护理本科生对毕业论文认知状态的调查分析

目的通过调查护理本科生对毕业论文的自评态度、参与撰写毕业论文的情况及其在完成毕业论文期间的期望,分析其对毕业论文的认知状况并提出相应的建议,为改进护理科研教学、毕业论文写作教学及管理提供科学依据。方法 2009年9月至2010年4月,采用自行设计的问卷对在广东地区实习的2010届136名护理本科毕业生进行调查。结果仅有33.1%的学生认为有必要写论文;18.4%的学生表示自己重视毕业论文;21.3%的学生被催促才匆忙选题。论文指导教师的投入程度与学生对毕业论文的态度有较明显的相关性(P<0.05)。半数以上学生在完成毕业论文期间希望能获取更多的教学资源。结论学生对撰写毕业论文认知不足,参与撰写毕业论文的主动性较低,应注意培养护理专业学生的科研兴趣,提高其对毕业论文的认知水平;建立督导检查机制,提高指导教师对护理专业学生毕业论文指导的投入程度;加强学校及临床教学医院对毕业论文的教学管理,确保学生毕业论文的质量。     

某高职高专院校护生对毕业论文认知情况调查

目的了解护理专科生对毕业论文的认识和态度,分析其科研素质现状,以便改进毕业论文的教学和管理工作。方法采用自行设计的问卷对本校2007级护理专科毕业生进行有关撰写毕业论文的调查。结果 77.44%的学生认为有必要撰写毕业论文;95.60%的学生表示主观上对撰写论文较重视;31.06%的学生经常与指导老师交流;69.90%的论文选题属于实习后期匆忙选题;71.94%的学生认为要求过高;56.09%的学生认为困难很大,难以应付。结论学生科研意识比较淡薄,对毕业论文投入精力较少。今后应加强学生科研训练,提高毕业论文质量,增强其科研能力。     

护理本科生毕业论文选题相关因素调查

目的了解我校护理学院护理本科生在毕业论文撰写选题阶段所遇到的问题,总结相关因素,以期为护理本科毕业生论文撰写选题阶段遇到的问题提供解决依据。方法对护理学院2010届127名护理本科毕业生通过自制问卷进行调查。结果护理本科生对于毕业论文选题的重要性都有很好的认识,学生认为选题是毕业论文撰写过程中最重要的阶段,选题到定题的时间较长,选题方式以导师指导下定题为主,选题内容多为社会调查类。结论应提高护理本科生对毕业论文认识的重要性,在校期间多给予选题相关方面锻炼机会,多参加科研活动,增加与导师之间的互动,获取有效信息,调整选题时间,做好毕业论文前期准备工作。通过合理选题提高护理本科生毕业论文质量,并按时顺利完成毕业论文。     

护理本科生毕业论文认知和撰写能力的调查

目的 调查护理本科实习生对毕业论文的认知及撰写能力的现状,为改进毕业论文指导工作提供依据.方法 以200名2006级全日制护理本科实习生为对象,自行设计问卷实施调查.结果 护生对护理科研的兴趣,64.02%为一般,28.04%为基本没有;认为自己完全能独立完成毕业论文的仅占2.64%,认为自己勉强能完成的占56.62%;83.60%的护生在实习中后期开始准备毕业论文;毕业论文类型中综述和个案护理占69.31%;认为实习期工作太辛苦以至于没有精力好好完成论文的占38.62%,认为实习期没有时间写论文占34.39%.结论 影响本科护生完成毕业论文的主要原因是学生科研兴趣低,科研能力不足,实习环境不能满足学生论文撰写的需要.学校和实习医院应注重培养学生的科研兴趣,并为他们创造良好的科研环境.     

关于护理本科生毕业论文撰写障碍的原因分析与思考

[目的]分析护理本科毕业生论文撰写存在的障碍及原因。[方法]采用问卷调查和学生座谈法,调查内容包括本科生撰写毕业论文时存在的障碍、在校学习和临床实习对写作能力的影响、自身对毕业论文的认识、写作态度和学习行为等。[结果]本科生论文撰写障碍形成的主要原因是教师对学生科研培养意识不高,科研相关课程学习要求较低,实习环境不能满足学生论文撰写的需要等。[结论]高等护理教育应适当降低对本科生论文撰写能力的要求,着重培养学生的科研兴趣与科学思维。     

关于护理本科生毕业论文撰写障碍的原因分析与思考

[目的]分析护理本科毕业生论文撰写存在的障碍及原因.[方法]采用问卷调查和学生座谈法,调查内容包括本科生撰写毕业论文时存在的障碍、在校学习和临床实习对写作能力的影响、自身对毕业论文的认识、写作态度和学习行为等.[结果]本科生论文撰写障碍形成的主要原因是教师对学生科研培养意识不高,科研相关课程学习要求较低,实习环境不能满足学生论文撰写的需要等.[结论]高等护理教育应适当降低对本科生论文撰写能力的要求,着重培养学生的科研兴趣与科学思维.     

护理本科生毕业论文选题障碍的影响因素分析

目的 分析护理本科毕业生论文选题中存在的障碍及影响因素,为今后本科生毕业论文选题指导提供参考.方法 采用自行设计的问卷对某高校98名护理本科生进行有关毕业论文选题困难程度与选题障碍认识的调查.结果 87.76%的学生认为论文选题过程存在困难.其中学生选题过程中的主观能力障碍主要是不会查找文献,90.82%无法完善选题、缺乏相关知识,68.37%不知如何选题,45.92%与毕业论文指导教师沟通不良 客观障碍主要是工作太辛苦,没有时间和精力占35.71%,未得到系统的教育与训练指导占31.63%.结论 护理本科生论文选题障碍主要与护理本科生科研相关课程的掌握情况欠佳,与指导教师沟通不良,缺少系统的科研训练及科研经历,临床实习任务重,精力投入不够等因素有关.     

护理本科毕业生对毕业论文提升科研能力认同情况调查分析

目的 了解护理专业本科毕业生对毕业论文提升科研能力认同情况,以发现护生科研能力培养方面存在的潜在问题,为提高本科生在校期间的护理科研能力的培养寻求对策.方法 采用自行设计的问卷对80名护理本科毕业生进行有关撰写毕业论文提升科研能力的调查.结果 80.9%的学生认同开展毕业论文撰写可以提高护理科研能力和科研兴趣,64.7%的学生认为撰写毕业论文,切实提高自己的科研能力和写作水平.结论 今后应从提高学生的科研意识与科研兴趣;严格选拔科研带教教师、增强师生间的互动,提高科研带教能力;调整毕业论文的准备及撰写时间,从加强毕业论文的管理工作入手,深化学生对毕业论文提升科研能力的认知,通过毕业论文的撰写过程切实提高学生的科研能力.     

护理本科生毕业论文指导中存在的问题与对策

目的 调查了解护理本科生毕业论文指导中存在的问题，提出对策。方法采用自制问卷对某校2003级30名护理本科生进行调查研究。结果63.3％以上的学生认为统计分析和统计软件的应用是最大的难题，也是老师指导最不足的方面。60．0％感到选题有困难，50．0％认为论文撰写方面指导不足，80．0％认为论文完成时间不够，大部分希望安排相关的讲座。结论为了提高护理本科生科研能力训练的效果，应严格临床指导教师资质的准入和完善激励机制，强化统计学及论文撰写的培训，加强与院校论文指导教师的联系，同时调整学校和医院有关论文指导的安排。     

护理本科毕业生科研实践体验的质性研究

目的探讨护理本科毕业生在科研过程中所遇的困难和收获,从而为提高科研带教质量提供依据。方法在查阅文献、咨询专家的基础上,设计半结构式的访谈提纲,应用焦点团体访谈法,对在我院完成毕业科研训练的10名护理本科毕业生进行小组访谈;对所得资料进行定性分析。结果通过科研训练,学生明晰了科研设计的过程,科研论文书写能力得到提高;双向导师在科研训练指导中起着重要的作用;多数同学感觉在选题、统计学方法、论文撰写上存在着一定的困难,需要指导老师给予帮助。结论双向导师具有优势互补的作用;科研训练中应加强选题和论文撰写的训练与指导;注重对学生早期科研能力的培养。     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

手转胎头术失败的原因与分娩结局临床分析

目的 探讨手转胎头术失败的原因与分娩结局.方法 选择2008年1月至2010年12月于我院住院分娩的持续性枕横位、枕后位产妇198例,根据行手转胎头术后结果分为成功组126例、失败组72例.比较两组分娩结局,对比分析失败原因.结果 失败组胎儿体质量≥3500 g的发生率[76.4％(55/72)]明显高于成功组[31.7％(40/126)],差异有统计学意义(x2=30.177,P=0.001)、失败组宫缩乏力发生率[58.3％(42/72)]高于成功组[38.1％ (48/126)],差异有统计学意义(x2=7.569,P=0.006)、失败组骨盆临界或轻度狭窄发生率[38.9％ (28/72)]高于成功组[23.8％(30/126)],差异有统计学意义(x2 =5.030,P=0.002)、失败组手转胎头时机不当(宫口开大＜6 cm、胎头位于坐骨棘上及宫口开大8～10 cm、胎头位于坐骨棘下≥2 cm)发生率[61.1％(44/72)]高于成功组[38.9％(49/126)],差异有统计学意义(x2=9.084,P=0.003).失败组母儿并发症(产后出血、产褥病率、胎儿窘迫、新生儿窒息)发生率高于成功组(x2 =9.586,P=0.002、x2=9.334,P=0.002、x2=5.910,P=0.015、x2=5.240,P=0.022)、失败组剖宫产发生率[72.2％(52/72)]明显高于成功组[34.1 ％(43/126),x2=26.641,P=0.001)].结论 手转胎头术能使难产变顺产,降低剖宫产率,减少母儿并发症,但须积极预防、处理导致手转胎头术失败的原因,对矫正失败后继续矫正及试产应慎重.