148例口腔颌面部恶性肿瘤的临床统计及随访观察

本文将我科1974年至1983年收治的148例口腔颌面部恶性肿瘤就性别、年龄、发病部位、肿瘤性质以及所随访的102例口腔领面部恶肿瘤的存活率与肿瘤性质、部位、治疗等的关系进行了统计分析,并评价了冷冻治疗及颈淋巴结根治术。同时阐明了唇癌、皮肤癌淋巴结根治术的指征。     

广东省输精管绝育技术应用状况调查

为分析影响输精管结扎术推广应用技术因素,了解基层手术点的手术质量,1994年～1995年对23个基层手术点作现场调查,发现影响男性结扎手术质量的一些因素,例如部分基层手术点操作不规范,未能按《节育手术常规》操作,手术管理制度不够严格。建议:①加强男性结扎术操作规范化的培训。②推广新型的手术消毒剂和先进的操作方法。③重视心理咨询和心理护理。④强调节育效果是手术质量的主要指际。⑤完善手术管理制度。     

Are there really many runners out there? Is the proportion of runners increasing over time? A population-based 12-year repeated cross-sectional study with 625,460 Brazilians

ObjectivesTo investigate the proportion of individuals who practice running, its temporal trend, and to describe the runners’ characteristics.DesignPopulation-based repeated cross-sectional study.MethodsThe data from the Protective and Risk Factors for Chronic Diseases by Telephone Survey (Vigitel) from Brazil were used. Telephone interviews were conducted with adults from the Brazilian capitals (27 cities) between 2006–2017. The interviewer read the questions and recorded the participants’ responses immediately in a questionnaire. Data analyses were conducted using a Bayesian approach.ResultsThe Vigitel database consisted of 625,460 Brazilian participants composed of 295,681 exercisers and within them 15,529 runners. The mean yearly proportion of runners was about 2.45% (95% Bayesian credible interval [CrI] 1.93 to 3.11) and 5.32% (95%CrI 4.29 to 6.54) in the entire study population and within exercisers, respectively. The absolute increase in the proportion of runners per year over the 12-year period was 0.13% and 0.17% in the entire study population and within exercisers, respectively. Runners were more likely to be younger, men, within normal body mass index, highly educated, moderate alcohol drinkers, non-smokers, less exposed to TV, living near physical activity/sports facilities and less exposed to health conditions such as arterial hypertension, diabetes and dyslipidaemia.ConclusionThere was a 95% probability that the yearly proportion of runners lies between 1.93% and 3.11% in the population of the 27 Brazilian capitals, and between 4.29% and 6.54% within exercisers. There has been an increase in the proportion of runners over time. Runners were associated with healthier characteristics compared to non-runners and non-exercisers.     

Workforce intelligence: what data do we need to collect to understand trends in substantive oral and maxillofacial surgery consultant posts? A retrospective review and plan for the future

Understanding workforce pressures within surgery is an inexact science. This paper assembles evidence regarding oral and maxillofacial surgery (OMFS) consultant appointments in the UK and plans for prospective data collection in the future.Information about the number of OMFS specialists joining the UK specialist list was obtained from the General Medical Council and compared to a database of substantive OMFS consultant posts. OMFS consultants were asked to contribute information about their training programmes and consultant appointments (date, interview experience, and sub-specialty interest). This information was collated on Excel© and analysed using WinStat©.Data on OMFS consultant posts advertised in ‘NHS Jobs’ and the British Medical Journal were collected. The mean (SD) number of specialists joining the specialist list per year is 24.1 (5.2) with a median of 24 and a range of 15 – 36. The number of trainees completing training and numbers joining the OMFS specialist list are in balance at present. The median delay between OMFS specialist listing and appointment as a consultant was 72 days and mean of 169 with the 25th centile of five days, standard deviation of 239 days and maximum of 5.2 years. Of those returning data, 135 (47%) candidates were the sole interviewee and 83 (29%) had one other candidate at their successful interview. The mean application ratio for each post was 1.9 and the median number of candidates was one, mean 1.6 and maximum candidates seven. About half of the posts were filled by trainees from their regional training rotation. Prospective data collection on advertised posts, interviews held, expected retirements/new posts, combined with a route for trainees approaching CCT to highlight their availability may streamline recruitment and allow a more rapid recognition of recruitment problems.     

Activities of contemporary Mayan elders

Social gerontology researchers have investigated various aspects ofelder activities in diverse culture contexts. This project assessed theknowledge that Mayan people have about the activities of their elders.Data were collected through two interview procedures. The firstprocedure, free-listing, was conducted with an initial sample of Mayansubjects (n = 31), who provided terms representing their culturalknowledge of elder Mayan activities. A second sample (n = 56)performed a pile sort task using 18 of those activities. The pile sortfindings were subjected to multidimensional scaling, and that techniqueproduced a two-dimensional visual representation of three distinctclusters of activities: productive work, serious socio-religiousundertakings and frivolous ventures. Besides the coherentmultidimensional scaling representation for that total sample of 56subjects, scalings for subsamples based on generational affiliation wererun. Two-dimensional pictures or visual maps for the aged, middle-agedand young adult subjects are remarkably similar to each other and to thepicture for the total sample. From a methodological perspective theresearch findings demonstrate that elder Mayan activities, andpresumably those of elders in other societies, are amenable to interviewprocedures that have high validity and high reliability.     

Unidentified communication challenges in the intensive care unit: A qualitative study using multiple triangulations

BackgroundCommunication in the intensive care unit is challenged by patients’ inability to speak owing to intubation, treatment, and illness. Research has focused on the use of communication tools or techniques, characteristics of the communication between patients and clinicians, and their experiences of communication challenges. However, few studies have combined the perspectives of patients, family members, and clinicians. We explored communication from different angles and investigated challenges that cannot be explained by ineffective use of aids and communication techniques.ObjectivesThe aim of this study was to explore communication between patients, family members, and nurses and to investigate previously unidentified communication challenges.MethodsThis study used a case-oriented design with multiple triangulations. It was conducted in two general intensive care units at a Norwegian university hospital. Participant observations were conducted on nine mechanically ventilated patients while communicating with family members and healthcare personnel. Following the observations, individual interviews were conducted with six patients, six family members, and nine healthcare personnel.FindingsCommunication often seemed uncomplicated at the time of observations, but information from the interviews revealed another picture. We demonstrate what participants emphasised differently when they discussed their experiences, revealing a discrepancy in perceived importance in the situation. Family members had an important role in interpreting signs from the patient, uncovering challenges that would have been unknown to the nurses otherwise.ConclusionsThis study illustrates how communication challenges in the intensive care unit may not be perceptible to an observer or to all of the participants involved at the time of the communication. Nurses need to be aware of these communication challenges and realise that the patient might face issues that cannot be easily solved without extensive involvement of the patient, family, and nurses, and perhaps not even until a later stage in the patient's recovery process.     

Can evaluation studies benefit from triangulation? A case study

Background: Information and communication technologies (ICTs) are increasingly being used in health care. Rigorous evaluations of ICT applications during both introduction and routine use are of great importance for decision makers and users. Within evaluation research, two main (and often rather distinct) traditions can be found: the objectivistic and the subjectivistic tradition. Methods: The theory of triangulation deals with the integration of methods and approaches as to conduct better evaluation studies. In evaluation research, triangulation in general means the multiple employment of various sources of data, observers, methods, and/or theories in investigations of the same phenomenon. We applied triangulation aspects in the analysis of the effects of a computer-based nursing documentation system. Results: We discuss, based on this case study, what benefits can be obtained from applying triangulation in an evaluation study. We show how both the validation of results and the completeness of results can be supported by triangulation. Discussion: The decision whether triangulation may be useful for a given research question, and how it may be correctly applied, requires—like other evaluation methods—intensive training and methodological experience. Medical informatics evaluation research may profit from this well-established theory.     

2004年深圳市6区居民行为危险因素电话调查分析

目的初步建立以随机电话拨号和计算机辅助电话调查为基础的行为危险因素监测系统,并对深圳市成年人疾病和伤害相关的行为危险因素进行调查和分析.方法采用ITACATI软件设计和修改调查问卷,以Mitofsky-Waksberg法进行两阶段抽样,获得电话头号并随机拨号,调查18岁以上深圳居民疾病相关行为危险因素和传染病防治知识.结果本次调查共产生1 180个号码,有效电话459个,有效电话的应答率为88.89%.常参加体育活动者自评健康状况较好,过去1月无疾病的天数较少;安全套使用率为34.8%,使用率随年龄增加而上升;既往和当前吸烟者共占31 9%,男性饮酒率为63.8%,女性为18.3%.调查发现市民自报高血压患病率6.9%.结论将电话调查用于行为危险因素监测是一个效率较高的可行的技术方法,应在今后的公共卫生实践中深入研究,进一步促进监测数据与疾病控制和健康促进实践相结合.