Critical care nurses and their clinical reasoning for customizing monitor alarms:a mixed-method study

Objective:To explore the clinical rationale of critical care nurses for personalizing monitor alarms.One of the most crucial jobs assigned to critical care nurses is monitoring patients'physiological indicators and carrying out the necessary associated interventions.Successful use of equipment in the nursing practice environment will be improved by a thorough understanding of the nurse's approach to alarm configuration.Methods:A mixed-method design integrating quantitative and qualitative components was used.The sample of this study recruited a convenience sample of 60 nurses who have worked in critical care areas.This study took place at Lebanese American University Medical Center Rizk Hospital,utilizing a semi-structured interview with participants.Results:The study demonstrated the high incidence of nuisance alarms and the desensitization of critical care nurses to vital ones.According to the nurses,frequent false alarms and a shortage of staff are the 2 main causes of alarm desensitization.Age was significantly associated with the perception of Smart alarms,according to the data(P=0.03).Four interconnected themes and subcategories that reflect the clinical reasoning process for alarm customization were developed as a result of the study's qualitative component:(1)unit alarm environment;(2)nursing style;(3)motivation to customize;and(4)clinical and technological customization.Conclusions:According to this study,nurses believe that alarms are valuable.However,a qualitative analysis of the experiences revealed that customization has been severely limited since the healthcare team depends on nurses to complete these tasks independently.Additionally,a staffing shortage and lack of technical training at the start of placement have also hindered customization.

An Explanation of the Temperature-Dependent Upper Critical Field Data of H3S on the Basis of the Thermodynamics of a Superconductor in a Magnetic Field

Excellent fits to a couple of the data-sets on the temperature (T)-dependent upper critical field (Hc2) of H3S (critical temperature, Tc ≈ 200 K at pressure ≈ 150 GPa) reported by Mozaffari, et al. (2019) were obtained by Talantsev (2019) in an approach based on an ingenious mix of the Ginzberg-Landau (GL), the Werthamer, Helfand and Hohenberg (WHH), and the Gor’kov, etc., theories which have individually been employed for the same purpose for a long time. Up to the lowest temperature (TL) in each of these data-sets, similarly accurate fits have also been obtained by Malik and Varma (2023) in a radically different approach based on the Bethe-Salpeter equation (BSE) supplemented by the Matsubara and the Landau quantization prescriptions. For T TL, however, while the (GL, WHH, etc.)-based approach leads to Hc2(0) ≈ 100 T, the BSE-based approach leads to about twice this value even at 1 K. In this paper, a fit to one of the said data-sets is obtained for the first time via a thermodynamic approach which, up to TL, is as good as those obtained via the earlier approaches. While this is interesting per se, another significant result of this paper is that for T TL it corroborates the result of the BSE-based approach.

On Multimodal Criticism of The Kitchen God’s Wife

Studying the covers of the three editions of The Kitchen God’s Wife by Amy Tan,a famous female Chinese American writer,the author finds Chinese cultural elements stood out in publishers’earliest recommendations,but later were replaced by immigrant mother-daughter relationship,and then were overwhelmed by the concern for human beings.It is interesting that this change fits the changing focuses of Chinese American writers in the 21st century.

Intensive care environment: Perspective of relatives of critically ill patient sustained by health technology

The intensive care unit(ICU)is a complex setting by nature,and some have described it as bizarre due to its numerous sirens that sound when anything is dangerous,constant activity,equipment,bright lights,and high fatality rate.The demands placed on nurses to care for critically ill patients in this environment frequently prevent nurses and other health‑care professionals from acknowledging the feelings of patient’s relatives or family caregivers,resulting in a hostile environment from the patient’s relative’s perspective.When a patient’s family enters the ICU,they feel that hospital administrators do little to nothing to alleviate their discomfort and fear.Despite research demonstrating the importance of providing a homely environment for patients’families,In Nigeria ICU is still far behind how a conventional ICU environment should be structured to accommodate patient’s relations in the unit.The goal of this study was to look at the patient’s relative’s perspective on providing care for a critically ill patient in an ICU,with a focus on the unit’s complexity and overall experience.Based on the findings of this study,we recommend that hospital administrators ensure that the environment of the upcoming ICU is designed to meet the needs of patient’s relatives by addressing identified environmental concerns,like caring neglect,by providing a friendly and stress‑free environment.

观察基于Watson人性照顾理论的干预对重症肺炎合并呼吸衰竭患者的应用效果

目的:观察基于Watson人性照顾理论的干预对重症肺炎合并呼吸衰竭患者的应用效果。方法:选取2021年6月至2023年6月泉州市第一医院呼吸与危重症医学科收治的重症肺炎合并呼吸衰竭患者94例作为研究对象,按照随机数字表法分为对照组和观察组,每组47例。对照组给予常规护理干预,观察组在对照组基础上给予Watson人性照顾理论的干预。采用匹兹堡睡眠质量指数量表(PSQI)比较2组患者干预前后睡眠质量的变化,采用阿森斯失眠量表(AIS)评估2组患者干预前后失眠的改善效果,并通过2组患者护理后的呼吸困难缓解时间、机械通气时间、重症监护室住院时间,以判断恢复情况。结果:干预后,观察组患者PSQI评分、AIS评分均显著低于对照组,观察组呼吸困难缓解时间、机械通气时间及重症监护室住院时间均显著短于对照组,差异均有统计学意义(均P<0.05)。结论:对重症肺炎合并呼吸衰竭患者应用基于Watson人性照顾理论的护理干预可有效改善其睡眠质量,促进病情恢复,值得临床推广应用。

S(+)-氯胺酮在急重症医学中的应用进展

S(+)-氯胺酮是氯胺酮的纯右旋对映体,主要用于临床镇痛和麻醉。根据药理学和临床特征,S(+)-氯胺酮被作为目前急救与重症医学的首选麻醉药。在急危重患者麻醉中,S(+)-氯胺酮被用于刺激循环及稳定血流动力学、扩张支气管及抑制组胺释放、神经保护及降低扩散性去极化、抗惊厥及抑制癫痫持续状态、抗炎及拟β-氨基和拟α-氨基等。在重症监护病房中,S(+)-氯胺酮被用于预防谵妄并减少谵妄发生、预防并减少痛觉过敏和耐受、抗炎抗惊厥、神经保护以及用于新型冠状病毒肺炎相关的急性呼吸窘迫综合征患者等。因此,全面了解S(+)-氯胺酮在急重症医学中的具体应用,可以为急危重患者的治疗提供更多帮助。

Analysis of New Senior English for China Student’s Book 1

This article will firstly discuss the context overview of English teaching and learning in China. Under thiscircumstance, a problematic element will be examined of the New Senior English for China Student’s Book 1 and critical appraisal ofhow this element relates to other elements of curriculum development will be analyzed. The recommended changes and demonstrationmechanisms for evaluating the changes are put forward in the last two parts.

On the Relationship between T. S. Eliot and the New Criticism from Their Opinions on Literary Work and Reader

T. S. Eliot is always considered as the pioneering father and founder of the New Criticism. This paper compares the similarities and differences of T. S. Eliot's relevant theories with those of the New Criticism from two aspects: their viewpoints of the literary works and those of the reader. It concludes that though they share the same belief in the importance of the literary works, the New Criticism is good at the subtle analysis of one text and another. However, Eliot recognizes the reader's function in the appreciation of the works which New Criticism totally objects to, and their responses should be properly considered in the criticism of the works.

A Dynamical Approach to the Explanation of the Upper Critical Field Data of Compressed H3S

Excellent fits were obtained by Talantsev (MPLB 33, 1950195, 2019) to the temperature (T)-dependent upper critical field (Hc2(T)) data of H3S reported by Mozaffari et al. [Nature Communications 10, 2522 (2019)] by employing four alternative phenomenological models, each of which invoked two or more properties from its sample-specific set S1 = {Tc, gap, coherence length, penetration depth, jump in sp.ht.} and a single value of the effective mass (m*) of an electron. Based on the premise that the variation of Hc2(T) is due to the variation of the chemical potential μ(T), we report here fits to the same data by employing a T-, μ- and m*-dependent equation for Hc2(T) and three models of μ(T), viz. the linear, the parabolic and the concave-upward model. For temperatures up to which the data are available, each of these provides a good fit. However, for lower values of T, their predictions differ. Notably, the predicted values of Hc2(0) are much higher than in any of the models dealt with by Talantsev. In sum, we show here that the addressed data are explicable in a framework comprising the set S2 = {μ, m*, interaction parameter λm, Landau index NL}, which is altogether different from S1.

Rock critical porosity inversion and S-wave velocity prediction

A critical porosity model is often used to calculate the dry frame elastic modulus by the rock critical porosity value which is affected by many factors. In practice it is hard for us to obtain an accurate critical porosity value and we can generally take only an empirical critical porosity value which often causes errors. In this paper, we propose a method to obtain the rock critical porosity value by inverting P-wave velocity and applying it to predict S-wave velocity. The applications of experiment and log data both show that the critical porosity inversion method can reduce the uncertainty resulting from using an empirical value in the past and provide the accurate critical porosity value for predicting S-wave velocity which significantly improves the prediction accuracy.

基于CRITIC和TOPSIS的区域工业科技创新能力评价研究

为有效评价区域工业科技创新能力,构建了融合绝对值指标和平均值指标的评价指标体系。以28个地区为研究对象,基于目前最新的2014-2017年数据,使用基于指标相关性的权重确定法(CRITIC)确定指标权重,运用逼近理想解排序法(TOPSIS)从"静态"和"动态"两个视角评价,识别出各地区工业科技创新能力的现状和发展。研究发现,技术引进、自主创新、R&D人员和经费、R&D项目活跃度、科技成果转化始终是影响各地区工业科技创新能力提升的重要因素。"静态"评价结果显示,中国工业科技创新能力总体一般,地区间差异较大,"很强"和"较强"的地区只有广东、江苏、上海、北京、浙江和山东6个省市。"动态"评价结果显示,工业科技创新能力发展存在明显的区域依存,强弱格局比较稳定,短期内难以改变。研究成果表明,该指标体系和模型能够有效评价区域工业科技创新能力。最后,结合重要影响因素,给出提升工业科技创新能力的建议。

Writer’s Workshop写作模式对英语写作的影响

文中对某高校93名非英语专业本科生,进行了一项运用Writer’s Workshop写作模式来提高学生英语写作中内容知识和写作成绩的研究。研究结果表明,在大学英语写作中,使用该写作模式,既能提高学生的英语写作能力,也能激发他们的自主学习能力和合作能力。

The critical realism of the novels of Haruki Murakami

Haruki Murakami is a serious belles-lettres writer with a title of petty bourgeois. With calm perspective, his writing points to the profound problems of human society, and also criticizes and analyses the history of World War II which is a closely guarded secret to most Japanese. The important topics of his literature are generally about the exposure of human nature under special time background, various deep problems accompanying with modern civilization, and the wounds brought to human by wars.

Writer’s Workshop对研究生英语写作课程的启示

以美国大学中的Writer’s Workshop写作课程为案例,从如何培养和激励研究生的创新能力、自主学习能力和协作学习能力等方面介绍Writer’s Workshop课程的模式和流程,总结其对研究生英语写作课程的启示。

Adaptive synchronization of a critical chaotic system

This paper further investigates the synchronization problem of a new chaotic system with known or unknown system parameters. Based on the Lyapunov stability theory,a novel adaptive control law is derived for the synchronization of a new chaotic system with known or unknown system parameters.Theoretical analysis and numerical simulations showthe effectiveness and feasibility of the proposed schemes.

Critical emancipatory reflection on a practice-based issue in relation to the working relationship between doctors and nurses in China

Objective: Reflection is viewed as the most significant skill and should be advocated for lifelong learning. In order to grasp the process of reflection and embrace the reflective skill, one of the authors of this paper reflects on a practice-based issue in relation to the communication between doctors and nurses, to gain new understanding and thus improve the authors' clinical practice.Methods: Smyth's framework with four stages is utilized as an ideal framework to guide the author's reflection on the practice-based issue to free the author from her entrenched assumptions and the oppressive forces that limit her practice.Results: The espoused and enacted theory, together with the critical reflection theory, are used to explore the values and beliefs that essentially govern the author's practice and how these are distinct from the author's worldviews. Following this, critical emancipatory reflection is undertaken to explore the dominant power structures within the author's workplace. Furthermore, given the hegemonic and chaotic working context of this issue, hegemony and symbolic interaction theory are applied to unearth the various hidden constraining and oppressive forces. Additionally, socialization theory is utilized to help the author achieve professional identity.Conclusions: Reconstructing the practice-based issue empowers the author to realize that in the future, she should act as a reflective practitioner, creating a daily habit, staying alert to practice, seeing things freshly, finding support systems, improving communication skills, conducting reflective research, and reifying reflective practice. Ultimately, the author will be sufficiently equipped to be able to transform her practice and change its outcomes.

REMARK ON CRITICAL SPEED OF TRAVELING WAVEFRONTS FOR NICHOLSON'S BLOWFLIES EQUATION WITH DIFFUSION

This note is devoted to the son＇s blowflies equation with diffusion, a critical speed of traveling waves, we give behavior with respect to the mature age study on the traveling wavefronts to the Nicholtime-delayed reaction-diffusion equation. For the a detailed analysis on its location and asymptotic

Critical emancipatory reflection on establishing an equal,trusting relationship among surgery participants in clinical practice in China

Objective: Reflection is considered to be one of the important ways to learn from one's experience, and one should be encouraged to apply the skill of reflection in lifelong learning. The author used the critical emancipatory reflection theory to reflect on a practice issue,which was related to the relationship between doctors and nurses, and tries to become a lifelong reflective practitioner in clinical work.Methods: Smyth's reflective framework, which includes the steps describe, inform, confront, and reconstruct, will be used in this article to help the author to understand the process of reflection and improve the skill of reflection. Utilizing Smyth's reflective framework to reflect on an issue in practice allows the author to break the routine way of thinking and learn from experience, as well as providing a higher quality of service for patients.Results: The theory of emancipatory reflection along with the critical reflection theory will be used to determine the beliefs and values that rule the author's action and derive how these are distinct from what the author is supposed to achieve. Besides, critical emancipatory reflection theory will be used to discover the dominant power structures in clinical practice; symbolic interaction and hegemony will be utilized to discover the factors that prevent the author from achieving the desired goals; socialization theory will be applied to facilitate the author in improving the professional identity.Conclusions: Using the critical emancipatory reflection on the issue in practice helps the author to find out the constraints in practice,bridge the espoused value and enacted value, and thereafter undertake transformative changes in practice. Eventually, the author can improve the skill of critical emancipatory reflection and become a lifelong reflective practitioner, and the quality of clinical practice can be improved as a result.

Critical emancipatory reflection on a practice-based issue in relation to nurses' communicative role with unsatisfied clients in Chinese hospitals

Objective: This study aims to use reflective theory and critical emancipatory theory to explore nurses' communicative role with unsatisfied clients.Methods: This paper begins with the broad issue, and the analysis will engage Smyth's cycle, which includes describing, analyzing,exploring, and reconstructing.Results: Critical emancipatory reflection is essential to make changes in the professional practice of nursing, because it is of primary importance for the professional learning and development of a nurse.Conclusions: Critical emancipatory reflection helps a nurse to analyze the constraints, including historical, sociocultural, political, and personal aspects.

Geochemical characteristics and growth suitability assessment of Scutellaria baicalensis Georgi in the Earth's critical zone of North China

Geochemical differentiation of soils has a series of consequences on plant and places pressure on the ecological environment.The quantitative evaluation of element migration in the Earth’s critical zone is a challenging task.In this study,two demonstration study areas of Scutellaria baicalensis Georgi were selected,and multiple chemical weathering indexes,chemical loss fraction,mass migration coefficients and biological enrichment coefficient method were used to assess the ecological and geochemical suitability.The results show that for the element of Fe,Zn,Se,Cu,Co,Ni,Mo and Ge,the degree of weathering and soil maturation,were greater in the rhyolitic tuff area than in the Plagioclase gneiss area.In both research sites,the heavy metal level of samples in Scutellaria baicalensis Georgi did not exceed the standard limits.The plagioclase gneiss region’s surface soil environment was more alkaline,and the content of soil organic matter was lower,resulting in a higher bioenrichment intensity of Ge,Co,Cu,and Se elements in Scutellaria baicalensis Georgi than in the rhyolite-tuff area.The elements of Cd,Nb,Mo,Pb and As are considerably enriched in the soil of the plagioclase gneiss area but lost by leaching in the soil of the rhyolite tuff area,which is connected to the interplay of elemental abundance and human impact in the parent materials.This study provides a good example of how to assess growth suitability of Chinese medicinal materials in the Earth’s critical zone.