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101.
JPMHN report on the 2018 Skellern Lecture and JPHMN Lifetime Achievement Award—held at the University of Greenwich Maritime Campus,June 14th 2018 下载免费PDF全文
102.
Determining the optimal approach to identifying individuals with chronic obstructive pulmonary disease: The DOC study 下载免费PDF全文
Sarah J. Ronaldson MSc BSc Lisa Dyson MSc BA Laura Clark MSc BSc Catherine E. Hewitt PhD MSc BSc David J. Torgerson PhD MSc Brendan G. Cooper PhD MSc BSc Matt Kearney MPH MB ChB William Laughey MBChB MSc Raghu Raghunath PhD MD Lisa Steele BSc Rebecca Rhodes BMED Sci Joy Adamson PhD MSc BSc 《Journal of evaluation in clinical practice》2018,24(3):487-495
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An integrative review exploring the physical and psychological harm inherent in using restraint in mental health inpatient settings 下载免费PDF全文
Pauline Cusack PG Cert HE MSc BA Dip. SW. Sue McAndrew PhD MSc BSc Mick McKeown PhD BA DPSN RMN RGN Joy Duxbury PhD MA PG Cert HE BSc. 《International journal of mental health nursing》2018,27(3):1162-1176
In Western society, policy and legislation seeks to minimize restrictive interventions, including physical restraint; yet research suggests the use of such practices continues to raise concerns. Whilst international agreement has sought to define physical restraint, diversity in the way in which countries use restraint remains disparate. Research to date has reported on statistics regarding restraint, how and why it is used, and staff and service user perspectives about its use. However, there is limited evidence directly exploring the physical and psychological harm restraint may cause to people being cared for within mental health inpatient settings. This study reports on an integrative review of the literature exploring available evidence regarding the physical and psychological impact of restraint. The review included both experimental and nonexperimental research papers, using Cooper's (1998) five‐stage approach to synthesize the findings. Eight themes emerged: Trauma/retraumatization; Distress; Fear; Feeling ignored; Control; Power; Calm; and Dehumanizing conditions. In conclusion, whilst further research is required regarding the physical and psychological implications of physical restraint in mental health settings, mental health nurses are in a prime position to use their skills and knowledge to address the issues identified to eradicate the use of restraint and better meet the needs of those experiencing mental illness. 相似文献
105.
Shefali Oza Joy E Lawn Daniel R Hogan Colin Mathers Simon N Cousens 《Bulletin of the World Health Organization》2015,93(1):19-28
ObjectiveTo estimate cause-of-death distributions in the early (0–6 days of age) and late (7–27 days of age) neonatal periods, for 194 countries between 2000 and 2013.MethodsFor 65 countries with high-quality vital registration, we used each country’s observed early and late neonatal proportional cause distributions. For the remaining 129 countries, we used multinomial logistic models to estimate these distributions. For countries with low child mortality we used vital registration data as inputs and for countries with high child mortality we used neonatal cause-of-death distribution data from studies in similar settings. We applied cause-specific proportions to neonatal death estimates from the United Nations Inter-agency Group for Child Mortality Estimation, by country and year, to estimate cause-specific risks and numbers of deaths.FindingsOver time, neonatal deaths decreased for most causes. Of the 2.8 million neonatal deaths in 2013, 0.99 million deaths (uncertainty range: 0.70–1.31) were estimated to be caused by preterm birth complications, 0.64 million (uncertainty range: 0.46–0.84) by intrapartum complications and 0.43 million (uncertainty range: 0.22–0.66) by sepsis and other severe infections. Preterm birth (40.8%) and intrapartum complications (27.0%) accounted for most early neonatal deaths while infections caused nearly half of late neonatal deaths. Preterm birth complications were the leading cause of death in all regions of the world.ConclusionThe neonatal cause-of-death distribution differs between the early and late periods and varies with neonatal mortality rate level. To reduce neonatal deaths, effective interventions to address these causes must be incorporated into policy decisions. 相似文献
106.
Role of Institutional Climate on Underrepresented Faculty Perceptions and Decision Making in Use of Work–Family Policies 下载免费PDF全文
The authors examined the institutional challenges that underrepresented minority (URM) faculty perceive in higher education with use of family support workplace policies. Evidence reveals that faculty encounter differences in access to information and explanations of how to use workplace–family statutes. A qualitative study of 58 URM faculty members highlighted five particularly notable themes: (a) faculty perceptions of how the institution views their family caregiving responsibilities, (b) inadequate compensation matters in the utilization of formal policies, (c) informal policies are often inaccessible and invisible, (d) social networks affect the inclusiveness of work–family institutional practices, and (e) fear of being regarded as a “red flag” constrains decisions regarding the use of policies. Given the push in higher education to diversify its faculty ranks, if administrators are to successfully implement diversity, equity, and inclusion and retain URM faculty, institutions need to pay particular attention to how URM faculty experience the academic climate regarding work–family balance. 相似文献
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Charles A. Austin Summer Choudhury Taylor Lincoln Lydia H. Chang Christopher E. Cox Mark A. Weaver Laura C. Hanson Judith E. Nelson Shannon S. Carson 《Journal of pain and symptom management》2018,55(3):946-952
Context
Patients triggering rapid response team (RRT) intervention are at high risk for adverse outcomes. Data on symptom burden of these patients do not currently exist, and current symptom management and communication practices of RRT clinicians are unknown.Objectives
We sought to identify the symptom experience of RRT patients and observe how RRT clinicians communicate with patients and their families.Methods
We conducted a prospective observational study from August to December 2015. Investigators attending RRT events measured frequencies of symptom assessment, communication, and supportive behaviors by RRT clinicians. As the rapid response event concluded, investigators measured patient-reported pain, dyspnea, and anxiety using a numeric rating scale of 0 (none) to 10 (most severe), with uncontrolled symptoms defined as numeric rating scale score of ≥4.Results
We observed a total of 52 RRT events. RRT clinicians assessed for pain during the event in 62% of alert patients, dyspnea in 38%, and anxiety in 21%. Goals of care were discussed during 3% of events and within 24 hours in 13%. For the primary outcome measure, at the RRT event conclusion, 44% of alert patients had uncontrolled pain, 39% had uncontrolled dyspnea, and 35% had uncontrolled anxiety.Conclusion
Hospitalized patients triggering RRT events have a high degree of uncontrolled symptoms that are infrequently assessed and treated. Although these patients experience an acute change in medical status and are at high risk for adverse outcomes, goals-of-care discussions with RRT patients or families are rarely documented in the period after the events. 相似文献109.
近年来,中国经济发展取得长足进步,但在卫生领域还面临诸多挑战。人口老龄化以及不断加重的慢性非传染性疾病负担,是当前中国亟待解决的卫生问题。然而,和世界上大多数国家一样,中国也面临着卫生人力短缺以及分配不均的问题。本文认为,中国卫生人力的发展需要重点关注三个方面:通过技能组合改善医护比;医学教育现代化,尤其是对教学目标及其内容进行改革;研究生教育和继续医学教育的标准化及推广。 相似文献
110.
Who are they and what do they do? Profile of allied health professionals working with people with disabilities in rural and remote New South Wales 下载免费PDF全文