Removing risk stratification in food allergy prevention guidelines

There is now level one evidence based on randomized controlled trials that early ingestion of allergenic solids in infancy has a preventive effect against food allergy development. As a result, guidelines now recommend early ingestion of allergenic solids as a means of food allergy prevention. However, guidelines in Canada currently focus this intervention specifically on infants at risk, defined currently as an infant who has a history of atopy such as eczema or food allergy, or who has an immediate family history of atopy. However, this definition fails to account for studies supporting early ingestion as a preventive measure within the broader population. Not all of these risk factors (such as immediate family history of atopy) are consistently supported by the literature to date. Finally, a more universal approach to food allergy prevention simplifies the message, decreases stigmatization, and reduces medicalization of infant feeding. It also has the potential to reduce reticence to feed in infancy. The goal of this commentary is to argue that food allergy prevention guidelines should focus their interventions on the broader population and not just those defined as at higher risk.     

医学重复观测数据裂区方差分析的假定条件的检验

目的 重复观测数据存在自相关性常导致一元方差分皙误用,探讨一元方差分析两个假定条件的检验。方法 通过标准正交对比变换克服数据间的自相关性,应用似然比统计量进行假定条件的检验。结果 给出了重复观测数据一元方差分析的假定条件检验方法,并用软件REP得以实现。结论 只有满足假定条件,才可以保证重复观测资料单变量方差分析的有产性。     

论数字化图书馆

数字化图书馆是 2 1世纪高速网络环境下图书馆发展的方向和主流。本文论述了数字化图书馆的概念、意义及其优越性 ,分析了当前我国数字图书馆发展存在的问题 ,并提出了我国数字图书馆建设的发展措施     

国内关于缩短平均住院日的影响因素及对策研究

平均住院日是衡量医院医疗质量与管理水平的综合指标。医院合理提速运行的基础是控制平均住院日的影响因素,这些因素可分为可控因素和不可控因素。相应可通过宏观协调转化不可控因素,引入的新的管理思想,制定适宜的平均住院日标准,配以微观措施以降低医院的平均住院日。     

试论健康价值观

健康是人类最宝贵的财富。健康价值观是指个体对健康各方面(包括生理功能、心理功能和社会功能等)的价值进行评价的稳定的内部标准和主观看法。健康价值观及其对它的测评研究有着不断完善和进取的发展过程,其结构也有着不同的划分。健康价值观受父母教养方式、文化环境、社会科技的进步、受教育程度及重大生活事件等因素的影响。对健康价值观的研究在理论上和实践应用中都有着重要的意义。     

Outcome from Complex Neurosurgery: An Evidence Based Approach

Summary ? Background. The aim of this study was to determine outcome, including quality of life, after surgery for petroclival meningioma using a standard skull base approach and to carry out an evidence based appraisal of the relevant literature.  Method. Pre- and post-operative data including adverse events were prospectively recorded in 19 patients (15 females, age range 29–63) undergoing a transpetrous approach for a petroclival meningioma. Patients were assessed using the GOS and SF-36 post operatively.  Findings. 24 operations were done. 6 patients developed a new permanent neurological deficit and 10 experienced a temporary deficit or exacerbation of existing deficits. At 1 year 15 patients had made a good/moderate recovery, 3 were severely disabled and 1 died – in keeping with other studies. By contrast the SF-36 showed that in all 8 categories of the SF-36 between 39–72% of surviving patients were functioning below the accepted norms.  Interpretation. After transpetrous excision of a petroclival meningioma the quality of life for the patient is worse than that indicated in surgeons' reported results. This paper represents an attempt to address the issue of evidence-based medicine and finds that such an approach is not apparent in the medical literature on this pathology. While we argue that methods for measuring outcome should be refined and carers input recognised it does raise certain philosophical considerations. It is the counsel of perfection and if achieved may lead to surgeons operating on fewer patients, more petroclival cases being viewed as inoperable because of the higher morbidity, despite there being an inescapable pathway to surgical intervention.     

兰州市小学生安全教育近期效果评价

目的评价儿童安全教育近期效果,为提高儿童安全意识、减少突发事件的发生及突发事件对儿童的伤害提供依据.方法对3所小学三～五年级(9～11岁)的小学生采取3种不同方式的安全教育,并在教育前后采用自制儿童安全知识问卷进行调查,评价安全教育的近期效果.结果接受安全教育后,学生的安全知识水平和安全意识普遍有所提高,答卷成绩的提高与平时学习成绩有关,而基本不受是否独生子女、父母文化程度、父母职业等因素影响.结论安全教育是提高儿童安全知识水平和安全意识行之有效的措施.     

某高校教职工健康状况调查

目的　了解我校教职工健康状况和疾病谱特征 ,为制定预防措施提供依据。方法　对 1 75 2名教职工健康检查数据进行统计分析。结果　我校教职工平均患病率为 88.30 % ,患病率随年龄增长而上升。高脂血症患病率最高 ,占 4 5 .89%。结论　加强高校保健服务 ,开展针对教职工的健康教育 ,是今后高校卫生保健工作的重要内容     

太原市家蝇抗性水平及防制策略

目的　采取综合治理措施 ,提高灭蝇效果。方法　用点滴法测定家蝇对常用杀虫剂的抗性变化。结果太原市家蝇 2 0 0 3年对溴氰菊酯、敌敌畏抗性属中抗水平 ,LD50 分别为 0 .0 2 3 2、0 .1188μg/只 ;对二氯苯醚菊酯和氯氰菊酯的抗性属低抗水平 ,LD50 分别为 0 .0 0 69、0 .0 0 99μg/只 。结论　开展综合防制 ,以科学的方法合理使用杀虫剂 ,延缓抗性的发生和发展。     

濮阳市控烟措施的效果评价研究

目的评价濮阳市控烟措施实施的效果,并探索一套控烟效果的评价指标。方法采用多阶段随机抽样的方法,共调查1551名15岁以上城区居民,另外收集有关资料。结果烟草销售量下降熏2001年销售量比1993年下降22.5%。总人群现在吸烟率为20.8%,比1996年全国水平低14.5个百分点(P<0.01);戒烟率为14.2%,比1996年全国高4.8个百分点(P<0.01);被动吸烟率为39.0%,比1996年全国水平低14.5个百分点(P<0.01);吸烟有关知识知晓率显著提高(P<0.01)。社会风气好转。多因素分析表明,人群吸烟行为的改变与控烟措施有关。结论控烟措施有效地改变了人群的吸烟行为。但是女性的吸烟问题没有得到有效遏制。评价方法和指标是可行的,有效的。