浅析安装工程预算中常见的问题

安装工程的预结算是招投标的重要基础,也是合理确定安装工程造价的重要依据。但在编制安装工程预结算过程中,由于各种原因常会出现这样或那样的问题,笔者结合多年的工作经验,就安装工程预结算编制过程中常见的问题及解决办法谈谈自己的看法。     

REM sleep behaviour disorder: an overview

REM sleep behaviour disorder (RSBD) is a recently described parasomnia characterised by a history of excessive nocturnal motor activity and absence of muscle atonia during REM sleep. Only limited literature is available on this condition. The exact prevalence is unclear, but recent studies suggest it might not be an uncommon condition. The elderly are more often affected and there is a male preponderance. While transient RSBD can be seen after taking certain drugs or during drug withdrawal, the chronic type is usually idiopathic or associated with an underlying degenerative neurological condition. It can result in considerable distress and/or serious injury to the patients or their bed partners. Differential diagnoses include sleep-walking, night terrors, nightmares, nocturnal seizures, obstructive sleep apnoea, post-traumatic stress disorder, dissociative states and nocturnal confusional states. The dramatic response to clonazepam highlights the importance of recognition and appropriate treatment of this sleep disorder.     

An overview of pharmacoepidemiology

Pharmacoepidemiology is the application of epidemiological principles and methods to the study of drug effects in human populations. The goal of this discipline is to characterize, control and predict the effects and uses of pharmacological treatment modalities. Pharmacoepidemiology is also concerned with the economic impact and health benefits of unintended drug effects. The increasing importance of pharmacoepidemiology has been created by the need to develop a more accurate portrait of how drugs are used in the general population. Sophisticated and potent drug therapies require surveillance beyond the scope of the carefully controlled clinical trials of Phases I, II and III. Case-control and cohort studies, which allow scientists to evaluate the effects of patient variables on clinical outcomes, provide a wealth of information regarding the study of unexpected drug effects, drug utilization, treatment costs and the individualization of therapy.     

An overview of childhood cancer

The purpose of this article is to present information of interest to nurse practitioners on childhood cancer. It will begin with a brief review of the disease including details of incidence, morbidity, and mortality. Information on the clinical presentation, treatment methods, and prognosis of the most common forms is included. The paper concludes with a brief overview of selected issues related to this disease of interest to the primary care provider.     

Nosologic groups. An overview

A general analysis is made of the concept of nosologic groups. It is concluded that, even when 'artificial',they may prove to be useful research, didactic and differential diagnosis purposes. Nosologic groupings must, however, progress toward the finding of 'phenotypic communities' whose component syndromes share multiple foci of dysmorphogenetically intimate phenotypic overlap. The concepts of syndrome, anomalad, association, combination, dysplasia, phenotypic community and family of diseases are briefly analysed.     

Hepatic imaging. An overview

Chronic food restriction reduces blood pressure (BP) and sympathetic support of BP in aortic coarctation hypertension. The purpose of this study was to test the hypothesis that chronic food restriction would reduce sympathetic support of BP mediated by the paraventricular hypothalamic nuclei (PVN). Hypertension was induced in male Sprague-Dawley rats (n=40) by suprarenal aortic coarctation. Rats were assigned to either an ad libitum fed (AL) group or a food restricted (FR) group that received 60% of the food consumed by AL for 3 weeks. One week prior to data collection, catheters were implanted in the left carotid artery and right jugular vein. BP was measured for 2 days prior to, and 7 days after rats in AL and FR groups received either bilateral electrolytic lesions of the PVN (PVNx) or sham lesions (SHAM). Prior to either PVNx or SHAM, FR rats had significantly lower BP (AL=152+/-5; FR=113+/-2 mmHg), less of a depressor response to ganglionic blockade (AL=-58+/-4; FR=-35+/-2 mmHg), and lower plasma norepinephrine levels (AL=758+/-71; FR=380+/-23 pg/ml) compared to AL. PVNx reduced BP in both AL and FR rats (AL-PVNx=105+/-6 mmHg, FR-PVNx=101+/-3 mmHg). PVNx also lowered the depressor response to ganglionic blockade (AL-PVNx=-28+/-5 mmHg, FR-PVNx=-29+/-4 mmHg) and plasma norepinephrine levels (AL-PVNx=372+/-74 pg/ml, FR-PVNx=248+/-31 pg/ml). FR decreased the magnitude of the reductions in resting BP and in sympathetic activity in response to PVNx. These results indicate that intact PVN are required for maintenance of aortic coarctation hypertension, and implicate the PVN as a site involved in BP reductions produced by chronic food restriction.     

Oculoplastic surgery. An overview

BACKGROUND. The interface between the subspecialties of dermatologic surgery and oculoplastic surgery is broad. However, there are many commonly seen oculoplastic conditions that are not foremost in the mind of the dermatologic surgeon. OBJECTIVES. Common oculoplastic problems are detailed in this article and should provide the reader with a basis for understanding the wide spectrum of oculoplastic problems encountered in practice.     

Cellular and metabolic engineering. An overview

Metabolic engineering is defined as the purposeful modification of intermediary metabolism using recombinant DNA techniques. Cellular engineering, a more inclusive term, is defined as the purposeful modification of cell properties using the same techniques. Examples of cellular and metabolic engineering are divided into five categories: 1. Improved production of chemicals already produced by the host organism; 2. Extended substrate range for growth and product formation; 3. Addition of new catabolic activities for degradation of toxic chemicals; 4. Production of chemicals new to the host organism; and 5. Modification of cell properties. Over 100 examples of cellular and metabolic engineering are summarized. Several molecular biological, analytical chemistry, and mathematical and computational tools of relevance to cellular and metabolic engineering are reviewed. The importance of host selection and gene selection is emphasized. Finally, some future directions and emerging areas are presented.     

An overview on nucleation theories and models

Several different models for coercivity are discussed. There are two main situations: i) nanocrystalline magnets, with grain size bellow the single domain particle size, and ii) magnets with grain size above single domain particle size. The described theories and models are general, and can be applied in either NdFeB magnets, SmFeCoCuZr or strontium ferrite magnets. The spring effect observed in isotropic nanocrystalline magnets can be explained with the Stoner-Wohlfarth model. Modifications of the StonerWohlfarth model are necessary to take into account the effect of interaction between grains. When the grain size is above the single domain size, energy considerations show that nucleation should occur at the surface of grains. Nucleation is interpreted as a two-step process, where domain wall displacement occurs for grain size above single domain size, after a nucleus is first formed. The effect of grain size on the coercive field is discussed.     

An overview of the older driver

Although MVC rates are not substantially higher among older drivers after adjusting for mileage and may even be lower, the crash risk of the elderly driver remains a matter of increasing public concern. In part this is due to media attention over isolated cases of fatal MVCs involving older drivers, occasionally with a demented driver. This media attention has led to growing apprehension over the issue of elderly drivers. Physicians are likely to be involved increasingly in the evaluation of older drivers, whether they want to or not. The physician's quandary is the competing interests of the patient's well-being (i.e., continued independence), and the public's welfare (i.e., protection from impaired drivers). Unfortunately, there are no certain guidelines to protect the physician from liability for either of these conflicting duties. At issue is the foreseeability of harm from an elderly driver, either to self or to others. What degree of impairment is necessary before a physician is bound to report a patient to authorities? Although there are no clear answers, the best advice is to follow clinical judgment. One suggestion is to consider the diagnosis as suitable evidence. Thus, if the patient has a dementing illness of sufficient severity to warrant documentation in the medical record as a diagnosis, then perhaps the physician should consider advising the patient not to drive; reporting the patient to the appropriate authorities would be left to the physician's discretion after consultation with the patient's family. This might have the added benefit of obliging physicians to think twice before mislabeling patients with benign forgetfullness as demented, an all-too-frequent phenomenon. In this weighty ethical decision, it is critical for physicians to consider the consequences of removal of driving privileges from their elderly patients as well as their duty to protect the public health. Neither should be taken lightly. Above all else, physicians should not forsake their responsibility for advising either patients or the public regarding the driving privilege. To do so would simply relinquish the decision-making to those without clinical training or evaluative skills relevant to driving tasks. The physician's role in the evaluation of the elderly driver should be regarded as a pivotal challenge in the complicated management of the health of the elderly population.     

Promoting breast-feeding by managing common lactation problems

Breast milk is nutritionally and immunologically superior to any known substitute. Morbidity and mortality are lower in breast-fed infants and their mothers, resulting in better health and lower health care costs. Despite the overwhelming evidence of health benefits and consequent endorsements from professional groups, many health care providers do not actively promote breast-feeding initiation. They may actually undermine breast-feeding duration by providing incorrect advice when problems develop. This article provides recommendations for promoting breast-feeding and discusses diagnosis and management options for common maternal lactation problems, including sore nipples, eczema, candidal infection, and mastitis.     

The acute abdomen. An overview and algorithms

The diagnosis and management of the patient with an acute abdomen remains one of the most difficult challenges for the surgeon. A thorough understanding of the anatomy and physiology of the abdomen are essential to properly generate a differential diagnosis and to formulate a treatment plan. While recent advances in technology can be extremely helpful in certain situations, they cannot replace a physician's clinical judgment based upon a good history and physical examination. This article provides a general overview of the evaluation of the patient with an acute abdomen. It will also suggest algorithms to consider in the diagnosis and treatment of these patients.     

Homosexuality and psychopolitics: An historical overview.

Traces various sources of attitudes toward homosexuality (HMSX) throughout history and explores the scientific and political forces that contributed to the depathologization of HMSX in the psychological community via the American Psychological Association. Advances in the understanding of lesbian and gay issues within psychology since the early 1970s are considered, as well as an analysis of the current state of attitudes toward HMSX within professional psychology. Attitudes toward HMSX within psychology have changed from viewing HMSX as a form of mental illness to considering gay males and lesbians to be an oppressed group in need of special considerations. However, more attention needs to be paid to the diversity within the lesbian and gay male populations in terms of race and ethnicity, religious diversity, class issues, and physical, emotional, and cognitive disability. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dyslipidemias in childhood. An overview

This article reviews the current screening and treatment guidelines for dyslipidemias in the pediatric and adolescent populations. In addition, the components of a comprehensive lipid program are reviewed.     

Subliminal stimulation: An overview.

"Seldom has anything in psychology caused such an immediate and widespread stir as the recent claim that the presentation of certain stimuli below the level of conscious awareness can influence people's behavior in a significant way." Recent history relating to the technique is discussed under the topics of Recent Advertising Demonstrations, Research on Behavior without Awareness, and Effects of Inner States upon Thresholds. Unanswered Methodological Questions and The Ethics of Subliminal Influence are the other major topic areas. "The indiscriminate and uncontrolled application of psychological principles is increasing at a fearsome rate in the form of motivation research, propaganda, public relations, and a host of other useful practices based on the work of psychologists." Psychologists have a responsibility for assisting society to use its findings wisely. 132 references. (PsycINFO Database Record (c) 2010 APA, all rights reserved)