Nurse consultants: organizational influences on role achievement

Aims. This paper reports on organizational influences on nurse consultant post holders. The influence of individual characteristics has been the subject of another paper. Background. Nurse consultant posts were set up in the United Kingdom from the late 1990s onwards and, therefore, there has been little opportunity to report on evaluations of these innovative initiatives. Design. A cross‐sectional design, using a convenience sample, was adopted. Methods. Ten nurse consultants working in a variety of settings and specialties participated in in‐depth, tape‐recorded interviews. The data were analysed using the Framework approach. Findings. Support systems were important influences on nurse consultants’ role achievement levels. These took the form of internal trust networks, nurse consultant forums and links with higher education institutions. Post holders both gave and received support and acted to empower other nurses. Thus, relationships were vital to successful role integration. The culture and structures of the National Health System were also a powerful influence in terms of local and national modernization policies, and participants had to be careful in their choice of strategies to deal with the traditional medically dominated culture. Conclusions. The new nurse consultant role is challenging and innovative, but a major area of contention is how much post holders are expected to take on work previously done by doctors rather than developing their nursing role. Organizational support and commitment are needed if nurse consultants are to maximize the benefits of this innovation. Relevance to clinical practice. The findings show that new nursing roles are not always easily accepted in multidisciplinary settings and that holders of such post need to have the appropriate previous knowledge, skills and personal characteristics, as well as the ability to negotiate their way through organizational influences.     

Governing time in operating rooms

Aim. This paper examines how time is controlled and governed in operating rooms through interpersonal communication between nurses and doctors. Background. Time is a valuable commodity in organizations with improvements often directed towards maximizing efficiencies. As a consequence, time can be a source of tension and interpersonal conflict as individuals compete for control of its use. Methods. The data in this paper emanate from an ethnographic study that explored a range of communication practices in operating room nursing. Participants comprised 11 operating room nurses. Data were collected over two years in three different institutional settings and involved participant observation, interviews and the keeping of a personal diary. A deconstructive analysis of the data was undertaken. Results. Results are discussed in terms of the practices, in which clinicians are engaged in, to govern and control their use of time. The four practices presented in this paper include; questioning judgment and timing, controlling speed, estimating surgeons’ use of time and coping with different perceptions of time. Conclusions. Time and speed were hotly contested by nurses. They used their personal knowledge of individual surgeon's habits of time to govern and control practice. Nurses thought about surgeons in terms of time and developed commonly accepted understandings about the length of surgical procedures. They used this knowledge to manage the scheduling of operations in the departments and to control the workflow in individual operating rooms. Knowledge of individual surgeons was a source of power for operating room nurses. Relevance to clinical practice. Nurses have more power in the operating room than might be imagined but they exercise this power in subtle ways. If operating rooms are to work effectively, the operating room team must understand each others' work better.     

Beneficial effects of regular exercise on sleep in old F344 rats

With aging there is a significant decline in the normal architecture of sleep and a reduction in the diurnal amplitude of core body temperature. Regular moderate exercise has been shown to have a positive impact in the elderly and here we investigate whether sleep–wake patterning can also be improved. Young (3 months) and old (22 months) F344 rats were exercised once a day for 50 min at night onset over an 8-week period. Thereafter, polysomnographic recordings were obtained immediately after exercise. To determine the lasting consequences of exercise, sleep was also recorded 2 days and 2 weeks after exercise had ended. Old rats that were exercised had a significant weight loss, were awake more during the last third of their active period, had less sleep fragmentation and the amplitude of the diurnal rhythm of core body temperature was significantly increased. Old exercised rats also had an overall increase in the amplitude of EEG power (0.5–16 Hz) during wake and theta EEG power during REM sleep. In young rats regular exercise increased EEG delta power (0.5–4 Hz) during NREM sleep. Our data indicate regular exercise in old rats improves sleep architecture, EEG power and diurnal rhythm of temperature.     

In vivo robotic capsules: determination of the number of turns of its power receiving coil

This paper introduces a strategy how to determine the number of turns of the receiving coil for in vivo robotic capsules to maximize the regulated load power. For the expected functionality additional to the endoscopic function, it is necessary to employ wireless power transmission and increase the receiving power to a maximum. The functional relation between the number of turns and the power is derived and verified by implementing a ferrite-loaded receiver coil.     

Electrographic Correlates of Adequate and Erroneous Responses Evoked by Conditioned Signals of Different Functional Signs During Operant Learning in Dogs

Power spectra over the frequency range 1–225 Hz in short-term (less than 1 sec) EEG reactions arising in different areas of the cerebral cortex in response to presentation of differential signals were investigated in dogs during operant feeding behavior in conditions of both adequate and erroneous responses. The energy levels of these reactions decreased several-fold as compared with responses to positive signals, mainly because of frequencies in the high-frequency range (90–225 Hz), where power was greater than not only the traditional range of 1–30 Hz, but also the gamma range of 30–80 Hz. The frequency composition of EEG reactions in adequate responses was determined by a series of discrete frequency subgroups belonging predominantly to the high-frequency band. In erroneous reactions, the discrete structure of the corresponding EEG reactions was lost. __________ Translated from Zhurnal Vysshei Nervnoi Deyatel'nosti imeni I. P. Pavlova, Vol. 54, No. 5, pp. 673–687, September–October, 2004.     

Downlink power control in multi-code CDMA for mobile medicine

In this paper, we propose a downlink power-control mechanism to be applied in a multi-code code division multiple access (CDMA) mobile medicine system. The mobile medicine system can provide (i) measured blood pressure and body temperature, (ii) medical signals measured by the electrocardiogram (ECG) device, (iii) mobile patient’s history, (iv) G.729 audio signals, (v) Joint Photographic Experts Group 2000 Medical images and Moving Picture Experts Group 4 charge-coupled device sensor video signals. By utilizing a multi-code CDMA spread spectrum communication system with downlink power-control strategy, it is possible for this system to meet the quality of service requirements of a mobile medicine network. In addition, such a system can maximize the resource utilization. For different messages to be sent, the power is controlled according to the requisite bit error rate (BER). Higher transmission power is given to the media with lower BER requirement. Numerical analysis shows that the ratios of transmission power for voice, video, and data virtual channels is approximately 1:2:13 when the BERs for voice, video, and data are 10^∧(− 3), 10^∧(− 4), and 10^∧(− 7), respectively. This power ratio is similar to the ratio of signal-to-noise plus interference power ratio for voice, video, and data during transmission. For the purpose of verifying the proposed argument, a simulation has been done and the results match the derivation very well.     

Involving children in the development of assistive technology devices

Purpose.?To investigate the implementation of a web-based survey for involving children in the design of assistive technology devices within the primary school environment.

Method.?Children were recruited within their normal school environment. They completed tasks within the survey that sought to gather their personal preferences about assistive technology devices. From six primary schools, 257 children (mean age?=?9 years and 8 months, SD?=?1.51; 123 males, 134 females) including children with cerebral palsy (N?=?11), varying levels of deafness (N?=?7), global developmental delay (N?=?2) and Down's syndrome (N?=?1) participated. Observations were taken whilst the children completed the survey tasks.

Results.?All children were able to complete the tasks from the survey, although children with disabilities had higher completion times and most required a form of assistance from support assistants and/or sign language interpreters.

Conclusions.?The use of the web-based survey provided a novel means with which to involve children with and without disabilities in the design of assistive technology devices within a primary school environment. In order for the survey to be utilised more widely, issues that arose when involving children with disabilities need to be addressed.     

构建医院动力设备运行管理绩效考核模式实践

通过在医院动力运行设备管理中实施绩效考核,论述了绩效考核的主要内容和实施流程,同时提出了绩效考核过程中应注意的问题,为医院后勤绩效考核提供了可供借鉴的经验。     

基于因子分析方法综合评价医疗器械上市公司竞争力

医疗器械行业发展迅速,但是我国医疗器械公司相对于国际大型公司存在较大差距。本文运用因子分析方法,选取了国际四家和国内六家上市医疗器械公司相关数据信息,用定性和定量相结合的因子分析方法,综合评价国际和我国医疗器械上市公司综合竞争力,从分析结果可知,国际上市公司的综合指标高于国内上市公司,分析原因为在经营规模和创新投入等方面,我国医疗器械公司水平都相对较低,但目前我国医疗器械行业潜力巨大,通过分析结论可以对我国医疗器械行业未来发展提供一些借鉴和指导。     

远程医疗的趋势与变革

随着互联网的发展,远程医疗从最初的萌芽时代,到以现代信息技术为基础的高速发展,对现代医疗机构及医疗模式造成改变,使医疗机构之间的协同分工初露端倪,医疗服务模式发生新的变换,医生与患者之间的沟通呈现出多样化、病人院前院后信息虚拟化而形成的信息连续化,分析远程医疗对诊疗模式产生的影响。指出远程医疗移动互联应用会逐渐深入,远程虚拟医疗中心会逐渐出现并发展壮大,基层医疗机构功能性将发生一定的转变,第三方远程医疗企业将会兴起,远程医疗将成为个人家庭的一项基本订阅服务。