基于Snell模型制定公立医院人才管理战略

公立医院传统的人事管理模式已愈来愈不适应医院发展的需要,创新已经成为管理者的共识.首先分析了目前我国公立医院人事管理中存在的问题,然后应用Snell模型对公立医院人力资源结构进行分类,提出公立医院人才管理战略.     

Evaluation of Border Entry Screening for Infectious Diseases in Humans

In response to the severe acute respiratory syndrome (SARS) pandemic of 2003 and the influenza pandemic of 2009, many countries instituted border measures as a means of stopping or slowing the spread of disease. The measures, usually consisting of a combination of border entry/exit screening, quarantine, isolation, and communications, were resource intensive, and modeling and observational studies indicate that border screening is not effective at detecting infectious persons. Moreover, border screening has high opportunity costs, financially and in terms of the use of scarce public health staff resources during a time of high need. We discuss the border-screening experiences with SARS and influenza and propose an approach to decision-making for future pandemics. We conclude that outbreak-associated communications for travelers at border entry points, together with effective communication with clinicians and more effective disease control measures in the community, may be a more effective approach to the international control of communicable diseases.     

Flemish high school students' everyday use of communication technologies for schoolwork-related communication

By combining network data from a third grade in a Flemish high school (14–15-year olds, N = 147) with interview data obtained from eighteen of the pupils, more insight is provided into high school students' everyday use of communication technologies (CT) for school-related communication. The study departs from an “affordances of technology” perspective, taking both technological characteristics of CT and social context factors into account for explaining CT use. Each technology provided a specific combination of affordances: SMS afforded information acquirement, and served as a communication hub; instant messaging afforded information acquirement, discussing groupwork and exchanging documents and E-mail afforded exchanging documents and discussing groupwork. The telephone was not frequently used for communication about school. The findings could not be explained by solely looking at technological characteristics: they needed to be interpreted (1) in the context of teens' overall use of CT and (2) by taking social context factors into account.     

Theorizing About Social Support and Health Communication in a Prostate Cancer Support Group

This article inquires into whether and how uncertainty reduction theory and problematic integration theory, two theories relevant to social support as enacted within a chapter of the Man-to-Man prostate cancer support group, inform us of how such groups can assist group members most effectively. Interview data from members of a prostate cancer support group shed light on theoretical assumptions about uncertainty. Although the group applies elements of both theories, prostate cancer survivors likely would benefit from a more comprehensive and flexible treatment of social support theory.     

抢救心得交流在提高ICU护士急救能力中的应用

目的探讨抢救心得交流在提高ICU护士急救能力中的应用效果。方法根据ICU工作年限和工作能力进行分层管理,不同层次明确抢救心得的交流次数,确定交流范围和内容,由N3级及以上护士进行分析、点评、指导,护士长点评总结,择优进行表彰学习。结果护士应急理论、急救技能操作考核合格率及医生对护士抢救配合的满意度均提高(P0.01)。结论抢救心得交流能激发护士学习的主观能动性,提高ICU护士的急救能力。     

Ultrasound Bone Fracture Sensing and Data Communication: Experimental Results in a Pig Limb Sample

Approximately 6.3 million fractures occur each year in the United States alone. Accurately monitoring the progression of fracture healing is essential to be able to advise patients when it is safe to return to normal activity. The most common method used to confirm and monitor fracture healing is the acquisition of multiple radiographic images over the many months required for healing. This imaging method uses large expensive equipment and exposes patients to high levels of ionizing radiation. In the study described here, we tested another technology for monitoring fracture healing that could minimize the need for multiple radiographic images. We tested a piezoelectric transducer fixed to the surface of a bone that uses electromechanical impedance spectroscopy to measure simulated fractures and transmits the measurement data to an acoustic receiver located externally on the skin surface.     

Conversation repair and adult cochlear implantation: a qualitative case study

Abstract

Conversation breakdown and repair has been suggested to be a common site of the disability arising from acquired hearing impairment in adults. This qualitative case study reports on certain consequences of the use of general versus specific conversation repair initiators for the resolution of repair sequences. The 47 repair sequences analysed in this paper arose in a single 20-minute free and unstructured conversation between an adult bilateral cochlear implantee and his wife, audio-recorded in a clinic setting. The repairs analysed in this paper were undertaken in response to either general (n = 18) or specific (n = 29) repair requests. No difference was found in the number of turns taken to resolve repairs in response to general or specific repair requests. Qualitative analysis demonstrated that uttering the repair initiator in the immediate vicinity of the miscommunicated portion of talk provided the primary cue to the conversation partner about the location and the content of what had been misunderstood. These preliminary findings imply a change to rehabilitation counselling offered to familiar communication partners. Copyright © 2006 John Wiley & Sons, Ltd.     

Clinician Confidence About Conversations at the End of Life Is Strengthened Using the Four Habits Approach

Communicating about cancer is not easy. At a time when patients are asked to make complicated choices about treatment and to be responsible for most of their own care, communication problems are consistently presented as a barrier to satisfactory medical treatment. This article identifies problems in communication and describes interventions the multidisciplinary team can use to improve the exchange of information and feelings among patients, families, and health care providers. The specific focuses are communication at the time of diagnosis and during progressive disease and the challenges and difficulties of communicating about pain, sexual functioning, and financial problems throughout the cancer experience.