糖尿病肾病患者维持性血液透析的护理探讨

目的探讨糖尿病肾病(diabetic nephropathy,DN))血液透析患者的护理措施,以减少并发症的发生.方法回顾性分析2007年4月-2009年10月我科63例DN维持性血液透析患者的并发症.结果透析中发生低血糖12例,低血压24例,16例发生高血压,9例发生不同程度的出血现象,2例穿刺处轻度感染,经过积极的对症治疗护理后,患者病情好转.结论良好的饮食护理、心理护理、皮肤护理、用药护理及病情观察有助于减少DN血液透析患者的并发症发生,延长患者的生命,提高患者的生活质量.参9.     

46例上消化道出血患者的临床护理分析

目的:总结46例上消化道出血患者的临床护理,探讨消化道出血患者的有效临床护理方法.方法:对上消化道出血患者在出血期间进行临床观察,实施急救护理、一般护理,输血期间护理、饮食护理、心理护理。结果:抢救成功44例,成功率为96%,44例患者匀取得良好的护理和治疗效果.结论:做好出血期观察与护理,注意出院的健康指导,密切配合医生积极进行抢救,能够明显提高护理质量及抢救成功率.参6.     

78例上消化道大出血患者的护理体会

目的:通过总结78例上消化道出血患者的临床观察,为抢救上消化道上消化道出血患者护理提供参考.方法:回顾2010年6月至2013年3月在南华大学附属南华医院消化内科78例上消化道出血临床观察及护理.结果:59例治愈,15例好转出院.结论:上消化道出血患者起病急,变化快,如通过积极有效的治疗和护理,提高抢救的成功率和预后.参4.     

仰卧位关节腔注射治疗膝骨性关节炎疗效观察及护理

目的:观察仰卧位关节腔注射治疗膝骨性关节炎(osteoarthritis,以下简称膝OA)的临床疗效并探讨护理方案.方法:选取116例符合诊断标准的膝OA患者,所有患者采用仰卧位髌骨外缘入路关节腔注射玻璃酸钠注射液,1次/周,连续5周为一个疗程,并于注射前后给予护理及康复指导.治疗前及治疗后应用视觉模拟评分(visual ana-log scale,VAS)、WOMAC骨关节炎指数、肿胀、压痛积分进行评分,以评价疗效.结果:治疗前后VAS疼痛评分、WOMAC骨性关节炎指数、肿胀、压痛指数均有显著性意义(P<0.05).经治疗后,临床控制2例(1.72%),显效26例(22.41%),有效76例(65.52%),无效12例(10.35%).结论:仰卧位关节腔注射治疗并配合护理康复能明显改善膝OA临床症状,且临床操作安全、方便.     

综合护理干预对慢性乙型肝炎抗病毒治疗临床观察及效果评价

目的分析探讨护理干预对慢性乙型肝炎抗病毒治疗的临床效果.方法选取84例慢性乙型肝炎抗病毒治疗的患者,随机分为观察组和对照组,每组42例,对照组采用常规护理,观察组通过饮食卫生、用药护理、情绪护理、健康教育护理等,比较两组患者用药依从性、患者的满意度、健康教育达标率.结果观察组在患者的用药依从性、住院的满意度、健康教育达标率等方面优于对照组.结论对抗病毒治疗的慢性乙型肝炎患者实施饮食、心理护理、健康教育可以有效消除或缓解患者焦虑情绪,提高患者满意度和用药依从性,使患者有效配合抗病毒治疗.     

胰十二指肠切除术患者的心理干预等个性化护理效果分析

目的:对胰十二指肠切除术抑郁症患者住院期间实施包括心理干预在内的个性化护理并评价其效果.方法:将我院2009年3月至2012年3月收治胰十二指肠切除术患者56例后随机分成对照组和干预组各28例,对照组接受常规护理,干预组住院期间接受心理干预在内的个性化护理.在入院当天、术前天和出院前1天对两组患者进行抑郁自评量表(SDS)并比较两组患者的SDS和分值,统计两组患者住院时间和并发症.结果:干预组患者SDS分值的降低幅度较对照组明显;差异有统计学意义(P<0.05)前者住院时间、并发症要少于后者,且满意率高.结论:心理干预等个性化护理能有效改善患者围手术期的抑郁情绪,减少并发症,有助于早期康复.表2,参10.     

颅内动脉瘤夹闭术围手术期的护理

目的:探讨颅内动脉瘤夹闭术围手术期的护理要点.方法:对我科2011年1月～2012年5月收治的100例动脉瘤夹闭术患者进行细致的围手术期护理,严密观察病情,术前预防动脉瘤再破裂出血,积极做好术前准备,术后做好引流管、并发症及康复等护理.结果:100例动脉瘤夹闭术患者,80例无任何并发症治愈出院,15例出现一侧肢体偏瘫,经术后康复治疗,随访3～6个月均恢复,5例死亡.结论:精心细致的围手术期护理,可有效提高手术成功率及治愈率,改善患者术后生活质量.     

手辅助腹腔镜结肠癌根治术手术配合分析

目的:探讨手辅助腹腔镜(hand-assisted laparoscopicsurgery,HALS)结肠癌根治术的手术配合方法和经验.方法:将南华大学附属第一医院2012年9月至2013年2月收治的20例应用手辅助腹腔镜实施结肠癌根治手术患者的手术配合要点进行总结分析.结果:20例患者均顺利完成手术,无中转开腹、吻合口瘘、肠梗阻及死亡病例发生.结论:有效的心理护理、充分的术前准备、避免术中不安全因素发生及术中无瘤原则的应用与手辅助腹腔镜结肠癌根治术顺利完成密不可分.     

对围手术期患者访视的实践与体会

以探讨对围手术期患者访视,围手术期患者的心理护理,提高手术室护理质量为目的.通过对1 860例大中型手术患者进行术前术后访视,随机调查其中276例,以了解访视效果的方法得到术中配合满意及能配合253例,术后精神状态、体温、伤口愈合、皮肤等良好,未发现体位性损伤、泌尿系感染及其他并发症.患者及家属对手术前后访视满意率为98%的结果.从而得出术前术后访视可以减轻患者对手术的恐惧,减轻焦虑心理,加强护患关系,提高手术室的护理质量,使病人以最佳的身心状态对待手术结论.表2,参3.     

COPD合并Ⅱ型呼吸衰竭患者无创通气的护理体会

探讨COPD合并Ⅱ型呼吸衰竭神志清楚患者无创通气的护理体会.方法:南华大学附属第一医院呼吸内科2009年1月-2012年2月收治的98例COPD合并Ⅱ型呼吸衰竭应用无创正压通气治疗的清醒患者,随机分为护理干预组(观察组)与对照组各49例,其中观察组给予系统的护理干预;对照组仅采取一般护理措施.比较两组患者治疗后呼吸参数.结果:护理干预组的pH、PaO2、SaO2等参数明显高于对照组,而PaCO2明显低于对照组.表1,参5.     

术后早期急性炎性肠梗阻的观察及护理

目的探讨术后早期急性炎性肠梗阻（EPII）的临床表现、治疗方法及护理．方法回顾性分析86例EPII的临床表现、治疗及护方法．结果EPII发生在术后4-21d,肠蠕动一度恢复,继而又出现呕吐,腹胀,腹痛等肠梗阻表现,大部分病例非手术治愈,仅少部分手术治疗．结论EPII以非手术治疗为主,积极的心理干预及护理有助于疾病康复．表2,参14．     

临床实习男护生现状分析与教学对策

目的：通过分析男护生现状,探讨临床教学对策,以提高男护生临床教学质量．方法：通过对22名男护生临床实习中存在的问题进行总结分析．结果：发现男护生专业态度不稳定,心理应对能力、工作积极主动性、人际沟通能力欠缺、职业安全意识比较淡薄．结论：在临床教学工作中,注意对其进行展望专业前景,稳定职业心态;增强其挫折承受力,适当保护男护生自尊,增强其自信心和工作积极性,培养良好的沟通能力,注意个性的培养,强化职业安全教育等对提高临床教学质量,帮助他们顺利走上护理工作岗位具有重要意义．参5．     

Towards a sustainable future: a holistic inquiry of waste management behaviors of Singapore households

ABSTRACT

In 2018, Singapore produced a 7.7 million tonnes of waste, which is a significant amount of waste for a small nation-state. In line with the Sustainable Development Goal (SDGs) targets 11.6 and 12.5 of the 2030 Agenda, which addresses cities’ waste generation and management impacts, we ask the question of why Singapore households are not more proactively engaged in waste minimization, despite the presence of local waste minimization public campaigns. This study is the first known study to comparatively apply and test three major theories – social psychological, social-structural, and sociocultural theories, to explain household waste management behavior in Singapore. A national survey followed by regression analysis of 303 households was conducted. In our findings, we firstly describe current trends in household waste management behaviors. Secondly, we compared each applied theory’s ability to predict households’: (1) reuse and (2) recycling of a variety of household items; and (3) recycling frequency. We obtained partial evidence supporting the role of future-orientedness and environmental identity on householders’ variety reuse and recycling. Social-structural (age cohort x income, education) and situational variables (the convenience thesis), also predicted various waste minimization behaviors. Finally, householders’ knowledge of what is recyclable affected all forms of waste minimization behaviors. In view of the study’s findings, we propose a need for targeted planning and policy interventions for different segments of the Singapore population, and different short- and longer-term measures to initiate and achieve sustained household waste minimization.     

Conservation practitioners’ understanding of how to manage evolutionary processes

Both academics and practitioners consider a lack of knowledge about evolutionary theory to be a general barrier to effectively managing genetic diversity. However, it is challenging to judge practitioners’ level of understanding and how this influences their management decisions. Knowledge built through experience may be difficult for practitioners to articulate, but could nonetheless result in appropriate management strategies. To date, researchers have assessed only the explicit (formal) knowledge practitioners have of evolutionary concepts. To explore practitioners’ understanding of evolutionary concepts, it is necessary to consider how they might apply explicit and implicit knowledge to their management decisions. Using an online survey, we asked Australian practitioners to respond to 2 common management scenarios in which there is strong evidence that managing genetic diversity can improve outcomes: managing small, isolated populations and sourcing seeds for restoration projects. In describing their approach to these scenarios, practitioners demonstrated a stronger understanding of the effective management of genetic diversity than the definitions of the relevant concepts. However, their management of genetic diversity within small populations was closer to best practice than for restoration projects. Moreover, the risks practitioners described in implementing best practice management were more likely to affect their approach to restoration than translocation projects. These findings provide evidence that strategies to build the capacity of practitioners to manage genetic diversity should focus on realistic management scenarios. Given that practitioners recognize the importance of adapting their practices and the strong evidence for the benefits of actively managing genetic diversity, there is hope that better engagement by evolutionary biologists with practitioners could facilitate significant shifts toward evolutionarily enlightened management.     

Academic Research Training for a Nonacademic Workplace: a Case Study of Graduate Student Alumni Who Work in Conservation

Abstract: Graduate education in conservation biology has been assailed as ineffective and inadequate to train the professionals needed to solve conservation problems. To identify how graduate education might better fit the needs of the conservation workplace, we surveyed practitioners and academics about the importance of particular skills on the job and the perceived importance of teaching those same skills in graduate school. All survey participants (n = 189) were alumni from the University of California Davis Graduate Group in Ecology and received thesis‐based degrees from 1973 to 2008. Academic and practitioner respondents clearly differed in workplace skills, although there was considerably more agreement in training recommendations. On the basis of participant responses, skill sets particularly at risk of underemphasis in graduate programs are decision making and implementation of policy, whereas research skills may be overemphasized. Practitioners in different job positions, however, require a variety of skill sets, and we suggest that ever‐increasing calls to broaden training to fit this multitude of jobs will lead to a trade‐off in the teaching of other skills. Some skills, such as program management, may be best developed in on‐the‐job training or collaborative projects. We argue that the problem of graduate education in conservation will not be solved by restructuring academia alone. Conservation employers need to communicate their specific needs to educators, universities need to be more flexible with their opportunities, and students need to be better consumers of the skills offered by universities and other institutions.     

Biodiversity of urban soils for sustainable cities

The last century was marked by a high demographic revolution and the fast development of urban environments. Now, more than 50% of the world’s 7.5 billion humans live in cities. This change has often induced the degradation of environmental quality in urban areas. As a consequence, management policies are now fostering the ‘return of nature’ in cities, which, in turn, is requiring a better understanding of the ecology of urban environments. In particular, there is a need for a better knowledge on soil management because soils provide many functions in cities such as urban agriculture. Optimizing the diversity of soil-living organisms is essential to many environmental functions such as water depollution, biochemical cycles, fertility and carbon storage. However, few studies on the biological quality of urban soils have been performed so far. This article reviews actual knowledge on soil biological quality for urban management. The definition of urban soils is discussed, and we present services provided by soils. We also review modern methods and techniques to assess the biological quality of urban soils. Last, we suggest communication means to improve the consideration of soil quality in urban planning policies aimed at sustainable cities.     

Waste control by waste: efficient removal of bisphenol A with steel slag,a novel activator of peroxydisulfate

Activated persulfates are efficient reagents for oxidation of organic contaminants and water treatment. Various compounds are currently used to activate persulfates, but there is a need for cheap and efficient activators. Here, we report the first use of steel slag, an industrial solid waste, as a solid activator for peroxydisulfate activation. We tested this system for bisphenol A degradation. Results indicate that about 70% of bisphenol A can be removed within 1 h. Conditions were 50 μg/L of bisphenol A, 2 g/L of peroxydisulfate, 3 g/L of steel slag and temperature of 298 K. The components and surface morphology of unused and recycled steel slag were analyzed by X-ray diffraction and scanning electron microscopy, whereas the main reactive oxygen species were elucidated by using radical scavengers. Findings show that both base oxides and iron oxides are responsible for peroxydisulfate activation. A redox mechanism involving liquid and solid phases is proposed. Overall, this study reveals the successful recycling of steel slag to activate persulfates for water treatment, following the principle of ‘waste control by waste.’     

Spatial segregation of calving and nursing Risso’s dolphins (Grampus griseus) in the Azores,and its conservation implications

Calving can be a critical period for cetaceans. Areas providing security for vulnerable calves, and high food availability for lactating females can be critical habitats requiring specific conservation measures. Here, we test the hypothesis that calving and nursing habitat could be defined for Risso’s dolphins (Grampus griseus). We investigated the spatial and temporal preferences of this species around Pico Island, Azores, using data gathered from land-based surveys and dedicated at-sea observations between 2004 and 2007. We divided observed pods into three groups: (1) those with newborn and young calves, (2) those with older calves or juveniles and (3) those consisting only of adults or sub-adults. We analysed eco-geographical variables and incorporated them into a presence-only spatial distribution model to evaluate differences in habitat suitability among the groups. We identified 694 pods of Risso’s dolphins overall. On the 267 pods observed in the first and second groups, 136 calves or juveniles were identified, of which 22 were newborns. The peak of the calving season was between June and August. The pods with newborn calves were larger and closer to shore, whereas the other groups were more widely dispersed offshore. Our results support the definition of critical habitat areas for this species, but we suggest widening the geographical coverage for better mapping around the island and throughout the archipelago generally. Conservation measures can, nevertheless, be implemented immediately, in order to reduce human impacts on a vulnerable component of the Risso’s dolphin population     

Voluntary environmental regulation in developing countries: Mexico’s Clean Industry Program

Because conventional command-and-control environmental regulation often performs poorly in developing countries, policymakers are increasingly experimenting with alternatives, including voluntary regulatory programs. Research in industrialized countries suggests that such programs are sometimes ineffective, because they mainly attract relatively clean participants free-riding on unrelated pollution control investments. We use plant-level data on more than 100,000 facilities to analyze the Clean Industry Program, Mexico’s flagship voluntary regulatory initiative. We seek to identify the drivers of participation and to determine whether the program improves participants’ environmental performance. Using data from the program’s first decade, we find that plants recently fined by environmental regulators were more likely to participate, but that after graduating from the program, participants were not fined at a substantially lower rate than nonparticipants. These results suggest that although the Clean Industry Program attracted dirty plants under pressure from regulators, it did not have a large, lasting impact on their environmental performance.