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1.
临床学习环境对护理本科生临床实习表现的影响   总被引:3,自引:2,他引:1  
目的探讨临床学习环境(CLE)对护理本科生(护生)临床实习表现(CPs)的影响。方法按比例分层从全国142所医药高校中抽取22所的毕业实习护生923名,采用护理临床学习环境评价量表、护理本科生毕业实习临床实践行为表现自评量表进行问卷调查。结果护生CLE总评分为3.39±0.62,CPs总评分为3.68±0.47;护生对CLE评价与其CPs相关系数是0.520(P<0.01);个性化、学生参与性、任务定位是影响护生CPs的主要因素(均P<0.01)。结论 CLE可影响护生的CPs。在临床实习中,护理管理者和临床带教老师应给护生一定的自主性,并进行因人而异的个性化施教,为护生创造更多的动手机会,对护生的实习活动指示明确,让护生清楚自己的实习角色和实习任务,以提高临床实习质量。  相似文献
2.
Bone mineral density (BMD) was measured over a ten year period in a cohort study in Miyama village, Wakayama Prefecture, Japan, to provide information on rate of bone loss in the mature and elderly population. Four hundred subjects were selected by sex and age decade from the full list of residents born in 1910–1949, and aged 40–79 years at the end of 1989, with 50 men and 50 women in each age decade. Baseline BMD of the lumbar spine and the proximal femur was measured using dual energy X-ray absorptiometry (DXA) in 1990 and again in 1993, 1997 and 2000. Annual rate of change in BMD (% per year) in the lumbar spine in men in their forties, fifties, sixties and seventies was 0.17, 0.55, 0.01 and −0.16, respectively, and in women, −0.87, −0.83, −0.48 and −0.48, respectively. Thus in men, BMD at the lumbar spine increased in all age strata but the oldest, when it decreased, whereas in women, it decreased in all age strata. On the other hand, BMD at the proximal femur decreased in both sexes in all age strata. Our results show that bone loss rates differ depending on the site involved, demonstrating that different strategies are needed for the prevention of bone loss in the spine and hip.  Furthermore, we found evidence of differences in BMD for given age strata between birth cohorts. Data in 1990 and in 2000 showed significant improvements for men in their sixties and for women in their fifties, suggesting that future problems of osteoporosis might be less severe than has previously been predicted in Japan. Received: 11 January 2002 / Accepted: 22 April 2002  相似文献
3.
Women are at higher risk for osteoporosis, but most of the literature examining the effect of alcohol abuse on bone mineral density (BMD) has been in men. The aim of this study was to determine differences in BMD and fracture prevalence among women in treatment for alcohol abuse, in recovery and non-alcohol-dependent women. This cross-sectional study was completed at two residential substance abuse centers in Iowa (USA). The patients were Caucasian women, aged 18-70 years, in treatment for alcohol abuse and dependence ( n=228); in recovery and abstaining from alcohol ( n=156); and women with no history of alcohol abuse ( n=447). The main outcome measures were femoral neck and lumbar spine BMD measured by dual-energy X-ray absorptiometry (DXA); self-reported lifetime fracture prevalence. After adjusting for age and menopausal status, women in treatment had BMDs that were 7.7% ( p<0.01) and 6.3% ( p<0.01) lower at the femoral neck and lumbar spine, respectively, than non-alcohol-abusing women, and 4.8% lower at both bone sites ( p<0.01) than women in recovery. Femoral neck BMD of women in recovery was 3.1% lower ( p<0.01) than in non-alcohol-dependent women; however, the difference was not significant following multivariate analysis. Women in treatment and recovery reported more fractures during childhood and early adolescence than non-alcohol-dependent women ( p<0.01). Women in recovery also reported significantly greater numbers of fractures following sobriety than their paired non-alcohol-dependent counterparts. Alcohol abuse and dependence was associated with lower femoral neck and lumbar spine BMD. Women with histories of alcohol dependence had a higher lifetime prevalence of fractures, including time periods before the onset of problem drinking and following abstinence, suggesting that factors other than acute intoxication contributed to the greater fracture prevalence.  相似文献
4.
目的:观察缺血预处理(IP)对缺血再灌注(IR)损伤引起的肝细胞凋亡及对调控基因Survivin、HIF-1α蛋白表达的影响,探讨IP对鼠肝IR损伤保护作用的机制。方法:将90只SD大鼠分为假手术(SO)组10只、IR组和IP组各40只。SO组术中只牵拉分离肝十二指肠韧带,操作完成后关腹;IR组阻断十二指肠韧带,造成缺血30min;IP组缺血30min前持续5min缺血及5min再灌注。IR组及IP组分别于再灌注2、6、12和24h后各处死10只动物,取肝脏标本;SO组于术后2h取肝组织标本。检测细胞凋亡指数(AI)及Survivin、HIF-1α蛋白表达水平。结果:IR组、IP组AI较SO组明显增加(P〈0.05),相同时相点IP组较IR组细胞AI明显降低(P〈0.05)。IR组、IP组Survivin、HIF-1α蛋白表达先升后降,6h左右达高峰;HIF-1α(除24h时)和Survivin蛋白表达在相同时相点IP组较IR组高(P〈0.05)。结论:IP对肝组织IR损伤的保护作用机制之一可能是通过上调HIF-1α、Survivin蛋白的表达抑制细胞凋亡,从而发挥肝脏保护作用。  相似文献
5.
成年女性性传播疾病知识行为及危险因素研究   总被引:1,自引:0,他引:1  
目的 了解成年女性性传播疾病(STD)相关知识和行为的现状,研究成年女性STD的危险因素,为预防和控制STD提供参考,方法 随机抽取STD女患者170例为病例组,同时抽取健康女性172人为时照组,采用自行设计的"成年女性STD相关知识和行为调查问卷"进行调查.结果 病例组STD相关知识及行为得分显著低于对照组(均P<0.01);STD知识得分越高者性行为及个人卫生习惯越好;单因素分析STD的危险因素有多个性伴、安全套的使用等.多因素分析示,STD相关知识缺乏、个人卫生习惯较差等是STD的危险因素.结论 STD女患者对STD相关知识的知晓程度低于健康成年女性,在性行为及性卫生习惯和个人卫生习惯方面比健康成年女性差.护理人员应针对性加强对成年女性的健康教育,改变不良习惯,提高认知水平,争取性伴、家庭和社会支持是控制和预防STD发生和传播的关键.  相似文献
6.
In order to investigate how the ganglia in ganglionated plexus were distributed throughout the overall region of the gallbladder, the gallbladder was dissected from guinea-pig and washed with Krebs solution via the cystic duct. This gallbladder was distended with 2 ml of the mixed solution of OsO4 and ZnI2 injected with a syringe via the cystic duct and the cystic duct was immediately tied with a thread. The gallbladder was placed in excess of the mixed solution for 7-10 hours. The gallbladder was longitudinally divided into two approximately equal parts and each was prepared for microscopic investigation. The one preparation was the ventral side of the gallbladder and the other preparation was its dorsal side. These preparations were viewed through a photomicroscope. The obtained results were as follows: 1. Ganglia which involved several nerve cells were observed. Ganglia and nerve bundles connecting the fellow ganglia formed an irregular network, that is, the so-called ganglionated plexus. These nerve bundles were connected with the perivascular nerves which ran parallel to and around blood vessels in several places of the wall of the gallbladder. 2. Ganglia were full of variety in size and shape. That is to say, the shape of ganglia is arranged in various patterns such as oval, spherical, triangular, square and so on. When the size of ganglia were shown by surface area of ganglia which were viewed within the sweep of photomicroscope, the size of ganglia were divided into three large groups, the small ganglia in the range of 1,400 microns2-3,500 microns 2, the large ganglia in the range of 3,500 microns2-10,000 microns2 and the extra-large ganglia in the range of 10,000 microns2-38,000 microns2. Per one gallbladder, 240 +/- 41 (n = 3) small ganglia, 263 +/- 28 (n = 3) large ganglia and 8 +/- 1 (n = 3) extra-large ganglia were found. And these ganglia were irregularly scattered all over the wall of gallbladder. Small ganglia were found more numerous than large ganglia in the cervical portion of the gallbladder. On the other hand, small ones were slightly fewer than large ganglia in the remainder portion of the gallbladder. 3. The ganglionated plexus contained 511 +/- 69 (n = 3) ganglia.(ABSTRACT TRUNCATED AT 400 WORDS)  相似文献
7.
Using electrical stimulation, we first investigated whether the movement of ureteral smooth muscle of the guinea-pig was myogenic in its control, or neurogenic. We then investigated the effects of aminoglycoside antibiotics (kanamycin, bekanamycin and ribostamycin) on the movement of ureteral smooth muscle induced by electrical stimulation. In these investigations, each ureter removed from the animal was cut into three approximately equal-sized segments, which are an upper segment (kidney side), a middle segment and a lower segment (urinary bladder side). Each segment was mounted in an organ bath filled with Krebs solution and the mechanical response induced by electrical stimulation of each segment was recorded isometrically. Each one of the upper, the middle and the lower segments was stimulated with rectangular pulses (50 volt, 0.1-3 msec durations, 40 Hz) for a period of 2 sec. Of all segments tested (ten in each group), none showed any response to the stimulation with pulses below 0.5 msec duration. While 2-3 segments out of ten of the upper, the middle and the lower ureteral segments showed a contractile response to stimulation with pulses of 1 msec duration, the rest of the segments showed no response to the same stimulation. This contractile response was not inhibited by tetrodotoxin which is known to block the nerve-mediated response. And also, all the ten samples of each upper, middle and lower segment never failed to show a contractile response to stimulation with pulses of 2 msec and 3 msec duration. Various drugs which are already known to block the nerve-mediated response (i.e., atropine, guanethidine, phentolamine, propranolol and tetrodotoxin) were tried, but none of them had an inhibitory effect on the contractile response. On the other hand, each one of kanamycin (KM), bekanamycin (AKM) and ribostamycin (RSM) in concentrations of 1 x 10(-5) g/ml-1 x 10(-3) g/ml produced a concentration-dependent decreasing effect in the magnitude of the electrical stimulation-induced contractile response of the ureteral segment. In addition, the decreasing effects of these antibiotics were also observed in the tetrodotoxin. From these results, we concluded that the contractile response of the ureter may be myogenic in its control, and the aminoglycoside antibiotics, KM, AKM and RSM, may act directly on the ureteral smooth muscle so as to decrease its contractile response.  相似文献
8.
Our aim was to find a simple method of removing labile glycosylated hemoglobin (HbA1c) from blood samples before it is measured by cation-exchange chromatography. Labile HbA1c is formed by the binding of glucose to the NH2-terminal valine of the beta-chain of HbA. We sought a more competitive binder for the same site to dissociate labile HbA1c to glucose and HbA. Inorganic phosphates were found to have a strong allosteric effect and a great ability to eliminate labile HbA1c. We developed our method with 4 mM tetrapolyphosphate in the hemolyzing solution to eliminate labile HbA1c during the automatic processing (at pH 6 and heated for 2 min at 45 degrees C) of blood samples for HbA1c estimation. This may be useful when estimating HbA1c by the manual method.  相似文献
9.
The relationship of medical variables and discharge functional status to vocational and educational outcomes was examined in 79 closed head-injured patients who were consecutively admitted to an inpatient rehabilitation hospital during a two-year period. A follow-up study, conducted after hospital discharge (median, 16.5 months), found that 66% (n = 52) of the patients had returned to work or school, while 34% (n = 27) did not. Patients were divided into return and non-return to work groups. Traditional variables included age, severity of brain-damage as characterized by CT head scan, duration of post-traumatic amnesia, duration of coma, length of stay and acute inpatient rehabilitation program.

Discharge functional scores were analysed by t-tests and chi-square analysis. Results suggest that traditional factors of younger age, shorter length of coma, minimal CT head scan findings and shorter length of stay were significant contributors to educational/vocational outcome. Their significance was enhanced by discharge functional profile measurement of medical, physical and psychological/neuropsychological integrity. Those functional measures not significant were in social, vocational, recreational and communication areas. These factors may continue to improve over a longer period of time and should be tracked in the post-acute rehabilitation phase for their significance in return to work/school.  相似文献
10.
Understanding factors associated with more rapid bone mineral loss among aging women is important for establishing preventive strategies for intervention. This study reports factors associated with the 5-year change in radial bone mineral density (BMD) determined prospectively in 435 women aged 55–80 years at baseline. The baseline study included measurement of radial BMD (gm/cm2) by single photon densitometry and personal interview. The baseline protocol was replicated 5 years later in a follow-up study. Women with a lower baseline weight or Quetelet index, smaller triceps skinfold and less arm muscle area had significantly greater 5-year bone loss (p=0.001). Current users of estrogens had less radial bone loss (2.8% vs 7.3%,p=0.0005) than women not currently using estrogens. Current users of estrogen had significantly less 5-year loss if use had been for 5 years or longer (–1.0% vs –6.9%,p=0.05). Current users of the thiazide class of medications had less 5-year radial bone loss (5.0% vs 7.4%,p=0.0035) than women without current thiazide use. Baseline dietary calcium, alcohol consumption and smoking were not associated with BMD change. This suggests that greater body size, and current use of estrogens or thiazide antihypertensives are associated with less radial bone mass loss in a 5-year period among postmenopausal women.  相似文献
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