医学研究生生涯规划现状调查研究

目的了解医学研究生生涯规划的现状和生涯教育的需求。方法问卷调查法。结果分析发现医学研究生生涯规划有如下特点:自我认知程度高;职业探索存在不足;个人调适有待提高,就业信心较为乐观;职业决策导师影响最大;生涯规划元认知较差,生涯教育需求大。经相关性分析发现:性别、年龄、考研身份都与生涯成熟相关。结论医学研究生存在很大的生涯教育需求。     

Outcome measures in physiotherapy management of patients with stroke: a survey into self‐reported use,and barriers to and facilitators for use

Objective . To investigate physiotherapists' self‐reported use of outcome measures as recommended in the Dutch Clinical Practice Guideline on Physiotherapy Management of Patients with Stroke (CPGPS) and to assess perceived barriers to and facilitators for the use of outcome measures in everyday practice. Method . A 41‐item survey, including the barriers and facilitators questionnaire (BFQ), was sent by post to 400 physiotherapists in each of the following settings in the Netherlands: acute care hospitals (ACH; n = 100), rehabilitation centres (RC; n = 100), nursing homes (NH; n = 100) and private physiotherapy practices (PPP; n = 100). Results . One hundred and eighty‐nine physiotherapists returned the survey (47%; ACH, n = 57; RC, n = 67; NH, n = 26 and PPP, n = 39) and the surveys of 167 physiotherapists involved in stroke settings were analysed. These physiotherapists reported regularly using three (median; range 0–7) of the seven recommended outcome measures, with those working in RC or ACH reporting a significantly higher use than their colleagues in PPP (4 vs. 0 and 3 vs. 0; p < 0.001 and p = 0.02, respectively). The BFQ revealed that there were setting‐specific facilitators, such as ‘a positive attitude towards outcome measures’ (as mentioned by 93% of the physiotherapists) and ‘acquaintance with outcome measures’ (90%), and barriers such as ‘changing routines’ (32%), ‘time investment’ (29%) and ‘financial compensation’ (21%). Conclusion . Despite an almost uniformly positive attitude, physiotherapists infrequently use the outcome measures recommended in the CPGPS. Robust setting‐specific tailored implementation strategies based on the reported barriers and facilitators are needed. Copyright © 2008 John Wiley & Sons, Ltd.     

采血环境霉菌生长情况调查分析

目的：探讨采血环境霉菌生长情况、生长原因与规律，找出预防和控制措施，确保血液质量，保障献血者和受血者安全。方法：统计2005—2009年每月站内采血室、流动采血车空气和物表霉菌检出情况，探讨采血环境霉菌生长规律。结果：（1）霉菌生长与季节有关：每年4—971份是采血环境霉菌生长时间，其中7—8月份最易滋生霉菌；（2）霉菌生长与采血环境有关：流动采血车较站内采血室容易生长霉菌；（3）霉菌生长与管理有关：加强管理可降低霉菌的检出率，2005—2009年采血环境霉菌生长逐年下降就证明了这点。结论：每年4—9月份，特别是每年7—8月份要加强采血环境的消毒灭菌工作；流动采血车更要加强消毒管理工作；建立采血环境的感染管理体系，加强采血环节全面质量管理工作，可有效控制采血环境的霉菌生长，提高采血环境的质量，避免和减少交叉感染的发生。     

Household diet-quality in relation to mortality in Portuguese regions: an ecological study

The aim of this study was to investigate the association between regional household diet quality and corresponding mortality data. Two household diet quality scores derived from household budget survey food and nutrient data were used: the Mediterranean Adequacy Index (MAI), assessing adherence to a Mediterranean food pattern, and a revised Healthy Diet Indicator (HDIr), based on compliance with WHO population dietary goals. Seven Portuguese regions were considered, in accordance with the officially adopted national territorial division NUT II. The corresponding regional age-standardised death rates were calculated for selected diet-related mortality causes. In order to allow for a minimum of 10 years latency period between exposure and outcome, dietary scores from 1989/1990 and its components were correlated to the 3-year average 1999/2001 death rates. Tobacco expenses were included for adjustment. Significant negative correlations with the proportion of families with highest MAI (≥4) or HDIr (≥7) scores were observed for mortality from diabetes mellitus (−0.87, P < 0.05; −0.89, P < 0.5), cardiovascular diseases (−0.89, P < 0.05; −0.96, P < 0.01) and ischaemic heart disease (−0.89, P < 0.05; −0.90, P < 0.05). Malignant neoplasms were positively correlated with protein, cholesterol and soft drinks, but inversely with polyunsaturated fatty acids (PUFA). Diabetes showed significant positive correlations with simple sugars and animal fat intake, but inversely with fruits and vegetables. Cardiovascular diseases presented positive correlations with simple sugars, milk and dairy products and animal fat, but inverse with fruits and vegetables and vegetable oils. Despite the limitations of ecological approaches in general and of the statistical power in this particular study, due to the use of broad geographical areas, significant correlations in the expected direction of reduced mortality risk with improved household diet quality was reported. The use of diet quality scores in data from household budget surveys could depict variations in Portuguese regional food and nutrient patterns, which were revealed to be related and partially explain differences in regional cause-specific mortality rates from diet-related diseases. An erratum to this article can be found at     

糖尿病患者情绪障碍和社会支持的城乡分布特点

[目的]探讨糖尿病患者焦虑、抑郁情绪和社会支持的城乡分布状况. [方法]对山西省4个地区8个调查点的2132名城乡居民,其中包括139名糖尿病患者,进行问卷调查,了解其一般情况以及情绪状况、社会支持等社会心理因素.[结果]城乡糖尿病患者问社会支持差异显著,城乡糖尿病患者与非糖尿病患者交互作用在抑郁得分差异显著.[结论]糖尿病患者情绪障碍和社会支持在城乡间分布是有差异的,这为临床根据社区、乡镇糖尿病患者各自特点,有针对性地实施心理干预提供了依据.     

Mothers’ Reports of Postpartum Pain Associated with Vaginal and Cesarean Deliveries: Results of a National Survey

ABSTRACT: Background: As cesarean rates increase worldwide, a debate has arisen over the relationship of method of delivery to maternal postpartum physical health. This study examines mothers’ reports of their postpartum experiences with pain stratified by method of delivery. Methods: Listening to Mothers II was a survey of a total of 1,573 (200 telephone and 1,373 online) mothers aged 18 to 45 years, who had a singleton, hospital birth in 2005. They were interviewed by the survey research firm, Harris Interactive, in early 2006. Online respondents were drawn from an existing Harris panel. Telephone respondents were identified through a national telephone listing of new mothers. Results were weighted to reflect a United States national birthing population. Mothers were asked if they experienced any of eight postpartum conditions and the extent and the duration of the problem. Responses were compared by method of delivery. Results: The most frequently cited postpartum difficulty was among mothers with a cesarean section, 79 percent of whom reported experiencing pain at the incision in the first 2 months after birth, with 33 percent describing it as a major problem and 18 percent reporting persistence of the pain into the sixth month postpartum. Mothers with planned cesareans without labor were as likely as those with cesareans with labor to report problems with postpartum pain. Almost half (48%) of mothers with vaginal births (68% among those with instrumental delivery, 63% with episiotomy, 43% spontaneous vaginal birth with no episiotomy) reported experiencing a painful perineum, with 2 percent reporting the pain persisting for at least 6 months. Conclusions: Substantial proportions of mothers reported problems with postpartum pain. Women experiencing a cesarean section or an assisted vaginal delivery were most likely to report that the pain persisted for an extended period. (BIRTH 35:1 March 2008)     

肝炎病毒感染的临床调查分析

目的　为进一步证实庚型肝炎病毒的感染途径 ,并探讨检测该病毒在献血员筛选工作中的意义。方法　采用 Elisa和 PCR法 ,检测 76名血液病患者、82名非血液病患者和 90名健康体检者血清中乙、丙、庚肝炎病毒标志物。结果　这 3型病毒感染标志物的阳性率 (Elisa法 )在上述 3组人中分别为 2 6 .3%、12 .2 %和 10 .0 % ,11.8%、3.7%和 2 .2 % ,以及 9.2 %、1.2 %和 1.1% ,血液病组显著高于另两组 (χ2 =32 .36 ,P<0 .0 0 5 ) ;PCR法检查结果类似 ;有受血史者高于无受血史者 ,且与受血量呈正相关。结论　庚型与乙、丙型肝炎病毒类似 ,可通过血液途径传播 ,因此对献血员采用高敏感性的筛选手段及严格控制输血指征 ,对控制可经血液传播的庚型肝炎病毒等的医院感染 ,具有重要意义     

Lifetime prevalence of specific mental disorders among people born in Iceland in 1931

The lifetime prevalence rates are presented for mental disorders in a random sample of people born in Iceland in 1931, interviewed at the age of 55-57 years. The diagnoses are made according to DSM-III, on the basis of the National Institute of Mental Health's diagnostic Interview Schedule (NIMH-DIS) used by trained lay interviewers. The most common diagnoses were alcohol abuse and dependence, generalized anxiety disorder, phobic disorders, dysthymic disorder and major depressive episode. Disorders more common in men were antisocial personality, alcohol abuse and alcohol dependence. Disorders more common among women were major depressive episode and generalized anxiety disorder. Alcohol abuse was more prevalent among those living in rural areas, but dependence was more prevalent in the urban area, where panic disorder is also more frequent. Widowed, separated and divorced people had most of the highest prevalences: tobacco-use disorder, alcohol abuse and dependence, dysthymia and generalized anxiety disorder. Except for a very high rate of alcohol abuse and dependence and a low rate of substance abuse disorders, the prevalence rates are similar to those obtained in North American studies using the NIMH-DIS as a survey instrument. The DSM-III criteria for alcohol abuse or dependence may be less applicable to Iceland than to North America, because of differences in what is culturally regarded as acceptable use of alcohol.     

我院2001年住院患者抗菌药物应用状况调查分析

目的:了解我院住院患者抗菌药物的实际应用情况。方法:以2001年各科住院人数为基数,按比例随机抽取出院患者的病历,预先设定调查项目,逐一录入Access数据库,链接Excel进行综合分析。结果与结论:我院抗茵药物的应用率较高(75.35％);外科(包括颈椎、妇科)预防手术部位感染应用抗菌药平均达97％;各科室平均应用抗菌药品种数为1.5种,趋于合理;抗菌药物的联合应用以喹诺酮类、青霉素类、头孢菌素类与硝咪唑类为主;广谱抗茵药与抗感染植物药的联合应用日渐增多;病原学检查的比率占12.72％。