Caring and cancer nursing: framing the reality using selected social science theory

Caring and cancer nursing: framing the reality using selected social science theory Despite the recent interest in caring for both academic and clinical nursing, the theoretical basis of this concept may appear somewhat elusive as the research and debate vary widely in their focus. As a result, the available literature may fail to consider the specific contextual issues which characterize caring as it is understood across different health care settings. Consideration of theory from disciplines close to nursing, it is suggested, may be useful in understanding the nature of such 'real world' caring. In this discussion the concept of caring within cancer nursing is explored by drawing on a number of social science and nursing sources. It is known that cancer provokes unique caring demands for nurses practising in this area. By examining the context of cancer, it is argued that effective caring deserves to be recognized as an important clinical variable which can influence a diverse range of issues such as patient satisfaction or therapeutic outcome. It is suggested that other nursing specialisms should also explore the psychosocial dimensions of caring in relation to their own role.     

劳动姿势对流量－容积曲线的影响─—波速学说的进一步验证

用“点值法”对健康工人４７３例［轻体力劳动工人（简称轻工）２４８例，重体力劳动工人（简称重工）２２５例］。作了流量一容积曲线和常规通气功能检查。结果表明：重工男女在４０岁以后其高肺容积流量下降，３０岁以后低肺容积流量上升，而且这些改变有随年龄增长而更加明显的倾向；轻工仅有个别年龄组的低肺容积流量上升。对７名健康坐位工作者模拟劳动的前倾姿势作多次通气功能检查，亦有明显高肺容积流量下降和低肺容积流量上升的现象，这一事实提示波速学说亦可应用于颈和躯干前倾进行重体力劳动工人的通气行为。     

An Electron Microscopic Study on the Process of Acid Demineralization of Cortical Bone

Demineralization has been shown to foster osteoinductive properties of cortical bone grafts, yet little is known about the process of demineralization and how to control it. The purpose of this study was to investigate the process of cortical bone demineralization by using scanning electron microscopy to evaluate how hydrochloric acid demineralizes cortical bone. Results showed that in the demineralization of diaphyseal cortical bone specimens using hydrochloric acid, a uniformly thick circumferential band of demineralized bone matrix surrounds an inner undecalcified bone core as the process of demineralization occurs. The interface between the demineralized and mineralized section of the bone specimens was extremely sharp. This interface between demineralized and undemineralized bone was noted to advance as a reaction front with increasing demineralization which resulted in continuous shrinkage of the inner cortical bone core. This study suggests that cortical bone demineralization can be best described using an advancing reaction front theory, and this explanation can be used for implementation of the concept of controlled demineralization. Received: 19 December 1996 / Accepted: 25 April 1997     

厄尔·迈纳的跨文化阐释

厄尔·迈纳的《比较诗学》从跨文化的角度对诗学作比较探讨 ,他以基础文类形成原创诗学为理论基础 ,以基础文类的分析作为跨文化阐释的切入点 ,以基础文类同异关系的把握作为诗学比较的可比性的基础 ,以一种宽容平等的对话精神作为跨文化阐释的态度 ,显示了比较诗学发展的一个必然的成熟过程。但科学的相对主义态度 ,注定了从事比较诗学面临着“诗学”“跨文化”“阐释”等因素的制约 ,这也同时为比较诗学的开拓提供了更多的空间。     

Improving Femoral Bone Density Measurements

Femoral bone density measurements are clinically important because of their strong relationship with hip fracture. However, current densitometers have not improved upon femoral densitometry since the introduction of dual-energy X-ray absorptiometry (DXA) systems. Recently, several advances in DXA measurement of the proximal femur have been proposed by various published studies. These advances can be added to existing DXA systems, while maintaining the conventional femoral regions of interest. Both upper neck bone mineral density (BMD) and hip axis length have been reported to be associated with hip fractures. With newer technology that enables a rapid assessment of both hips, bilateral femur measurements are now clinically practical and are of importance in those with T-scores approaching, yet not reaching, diagnostic or therapeutic thresholds. Bilateral femur measurements also reduce precision error compared to a single femur measurement, yielding precision errors less than observed at the spine. With this decrease in precision error, monitoring of bone changes is now possible at the femur with the utility comparable to the spine.     

Building a relationship: communications and relationships between staff and stroke patients on a rehabilitation ward

Communications among staff and patients on a stroke rehabilitation ward form the focus of this article, which reports on some aspects of a larger study using a grounded theory approach. Tape-recorded interviews were transcribed and analysed concurrently according to recommendations for the approach. A main theme entitled building a relationship was identified, and this process was found to occur in a context varying from participative at one end of a continuum to hierarchical at the other. Building a relationship was found to be influenced by role, personal qualities and organizational context. Appropriate relationships between role-holders were subject to negotiation, leading to a resulting congruence or incongruence between participants' expectations of each other and their roles. Personal qualities were brought into play in the process, with patients' views of staff and staff views of patients both being influential. Some of these views seemed to parallel what has been described in earlier literature as ‘the sick role’ and the labelling of patients as ‘good’ or ‘bad’. Responses to personal qualities led to nurses ascribing meaning to patients' behaviour in terms of adjustment to their stroke, giving time to them to help them to adjust, and withdrawal and handing over to other staff if this strategy failed. Organizational context also had an influence on building a relationship, with time constraints being identified particularly by nurses, and the need to fit in the most essential aspects of care. Place was also important, in that nurses were confined to the ward as a work location, whereas other therapists and doctors worked in other places and sometimes had the facility to take patients off the ward to concentrate on therapy. The findings are discussed against the background of related literature and the conclusion is drawn that the crucial role of nurses in rehabilitation is not recognized and valued, and that shortages of resources - especially suitably qualified and trained nursing staff- are a negative influence on building the relationships which are vital to successful rehabilitation.     

Influence of elevated pH levels on structural and functional characteristics of the human zona pellucida: Functional morphological aspects

Purpose A total of 86 fresh and salt-stored immature human oocytes derived from postmortem ovarian tissue were used for this study.Methods Oocytes were randomly incubated either in synthetic human tubal fluid medium (untreated zonae) or in a chemically defined medium (treated zonae).Results Sperm binding experiments using hemizona assay conditions exhibited a 10-fold increased binding of sperm to treated compared to untreated oocytes (272.7±43 versus 24.3±15 sperm bound, respectively; P<0.0001). pH recordings during incubation showed elevated pH levels of 8.1 compared to pH 7.2 among treated and untreated zonae, respectively. Ultrastructural examination showed a spongy appearance of the surface of treated zonae, whereas untreated zonae appeared compact with smooth surface.Conclusions The marked increase in sperm binding among treated zonae, together with the ultrastructural findings, suggest that the altered zona surface enhances sperm binding. The physiological maturational process of the zona pellucida might be manipulated in vitro, thus increasing sperm binding to the zona.Presented at the IXth World Congress on In Vitro Fertilization and Alternate Assisted Reproduction, April 3–7, 1995. Vienna, Austria.     

关于新型农村合作医疗的支持结构及均势模式探讨

新型农村合作医疗可持续发展需要有完备的社会支持系统,除了要有来自政府的正式支持,如政府责任、完善的组织管理及合理的政策方案外,其他非正式支持同样对新型农村合作医疗的发展有着至关重要的影响。通过研究新型农村合作医疗的社会支持系统结构,探讨社会因素对新型农村合作医疗的双向作用,提出新型农村合作医疗发展的社会支持模式,为提高新型农村合作医疗社会支持程度提供科学依据。     

人本原理在医院管理中的应用价值

目的:研究人本原理在护理管理中的应用。方法:把人本原理的管理原则、动力原则、行为原则、能级原则应用于护士长的管理中,尊重、关心、帮助和激励护士,人人参与管理。选择2005年上半年住院病人180例作为改革组,应用人本原理管理。2004年下半年住院病人150例作为传统组,用传统方法管理。结果:通过人本原理管理原则的应用,提高了护理质量,各项指标应用后高于应用前(P<0.05或P<0.01),无投诉、无差错事故发生,病人满意度一直在95%以上,护士参与管理意识增强,团队精神加强,护士按期晋升。护士对病人实行人性化服务,为医院赢得了相应的社会效益和经济效益。结论:人本原理应用于护理管理行之有效,值得推广。