Current and future trends in lymphedema management: implications for women's health

Breast cancer has served as a catalyst for improvements in lymphedema care and research for the last 20 years. Awareness must be extended to other instigating factors in light of shifting epidemiology. The aging population, obesity epidemic, and higher 5-year cancer survival rates are changing the face of lymphedema. Lymphedema patients are now older, heavier, and more medically complex. A higher proportion have nonbreast malignancies and advanced cancer. This article describes the current standard of care, as well as recent concessions for patient comfort, convenience, and economic reality. Primary prevention remains underemphasized. Patient education, timely diagnosis, and the early initiation of treatment represent important targets for improvement. Hopefully, new diagnostic tools for detecting subclinical lymphedema, identifying modifiable risk factors, and better understanding lymphedema pathogenesis will improve primary prevention and care.     

The future of graduate education in nursing: Scholarship, the health of communities, and health care reform

The authors critically examine the urgent needs posed by national health care reform and the forces impinging on the nursing profession to prepare nurse practitioners to meet these needs. With references to other struggles in nursing's professional history, the authors caution against exclusive investment in the nurse practitioner role as the discipline's hope for long overdue recognition of nursing's value to society. They argue that with health care reform, nurses have the chance to make graduate nursing education more responsive to the actual health needs of the populace and more relevant for practice in communities. The actions advocated include reflecting carefully on the articulation of nurse practitioner roles with others in the discipline, taking a partisan stand with vulnerable groups, developing substantive expertise in community-based practice and research, applying an understanding of the broader environmental context of health, and committing as a discipline to practice and scholarship that really makes a difference in the health of the public.     

现代康复功能训练的新概念与新技术

联合国第54届世界卫生大会于2001年5月通过实行新的国际残疾分类,即《国际功能、残疾和健康分类》(interna鄄tionalclassificationoffunctioning,disabilityandhealth,ICF),这一分类系统的理论模式如图1。这一理论模式反映了近年来人们对功能概念、残疾概念、健康与康复概念的新认识。本文拟以此模式为基础,探讨现代康复功能训练的新概念与新技术。1现代康复功能训练的新概念1.1功能训练是康复治疗的核心,也是伤残人士改善生活质量的基础现代康复治疗的目标着重在使伤患和残疾人士改善功能、融入社会,提高生活质量。在众多的康复治疗手段…     

社区卫生服务适宜技术的运用及培训

全科医生在社区卫生服务过程中以其便捷、高效、经济的方式为社区居民提供整体性、协调性的预防、治疗、保健、康复、健康教育、计划生育技术指导六位一体的服务,从而形成全科医学专业服务主要特色。为此其服务中所使用的适宜技术（Appropriate Technology）一般应具备社区中容易实施、操作简单、安全性高而又价格低廉、效果明显、病人参与度大等特征。具有这些特征的适且技术的广泛运用也是社区卫生服务健康发展的有效保障。     

Model Spinal Cord Injury System trends, and implications for the future

In the 25 years since the federally designated Model Spinal Cord Injury Systems program was started, many changes have occurred. The systems have increased in number and location and have changed in composition. Data are available on approximately 19,000 acutely injured traumatic spinal cord injured individuals, with more than 117,000 total records. This volume of data allows analysis of many trends affecting the care of people with spinal cord injuries. The time span covered by the database allows comparison of various time periods, including the most recent decade--during which managed care has emerged as a dominant force in health care evolution. This article summarizes these trends, based on information in the articles in this special issue devoted to the Model Spinal Cord Injury Systems. Finally, this article offers an analysis of future implications for SCI care in general and the federally designated Model Spinal Cord Injury Systems program in particular.     

生物芯片的临床应用现状和未来发展趋势

经过近20年的创新和努力,现在已有一批基因和蛋白类的芯片在世界各国研发成功,并通过临床验证,被越来越多的医院在日常检验工作中所采用.基因微阵列芯片是目前开发产品最多且应用也最广的一类芯片,除了人们所熟悉的DNA SNP分析和突变检测外,分析各种RNA的表达变化也开始成为检验人员逐渐所熟悉的内容.     

Preparing for health reform: a blueprint for improving health care access, cost, and quality in metropolitan areas

This article analyzes the preparedness of 16 cities for health care reform. Readiness for reform is defined as when cities' health care systems are aligned with three goals of health care reform: increased access, reduced cost, and improved quality. The study confirms that health care is distinctly different among metropolitan areas and that each city has strengths on which to build and challenges to overcome. The study concludes that steps toward health care reform are within the reach of many cities, with health care purchasers, providers payers, and patients playing significant roles.     

Mandatory continuing education: past, present, and future trends and issues

Mandatory continuing education (CE) for nurses continues to be a viable means by which nurses can remain competent in the face of ever-increasing knowledge and technology in the health care setting. A multiplicity of CE providers, offering a variety of teaching approaches, exists to ensure nurses remain competent and advance in their fields of practice. Presently, more research must be conducted to measure the effectiveness of CE programs on patient care outcomes. Scholarly investigation may assist in justifying mandatory CE for nurses if positive patient care outcomes can be identified. Several states are regulating professional nursing practitioners by requiring CE. Although some states have not endorsed mandatory CE for nurses, it is likely that more state boards of nursing will continue the slow but steady trend of requiring CE for relicensure--especially if research establishes positive patient care outcomes.     

Mental health services under health reform: the less government, the better

Federal and state governments are now rapidly preparing to restructure the delivery and financing of health care services in the United States. Unfortunately, the bureaucratic structures promised under managed competition do not acknowledge the successes of private sector "market-regulated" programs. A needlessly costly and burdensome system could evolve that will undermine the goals of improved access and quality of care.     

Nursing and information and communication technology (ICT): a discussion of trends and future directions

This paper traces the development of information and communication (ICT) within health care and the emergence of telehealth as a key component of modern health care delivery as health care moves from the ‘face to face age’ to the ‘information age’. The paper examines the interface of ICT and nursing practice and highlights the limited evidence relating to the nursing contribution within telehealth particularly beyond data input and output analysis for other health care personnel. Additionally, the absence of research relating to the impact of ICT upon nurses and their working lives is identified. The paper concludes that nurses need to engage more fully with ICT so that they contribute to shaping the care system and emerge as leaders of the new care systems delivering future clinical activity.     

健康、健康管理、健康管理师及中国健康管理的发展前景

健康是人类生存发展和民族兴旺发达的基础,享有健康和促进健康是公民的重要权利。确立健康管理专家这个职业是维护和促进健康的重要措施。本文着重介绍了健康和健康管理的形势和任务,健康管理师的出现,以及健康管理在中国发展前景的展望。