Bondage and Feminist Consciousnessin the Patriarchal Society——A Feminist Approach to The Age of Innocence

This paper is focused on women’s status in the conventional society of masculine superiorityin The Age of Innocence.By studying the two female characters May Welland and Ellen Olenska,the paper analyses the topic of womenas victims in the patriarchal society.And through the further study of the character Ellen Olenska,the paper explores the feminist consciousness in the novel.

In a Historical Heritage Trap: Modern Social-philosophical Approach to the Problem of Transformation of Post-Soviet Society

The article deals with the actual social and philosophical problems connected with the value transformations of post-Soviet society in the transition period of its development.The focus is on mental(ideological)attitudes or“traps for practical reason”that prevent the democratization and humanization of Russian public consciousness.One of such mental attitudes is the trap of historical heritage,which is a complex of probabilistic judgments about the historical purpose of society and the complete determination of the future by its past.In the course of rational-critical analysis,the erroneous biogenetic approach to Russian history is revealed,as well as possible negative consequences of its application to the solution of urgent social problems.The historical situation of the“Blockade of Leningrad”is considered to be such a pressing problem.

Challenges and Possibilities for the Household Medicine Lease （HML） System Viewed in Light of CRM： HML-Based Everyday Self-Medication in Ubiquitous Network Society

Household medicine lease （HML） industry originated way back in the Edo period （17C-19C）, when it was promoted by the local fiefdom government to revitalize the economy. Accumulations of wealth, acquired thereafter from everywhere outside the region, have culminated in the formation of the present-day industrial cluster in Toyama, the largest in the whole area facing the Sea of Japan. Today an adaptation of the quasi-CRM （customer relationship management） business model of the HML system has proved to be a success in Mongolia. This fact seems to offer the authors some clues for dealing with those problems that healthcare and medical services in Japan and elsewhere are riddled with. In this paper, focusing on the common critical success factors （CSFs） behind the success of the authors＇ prototype HML system and its recent successful application in Mongolia, the authors will analyze these factors from the perspective of CRM. The authors will then clarify the following： （1） the usefulness of the business model for ensuring primary healthcare for people in developing countries; （2） the usefulness in our ubiquitous network society of applying ICT to the HML system; （3） possible contributions that the use of the system can make toward improving the quality of our everyday healthcare and medical services in our prominently aging society; and the authors will also suggest （4） the importance of elevating ＂individual self-medication＂ to ＂community-based self-medication＂.

Healthy Business Environment According to the General Theory of Sustainable Development

The article continues thinking about prospective of human society. Is the healthy business environment a fiction or a real opportunity？ How far-reaching are the roots of the future natural processes of changes？ How to work with the current global economic models？ Can the current European integration process be considered as natural？ Is a weak state a new opportunity for a future strong economy？ What is the historical essence of the liberal thought？ Why the current economic models are not permanent, why are they not sustainable, and why are they not developing for the basic quantum, which is the man as an individual？ Can also the basic quantum be integration units as family, society, company, municipality, region, country, or EU, etc.？ Qualified answers to the questions can be seen in a theoretical context of the General Theory of the Sustainable Development （GTSD）, too. Theoretical trinity of GTSD is based on three theoretical pillars： GPT （Gravitation Polarity Theory）, QET （Quantum Economy Theory）, and BIT （Big Integration Theory）. They can be considered as relevant theoretical basics for historical, current, and future sustainable development process. The healthy business environment is based on the healing of man. In GTSD, businessman and man gain a new source of knowledge, a new natural relationship, and a new content. This is a responsibility towards the customer and towards the pa^ner in business. Businessman＇s profit speaks about a new business in natural partnerships. Sustainable development without the Groove Management （second generation management） and without the fourth Reformation （with second generation of innovation） is a process that only reflects the regressive trend that takes place for more than 6000 years. Without the new content of the Fifth Theoretical Dimension （Consciousness） the historical mainstream of sustainable development process cannot be grasped. The biggest risk for the expected Healthy business society is a contemporary slave communism and contemporary crazy capitalism. Feasibility of business models of healthy business doing societies stands not only on adequate theoretical basis, but also on predicted cannibalism between slave communism and crazy capitalism. The biggest current risk of healthy business environment is a political arbitrariness, the desire for power, and the desire for money----corruption.

The Oppressed Feminism in The Story of an Hour — A Feminism Comparison Between Kate Chopin and Her Character Mrs. Mallard

As a forerunner of feminist authors of the 20 th century, Kate Chopin explores the social role, the emotional role of women and their wants and needs in her works. Her feminism themes can not be separated from her own life experiences. So based on her owning sufferings, she creates the heroin Mrs. Mallard in "The Story of an Hour". She wants to spread her feminism to the world from Mrs. Mallard. But both the author and her character reflect the oppressed feminism. Through the comparison between the author and Mrs. Mallard, the article discloses feminism can not be accepted in a patriarchal society. But both the author and Mrs. Mallard show the awakening of female consciousness.

Intraoperative Care of the Conscious Patient from the Perspective of the Operating Theatre Nurse:A Grounded Theory

Introduction: Intraoperative care includes a unique knowledge of how to perform a safe and effective surgery procedure. Surgery performed under regional or local anaesthesia allows the patient to remain conscious during the procedure and is rather common in Swedish healthcare today. Aim: The aim was to obtain a deeper understanding of the main concerns of operating theatre nurses (OTN) when caring for conscious patients during the intraoperative phase. Methods: Interviews were conducted with 23 OTNs from five different hospitals in Sweden and analysed according to grounded theory. Findings: The main concern among the OTNs was to take the patient in consideration. The core category “achieve and maintain ethical treatment of patients” in the operating theatre (OT) was a strategy used throughout the intraoperative process. Ethical treatment was described as moral behaviour at different levels and included the team’s behaviour, respectful and individualised patientcare, and the working-morale of the professionals. Being vigilant and being flexible were the categories related to the core category. The OTNs constantly assessed where to pay most attention as they balanced between the needs of the patient, the team, and the surgery procedure. Conclusion: It is important that every patient is taken into consideration and that ethical principles are held to the highest standards in the OT. A familiar team can facilitate that. The complex skills that operating theatre nurses develop can be added to explain important competencies within the profession.

Performance of American Society for Gastrointestinal Endoscopy guidelines for dyspepsia in Saudi population: Prospective observational study

AIM: To evaluate adherence of primary care physicians(PCPs) to international guidelines when referring patients for upper-gastrointestinal endoscopy(UGE), evaluate the importance of alarm symptoms and the performance of the American Society for Gastrointestinal Endoscopy(ASGE) guidelines in a Saudi population.METHODS: A prospective, observational cross-sectional study on dyspeptic patients undergoing UGE who were referred by PCPs over a 4 mo period. Refer-rals were classified as appropriate or inappropriate according to adherence to ASGE guidelines.RESULTS: Total of 221 dyspeptic patients was enrolled; 161 patients met our inclusion criteria. Mean age was 40.3 years(SD ± 18.1). Females comprised 70.1%. Alarm symptoms included low hemoglobin level(39%), weight loss(18%), vomiting(16%), loss of appetite(16%), difficulty swallowing(3%), and gastrointestinal bleeding(3%). Abnormal endoscopy findings included gastritis(52%), duodenitis(10%), hiatus hernia(7.8%), features suggestive of celiac disease(6.5%), ulcers(3.9%), malignancy(2.6%) and gastroesophageal reflux disease(GERD: 17%). Among patients who underwent UGE, 63% met ASGE guidelines, and 50% had abnormal endoscopic findings. Endoscopy was not indicated in remaining 37% of patients. Among the latter group, endoscopy was normal in 54% of patients. There was no difference in proportion of abnormal endoscopic findings between two groups(P = 0.639).CONCLUSION: Dyspeptic patients had a low prevalence of important endoscopic lesions, and none of the alarm symptoms could significantly predict abnormalendoscopic findings.

基于微信小程序的“校企社”联动社区药学服务模式构建与应用

目的构建基于微信小程序的“校企社”联动社区药学服务模式,提档升级社区药学服务内容和服务方式,提升居民健康生活质量。方法围绕社区居民药学服务需求,整合学校、企业及社区药学资源,打造“药享健康”微信小程序,构建“线上+线下”社区药学服务模式。采用分类随机抽样,随机选取小程序用户为观察组,以线下药学服务结对帮扶社区居民为对照组,围绕用药健康知识掌握合格率、用药依从率、用药行为正确率3个方面进行干预效果比较。结果“药享健康”小程序由“药健康”“药温暖”“药安全”“个人信息”4个模块构成。基于“药享健康”小程序的“校企社”联动社区药学服务模式于2022年7月开始实践应用,小程序现有用户6185人,完成回收过期药品2732次,完成药学服务941次,完成咨询订单3354次。干预后,观察组居民的用药健康知识掌握合格率、用药完全依从率、用药行为正确率分别由干预前的33.53%、20.23%、49.71%提升至76.87%、46.26%、89.80%,且干预后的提升效果均显著优于对照组(P<0.05)。结论该服务模式有效提升了社区药学服务质量,提高了社区居民用药健康意识,促进了居民用药规范化、合理化、安全化。

以银发经济推进农村互助养老发展的政策支持研究——以J省X市颐养之家为例

我国首部“银发经济”政策文件出台,为农村互助养老模式提供了“有为政府”与“有效市场”相结合的实践场域。通过对具有全国性影响的J省X市颐养之家的典型案例分析发现,当前农村互助养老模式的主要政策目标是为有需要的农村留守、独居及困难老年人提供基本生活保障的兜底型养老。在银发经济“产品化-商品化-产业化”阶段性发展的大趋势下,农村互助养老还可以是普惠式养老,更应该是高质量的积极养老。针对农村互助养老模式在政策执行中分配基础、分配内容、输送策略、筹资机制等方面存在的不足,建议将发挥有效市场作用与有为政府作用更好结合,进一步完善优化政策支持,纳入“一老一小”,扩展受益对象;引进商品化竞争机制,丰富服务供给;推动多主体跨部门合作,形成网状输送;划定红线并链接资源,发展团结经济,着力推动农村互助养老高质量发展。

智慧养老服务高质量发展:现实障碍、建设逻辑与实现路径

打造高质量的智慧养老服务是顺应时代发展、积极应对人口老龄化的必然要求。然而囿于养老服务的技术斥老化、主体碎片化、模式分层化和保障空心化等问题,老年人并未在智慧养老领域中获得较好的数字化服务体验。文章对当前我国智慧养老服务低效运行现象隐含的底层冲突和诱发的现实原因进行了系统深入分析,基于主体性和嵌入性的建设逻辑,从多个维度探寻应对问题的有效良方:一是针对数字技术进行适老改造,使老年人摆脱被动型数字化,消解其与数字社会的双向互斥,实现老年友好型数字社会的建设构想;二是侧重服务主体、强调包容协同,从整体性视角出发,整合各方利益诉求,调配多元角色站位,落实主体本位职责,推动服务开发升级;三是围绕服务模式展开耦合创新,根植于多种养老模式的性质与类型差异,巧妙化解资源整合困难、资源配置效率低下等矛盾现象,实现模式机制的共生共创;四是立足保障制度深化要素改革,完善养老保障体系建设,提升政策支撑力度,扩大福利配套范围,强化老年群体的服务购买能力与意愿,优化智慧养老结构。在此基础上,合理维持多重举措间的动态平衡与辩证调整,为老龄群体享受高质量的老年生活、破解数字时代老年人急需解决的服务难题提供一条可供参考的实践路径。

“乡村医疗社会”的生成与显现——基于一个农村老人生病、治疗与护理的医学人类学观察与思考

乡村居家治疗与照护中的疾病不仅是科学的存在,也是宇宙论意义的存在以及在世的存在。就科学的存在而言,疾病是自然界的物质与病者的身体相遇而互构出来的一种界面,现代医学和传统医学在这个界面上实施干预。就宇宙论意义的存在而言,疾病是宇宙神秘力量的显象,需要借助秘术和民俗医疗手段进行救治。就在世的存在而言,疾病创建了以病人为核心的医疗社会,该类医疗社会是各种医学知识观念显象、具身与交流的场域,即科学的存在和宇宙论的存在在其中存在。然而,按照西方医学科学模式开展救治和护理的城镇医院则把上述诸多内容屏蔽在外。

再论中国社会的乡土性--阅读《乡土中国》的新探索

在我们重新去阅读费孝通半个多世纪以前出版的《乡土中国》一书时,当是以深入认识此书背后作者的写作方式为开始的,借此而成为理解乡土中国自身发展历程的一种独特方式的新发现,并寻求一种在观念中存在的乡土中国来作为社会学、人类学知识探索的独特性路径的梳理。还需要从清楚地析分出《乡土中国》一书的剖面图而去追溯此书背后所隐含着的可能的人类学原理,而这种原理的核心的核心就在于其对乡土本色的发现和解释。与此同时,我们也同样要从一种变化的语境之中去探索乡土中国自身的文化转型的发生,这自然也体现出了日益融入到了世界文明进程中的文化自觉,这种文化自觉意识也正是费孝通一生之中从《乡土中国》一书为开始而一以贯之地试图要去予以揭示的。

未来社会视野中马克思恩格斯文明塑造思想的历史自觉性探析

未来社会是马克思恩格斯所要实现与追求的有别于旧的社会和旧的时代的理想目标,它体现着马克思恩格斯所主张倡导的人类文明将要走向新的进程和篇章的观点。在未来社会中,人的历史主体作用表现在不断将整个人类发展与自然客观进程作为一个动态的、不息的、永无止境的过程,以动态的历史自觉性发现世界与人的本质价值,在动态的价值开掘利用过程中永不停息地扩展提升人与自然世界的一切有利价值。马克思恩格斯未来社会文明塑造思想的历史自觉性是历史主体对于世界文学的动态价值追求,对于世界本质的动态价值发现,对于人的本质的动态价值塑造,从而以动态的进程提升历史主体与历史客体的实践历史价值。

于“情”于“理”:失能老人家庭照护危机研究

应用情理社会理论从照护者角度出发分析失能老人家庭照护危机的形成与应对。家庭照护是当前老人照护的主导模式,而女性在老人家庭照护者中占七成。个案研究发现,在中国式情理社会中,女性照料者的照护决策、行为和感受取决于“情”“理”状况;以“情”为核心的联结感决定照护责任承担主观意愿,作为“理”之关键的其他责任重要性决定照护责任承担的客观条件;在联结感强且其他责任较少的情况下,照护承担带来较强的意义感和价值感,而在其他情况下,照护承担可能为照护者带来较多的压力;同时,“情”和“理”的松动和变化也造成新的照护危机和心理危机。鉴于照护承担意愿和条件多样性,应调整社会政策及相关举措协助、促成或替代女性照护者进行失能老人家庭照护。

构建人口发展支持与服务新格局的新思考

健全人口发展支持与服务体系是进一步深化改革,全面推进中国式现代化的重要保障。当前我国人口迎来负增长叠加少子老龄化的重要转折,面临重要战略机遇期。研究提出要客观看待人口发展新常态,从人口问题的发展与安全属性、市场动能潜力、社会治理抓手等角度创新认识政府、市场和社会的作用。着力构建有为政府、做强有效市场、培育友好社会,以人口高质量发展支撑中国式现代化目标实现。

动态脑电图联合儿童改良GCS对儿童重症监护病房非创伤性意识障碍患儿不良结局的预测效果

目的:探讨动态脑电图(EEG)联合儿童改良格拉斯哥昏迷评分(GCS)对儿童重症监护病房(PICU)非创伤性意识障碍(NCA)患儿不良结局的预测效果。方法:选取2021年6月—2022年12月于广西医科大学第一附属医院PICU进行治疗的NCA患儿69例作为研究对象。所有患儿接受动态EEG监测、儿童改良GCS评估并预测治疗结局,随访1年,比较动态EEG、儿童改良GCS单独及二者联合预测患儿不良结局的效果。结果:1年后,69例患儿中预后不良37例,占比53.62%,预后良好32例,占比46.38%。联合检测准确度高于儿童改良GCS,特异度、阳性预测值高于动态EEG与儿童改良GCS,动态EEG灵敏度、特异度高于儿童改良GCS,差异有统计学意义(P<0.05);三组阴性预测值比较,差异无统计学意义(P>0.05)。结论:动态EEG联合儿童改良GCS对PICU中NCA患儿预后预测价值较高。

气脉冲K点刺激口腔护理对颅脑损伤意识障碍患者的促醒效果

目的评价气脉冲K点刺激口腔护理为主要形式的超早期促醒对颅脑损伤(TBI)意识障碍患者的促醒效果。方法便利抽样选取2022年1-9月南昌大学第一附属医院神经外科TBI意识障碍患者100例,最终纳入研究95例,将2022年1-4月的48例患者设为对照组,2022年6-9月的47例患者设为观察组,5月为洗脱期。对照组在常规促醒治疗的基础上采取传统口腔护理方法,观察组在对照组基础上采用气脉冲K点刺激口腔护理,频率为1次/6 h。比较2组患者干预前、干预后2周、4周意识状态和口腔情况,采用修订版昏迷恢复量表(CRS-R)、格拉斯哥评分(GCS)及RLAS-R认知功能分级量表评估患者意识状态及认知功能的改变,采用改良Beck口腔评估法评估患者口腔情况,同时以横断面方式记录2组口腔护理操作时间。结果干预前,2组患者CRS-R、GCS以及RLAS-R评分,Beck评分比较,差异均无统计学意义(P>0.05)。经干预后2周、4周,患者CRS-R、GCS以及RLAS-R评分逐渐提升,观察组得分高于对照组,差异均具有统计学意义(P<0.05);Beck评分逐渐下降,观察组Beck评分低于对照组,口腔情况优于对照组(P<0.05)。治疗期间2组患者均未发生不良安全事件及不良反应。观察组口腔护理时间短于对照组。结论气脉冲K点刺激方法辅助口腔护理,以临床常见操作为捆绑,实现多频次和规律的感觉刺激,能够改善患者的意识水平,提高口腔护理质量。

渐进式肌肉放松训练在清醒俯卧位通气患者中的应用效果

目的探讨渐进式肌肉放松训练在急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)患者清醒俯卧位通气中的实施效果.方法采用类实验研究法,选取2023年5月-7月湖南省某三级甲等医院ARDS患者45例为试验组,清醒俯卧位通气前采用渐进式肌肉放松训练方案;2022年12月-2023年2月的ARDS患者45例为对照组,采用常规清醒俯卧位通气.比较两组患者清醒俯卧位通气治疗前3 d内的每日单次治疗最长时间、治疗总时长、耐受性和治疗效果.结果试验组在清醒俯卧位通气第3天的单次治疗最长时间[(3.68±0.71)h]高于对照组[(2.50±0.67)h],试验组前3 d治疗总时长[(36.72±0.56)h]高于对照组[(23.25±1.76)h](P<0.001);试验组在治疗第3天的耐受性指标(视觉模拟评分)[(2.83±1.74)分]小于对照组[(6.17±1.11)分](P<0.001);试验组在俯卧位治疗开始4 h后的血氧分压及氧合指数均优于对照组(P<0.001).结论渐进式肌肉放松训练能有效延长ARDS患者清醒俯卧位通气的治疗时间,提高耐受性,从而改善治疗效果.

内生型农村养老服务实践路径研究——基于山西A县多家养老院的调研

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