创伤相关的特殊类型感染的预防、诊断及治疗

复苏水平的进步已大大提高了烧伤患者的幸存者数目,烧伤休克死亡已较为罕见。21世纪,对烧伤创面的妥善处理很大程度上可使烧伤患者迅速恢复良好的功能。     

Endogenous and exogenous research? Findings from a bibliometric study of UK nursing research

AIMS OF THE STUDY: This paper uses the findings of a recent bibliometric analysis of published UK nursing research to ask whether the field is characterized by a fundamental split between two underlying areas of research interest. These can be termed 'endogenous' and 'exogenous'. The former term describes research which tends to be concerned with problems and issues to do with nursing as a profession; the latter is concerned with problems and issues centring around the nursing of patients. DESIGN/METHODS: Papers in the Wellcome Trust's Research Outputs Database (ROD), a database of UK biomedical research, were analysed. Nursing papers published between 1988 and 1995 numbered 1,845, just less than 1% of the total papers in the ROD. RESULTS/FINDINGS: Analysis of the subfield identified that nursing research was atypical of biomedical research as a whole in a number of ways. One difference was that usually in biomedical research there is a general correlation between numbers of funders acknowledged on a paper, numbers of authors, and esteem of the journal in which a paper appears. In nursing there was, if anything, a tendency for highly esteemed papers to have fewer authors and be less likely to have acknowledged funding. However, the apparently endogenous and exogenous papers have quite different characteristics. This paper explores this apparent difference and possible reasons for this difference and will briefly compare nursing research with some other newly emerging social and academic groups. CONCLUSIONS: Thinking of nursing research outputs in this way can provide insight into the existence of different reward systems influencing nurse researchers. However, it is impossible to draw too confident a differentiation without reading each individual paper and making judgements about whether they are 'endogenous' or 'exogenous', a practice generally beyond the scope of bibliometric practice.     

Skills competency in nurse education: nurse managers'' perceptions of diploma level preparation

This paper reports on part of a national study conducted between 1994 and 1996, the overall aim of which was to examine the 'fitness for purpose' of the Project 2000 nursing education reforms. The study used multiple methods of data collection, including an individual and group interview study of nurse managers (n = 132) and a national survey of Project 2000 diplomates and traditionally prepared registered nurses (n = 5417). Findings in relation to the managers' expectations and experiences of diplomates are presented. This includes views on the level of skills achievement and skills acquisition of diploma level education. The qualities of the diplomates are discussed and this includes those areas where the skills of the diplomates are felt to achieve what is required of the role. Also included is an exploration of those skills which the managers felt fell short of expectations. Managers raised the long-standing concerns of clinical skills and competencies and discussed these in relation to the changing health care environment and the relative roles of other health care workers. The conclusions highlight the need to identify what could be seen as the 'core skills' required of a registered nurse and the need to explore the environment in which the diplomate takes up first appointment.     

Project 2000 students' perceptions of their training

This paper reports on the findings of a study conducted into the perceptions of final year Project 2000 pre-registration students towards their pre-registration education programme The aim of the research was to discover how students perceive their training in terms of value, relevance, intellectual potency, teaching methods and organization Data were collected using the Hoste scale which has been developed for the evaluation of educational courses A convenience sample of students (n = 131) within one college of nursing were invited to participate Findings include a particularly high level of satisfaction with Project 2000 in terms of value, breadth and relevance Organization and liveliness of the course were perceived much less satisfactorily There was a trend for a statistically significant difference between the mean scores of the theoretical and practical components of the course The findings are discussed with particular reference to the perceptions of theory and practice within the educational programme     

Conceptualizing advanced nursing practice: curriculum issues to consider in the educational preparation of advanced practice nurses in the UK

The findings from a Florence Nightingale Scholarship to the USA and Canada, investigating the educational preparation of advanced practice nurses, are reported. The author considers a number of issues facing curriculum designers who might wish to develop clinically based advanced practice nurse programmes in the UK. Utilizing the experiential nature of personal visits, along with the available literature, the strategy adopted by some American and Canadian universities is highlighted to exemplify curriculum issues likely to be encountered in the UK. A definition of advanced nursing practice is provided as a foundation for discussion on curricular construction. This is followed by a discussion on advanced role nomenclature and components and characteristics of the 'nurse practitioner', 'clinical nurse specialist', 'nurse consultant' and 'nurse clinician', in order to clarify terminology and disentangle different advanced practice roles. The issues examined include the academic level of advanced practice nurse programmes; the determination of curricular content based on both a 'generalist' and 'specialist' model of practice; factors considered when exploring advanced practice competencies; and the resource implications for delivering opposing curriculum models. The paper suggests that there is a unique opportunity for advanced practice nursing to establish a key collaborative relationship in the delivery of health care, based on a nursing model, graduate study and the integration of key nursing and related concepts into clinical practice.     

Hours worked and patient visits provided by dentists in Australia

Background

The aim was to examine the numbers of hours worked and patient visits provided by age and gender of dentists in Australia, and compare with previous estimates to describe trends.

Methods

Data were collected from a random sample (N = 2961) of Australian dentists. Private sector dentists working in clinical practise were included in the analysis.

Results

The response rate was 49% (N = 1345 dentists). Hours per year worked and number of patient visits per year were lower for dentists aged 65 years and older compared with younger dentists, and were higher for male compared with female dentists aged 35–45 to 55–64 years. Hours per year worked were lower in 2013–2014 than reported in 2009–2010, but the number of patient visits in 2013–2014 was similar to the previously reported estimate from 2009–2010.

Conclusions

Hours worked and visits provided were only lower among older dentists aged 65 years or more. Male dentists tend to work more hours per year and provide more patient visits per year than female dentists. Over the last decade, Australian dentists maintained a stable output of visits per year despite a trend towards fewer hours worked per year.     

Dental insurance,service use and health outcomes in Australia: a systematic review

Private health insurance plays a key role in financing dental care in Australia. Having private dental insurance has been associated with higher levels of access to dental care, visiting for a check‐up and receiving a favourable pattern of services. Associations with better oral health have also been reported. In the absence of any existing review, this paper aims to systematically review the relationship between dental insurance and dental service use and/or oral health outcomes in Australia. A systematic search of online databases and subsequent sifting resulted in 36 publications, 33 of which were cross sectional and three cohort analyses. Dental service outcomes were more commonly reported than oral health outcomes. There was considerable heterogeneity in the outcome measures reported, for both service use and health outcomes. Overall, the majority of the evidence was from cross sectional studies and few studies reported analyses adjusted for confounding factors. The consolidated evidence points towards a positive association between dental insurance and dental visiting. Dentally insured adults are likely to have more regular access to dental care and have a more favourable pattern of service use than the uninsured. However, evidence of associations between dental insurance and oral health are mixed.