An action research investigation into the feasibility of experienced registered sick children's nurses (RSCNs) becoming children's emergency nurse practitioners (ENPs)

• ? Emergency nurse practitioners (ENPs) formally developed in accident and emergency (A & E) departments as a direct response to waiting times for the walking wounded, the need to reduce junior doctors hours and changes in nursing practice.
• ? ENPs existed informally for many years in minor injuries units and specialist ophthalmic departments.
• ? This study aimed to examine whether or not the role of ENP could be applied to the specialist service of a paediatric casualty department.
• ? The results showed that 3% of patients could be seen and treated to conclusion by a children's ENP, and some patients could have their care accelerated by a children's ENP.
• ? The introduction of children's ENPs would have an impact on waiting times, junior doctors work-load and the quality of patient care.

     

Developing a worker role: Stories of four people with mental illness

Background and Aims:  Work plays an important role in adults' well-being, irrespective of health status. Vocational rehabilitation can enable people with mental illness to return to open employment. A narrative approach was used to explore how individuals with a mental illness made sense of their work-related experiences.
Methods and Results:  Four Clubhouse members in open employment for at least 6 months completed in-depth, semistructured interviews, from which narratives were created to reveal events, significant persons and actions that assisted these individuals to resume work. Woven into the participants' stories were four 'impelling forces' contributing to a sense-of-self as a worker. These impelling forces were: support from significant others, the personal meaning of work, experiences within the Clubhouse programme, and the ongoing struggle with illness. Implications for occupational therapy practice are discussed.
Conclusion:  The findings of this study urge occupational therapists and others to provide opportunities to provide on-going support to people with a mental illness who seek paid employment.     

“军卫一号”用户管理的安全漏洞与解决模型

本文分析了“军卫一号”内部网用户管理系统在运行过程中所遇到的网络安全问题，提出了一种全新的“程序代理角色”模型。实践证明，该方法行之有效，在一定程度上可以适应医院管理系统的安全策略。     

Two-stage versus one-stage sex reassignment surgery in female-to-male transsexual individuals

The objective was to compare the outcome of a combined total hysterectomy-vaginectomy-phalloplasty procedure vs. a vaginectomy-phalloplasty procedure in female-to-male (FTM) gender dysphoric individuals, and to report on a large series of vaginectomies in young women. This was a retrospective study and the setting was the Gender Team at Ghent University Hospital. One hundred and five consecutive cases of vaginectomy-phalloplasty with (one-stage) or without (two-stage) total hysterectomy between 1993 and 2003 were included in the study. Patient files of 69 one-stage and of 36 two-stage procedures were reviewed and analysed. Operation time, the need for transfusions, complications, repeated surgery and hospitalisation time were the main outcome measures. Patients were equally distributed over the study period of 10 years. Comparing the two groups, there was a greater need for transfusion in the group of patients undergoing the one-stage procedure. There was no difference in operation time, rate of major complications or hospitalisation time. One-stage sex reassignment surgery (SRS) in FTM transsexual individuals is associated with more blood loss. However, there is no difference in operative and postoperative complications. Vaginectomy seems to be a safe and relatively simple procedure in FTM transsexual patients.     

基于分级角色的访问控制

结合RBAC模型,提出了一种基于分级角色的访问控制模型,将系统用户依据职能的不同分为不同的角色,同一类角色又划分不同的等级。定义了基本概念和等级-角色矩阵,进行了形式化的描述,并应用在实际系统中。每一个实际用户通过不同等级的角色,对应于不同访问权限的资源,并可动态地进行角色转换和等级变迁,从而使访问控制机制更为灵活。     

课堂多媒体教学中教师角色定位的探讨

课堂多媒体教学已经成为各级各类学校重要的教学组织形式。在多媒体教学中如何定位教师的角色是一个值得探讨的问题,文章分析了教师在多媒体课堂教学中主要扮演的五种角色的职责和要求。     

不同性别不同年龄成年人体成分测量指标的检测分析

目的探讨安徽省不同性别、不同年龄成年人体成分检测指标的差异,为安徽省成年人的健康指导及慢性疾病预防提供数据参考。方法选取2018年1～12月在安徽医科大学第一附属医院体检的4 944位体检者,按性别不同分为男性组2 556人和女性组2 388人;再对不同性别组按不同年龄(y)分为5组[18≤y <30岁组; 30≤y <40岁组; 40≤y <50岁组; 50≤y <60岁组;y≥60岁组(在男性中为60≤y≤83岁组,在女性中为60≤y≤81岁组)];比较男性组和女性组体成分测量指标(体质指数、体脂肪含量、体脂百分比、腰臀比、内脏脂肪面积、去脂体质量、骨骼肌肉量、骨矿物质含量、蛋白质含量及浮肿指数)差异,同时分析不同性别人群上述各项体成分测量指标在不同年龄层的变化。结果①女性组体脂肪含量、体脂百分比及浮肿指数均高于男性组,其余各项指标男性组均高于女性组,差异均有统计学意义(P <0. 05);②男性体质指数、体脂肪含量和腰臀比在30≤y <60岁各年龄组均高于18≤y <30岁组,差异有统计学意义(P <0. 05);体脂百分比、内脏脂肪面积和浮肿指数在y≥30岁各年龄组均高于18≤y <30岁组,差异有统计学意义(P <0. 05);去脂体质量、骨骼肌肉量、骨矿物质含量及蛋白质含量在y≥50岁各年龄组均低于18≤y <30岁组,差异有统计学意义(P <0. 05)。女性体质指数、腰臀比及内脏脂肪面积在y≥30岁各年龄组均高于18≤y <30岁组,差异有统计学意义(P <0. 05);体脂肪含量、体脂百分比及浮肿指数在y≥40岁各年龄组均高于18≤y <30岁组,差异有统计学意义(P <0. 05);去脂体质量、骨骼肌肉量、骨矿物质含量及蛋白质含量在y≥60岁组均低于18≤y <30岁组,差异有统计学意义(P <0. 05)。结论安徽省成年人体成分存在性别差异,女性体脂肪含量高于男性,男性内脏脂肪面积及骨骼肌肉量高于女性;成年人体成分在不同年龄间亦存在差异,脂肪组织含量及浮肿指数在高年龄段增加,而其他非脂肪组织含量在高年龄段减低。     

医院健康科普教育对癌症防治的作用及探讨

健康科普教育对癌症防治具有重要的意义,可以改进生活方式,预防癌症发生;减少医疗费用,减轻就医负担;促使患者积极配合治疗;推动癌症医学研究的进步.中国医学科学院肿瘤医院以满足群众的需求为中心,不断丰富健康科普教育活动的内容和形式,取得了较好效果.但仍有很多需要改进的地方:提高科普教育人员的整体素质;创新健康科普教育的内容和形式;加强与媒体沟通合作.     

先验约束水平集方法提取乳腺超声病灶

超声图像自动分割技术具有重要的应用价值,同时面临很大挑战。本文针对乳腺超声图像局部分割需求。通过区域生长法自动快速提取初始分割区域作为水平集的初始条件,实现先验区域约束的作用,显著提高分割准确度;基于CV模型进行全局信息和区域信息的拟合,提高了弱边界的定位准确度;增加速度能量项,使零水平集更快地收敛在边界处;对经典水平集模型的一些能量项进行删减调整,以降低计算复杂度。分割实验结果表明,本文方法能够较为准确快速地实现病灶分割,有一定的临床辅助价值。