关于病证结合的思考

在护理这样一个女性为主导的职业,社会偏见、传统观念的影响是导致男护士产生职业困惑的主要原因。从社会性别视角分析了这种原因的产生是由于社会性别定义与分工模式被内化的结果,并依此提出了加强护理宣传与护理教育改革、护理分工合理化等对策。     

一起四级医疗事故引发的几点思考

目前,规范护士执业范围的法律、法规存在着盲区。作者通过对一起四级医疗事故的护理责任及护士执业范围的合法性进行分析探讨,认为应当尽快出台与《护士条例》配套的实施细则,以明确规范护士的执业范围及合法性,保障护士执业的安全。     

Associations of Trait Emotional Intelligence with Social Support,Work Engagement,and Creativity in Japanese Eldercare Nurses

Work‐related resources can be positive antecedents of employee work engagement (WE) and creativity. Although trait emotional intelligence (EI) and social support may be crucial resources in nursing, their relationships with WE and creativity remain unclear. Hence, with special focus on the role of trait EI, we examined this relationship by applying the job demands‐resources (JD‐R) model. The participants were 489 eldercare nurses in Japan (female: n = 401; male: n = 88; age = 39.5 ± 11.0 years). The results showed positive associations between EI and the other studied variables. Furthermore, moderated mediation analyses revealed that higher trait EI enhanced the positive association among the triad of social support, WE, and creativity. The findings provide additional evidence that, in nurses, trait EI may be a noteworthy personal resource for creativity in the relationship between social support and WE.     

Ethics,Brain Injuries,and Sports: Prohibition,Reform, and Prudence

Abstract

In this paper, we explore the issue of the elimination of sports, or elements of sports, that present a high risk of brain injury. In particular, we critically examine two elements of Angelo Corlett’s and Pam Sailors’ arguments for the prohibition of football and Nicholas Dixon’s claim for the reformation of boxing to eliminate blows to the head based on (a) the empirical assumption of an essential or causal connection between brain injuries incurred in football and the development of a degenerative brain disease known as chronic traumatic encephalopathy (CTE); and (b) John Stuart Mill’s rejection of consensual domination (ie voluntary enslavement). We present four arguments to contest the validity of Corlett, Dixon’s and Sailor’s positions. Specifically, we argue that (i) certain autonomy-based arguments undermine paternalist arguments for reform; (ii) the nature of the goods people pursue in their lives might justify their foregoing (degrees of) future autonomy; (iii) Mill’s argument against consensual domination draws on ambiguous and arbitrary distinctions; (iv) the lack of consensus and empirical evidence regarding CTE arising from brain injuries in sport underdetermines calls for reform. We conclude that these proposals for reforming or eliminating sports with high risks of brain injuries are not well founded.     

糖尿病专科护士在2型糖尿病防治中的作用与地位

当前我们对糖尿病防治措施和手段可以说是无所不先进,但患者血糖、血脂、血压达标情况仍旧令人担忧。防治领域的相关人员都在竭尽全力探讨其原因,结果令人失望。但是糖尿病作为慢性终生性习惯性疾病,当前几乎所有的有意义的研究均指向良好的生活习惯（饮食控制、增加体育锻炼）有利于减少糖尿病发病。糖尿病专科医生作为疾病防治的三级层面,很...     

Intervention Models for Mothers and Children at Risk for Injuries

We review risk factors commonly associated with childhood unintentional injuries and highlight adolescent mothers and their young children as a high risk group. Several intervention models of injury, including the epidemiological model, Peterson and Brown's working model, and the socioecological model have been proposed to explain the events that lead to injuries. Discussion of these models is provided and a synthesis of the adolescent parenting model and the socioecological model of injury is suggested as way to address the complex variables that lead to an injury causing event for adolescent mothers and their young children. Finally, we suggest areas of future investigation and their implications for prevention and treatment.     

Natural sequence of recovery from child post-traumatic amnesia: A retrospective cohort study

The aim of this study was to determine the sequence of skills recovery during post-traumatic amnesia (PTA) in children with moderate to severe traumatic brain injuries (TBIs). Setting: Fifty children aged 8 to 15 years consecutively admitted to a children’s hospital with TBI and PTA>24 were tested in a retrospective cohort study where the main measure was the Westmead PTA Scale (WPTAS). The group analyses show that orientation to time took longer to recover than orientation to person and place, but not memory, while the individual analyses revealed that when orientation to time was grouped with memory, 94% of children recovered orientation to person and place before orientation to time and memory (examiner and pictures). Correlation coefficients between age and the number of days taken to recover skills were not found to be significant. It was established that, in terms of the natural sequence of skills recovery in children aged 8 to 15 years following moderate to severe TBI, recovery of orientation to time is more closely aligned to memory than to orientation to person and place. It was also established that WPTAS items are developmentally appropriate for children aged 8 to 15 years who have sustained TBI. These findings are clinically important because monitoring recovery from PTA both impacts the rehabilitation offered to individuals during acute care and aids discharge planning.     

Reducing obstacles to the provision of quality diabetic care

Abstract

High quality diabetic care is seen as influenced by the organisation of care, health care workers' involvement in diabetes-specific areas, co-operation among staff members, the availability of resources, and the competence of medical staff (including both physicians and nurses). In a prospective study we have tested a programme for improvements of the quality of diabetes services which combined organisational development and continuing medical education (CME) measures. The study involved 34 primary health care centres over an 18 month period and was based on the responses to questionnaires answered by 123 general practitioners and 247 registered nurses at the 34 PHCCs.

The combined programme had a considerable influence on inter-group co-operation, staff members' perceptions of resources available, and nurses' involvement in diabetic care (54 versus 30% seeing diabetic patients for regular check-ups).

The results show that, in order to diminish obstacles to high quality care, organisation of care as well as care workers' theoretical knowledge has to be focused.     

Teaching preschoolers with disabilities to seek adult assistance in response to simulated injuries

Four preschool-aged children with disabilities received training to seek adult assistance in response to simulated injuries. The children first watched while the instructor modeled and verbalized a first-aid procedure for obtaining adult assistance when injured, and then they practiced the skill with instructor praise or correction. Following this practice with feedback, the children demonstrated their skill without instructor feedback. Generalization probes were conducted before and after training on the school playground and at the children's homes. A multiple baseline design across children was used to evaluate the effects of the program. Rapid increases in the children 's performances of this skill was demonstrated. Further, the posttraining generalization data indicated that the children's performance had generalized across the two settings (school playground and children's homes). More importantly, this skill maintained at 100% at a 1-month follow-up generalization probe.