Participative style of management in a family planning program

In 1973, a small-scale project to involve family planning staff in program management was introduced in the Sangam primary health center in Andhra Pradesh by the Adminstrative Staff College of India, Hyderabad. Through group meetings, involving all levels of health center personnel, problem areas were identified and analysed and solutions sought. On the basis of recommendations made by the groups, a work plan was drawn up. Monthly review meetings were held to discuss progress in implementing the plan. The project was found to have a positive effect on staff morale and commitment, and program acceptance levels increased. In light of the success of the project at Sangam, a proposal has been submitted to the government to expand the project to other primary health centers in the district.     

落实科学发展观促进氧化铝工业的循环经济发展

近年来,氧化铝工业得到了较大的发展,但部分仍然是走纯粹拜尔法的道路,是“资源产品废弃物”的线性道路。应转变观念向“资源产品再生资源”的循环模式转变,提高资源利用率,减少环境污染,利用我国占总储量80%的高铝、高硅、低铁、铝硅比(A/S)为7-5的铝矿资源和拜尔法赤泥,持续发展铝工业。     

Caring for AIDS patients at home--requirements for development of the concept

Exercise tolerance in chronic obstructive pulmonary disease (COPD) patients treated with oral aminophylline may be different from those treated with high-dose inhaled ipratropium bromide. The purpose of this study was to compare the effects of therapeutic doses of oral aminophylline with high-dose ipratropium bromide on spirometry and exercise tolerance. The study was conducted on three consecutive days in a double-blind, randomized, crossover fashion. Baseline studies obtained on each study day included vital signs, simple spirometry and a symptom-limited maximal cardiopulmonary stress test, after which patients received one of the following treatments on each day: Treatment 1, inhaled ipratropium (total dose of 144 micrograms) with placebo tablets; Treatment 2, inhaled placebo with oral aminophylline (400 mg); Treatment 3, inhaled placebo and placebo tablets. Simple spirometry was repeated at 60 and 120 min after baseline. Vital signs and cardiopulmonary stress testing was repeated at 120 min. Eighteen patients were enrolled in the study, and 17 of these completed the study. There was a significant (P < 0.05) increase in both forced expiratory volume in 1 s (FEV1), from 0.75 (0.21) to 0.92 (0.3), and forced vital capacity (FVC), from 1.8 (0.79) to 2.11 (0.84), with high-dose ipratropium despite prior beta-agonist therapy. Lack of improvement in exercise capacity was noted with ipratropium despite improvement in spirometry. These results suggest that elderly patients with severe COPD may have exercise limitation that is not directly dependent on severity of airflow obstruction. Ipratropium bromide and aminophylline demonstrated no acute effects on exercise capacity.     

Discrimination of sinusoidally frequency-modulated sound signals mimicking species-specific communication calls in the FM-bat Phyllostomus discolor

The 14-3-3 family are homo- and heterodimeric proteins whose biological role has been unclear for some time, although they are now gaining acceptance as a novel type of 'adaptor' protein that modulates interactions between components of signal transduction pathways, rather than by direct activation or inhibition. It is becoming apparent that phosphorylation of the binding partner and possibly also the 14-3-3 proteins may regulate these interactions. 14-3-3 isoforms interact with a novel phosphoserine (Sp) motif on many proteins, RSX1,2SpXP. The two isoforms that interact with Raf-1 are phosphorylated in vivo on Ser185 in a consensus sequence motif for proline-directed kinases. The crystal structure of 14-3-3 indicates that this phosphorylation could regulate interaction of 14-3-3 with its target proteins. We have now identified a number of additional phosphorylation sites on distinct mammalian and yeast isoforms.     

Investigation of a spontaneous abortion cluster: development of a risk communication plan

A risk communication plan was developed for a group of payroll office workers who were investigated for a possible cluster of spontaneous abortions (SABs). Survey and focus group methods were used to assess the workers' attitudes, beliefs, and information preferences. We found that four features of the workforce needed to be considered in developing an effective plan: 1) subgroups of workers varied on their levels of concern, awareness, involvement, and definitions of the problem; 2) workers did not have the necessary knowledge concerning SABs or the scientific method to participate in a two-way communication; 3) workers were highly stressed; and 4) workers were distrustful that they would be told the truth about the SABs. A multicomponent risk communication strategy was developed to overcome these barriers. Specifically, we recommended that background information on SABs and the scientific method be presented before the report of the study results and that follow-up sessions should be conducted on job stress and the emotional aspects of miscarriages.     

Telephone triage of cardiac emergency calls by dispatchers: a prospective study of 1386 emergency calls

OBJECTIVES: To evaluate the handling of potential cardiac emergency calls by dispatchers, to determine their final diagnosis and urgency, and to determine the value of the main complaint in predicting urgency and the ability of the dispatchers to recognise non-urgent conditions. DESIGN: Prospective data collection and recording of main complaint of emergency calls placed via the 06-11 alarm telephone number with follow up to hospital when the patients were transported and the general practitioner when they were not. SETTING: Dispatch centres of the emergency medical services in Amsterdam (urban area) and Enschede (rural area). PATIENTS: 1386 consecutive adult subjects of emergency calls placed by citizens about chest problems or unconsciousness not caused by injury. MAIN OUTCOME MEASURES: Frequency of characteristics of the calls, outcome in diagnosis, and assessment of urgency. RESULTS: 69 (5%) patients were dead when the ambulance arrived. Diagnosis was established in 1071 patients (77%). The disorders most often reported were cardiac, with acute ischaemia in 15% of all subjects. In 28% of cases and for each presenting complaint no organic explanation was found. Overall 39% of all emergency calls were urgent; the urgency rate was lowest for calls for people with abdominal discomfort. Dispatchers correctly identified 90% of the non-urgent calls, but 55% of the calls that they identified as urgent proved to be non-urgent. CONCLUSION: Currently, direct dialling for an ambulance without the intervention of a general practitioner imposes a high work load on emergency systems and hospitals because triage by dispatchers is not sufficiently accurate. It may be possible to increase the accuracy of triage by developing and testing decision algorithms.     

Weaning from mechanical ventilation: concept development

This article, the first in a series, is written to clarify the process of weaning from mechanical ventilation and to promote the development of a common language for understanding the complex weaning process. The Third National Study Group on Weaning From Mechanical Ventilation proposes a conceptual model and definitions that will provide a framework for future research on this important topic. This conceptual framework describes the preweaning phase, the weaning process, and the outcome phase of mechanical ventilation. Potential outcomes are completion of weaning, lack of completion, and terminal weaning. The weaning decision continuum incorporates: (1) when and how to begin the weaning process, (2) how to select therapies to assist with difficult weaning and chart progress during weaning, and (3) when to stop weaning if progress is no longer being made. An inherent assumption of this model is that each patient will display unique responses to the weaning process. The proposed conceptual framework and definitions provide a foundation for developing clinical practice guidelines and for guiding future ventilator weaning research.     

落实科学发展观 建设和谐高职学院

落实科学发展观对建设和谐高职学院是十分重要的，落实科学发展观必须从建立机制、以人为本、校园文化建设、校园稳定等方面下功夫，才能见到实效。     

A new concept of the development of organ failure

Organ failure, a syndrome caused by various etiologic factors, has been treated by a single therapeutic method. The author proposes classifying organ failure into 4 groups depending on its etiology. This new classification will serve as an organ failure prevention and treatment strategy.     

The value of voice in participative decision making.

Relying on concepts found in prospect theory (D. Kahneman & A. Tversky, 1979), the value function of voice-based participation (i.e., the relationship between the amount of voice received and the value attached to that quantity) was examined. In keeping with tenets of prospect theory, the value function of voice exhibited a nonlinear pattern. Points were identified in which voice displayed significant improvements and diminishing marginal returns on response measures of process fairness, decision control, and outcome satisfaction. Task meaningfulness, a moderator of voice-based participation, did not change the general shape of the value function but did influence the intensity of participant reactions at low and high levels of voice. Voice influence, a second moderator of voice-based participation, had minimal impact on participant responses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

加强行业自律 开展有序竞争 维持供需平衡 力求市场稳定

这次理事（扩大）会议,国家有关部委领导同志到会就如何做好2009年钢铁行业工作作了重要讲话,提出了殷切的希望和要求,使我们增强了认真贯彻中央经济工作会议精神的责任心和紧迫感。张晓刚会长代表常务理事会作了工作报告,提出了2009年协会工作的指导思想和工作的总体要求及重点工作。会议按章程规定,两年一次改选会长。     

Successful aging calls for more than drugs

Paracetamol is a common cause of fatal self-poisoning in the UK every year. Despite this, it continues to be sold freely without medical supervision and can be found in quantity in most household medicine cabinets.     

冶金过程控制开发平台中进程通信系统的开发及应用

在冶金计算机过程控制系统中,软件系统通常按照功能和作用范围不同划分为若干个子系统。为使这些子系统协调工作,需解决分布式进程间的通信问题。为此,北京首钢自动化信息技术有限公司自主研发了分布式进程通信系统,采用进程通信中间件解决进程问通信问题,同时采用进程通信代理器解决计算机之间的通信问题,并在Windows操作系统环境下成功地搭建了分布式进程通信网络。目前该系统已在京唐钢铁公司和首秦金属材料公司连铸过程控制系统中得到了应用且运行稳定。实践证明,该系统性能优越、可靠性强且简单易用。