Linguistic entrapment: medico-nursing biographies as fictions

This paper argues that in their trainings health professionals are encouraged to use language naively as if it were a transparent medium of scientific communication We contend that language use, particularly in the field of mental health care, should be studied in terms of its social functions and attention should be paid to the inevitably constructive nature of language in patients'records, in order that a'fictional distance'opens up between patients and their records Recent developments in literary theory and narrative analysis can be deployed as theoretical frameworks to understand this process, and we suggest that more attention to the use of language should be included in the educational programmes for health care professionals to counteract the risk of'linguistic entrapment'or'incarceration'     

The rationale for the use of risk calculators in pressure sore prevention, and the evidence of the reliability and validity of published scales

Recent studies have shown an increase in pressure sore prevalence rates However, methodological inconsistencies and demographic considerations, which include an ageing population, make it difficult to interpret and compare results A multiplicity of intrinsic and extrinsic factors are thought to be associated with increased risk The development of risk calculators which incorporate these factors has been an attempt to identify which subjects are most at risk so that equipment and nursing interventions can be allocated appropriately Since the 1960s there has been a proliferation of risk assessment scales which have not been subjected to rigorous scrutiny of then- reliability and validity, and this is held to represent a failure of nursing research Recent evidence suggests that if critical cut-off points for'at-nsk'vs'no risk'are adjusted for particular patient populations the validity of existing scales can be improved Missing from the literature are research reports of studies earned out in the community As a result of demographic changes and community care policies, more'at-nsk'patients are likely to be nursed at home Future research needs to include community studies, and a more systematic approach in general, to the study of the predictive value of existing scales     

Paediatric day surgery: day-case unit admission compared with general paediatric ward admission

A small exploratory study ( n = 20) is described which compares the experience of children admitted to a day-case unit with that of children admitted to a general paediatric ward. Both samples received inadequate amounts of information, particularly prior to discharge. The care offered in the day-case unit was found to be woefully deficient in many areas and the wisdom of utilizing occasional sessions in an adult day-case unit is questioned. The crucial role of skilled nurses trained in the care of sick children is emphasized.     

Preparing for Trust status–an investigation into the morale of nurses undergoing change

The morale of nurses is a phenomenon often open to public comment without substantiated evidence. This study objectively explored the morale of nurses in a large district general hospital preparing for transition to National Health (NHS) Trust status. Information was sought using a 72-item questionnaire. The investigation was firmly centred around a structured theory which construes morale in terms of nine dimensions. The notion of morale being a construct synthesized of nine dimensions adds to the uniqueness of the study. Other studies fail to differentiate between the dynamic morale construct and the more complacent attitudes of job satisfaction.     

Collegiality, adaptation and nursing faculty

Many nurse educators in the United Kingdom are currently faced with the challenge of change, of leaving the culture of the British National Health Service and integrating into the culture of tertiary education This paper reports on a study of the process of developing collegial relationships in the context of a new collaboration to develop a combined curriculum for nurses within a tertiary institution The aims of the study were to analyse this process of integration and to identify the conditions that enhanced the development of collegiality between members of the nursing group The case study centred on the analysis of data collected on video during unstructured interviews with the five members of the group Data were analysed using Burnard's method of thematic content analysis The paper argues that during the transition from the National Health Service to tertiary education, individual nurse educators and their managers must address problems related to issues such as 'ingroupism', nursing the students, perceived difference between nurse academics and other academics, and expectations of power-relationships     

长效甾体避孕药RP-HPLC流动相选择性优化与定量分析

采用极角混合设计技术,模拟溶质色谱保留行为的数学模型,用预测优化流动相实验,对溶质色谱保留行为的数学模型进行修正。通过数次预测、迭代、修正数学模型,提高模型的拟合精度,采用多目标优化指标,计算机辅助,寻求三元流动相的最佳组成。首次利用可编程序紫外检测器的时间程序检测功能,提高微量组分的检测灵敏度,成功地解决了两种长效避孕药制剂的定量分析。     

An anatomic evaluation of T-Fix suture device placement for arthroscopic all-inside meniscal repair.

This investigation documented the locations of endoscopically applied T-Fix suture devices (Acufex Microsurgical, Mansfield, MA) placed in six fresh-frozen cadaveric knees (age, 60 to 72 years) in relationship to the joint capsule, and adjacent neurovascular and musculotendinous structures. Five T-Fix devices were placed in the posterior meniscal regions at approximately 20 degree intervals. Gross dissection enabled T-Fix bar and suture placement identification. Fifty total devices were placed (23 medially and 27 laterally). Lateral: None of the devices penetrated more superficially than the deepest capsular layer (layer III). Six of the 27 devices placed at the posterior horn of the lateral meniscus pierced the popliteus tendon. None of the bars pierced the lateral collateral ligament (layer III). All devices placed at the posterolateral knee were outside the arcuate ligament (layer III) but inside the fabellofibular ligament (layer II). Medial: Seven of the 23 devices pierced the deep medial collateral ligament (MCL, layer III), and 4 pierced the superficial MCL (layer II). Three devices pierced the sartorius tendon (layer I) and one pierced the gracilis tendon (layer II). None of the medial devices created a plicating effect on the posterior capsule. None of the devices were placed near neurovascular structures. Devices placed within the posterior meniscal horns had a > or =1.5-cm buffer zone from the popliteal neurovascular bundle. Most bars (36 of 50) were anchored to the capsular layer (layer III) after piercing the meniscocapsular junction (layer II). T-Fix devices simulating arthroscopic all-inside meniscal repair provided well-positioned, solid suture anchorage through the junction with no neurovascular involvement. Care needs to be taken when placing lateral (popliteus muscle) and medial (gracilis, sartorius tendons and superficial MCL) devices to avoid possible soft tissue tenodesis.     

Survey of carer satisfaction with the quality of care delivered to in-patients suffering from dementia

Quality assurance in British National Health Service provision stresses the importance of taking account of the consumer's viewpoint Elderly patients with dementia are not always able to contribute usefully to satisfaction surveys Therefore, their carers' views were sought in order to assess the quality of services offered to this client group Forty-one carers of patients discharged from the eight wards for the elderly mentally ill in Leicestershire, England, were randomly selected Individual focused interviews were conducted in carers' own homes Both quantitative and qualitative data were obtained by use of a questionnaire designed to tap the patients'/carers' experiences from preadmission, through hospital stay to post-discharge Interviewees were asked to describe their favourable/unfavourable impressions of, and reactions to, all aspects of hospital care These interviews were tape-recorded Analysis of the data included quantitative measurements of scale ratings Grounded theory was used to analyse qualitative data A wealth of information was uncovered using this research technique Much that was positive about the service was elicited However, carers highlighted areas where they felt the quality of care could be improved within all the foci discussed Twenty-two recommendations for quality improvements in service provision were made in the report as a result of this survey