从弑父向寻父的转变：晚生代创作转型研究

新世纪以来，随着一批以写农村题材为主的文学作品的问世，毕飞宇、李洱、林白等为中坚的晚生代作家的创作出现了转型迹象，开始有意无意从欲望都市中撤退，在乡村和历史中进行书写，显示了对写作深度和写作意义的自觉思考和追问，呈现了某种历史主义的悲悯情怀。与这种空间的转换相对应的，还有叙事立场从原先的边缘向中心的靠拢，叙事方式上从现时态的写作向过去式的写作，话语方式从原先的反讽式写作向悖论式写作转向，这些文本中呈现出了一种人到中年的精神气质，与现实和解，向历史握手。这种写作固然源于作家写作的探索，更源于现实的召唤，还来自于人到中年的生命体验。     

Complications during multiorgan retrieval and pancreas preservation

In pancreas transplantation, complications can arise at each step of the process, from the initial selection of donors and recipients through the surgical technique itself and the post-operative period, when lifelong immunosuppression is required. In the early steps, careful retrieval and preservation of the pancreas are crucial for the viability of the organ and ultimate success of the transplant. The pancreas is a low-flow gland, making it highly sensitive to transplantation conditions and presenting risk of pancreatitis due to periods of ischemia. The two groups of donors - after brain death (DBD) or after cardiac arrest (DCD) - require different strategies of retrieval and preservation to avoid or reduce the risk of complications developing during and after the transplantation. For DBD donor transplantation, multiorgan retrieval and cold preservation is the conventional technique. Asystole donor (DCD) transplantation, in contrast, can benefit from the newest technologies, such as hypothermic and especially normothermic preservation machines (referred to as NECMO), to optimize organ preservation. The latter has led to an increase in the pool of donors by facilitating recuperation of organs for transplantation that would have been discarded otherwise.     

Errorless Learning and Spaced Retrieval Training for Clients with Alzheimer's Dementia

ABSTRACT

Clients with Alzheimer's dementia (AD) may experience limitations in completing activities of daily living (ADL) due to impairments in cognition, memory, and problem-solving. These clients are often referred to occupational therapy (OT) services in order to maximize independence in ADL and decrease caregiver burden. Occupational therapists may be challenged when developing treatment interventions for clients with AD due to client deficits in memory and learning. This article explores evidence-based learning strategies—errorless learning (EL) and spaced retrieval (SR)—to improve learning and memory and OT outcomes for clients with AD. The roles of memory and learning are discussed, and EL and SR strategies are explored for clients with AD. OT intervention ideas are identified, and strategies for integrating EL and SR techniques into the OT plan of care (POC) are also discussed. Future research implications are explored for expanding evidence for EL and SR as part of the OT POC.     

The value of simulation-based learning in pre-licensure nurse education: A state-of-the-art review and meta-analysis

Simulation modalities are numerous in nursing education, with a need to reveal their range and impact. We reviewed current evidence for effectiveness of medium to high fidelity simulation as an education mode in pre-licensure/pre-registration nurse education. A state-of-the-art review and meta-analyses was conducted based on a systematic search of publications in English between 2010 and 2015. Of 72 included studies, 43 were quantitative primary studies (mainly quasi-experimental designs), 13 were qualitative studies and 16 were reviews of literature. Forty of 43 primary studies reported benefits to student learning, and student satisfaction was high. Simulation programs provided multi-modal ways of learning. A meta-analysis (8 studies, n = 652 participants) identified that simulation programs significantly improved clinical knowledge from baseline. The weighted mean increase was 5.0 points (CI: 3.25–6.82) on a knowledge measure. Other objectively rated measures (eg, trained observers with checklists) were few. Reported subjective measures such as confidence and satisfaction when used alone have a strong potential for results bias. Studies presented valid empirical evidence, but larger studies are required. Simulation programs in pre-licensure nursing curricula demonstrate innovation and excellence. The programs should be shared across the discipline to facilitate development of multimodal learning for both pre-licensure and postgraduate nurses.     

Applicability of consumer activity monitor data in marathon events: an exploratory study

Emerging opportunities to measure individual and population-level health data with activity monitors during recreational running activities may set the stage for new research possibilities in mass participation running events and marathon medicine. This study explores the applicability of consumer activity monitor data in a preliminary study for future marathon health research with a cohort of 12 (n?=?12) participants completing a 3.379?km walking or running course. This study explored the feasibility of collecting pace and distance data from Fitbit brand consumer activity monitors, from access to user data to reporting of data characteristics and data analysis. We show that a large percentage of participant data can be successfully retrieved from Fitbit consumer activity monitor devices for analysis in marathon health research, and that identifying variations in pace across participants is a practical possibility. We note a mean absolute percentage error of 13% over the true distance of 3.379?km, a higher error than that reported by other studies. We also observe a Pearson correlation coefficient between participant variation in pace and absolute distance error of 0.61. This study provides preliminary evidence to support the applicability of consumer activity monitor data in marathon health research.     

患者健康教育需求评估工具研究进展

<正>健康教育是通过信息传播和行为干预帮助个人或集体掌握卫生健康知识,树立健康观念,自愿采取有利于健康的行为和生活方式的健康活动过程,其目的就是消除或减轻影响健康的危险因素,预防疾病,促进健康和提高生活质量[1-2]。随着以"健康为中心"的医学模式的转变和优质护理的推进,健康教育也已成为责任制医院整体护理的一个重要组成部分。护士作为健康教育的主要执行者,其教育内容直接影响健康     

体验式学习在护理临床教学中的应用研究进展

<正>体验式学习(experiential learning)是指学生从日常生活或他人构建的程序里获得亲身体验,之后进行反思、概括、讨论、评价等活动,最终产生新的认识、情感以及行动,并在实践中加以检验、运用,以指导后续行为的过程或能力[1]。20世纪80年代,Kolb系统阐述了体验式学习理论,该理论指出每名学生都有其最适合的学习方式,可通过学习方式调查表(Learning Styles Inventory,LSI)