高职护理专业学生对老年高血压患者家庭护理的认知与态度

目的了解高职护理专业学生对老年高血压患者家庭护理的认知与态度。方法对218例高职学生进行关于老年高血压患者家庭护理的问卷调查,内容包括疾病基本知识、营养知识、健康教育、心理护理、家庭护理技能以及异常情况观察等方面。结果高职学生对老年高血压及其家庭护理了解程度较好者占19.72%和32.57%;有一定了解者占52.29%和45.41%;完全不了解者27.98%和22.02%。其相关知识问卷总分为(51.66±4.02)分;其中对心理护理了解最差,其次为营养知识、健康教育、疾病基本知识、异常情况的观察、家庭护理技能。结论高职学生对老年高血压患者家庭护理的认知与态度不容乐观,应加强相关知识和技能的教育,对减少患者并发症的发生、提高其生活质量具有重要意义。     

Bortezomib combined with low-dose cytarabine in Intermediate-2 and high risk myelodysplastic syndromes. A phase I/II Study by the GFM

Marrow cells from patients with higher-risk myelodysplastic syndrome (MDS) exhibit constitutive nuclear factor (NF)-κB activation. The proteasome inhibitor, bortezomib, has limited efficacy as a single agent in acute myeloid leukaemia. Its activity on leukaemic cell lines is potentiated by chemotherapy. We treated 43 higher-risk MDS patients with bortezomib (1·5 mg/m(2) , days 1, 4, 8 and 11) and low dose cytarabine arabinoside (LDAC; 10 mg/m(2) , then 20 mg/m(2) from days 1-14), every 28 d for four cycles. Median follow-up was 29·7 months. Responses were seen in 12 of the 43 patients (28%), including complete response (CR, n = 1), marrow-CR (n = 3), partial response (PR, n = 5) and haematological improvement (HI, n = 3). Responses were seen in 12 (36%) of the 33 previously untreated patients (11% CR, 13% PR, 2·5% HI), compared to none in the 12 previously treated patients (P < 0·01). Responders had better overall survival (median 18·2 vs. 10 months). One CR and 3 marrow-CRs were seen in patients with complex karyotypes. Main toxicity was haematological, responsible for infection in six patients and bleeding in 3. Three patients with Grade 1-2 pre-treatment haematotoxicity developed Grade 3-4 toxicity. Neuropathy was seen in 12% of patients. The addition of bortezomib to LDAC in higher-risk MDS may improve results obtained with LDAC alone, especially in patients with unfavourable karyotypes.     

The psychological sequelae on mothers of thermally injured children and adolescents: Future directions: Part 3

Part 3 of this study focused on maternal psychopathology and relationship with their children in three groups, assessed in Parts 1 and 2. Evidence of greater psychopathology in the mothers of burned children was supported by findings of both interview and self-report data, which indicated more symptoms of worry, depression, tension, anxiety, lack of energy, lower self confidence with other people and guilt, compared with mothers of Fracture Clinic and Normal Controls. Marital and social functioning and adverse life events did not differentiate groups, with the exception of a significantly higher divorce rate in the parents of burned children, following thermal injury.     

贵州地区1244名高职新生乙肝病毒感染情况调查

用酶联免疫吸附实验(ELISA)对入校的1 244名贵州地区高职新生乙型肝炎病毒(HBV)感染情况进行检测,结果1 244名高职新生HBV感染率为12.70%(158/1244),抗-HBs阳性率为11.74%(146/1244),5项标志物全阴性为75.56%(940/1244)。高校新生抗-HBs阳性率较低,因此需做好学生乙肝防治知识的宣教及疫苗接种工作。     

中医美容专业高职人才培养考评体系建设

考核评价体系是人才培养方案的重要组成部分。笔者对中医美容专业高职人才培养考评体系建设进行了详细的阐述,根据课程体系建设当中的理论知识模块、专业技能模块和职业素质教育模块来设置不同的考核方式,设计了独具特色的理论考试、技能考核和素质评定方法,注重过程考核,引进学分制,采用多元化的考核模式及考试主体,加强综合素质考核,使学生的职业能力得到充分的锻炼与提升。     

A qualitative study of how caseload midwifery is constituted and experienced by Danish midwives

Objectivethe aim of this study is to advance knowledge about the working and living conditions of midwives in caseload midwifery and how this model of care is embedded in a standard maternity unit. This led to two research questions: 1) What constitutes caseload midwifery from the perspectives of the midwives? 2) How do midwives experience working in caseload midwifery?Design and settingphenomenology of practice was the analytical approach to this qualitative study of caseload midwifery in Northern Denmark. The methodology was inspired by ethnography, and applied methods were field observations followed by interviews.Participantsthirteen midwives working in caseloads were observed during one or two days in the antenatal clinic and were interviewed at a later occasion.Findingsbeing recognised and the feeling of doing high quality care generate high job satisfaction. The obligation and pressure to perform well and the disadvantages to the midwives׳ personal lives are counterbalanced by the feeling of doing a meaningful and important job. Working in caseload midwifery creates a feeling of working in a self-governing model within the public hospital, without losing the technological benefits of a modern birth unit. Midwives in caseload midwifery worked on welcoming and including all pregnant women allocated to their care; even women/families where relationships with the midwives were challenging were recognised and respected.Key conclusionscaseload midwifery is a work-form with an embedded and inevitable commitment and obligation that brings forward the midwife׳s desire to do her utmost and in return receive appreciation, social recognition and a meaningful job with great job satisfaction. There is a balance between the advantages of a meaningful job and the disadvantages for the personal life of the midwife, but benefits were found to outweigh disadvantages.Implications for practiceIn expanding caseload midwifery, it is necessary to understand that the midwives׳ personal lives need to be prepared for this work-form. The number of women per full time midwife has to be surveilled as job-satisfaction is dependent on the midwives׳ ability of fulfilling expectations of being present at women׳s births.     

五年制高职护生专业自我概念的纵向研究

目的了解五年制高职护生专业自我概念的变化趋势,分析影响因素。方法便利抽取某校2010级五年制高职护生104人进行为期5年的追踪调查,调查内容包括专业自我概念及其影响因素。结果 5年来,护生的专业自我概念总分均75分,领导力、满意度、沟通交流维度及总分变化有统计学差异(P0.05,P0.01)。发展前景、护士形象、劳动报酬、理论知识是影响护生专业自我概念的主要因素,共解释其变异的69.5%。结论五年制高职护生专业自我概念总体较积极,各维度的变化趋势不相同,需针对影响因素采取干预策略。     

Bartlett‐type corrections and bootstrap adjustments of likelihood‐based inference methods for network meta‐analysis

In network meta‐analyses that synthesize direct and indirect comparison evidence concerning multiple treatments, multivariate random effects models have been routinely used for addressing between‐studies heterogeneities. Although their standard inference methods depend on large sample approximations (eg, restricted maximum likelihood estimation) for the number of trials synthesized, the numbers of trials are often moderate or small. In these situations, standard estimators cannot be expected to behave in accordance with asymptotic theory; in particular, confidence intervals cannot be assumed to exhibit their nominal coverage probabilities (also, the type I error probabilities of the corresponding tests cannot be retained). The invalidity issue may seriously influence the overall conclusions of network meta‐analyses. In this article, we develop several improved inference methods for network meta‐analyses to resolve these problems. We first introduce 2 efficient likelihood‐based inference methods, the likelihood ratio test–based and efficient score test–based methods, in a general framework of network meta‐analysis. Then, to improve the small‐sample inferences, we developed improved higher‐order asymptotic methods using Bartlett‐type corrections and bootstrap adjustment methods. The proposed methods adopt Monte Carlo approaches using parametric bootstraps to effectively circumvent complicated analytical calculations of case‐by‐case analyses and to permit flexible application to various statistical models network meta‐analyses. These methods can also be straightforwardly applied to multivariate meta‐regression analyses and to tests for the evaluation of inconsistency. In numerical evaluations via simulations, the proposed methods generally performed well compared with the ordinary restricted maximum likelihood–based inference method. Applications to 2 network meta‐analysis datasets are provided.     

Central concepts in the midwife-woman relationship

The relationship between the midwife and the woman is essential for a positive experience for woman during childbearing period, i.e. pregnancy, childbirth and the first postpartum phase. Thereby, the aim of this study was to delineate central concepts in the midwife-woman relationship, in normal as well as high-risk situations. A secondary analysis was performed on original texts from eight Swedish qualitative studies, all with a phenomenological or phenomenological-hermeneutic approach. Six pairs of concepts were elucidated; each one describing one aspect from the woman's perspective and one responsive aspect from the midwife. The pairs of concepts are: surrender-availability, trust-mediation of trust, participation-mutuality, loneliness-confirmation, differenceness-support uniqueness and creation of meaning-support meaningfulness. Disciplinary concepts about the midwife-woman relationship have evolved that are essential for care in both normal and high-risk contexts, and we suggest that they should be implemented as a guide for midwifery care.