Protection of Maternity in Greece and the E.U.——A Comparison Analysis

Pregnancy and motherhood are two situations which impose on the special regulation of the working conditions in order to secure the protection of the physical and psychological health of woman. Furthermore, the disproportion between woman＇s and man＇s work and the mentality that labour and the raising of child is a burden that only woman has to bear, needs to be eliminated. This burden is softened by the protection provided to pregnant women by the state. This way, a great effort is made to promote the equality in working relations between men and women. This kind of protection is realized through the National Health and Social Care by giving economical provisions and through legislative regulations in order to harmonize work and parental role. In this study, regulations and services along with their health care personnel, referring to motherhood＇s protection in Greece, are presented and related data concerning other EU countries are given. Until now, the existing system of maternity of the ＂Social State＂ has not reached yet the desired goal.

Practices and Barriers for Personal Protective Equipment among Health Care Workers during COVID-19 Pandemic Management at Tertiary Care Government Hospital of South Gujarat, India

Introduction: The recent COVID-19 pandemic has prompted concern about the compatibility of IPC guidelines with health care workers, their working practices and behaviours. These guidelines can be difficult and time-consuming to adhere to in practice. By identifying barriers and facilitators to IPC guideline adherence, especially using personal protective equipment (PPE), we can identify focussed strategies that will support health care workers to undertake the IPC measures needed at such a critical time in health care internationally. Material & Methods: This was a cross-sectional study designed during the COVID-19 pandemic management in the South Gujarat region, to analyse the knowledge, attitude and practices of health care workers about their usage of personal protective equipment. A semi-structured questionnaire-based study was prepared, deriving pointers from our previous experience of seasonal flu outbreaks. 225 participants enrolled who were doctors, resident doctors, nurses, lab technicians, ward boys and food distributors. Result: Analysis of the barriers-related questions show good preparedness by the medical institution. Overall we found good knowledge, attitude and practice related to PPE during COVID-19 pandemic management. There are few gaps found in the knowledge of donning of PPE (p-0.0075), N-95 mask related knowledge (p-0.01) and the attitude that PPE use causes discomfort while nursing patients (0.0001).

Force application of laparoscopic surgeons under the impact of heavy personal protective equipment during COVID-19 pandemic

Objective:Surgeons are required to wear heavy personal protective equipment while delivering care to patients during the COVID-19 pandemic.We examined the impact of wearing double gloves on surgeons’performance in laparoscopic surgery.Methods:Eleven surgeons-in-training at the Surgical Simulation Research Lab of the University of Alberta were recruited to perform laparoscopic cutting tasks in simulation while wearing none,one pair,and two pairs of surgical gloves.Forces applied to laparoscopic instruments were measured.Results:Wearing gloves prolonged task times(one pair of gloves:301.6±61.7 s;two pairs of gloves:295.8±65.3 s)compared with no gloves(241.7±46.9 s;p=0.043).Wearing double gloves increased cutting errors(20.4±5.1 mm^(2))compared with wearing one pair of gloves(16.9±5.5 mm^(2))and no gloves(14.4±4.6 mm^(2);p=0.030).Wearing gloves reduced the peak force(one pair of gloves:2.4±0.7 N;two pairs of gloves:2.7±0.6 N;no gloves:3.4±1.4 N;p=0.049),and the total force(one pair of gloves:10.1±2.8 N;two pairs of gloves:10.3±2.6 N;no glove:12.6±1.9 N;p=0.048)delivered onto lapa-roscopic scissors compared with wearing no glove.Conclusion:The combined effects of wearing heavy gloves and using tools reduced the touching sensation,which limited the surgeons’confidence in performing surgical tasks.Increasing practice in simulation is suggested to allow surgeons to overcome difficulties brought by personal protective equipment.

The effect of protective genital care protocol on preventing diaper dermatit development in 0 - 18 month old children using antibiotics

Diaper dermatit is among the widely seen inflamatory skin diseases in neonatals and small 0 - 18 month old children. Control of causative agents as well as providing good genital care may prevent or reduce the risk of the disease. The aim of this study is find out the effect of protective genital care on reducing the diaper dermatit development in 0 - 18 months old inpatient 0 - 18 month old children who are using antibiotic. The study was conducted as prospective half-experimetal using control-experimental groups. Our samples comprise of 0 - 18 month old children admitted at Dokuz Eylul University Practical and Research Hospital, pediatric clinic between January and May 2009, 41 0 - 18 month old children as a control group were not under protective genital care, and 42 0 - 18 month old children as an experimental group were under the protecion and using vaseline. The mothers of the experimental group 0 - 18 month old children were given education. All 0 - 18 month old children were followed-up 3 - 7 days and the collected data were evaluated in computer using Pearson’s chisquare, Fisher’s exact chi-square and Yatest-corrected chi-square tests. The diaper dermatit develop- ment ratio was 34.1% in the control group and 7.1% in the experimental group

Protection of Childhood in Greece

The early childhood care is important not only for individual Greek children and families but also for Greek society at large. Furthermore, it needs to be secured that the burden of labour and the raising of child is not only a woman＇s duty. There is a broad recognition that a strategy for developing early childhood services and childcare to support mother＇s labour force participation is in the public interest and should be the primary scope of the national health and social care policy. The inadequate organization of the child welfare system has adverse effects on the well-being, and function of the family. Only the improvement of the expected protection can lead to social politics that will give a chance to mother and child to live in conditions fitting human value and dignity. Herein, we presented the regulations and services along with health care professionals that refer to the protection of child in Greece.

Health care worker occupational experiences during the COVID-19 outbreak:A cross-sectional study

BACKGROUND Health care workers treating coronavirus disease 2019(COVID-19)patients experience burnout and stress due to overwork and poor working conditions.AIM To investigate the work experiences of frontline health care workers in Wuhan city and Qinghai province,China,during the COVID-19 outbreak.METHODS In this cross-sectional descriptive study,a self-reported questionnaire was designed to evaluate work experiences of medical staff throughout the course of the COVID-19 pandemic.A total of 178 health care workers responded to the questionnaire between February 19 and 29,2020.Higher questionnaire dimensional score confirmed dimensional advantage.RESULTS Of all dimensions evaluated by this questionnaire,the occupational value dimension had the highest mean score of 2.61(0.59),followed by the support/security dimension score of 2.30(0.74).Occupational protection scored lowest at 1.44(0.75),followed by work environment at 1.97(0.81).The social relationships dimension had an intermediate score of 2.06(0.80).Significant differences in working conditions were observed across hospital departments,with the fever ward scoring lowest.Total scores also differed significantly across workplaces;the fever outpatient department scored lowest(P<0.01).This phenomenon was likely due to the fact that work in the fever outpatient department,where many patients present to hospital,necessitates constant contact with a large number of individuals with insufficient provision of resources(such as protective equipment and social support).Medical workers in the fever outpatient department were burdened with a fear of COVID-19 infection and a lower sense of professional value as compared to workers in other hospital departments.Medical staff in Wuhan worked longer hours(P<0.01)as compared to elsewhere.The mean support/security dimension score was higher for tertiary hospital as compared to secondary hospital medical staff as well as for Wuhan area as compared to Qinghai region staff(P<0.01).Staff in Wuhan had a lower mean work environment score as compared to staff in Qinghai(P<0.05).CONCLUSION Medical staff treating COVID-19 patients in China report poor occupational experiences strongly affected by work environment,occupational protection and social relationships.Health care managers must address the occupational needs of medical staff by ensuring a supportive and safe work environment.

Intraoperative care of elderly patients with COVID-19 undergoing double lung transplantation:Two case reports

BACKGROUND Lung transplantation is considered an effective method for treating patients with end-stage coronavirus disease 2019(COVID-19).The nurses play a pivotal role in lung transplantation for COVID-19 patients.CASE SUMMARY Two elderly patients were admitted to the emergency department due to cough,and the nucleic acid test was positive.The patients were preliminarily diagnosed with COVID-19.The chest computed tomography scan revealed massive lung consolidation,and the patients did not improve after treatment with antiviral drugs,glucocorticoids,antibiotics,and other drugs.Under the support of pure oxygen in extracorporeal membrane oxygenation,the patients’oxygen levels were still poor,indicating that they were in the terminal stage of viral pneumonia.The patients underwent double-lung transplantation and received intraoperative care.The extracorporeal membrane oxygenation device was removed within a week of the surgical procedure,and the respiratory circulation of the patients were stabilized.CONCLUSION High-quality care for COVID-19 patients undergoing lung transplantation ensures patient safety during operation while protecting the safety of the medical staff.

用CARE Dose4D技术进行胸部扫描的临床价值

目的:探讨优化胸部CT扫描剂量在减少辐射方面的价值。方法:对50例患者利用在线式自动化实时动态放射剂量调节技术(CARE Dose4D)进行胸部CT扫描,观察其成像质量,分析其每一层的曝光量(mAs)和容积CT剂量指数(CTDIvol),然后和常规胸部CT扫描(200 mAs,15.3 mGy)进行比较。结果:利用CARE Dose4D技术进行胸部CT扫描的单层曝光量与常规胸部CT扫描的曝光量200 mAs比较,最多下降幅度84%,平均下降48.2%;CTDIvol最多下降56.5%,平均下降32.98%。两者有统计学意义(P<0.05)。结论:CARE Dose4D技术在胸部扫描中可以有效降低患者的受照射剂量,且不影响图像质量。

SARS-CoV-2, surgeons and surgical masks

The exact risk association of coronavirus disease 2019(COVID-19)for surgeons is not quantified which may be affected by their risk of exposure and individual factors.The objective of this review is to quantify the risk of COVID-19 among surgeons,and explore whether facemask can minimise the risk of COVID-19 among surgeons.A systematised review was carried out by searching MEDLINE to locate items on severe acute respiratory syndrome coronavirus 2 or COVID-19 in relation to health care workers(HCWs)especially those work in surgical specialities including surgical nurses and intensivists.Additionally,systematic reviews that assessed the effectiveness of facemask against viral respiratory infections,including COVID-19,among HCWs were identified.Data from identified articles were abstracted,synthesised and summarised.Fourteen primary studies that provided data on severe acute respiratory syndrome coronavirus 2 infection or experience among surgeons and 11 systematic reviews that provided evidence of the effectiveness of facemask(and other personal protective equipment)were summarised.Although the risk of COVID-19 could not be quantified precisely among surgeons,about 14%of HCWs including surgeons had COVID-19,there could be variations depending on settings.Facemask was found to be somewhat protective against COVID-19,but the HCWs’compliance was highly variable ranging from zero to 100%.Echoing surgical societies’guidelines we continue to recommend facemask use among surgeons to prevent COVID-19.

英国医疗健康大数据Care.data的前车之鉴

英国有着世界领先的医疗健康保障体系,积累了丰富而又宝贵的数据资源,为大数据在医疗健康领域的应用创造了良好的条件,Care.data项目是其重要的探索。但在项目实施过程中由于缺乏必要的规划部署和试点探索、没有正确处理好家庭医生与项目的关系、缺乏公众的理解和支持、不当的商业开发及技术方案不够完善等原因最终导致了项目失败,为我国医疗健康大数据的开发利用提供了前车之鉴。我国正在大力推进大数据在医疗健康领域的应用,必须从英国的实践中汲取教训,以少走不必要的弯路。

A case report of attending to one critically ill patient with COVID-19

The outbreak of COVID-19 in Wuhan began to spread rapidly in December 2019.It is highly infectious and widely spread.This article summarizes the care experience of one critically ill COVID‑19 patient,including the strict implementation of protective measures,avoiding infection,precautions for high‑risk caring of tracheal intubation,giving psychological care,improving the coordination,the importance of vital signs,food intake and excretion,and how to reduce the risk of infection during sample collection,as well as strengthening discharge guidance.

长期护理保险制度试点中的老年人权益保障

基于我国现行的长期护理保险政策和实践,梳理总结了长期护理保险试点阶段的基本情况、主要经验与基本制度框架;结合实地调研资料,分析试点过程中老年人的权益保障问题。结果显示,筹资机制的多元性不强,参保范围与保障对象的城乡覆盖、失能失智覆盖不足,服务需求评估的精准度还有待提高,服务过程中老年人合法权益易受损害且申诉难度较高。结合国内外长期护理保险制度的实践经验,从老年人权益保障的公平性等视角出发提出了相应对策建议:拓宽筹资渠道;逐步扩大制度覆盖面;加大对农村及特殊困难群体的资源倾斜力度;以老年人需求为导向提供长期护理服务;加强服务标准监管与人才队伍建设;完善长期护理保险的法律规制与投诉机制。

未成年男性性权益的刑法保护——对我国《刑法》第236条之一的立法论思考

我国刑事立法对未成年男性的性权益保护存在不均衡、不完整情况。并且学界对于性侵未成年人犯罪的法益尚未达成共识,致使对未成年男性性权益的保护并不完整。基于未成年人的特殊身份以及以性别不同为基础的心理差异,家长主义应当介入未成年男性性权益的保护。根据平等原则以及儿童利益最大化原则的要求,加强未成年男性性权益的保护具有必要性。为实现对未成年男性性权益的周延保护,首先,应将身心健康作为被性侵未成年男性的首要法益;其次,应扩充负有照护职责人员性侵罪的犯罪对象,将男性也纳入本罪保护范围,并将年龄保护区间扩大至14周岁到18周岁;再次,还需增设负有照护职责人员猥亵罪,以完善对未成年男性的保护;最后,应强化未成年男性保护行政、刑事衔接,凝聚法治保护合力。

基于保护动机模式的护理对子宫肌瘤患者自护能力、并发症、情绪状态、睡眠及生活质量的影响

目的探讨基于保护动机模式的护理对子宫肌瘤患者自护能力、并发症、情绪状态、睡眠及生活质量的影响。方法按照入院顺序对2023年1月-12月福建省妇幼保健院的60例患者进行编码,按照单双数来确定对照组(30例,常规护理)和干预组(30例,基于保护动机模式的护理)。比较两组患者自护能力、并发症、情绪状态、睡眠质量、生活质量。结果干预组ESCA 4项评分均高于对照组(P<0.05)。干预组出现切口感染、恶心、呕吐、高热4项并发症患者低于对照组(P<0.05)。干预组及对照组SAS、SDS评分与护理前比均降低,且干预组低于对照组(P<0.05)。干预组睡眠质量7项PSQI指标均低于对照组(P<0.05)。两组SF-36评分均较护理前提高,干预组高于对照组(P<0.05)。结论干预组方法能够减少子宫肌瘤患者术后并发症的产生,情绪状态更佳,其睡眠质量、自我护理能力均得到了提高,患者生活质量更高。

试析医养结合规范性文件的法理依据、效力及合法性要求

2013年国家提出医养结合新型养老模式,是应对人口老龄化的创新举措。中央和省级政府及其部门陆续出台一系列规范性文件,促进各地探索医养结合体制机制试点工作,并取得一定成效。然而,由于这些规范性文件效力位阶低,其创设的相关义务超越所涉上位法规定,致使医养结合面临制度性障碍。对此,应加大力度推进医养结合法治建设,为医养结合发展提供法治保障。这也是我国全面依法治国战略对医养结合依法推进的必然要求。

论老年人的安宁疗护权及其法律保障原则

在人口老龄化的冲击下,越来越多的终末期老年患者承受着身体、精神的痛苦及尊严的减损,这也在客观上增加了老年人对安宁疗护服务的需求。近年来,安宁疗护权已逐渐获得国际认可。目前我国虽然尚未制定关于安宁疗护的国家层面立法,但是我国的宪法、法律以及政策都能够为安宁疗护权提供充分的法理基础。在我国安宁疗护地方试点先行的基础上,未来我国安宁疗护立法应当遵循多层次服务体系、患者知情选择、谨慎审查、全人照顾、多学科服务模式的法律保障原则。

关于完善我国安宁疗护法律保障制度的思考

安宁疗护已被世卫组织列为优先公共卫生议题;我国自2017年起选定启动5个地区作为第一批试点城市,且在过去7年实践中主要倡导医院、社区、医养结合、居家以及远程服务这5种安宁疗护模式,研究内容涉及多个学科和层面。对于这项具有紧迫需求的社会事业,我国安宁疗护领域当前面临困境--立法需求、具体实践呈碎片化推进以及常态化政策需求三者与保障机制薄弱之间存在矛盾;故需要借助多方力量标本兼治,以加强“健康中国”建设、促进安宁疗护政策的运行,更需要依托硬策和软策的革新与变化,从健康权视角保障、临终关怀法律完善以及安宁疗护法律推进等方面逐步完善我国安宁疗护法律制度。

移情式关怀理论在刑事诉讼中的融入研究——以人权保障为视角

刑事诉讼现有研究主要集中于客观维度的程序制度建构,而对司法工作人员在认知方面的主观维度缺乏关注。但是,客观的程序制度无法自动产出公正的结果,司法工作人员的决策行为贯穿整个刑事诉讼过程,其主观认知在其中发挥着重要作用,甚至对决策结果产生决定性影响,因此,需要对刑事诉讼主观维度予以足够重视。刑事诉讼主观维度以司法工作人员的道德情感为核心,影响其立场和决策。主观维度的研究可以从移情式关怀理论中得到启发,使人们具有以对他人苦难产生情绪反应的能力为出发点,并提出禁止引发他人苦难,乃至尽力消除他人痛苦的道德要求。在刑事诉讼中融入移情式关怀理论,可以产生舒缓惩罚犯罪原则与保障人权原则之间的张力,推进无罪推定原则的完善,为审判中心主义提供支持等积极效果。虽然,移情式关怀理论无法避免人类主观方面的局限,但是,通过司法工作人员的立场确立和诱导训练可以弥补刑事诉讼人权保障中的不足。

保护动机理论的延续性护理对糖尿病视网膜病变患者负性情绪及应对方式的影响

目的:探究保护动机理论的延续性护理,对糖尿病视网膜病变(DR)患者负性情绪及应对方式的影响.方法:选取2022年1月至2023年4月本院收治的80例DR患者为研究对象.采取随机数字表法将其分为实验组(n=40,采用保护动机理论的延续性护理)和对照组(n=40,采用常规护理).对两组患者护理前、后各项功能指标变化进行统计学分析.结果:采取不同方法护理后,实验组空腹血糖、餐后2h血糖、焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分、回避评分、屈服评分,均显著低于对照组,差异均有统计学意义(P<0.05);而应对方式评分显著高于对照组,差异有统计学意义(P<0.05).结论:在DR患者中实施保护动机理论的延续性护理,能够有效缓解患者的负性情绪,加强患者的血糖控制效果,值得广泛应用.

正念认知疗法结合强化自能护理对糖尿病肾病血液透析患者疲乏状况及自护行为的影响

目的:探讨正念认知疗法结合强化自能护理对糖尿病肾病(DN)血液透析患者疲乏状况及自护行为的影响。方法:选取2021年3月—2023年2月厦门市中医院收治的125例DN血液透析患者作为研究对象,随机分为对照组62例和研究组63例,对照组给予常规护理干预,研究组给予正念认知疗法结合强化自能护理干预。对比两组心理状态[焦虑、抑郁自评量表(SAS、SDS)]、疲乏状况[修订版Pieper疲劳量表(PRFS)]、自护行为[糖尿病自护行为量表(SDSCA)]、生活质量[肾脏病生活质量量表(KDQOL-SF)]。结果:护理后研究组SAS、SDS评分较对照组低,差异有统计学意义(P<0.05);护理后研究组PRFS各维度评分较对照组低,差异有统计学意义(P<0.05);护理后研究组SDSCA各维度评分较对照组高,差异有统计学意义(P<0.05);护理后研究组KDQOL-SF评分较对照组高,差异有统计学意义(P<0.05)。结论:正念认知疗法结合强化自能护理能改善DN血液透析患者心理状态,缓解其疲乏,提高患者自我行为、生活质量。