Direct measurement of the thermal responses of nude resting men in dry environments

Summary Two nude resting men were exposed for two-hour periods to each of 25 dry environments, with air temperatures ranging between 12.8° C and 49.1° C and wind speeds between 0.67 m/sec and 4.94 m/sec. The mean radiant temperature of the surroundings was kept equal to the air temperature. Rates of radiant and convective heat exchange were measured directly, separately and continuously. The men had reached a thermal steady state after 105 min in the warm environments, but not in the cold environments. Graphs are presented to show the effect of ambient temperature and wind speed on the radiation and convection rates attained after 105 min, as well as on metabolic rate, sweat evaporation rate, rectal temperature and mean skin temperature. These graphs revealed some important aspects of the behaviour of man's thermal control system. In particular the physiological conductance increased with increasing ambient temperature and then saturated at an ambient temperature near 35° C. This saturation resulted in a constant difference between rectal temperature and mean skin temperature irrespective of the environmental conditions.Published with the permission of the Chamber of Mines of South Africa.     

A follow-up study on chromosomal aberrations in lymphocytes of alcoholics during early, medium, and long-term abstinence

The frequencies of structural chromosomal aberrations were analyzed in peripheral blood lymphocytes of 31 chronic alcoholics at the beginning of an intensive outpatient treatment program at a neuropsychiatric clinic and were compared with 31 controls matched for gender, age, smoking habits, and nondrinkers. A statistically significant difference was observed in the level of chromosomal aberrations in somatic cells from alcoholics when compared with controls (3.01% vs. 1.28%, p < or = 0.001). A follow-up study was carried out for a subset of the patients after 3 months (8 subjects) and 12 months (14 subjects) of controlled abstinence. A statistically significant increase in the mean frequency of cells with aberrations was observed in the group of 14 subjects reinvestigated after 12 months of abstinence when compared with the mean value of the first blood samples immediately after hospitalization (4.61% vs. 3.01%; p < or = 0.001). An excessive increase in cigarette consumption during alcohol abstinence, reflected by a dramatic elevation of CO-hemoglobin levels, may, at least in part, account for this finding. In conclusion, chronic alcoholism leads to genotoxic effects that, instead of recovering after 1 year of alcohol abstinence, are even enhanced, most likely due to the "shift in addictive behavior."     

Assessing incentives for service-level selection in private health insurance exchanges

Even with open enrollment and mandated purchase, incentives created by adverse selection may undermine the efficiency of service offerings by plans in the new health insurance Exchanges created by the Affordable Care Act. Using data on persons likely to participate in Exchanges drawn from five waves of the Medical Expenditure Panel Survey, we measure plan incentives in two ways. First, we construct predictive ratios, improving on current methods by taking into account the role of premiums in financing plans. Second, relying on an explicit model of plan profit maximization, we measure incentives based on the predictability and predictiveness of various medical diagnoses. Among the chronic diseases studied, plans have the greatest incentive to skimp on care for cancer, and mental health and substance abuse.     

The impact of international experience on student nurses' personal and professional development

Background: Many student nurses undertake international clinical experience during their education programmes, which raises the question ‘How do these experiences impact on students nurses’ personal and professional development?’ Method: A case study was conducted in one School of Nursing in the United Kingdom. Student nurses participating in a new module, International Nursing and Health Care, which included clinical experience overseas, gave qualitative accounts of their international experiences and subsequent learning. Their accounts were also compared with the perceptions and expectations of the module facilitators. Findings: While there were some similarities in student experience and facilitator expectations, there were also notable differences. The students believed that their international experiences had a deep impact on their personal development, helping them make the transition from student to qualified nurse. The case study raised further questions about the acquisition of cultural knowledge and the facilitation and provision of learning from experience.     

香烟烟雾水溶物对人外周血淋巴细胞SCE的影响

SCE频率分析是研究环境诱变剂和致癌剂引起人类遗传物质损伤的有效手段。本文以人外周血淋巴细胞姐妹染色单体交换(SCE)为指标,研究了香烟烟雾水溶物对体外培养的人外周血淋巴细胞SCE的影响。结果表明香烟烟雾水溶物引起人的外周血淋巴细胞SCE数的增加,证明香烟烟雾水溶物具有诱发突变作用。     

加强消毒供应中心器械收送过程中的感染控制

目的：加强医院消毒供应中心器械回收过程的感染控制.方法：制定感染控制的程序,贯彻实施感染控制管理.结果：消毒供应中心实施回收、清洗、包装、消毒灭菌、储存发放和回收控制等管理,可以确保可靠的无菌物品质量.实施密封回收,可避免污染扩散、严格的清洗,可保证消毒与灭菌效果 正确的包装,不仅满足了灭菌要求,也便于储存和安全输送 合格的灭菌质量,保证医院感染控制的有效性 无菌储存发放及安全的收送控制,可有效防止无菌物品损坏和再污染.结论：医院消毒供应中心实施收送过程感染控制程序,可明显提高供应中心无菌物品管理质量.     

Sister chromatid exchanges induced in human lymphocytes by cis-diamminedichloroplatinum (II)

Sister chromatid exchanges (SCE) frequency in cultured lymphocytesfrom seven patients with lung cancer receiving cis-Diamminedichloroplatinum(II) (Pt(II)) for chemotherapy was studied. Significantly increasedSCE frequency was observed in all the patients, six of whomreceived intravenous infusion of Pt(II) and one of whom receivedthe agent as an intrapleural infusion. In addition, a dose-dependentincrease in the frequency of SCE was observed in lymphocytesfrom healthy subjects upon exposure to Pt(II) in vitro. The results of the present study revealed that Pt(1l) is a potentinducer of SCE in human lymphocytes in vivo and in vitro. Itthus appears that follow-up study of the long-term survivorswho have been treated with this agent for cancer is necessarybecause of the possible occurrence of secondary neoplasms.     

Integrating risk adjustment and enrollee premiums in health plan payment

In two important health policy contexts – private plans in Medicare and the new state-run “Exchanges” created as part of the Affordable Care Act (ACA) – plan payments come from two sources: risk-adjusted payments from a Regulator and premiums charged to individual enrollees. This paper derives principles for integrating risk-adjusted payments and premium policy in individual health insurance markets based on fitting total plan payments to health plan costs per person as closely as possible. A least squares regression including both health status and variables used in premiums reveals the weights a Regulator should put on risk adjusters when markets determine premiums. We apply the methods to an Exchange-eligible population drawn from the Medical Expenditure Panel Survey (MEPS).     

Les échanges franco-mexicains en psychiatrie. Hommage à Jean Garrabé (1931–2020)

ObjectiveIn this text, the aim is to present the history of the exchanges between French and Mexican psychiatry in order to show their richness, parallel to the major influence of the model of Mexico's imposing American neighbor.MethodThis text follows the chronology of these exchanges, detailing the most prestigious invitations, colloquia, congresses, publications, the various psychiatrists and psychologists who participated in creating these links, on the French side and the Mexican side, as well as the various associations and federations. These illustrations are nourished by the first-hand experience of two of the authors who played a central role in these exchanges. Two areas are addressed: intellectual exchanges (conferences, presentations, books, etc.) and institutional links (mutual internships, etc.).ResultsThe article testifies to a rich tradition of exchange that has been kept alive since its inception, step by step.DiscussionAlthough the presentation of the article follows the chronology, it is possible to draw a lesson for the future, as it seems that the French model offers a counterweight to the predominant American model. We will present the anthropological and ethnopsychiatric work of one of the authors in Mexico, who drew heavily on the French example and who is institutionally implanted in both France and Mexico. We will also present the initiative of another author, a project to diversify care in Mexico inspired by the French sector model and its institutional proposals.ConclusionThis article accounts for an already rich tradition, but it also wants to be part of the continuity of the link, which, thanks to the initiatives of the present, will be able to maintain itself and remain dynamic.