Detection of alcohol misusing patients in accident and emergency departments: the Paddington alcohol test (PAT)

The list of hepatitis viruses is increasing over the years. Now the viruses range from A to G. Hepatitis A virus is a short incubation RNA virus which is transmitted oro-faecally. It does not cause chronic illness but may be fatal in a few cases especially in pregnancy. It can now be prevented by vaccination. Hepatitis B virus is a long incubation DNA virus which is transmitted mainly through blood and blood products. It causes chronic illness and can lead to liver cancer in some cases. It can be prevented by vaccination and WHO is now recommending global vaccination of all infants irrespective of endemicity of hepatitis B virus. Hepatitis C virus is an RNA virus which used to be known as parenterally transmitted non A non-B virus. It leads to chronic illness and can lead to liver cancer. It is now responsible for most cases of post transfusion hepatitis in Europe, North America and Asia. Hepatitis Delta virus is a defective virus which requires hepatitis B virus for its existence. Thus it affects only those who have hepatitis B virus. Hepatitis E virus used to be known as the enterically transmitted non-A non-B virus. It is transmitted oro-faecally and seems not to lead to chronic illness. It is endemic in some areas like Middle East and parts of Africa. Hepatitis G virus is just being described. More information about it will soon be available.     

Resolution of hyperparathyroidism associated with immunosuppressive therapy

The documentation of patient care is a critical nursing function. In addition to confirming that the nurse has practiced within the standards of care, the documentation is intensely scrutinized by those making payment and legal decisions. With the stroke of a pen or the tap of a keyboard the nurse records a fact or observation that will forever be a part of the data base. That data base may be used to determine benefits, allocate resources, settle legal arguments and even weigh criminal justice. Charting on the patient's record is both a privilege and a responsibility. It is not to be taken lightly. Every effort should be made to write from the perspective of a neutral reporter. The scope of documentation should be comprehensive and relevant. Observations should include the realms of psychosocial and emotional concerns as well as the physical. It is not necessary to make judgements or draw conclusions about the observations charted. It is enough to record pertinent assessments, actions and outcomes. It is from a database with these characteristics that we may be assured we are practicing in an ethical and responsible manner.     

The Oxyvent. An anaesthetic machine designed to be used in developing countries and difficult situations

The Oxyvent is an anaesthetic machine designed specifically for use in the developing world and difficult situations. It is made up of four components, each of which has, in its own right, already proved to be of great value in difficult situations. These are the drawover system, the Penlon Manley Multivent Ventilator, the DeVilbiss Oxygen Concentrator and the air compressor. The four components are mounted on a simple trolley carrying two oxygen cylinders. The Oxyvent can be used to provide anaesthesia in the absence of electricity or oxygen or both. It is simple, robust and easily serviceable. It is versatile and can be used both as an anaesthetic machine in the operating theatre and as a ventilator in an intensive care unit.     

Hermes and his tricks in the child therapy relationship.

Explores the role of the child god Hermes in the development of the child/therapist relationship. It is suggested that Hermes models the backward walking necessary both in therapist development and in the child/therapist relationship. The metaphor of walking backward plays a paramount role throughout the paper. It is walking backward to our own child space that prepares us to be with children in their space. It is walking backward with the child, mirroring him, that allows us to be in the child space. It is in walking backward that our stories lie, and this is how we can be a guide and protector to children as their stories unfold. Case material examined in the paper explores the therapeutic experiences of a sexually and physically abused 7-yr-old boy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Multifocal atrial tachycardia (MAT). The misdiagnosed atrial arrhythmia of old age

The clinical and electrocardiographic features of multifocal atrial tachycardia are described and illustrated by nine examples. It is almost entirely seen in later life and is often misdiagnosed as atrial fibrillation. It is associated with a high mortality and the majority of the cases described here reverted to sinus rhythm. Little attention has been so far paid to this important arrhythmia in the elderly in standard textbooks of cardiology. The literature is reviewed and management discussed. It is not a rare supreventricular tachycardia in the aged and many examples may be not diagnosed. It merits further study in relation to unanswered questions.     

Flow visualisation study in porous media using X-rays

An X-ray technique has been developed to visualise the fluid flow behaviour in three-phase packed column. It can be used in both static and transient conditions. This technique is capable of differentiating between various liquids or solids or both. It can be used to visualise the flow in one, two or three dimensions. The technique has been used to study the complex flow behaviour of fluid (rivulets/droplets/film formation, dispersion, etc.) in a porous medium in both static and dynamic conditions. It is shown that X-ray is a powerful and simple tool for visualisation and is very useful in research.     

Progress in oesophagoscopy. The role of the conventional oesophagoscope as against the supple fibroscope (author's transl)

In the history of endoscopy, laryngologists have played an important role in knowledge of the oesophagus. For those familiar with gastroscopy, the supple fibroscope represents a diagnostic instrument which may be used for observation of the oesophagus with the exception of natural or pathological areas of stenosis. It offers considerable possibilities in the photographic documentation of lesions. It is relatively easy to perform though not completely harmless. The rigid oesophagoscope remains an effective method of investigation of the whole oesophagus, including the oesophageal opening. It remains the best method for the performance of endoscopic surgery and in particular the extraction of foreign bodies. It is not dangerous in the hands of a competent and trained operator. Rather than opposing each other, the two instruments may be seen to be complementary.     

Semantic transparency in the processing of compounds: consequences for representation, processing, and impairment

The role of semantic transparency in morphological processing in general and in compound processing in particular is examined. It is argued that the notion of semantic transparency is crucial to an account of how compounds are represented and processed in the mind. A sketch of a model is proposed in which compound processing is described in terms of stimulus properties, lexical properties, and conceptual properties. The model represents the notion of semantic transparency in terms of a four-way classification of the semantic relationship between a compound's constituents and the corresponding independent morphemes. It also distinguishes between semantically componential and noncomponential compounds. It is proposed that the model offers a framework within which experimental psycholinguistic findings can be understood and within which aphasic deficits associated with compound processing can be characterized. As an example of this, the paper presents a reanalysis of an aphasic patient who exhibits the tendency to interpret semantically opaque compounds as though they were transparent and to interpret opaque compounds in terms of a blend of constituent and whole-word meaning. It is argued that the underlying deficit in this patient is the failure for inhibition to result from the competition among stimuli at the conceptual level of representation.     

An acceptance of suicide.

Discusses suicidal behavior, which is traditionally considered to be reflective of a mental disorder or at least a psychopathological event. The acceptance of suicide has been defended primarily in terms of an ethical right to and psychotherapeutic respect for autonomy. These arguments, however, have failed to provide an adequate basis for refraining from indiscriminate prevention. The acceptance of suicide can also be defended in terms of the reasonableness of death as an alternative to a tragic life. Arguments for voluntary euthanasia are shown to be applicable to insurmountable and intolerable psychosocial conditions. It is asserted that acceptance of suicide entails an empathic understanding of the patient's tragic condition and a recognition of an inability to relieve the suffering. It is a difficult decision but nonetheless reasonable and deserving of consideration. It is concluded that suicide prevention can be as harmful as failing to see a suicidal gesture as a cry for help, especially if it becomes a dogmatic, unthinking intervention that does not consider the alternative and potentially acceptable view of suicide acceptance. (49 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Fourier analysis of the pulse wave in obliterating arteriosclerosis

It can be seen that the technique of using properly selected filters to provide rigidly defined monochromatic bands with which to observe the fundus presents interesting and challenging information that is as yet mainly untapped. The applications quoted present only a small part of the areas that can be investigated. The technique is basically standard, but advances can still be made in optimizing filters. The question of what band width to use for a given application is by no means solved and presents a challenging avenue of inquiry. It should be pointed out that the use of color film with interference filters offers no advantage. The only dimension being recorded at each point in the film is reflectivity of the structure at the wavelength of the filter being used. Documenting the color of this wavelength by the use of color film is a fruitless exercise.     

Ideal total hip prosthesis in 1993

Although it is a hazardous adventure to define what is an ideal in any field, it would appear that there is a certain consensus about total hip prostheses. The fundamental principle of the total hip replacement was based on the articulation of a spheric segment, a mobile head contained in a hemispheric non-retaining element. To date, the first material is a titanium in a alloy containing 6% aluminum and 4% vanadium. The second material facing the titanium is polyethylene or alumine. Thus the joint couple could be "polyethylene-metal", or "polyethylene-alumine" or even "alumine-alumine". The hemispheric element can be a massive piece of polyethylene or formed by a peripheral metal (an open hemisphere) filled with the joint surface, itself made of polyethylene. This solution offers the possibility of changing the prosthesis in case of wear without interrupting the implant-bone contact. The first type is cemented to the bone with methyl polymethacrylate. With the second, the metallic part need not to be cemented and can be fitted to the bone by simple pressing. Several points are essential in the femoral piece. It should include a removable head so the length of the neck can be adjusted. It must fill the medullary canal as closely as possible and fill the methaphyseal space. It is fixed by a self-fitting system leading to stable secondary long-term fixation-a porous covering, sometimes with hydroxy apatite can also be useful. In certain cases it must be cemented, although the cement must only play the role of adaptation.(ABSTRACT TRUNCATED AT 250 WORDS)     

顶底侧吹转炉炼钢新技术开发研究

在顶底复吹转炉熔池侧壁上安装侧吹枪,形成顶底侧吹转炉。通过实验室物理模拟研究了顶底侧吹条件下转炉熔池的混匀行为;在工业试验中,对比了顶底侧吹转炉和顶底复吹转炉炼钢的冶金效果。实验室研究结果表明,顶底侧吹技术可以显著提高转炉熔池的搅拌能力,大幅度降低转炉熔池的混匀时间,存在一个临界侧吹气量,当侧吹气量大于该临界值后,熔池混匀时间变化不大。工业试验结果表明,转炉采用顶底侧吹技术,可以降低钢铁料消耗,吨钢石灰消耗可降低将近3kg,提高了转炉的脱磷能力,降低炉渣和钢水的氧化性,平均出钢碳氧积为0.0025×10-4,钢水氧化性的降低提高了合金收得率。     

DSM-III and the politics of truth.

Argues that traditional and prevalent beliefs about the relationship between science and politics cause many communications about the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) to become mired in double-talk, in which disavowal of DSM-III's political aspects often serves to affirm that which is being denied. The DSM-III is examined through a conceptual lens in which science and politics are mutually exclusive. Consequently, any mention of the political dimensions of DSM-III may be automatically perceived as an attack on the scientific integrity of the taxonomy. It is suggested that integral aspects of science and politics should be acknowledged, and self-defeating dichotomous reasoning about DSM-III's scientific and political dimensions should be avoided. It is concluded that the DSM-III is both a tool for the production of scientific knowledge and an instrument of rhetoric, social organization, and power distribution. It can be viewed in a way that transcends dichotomy. (50 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Tolerability to prolonged lifting tasks. A validation of the recommended limits

The cost of providing dental treatment for severely mentally/physically handicapped patients under general anaesthesia in a specially designed unit are investigated in this study. The costs involved in the provision of such treatment were found to be high at 613 IR Pounds per patient. It is recommended that the full potential of primary care services for handicapped patients be developed in order to reduce the use of these necessary, but expensive secondary care facilities. It is also recommended that such facilities should be shared with other services in order to reduce overall costs.     

PSRO: a new direction for quality assessment in Otolaryngology

At the present time, the University of Michigan Hospital Department of Otorhinolaryngology has an 18-month experience in a quality assessment program directed toward compliance with PSRO legislation. This experience, we hope, provides an approach to the continuing assessment of medical care, whether it is for conforming to a particular legislative action or for the evaluation of patient care. It has been encouraging to the physicians involved that this is a program which is organized at the local level. It is oriented toward the local physician and in most instances will be administered by local physicians. The process of quality assessment has provided a milieu for educational experience and positive action toward correction of medical care problems. It has been said before that this may be the last opportunity for the physician to maintain control at the local level. This may be the opportunity for the profession to proceed with controlled quality assessment before outside agencies intercede.     

Further Comment on "Football Numbers".

It is only fair to any prospective critic to state clearly the final conclusions reached in my note, "On the Statistical Treatment of Football Numbers," (American Psychologist, Dec. 1953, 8, pp. 750-751). The conclusion is that nominal and ordinal numbers (including test scores) may be treated by the usual arithmetic operations so as to obtain means, standard deviations, and other similar statistics from which (in certain restricted situations) correct conclusions may usefully be deduced with complete logical rigor. This conclusion is reached by a tight chain of reasoning, which is expounded here. It seems very fortunate that any fundamental disagreement here between critic and statistician need not long remain a matter of opinion since the question is so readily submitted to wholly objective, practical verification by a "game" described here. It would be unfortunate if what has been written here were to lead anyone to ignore the very serious pitfalls actually present. The conclusion to be drawn is that the utmost care must be exercised in interpreting the results of arithmetic operations upon nominal and ordinal numbers; nevertheless, in certain cases such results are capable of being rigorously and usefully interpreted, at least for the purpose of testing a null hypothesis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

高氮钢制备及焊接过程中氮的溶解与释放

综述了高氮钢制备及焊接过程中氮的溶解与释放规律;论讨了不同制备及焊接工艺下钢中氮溶解度的计算公式、适用条件及影响因素等;指出大气压力下的GTA焊接过程是一个非平衡过程,焊缝处的氮含量与保护气体中的氮分压之间不满足Sievert定律,焊缝处的氮含量主要取决于钢中平衡氮含量和Cr的含量;选择GTA焊接时,在较低的氮分压下,便可对焊缝氮含量进行控制,但由于氮的吸收和释放较快,采用GTA焊接时焊缝氮含量不能精确控制;采用（CO2,YAG）激光焊接时需要考虑焊缝氮的释放;氮质量分数大于1．0％的高氮钢焊接方法亟待开发．     

THE PRODUCTION OF SILICON-IRON MAGNETIC STRIP WITH THE (110) [001] TEXTURE,BY COLD ROLLING FROM SINTERED COMPACTS

Abstract

It is shown that secondary recrystallization and development of the (110) [001] texture in 3¼% silicon-iron strip can be obtained by control of the oxygen content of the hydrogen sintering atmosphere. The conditions required are described.

The sintered compact is then cold rolled according to a schedule used for rolling grain-oriented silicon-iron from a cast ingot.

It is found that the temperature of secondary recrystallization is higher than that for conventionally made strip.

It is suggested that a critical amount of silicon is oxidized to silica during sintering and that this silica acts as a dispersed phase in the inhibition-dependent mechanism known to be responsible for secondary recrystallization.

In an appendix, an account is given of a short X-ray method for checking the texture of the silicon-iron strip.     

The shape,configuration and stress field of twins and martensite plates

It is shown that the equilibrium shape of a twin or martensite plate can be calculated by treating the interface as a distributed array of dislocations and by calculating their equilibrium distribution. The shape of an isolated twin is an ellipse to first approximation. Second approximation treatments show that the tip of the twin sharpens with increasing stress for the screw dislocation case while it becomes blunter with increasing stress for the edge dislocation case. A colony of twins is treated in much the same way as a stacked array of piled-up dislocations for the screw dislocation case. It is found that the twins flatten out with decreasing separation. Expressions are derived for the stress-field and for the strain energy of such stacked twins. It is shown that the twin spacing should be proportional to the square root of the twin length, from which the twin boundary energy can be calculated.     

The role of solute segregation in promoting the hardenability of steel

The two most potent promoters of hardenability in steel are boron and phosphorus. It appears that these elements function by segregating to austenite grain boundaries and interfering with the nucleation of proeutectoid ferrite. It is suggested that this occurs by the stabilization or alteration of the structure of certain special grain boundary re-gions which serve as favored nucleation sites for ferrite. It is demonstrated how at least part of the effect of alloying elements like manganese and chromium might be ascribed to their enhancement of phosphorus segregation. Under certain conditions phosphorus could be a useful addition to increase the hardenability of low alloy steels.