养老机构老年人家庭参与的研究进展

介绍家庭参与的概念和发展,阐明家庭参与对机构老年人身心健康发挥积极作用,简述老年人机构养老后家庭成员角色的变化,深入探讨养老机构老年人家庭参与的具体内容,全方面分析家庭参与的影响因素,旨在明析养老机构老年人家庭参与机制和内涵,以提高机构老年人的晚年生活质量。     

养老机构老年人心理调适与关怀期望落差的关系研究

目的 探讨养老机构老年人心理调适与关怀期望落差的关系,分析老年人心理调适的影响因素.方法 使用一般资料调查表、养老机构老年人心理调适量表、养老机构老年人关怀行为评价量表以及关怀实际感受量表,采用便利抽样的方法,对广州市4所养老机构中符合标准的195名老年人进行调查.结果 养老机构老年人心理调适得分为94.00(80.0...     

湖北省县、乡两级计划生育服务机构护理人员专业能力及影响因素研究

目的了解湖北省县、乡两级计划生育服务机构护理人员专业能力现状,为进一步制定具有针对性的培训计划和方案提供依据。方法于2007年3月对湖北省17个地、市(州)县乡两级计划生育服务机构工作的820名护理人员,分别以地、市(州)为考区进行理论考试。考试结果利用Epidata3.0软件进行数据录入,采用SPSS11.0软件对数据进行统计描述、方差分析和多元逐步线性回归分析。结果县级计划生育机构护理人员考试成绩平均分60.92±11.25,及格率53.64%;乡级计划生育机构护理人员考试成绩平均分74.90±9.70,及格率94.47%。县乡两级计划生育机构护理人员考试成绩得分率:县级基本理论50.52%、基本技能65.88%和专科护理知识82.32%;乡级基本理论79.74%、基本技能70.14%和专科护理知识71.35%。年龄、学历、从事计划生育工作年限对县、乡两级计划生育机构护理人员考试成绩有显著影响(均P0.05);年龄和职称是县级护理人员考试成绩的影响因素,而最后学历、工作年限是乡级护理人员考试成绩的影响因素(均P0.01)。结论县级计划生育服务机构护理人员基本理论、基本技能相对较差;乡级计划生育服务机构护理人员基本技能和专科护理知识相对较差。护理人员的年龄、学历、从事计划生育工作年限均对考试成绩有影响,应采取针对性措施提高其专业能力。     

养老机构老年人死亡态度及其影响因素研究

目的探究养老机构老年人死亡态度的现状及影响因素,为开展养老机构老年人死亡教育提供参考。方法采用死亡态度描绘量表修订版,对济南市5所养老机构的214名老年人进行调查。结果养老机构老年人死亡态度自然接受维度得分最高,为3.88±0.69,其次依次为趋近接受(3.06±0.74)、死亡逃避(2.53±0.84)、逃离接受(2.44±0.71)、死亡恐惧(2.36±0.91)。回归分析结果显示,家庭内讨论死亡情况、文化程度、年龄及子女看望次数对老年人死亡态度有显著影响(P0.05,P0.01)。结论养老机构老年人死亡态度偏正向。营造公开的家庭氛围、鼓励子女看望和陪伴老年人,能够帮助养老机构老年人树立正确的生命观和死亡观。     

VC473等弹力丝假捻机卷绕机构的运动分析及其设计

对ＶＣ４７３等弹力丝假捻机卷绕机构进行了运动分析，将导得的方程用计算机进行了计算。论证了该机构工作可靠、运转平稳、结构合理。探讨了该机构主要设计参数的选择对运动的影响。     

社会养老机构老年人主观幸福感及相关因素研究

目的 探讨社会养老机构老年人主观幸福感(SWB)及其相关影响因素.方法 采用自制问卷、纽芬兰大学幸福度量表(MUNSH)对西安市城区20所社会化养老机构的462名老年人的SWB进行调查,并分析人口社会因素、负性生活事件等对老年人SWB的影响.结果 社会养老机构老年人的MUNSH总分32.93±12.23,高SWB水平者246名(53.25%),低SWB水平者47名(10.17%),不同性别、年龄、婚姻状况老年人的SWB比较,差异无显著性意义(均P＞0.05).多元逐步回归分析结果表明,养老机构老年人SWB的主要影响因素排序依次为:个性、经济状况自评、在社会家庭中地位、健康恶化、对养老公寓满意度、子女就业困难、体育锻炼.结论 社会养老机构老年人SWB不容乐观,应采取针对性措施提高其SWB水平.     

养老机构老年人对人文关怀行为的评价及影响因素分析

目的了解杭州市部分养老机构老年人对人文关怀行为认知的现状及影响因素,为社会及养老机构的照护人员给老年人提供更好的关怀照护服务提供参考。方法应用养老机构老年人关怀行为评价量表,对杭州市3家养老机构的124名老年人进行调查。结果老年人对人文关怀行为的评价总得分率为83.7%,家人探望频率、机构关心程度不同的老年人对人文关怀行为的评价得分比较,差异有统计学意义(均P0.01)。结论养老机构老年人对关怀行为的认知较高,家人、社会和养老机构应共同关注老年人的人文关怀需求,开展丰富多彩的文化活动,积极提倡"孝"文化,以满足其情感呵护、精神慰藉的需求。     

建立创面治疗中心的管理学探讨——(二)建立创面治疗中心的依据

管理学上认为,影响组织机构设计的因素主要有战略因素、规模因素、环境因素和技术因素。围绕以上学说,我们对医院建立创面治疗中心的组织机构设置与病床编制进行了探索。     

固定凸轮与连杆组合机构的设计

本文简要介绍固定凸轮与连杆组合机构的工作原理与设计方法,并比较全面地分析讨论了结构参数,摆动从动杆支点位置和驱动方案对压力角的影响,从而为该机构的优化设计提供了依据。     

养老机构非卧床老年人衰弱影响因素的路径分析

目的探讨养老机构非卧床老年人衰弱的影响因素,并进行路径分析。方法采用一般情况问卷、养老机构老年人衰弱评估问卷、简明精神状态量表、老年抑郁量表对上海市9所养老机构中符合纳入排除标准的218名老年人进行调查。结果养老机构非卧床老年人的衰弱总分为(55.02±11.75)分,各维度按其条目均分从高到低排序为:心理维度、生理维度、社会维度。路径分析显示,抑郁评分、活动情况、认知评分、睡眠情况、患病情况、文化程度及婚姻状况直接或/和间接影响老年人衰弱(总效应依次为0.59、-0.42、-0.27、0.21、0.17、-0.15、0.09)。结论养老机构非卧床老年人存在不同程度的衰弱,其衰弱受多种因素影响,养老机构应采取积极措施,延缓老年人衰弱的进展。     

The pathophysiological effects of brain death on potential donor organs, with particular reference to the heart.

Major electrocardiographic, haemodynamic, and histopathological changes take place during the development of brain death; myocardial and pulmonary injury may result. Significant depletion of certain circulating hormones occurs, resulting in an inhibition of mitochondrial function, leading to reduced aerobic metabolic oxidative processes, affecting the body as a whole. Major organ energy stores are therefore diminished, leading to deterioration of function. Replacement of the depleted hormones, in particular triiodothyronine (T3), cortisol, and insulin, leads to rapid replacement of organ energy stores, associated with a return to normal function. T3 alone leads to reactivation of the mitochondria, stimulating aerobic metabolism. Hormonal therapy to brain-dead potential organ donors has been shown to lead to metabolic and haemodynamic stability, resulting in no wastage of organs, and in improved function after transplantation.     

Identification of donor factors predisposing to high discard rates of cadaver kidneys and increased graft loss within one year posttransplantation--SEOPF 1977-1982. South-Eastern Organ Procurement Foundation

From 1977 to 1982, the South-Eastern Organ Procurement Foundation (SEOPF) conducted a prospective study to determine the fate of all cadaver kidneys retrieved by member institutions. During the study period, 6152 kidneys were retrieved, 1264 being discarded. Donor factors predisposing to wastage included AB and A blood groups, donor age greater than 30, hospitalization greater than 3 days, serum creatinine greater than 2.0 mg%, average systolic blood pressure less than 80, last-hour urine output less than 100 ml, proteinuria, heart not beating at time of nephrectomy, and kidneys not removed en bloc. Donor factors affecting graft survival rate at one year include age, length of hospitalization, last-hour urine output, and changing serum creatinine. The data suggest that certain donor kidneys are less likely than others to be transplanted depending on donor characteristics and retrieval practices. Furthermore, some of these factors have a negative impact on long-term success when kidneys are transplanted.     

Fertility, reproduction, and postnatal survival in mice chronically exposed to isoflurane

The effects on fertility and reproductive wastage of 110 female Swiss/Webster mice and postnatal survival of their offspring were examined after exposure to either air, 0.4% isoflurane, or 0.1% isoflurane. Treatments were for 4 h daily for 2 weeks before and during pregnancy. In a second experiment, the effects on fertility of 54 male Swiss/Webster mice and on reproductive wastage of their unexposed mates were examined after 4-h daily exposures to either air, 0.4% isoflurane, or 0.1% isoflurane throughout spermatogenesis and during mating. There were no adverse reproductive effects in either experiment. The lack of toxicity of isoflurane is consistent with the results of other reproductive studies in animals that have examined chronic intermittent exposure to subanesthetic concentrations of halothane, enflurane, methoxyflurane, and nitrous oxide. They suggest that these and lower (trace) levels of anesthetic gases may not be the cause of the harmful reproductive effects said to occur in operating room personnel.     

Maternal and infant sexually transmitted diseases

Sexually transmitted infection may result in serious damage to the reproductive tract of the mother, damage to the fetus, wastage of pregnancy, or illness or death of the infant. The effects of gonorrhea, Chlamydia trachomatis infection, mycoplasmal infections, group B streptococcus infections, syphilis, and viral infections are discussed separately for both mother and infant.     

Significantly Minimizing Drug Wastage and the Cost of Cabazitaxel Used to Treat Metastatic Castration-Resistant Prostate Cancer

Cabazitaxel is used to treat patients with metastatic castration-resistant prostate cancer progressing after docetaxel. It is prepackaged in 60 mg single-dose vials, a quantity much higher than the average prescribed dose, which leads to, substantial drug wastage (DW) and associated costs. To minimize DW we implemented a cost-saving, cohorting strategy where multiple patients scheduled to receive cabazitaxel (at a dose of 20 mg/m² every 3 wks) were cohorted and treated on a single weekday whenever possible. Excess drug from each vial was then saved and used for subsequent patients treated on the same day. The drug cost with cohorting was calculated from the actual number of vials used, and the drug cost without cohorting was estimated by assumingthat one vial was used per treatment. The cost of DW was determined based on the amount of drug that was discarded. All cost calculations also accounted for the discount incentives offered by Sanofi-Aventis. Over a 3-yr period, 74 patients received 402 treatments of cabazitaxel. Multiple patients were treated on 67.4% of the treatment days, and grouping of three patients on one day saved one vial. The estimated total drug cost saved was $394 536 CAD (21.1%). Pending further studies on safety and efficacy, this strategy could potentially be adopted to mitigate DW for cabazitaxel and similarly for other oncology drugs. This would significantly decrease the overall financial burden on patients, institutions, and stakeholders.Patient summaryCabazitaxel chemotherapy is associated with substantial drug wastage and associated costs. By cohorting patients scheduled to receive cabazitaxel on a single weekday, the total drug cost was decreased by $394 536 CAD (21.1%) over a 3-yr period. Similar strategies could be considered to overcome the prohibitory costs associated with drug wastage for cabazitaxel and other cancer drugs.     

Results from a single kidney procurement center

During a 16-month interval 235 kidneys were recovered from 120 consecutive donors, 15 of which were not transplanted for a variety of reasons. The factors believed to be important in producing a low wastage rate of procured kidneys included careful management of the donor during the brain death period, en bloc resection to avoid damage to vascular structures and the ureter, and avoidance of cold ischemia.     

Women doctors wasted.

The problem of wastage of women doctors has exercised the minds of South African medical planners very little. Numerous articles have appeared in the English literature, but we have been able to find only two editorials in semi-facetious vein in the South African Medical Journal over the last 20 years. We have looked at some trends, and believe that there is a need for further investigation, because there are important implications concerning future medical manpower resources in this country.     

Reduced Protein Loss During Hemofiltration Using Cuprophan Membranes

In a study of four patients treated with one hour of hemofiltration using Cuprophan membranes, followed by three hours of hemodialysis, it was found that protein loss during hemofiltration was minimal. Losses ranged from 0.013 mg/mg at a transmembrane pressure (TMP) of 300 mmHg to 0.012 mg/ml at a TMP of 600 mmHg. Protein loss was not dependent on TMP and varied from dialyzer to dialyzer. Protein levels in serum remained unchanged during the period of hemofiltration in these patients and no evidence of protein wastage was evident.     

Evaluation of fresh frozen plasma usage at a tertiary care hospital in North India

BACKGROUND: Concerns regarding transfusion-transmitted infections and non-availability of blood components in developing nations, make it crucial to optimize fresh frozen plasma (FFP) transfusions and reduce wastage. METHODS: A concurrent prospective study of FFP usage was carried out in a tertiary care hospital in north India. RESULTS: A total of 595 units were issued to 112 patients during the study period, of which 53 units (8.9%) were returned to the blood centre unused, leading to wastage. Appropriate indications for FFP usage were as per accepted British Council for Standardization in Haematology (BCSH) criteria. Among 112 patients 33 (29.5%) had had appropriate FFP transfusions (205 units) for indications that primarily included chronic liver disease, disseminated intravascular coagulopathy and prolonged bleeding with abnormal coagulation profile. Out of 33 patients with appropriate indications, 24 had abnormal coagulation profile but only half of these patients (n = 12) received adequate dose of FFP. Fresh frozen plasma was used for inappropriate indications in 79 patients (70.5%), which mainly included bleeding following cardiac surgery with normal coagulation test results, hypovolaemia and hypoproteinaemia. Such misuse was higher in surgical units than medical services (78 vs 45%). CONCLUSION: Fresh frozen plasma is grossly misused even in resource-deficient nations and immediate intervention is needed to stem the flow of this component. Physician education programmes and a monitoring system to ensure strict adherence to the established guidelines are required to reduce undue waste of this blood component.     

Cost comparison between three different general anaesthetic techniques for elective arthroscopy of the knee

INTRODUCTION: We compared three anaesthetic techniques for elective knee arthroscopy with special reference to cost-effectiveness. METHOD: Seventy-five ASA I-II patients having elective arthroscopy of the knee joint were randomised to receive an anaesthetic technique based on propofol, fentanyl for induction followed by sevoflurane in oxygen:nitrous oxide (1:2 l/min) for maintenance of one of two intravenous techniques: propofol alfentanil or propofol-remifentanil infusions in combination with oxygen in air. RESULTS: All patients had an uncomplicated course. No differences were seen with regard to emergence, postoperative pain or emesis or time to discharge. The anaesthetic technique based on sevoflurane was associated with the lowest cost US$ 14.7 as compared to US$ 18 for the propfol/alfentanil and US$ 19.9 for the propofol/remifentanil technique, including both cost for wastage as well as premedication and other fixed drug costs. Looking only at the anaesthetic drugs consumed, the cost per minute was US$ 0.56 for sevoflurane/nitrous oxide as compared to US$ 0.68 and 0.63 per minute for the propofol/alfentanil and proprofol/remifentanil, respectively. When the cost for wastage was taken into account, the difference in mean anaesthetic drug cost was more pronounced: the sevoflurane anaesthetic technique US$ 0.58, the propofol/alfentanil US$ 0.74 and the propofol/remifentanil US$ 0.84 per minute respectively. CONCLUSION: From a cost-minimisation point of view, anaesthesia based on sevoflurane in oxygen:nitrous oxide is the technique of choice.