老年病房患者病床安全高度相关因素分析

目的调查老年病房患者病床高度的现状,为有效预防跌倒制订干预措施提供依据。方法固定1天工作日及1天非工作日,在4个固定的时间段对老年病房患者的小腿长度及使用病床的高度进行测量,对测量值进行分析。结果病床高度为60.00~86.50(64.61±4.92)cm,患者小腿的长度为35.61~59.14(42.96±5.12)cm。工作日病床高度与非工作日病床高度差异有统计学意义(P0.01),工作日600~2000患者病床高度低于非工作日病床高度(P0.05)。结论老年病房患者病床高度现状堪忧,医院管理部门应引起重视,加强护士关于病床高度相关知识培训,制订并实施干预措施,有效预防跌倒及跌倒相关伤害的发生。     

‘One of the good guys’: sperm donor masculinity and the falling Danish sperm count discourse

Sperm banks in Denmark produce and export donor semen worldwide. The role of the sperm bank is to provide high-quality, safe semen from desirable donors. However, over the last 20 years, global sperm counts are reported to be falling. Along with these discourses comes the implication that poor fertility is a personal failing, which implies a conflation of ‘fertility’ with ‘potency’. This paper draws on qualitative research with Danish sperm donors to explore how donors construct their identities as donors and as the producers of ‘good sperm’. Accounts of the drive to produce the best sperm possible and the resultant confidence boost are bound up in ideas about masculine potency and potential and bodily performance and set against a backdrop of a moral panic surrounding the apparently declining Danish sperm count.     

Fear of falling among community-dwelling older adults: A scoping review to identify effective evidence-based interventions

Fear of falling presents a significant problem for many older adults by reducing physical function and increasing the risk of future falls. Several different types of interventions have improved fear of falling and a summary of efficacious interventions will help clinicians recommend treatment options. Using the Arksey and O'Malley Framework for scoping reviews, the purpose of this review was to identify efficacious interventions for treating fear of falling among community-dwelling older adults in order to provide a list of potential treatment options for care providers. A total of 45 publications were identified for inclusion in this review.     

Viability study of a personalized and adaptive knowledge-generation telehealthcare system for nephrology (NEFROTEL)

OBJECTIVES: Several important problems in the majority of countries are challenging the centralized and overburdened current model of healthcare. Telehealthcare is presented as a new paradigm that offers high expectations to solve this picture. In this paper we present the major outcomes of the viability study of a novel personalized telehealthcare system for nephrology (NEFROTEL). METHODS: The study evaluates the accuracy and quality of the knowledge generated by two key processing layers, namely, sensor layer and patient physiological image (PPI) layer, in an independent way, thanks to its modular design. The first one was defined by a personalized falling detection monitor, on account of the consequences of falls in chronic renal patients. The second one was analyzed by means of a PPI's prototype based on a urea compartmental pharmacokinetic model. The experimental study of the falling detector monitor has been more extensive than the other because the latter has already been addressed in other works. RESULTS: The outcomes show, firstly, the capability of the PPIs to provide integrated and correlated physiological knowledge adapted to each patient, and secondly, demonstrate the reliability of the impact detection function of the adaptive human movement monitor compliant with the NEFROTEL paradigm. CONCLUSIONS: The study confirms that NEFROTEL is able to provide knowledge concerning a patient in a manner that cannot be accomplished by the ordinary healthcare model at the present time.     

Vasorelaxation to N-oleoylethanolamine in rat isolated arteries: mechanisms of action and modulation via cyclooxygenase activity

Background and purpose:

The endocannabinoid-like molecule N-oleoylethanolamine (OEA) is found in the small intestine and regulates food intake and promotes weight loss. The principal aim of the present study was to evaluate the vascular effects of OEA.

Experimental approach:

Perfused isolated mesenteric arterial beds were pre-contracted with methoxamine or high potassium buffers and concentration-response curves to OEA were constructed. Combinations of inhibitors to block nitric oxide production, sensory nerve activity, cyclooxygenase activity, potassium channels, chloride channels and gap junctions, and a cannabinoid CB₁ receptor antagonist, were used during these experiments. The effects of OEA on caffeine-induced contractions in calcium-free buffer were also assessed. Isolated thoracic aortic rings were used as a comparison.

Key results:

OEA caused concentration-dependent vasorelaxation in rat isolated mesenteric arterial beds and thoracic aortic rings, with a greater maximal response in mesenteric vessels. This relaxation was sensitive to inhibition of sensory nerve activity and endothelial removal in both preparations. The cyclooxygenase inhibitor indomethacin reversed the effects of capsaicin pre-treatment in perfused mesenteric arterial beds and indomethacin alone enhanced vasorelaxation to OEA. The OEA-induced vasorelaxation was inhibited by a CB₁ receptor antagonist only in aortic rings. In mesenteric arteries, OEA suppressed caffeine-induced contractions in calcium-free buffer.

Conclusions and implications:

The vasorelaxant effects of OEA are partly dependent on sensory nerve activity and a functional endothelium in the vasculature. In addition, vasorelaxation to OEA is enhanced following cyclooxygenase inhibition. OEA may also interfere with the release of intracellular calcium in arterial preparations.This article is part of a themed issue on Cannabinoids. To view the editorial for this themed issue visit http://dx.doi.org/10.1111/j.1476-5381.2010.00831.x     

Gait analysis in demented subjects: Interests and perspectives

Gait disorders are more prevalent in dementia than in normal aging and are related to the severity of cognitive decline. Dementia-related gait changes (DRGC) mainly include decrease in walking speed provoked by a decrease in stride length and an increase in support phase. More recently, dual-task related changes in gait were found in Alzheimer's disease (AD) and non-Alzheimer dementia, even at an early stage. An increase in stride-to-stride variability while usual walking and dual-tasking has been shown to be more specific and sensitive than any change in mean value in subjects with dementia. Those data show that DRGC are not only associated to motor disorders but also to problem with central processing of information and highlight that dysfunction of temporal and frontal lobe may in part explain gait impairment among demented subjects. Gait assessment, and more particularly dual-task analysis, is therefore crucial in early diagnosis of dementia and/or related syndromes in the elderly. Moreover, dual-task disturbances could be a specific marker of falling at a pre-dementia stage.     

Investigation of Mechanical and Hydrologic Characteristics of Porous Asphalt Pavement with a Geocell Composite

Porous asphalt pavement is a part of the permeable pavement system, which can be used to mitigate the negative impacts of urbanisation on the water hydrological cycle and environment. This study aims to assess the mechanical and hydrologic characteristics of porous asphalt pavements, with and without geocell composites, using a plate load test, falling weight deflectometer test, and rainfall simulation test. The corresponding results indicate that the elastic modulus of the unreinforced pavement is lower than that of the reinforced pavement. The analysis demonstrates that the use of geocell composites effectively increases the load-bearing capacity of the pavement. When the base layer is reinforced with geocells, its load-bearing capacity increases. Observation of the rainfall simulation tests on the reinforced pavement indicates that the reinforced pavement effectively handles the surface runoff.     

病情及服药记录卡在家庭病床患者中应用的效果评价

目的 探讨病情及服药记录卡在家庭病床患者中的应用效果.方法 将126例家庭病床患者随机分为观察组和对照组各63例.对照组采用传统口头健康教育和服药指导;观察组由护士向每位患者发放病情及服药记录卡,指导实施方法 .用自行设计的调查表分别于患者住院时和住院后6个月调查患者自我保健知识掌握情况、医生和患者陪护对护理工作满意度及患者服药依从性.结果 观察组患者在使用病情及服药记录卡后患者自我保健知识掌握情况和医生及患者陪护满意度以及服药依从性方面明显高于对照组.结论 患者通过使用病情及服药记录卡,可有效改善其掌握自我保健知识,提高医生和患者陪护满意度及患者服药依从性.     

Regulating hospital use: length of stay, beds and whiteboards

This paper presents part of a larger study of contemporary nursing practice and the rationalisation of hospital length of stay. Informed by Michel Foucault's work on governmentality, length of hospital stay and the re-engineering of surgical services are examined, not in terms of numerical representations of hospital use, but as part of social and political processes through which certain concepts are made susceptible to measurement and practices are organised. Using data generated through fieldwork in a hospital surgical division this analysis offers understandings of how social practices around length of hospital stay are translated and how they pattern contemporary hospital nursing practice. Nursing practice is explored through the reconstitution of hospital beds and the demands of local administration of hospital length of stay.