目的总结并评价成人择期手术术前焦虑非药物管理的证据。方法系统检索BMJ best practice、Up to date、ASA、AORN、各大指南网、JBI、Cochrane图书馆、PubMed、CINAHL、psycINFO和中国知网、万方、中国生物医学文献数据库中术前焦虑非...目的总结并评价成人择期手术术前焦虑非药物管理的证据。方法系统检索BMJ best practice、Up to date、ASA、AORN、各大指南网、JBI、Cochrane图书馆、PubMed、CINAHL、psycINFO和中国知网、万方、中国生物医学文献数据库中术前焦虑非药物管理的相关研究,涵盖临床决策、指南、证据总结、系统评价等文献类型,对纳入文献进行方法学质量评价、证据提取整合、等级评价和推荐级别确定。结果共纳入16篇文献,整合了涵盖术前焦虑的基本特征、筛查和评估、非药物预防、非药物干预和效果评价5大方面,共38条目证据。结论建议护理人员应基于术前焦虑筛查和评估的结果,改善沟通和手术评估、优化健康宣教和手术准备工作,结合客观条件有计划地实施非药物干预措施,并多维度综合评价干预效果,持续改进术前焦虑的管理质量,从而提高患者的舒适度和满意度。展开更多
By tracking and monitoring the profile configuration, topography, and hydrodynamic factors of an artificial cobble beach in Tianquan Bay, Xiamen, China over three consecutive years after its completion, we analyzed th...By tracking and monitoring the profile configuration, topography, and hydrodynamic factors of an artificial cobble beach in Tianquan Bay, Xiamen, China over three consecutive years after its completion, we analyzed the evolution of its profile configura- tion and plane morphology, and its storm response characteristics. The evolution of the profile configuration of the artificial cobble beach in Tianquan Bay can be divided into four stages. The beach was unstable during the initial stage after the beach nourishment the profile configuration changed obviously, and an upper concave composite cobble beach formed gradually, which was character- ized by a steep upper part and a gentle lower part. In the second stage, the cobble beach approached dynamic equilibrium with minor changes in the profile configuration. At the third stage the beach was in a high-energy state under the influence of Typhoon Meranti, and the response of the artificial cobble beach differed significantly from that of the low-tide terrace sandy beach. Within a short time, there was net onshore transport of cobbles in the cross-shore direction. The beach face was eroded, the beach berm was accumulated, and the slope of the beach was steepened considerably. In the alongshore direction, there was notable transport of cobbles on the beach from east to west along the shore, and the total volume of the beach decreased by 4.5×103 m 3, which accounted for 50% of the total amount of beach volume lost within three years. The fourth stage was the restoration stage after the typhoon, characterized by a little gentler profile slope and the increase in width and the decrease in height of beach berm. Because of the action of waves and the wave-driven longshore current caused by the specific terrain and landform conditions along the coast (e.g., coastal headlands, near-shore artificial structures, and reefs), the coastline of the artificial cobble beach gradually evolved from being essentially parallel to the artificial coast upon completion to a slightly curved parabolic shape, and three distinct erosion hotspots were formed on the west side of the cape and the artificial drainpipe, and the reefs. Generally, the adoption of cobbles for beach nourishment on this macro-tidal coast beach with severe erosion has yielded excellent stability and adaptability.展开更多
文摘目的总结并评价成人择期手术术前焦虑非药物管理的证据。方法系统检索BMJ best practice、Up to date、ASA、AORN、各大指南网、JBI、Cochrane图书馆、PubMed、CINAHL、psycINFO和中国知网、万方、中国生物医学文献数据库中术前焦虑非药物管理的相关研究,涵盖临床决策、指南、证据总结、系统评价等文献类型,对纳入文献进行方法学质量评价、证据提取整合、等级评价和推荐级别确定。结果共纳入16篇文献,整合了涵盖术前焦虑的基本特征、筛查和评估、非药物预防、非药物干预和效果评价5大方面,共38条目证据。结论建议护理人员应基于术前焦虑筛查和评估的结果,改善沟通和手术评估、优化健康宣教和手术准备工作,结合客观条件有计划地实施非药物干预措施,并多维度综合评价干预效果,持续改进术前焦虑的管理质量,从而提高患者的舒适度和满意度。
基金supported by the Scientific Research Foundation of the Third Institute of Oceanography, State Oceanic Administration (Nos. 20170305, 2011010)the Public Science and Technology Research Funds Projects of Ocean (No. 201405037)
文摘By tracking and monitoring the profile configuration, topography, and hydrodynamic factors of an artificial cobble beach in Tianquan Bay, Xiamen, China over three consecutive years after its completion, we analyzed the evolution of its profile configura- tion and plane morphology, and its storm response characteristics. The evolution of the profile configuration of the artificial cobble beach in Tianquan Bay can be divided into four stages. The beach was unstable during the initial stage after the beach nourishment the profile configuration changed obviously, and an upper concave composite cobble beach formed gradually, which was character- ized by a steep upper part and a gentle lower part. In the second stage, the cobble beach approached dynamic equilibrium with minor changes in the profile configuration. At the third stage the beach was in a high-energy state under the influence of Typhoon Meranti, and the response of the artificial cobble beach differed significantly from that of the low-tide terrace sandy beach. Within a short time, there was net onshore transport of cobbles in the cross-shore direction. The beach face was eroded, the beach berm was accumulated, and the slope of the beach was steepened considerably. In the alongshore direction, there was notable transport of cobbles on the beach from east to west along the shore, and the total volume of the beach decreased by 4.5×103 m 3, which accounted for 50% of the total amount of beach volume lost within three years. The fourth stage was the restoration stage after the typhoon, characterized by a little gentler profile slope and the increase in width and the decrease in height of beach berm. Because of the action of waves and the wave-driven longshore current caused by the specific terrain and landform conditions along the coast (e.g., coastal headlands, near-shore artificial structures, and reefs), the coastline of the artificial cobble beach gradually evolved from being essentially parallel to the artificial coast upon completion to a slightly curved parabolic shape, and three distinct erosion hotspots were formed on the west side of the cape and the artificial drainpipe, and the reefs. Generally, the adoption of cobbles for beach nourishment on this macro-tidal coast beach with severe erosion has yielded excellent stability and adaptability.
