Strategies for brain shift evaluation

For the analysis of the brain shift phenomenon different strategies were applied. In 32 glioma cases pre- and intraoperative MR datasets were acquired in order to evaluate the maximum displacement of the brain surface and the deep tumor margin. After rigid registration using the software of the neuronavigation system, a direct comparison was made with 2D- and 3D visualizations. As a result, a great variability of the brain shift was observed ranging up to 24 mm for cortical displacement and exceeding 3 mm for the deep tumor margin in 66% of all cases. Following intraoperative imaging the neuronavigation system was updated in eight cases providing reliable guidance. For a more comprehensive analysis a voxel-based nonlinear registration was applied. Aiming at improved speed of alignment we performed all interpolation operations with 3D texture mapping based on OpenGL functions supported in graphics hardware. Further acceleration was achieved with an adaptive refinement of the underlying control point grid focusing on the main deformation areas. For a quick overview the registered datasets were evaluated with different 3D visualization approaches. Finally, the results were compared to the initial measurements contributing to a better understanding of the brain shift phenomenon. Overall, the experiments clearly demonstrate that deformations of the brain surface and deeper brain structures are uncorrelated.     

儿童医院夜班护士工作应激状态的调查分析与应对策略

目的:了解儿童医院夜班护士的工作应激程度,引导处于高度应激状态的夜班护士对应激采取积极应对方式,保护护士身心健康.方法:运用工作应激调查表和简易应对方式量表,对儿童医院178名夜班护士的应激状况及应对方式在干预前后进行调查分析.结果:儿童医院夜班护士的应激程度、应激应对方式在干预前后差异有统计学意义(P<0.01).结论:通过加强夜班护士技能操作培训、优化工作流程、积极的予以心理疏导、增加夜班护士、降低床位使用率,可有效引导高应激状态的夜班护士采取积极有效的应对方式,维护了护士的身心健康,提高了护理质量.     

Strategies for coping with chronic low back pain: Relationship to pain and disability

Seventy-four chronic low back pain patients in a study assessing the effectiveness of group outpatient cognitive-behavioral and operant behavioral treatment completed the Coping Strategy Questionnaire (CSQ) and measures of pain, depression, and functional disability pre- and post-treatment. The previously reported factor structure of the CSQ was generally replicated, and significant associations were found between use of ignoring and reinterpretation strategies and downtime, between use of attention diversion strategies and pain intensity, and between tendency to catastrophize and physical and psychosocial impairment. Both treatments resulted in significant changes in types of coping strategies used to deal with pain. Increased use of praying and hoping strategies was significantly related to decreases in pain intensity. Decreased catastrophizing was also significantly related to decreases in pain intensity, as well as to decreases in physical and psychosocial impairment.     

倒班工作睡眠障碍相关机制的探讨

目的　探讨医护工作者倒班所导致睡眠障碍的原因及机制。方法　以64 例一线科室工作的医护人员为研究对象,其中34例倒班工作者设为倒班组,余30例设为正常对照组。两组分别行整夜PSG监测,包括EEG,ECG、EOG、EMG; 并行试验,观察是否存在正常睡眠一觉醒模式丧失。以各组MSLT时间及REM次数为评定指标,通过统计学分析比较两组间差异,得出结论。结果　倒班组有30 例存在正常睡眠一觉醒模式丧失,检出率为88.2%,正常对照组2例存在正常睡眠一觉醒模式丧失,检出率为6.7%。对照组平均MSLT为(20.1±6.7)min,REM睡眠次数为(0.1±0.3)次;倒班组平均MSLT为(3.1±1.9)min,REM睡眠次数为(3.4±1.7)次。结论　长期倒班对睡眠有影响,它是由生物节律变化、睡眠障碍及社会家庭问题3种因素相互作用的结果。     

Influences of shift work on fatigue among nurses

yuan s.c., chou m.c., chen c.j., lin y.j., chen m.-c., liu h.-h., & kuo h.-w. (2011) Journal of Nursing Management  19 , 339–345
Influences of shift work on fatigue among nurses Aim To compare the symptoms of fatigue and physiological indices in nurses who work during the day with nurses who work in shifts. Method One-hundred and seven nurses were recruited and asked to assess their symptoms of fatigue before their work commenced and after it finished. Results Using logistic regression analysis adjusted for covariates, it was found that nurses who work in shifts were more fatigued than nurses who work during the day (odds ratio = 2.44, P < 0.10). There was a significant difference regarding critical flicker fusion in the two groups of nurses (P = 0.032), and nurses who work in shifts had poorer physiological indices than nurses who work during the day. Conclusion It is clear that differing work schedules result in differing levels of fatigue, with shift work attributing to higher levels than day work. Implications for Nursing Management Nurse managers need to take into account the fatiguing effects of different work schedules when designing rostering patterns.     

护理工作应激及应对研究

[目的 ]了解护士的应激水平及应对方式。 [方法 ]采用护理工作应激量表、简易应对方式问卷及社会支持量表对 198名护士进行调查。 [结果 ]护理人员应累计解释率达到 5 9% ,主要是工作需求压力。护士年龄小、收入、应对技巧和社会支持与应对水平呈显著负相关 ;应激与正式支持呈显著负相关。 [结论 ]护士应激水平高于一般人群。护理管理者应通过教育提高护士应对能力 ,有效预防和控制应激。     

Strategies for success: a toolbox of coping strategies used by breastfeeding women

Aims. The purpose of this paper is to present the findings of two qualitative studies which identified strategies used by breastfeeding women to assist them to continue breastfeeding. Background. While breastfeeding initiation rates are high in Australia, the majority of women wean before the recommended time. The identification of interventions which may increase breastfeeding duration is therefore a research priority. Design. The Against All Odds study used a case‐controlled design to investigate the characteristics of women who continued to breastfeed in the face of extraordinary difficulties. Phase One of the I Think I Can study employed the Nominal Group Technique to investigate the views of subject matter experts regarding which psychological factors may influence the duration of breastfeeding. Method. Against All Odds study participants (n = 40) undertook a one‐ to two‐hour interview and the transcribed data were analysed using thematic analysis. Stratified purposeful sampling was employed in the I Think I Can study (n = 21), with participants assigned group membership according to their most recent breastfeeding experience. A fourth group was composed of experienced breastfeeding clinicians. The nominal group technique was used to generate group data and segments of the discussion were audiotaped and transcribed for thematic analysis. Results. Participants in both the studies raised strategies used to assist them in their efforts to cope with the challenges of breastfeeding and early motherhood. These strategies included increasing breastfeeding knowledge, staying relaxed and ‘looking after yourself’, the use of positive self‐talk, challenging unhelpful beliefs, problem solving, goal setting and the practice of mindfulness. Conclusions. Employment of these simple behavioural and cognitive strategies may assist women to cope with the pressures inherent in the experience of early mothering, thereby increasing the duration of breastfeeding. Relevance to clinical practice. These results may represent a ‘tool box’ of coping strategies which can be provided to women for use in the postnatal period.     

Biochemical hypoglycemia in female nurses during clinical shift work

Female nurses in Japan commonly experience symptoms similar to those of hypoglycemia while working. Biochemical hypoglycemia can lead to impaired cognition; thus, it is important to know the prevalence of biochemical hypoglycemia among nurses. Five hundred and sixty-eight female nurses (53% of the target population) in four hospitals completed questionnaires. They determined their blood glucose levels 12 times, at four points during three shifts. Fifty-seven nurses (10%) recorded biochemical hypoglycemia (相似文献   

ICU护士轮班模式的质性研究

目的 了解ICU护士对不同轮班模式的体验,探讨适合ICU护士的轮班模式.方法 选择5名有多种轮班模式经验的护士,采用质性研究中的现象学研究方法,以深入访谈的方式了解ICU护士对不同轮班模式的体验,并对资料进行阅读、分析、反思,最终提炼主题.结果 12 h轮班制,上班频率低,但疲劳感强烈.传统8 h轮班制,倒班频繁,不利于护息沟通.短期连续APN轮班制,病情管理连续,医护合作改善,生活短期稳定.结论 短期连续APN排班,可以使护士工作和休息的时间相对集中,缓解倒班对护士所致的压力,同时提高患者、家属、医生对护理工作的满意度,提高护士在ICU团队中的作用,保证护理质量,最终保障患者的安全,并受到ICU护士的好评.     

The impact of long work hours and shift work on cognitive errors in nurses

Aim

Pilot study to examine the impact of long work hours and shift work on cognitive errors in nurses.

Background

Twelve‐hour shifts are more commonly used in hospital settings and there is growing concern over the impact that extended and irregular work hours have on nurses’ well‐being and performance.

Method

Twenty‐eight nurses working different shifts (8‐hr days and 12‐hr rotation) participated in this study. Nurses were assessed at the beginning of four consecutive shifts using actigraphy, a sleep diary and an after work questionnaire.

Results

Nurses working 12‐hr rotations had less total sleep time and less sleep efficiency than 8‐hr day nurses. Twelve‐hour rotation nurses also napped more than their counterparts. There were no differences between the two groups with respect to cognitive errors.

Conclusions

Twelve‐hour rotations have a negative effect on nurses’ sleep patterns. There is no evidence indicating 12‐hr rotations increased errors.

Implications for nursing management

Nurse managers can implement specific strategies, such as greater shift work flexibility and designated quiet time, to reduce the effects of disturbed sleep patterns in nurses.