医务人员道德推脱与道德决策关系

目的探讨医务人员道德推脱与道德决策的关系以及组织承诺在两者之间的调节作用。方法采用整群抽样的方法对江西省5所三甲医院的286名医务人员进行问卷调查,采用SPSS 16.0进行数据分析。结果医务人员道德推脱、道德识别、道德判断、道德意图、组织承诺平均分分别为（88.10±16.78）、（18.53±3.47）、（13.47±3.58）、（30.43±9.95）、（67.28±8.57）分;不同学历的医务人员道德推脱、道德判断得分差异均有统计学意义（P<0.05）,不同年龄医务人员道德识别、道德判断得分差异均有统计学意义（P<0.05）;医务人员道德推脱与道德识别呈负相关（r=-0.349,P<0.05）,与道德判断和道德意图均呈正相关（r=0.301、0.211,P<0.01）;组织承诺对道德推脱和道德识别之间的关系产生显著的调节作用,对道德判断和道德意图产生直接作用。结论医务人员道德推脱与道德决策存在显著相关,组织承诺在道德推脱与道德识别关系中存在调节作用。     

Medical and social paternalism Regulation of and attitudes towards compulsory psychiatric care

In Sweden, recommendations and reforms in psychiatric care have increasingly stressed respect for patient autonomy and justice with less emphasis on medical and social paternalism. This is the official policy. But what are the attitudes of the people involved in or affected by compulsory psychiatric care? To answer this question, the attitudes of committed and voluntarily admitted patients, their relatives, psychiatric staff, health and welfare personnel of primary care and a sample of the general public were studied in 2 Swedish counties. Strong support for medical and social paternalism was reported, and according to most of the people asked, doctors, not legal authorities, should decide about commitment. These attitudes are discordant with the recent legislative changes in Sweden.     

Prevalence of risk factors for aggressive behavior: characteristics of an involuntarily admitted population

In Västmanland County, Sweden, 105 patients were acute admitted and involuntarily treated during a six-month period. In spite of a low mean age (39.2 years), abuse of alcohol or other drugs was common (29%). Thirty-nine percent of the patients showed violent behavior prior to the actual admission and 36% of the patients had shown such behavior prior to earlier admissions. Of the patients below 40 years, 32% had a disability pension.     

Do implementation intentions help to turn good intentions into higher fruit intakes?

OBJECTIVE: The present study examined (1) whether respondents who were encouraged to make implementation intentions to eat more fruit increased their fruit intakes, as measured by three measures of fruit intake; (2) whether the effects of implementation intentions on fruit intake were dependent on positive goal intentions at baseline; and (3) the respondents' commitment to perform their implementation intentions. DESIGN: Dutch adults (n = 535) were randomly assigned to either receive implementation intention instructions or not. Two questionnaires were completed with a 1.5-week time interval. Respondents in the implementation intention condition were asked to form implementation intentions to eat an extra serving of fruit per day during one week. RESULTS: Respondents in the implementation intention group reported a high frequency of eating an extra serving of fruit per day. The implementation intention effect on frequency of extra fruit did not depend on goal intention at baseline. The more committed respondents were to carrying out their implementation intention, the more likely they were to increase their fruit intake. CONCLUSION: These results provide some indications that implementation intentions could be a useful strategy to induce a short-term increase in fruit intake.     

c-myb对胚胎干细胞体外造血分化及定型的影响

目的　通过体外胚胎干细胞培养体系对ES细胞进行c- myb等位基因打靶,建立c -myb 及c -myb ES细 胞模型的基础上,探讨转录因子c- myb在造血定型和分化中的作用。方法　通过体外ES细胞去除LIF半固体介质EBs的 造血分化体系,采用甲基纤维素克隆形成分析和real timePCR观察c- myb 及c -myb ES细胞,比较分析其不同分化过 程及阶段中造血各系形成和相关基因表达变化。结果　c -myb 及c -myb ES胚胎体(EBs)大小及形态相似,c -myb ESEBs形成显著多于c -myb 。c -myb 组CFU- E出现在第6天,高峰为第8天;c- myb 组也有相似的改变,但其 CFU- E数目少于c -myb 。c -myb 组CFU- M高峰为第7天;c- myb 也有相似的改变,但其CFU- M数目高于c- myb 。c -myb CFU -GM出现在第7天,高峰为第12天,而c -myb 未见CFU -GM形成。real timePCR分析显示,c -myb 及 c- myb β globin,zeta globin,Lys,C- fms基因表达无显著变化。结论　低水平的c -myb不影响祖细胞的扩增,但影响其 终末分化。低水平的c -myb表达在造血定型中对红系的发育具有一定的影响,而对巨噬细胞的发育成熟无明显影响。 c -myb的表达水平对造血分化相关基因的表达没有明显的影响。     

Change-related expectations and commitment to change of nurses: the role of leadership and communication

portoghese i., galletta m., battistelli a., saiani l., penna m.p. & allegrini e. (2012) Journal of Nursing Management  20, 582–591 Change-related expectations and commitment to change of nurses: the role of leadership and communication Aim The purpose of this study was to test a theoretical model linking the impact of expectations on commitment to change and to explore whether change-related communication is a mediating variable between leader–member exchange and expectations. Background Expectations for change outcomes are an important condition to increase nurses’ commitment to change. To understand the role of leadership and communication in expectations development is crucial to promote commitment to change. Method A predictive, non-experimental design was used in a random sample of 395 nurses. Structural equation modelling was used to analyse the hypothesized model. Results Positive expectations had a direct effect on affective commitment to change, whereas negative expectation had a direct effect on continuance commitment to change. Leader–member exchange and communication influenced nurse’s expectations about change. Communication partially mediated the relationship between Leader–member exchange and expectations. Conclusion These findings suggested that nurses’ expectation about change were strongly linked to commitment to change. Furthermore, the enhancement of communication and relationship with leader contributed to the development of positive and negative expectations. Implications for nursing management Strategies to promote commitment to change include developing positive expectations about change outcomes and building high-quality leadership style oriented to the communication.     

二级甲等医院急诊科护理人员工作投入与组织承诺相关性研究

目的 探索二级甲等医院急诊科护理人员工作投入与组织承诺的关系.方法 抽取成都市46所二级甲等医院的281名急诊科护理人员,采用护理人员一般资料问卷、Utrecht工作投入量表和三因素组织承诺量表对其进行调查,采用多元线性回归分析及验证性因子分析方法进行分析.结果 二级甲等医院急诊科护理人员工作投入总体水平对组织承诺中情...     

Involuntary psychiatric attendances at an Australasian emergency department: A comparison of police and health‐care worker initiated presentations

Objective: To identify any significant differences in the population of patients brought in to a hospital ED under involuntary mental health orders, based on whether the orders are initiated by police or health professionals. Methods: A retrospective analysis of consecutive presentations to a tertiary hospital ED with a co‐located psychiatric emergency care centre over a 12 month period, with univariate and multivariate statistical comparisons. Results: Two hundred and eighty‐two patients (making 378 ED presentations) met the case definition and were analysed. Compared with patients on medical orders, patients on police orders had significantly more presentations related to violence, longer stays in ED and lower rates of admission to an inpatient bed, but were no more likely to require restraint or security intervention within the ED. Conclusions: Patients on police and medical orders differ considerably, but the impact of these differences on ED workload is small.