膝上假肢的智能控制方法

目前国际上已开发出了多种商品化的液压／气压智能膝关节假肢产品，包括Otto Bock的C-LEG、Blatchford的IP、SmartIP、AdaptiveKnee、Nabco公司的NI—C411、德林公司的Auto-Pilot电子膝关节和Ossur公司的Smart Magnetix Knee等．其中NI-C411和Auto—Pilot膝关节是四连杆电子膝关节。综观这些最新的微电脑控制膝关节，大部分可以通过控制液压／气压缸同时控制摆动相的速度和支撑相的稳定性，此外还可以适应不同的环境自动调整行走模式，如下坡／楼梯、绊倒、坐下等。不过这些关节的速度大多只有有限的几种，不能随意适应任意步速的变化。有些假肢关节还能模拟人体站立相的屈曲功能．如德林Auto—Pilot和Blatchford的AdaptiveKnee就可以在支撑相前期产生一定的弯曲，以缓冲腿的步行冲击。     

制约社区护理发展的关键问题及对策

随着我国经济的发展,人民的生活水平得到了极大的改善,但是,相应的科学合理的饮食结构、生活方式却并没有被广大群众所重视和掌握,加上我国老龄化进程的加快和人们生活节奏的加快,环境的污染,致使我国人群慢性非传染性疾病的发病率快速提升,特别是癌症、糖尿病、心脑血管等病对人群的健康造成了极大的危害.     

想你,是我的四季

在春寒料峭的夜晚,想你;在花香时隐时现的夜晚,想你。冬天已经走了,怀着春天已近的殷殷期盼,坐在已抽出粉红花苞的桃树下,想你,即将挂满绿叶的希望使抑制不住的欣喜在慢慢溢出。迎春花柔软的手臂轻揽着我,鹅黄色的热烈亦满满地舒展开来。一天一天的想你,一天一天的     

护士工作环境与护理人员流失的研究进展

综述了护士工作环境的定义,护士工作环境的构成,建立良好护士工作环境的意义,人员流失的概念,护理人员流失的现状及其负面的影响.重点介绍了护士工作环境与护理人员的关系.     

如何向SCI收录的优秀期刊投稿:怎样获得好的idea?!

Idea这一简单的英文单词,却似乎很难用一个对应的中文词来翻译,它应该包括了想法、思路、点子等多种意思,所以这个看似简单的单词代表的是相对复杂的意思,更代表了对于科研人员而言非常重要的问题:怎样获得好的idea?不少人,尤其是刚从事科研的研究生认为,撰写论文是在试验做完之后的事情     

中风恢复期的针灸治疗概况

中风病属于西医的脑血管病，具有很高的致死率和致残率。中风病所致的生活质量下降比其他任何一种疾病都要严重，同时它所带来的经济负担也是相当沉重的。据2000年美国国家卒中协会报道，每年约40万美国人发生脑梗死，每年约718亿美元用于治疗脑梗死。中风病恢复期是指发病后半个月至半年的一段时间。病人进入中风恢复期多有不同程度的神经功能障碍。大量的临床实践表明，这一时期是中风病恢复的关键阶段。采取积极有效的治疗，对病人的康复具有促进作用，有利于疾病的痊愈，反之，当病程进人中风后遗症期，若想取得治疗进展则非常困难。     

精神科护士应对方式与身心健康关系的调查分析

面对日益增多的精神病病人,精神科护士具有健康的心身是工作得以顺利进行的必备条件.而精神病医院的特殊性,在诸多方面影响着护士的心身健康,应对方式便是其中重要的因素之一.应对方式是个体面对有压力的情境和事件时所采取的认知和行为方式[1].     

护理的力量:跨越大海、心心相连——日本护士在中国工作的感受

2005年11月,我来到中国,在北京接受了1个月的语言培训之后,前往位于河北省的一家医院赴任.开始的时候,由于突然进入只有中文的世界,我每天都为无法表达自己的想法而困惑,为理解不了对方的想法而焦急,好像就要被害怕、不安、焦躁的情绪压垮了.但是,护理部主任不急躁,她抽出时间来耐心地帮助我,使我能够从容地面对后来的新生活.     

那逝去的美丽

她是一个12岁的小女孩,叫瑶瑶,曾经,她也是一个无忧无虑的孩子,有着每一个小孩的天真,有着每一个小孩的顽皮,有着每一个小孩的美好梦想,甚至她还有着很多小孩的坚强。一个噩梦的来临改变了她的美好童年,她患上了被称为血癌的白血病。看着她,我曾一次次的问老天爷为什么要这样,为什么要这样让那么可怕的病魔来折磨这个可爱的生命。当初确诊是白血病时,对于12岁的瑶瑶来说并不知道意味着什么,但是     

浅谈护士与疗养员交流的技巧

随着科学技术的不断发展,人民的生活水平逐渐提高,人类的平均寿命延长,老年人口的数量也不断增多,这给疾病的结构、医疗保健、社会福利等事业带来了巨大的影响.     

A new statistical test based on the wavelet cross-spectrum to detect time-frequency dependence between non-stationary signals: application to the analysis of cortico-muscular interactions

The study of the correlations that may exist between neurophysiological signals is at the heart of modern techniques for data analysis in neuroscience. Wavelet coherence is a popular method to construct a time-frequency map that can be used to analyze the time-frequency correlations between two time series. Coherence is a normalized measure of dependence, for which it is possible to construct confidence intervals, and that is commonly considered as being more interpretable than the wavelet cross-spectrum (WCS). In this paper, we provide empirical and theoretical arguments to show that a significant level of wavelet coherence does not necessarily correspond to a significant level of dependence between random signals, especially when the number of trials is small. In such cases, we demonstrate that the WCS is a much better measure of statistical dependence, and a new statistical test to detect significant values of the cross-spectrum is proposed. This test clearly outperforms the limitations of coherence analysis while still allowing a consistent estimation of the time-frequency correlations between two non-stationary stochastic processes. Simulated data are used to investigate the advantages of this new approach over coherence analysis. The method is also applied to experimental data sets to analyze the time-frequency correlations that may exist between electroencephalogram (EEG) and surface electromyogram (EMG).     

Community-based Service Delivery in Rehabilitation: The Promise and the Paradox

Purpose : According to many researchers, rehabilitation is being prevented from developing as a distinct profession due to two major problems. First, it has been claimed that rehabilitation is in need of a professional identity and a sense of cohesion if it is to emerge as a discipline. Second, it has been recognized that there is a need for a rehabilitation framework to challenge the restorative approach that continues to dominate rehabilitation, linking it back to the medical model from which it has attempted to escape. The model of community-based rehabilitation (CBR) is offered as a model that can provide the impetus for an attitudinal shift from the restorative tradition and unite rehabilitation workers through a cohesive framework. Method : Unfortunately, the implementation of community-based rehabilitation in urban societies has been disappointing. The current paper is a conceptual discussion of communitybased rehabilitation that explores some potential causes of this poor implementation. Results : To some extent, the implementation failure of community-based rehabilitation can be attributed to the paradoxes that are inherent in its fundamental construct sempowerment and community inclusion. These paradoxes occur at a conceptual level, a practical level and a contextual level. Conclusions : Some solutions are offered to enable the paradigm to be implemented more fully. In particular, it is suggested that there is a need to develop useful working definitions of these constructs, favourable attitudes among rehabilitation workers and a focus on community development.     

Evidence-based uncertainty in mental health nursing

The drive towards evidence-based practice is part of a modern reflective and caring service. However there is a paradox at the heart of the notion of evidence-based care. In order to perform any systemized examination of treatment there has to be a conscious acknowledgement of uncertainty about that treatment. This is uncomfortable and when research does find evidence in favour of a treatment, there is a relief and a return to conviction about what is the best. The paradox is that it seems the most valued research practices are predicated on generalizations about patient treatments and categories. However, nursing care is based on the notion of the uniqueness of the patient and the nurse-patient relationship. Sometimes it is necessary to address the particular and not to rush to generalizations and certainty. The psychoanalytic framework promotes a capacity to tolerate uncertainty and provides a model for understanding conflicting feelings, which can occur within the nurse-patient relationship. The author proposes the psychoanalytic observational method as an adjunct to other research methods. This method places certain kinds of evidence within the rubric of evidence-based nursing practice. The evidence collected in this method is the evidence of the conscious and unconscious experience within the nurse-patient relationship. The author will describe and argue for the place of this research method within the canon of other more widely practised methods within mental health practice. She will propose that for safe practice it is necessary to value and examine the veracity of the feelings and tacit understanding of the nurse. She contends that the current climate of excessive bureaucracy and persecutory risk management is having a damaging effect on both the research process and effective nursing care.     

ANNUAL REPORT OF COUNCIL FOR THE YEAR ENDING 30th JUNE, 1949

The thinning guide presented with this paper is a graph of stocking per acre on predominant height, and it indicates what is considered to be the optimum range of stocking within which thinning should maintain P. radiata stands in South Australia, if an optimum compromise between certain factors is to be achieved.

These factors include a commercial first thinning as a pre-requisite, full site use, reasonable rates of diameter growth, and stability to wind.

It is suggested that representation of a thinning guide in terms of stand height and in graphical form gives it a flexibility to individual stand characteristics which is not possible in tabular form, and that such flexibility is necessary if a thinning guide is to be a ready practicable guide to logging officers. A special value of the graphical form is that past and proposed thinning of a stand can be represented diagrammatically, against a background of growth and stability criteria. By indicating long-term possibilities, this should assist with short-term decisions.     

Relationship between sample size and the definition of equivalence in non-inferiority drug studies

Statistical testing of clinical trial data leads to acceptance of a hypothesis if a test of the opposite (null) hypothesis (H0) fails to reach a critical probability value. The usual aim is to demonstrate that a new treatment is superior to a comparator, whence H0 is that the two treatments are the same. By contrast, in studies designed to show that a new treatment is equivalent to an existing therapy, the same principle is satisfied by an amended null hypothesis, that the treatments differ by more than a defined amount. This reversal entails subtle but important logical and practical problems which affect particularly the calculation of sample size. The choice of the limits used to define equivalence is critical to the calculation of sample size in a manner not previously discussed, and in the interpretation of data in relation to the probability of Type I and Type II errors. Investigators, regulatory bodies and institutional ethics committees must ensure that the range of values chosen to indicate equivalence is clinically appropriate and be aware of the effect of this decision on possible errors in accepting or rejecting H0.     

Mothers' experiences of having their newborn child in a neonatal intensive care unit

BACKGROUND: From birth the child has an ability to respond to the environment, which influences the interaction between mother and child. If this attachment is interrupted, the child's emotional development is negatively influenced. When the child needs care in a neonatal intensive care unit (NICU) it is difficult to establish contacts between mother and child. Separation from the child is found to be the most difficult aspect for mothers when their newborn child is hospitalized in a NICU. AIM: The aim of this study was to describe mothers' experiences when their full-term newborn child was cared for in a NICU during the postpartum maternity care period. METHOD: A phenomenological hermeneutic interview study was performed. Ten mothers were interviewed once, 6 months to 6 years after the experience. RESULTS: The essence of the experience is understood as an alternation between two opposite concepts, exclusion and participation, with emphasis on exclusion. A feeling of exclusion dominates when the new mother feels a lack of interaction and a sense of not belonging to either the maternity care unit or the NICU. This has a negative effect on her maternal feelings. On the contrary, when a feeling of participation dominates, a continuous dialogue exists and the mother is cared for as a unique person with unique needs. This supports her maternal feelings in a positive direction. The implication of the result for nurses is that it is important to decrease mothers' experience of exclusion and to increase their feeling of participation when their child is cared for in a NICU. A return visit to the responsible nurse to go through the treatment and experiences should be offered to all parents whose child has been cared for in a NICU.     

Narrative inquiry as a research methodology exploring person centred care in nursing

Background

Although, person centred care has for a long time been an important approach to nursing care, it is often not a reality in the clinical environment. The focus of health research has, until recently, been on the physical aspects of a persons’ illness and this has influenced how care is delivered. There is a need to broaden the focus from the illness to the person who is ill. A holistic approach to the persons’ social and cultural experience of their illness will aid health care professions to provide person centred care.This paper will make the argument that narrative inquiry is a well suited to health care research in general and nursing research in particular as it focuses its inquiry on the individual person's experience of their illness – ‘what matters’ from the person's point of view. Narrative inquiry explores the narrative from a temporal, social and spatial view.

A kaleidoscope of understandings: Spiritual nursing in a multi-faith society

BACKGROUND: Spirituality is an increasingly discussed topic in nursing. In some parts of the UK there is a policy requirement to establish policies of spiritual health care which are appropriate to a multi-cultural society. In the nursing literature, spirituality is discussed from religious and secular perspectives which seem impossible to reconcile into a coherent philosophy. AIMS: To discuss the relationship of spirituality to nursing and to suggest how we can think about spirituality as nurses working in a society of many faiths and cultures. DISCUSSION: Spirituality can be thought of in relation to individual patients and nurses. It also has significance for the profession of nursing and for health care as a whole. The difficulty of defining spirituality is discussed, and it is suggested that a definition of 'spiritual nursing' may be more achievable. Different concepts of spirituality are compared, including religious and secular spirituality. The relationship between religion and spirituality is seen as potentially problematic, with some religions denying the existence of secular spirituality. Secular spirituality and New Age movements are non-religious but spiritually influential phenomena. The problem for nursing is how to reconcile the immense variety of approaches to spirituality. CONCLUSIONS: The concept of spirituality as a meta-narrative is considered, and a postmodern appreciation of pluralism is employed as a way of embracing different spiritual realities. Spiritual nursing can be an opportunity for nurses to enlarge their understanding of the human condition rather than a narrowly defined concept to be applied within a model of practice.     

Being in transit and in transition The experience of time at the place,when living with severe incurable disease ‐ a phenomenological study

The aim of this study is to describe the experience of time as it presents itself at the place being situated when living with severe incurable disease and receiving palliative care. The empirical data consist of 26 open‐ended interviews with 23 patients receiving palliative care at home, at a palliative day care, in a palliative bed unit in hospital or in a nursing home in Norway. A common meaning of a shifting space for living emerged from the analysis and was revealed through three different aspects: (i) Transition from a predictable to an unpredictable time: To live with severe incurable disease marks a transition to a changed life involving an ongoing weakened and altered body with bothersome symptoms making experience of time different and unpredictable. (ii) Transition between a safe and unsafe time: When time is unpredictable, feeling safe is revealed as essential to how time is experienced at the place being situated. (iii) To be in transition from a homely to a homeless existence: In a time of increased bodily weakness, unpredictable ailments and displacements, the sense of belonging to the place is revealed as significant to the experience of time. Not knowing where to be in a time of change is like an existential cry of distress where the foothold in existence is lost. The findings are discussed and interpreted as an embodied experience originating from the passage of time continually affecting life sometimes so fundamentally that it marks a transition to a changed space of life that is reflected in the experience of time.     

Bayesian statistics in medical research: an intuitive alternative to conventional data analysis

Statistical analysis of both experimental and observational data is central to medical research. Unfortunately, the process of conventional statistical analysis is poorly understood by many medical scientists. This is due, in part, to the counter-intuitive nature of the basic tools of traditional (frequency-based) statistical inference. For example, the proper definition of a conventional 95% confidence interval is quite confusing. It is based upon the imaginary results of a series of hypothetical repetitions of the data generation process and subsequent analysis. Not surprisingly, this formal definition is often ignored and a 95% confidence interval is widely taken to represent a range of values that is associated with a 95% probability of containing the true value of the parameter being estimated. Working within the traditional framework of frequency-based statistics, this interpretation is fundamentally incorrect. It is perfectly valid, however, if one works within the framework of Bayesian statistics and assumes a 'prior distribution' that is uniform on the scale of the main outcome variable. This reflects a limited equivalence between conventional and Bayesian statistics that can be used to facilitate a simple Bayesian interpretation based on the results of a standard analysis. Such inferences provide direct and understandable answers to many important types of question in medical research. For example, they can be used to assist decision making based upon studies with unavoidably low statistical power, where non-significant results are all too often, and wrongly, interpreted as implying 'no effect'. They can also be used to overcome the confusion that can result when statistically significant effects are too small to be clinically relevant. This paper describes the theoretical basis of the Bayesian-based approach and illustrates its application with a practical example that investigates the prevalence of major cardiac defects in a cohort of children born using the assisted reproduction technique known as ICSI (intracytoplasmic sperm injection).