Ergonomics and occupational medicine: future challenges

Ergonomics has come a long way since the birth of the subject some 50 years ago. It now has an established research base and an appropriate portfolio of methodologies. A brief overview of the subject's development will be presented, with a particular focus on the contribution of ergonomics to our understanding of work related musculoskeletal disorders. Future challenges are also considered in this area, with particular emphasis on the need for a multidisciplinary approach to many industrial problems where the ergonomist, occupational physician and other professionals are needed to tackle existing and future work problems. Additionally, the importance of participatory ergonomics is considered, with respect to understanding and advancing solutions in this area. The issues of the ageing workforce and the challenges that must be met are also outlined. This area again emphasizes the need for a multidisciplinary team approach that is proactive and designed to maximize the health and wellbeing of workers at all ages, whilst also ensuring a full and productive life.     

腹腔镜辅助下直肠癌根治术的护理探讨

目的 探讨腹腔镜辅助下直肠癌根治术的护理方法及配合特点。方法 56例行腹腔镜直肠癌根治术患者，均采用统一的整体护理。观察术前患者准备情况、手术是否顺利进行及术后生活质量。结果 56例患者均顺利完成手，术后生活质量好。结论 术前精心的护理准备及术中娴熟的护理配合，能有效促进腹腔镜直肠癌根治术的顺利完成，有助于提高患者术后生活质量。     

The use of home remedies and complementary health approaches in endometriosis

Research question

Conventional treatments are often associated with adverse effects and endometriosis pain symptoms may reoccur despite treatment. Consequently, many women use complementary health approaches (CHA) and home remedies (HR) to relieve their pain. The aim of this study was to examine the frequency and the subjectively perceived efficacy of CHA/HR use by women affected by endometriosis.

Developmental coordination disorder (dyspraxia): an overview of the state of the art

A large number of school-aged children present with motor-based performance problems that have significant negative effects on their ability to participate fully in the daily activities of home, school, and play. These children have a neurodevelopmental disorder most commonly known as developmental coordination disorder (DCD). These children are frequently brought to the attention of the family doctor and referred to health care professionals in search of answers and services. Therapists treating these children have a large number of intervention approaches at their disposal. This paper presents an overview of these approaches and a review of the available evidence. The evidence for the older, deficit-oriented approaches remains inconclusive, at best; whereas the task-oriented approaches, seem to be better supported. While more work is needed to validate the use of the task-oriented approaches, the results suggest that a shift in perspective from a deficit-oriented to a task-oriented perspective would be appropriate.     

The concepts of fatigue and depression in cancer

A strong association between fatigue and depression in cancer patients has been reported repeatedly in clinical studies. The distinction remains difficult, mainly because of the similar phenomenology of fatigue and depression. It is the aim of this paper to work out similarities and differences in the conception of fatigue and depressive disorders. For that, a differentiation between depression as emotional distress and depression as clinical syndrome, according to the current classification systems, has to be made. Therefore, the classification of depressive disorders and their criteria is presented in the second section of this paper, especially in view of the diagnosis of depressive disorders in cancer patients. The comparison of the multidimensional fatigue construct and depression shows a strong overlap of symptoms. None of the fatigue symptoms are specific for fatigue, all being elements of depressive syndromes. It is in particular the psychological symptoms of depressive disorders that differentiate between the two concepts. To that end, the question is discussed whether fatigue in its current conceptualization can be defined as a diagnostic entity independent of depressive disorders. Additionally, research approaches are presented from the area of the chronic fatigue syndrome and neurasthenia, which could be adapted to cancer-related fatigue and help to clarify the clinical differences between fatigue and depression. In order to ensure better differential diagnostics in the future, criteria-orientated research in particular is needed.     

Nurses' perceptions of care and caring

Care and caring have been identified as inherently difficult concepts to define, but many authors believe that care is the central and unifying core of nursing. It is vital that nurses understand what care is, with the current issues about measuring and justifying exactly what they do for patients in order to be clear about what good care is. If nurses are to constantly improve the care they give, they need to be clearer about how to care for patients. Nurses need to make sure that they are giving the patients what they want and not what the nurses want. This review of the literature explores nurses' perceptions of care and compares it with what patients want in terms of care. It also highlights some important and interesting differences between what patients and nurses perceive as good care.     

Re-thinking representations, re-writing nursing texts: possibilities through feminist and Foucauldian thought

FOCUS: Critical approaches are increasingly being used to inform theory and research within the discipline of nursing. In this paper we discuss the work of feminist writers, particularly those located within the postmodern, and Michel Foucault. Their work, although having significant points of difference, can be viewed as complementary and our engagement with these ideas has led us to re-think nursing knowledge. RATIONALE: Using ideas from Foucault and postmodern feminism foregrounds critical questions such as whose knowledge is visible in nursing literature, whose is suppressed, and the power relationships reflected in representations of knowledge. Our exploration of representations of knowledge has led us to review fundamental nursing texts that we consider to be important political and ideological artefacts in the enculturation of student nurses. The dominant position of medical knowledge in the texts reviewed continues to position this 'voice' as primary in nursing literature. DISCUSSION: Drawing on our current research on endometriosis to illustrate the potential inherent in rewriting such texts, we argue for a repositioning of knowledge related to the illness experience. Privileging the voices of people who are the focus of our clinical care reflects the reality of nurses' work; the embodied experience of the person is made visible rather than marginalized in the illness discourse.     

The paediatric diabetes specialist nurse and diabetes education in childhood

AIMS OF THE STUDY: The aim of this study was to identify the job title, work setting, qualifications and training of the paediatric diabetes specialist nurse (PDSN) as well as to examine the composition of the multidisciplinary diabetes team. It also aimed to determine who is involved in diabetes education and to explore the teaching methods, approaches, tools and materials that the PDSN uses in the educational process. DESIGN AND METHODS: A survey design was used. Questionnaires, which combined quantitative and qualitative approaches, were sent to 80 participants from eight opportunistically selected regions of the United Kingdom (UK). Access to names and addresses was gained through the directory of diabetes specialist nurses (DSNs). The selection criteria were nurses working full-time with children with diabetes or having children with diabetes on their caseloads. The overall response rate was 66 (82.5%). FINDINGS: The study findings showed that the majority of the respondents were based in both hospital and community, held paediatric qualifications and had undertaken further training to prepare as diabetes specialists. Respondents used a wide range of teaching methods and materials in the educational process. A substantial number of individuals and voluntary organizations were also involved in diabetes education. CONCLUSIONS: The findings of this study support the belief that the PDSN, as a member of the multidisciplinary paediatric diabetes team, has a key role in the education of children with diabetes and their parents/carers. However, the importance of the team approach as a whole should not be underestimated.