New ED will feature wired private patient rooms

Some innovations in your ED may be worth doing, even if you can't guarantee a return on investment. High-tech amenities for patients can be expected to boost satisfaction and increase market share. Recognize that patients may need to take care of real-world responsibilities while in the ED. Accessing test results electronically at the bedside speeds processes and enhances physician-patient relationship.     

Social group work in a group practice. Group work with the retired elderly in Copenhagen

Standards of value exist in our society, which are based on a predominant conception of personal worth through socioeconomic utility. This gives some elderly people in their nonwork status, a self-image of uselessness and worthlessness, due to the loss of role, reference group, and decrease in prestige. This condition may lead to depression. Two social workers implemented an experiment on social group work in general practice in Copenhagen. The general practitioners referred for participation thirteen men and women, between sixty and seventy years old, who had left the labour market within the last three years. It seems possible to involve elderly people in expressing their individual problems to each other in a group, and to stimulate a better adaption to the new role as pensioner by increasing the members' ability to compensate through other activities. This might produce guidelines for resolving various common problems among elderly people.     

着眼战时立足平时发展我军高等护理教育

提出建立既适应高技术局部战争需要，又适应社会经济发展需求的现代高等护理教育体系，是军队护理教育发展不容回避的课题，分析了军队高等护理教育同时应对现代战争和社会经济发展要求的必要性，介绍了近年来我军高等护理教育应对战场和市场要求的实践探索，并有针对性地提出了还需注意的问题。     

我国制药业面临国际市场的严峻挑战

国际医药市场的竞争日趋激烈。现就我国制药业如何面对这种竞争,阐述了国际市场的概况或一些必须具备的技术条件和规程,为我国医药业和国际市场接轨、尽快拓宽国际医药市场的渠道打下基础。     

Integrating emergency services in an urban health system

When planning for growth and management efficiency across urban health systems, economic and market factors present significant service line challenges and opportunities. This article describes the evolutionary integration of emergency services in St John Health System, a large, religious-sponsored health care system located in Detroit, Michigan. Critical business elements, including the System's vision, mission, and economic context, are defined as the framework for site-specific and System-wide planning. The impact of managed care and market changes prompted St John's clinicians and executives to explore how integrating emergency services could create a competitive market advantage.     

Evaluation research: the need for multiple criteria

Evaluation research: the need for multiple criteria The Research Unit was established in 1968 and one of its primary functions since then has been an attempt to evaluate experimental schemes of nurse training. Two of the explicit objectives of the research were to establish whether students could be attracted to such schemes of training and, if so, whether they could be successfully prepared by them to pass State finals examinations. The author is concerned that courses are‘evaluated’too readily in terms of single criterion measures such as pass rates, which may in fact be misleading. The paper argues that evaluation of a training course should involve the question‘Is it worth it?’and this implies a need for the use of multiple criteria.     

NARRATIVE ENRICHMENT IN THE PSYCHOTHERAPY FOR PERSONS WITH SCHIZOPHRENIA: A SINGLE CASE STUDY

Recovery from schizophrenia may involve persons developing a renewed sense of their illness, identity, agency, and worth within their life stories. To explore the requirements and challenges of psychotherapy that could facilitate this, we present a case study of a person with schizophrenia enrolled in treatment for over 19 months. Observed challenges to this process include the therapist's inclinations to “fix” the client, the client's own deficits and symptoms, and discomfort within the therapeutic relationship. Techniques to address these difficulties are presented, along with an objective means of assessing the treatment outcomes in terms of changes in narrative processes.     

Narrative enrichment in the psychotherapy for persons with schizophrenia: a single case study

Recovery from schizophrenia may involve persons developing a renewed sense of their illness, identity, agency, and worth within their life stories. To explore the requirements and challenges of psychotherapy that could facilitate this, we present a case study of a person with schizophrenia enrolled in treatment for over 19 months. Observed challenges to this process include the therapist's inclinations to "fix" the client, the client's own deficits and symptoms, and discomfort within the therapeutic relationship. Techniques to address these difficulties are presented, along with an objective means of assessing the treatment outcomes in terms of changes in narrative processes.     

四川省成人高护自考毕业生综合能力及自我价值实现调查

目的了解高护自考毕业生综合能力、自我价值、教育需求及其影响因素。方法采用信访随机对 32 0名四川省高护自考毕业生及其用人单位领导进行了调查 ,采用T test,ANOVA分析及Pearson相关分析等方法分别对自考生的职称、职务、学历、年龄、工作年限等与其综合能力、自我价值、教育需求的关系进行分析。结果自考毕业生综合能力及自我价值实现自评和他评多数较好 ,毕业生和单位领导对护理教育都有较高的需求 ;自考学生和单位领导在毕业生自我价值实现方面的评价存在显著差异 (P <0 0 1) ,他评高于自评 ;不同职务和在临床护理中承担不同角色的自考生综合能力、自我价值实现评价及教育需求有一定差别 ;教育需求与自考生年龄有一定的负相关关系。结论高护自考教育对提高护理人员的综合能力、自我价值实现具有积极作用 ,护理自考生的职务、在护理工作中承担的角色及年龄对其综合能力评价、自我价值实现及教育需求有一定影响     

Patient perceptions of quality of life after coronary artery surgery: Was it worth it?

Quality of life and perceptions of the consequences of surgery were examined in 155 individuals having coronary bypass surgery. One year after surgery, subjects believing surgery was worth it because of functional improvement (n = 64) had more positive scores on subjective indicators of life satisfaction and mood than those believing surgery was worth it because it saved them from death (n = 62) or those who were not sure surgery was worth it (n = 23). Differences in perceptions of quality of life between the two groups who believed surgery was worth it are discussed in terms of focus of attention. Individuals who perceive improved functional ability may focus on concrete outcomes of surgery, whereas those who interpret the benefit of surgery in light of the alternative of death may focus their attention on affective aspects of recovery. Findings emphasize the need for using a multidimensional approach to studying quality of life.     

Why perform a routine history and physical examination?

Science uses two types of data--one for generating hypotheses and a second for testing hypotheses. In clinical medicine the history and physical examination generate the data used for making hypotheses about what could possibly be wrong with the patient; but the various laboratory and imaging procedures are used for hypothesis-testing, ie, deciding which of the possible problems is actually the one bothering the patient. Although comparisons between physical examination maneuvers and imaging procedures may tell something about the precision of the former, in general such comparisons can tell little about the intrinsic worth of one versus the other, because these two different types of procedures generate data with two completely different types of usage.     

护士安全用药体验的研究

目的:深入了解护士对安全用药的体验,探索促进护士安全用药的措施,为护士用药安全管理提供科学依据。方法:运用质性研究中的现象学研究方法,采用小组讨论法进行研究。结果:在外界硬件设施无法改变的条件下,护士在实施药物治疗过程中总结出了很多安全用药的经验与改良措施,这些经验与措施在一定程度上保证了用药安全。结论:护士总结的操作体验、理论体验、管理体验和护理操作改良方法体验可以促进护士安全用药,值得护理界讨论借鉴。     

综合性医院护理人力资源管理改革的实践

综合性医院面对日趋激烈的医疗市场竞争,如何对人力资源进行有效的整合、调控、开发和利用,是值得研究的重要课题。我院护理部针对护理人力资源的状况及存在的问题,进行了一系列护理人力资源管理改革的尝试。通过建立与护理实际工作量相符的灵活、合理的人员编配体制,改进护理服务流程,制订各岗位说明书,分层次使用护理人员,使护理人力资源得到较为合理的配置,达到了以事设岗、以岗定人、逐级聘用、系统培训的目标。新型的护理组织管理模式的建立,提高了护理管理的水平,并且激发了护理人员的成就感和进取心,为她们的专业成长提供了条件。     

Professional responsibility in relation to cervical spine manipulation

Manipulation of the cervical spine is one of the few potentially life-threatening procedures performed by physiotherapists. Is it worth the risk? A comparison of risks versus benefits indicates that at present, the risks of cervical manipulation outweigh the benefits: manipulation has yet to be shown to be more effective for neck pain and headache than other interventions such as mobilisation, whereas the risks, although infrequent, are serious. This analysis is of particular concern because the conditions for which manipulation is indicated are benign and usually self-limiting. Because physiotherapists have legal and ethical obligations to the community to avoid foreseeable harm and provide optimum care, it may be prudent to determine who in our profession should perform cervical manipulation. That is, the profession could restrict the practice of cervical spine manipulation. Although all registered physiotherapists in Australia are entitled to perform cervical manipulation, few choose to use this intervention. Therefore, it might be feasible to encourage those practitioners who wish to use cervical manipulation to undertake formal education programs. Such a requirement could be embodied in a code of practice that discourages those without formal training from performing cervical manipulation. By taking such measures, we could ensure that our profession exercises wisdom in its monitoring and use of cervical manipulation.     

四川省双流县镇级医疗单位特色专科创建现状调查

目的调查四川省双流县镇级医疗单位特色专科建设现状,为探索小康型乡镇卫生院特色专科建设原则、思路及标准等提供参考。方法采用自行设计的特色专科调查问卷全面调查该县24家镇级医疗单位（3家中心型卫生院、3家社区卫生服务中心及18家一般型卫生院）特色专科建设情况。使用Epidate 3.1录入数据,采用SPSS 17.0进行描述性统计及分层分析。结果该县24家镇级医疗单位中有15家（62.5%）共设立了21个特色专科;其中中医骨科最多,共9家占42.9%,其次为中医康复理疗科,共6家占28.6%。结论镇级医疗单位特色专科的创建应根据当地疾病诊治需求和医院自身条件合理规划建设,以专科建设推动特色诊疗服务参与市场竞争。中医骨科和中医康复理疗科群众基础较好,值得作为特色专科创建并推广。     

多功能测温配置器的研制及临床应用

按工作流程 ,研制多功能测温配置器 ,通过试验测定消毒效果及甩表合格率 ,并进入临床试用。结果该仪器能自动完成体温计的消毒、甩表 ,臭氧消毒方法与效果以及甩表效果可靠 ,临床试用认为仪器配置成套测量用具方便、实用 ,自动化程度高 ,有推广应用价值。     

Do skewed sex ratios among children promote parental smoking? Longitudinal evidence from rural China

China and some other Asian countries have experienced skewed sex ratios, triggering intense competition and pressure in the marriage market. Meanwhile, China has more smokers than any other country, with half of men smoke while few women smoke. Men are the major income earners in most Chinese families and thus bear much of the financial burden in preparation for children’s marriage. This paper investigates how a demographic factor—a large number of surplus men in the marriage market in China—affects their fathers’ smoking behavior. We utilize a household longitudinal survey as well as a random subsample of the China Population Census to examine fathers’ smoking in response to skewed sex ratios. Strikingly, fathers smoke more for families with a son living in counties with higher sex ratios. In contrast, those with a daughter do not demonstrate this pattern. Coping with the marriage market pressure is a most plausible pathway linking skewed sex ratios and intense smoking among fathers. Considering worsening sex ratios and highly competitive marriage market in the coming decade as well as lasting health impacts due to smoking, policies suppressing unbalanced sex ratios could lead to welfare gains.     

Antibiotic cycling: more than it might seem?

In the present battle against the rising tide of resistance, several interventions have been proposed to help control the situation. One of these is a process of planned antibiotic restriction, introduced through cycling drug selection based on local surveillance. Although such antibiotic cycling has been the subject of much discussion for 20 years, there are relatively few data available to assess its worth. A recent systematic review found only four studies worthy of inclusion and concluded that antibiotic cycling could not, at present, be promoted as a methodology to control resistance. This paper considers the complete literature and through demonstrating consistent benefits across the breadth and depth of the findings, suggests that whereas further work is required, nevertheless antibiotic cycling-as part of a suite of control measures-is a valid option.