equal treatment in favour of silent moral judgments in legal cases. Whatever the cause, I suggest that once this practice is seen to occur, acceptable justification of it in some cases is difficult to find.