中医理念在拇趾外翻临床中的运用

探讨运用中医治病求本、阴阳学说、筋束骨、小夹板纸压垫原理、辨证施治等中医理论,构筑的中西医结合微创技术治疗拇外翻畸形的诊疗体系.从拇外翻畸形的病因、病理、矫形手术、手法复位、生物固定、术后康复等几方面,阐述对拇外翻畸形的新的矫形理念.     

Occupational Stress in University Staff

A survey was conducted of all staff members of an established Australian metropolitan university. The overall response rate for noncasual staff was 72% (77% for general staff and 65% for academic staff) resulting in a sample of N = 2,040. High levels of psychological stress were observed, despite the fact that trait anxiety and job satisfaction were normal. Psychological distress was highest and job satisfaction lowest among academic staff engaged in both teaching and research. In general, university staff reported high levels of autonomy and social support from colleagues. However those engaged in both teaching and research reported increased pressure arising from funding cuts to universities, resulting in heavier teaching loads and greater difficulty in securing research funds, as well as a decline in facilities and support for both teaching and research. The results are discussed in relation to the Demand–Control and Person–Environment Fit models of job stress.     

The impact of organisational change on professionals working within a Community Mental Health Team (CMHT): a psychodynamic perspective

The aim of this study was to explore the effects of organisational change upon staff working in a Community Mental Health Team (CMHT). A grounded theory methodology was employed to analyse data from eight interviews with a range of staff. Analysis identified one core category and five key categories. ‘Corrosion of good work: an ethos in decline’ represents the core category and refers to the staff members’ sense of demoralisation of their professional values and integrity. The first key category, ‘Cultural change’, refers to staff members’ perception of change within the CMHT, with an increased emphasis on regulation, performance management and proceduralisation. Three further key categories were identified: ‘Caring clinicians and uncaring managers’, ‘Confusion regarding professional roles’ and ‘Disconnecting and isolating’. The fifth key ‘Staff departing and increasing risk for clients’, describes the impact of the working culture. These categories and emerging theory were interpreted through a psychodynamic lens, and identified the need for better management practice, support, training and supervision of staff as the foundations of safe practice.     

The Governance of Sport

Political philosophy is an examination of distribution of power in human communities and institutions. In previous period when identity issues were the most important political approach philosophy of sport had to deal mostly with discrimination and much less with the distribution of power in sport governance. Recent scandals revealed that at the top of sport governing bodies. Even more: it exposed the political character of the distribution of unleashed power in sport. That is why it is not enough to punish ad to prevent. It is necessary to change the distribution of power, reform the models of control over political power in sport and to rethink the whole system of governance in sport. The proposal of this paper is just one short step in this direction with two points of departure: a change in initial sport’s associational character of aristocratic distribution of power into contemporary state of corporation with managerial distribution of power; and political philosophy’s proposals for models of democratic control at the global level.     

Building and sustaining work engagement – a participatory action intervention to increase work engagement in nursing staff

This study evaluated whether a participatory action research intervention with nursing staff on acute care older people National Health Service wards in the United Kingdom was effective for increasing work engagement. Mediation analyses between job resources (social support, influence in decision-making), job demands, work-related needs (autonomy, competence, relatedness), and work engagement explored the presumed psychological mechanisms underlying the intervention. A non-randomized, matched control group, pretest, post-test design involved three intervention and five control wards. A significant decrease in relatedness, and a borderline significant decrease in competence, was observed in the intervention group compared to the control group, with no effect on work engagement (N = 45). Work-related needs mediated between resources and work engagement, supporting the job demands-resources model and self-determination theory as an underlying explanatory theory. Intervention implementation was difficult, highlighting the need for participant and organizational readiness for change, and strong management support. This is the first known study to apply participatory techniques to increase work engagement in nursing staff and explore the underlying explanatory psychological mechanisms, offering a novel means of taking work engagement research forward. Crucially, it highlights the challenges involved in intervention research and the importance of including evaluations of intervention implementation alongside statistical evaluations to avoid erroneous conclusions.     

Conflict management styles and work-related well-being among higher education employees

The objective of the study was to assess the relationship between conflict management styles and work-related well-being of employees in a higher education institution in South Africa. Participants were academic personnel (n = 180) and support staff (n = 201), of which 59.9% were females and 29.9% were black African participants of a large South African university. They completed self-report measures of conflict management and work-related well-being. The data were analysed to predict work-related well-being from conflict management styles and to determine the differences between support staff and academic personnel regarding conflict management styles and work-related well-being. Findings indicated the conflict management style of compromise to predict lower levels of engagement and higher levels of disengagement. Support staff reported to utilise the compromising and dominating style more than did academic personnel. Diversity in conflict management styles may serve organisations better than a monolithic conflict management style.     

The effects of behavioral skills training on staff implementation of discrete-trial teaching

A behavioral skills training package was used to train 3 teachers to correctly implement discrete-trial teaching. The mean baseline proportion of possible correct teaching responses for Teachers 1, 2, and 3 increased from 43%, 49%, and 43%, respectively, during baseline to 97%, 98%, and 99%, respectively, following training. These data indicate that the training package consisting of instructions, feedback, rehearsal, and modeling produced rapid and large improvements in the teachers' implementation of discrete-trial teaching.     

Training educators to implement functional analyses

The present study examined the use of an instructional workshop for training educators to conduct functional analyses. Results indicated that 2 of 3 participants met the accuracy criterion following group training, whereas 1 participant required direct verbal feedback. During generalization probes, one participant accurately conducted sessions with a student in her classroom.     

Enhancing frequency recording by developmental disabilities treatment staff

We evaluated a staff training and management package for increasing accuracy of recording frequency of problem behavior in a residential care facility. A multiple baseline design across the first and second work shifts showed that 2 of 8 participants increased their accuracy following in-service training, and all 8 improved during a condition with supervisor presence and feedback. Improvements were maintained when feedback was removed and generalized to activity periods when neither supervisor presence nor feedback was provided. Other staff behavior was not adversely affected by the intervention package.     

Aggressive encounters between patients and general hospital staff: Staff perceptions of the context and assailants' levels of cognitive processing

A considerable body of research has accumulated regarding aggression toward health care staff, yet little is known about the contextual factors involved. The present study examined the context within which aggressive incidents occurred and the dynamics of the interaction between staff and patients. Two aspects in particular were investigated; firstly, whether incidents were preceded by some anxiety provoking stimulus and secondly, the assailants' levels of cognitive processing apparent at the time of the incident. A prospective study collected data concerning incidents of physical assault and threatening behaviour in a general hospital. Staff were interviewed soon after the incident occurred. A content analysis determined that 82.8% of incidents involved experiences delivered by the staff victims likely to have provoked anxiety in the assailant. Most commonly, incidents involved staff intervening in the patient's intended behaviour. In addition, in 64% of cases, assailants were actually displaying some impairment in cognitive processing at the time of the incident Data suggest that many patients may not have been fully aware of their situation and might have experienced some difficulty in comprehending the staff member's actions. Patients who do not appear to understand what is happening may require additional time and effort to ensure they comprehend fully and accept what the staff member is intending to do, particularly if patients are experiencing an event likely to increase anxiety levels. Aggr. Behav. 30:534–543, 2004. © 2004 Wiley‐Liss, Inc.