高职护生就业趋向的调查研究

目的 了解高职护理专业学生的就业趋势,加强就业指导与服务工作,引导学生认清就业形势,准确定位,成功就业.方法 采用问卷调查法对我院1999-2002级高职护理专业学生对就业的相关问题进行调查.结果 在校生与2004,2005年已毕业的往届生比较,在校生对今后的就业方向、就业医院、就业首选去向的选择及对就业形势的估计与往届生均有较大的差异,对就业指导有比较一致的需求.结论 高职护理院校应深化护理教育教学改革,拓展学生知识面;加强就业指导及相关服务工作,扩大就业口径和渠道以增加就业率.护生要勤奋学习、刻苦训练,加强能力与综合素质的培养,并调适好择业心理,增强就业竞争力.     

影响护理本科毕业生就业的相关因素调查分析

目的通过调查本科护理毕业生就业期望,探讨影响其就业的相关因素。方法运用自行设计的问卷调查表对220名即将赴临床实习的应届护理本科生进行就业期望及相关因素的调查。结果护理本科生对于未来工作的期望值与社会现状有差距,专业思想、就业心态及有计划的就业指导都将对护理本科生就业产生影响。结论了解护理本科毕业生就业的影响因素,有目的地进行就业指导等工作,对提高护理本科毕业生就业及培养高素质护理人才都具有现实意义。     

护理本科生与专科生择业期间焦虑程度及其相关因素的对比性研究

[目的]探讨护理专业本科生与高职护理专科生在择业期间焦虑程度及其影响因素。[方法]选取处于择业期间的护理本科生和高职护理专科生各56人,采用“状态-特质焦虑自评量表”“焦虑相关因素调查表”进行调查,并对其焦虑相关因素进行分析。[结果]择业期间护生的状态-特质焦虑自评得分均高于正常人群;引起护理本科生焦虑的相关因素主要有不正之风干扰、自身能力不强、职业收入丰厚等;引起高职护理专科生焦虑的相关因素主要有不正之风干扰、性格内向、专业不受重视。[结论]择业期间护生的焦虑心理是普遍问题。对护理本科生要加强就业心态调整和就业指导等,对高职护理专科生要加强专业重视力度等。     

高职护生社区护理认知及就业意向的调查分析

目的 调查分析高职护生社区护理认知情况及就业意向影响因素,为高职院校开展社区护理教育和就业指导提供参考.方法 采用分层整群抽样的方法,选取不同年级、不同教育层次的护生1 227名为研究对象,采用自设问卷进行调查.结果 不同年级、不同教育层次和不同生源地的护生对社区护理的认知情况与就业意向比较差异有统计学意义.结论 高职护理院校要加强社区护理实践教育和社区就业指导,提高护生社区护理认知程度和社区就业意向.     

护理本科生与专科生择业期间焦虑程度及其相关因素的对比性研究

[目的]探讨护理专业本科生与高职护理专科生在择业期间焦虑程度及其影响因素。[方法]选取处于择业期间的护理本科生和高职护理专科生各56人，采用“状态-特质焦虑自评量表”“焦虑相关因素调查表”进行调查，并对其焦虑相关因素进行分析。[结果]择业期间护生的状态-特质焦虑自评得分均高于正常人群；引起护理本科生焦虑的相关因素主要有不正之风干扰、自身能力不强、职业收入丰厚等；引起高职护理专科生焦虑的相关因素主要有不正之风干扰、性格内向、专业不受重视。[结论]择业期间护生的焦虑心理是普遍问题。对护理本科生要加强就业心态调整和就业指导等，对高职护理专科生要加强专业重视力度等。     

护理本科生就业价值取向现况调查与分析

目的:调查护理专业本科生择业观念与就业价值取向,采取有效措施提高本科生就业率,为高等护理教育改革提供参考依据。方法:采用自设问卷对某护理学院4个年级600名学生进行现况调查。结果:79.17%护理专业本科生表示就业单位意向为三级医院临床护理工作,61.50%护理专业本科生在择业首选因素中选择经济收入与福利待遇,39.67%护理专业本科生愿意到经济发达地区或沿海地区医院,69.67%护理专业本科生迫切需要了解单位用人标准和聘用条件,87.73%护理专业本科生希望学校提供就业政策、形势分析及就业相关信息;2009级护理本科生就业价值观和就业态度与2012级比较差异有统计学意义(P0.05)。结论:护理本科生就业观和就业价值取向不断变化,其选择单位的局限性和功利性应引起学校的高度重视。加强对本科生正确引导,为学生提供相关就业信息,全面了解用人单位需求,为提高护理本科生的就业率和就业质量提供参考。     

对94名本科男护生就业态度的调查与分析

目的了解在校本科男护生的就业认知和就业心态,为其就业提供参考。方法自行设计问卷,对94名男护生进行调查分析。结果男护生认为就业形势较好,但大部分不准备从事护理工作;对就业指导方面有较高的需求。结论护理工作需要男护生的加入,应加强男护生专业思想稳定性教育,使其正确认识就业现状,调整心态、顺利就业。     

我校护理专业毕业生就业指导工作的实效性调查

[目的]了解我校就业指导工作实效性的途径,改进就业指导工作中的不完善之处,为今后的就业指导工作方法的改革与实践提供参考依据。[方法]对大学生就业问题和就业指导等相关资料进行了查阅,对我校608名护理专业应届毕业生就业指导工作现状进行调查分析。[结果]2015年、2016年同一个时间段统计的不同年级各层次毕业生签协议情况的数据分析结果显示2016年毕业生签协议比例明显增加,占毕业生总数的73.85%;2015年级、2016年级护理毕业生的签协议情况比较,差异有统计学意义(χ2=12.15,P0.01);2015年级、2016年级已签协议护理毕业生的医院分布情况比较,差异有统计学意义(U=8.000,P0.01)。[结论]我校应继续重视并加强就业指导工作,以切实提高就业指导工作的实效性。     

在校护理本科生就业意向调查

目的了解护理本科生毕业前的就业意向和就业方面存在的问题,以便采取相应的措施指导其就业。方法采用配额抽样的方法,以自行设计问卷对90名护理本科生关于就业意向、就业观念、就业指导需求及就业途径进行调查。结果在校护理本科生就业期望值偏高,基层就业热情不高,对本专业的相关政策了解较少,求职途径单一,对就业指导的需求很大。结论护理教育者应积极引导在校护理本科生转变就业观,加强实践能力和择业技能的培养,加大就业指导力度,并建立畅通的就业渠道。     

民办高校护理专业学生就业情况调查及分析

目的了解民办高校护理专业毕业生就业情况，为更好地开展学生就业指导提供借鉴。方法针对学生和就业单位设计书面调查问卷，回收后进行统计和分析。结果学生就业、目前工作情况及用人单位对毕业生的反应均较好。结论进一步完善就业工作机制，通过各种途径加强就业指导工作，注重综合能力的培养是解决就业问题的主要措施。     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.