目的了解白山市健康人群百日 咳、白喉、破伤风血清抗体水平。方法在全市6个县(市、区)采取随机抽样的方法抽取八道江区，对0～1岁、1～2岁、3～4岁、5～6岁、7～14岁、 15～19岁、﹥20岁7个年龄组的健康人群进行抗体水平监测。结果百日咳IgG抗体阳性率为80.0%，白喉IgG抗体阳性率为68.10%，新生儿破 伤风IgG抗体阳性率为49.52%。不同年龄组人群百日咳、白喉、破伤风抗体阳性率比较，差异有统计学意义(P﹤0.05)。结论在进一步提高常规免疫 接种率的基础上，加强人群免疫水平监测，考虑对成人进行加强免疫。
Factors associated with quality of services for marginalized groups with mental health problems in 14 European countries
BACKGROUND： Different service characteristics are known to influence mental health care delivery. Much less is known about the impact of contextual factors， such as the socioeconomic circumstances， on the provision of care to socially marginalized groups.The objectives of this work were to assess the organisational characteristics of services providing mental health care for marginalized groups in 14 European capital cities and to explore the associations between organisational quality， service features and country-level characteristics. METHODS： 617 services were assessed in two highly deprived areas in 14 European capital cities. A Quality Index of Service Organisation (QISO) was developed and applied across all sites. Service characteristics and country level socioeconomic indicators were tested and related with the Index using linear regressions and random intercept linear models. RESULTS： The mean (standard deviation) of the QISO score (minimum = 0; maximum = 15) varied from 8.63 (2.23) in Ireland to 12.40 (2.07) in Hungary. The number of different programmes provided was the only service characteristic significantly correlated with the QISO (p < 0.05). The national Gross Domestic Product (GDP) was inversely associated with the QISO. Nearly 15% of the variance of the QISO was attributed to country-level variables， with GDP explaining 12% of this variance. CONCLUSIONS： Socioeconomic contextual factors， in particular the national GDP are likely to influence the organisational quality of services providing mental health care for marginalized groups. Such factors should be considered in international comparative studies. Their significance for different types of services should be explored in further research.
Nurse coordinator leadership and work environment conflicts: consequences for physical and work-related health of nursing staff
BACKGROUND： Research has amply demonstrated that positive leadership counters the onset of burnout and conflicting situations between colleagues that in turn create favourable conditions for a healthy organization and consequently for good quality of care. OBJECTIVES： To investigate if more positive leadership is associated with lower levels of conflict in the work environment that in turn are associated with lower levels of burnout， psychosomatic disorders and negative indicators of work environment (feeling not being adequately appreciated， lack of clarity about tasks and roles， gossip， resentment towards the organization)， and with higher levels of work satisfaction. METHOD： Five scales of QISO (Nursing Organizational Health Questionnaire) and the Maslach Inventory (Burnout scale)， were administered to a total of 192 nurses working in medical and surgical departments of two different Italian hospitals. The study design was cross-sectional. To test the hypothesis a structural equation model (SEM) was used. RESULTS： The results of this study demonstrate the crucial role played by positive leadership of nursing coordinators that， directly and indirectly， promotes a healthy work environment with lower conflicts， burnout， and psychosomatic disorders among nurses and limits the presence of negative indicators in workplace. CONCLUSION： This study demonstrates the key role of the nursing coordinator in creating a healthy work environment that contributes to physical and work-related health of the nursing staff.
摘 要： [目的] 为更好地做好吉林省霍乱预防控制工作，将吉林省霍乱流行特征进行回顾性分析，为完善吉林省霍乱防治方案，提供科学依据.[方法] 依据吉林省疫情资料汇编和吉林省卫生防疫站站志等资料，采用Epi-info和Microsoft Excel软件进行分析.[结果] 吉林省从1980～1999年共有霍乱报告病例558例，死亡8例;发病最高年份1994年发病364例，发病率为1.45/10万，死亡6例，死亡率 0.02/10万.从1994年开始发生本土霍乱报告病例以来，到1999年连续6年有霍乱爆发流行;地区分布以县为单位，1994年发病数最高的县 (市、区)是四平市的梨树县，发病312例;1995年发病数最高的县(市、区)是四平市的铁西区，发病140例;1996年发病数最高的县(市、区)是 白山市的八道江区，发病10例.时间分布：从6～11月均有发病，发病高峰为6～9月;人群分布：年龄以25～30岁年龄组最多132例，占病例总数的 23.7%，年龄最大为75岁，最小为5岁.菌型分布：1984年病例的噬菌体-生物分型为稻叶1d型，1994～1999年病例的噬菌体-生物分型都是 小川1b型.[结论] 吉林省历年霍乱的流行没有明显规律，但基本上与我国第3次流行高峰相吻合.
OBJECTIVES： PRIMARY OBJECTIVE： to investigate the usefulness of cuff flowmetry for the diagnosis of lower urinary tract obstruction in males. SECONDARY OBJECTIVES： 1) To investigate the relationship between isovolumetric pressure (Piso) and bladder contractility. 2) To investigate the relationship between the type of flow curves obtained by this method and the type of lower urinary tract obstruction， and previous history of prostate surgery. METHODS： We perform a cohort study in a series of 93 consecutive males (mean age 54.1 yr.) referred with functional lower urinary tract symptoms. They were interviewed about history of prostatic surgery， and they underwent isovolumetric pressure measurements (Piso)， and corresponding flow (Qiso) by means of cuff flowmetry. From these parameters we calculated the Riso parameter， defined as Piso/(Qiso)2. A conventional pressure/flow study was performed afterwards， with computer calculation of urethral resistance parameters--footpoint and PURR curvature--， and the bladder contractility parameter Wmax. RESULTS： The diagnostic efficiency curve for the Riso parameter showed that the ideal cutpoint corresponded to a value of 1.29 cm H2O/(ml/sec)2. For this value the sensitivity for the diagnosis of lower urinary tract obstruction was lower than 78% and specificity was 73%. We elaborated a nomogram for the relationship between Piso and Qiso using a logistic regression model. This nomogram was divided in three areas (obstructive， equivocal， and not obstructive). If patients within the equivocal area (9.7% of the sample) were excluded， then the nomogram had a sensitivity of 84% and a specificity of 73% for the diagnosis of obstruction. We observed a significant association between flow curves with an absent initial peak morphology and obstruction of the constrictive type. No relationship was demonstrated between history of prostate surgery and type of curve. CONCLUSIONS： Cuff flowmetry has an acceptable sensitivity and specificity for the diagnosis of lower urinary tract obstruction. However， our study did not demonstrate its usefulness for the determination of the detrusor contractile capacity. Piso and Qiso parameters would be urethral resistance parameters.
正 1998年白山市咋子矿、八道江矿等地群众反映，当地水质受污染。市人大非常重视，组织市卫生防疫站、市环保局等有关部门对咋子矿、八道江矿、石人化工厂 等地水源水质进行了调查，并分段采样化验。现将调查、检验情况报告如下： 1 样品采集 取样工具理化指标用1500ml塑料桶，细菌指标用500ml消毒玻璃瓶，对咋子水源、八道江矿二井水源分别在水源水、出厂水和末梢水各取一个样
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