Practices for the prevention of sexually transmitted infections among university students / Prácticas para la prevención de infecciones de transmisión sexual entre estudiantes universitarios / Práticas de prevenção de infecções sexualmente transmissíveis entre estudantes universitários

ABSTRACT Objective: to analyze the sexual practices adopted by university students for the prevention of Sexually Transmitted Infections Method: a quantitative, descriptive and cross-sectional study, conducted in 2016, at a private university in the municipality of Rio de Janeiro, Brazil. A convenience sample was selected, stratified by gender, of 768 students who answered a self-administered questionnaire, structured with variables of sociodemographic characterization and related to knowledge about sexually transmitted infections, sexual practices, prevention practices and care with sexual health. In the analysis, descriptive statistics, chi-square tests and analysis of variance were used, with a significance level of 5%. Results: most of the university students ‒ 654 (85.16%) ‒ had an active sex life and 480 (62.54%) did not use condoms in all their sexual encounters. Among the participants, 509 (84.83%) said they had sexual intercourse with a steady partner, of which 224 (44.01%) used a condom. In the investigated group, 313 (47.86%) had relationships with casual partners, with 199 (63.58%) reporting having used a condom. Among the participants, 174 (26.61%) had their sexual practices classified as adequate/satisfactory. Conclusion: the findings show that the university students investigated present a risk behavior for Sexually Transmitted Infections due to inadequate/unsatisfactory sexual practices. Health education actions should consider cultural and individual aspects of the group in order to encourage reflection on practices for the prevention of sexually transmitted diseases.

RESUMEN Objetivo: analizar las prácticas sexuales adoptadas por estudiantes universitarios para prevenir Infecciones de Transmisión Sexual. Método: estudio cuantitativo, descriptivo y transversal, realizado en el año 2016 en una universidad privada del municipio de Río de Janeiro, Brasil. Ajustada por conveniencia y estratificada por sexo, la muestra estuvo compuesta por 768 estudiantes que respondieron un cuestionario autoaplicado, estructurado con variables de caracterización sociodemográfica y relacionadas con el conocimiento sobre infecciones de transmisión sexual, prácticas sexuales, prácticas de prevención y cuidados con la salud sexual. En el análisis se empleó la estadística descriptiva, pruebas de Chi-cuadrado y análisis de variancia, con un nivel de significancia del 5%. Resultados: la mayoría de los universitarios ‒ 654 (85,16%) ‒ tenía una vida sexual activa y 480 (62,54%) no usaban preservativo en todos sus encuentros sexuales. Entre los participantes, 509 (84,83%) afirmaron tener relaciones sexuales con una pareja fija y, de ellos, 224 (44,01%) utilizaban preservativo. En el grupo investigado, 313 (47,86%) tuvieron relaciones con parejas casuales, y 199 (63,58%) declararon haber usado preservativo. Entre los participantes, las prácticas sexuales de 174 (26,61%) de ellos se clasificaron como adecuadas/satisfactorias. Conclusión: las conclusiones del estudio evidencian que los universitarios investigados presentan un comportamiento de riesgo para contraer Infecciones de Transmisión Sexual como resultado de prácticas sexuales inadecuadas/insatisfactorias. Las medidas de educación en salud deben considerar aspectos culturales e individuales del grupo para favorecer la reflexión sobre las prácticas de prevención de enfermedades de transmisión sexual.

RESUMO Objetivo: analisar as práticas sexuais adotadas por estudantes universitários para prevenção de Infecções Sexualmente Transmissíveis Método: estudo quantitativo, descritivo e transversal, realizado em 2016, em uma universidade privada no município do Rio de Janeiro, Brasil. Selecionou-se amostra por conveniência, estratificada por sexo, de 768 estudantes que responderam a um questionário autoaplicado, estruturado com variáveis de caracterização sociodemográfica e relacionadas ao conhecimento sobre infecções sexualmente transmissíveis, práticas sexuais, práticas de prevenção e cuidados com a saúde sexual. Na análise, empregou-se a estatística descritiva, testes de quiquadrado e análise de variância, com nível de significância de 5%. Resultados: a maioria dos universitários ‒ 654(85,16%) ‒ tinha vida sexual ativa e 480(62,54%) não fazia uso do preservativo em todos os intercursos sexuais. Entre os participantes, 509(84,83%) afirmaram ter relação sexual com parceiro fixo, dos quais 224(44,01%) utilizaram o preservativo. No grupo investigado, 313(47,86%) tiveram relações com parceiros casuais, sendo que 199 (63,58%) informaram ter usado o preservativo. Entre os participantes, 174(26,61%) tiveram suas práticas sexuais classificadas como adequadas/satisfatórias. Conclusão: os achados evidenciam que os universitários investigados apresentam um comportamento de risco para Infecções Sexualmente Transmissíveis decorrente de práticas sexuais inadequadas/insatisfatórias. Ações de educação em saúde devem considerar aspectos culturais e individuais do grupo para favorecer a reflexão sobre as práticas de prevenção de doenças transmitidas pelo sexo.

Sartre, lector del estoicismo: a propósito de la asunción y la libertad / Sartre as a reader of Stoicism / Sartre como leitor do estoicismo

Resumen En el marco de la filosofía existencial de Jean-Paul Sartre, el estoicismo constituye un referente dialógico a efectos de comprender el sentido en que el ser humano es libre y asume su realidad. En sus escritos autobiográficos, así como en las obras filosóficas de corte fenomenológico y marxista, Sartre leerá a los estoicos con la finalidad de definir, con mayor cercanía o distancia, algunas de sus principales tesis filosóficas. De esta manera, desde una perspectiva interpretativa, nuestro interés es evidenciar las diferentes lecturas que Sartre hace del estoicismo en clave de las categorías de asunción y libertad.

Abstract In the framework of the existential philosophy of Jean-Paul Sartre, Stoicism is a dialogical benchmark to understand the sense in which the human being is free and takes on that responsibility. In his autobiographical writings, as well as in his phenomenological and marxist philosophical works, Sartre reads the Stoics to define, closer or farther away from Stoicism, some of his main philosophical theses. In this way, from a interpretative perspective, we like to show Sartre's different readings of Stoicism in his autobiographical writings, as well as in the leading phenomenological existentialism and marxist existentialism, in terms of the categories of assumption and freedom.

Resumo No quadro da filosofia existencial de Jean-Paul Sartre, o estoicismo é uma referência dialógica para entender o sentido em que o ser humano é livre e assume sua realidade. Em seus escritos autobiográficos, bem como em suas obras filosóficas fenomenológicas e marxistas, Sartre lê os estóicos para definir algumas de suas principais teses filosóficas. Dessa forma, de uma perspectiva interpretativa, gostamos de mostrar como Sartre lê o estoicismo em seus escritos autobiográficos, bem como no existencialismo fenomenológico principal e no existencialismo marxista, em termos de categorias de assunção e liberdade.

Application of restricted mean survival time in clinical follow-up study / 中华流行病学杂志

In clinical follow-up studies,hazard ratio (HR) is routinely used to quantify the differences between-groups,however,it is being estimated by the Cox procedure.HR,the ratio of two hazard functions has abstract meaning only and is in lack of the context to give an intuitive explanation of the survival of patients and the assumption of proportional hazards (PH) must be satisfied.Under this context,the restricted mean survival time (RMST) can be used as a relatively effective measure or index of statistics.This paper introduces the RMST-based statistical analysis methods,including estimation of RMST and its difference,hypothesis testing and regression analysis.The application of RMST in data analysis is also introduced.All the evidence demonstrates that RMST can be used as an effective analytical tool with straightforward interpretation.RMST is also more effective than HR in comparing differences between groups,when non-PH is observed.Therefore,RMST is suggested to be stated along with HR in the process of disease efficacy evaluation and prognosis analysis.Cooperation and complement of the two,a precise reflection on the characteristics of data can be expected.

Application of restricted mean survival time in clinical follow-up study / 中华流行病学杂志

In clinical follow-up studies,hazard ratio (HR) is routinely used to quantify the differences between-groups,however,it is being estimated by the Cox procedure.HR,the ratio of two hazard functions has abstract meaning only and is in lack of the context to give an intuitive explanation of the survival of patients and the assumption of proportional hazards (PH) must be satisfied.Under this context,the restricted mean survival time (RMST) can be used as a relatively effective measure or index of statistics.This paper introduces the RMST-based statistical analysis methods,including estimation of RMST and its difference,hypothesis testing and regression analysis.The application of RMST in data analysis is also introduced.All the evidence demonstrates that RMST can be used as an effective analytical tool with straightforward interpretation.RMST is also more effective than HR in comparing differences between groups,when non-PH is observed.Therefore,RMST is suggested to be stated along with HR in the process of disease efficacy evaluation and prognosis analysis.Cooperation and complement of the two,a precise reflection on the characteristics of data can be expected.

Perception of risk and driving under the effects of alcohol and marijuana on university students in a multicenter study: colombia / Percepção de risco e direção sob efeitos do álcool e da maconha em estudantes universitários em um estudo multicéntrico: colômbia / Percepción de riesgo y conducción bajo los efectos del alcohol y la marihuana en estudiantes universitarios en un estudio multicéntrico: colombia

ABSTRACT Objective: analyze the relationship between the perception of risk and the behavior of driving under the influence of alcohol or marijuana or getting into a vehicle driven by someone under the effects of these substances in order to identify risk factors and protective factors. Method: multicenter study cross sectional survey with students from a University in Colombia (n = 493) completed a survey prepared during the International Program of Training in Research for Health Professionals and Related Areas to Study the Drug Phenomenon in Latin America and the Caribbean. Results: an inverse relationship was observed between each of the three levels of risk perception: detection (p<.001), punishment (p<.05) and harm (p<.001), and driving behaviors with alcohol. This same type of relationship is observed with marijuana in terms of perceived risk of being involved in an accident (p<.05). However, regarding to marijuana, there is not enough evidence of an association with the perceived risk of being arrested or punished. The results show that there is an inverse relationship between what the students' relatives and friends think and do and the perception of risk of being arrested (p<.001), punished (p<.001) or of being involved in an accident (p<.001) for driving under the influence of alcohol and marijuana at the same time. Conclusion: the results suggest that there are risk factors and protective factors that can be intervened to prevent injuries or fatal events associated with driving under the influence of alcohol or marijuana.

RESUMO Objetivo: analisar a relação entre a percepção de risco e o comportamento na direção sob os efeitos do álcool ou da maconha, ou subir em um veículo dirigido por alguém sob os efeitos dessas substâncias, com o objetivo de identificar fatores de risco e fatores de proteção. Método: estudo multicéntrico cross seccional survey com estudantes de uma Universidade na Colômbia (n=493) que participaram de uma pesquisa elaborada durante o Programa Internacional de Treinamento em Pesquisa para Profissionais da Saúde e Áreas Afins para Estudar o Fenômeno de Drogas na América Latina e no Caribe. Resultados: observou-se relação inversa entre cada um dos três níveis de percepção de risco: detecção (p<0,001), punição (p<0,05) e danos (p<0,001), e os comportamentos na direção com álcool. Esse mesmo tipo de relação pôde ser observado com a maconha em termos de risco percebido de estar envolvido em um acidente (p<0,05). Porém, em relação à maconha, não há evidências suficientes de associação com o risco percebido de ser preso ou punido. Os resultados mostram que existe uma relação inversa entre o que pensam e fazem os parentes e amigos dos estudantes e a percepção de risco de serem presos (p<0,001), punidos (p<0,001) ou de estarem envolvidos em um acidente (p<0,001) por dirigirem sob os efeitos do álcool e da maconha ao mesmo tempo. Conclusão: os resultados sugerem que existem fatores de risco e fatores de proteção que podem ser intervencionados para evitar lesões ou eventos fatais associados à condução sob a influência do álcool ou da maconha.

RESUMEN Objetivo: analizar la relación entre la percepción de riesgo y el comportamiento de conducir bajo los efectos del alcohol o marihuana o subirse a un vehículo conducido por alguien bajo los efectos de estas sustancias con el fin de identificar factores de riesgo y factores protectores. Método: estudio multicentrico cross seccional survey con estudiantes de una Universidad en Colombia (n=493) diligenciaron una encuesta elaborada durante el Programa Internacional de Capacitación en Investigación para Profesionales de la Salud y Áreas Relacionadas para Estudiar el Fenómeno de las Drogas en América Latina y El Caribe. Resultados: se observó una relación inversa entre cada uno de los tres niveles de percepción de riesgo: detección (p<.001), sanción (p<.05) y daño (p<.001), y los comportamientos de conducción con alcohol. Este mismo tipo de relación se observa con marihuana en términos de percepción de riesgo de verse involucrado en un accidente (p<.05). Sin embargo, con respecto a la marihuana, no existe suficiente evidencia de una asociación con la percepción de riesgo de ser detenido o sancionado. Los resultados muestran que existe una relación inversa entre lo que piensan y hacen los familiares y amigos de los estudiantes y la percepción de riesgo de ser detenido (p<.001), sancionado (p<.001) o de verse involucrado en un accidente (p<.001) por conducir bajo los efectos de alcohol y marihuana al mismo tiempo. Conclusión: los resultados sugieren que existen factores de riesgo y factores protectores que pueden ser intervenidos para prevenir lesiones o hechos fatales asociados a la conducción bajo los efectos de alcohol o marihuana.

Risk perception and driving a motor vehicle under the influence of cannabis: a study with college students of a private institution / Percepción de riesgo y conducción de vehículo automotor bajo los efectos de la marihuana: un estudio con universitarios de una institución particular / Percepção de risco e condução de veículo automotor sob o efeito de maconha: um estudo com universitários de uma instituição particular

ABSTRACT Objective: to analyze the relationship between risk perception and behaviors related to driving a motor vehicle under the influence of cannabis. Method: The research was carried out through a cross-sectional survey. 382 undergraduate students between the ages of 17 and 29 were interviewed at a private higher educational institution in the Federal District, Brazil. Descriptive and inferential statistics (cross tabulations and chi-square) were used to analyze the data. Results: they indicate that more than 1/3 of the participants used cannabis in the past 12 months, and 36.4% reported problematic use. It was possible to establish a relationship between the behaviors of perception of risk and driving a motor vehicle under the influence of cannabis: 1) the perception of being sanctioned as a driver and driving a motor vehicle under the influence of cannabis (χ2(1) = 3.96, p=≤0); 2) to perceive damages as driver and driving a motor vehicle under the influence of cannabis (χ2(1)=3.96, p = ≤05); 3) perception of damages as passenger and driving a motor vehicle under the influence of cannabis (χ2(1)=3.96, p=≤5.0). Conclusion: damages caused by cannabis are underestimated by university students, since they have a very low risk perception, especially when compared to alcohol. In Brazil, there is also a lack of regulation and sanctions with respect to driving a motor vehicle under the influence of cannabis, which may contribute to an important risk among this population.

RESUMEN Objetivo: analizar la relación entre percepción de riesgo y conductas relacionadas a la conducción de vehículo automotor bajo los efectos de la marihuana. Método: investigación realizada por medio de un survey transversal. Se entrevistaron a 382 estudiantes de grado entre 17 y 29 años de edad en una institución privada de enseñanza superior en el Distrito Federal, Brasil. Para analizar los datos, se realizaron estadísticas descriptivas e inferenciales (tabulaciones cruzadas y chi-cuadrado). Resultados: indican que más de 1/3 de los participantes consumieron marihuana en los últimos 12 meses; 36,4% relató uso problemático. Se pudo establecer una relación entre la conducta y la percepción de riesgo en el vehículo propulsado y conducido bajo los efectos de la marihuana: 1) la percepción de ser sancionado como conductor del vehículo y el efecto de conducción de la marihuana (χ2(1) = 3,96, p = ≤ ,0); 2) notar los daños como conductor del vehículo y conducir el vehículo bajo los efectos de la marihuana (χ2(1) = 3,96, p = ≤05); 3) la percepción del daño como pasajero y conducción de un vehículo automotor bajo los efectos de la marihuana (χ2(1) = 96, p = ≤5,0). Conclusión: los estudiantes universitarios subestiman las pérdidas que genera la marihuana, dado que para ellos presenta una percepción de riesgo muy reducida, sobre todo cuando se la compara con el alcohol. En Brasil, también hay una falta de reglamentación y sanciones en relación a la conducción de vehículo automotor bajo efecto de la marihuana, lo que puede contribuir a un riesgo importante en esta población.

RESUMO Objetivo: analisar a relação entre percepção de risco e comportamentos relacionados à condução de veículo automotor sob efeito de maconha. Método: A pesquisa foi realizada por meio de um survey transversal. 382 estudantes de graduação entre 17 e 29 anos de idade foram entrevistados em uma instituição privada de ensino superior no Distrito Federal, Brasil. Foram realizadas estatísticas descritivas e inferenciais (tabulações cruzadas e qui-quadrado), utilizadas para a análise dos dados. RESULTADOS: indicam que mais de 1/3 dos participantes usaram maconha nos últimos 12 meses, 36,4% relataram uso problemático. Foi possível estabelecer uma relação entre os comportamentos percepção de risco e condução de veículo automotor sob efeito de maconha: 1) a percepção de ser sancionado como motorista e condução de veículo automotor sob efeito de maconha (χ2(1)=3,96, p=≤,0); 2) perceber danos como motorista e condução de veículo automotor sob efeito de maconha (χ2(1)=3,96, p=≤05); 3) percepção de dano como passageiro e condução de veículo automotor sob efeito de maconha (χ2(1)=,96, p=≤5,0). CONCLUSÃO: a maconha tem prejuízos subestimados pelos estudantes universitários, pois apresentam uma percepção de risco muito reduzida, especialmente quando comparada ao álcool. No Brasil, também há uma falta de regulamentação e sanções em relação à condução de veículo automotor sob efeito de maconha, o que pode contribuir para um risco importante entre essa população.

Survival analysis: part II – applied clinical data analysis / 대한마취과학회지

As a follow-up to a previous article, this review provides several in-depth concepts regarding a survival analysis. Also, several codes for specific survival analysis are listed to enhance the understanding of such an analysis and to provide an applicable survival analysis method. A proportional hazard assumption is an important concept in survival analysis. Validation of this assumption is crucial for survival analysis. For this purpose, a graphical analysis method and a goodness-of-fit test are introduced along with detailed codes and examples. In the case of a violated proportional hazard assumption, the extended models of a Cox regression are required. Simplified concepts of a stratified Cox proportional hazard model and time-dependent Cox regression are also described. The source code for an actual analysis using an available statistical package with a detailed interpretation of the results can enable the realization of survival analysis with personal data. To enhance the statistical power of survival analysis, an evaluation of the basic assumptions and the interaction between variables and time is important. In doing so, survival analysis can provide reliable scientific results with a high level of confidence.

Study on isotropic elasticity reconstruction algorithms for magnetic resonance elastography / 医疗卫生装备

Objective To analyze the advantages and disadvantages of various harmonic magnetic resonance elasticity reconstruction algorithms.Methods Different reconstruction algorithms were categorized according to their mathematical hypotheses.The influence of different assumptions on elasticity reconstruction was investigated with experiments and from mathematical fundamentals.Results The finite element full inversion method had higher precision while more computational time.The algorithms with local homogeneity and incompressibility assumptions were faster while less accurate.The algorithms considering the local change of elastic moduli could effectively reduce boundary artifacts.Conclnsion Different assumptions of algorithms may cause levels of errors between the estimated and real elastic moduli.The selection of elasticity reconstruction algorithms in practical experiment requires a comprehensive tradeoff.

El sentimiento inconsciente de culpa freudiano: clínica diferencial y suposición de sujeto. Una aproximación metodológica / The freudian unconscious feeling of guilt: differential clinic and supposition of subject. A methodological approximation

En este artículo presentamos dos aspectos del estado de avance de nuestra investigación sobre el sentimiento inconsciente de culpa y su relación con el deseo. En primer lugar, y en relación con nuestro primer objetivo específico, damos cuenta aquí de la revisión bibliográfica sobre el contexto de surgimiento y el camino de construcción de la noción mencionada. Luego, en un segundo movimiento, realizamos un análisis de la metodología aplicada por Freud en su investigación, para establecer y explicitar, por comparación, nuestra propia metodología. Respecto de la primera parte del trabajo, hemos hallado que Freud parte, a modo de regla general, de la postulación de la represión del complejo de Edipo y la formación del Superyó como instancia subrogante de la autoridad paterna; luego formula la hipótesis de sentimiento inconsciente de culpa para aquellos casos en que detecta diversos fenómenos clínicos, como la reacción terapéutica negativa, por ejemplo. A continuación, prosigue su conceptualización hacia la necesidad de auto-castigo, y de allí, al masoquismo generalizado de las neurosis. En lo que respecta a la segunda parte del trabajo, encontramos que la metodología freudiana responde al razonamiento abductivo. Por comparación con dicha metodología, caracterizamos y explicitamos la nuestra, que también responde a la abducción.

In this article we are going to introduce two aspects about our state of progress regarding our first investigation about the unconscious feeling of guilt and its relation with desire. Firstly, and in relation to our first purpose, we notice here the literature review about the context of emergence and the way of the construction of the mentioned notion. Then, in a second movement, we analyze the methodology applied by Freud in his investigation, to state and explain, by comparison, our own methodology. In regards with the first part of the work, we have found that Freud begins, as a general rule, with the postulation related to the repression of the Oedipus complex and the formation of the superego as a surrogate instance of paternal authority; then he formulates the hypothesis of unconscious feeling of guilt for those cases in which he detects various clinical phenomena, like negative therapeutic reaction, for instance. After that, he continues his conceptualization to the need of self-punishment, and from there, to the widespread masochism of neuroses. In the second part of the article, we find that the freudian methodology goes along with the abductive reasoning. By comparing these methodologies, we describe and explain ours, which also responds to abduction.

La retraumatización en los procesos psicoanalíticos / Retraumatization in the psychoanalytic processes

La autora postula que aquellas teorías que otorgan mayor relevancia al medio ambiente y al trauma temprano versus aquellas que se centran en el rol de las pulsiones, tendrían por lógica que ayudarnos a estar alertas y considerar más nuestro potencial poder retraumatizador con nuestros pacientes. A pesar de lo anterior, como terapeutas no podemos eludir nuestra condición de animal gregario, y caer, como Bion afirma, en funcionamiento de supuesto básico, en la comunidad que nos acoge como analistas, en el uso que le demos a nuestras teorías y también directamente con nuestros analizados. El no poder “despertar” y reconocer este tipo de funcionamiento se postula como la principal fuente de retraumatizaciones en los procesos psicoanalíticos.

The author postulates that those theories that give more importance to the environment and early trauma to the genesis of psychopathology versus those which are focused on drives would help us to be aware and consider more our re-traumatizing potential with our patients.Despite the about, as therapist, we cannot elude our condition as gregarious animal and fall, as Bion asserts, upon basic assumption functioning in the analytic community, in the use we give to our theories and directly with our analyzands. Not being able to wake up and acknowledge this type of functioning is probably the main source of re-dramatizations in psychoanalytic processes.

El supuesto de la continuidad conductual entre especies y la comprensión de la conducta Humana / The assumption of behavioral continuity between Species and the understanding of Human behavior

El supuesto de continuidad en la tradición operante, es decir, considerar la conducta de todas las especies en términos de los mismos procesos, ha inducido una confusión de categorías que impide el estudio y la comprensión de la conducta propiamente humana. Se revisan los argumentos continuistas, especialmente basados en la simplicidad científica y la continuidad filogenética. Sin respaldar la postura anticontinuista, se desarrollan tres contraargumentos mostrando cómo es defendible la posibilidad de diferentes procesos conductuales entre especies, incluyendo la humana, sin desconocer que el origen de las diferentes especies y de la conducta de los organismos responde a los mismos principios. Al final, se esboza una propuesta frente al debate que abre la posibilidad de identificar diferentes procesos conductuales, en lo que sería un análisis de organizaciones conductuales, que permitiría un acercamiento más provechoso al estudio de la conducta propiamente humana desde una perspectiva conductual.

The continuity assumption in the operant tradition, that is, to consider the behavior of all species in terms of the same processes, has induced a confusion of categories that prevents the study and understanding of proper human behavior. Continuity arguments are reviewed, especially those based on scientific simplicity and phylogenetic continuity. Three counterarguments are developed, showing how the possibility of different behavioral processes among species, including the human one, is defensible, without denying that the origins of different species and of the behavior of organisms respond to the same principles. In the end, a proposal is outlined about the possibility of identifying different behavioral processes, as an analysis of behavioral organization, which would allow a more fruitful study of properly human behavior from a behavioral perspective.

Reliability and Validity on Measurement Instrument for Health Status Assessment in Occupational Workers / 예방의학회지

In order to test scaling assumption, and to assess the validity, reliability, and acceptability of the Short Form 36(SF-36) health survey questionnaire, we conducted a survey. Samples were 296 workers who had been employed in small sized companies. All scale passed for item internal consistency(100% sucess rate) and item discriminant validity(100% success rate). Reliability coefficients were ranged from a low of 0.51 to a high of 0.85. For 87.5% of the total workers, inconsistent responses were not observed. Only 3.0% of the total workers failed two or more checks. Factor analysis was performed using principal axis factor method and quartimax rotation. In this survey, the SF-36 retained available psychometric properties even when used in a generally healthy worker group. But further study with some consideration to develope health status measurement is expected ; first, the definition of health status should be rationalized. Second, the measurement of outcome is an important consideration in evaluations of quality of care. But ambiguities hinder understanding of this important topic. Third, internal consistency should be interpreted with caution as an indication reliability because it ignores potentially important sources of variation that can occur over time.

Assumption of the Age of Subdural Hematomas Based on Computerized Tomographic Findings

A series of 89 patients diagnosed between 1988 and 1993 with computerized tomography(CT) as having subdural hematoma was studied retrospectively in order to evaluate the age of the subdural hematomas according to its appearance on CT scans. In all the patients, the interval from onset of injury to performance of CT scans was more than 2 days. The patients were divided into 4 groups based on the difference in density of the hematoma as seen on the CT scans;hyperdensity(16.9%), isodensity(30.3%), hypodensity(19.1%), and mixed-density(33.7%) groups. The mean interval from onset of injury to diagnosis in hyperdensity, hypodensity, mixed density, and isodensity groups was 15.7+/-18.3 days, 18.8+/-27.9 days, 35.6+/-62.1 days, and 47.6+/-52.1 days, respectively. The configuration of the hematomas on CT scans was crescentic in 74.2%, planoconvex in 12.4%, and biconvex in 13.5%. As the interval became longer, the hematomas tended to take on a planoconvex or biconvex shape rather than the crescentic shape;when the interval from onset of injury to diagnosis was within 7 days, crescentic shape was observed in 91%, within 8 to 21 days, 69%, and over 21 days, 58%. It is concluded from these findings that subdural hematomas undergo a progressive change in their attenuation as the hematomas age, changing from the initial hyperdense stage, go through a hypodense stage, and eventually to an isodense stage. These changes of attenuation values correlates fairly well with the rebleeding theory. The appearance of the hematomas as seen on CT scans also tended to change from the initial crescentic shape to the planoconvex or biconvex shape with time. However, given the possible variations of attenuation values and shapes of subdural hematomas, assumption of the age of the hematomas based on CT findings alone should be made with caution.

An Assumption on Setting up the Course of "Logical Thinking Training" for Medical Students / 中国医学伦理学

High-quality medical talents must possess high accomplishment of logical thinking,but the current logic thinking standard of medical students is far from the needs of modern medical development.Therefore,setting up of a "logical thinking training" course for medical students is necessary and significant for the innovation,diagnosis,nursing care and management of modern medicine.The theoretical and practical conditions for the new course are both mature with feasibility.