健康教育在糖尿病病人中的应用

目的：通过对患者在住院过程中的系统教育，使患者了解自己疾病的知识，提高患者对糖尿病的认知水平和自我管理能力，养成良好的健康行为和生活方式，从而提高生活质量。方法：采用集体、个体、自学等形式进行教育。结果：通过培养，患者掌握了一些基本的操作技能，明显缩短了住院日，同时激发了护士与患者学习专业知识的热情，减少或延缓了并发症的发生。结论：①健康教育是一个护患双边活动过程。②通过教育，可不断提高护士的自身修养和专业知识水平。③健康教育是糖尿病患者学习糖尿病知识，提高自我护理能力的有效途径。     

Effects of haloperidol on the multitrial partial reinforcement extinction effect (PREE): evidence for neuroleptic drug action on nonreinforcement but not on reinforcement

Two experiments investigated the effects of haloperidol (0.1 mg/kg) on the partial reinforcement extinction effect (PREE). In experiment 1 two groups of rats were trained to run in a straight alley using six trials/day with an intertrial interval (ITI) of 5–8 min. The continuously reinforced (CRF) group received food reward on every trial. The partially reinforced (PRF) group was rewarded on a quasi-random 50% schedule. All animals were then tested in extinction. Haloperidol was administered in a 2 × 2 design, i.e., drug-no drug in acquisition and drug-no drug in extinction. In experiment 2 two groups of rats were trained to press a lever in an operant chamber using a discrete trial procedure of ten trials/day with an ITI of 60 s. The CRF group was rewarded on each trial and the PRF group was rewarded on a quasi-random 50% schedule. Haloperidol was administered for 22 days prior to the start of the PREE procedure as well as throughout acquisition and extinction. The PREE, i.e., increased resistance to extinction of PRF as compared to CRF animals, was obtained in both experiments in all drug conditions. In both experiments haloperidol increased the rate of extinction. Experiment 1 revealed that this effect was entirely dur to the administration of the drug in extinction, independently of the drug condition in acquisition. In contrast to previous results in a one trial/day procedure, the administration of haloperidol to CRF animals did not increase resistance to extinction, failing to support the notion that neuroleptics attenuate the rewarding properties of reinforcement.     

Organization and physiology of thesubstantia nigra

Summary A comprehensive review of the literature on the anatomy, electrophysiology and pharmacology of thesubstantia nigra is presented. A diagram is developed taking into account the interneuronal interactions of neurotransmitters and receptors that control firing rates and neurotransmitter releases. The central features of the diagram are a positive dopaminergic feedforward process and a positive feedback mechanism mediated by extrasynaptic substance P diffusing from striatal terminals to dopaminergic dendrites of thezona compacta neurons. This loop can enhance the transmission of information from thestriatum through thepars reticulata output neurons. The loop is controlled at the level of zona compacta neurons by a negative feedback supported by the dendritic release of dopamine and boosted by pedunculopontine activation mediated by muscarinic receptors. The output of the loop is controlled by two negative feedforward processes, both involving GABAergic striatonigral afferents. Application of the model to pharmacological studies of diverse behaviors including seizures, turning, and conditioned behaviors reveals unforseen relationships and may offer insights into, and directions for, further analysis of the mechanisms and functions involved.     

人的社会能力和适应性的影响因素研究

目的：探讨影响人的社会能力和适应性的主要因素。方法：应用世界卫生组织提供的量表进行问卷调查，并对资料进行单因素及多元逐步回归分析。结果：男性、城市环境、青壮年、非政府职员职业、较高文化程度、已婚、较好经济收入、医疗保险及较低医疗费用会对社会能力和适应性产生积极影响。结论：年龄、家庭年收入、家庭年医疗费用及文化程度是社会能力和适应性的重要影响因素。     

关于加强医学生实践能力培养的研究

文章比较科学系统地提出了三种有效培养医学院校大学生实践能力的途径与方法,即以课堂教学活动为基点、以实践教学环节为中心和以课外实践活动为辅助。以期为各医学高等院校就如何加强医学生实践能力培养的问题提供有益的借鉴。     

Experiences and perceived roles of occupational therapists working with children with special learning needs during transition to school: A pilot study

Occupational therapists provide support to children with special learning needs and their families during the child's transition from early childhood to mainstream school. Little has been documented regarding the role and experiences of occupational therapists working with children, families and teachers during transition in an Australian context. Six paediatric occupational therapists from one geographical area in New South Wales were interviewed and asked to relay their role and experiences when providing a service to children with special learning needs during their transition to school. Participants described their role to include: preparing the child for school; working with school personnel; and providing parental support. Although participants described both positive and negative experiences, among the negative experiences were: limited time to provide a service; recommendations to school personnel not being followed; school personnel not being supportive; feeling uncomfortable in the classroom; and limited involvement in planning. Participants described a role which is consistent with current school-based occupational therapy practice; however, in the participants' experience, there was a gap between the ideal service and what participants were able to provide. This included limited collaboration with teachers.     

对构建特色医院文化的思考

21世纪的医院是文化的医院,21世纪医院的竞争是文化的竞争,谁能构建出具有特色的医院文化,谁就能赢得竞争主动权。构建特色医院文化,核心是形成共同的理想和精神支柱;关键是打造“学习型”医院组织;根本是树立以人为本、诚信求实的服务理念;目标是树立良好的医院形象;基础是加快医院信息化建设。     

Effectiveness of an intensive stress intervention workshop for senior managers

This study investigates the efficacy of an intensive, integrated approach to stress reduction and coping enhancement directed towards an educated, upper level management population. Ninety‐five US governmental senior managers participated in a 35‐h stress management retreat held over a 3.5‐day period. The retreat combined didactic and experiential activities that were designed to increase participants' knowledge of stress liabilities and coping skills. Participants were encouraged to make positive lifestyle changes and to create specific action plans for the year following the workshop. Evaluations of participant satisfaction were completed at the close of the workshop. Eighty‐three participants completed baseline and follow‐up Stress and Coping Inventory (SCI) assessments in order to identify durable changes in these measures. Across 10 months, participants showed significant improvements in their overall Global Balance scores, psychological symptoms, depression symptoms, and all major coping scales, including Health Habits, Social Support, Responses to Stress and Life Satisfactions. Therefore, an intensive, multifaceted approach to stress intervention is a viable option for encouraging sustained behavioural change. Copyright © 2003 John Wiley & Sons, Ltd.     

元认知能力在医学生临床实习中的培养

元认知能力在医学生临床实习过程中起着非常重要的作用。培养医学生的元认知能力 ,必须丰富医学生的元认知知识 ,强化医学生的元认知体验 ,促进医学生加强元认知监控 ,从而使他们成为独立自主、有创造力的学习者。     

重庆地区驾驶员血液中乙醇浓度与驾驶能力的关系

目的　探讨重庆地区驾驶员血液中乙醇浓度 (BAC)和驾驶能力的关系 ,为交通安全立法提供科学依据。　方法　随机选择重庆地区 59名驾驶员志愿者 ,建立饮酒后驾车模型、科学的BAC测定以及驾驶能力评价体系 ,对不同BAC下驾驶能力进行测评。　结果　受试者出现驾驶能力损害时的BAC均数为 685.9mg/L ,最小值 190 .0mg/L ,最大值 152 0 .0mg/L ,总体均数 95%可信区间为 60 2 .4～ 70 9.5mg/L。汉族和土家族间、汉族男性和女性间、2 3～ 3 5岁和 3 6～ 56岁年龄组间差异无显著性意义 (P >0 .0 5) ,而既往饮酒量不同的三个组别间差异有显著性意义 (P <0 .0 5)。随着BAC增高 ,驾驶能力受损人数增加。在 2 0 0 .0mg/L有 3 % (2 / 59)的受试者驾驶能力降低 ,80 0 .0mg/L则达到 68% (40 / 59)。　结论　随着BAC增高 ,重庆地区驾驶员驾驶能力受损人数比例增加 ,出现驾驶能力明显损害时BAC为 60 2 .4～ 70 9.5mg/L ,既往酒量较大人群中该值较高