我国临终关怀准入标准界定的质性研究

目的了解临终关怀实施者、管理者及研究者对临终关怀准入的看法,界定我国临终关怀准入标准。方法采用焦点小组访谈法进行访谈,采用主题分析法整理分析资料。结果提炼出的主题有以预后为基础的准入为主,结合考虑以需求为基础的准入;增加限定条件“对临床根治治疗不获益”;可以考虑缩短准入患者预计生存期的时间;临终关怀准入应先从肿瘤患者入手;可将准入标准的评价指标细化;专业临终关怀机构可作为其他服务的中转站。结论应参考以预后为基础的准入,制定我国临终关怀准入标准。今后随着临终关怀机构的发展扩大,此标准可进一步修订。     

基层医院开展护理病例讨论的做法及体会

目的：通过开展护理病例讨论，督促护理人员不断学习。提高护理业务水平。方法：由病区护士长组织，全院护理人员参加，共同对所选病例在住院期间发生的各种护理问题进行讨论、分析、总结。结果：开展护理病例讨论后，护理人员在护理程序应用能力、团结协作能力、业务水平、学习积极性方面均有显著提高。结论：护理病例讨论是提高护理人员业务水平的一种有效形式。     

胸腔闭式引流患者的舒适护理探讨

目的：探讨关于胸腔闭式引流患者的舒适护理。方法：选择2006年7月-2007年9月120例胸外科胸腔闭式引流术患者，分析其在环境、体位、生活、疼痛、心理、社会、精神舒适和护理操作方面的不舒适问题，将舒适护理融人整体护理过程中。结果：有效地恢复呼吸功能，减少了并发症的发生，缩短不舒适和治疗的时间，减轻了不舒适的程度。结论：让患者感觉舒适，增强了患者战胜疾病的信心，取得了良好的治疗效果。     

牙冠延长术后美容修复方法的探讨

目的:对于上前牙外伤后行牙冠延长术的患者,探讨其术后美容性修复方法的选择及其效果。方法:对27例行牙冠延长术的患者进行常规的前牙美容修复,其中16例采用单纯桩冠修复,11例采用综合法进行美容修复。结果:通过临床观察,并结合患者满意程度,27例患者均达到了较为理想的修复效果,患者和医生都满意。结论:正确修复方法的选择与灵活的修复设计相结合,才能够满足患者日益提高的美学要求。     

The role of parents' learning facilitation mode in supporting informal learning in mathematics

The aim of this research was to investigate the way in which parents of Grade One learners in a traditionally black school facilitate learning to help their children acquire mathematical skills and knowledge in mathematics, and also to help them become confidently involved in and give meaning to mathematics learning in Grade One. A questionnaire, which was compiled after an intensive literature study, was administered and semi-structured interviews were held. Data were analysed quantitatively and qualitatively, and it became evident that the parents of Grade One learners in the school used for the investigation not only use dialogue to guide their children with regard to the demands of mathematics in Grade One, but they also rely on example as basic learning facilitation mode. The parents who guide their children informally with regard to mathematics in Grade One, however, most frequently use dialogue.     

A Sociological Analysis and Exploration of Factors Associated with Commercial Preparations of Smokeless Tobacco Use in Sri Lanka

Background: Use and addiction to commercial preparation of Smokeless Tobacco (CPSLT) is creating new socio-cultural issues and health challenges in Sri Lanka.  The objective of this sociological study is to investigate and analyse the socio-cultural factors that influence CPSLT use Sri Lanka to enable development of effective interventions.  Methods: This is a qualitative study for which data was collected through in-depth interviews in selected groups that use CPSLT. Thirty-five interviews were carried out in seven of the 24 districts in the country representing urban, rural, plantation communities and different livelihood and ethnic, gender and age groups in the year 2016. Purposive and snowball sampling techniques were used for selecting interviewees. The data was analysed by using qualitative data analysis techniques and sociological perspectives. Results: This study reveals that the CPSLT use has integrated with the culture of several sociological and livelihood groups. Products such Thool (tobacco powder) and Maawa (dried areca-nut with flaked tobacco and some flavoured chemicals) were identified as the most popular forms of CPSLT.  Use of CPSLT has developed as a silent sub-culture specific to several social and livelihood groups. The informal CPSLT industry operating in the urban and sub-urban areas is influencing the school children and youth engaged in sports. Different groups of users express different reasons and justifications for its use. Conclusion: Use of CPSLT is closely integrated with the day to-day lifestyle and values of people of specific groups. and is an unseen part of life. Therefore, interventions will be urgently required to control the use of CPSLT to prevent its significant health impacts, considering the different contexts, symbolisms and justifications of its among the different groups.     

Special Time in a crèche

The paper describes Special Time carried out in a crèche with a boy with developmental delay and autistic features. Special Time is a form of therapeutic intervention that consists of weekly sessions during which a child is given individual attention by a teacher, an educator or a specific professional. A key aspect of the methodology is that there is a Work Discussion seminar where the professional can be helped to develop the specific stance required by the work and give meaning to the child’s communication. In this case, the Work Discussion seminar was tailor-made and included the Special Time professional and the head of the crèche who presented her work with the child's parents and with the educators, which took place in parallel with the Special Time sessions. The developments achieved by the child in the area of language, his capacity to relate to people, the symbolic use of toys and play, and the reduction of autistic states of mind and behaviour is illustrated through excerpts from the sessions.     

关于开展学术讨论的几点看法与建议

20世纪50年代末以来,我国的肿瘤防治研究事业逐步发展,各级肿瘤专业机构不断建立和完善.到了本世纪的近二三十年来,无论在科研方面还是临床医疗方面,大都已经接近国际水平,有的达到或者个别领先国际水平,从医疗科研领域里反映了我国改革开放政策带来的科技发展繁荣景象.     

中医处方及书写规范化的商讨

目的：探讨中医处方辨证用药的特色,使其更加合理完善、科学使用。方法：通过对国中医药医政发（2010）057号《中药处方格式及书写规范》一文及国家其它有关处方文件的学习。结果：发现《中药处方格式及书写规范》中有些地方不符合实际情况或解说不明了。结论：《中药处方格式及书写规范》一文及式样符合中医药辨证特色,但中药饮片处方样式注2和中成药处方正文对丸剂单位要求需要修改,才能更加符合实际应用。     

抗菌药物合理应用干预模式探讨

目的：探讨抗菌药物临床合理使用管理模式。方法：建立医院抗菌药物使用管理小组,采用综合干预措施,随机抽取2010年（干预前）和2012年（干预后）出院患者病历各630份、门急诊处方各810张,进行对照研究。结果：干预前后比较,住院患者抗菌药物使用率由87．93％下降至52．06％,抗菌药物使用强度由87．5DDD下降至39DDD,微生物送检率由27．06％上升至86．03％,I类切口手术预防用药比例由89．55％下降至28．03％,门诊处方抗菌药物比例由53％下降至15％,差异均具有统计学意义。结论：宣传培训、量化指标、行政干预、监控管理等综合干预,可提高临床合理使用抗菌药物的水平,对预防医院感染起到积极的促进作用,达到预期目标。