Head movement measurement: An alternative method for posturography studies

The present study evaluated the measurement of head movements as a valid method for postural emotional studies using the comparison of simultaneous recording of center of pressure (COP) sway as criterion. Thirty female students viewed a set of 12 pleasant, 12 unpleasant and 12 neutral pictures from the International Affective Picture System, repeated twice, using a block presentation procedure while standing on a force platform (AMTI AccuSway). Head movements were recorded using a webcam (©KPC139E) located in the ceiling in line with the force platform and a light-emitting diode (LED) placed on the top of the head. Open source software (CvMob 3.1) was used to process the data. High indices of correlation and coherence between head and COP sway were observed. In addition, pleasant pictures, compared with unpleasant pictures, elicited greater body sway in the anterior-posterior axis, suggesting an approach response to appetitive stimuli. Thus, the measurement of head movement can be an alternative or complementary method to recording COP for studying human postural changes.     

Staff attitudes towards institutionalised dementia residents

Aim. To explore the attitudes of staff caring for institutionalised dementia residents and the variables associated with these attitudes. Methods. Fourteen nursing homes and one hospital‐based geriatric ward in Bergen, Norway were surveyed, using the translation of an Approach to Dementia Questionnaire. The study population (n = 291) was a mixture of registered nurses, auxiliary nurses, nursing assistants and non‐trained aides. Design. Survey. Results. Significant differences in hope and person‐centred attitudes were identified in this study. Nursing assistants, compared with registered nurses (p = 0·02), had significantly lower hope attitudes· Staff over 50 years of age reported significantly lower hope attitudes (p = 0·01) than those under 40 years of age. Staff with 10 and fewer years of work experience reported significantly lower hope attitudes (p = 0·02) than those with more than 10 years of experience. Nurses with specialised training in geriatrics, psychiatry or dementia care had significantly higher hope attitudes, compared with nurses without any special training (p = 0·04). The person‐centred attitude was lower among participants who were over 50 years old, compared with their counterparts under the age of 40 (p ≤ 0·01). Discussion. Education, age, work experience, care unit size and specialised training are associated with differences in attitudes. We recommend that employers be proactive in encouraging and facilitating staff development by offering further training that aims to impart more positive attitudes. Relevance to clinical practice. Improvements in staff competency levels will be more important in the future, as a result of the forecasted increase in the percentage of the population who will suffer from dementia and reside in nursing homes.     

From biomedical teaching to biopsychosocial education: a process of change in a Finnish medical school

A group of clinicians, teachers and researchers in the University of Oulu have been worried for years about the predominantly biomedical orientation in the local Faculty of Medicine. Therefore, a project group was founded in 1992 to develop the medical degree programme towards a more comprehensive model. This article introduces the main strategies used in the process of change and describes the challenges encountered during the process. There are still many problems in the education of medical students towards a patient and family orientation and in the effort to change the whole medical culture of the university from a biomedical to a biopsychosocial approach. However, in the postgraduate education of general practitioners, we no longer prefer to teach only doctors, but education on the biopsychosocial model will also be arranged to the interdisciplinary teams working in the municipalities in the Province of Oulu in Finland.     

Postmortem inspection for neurosurgery: a training model for endoscopic dissection technique

In 63 specimens, 74 aneurysms, and five other lesions, postmortem microsurgical and endoscopic inspection (PMI) was done. This work not only allowed for safe pathoanatomic findings, but moreover showed characteristics of a training method developed according to a model with clear standards. PMI gives training in: 1. Understanding of pathoanatomic topography and syntopy 2. Analysis of imaging findings 3. Analysis of approaches (approach planning) 4. Paraendoscopic methods (video surgery) 5. Clipping training 6. Analyzing the ergonomy of the setting and instrumentation In the series presented, aneurysms were the focus of attention. Postmortem inspection trains nearly all manipulative and cognitive abilities necessary for operative management of this difficult lesion. The acceptance and applicability of this method for resident training must be evaluated in the future. Electronic Publication     

前颅底恶性肿瘤整块切除及缺损修复方法探讨

本文了介绍２１例前颅底恶性肿瘤整块切除及颅底、颌面部缺损修复治疗方法。根据肿瘤的大小及周围组织侵犯范围，制定了肿瘤部位切除方法的分类，根据其分类来设定肿瘤切除范围及缺损修复方法的选择。本手术方法，不仅能够完整地切除肿瘤，而且可以一期进行肿瘤切除后的颅底、颌面以及硬膜缺损的修复，有效地防止术后脑脊液漏等并发症的发生。本方法特别适用于鼻窦、颌面部恶性肿瘤向颅底侵犯的病例，以及颅底内、外肿瘤需手术切除的病例。本文还特别提出颅底、颌面缺损修复时的并发症及注意事项。     

谈医院管理工作作风的转变

结合医院管理工作实际,对医院管理工作的角色定位和职能进行了阐述,指出医院管理工作就是以病人和职工为中心,努力为患者、医疗一线和临床业务部门提供质优、安全、快捷、经济的医疗和保障服务。同时,对医院管理工作中存在的问题及原因进行了分析,在提出问题、分析原因的基础上,指出了解决问题的途径和对策。     

抗敏止痒乳膏的研制

研制了一种非激素的抗敏止痒乳膏,并按拟定的质量控制方法进行实验性检测,结果表明,该制剂性质稳定,对皮肤无刺激性,其鉴别反应与含量测定方法简便易行,等指标完全符合药用乳膏剂的质量要求。     

显微外科条件下鞍区肿瘤入路的选择

目的：评价治疗鞍区肿瘤常用的各种手术入路的治疗效果。方法：应用显微外科手术并采用不同的手术入路治疗４１例鞍区常见肿瘤，从手术显露范围、全切率等不同角度评价呼种手术入路的效果。结果：翼点入路的改良点入路能够取代一些创伤较大的入路，在显微外科条件下已成为最常用的手术入路。结论：结论各类肿瘤的临床特点，尤其是肿瘤与邻近结构、生长方面的关系，选择适当的手术入路并与显微外科技术有机结合是取得最好疗效的关键。     

经鼻中隔蝶窦进路切除脑垂体肿瘤10例

探讨脑垂体腺瘤经鼻中隔蝶窦进路手术方法，并分析蝶窦解剖变异在术中可能发生的问题。方法在全麻心肺监控下进行手术，术中遇解剖变异辨认困难时，用金属探针在手术治边摄头颅侧位Ｘ线片定位；暴露鞍底硬脑膜时先穿刺抽吸无血液后始切开脑膜。     

Predictor Variables for a Positive Long-Term Functional Outcome in Patients with Acute and Chronic Neck and Back Pain Treated with a McKenzie Approach: A Secondary Analysis

A cognitive behavioral approach was previously compared to a biomechanical approach (the McKenzie method) for the treatment of patients with back and neck pain in a randomized trial. Few differences between the treatment interventions were found. The aim of this secondary analysis was to determine if any clinical characteristics distinguished those patients who responded best to the McKenzie approach. Treatment success was defined as 50% reduction in original functional disability scores (Roland-Morris Disability Questionnaire or Northwick Park Neck Pain Questionnaire); failure to achieve this was defined as treatment failure. A liberal definition of success was 50% improvement retained at either 6 or 12 months, whereas a strict definition of success was 50% improvement at both 6 and 12 months. Ten variables were screened by univariate regression analysis to see if they predicted success. Any significant variables (P < 0.1) underwent multiple regression analysis. Only 21 and 16 patients out of 102 were deemed treatment successes according to the liberal and strict definitions, respectively. With the liberal definition, only centralization (P = 0.065), spine region (back rather than neck pain) (P = 0.089), and duration of pain (P = 0.001) emerged as predictors from the univariate regression analysis. With the strict definition, only the latter two variables emerged: spine region (P = 0.026) and duration of pain (P <0.01). All these variables were retained in the multiple regression analysis. In this study, duration of pain was the strongest predictor of success, although back pain and centralization had some predictive ability.