Nursing as a lesbian

Minority status within any larger group is often difficult. Lesbian nurses face a dilemma of choice—whether or not to come out of the closet to their colleagues and patients. This essay describes the professional reflections of one lesbian nurse.     

70岁以上离休干部卫生保健的相关性调查

目的了解70岁以上离休干部生活质量及其影响因素,为制订相应的卫生保健措施提供科学依据。方法采用问卷调查和体格检查相结合的方法,对济南部队3所干休所109名70岁以上离休干部进行调查。数据用STATA7.0软件包分析。结果本次调查表明,本组70岁以上离休干部生活质量良、中、差分别占21.10%、60.55%、18.35%。在调查的19种因素中,主要影响因素顺次为:生活习惯、健康状况、体检状况、日常生活功能、年龄、独居或与家人同住、生活满意度、社会交往、心理健康、婚姻、家庭和睦情况。结论70岁以上离休干部的生活质量较差,应针对其影响因素制定相应的医疗保健措施,提高离休老年人的生活质量和健康水平。     

儿科重症监护病房中影响机械通气成功的相关因素

目的 探讨儿科重症监护病房(PICU)中影响机械通气成功的相关因素。方法 将lll例行机械通气的危重病儿分成治疗成功组与失败组，对其相关因素进行回顾性分析。结果两组患儿在上机前危重病例评分、是否伴有心跳呼吸骤停和(或)休克及并发多系统器官功能衰竭(MODS)等方面差异有权显著意义(P＜0．001)；超过48h的机械通气患儿是否继发呼吸机相关肺炎(VAP)亦有显著意义(P＜0.05)。结论 PICU中影响机械通气成功率的因素主要是原发病的性质及严重程度，并与MODS与VAP有密切关系。     

反复流产患者的中医护理对策

目的 :探讨结合现代护理观为指导的具有中医特色的整体护理模式。方法 :运用中医基础理论知识 ,针对引起反复流产患者的病因 ,将患者主要分为内分泌异常型、免疫异常型、生殖道异常型、感染型、全身性疾病影响型、染色体异常型施以护理。结果 :依据不同证型 ,有的放矢的实施护理 ,使患者明确了引起反复流产的根本原因、治疗措施、注意事项、预防保健方法 ,消除了紧张、恐惧、焦虑等心理障碍 ,树立了再次妊娠的信心 ,提高了妊娠成功率     

论医院药学服务的多学科支撑性及其有效开展

目的 :促进我国医院药学服务工作的有效开展。方法 :对与药学服务密切相关的各学科分别加以分析。结果与结论 :多学科支撑性是医院药学服务的基本特性 ,这一性质决定了医院药学服务的有效开展需要多种技术人才的通力协作。     

三十年子癎的变化趋势

目的探讨30年来我院子的变化特点. 方法回顾性分析1971～2000年期间发生的98例子病例. 结果子的发生率由70年代0.3%降至90年代0.1%(P<0.01),产前子占子总数的比率由70年代52.1%降至90年代26.3%(P<0.05),产后子由70年代20.8% 升至90年代47.4%(P<0.05).围产儿死亡率由70年代203.7‰下降至90年代100.0‰. 三个年代子所致孕产妇的死亡占同期子的比率依次为4.2%、6.5%、5.3%(P>0.05 ). 结论 30年来子的发生率明显下降,子类型构成比发生明显变化 ,产前子减少,产后子相对增多,子患者的围产儿死亡率逐渐下降,子致孕产妇死亡率未降低.     

Quality of care in institutionalized deliveries: the paradox of the Dominican Republic.

OBJECTIVES: To better understand the paradox in the Dominican Republic of a relatively high maternal mortality ratio despite nearly universal institutionalized deliveries with trained attendants, a rapid assessment using an adaptation of the strategic assessment method was conducted. METHODS: A multi-disciplinary team reviewed national statistics and hospital records, inventoried facilities, and observed peripartum client-provider interactions at 14 facilities. RESULTS: The major referral hospitals, where more than 40% of births in the country occur, were overcrowded and understaffed, with inexperienced residents overseeing care provided by medical students, interns and nurses. Uncomplicated labor and deliveries were overmedicalized, while complicated ones were not managed appropriately; emergencies were not dealt with in a timely fashion. In the peripheral hospitals physicians were seldom present and clients were either turned away or delivered by unprepared nursing staff. Providers in the busiest facilities suffered from compassion fatigue, and were demoralized and overworked. In all facilities, quality of care was lacking and the delivery and birthing process was dehumanized. CONCLUSIONS: Access and availability of institutional delivery alone is not enough to decrease MMR, it is also the quality of emergency obstetric care that saves lives.     

Infection control and paediatric tuberculosis: A practical guide for the practicing paediatrician

Tuberculosis (TB) in children requires close attention to infection control to prevent transmission to other patients and health care workers. Although many children with TB are not infectious, appropriate airborne precautions must be maintained until conditions that increase the risk of transmission have been ruled out and accompanying adults, who may also be infectious, have been screened. Concurrent strategies to prevent TB transmission should be implemented, including administrative, engineering and personal protective measures. The most important measure is maintaining a high clinical index of suspicion for TB in patients with compatible symptoms and epidemiological risk factors. Comprehensive tuberculin skin test programmes and the use of N 95 masks can reduce the risk of transmission within health care settings. Current standards of practice should be followed to prevent transmission from patients with active TB disease.     

The clinical physiology of aging

International Urology and Nephrology -     

急性颅高压心脏停搏类型的临床分析

目的　探讨急性颅高压患者心脏停搏类型。方法　对 2 5例急性颅高压患者进行 2 4 h连续心电监护 ,选择心肺复苏术前 5～ 30 s心电描记波形为心脏停搏类型。结果　 13例急性颅脑损伤患者有 12例表现为缓慢性心律失常—心室停顿。1例为心室颤动 ,12例急性脑中风患者有 11例表现为缓慢性心律失常—心室停顿。1例为电机械分离。结论　缓慢性心律失常—心室停顿是急性颅高压患者心脏停搏的最主要类型