The community mental health nurse: a new professional role

This review of recent literature explores the similarities and differences between the work of community psychiatric nurses and their mental handicap counterparts. The comparisons which have been made between groups of nurses are related to the authors own research studies. These included an observations study of one community mental handicap nursing team and a national survey of all such teams in England and Wales. The importance of trade union membership, the place of the Community Psychiatric Nursing Association and the implication of joint training courses are discussed. The emergence of a new professional role that of the 'community mental health nurse' is discussed and the implications which this might have for the future organization of community psychiatric nursing services is outlined.     

Sense of coherence among elderly somatic patients: predictive power regarding future needs of care

The main aim was to study the predictive power of sense of coherence regarding future needs of care among elderly patients evaluated as medically ready for discharge from somatic emergency care. A secondary aim was to study the consistency of sense of coherence over time among patients with this kind of experience. The sample consisted of 53 Swedish patients (mean age 82.8 years, SD = 6.6 years) who had completed their medical treatment at surgical or orthopaedic departments. The predominant diagnosis was lower limb fractures. Sense of coherence was assessed twice, on the day the patient was evaluated as medically ready for discharge and 1 month later. On the second assessment occasion, 28 patients had returned to their homes, 17 were staying at institutions, and eight had died. Patients who returned to their homes reported the strongest sense of coherence while still in hospital. Patients who were staying at institutions scored lowest on the overall sense of coherence scale and on the comprehensibility subscale. Patients who died before the second measurement occasion scored lowest on the meaningfulness subscale. A correlation of 0.51 was noted between the two assessments of sense of coherence, indicating a moderate temporal consistency.     

Causes, management and morbidity of acute hypoglycaemia in adults requiring hospital admission

In the community, acute hypoglycaemia is commonly caused by therapies for diabetes mellitus or the excessive consumption of alcohol. Although most episodes do not require admission to hospital, little information is available on the causes and outcome of those that do. We retrospectively surveyed adult patients admitted to a large urban teaching hospital with acute hypoglycaemia in a 12-month period, identifying 56 admissions of 51 patients. Forty-one had diabetes mellitus, 33 (80%) of whom were receiving treatment with insulin. The others had hypoglycaemia induced by excessive consumption of alcohol or by deliberate self-poisoning with insulin. A history of psychiatric illness and/or chronic alcoholism was common. Neurological manifestations of hypoglycaemia were the principal reason for admission, observed on 50 occasions (89%), and 11 events (20%) had precipitated convulsions. Although many patients (59%) had received treatment for hypoglycaemia before admission, hypoglycaemia recurred in 16% of patients in hospital. Four patients (7%) died following admission, but in only one case was this the direct result of hypoglycaemia. However, within 15 months of the index hypoglycaemia event, a further six patients (11%) had died, mostly of causes unrelated to hypoglycaemia. Patients who require hospital admission for treatment of hypoglycaemia have a high incidence of neurological manifestations, a high rate of mental illness and other medical disorders, and may represent a high-risk subgroup with a poor long-term prognosis.      

基于光电传感器的多段脉搏波传播速度检测系统的研制

采用了一种以反射式和透射式红外光光电传感器和单片机为基础,用同步检测心电信号、桡动脉脉搏波、手指脉搏波信号来测定桡动脉和外周动脉脉搏波传播速度的方法,研制一种无创的多段脉搏波传播速度检测系统。在软件编程中脉搏波周期信号的识别是以心电R波峰值为基准,同时再根据它们之间的时延关系进一步确定脉搏波的波峰与波谷的范围,提高检测准确性及精度。该系统通过检测心电、桡动脉脉搏波和手指脉搏波信号可获得多段脉搏波传播速度参数,具有较高的检测精度和良好的应用前景。     

Publication misrepresentation among otolaryngology residency applicants

Objective

To assess the extent of research publication misrepresentation among otolaryngology residency applicants and to determine applicant attributes associated with misrepresentation.

Study Design

Prospective study.

Setting

A single otolaryngology residency program.

Subjects and Methods

Electronic Residency Application Service (ERAS) applications to the incoming 2010 class of an otolaryngology residency program were reviewed for peer-reviewed journal publications reported as “provisionally accepted,” “accepted,” or “in print.” Publications were verified by searching PubMed, Google Scholar, and electronic journals. Applicants with remaining unverified publications were e-mailed before announcing interviews. Erroneously reported or unverifiable publications were considered misrepresented.

Results

There were 432 publications reported by 173 of 325 applicants (53.2%). Twenty-two publications (5.1%) were misrepresented by 17 applicants (9.8%). Contacting applicants verified 26 publications and identified 10 errors. Seven publications were inappropriately reported as provisionally accepted, three articles were not peer-reviewed, and applicants were erroneously listed as first author on two publications. Ten publications remained unverifiable. Multivariate logistic regression models showed that being an international medical graduate (P = 0.002) and male gender (P = 0.040) were predictors of misrepresentation after adjusting for potential confounders. Among international medical graduates alone, no attributes were associated with misrepresentation. All U.S. applicants with misrepresented publications were male (P = 0.033) and were from a medical school not ranked in the top 50 by U.S. News & World Report for research (P = 0.002) or primary care (P = 0.018).

Conclusion

Misrepresentation of research experience exists among otolaryngology residency applicants. ERAS should develop standardized definitions for publication statuses to help reduce inadvertent misrepresentation.