Objective:We conducted an analysis of the American College of Surgeons National Surgical Quality Improvement Program database for minimally-invasive partial nephrectomy cases reported with the goal to identify pre-and...Objective:We conducted an analysis of the American College of Surgeons National Surgical Quality Improvement Program database for minimally-invasive partial nephrectomy cases reported with the goal to identify pre-and peri-operative variables associated with length of stay(LOS)greater than 3 days and readmission within 30 days.Methods:Records from 2008 to 2018 for“laparoscopy,surgical;partial nephrectomy”for prolonged LOS and readmission cohorts were compiled.Univariate analysis with Chi-square,t-tests,and multivariable logistic regression analysis with odds ratios(ORs),p-values,and 95%confidence intervals assessed statistical associations.Results:Totally,20306 records for LOS greater than 3 days and 15854 for readmission within 30 days were available.Univariate and multivariable analysis exhibited similar results.For LOS greater than 3 days,undergoing non-elective surgery(OR=5.247),transfusion of greater than four units within 72 h prior to surgery(OR=5.072),pre-operative renal failure or dialysis(OR=2.941),and poor pre-operative functional status(OR=2.540)exhibited the strongest statistically significant associations.For hospital readmission within 30 days,loss in body weight greater than 10%in 6 months prior to surgery(OR=2.227)and bleeding disorders(OR=2.081)exhibited strongest statistically significant associations.Conclusion:Multiple pre-and peri-operative risk factors are independently associated with prolonged LOS and hospital readmission within 30 days of surgery using the American College of Surgeons National Surgical Quality Improvement Program data.Recognizing the risks factors that can potentially be improved prior to minimally-invasive partial nephrectomy is crucial to informing patient selection,optimization strategies,and patient education.展开更多
Objective: The pilot study was intended to test the feasibility of a multiple-component lifestyle intervention targeting African American adults in a weight control and cardiometabolic risk reduction program on diet, ...Objective: The pilot study was intended to test the feasibility of a multiple-component lifestyle intervention targeting African American adults in a weight control and cardiometabolic risk reduction program on diet, activity, and stress, using community-engagement principles. Methods: Applying mixed qualitative and quantitative measures, the intervention had a two-part sequential study design consisting of 12 weekly small group sessions that provided individual and group counseling in nutrition, exercise, and mindfulness, while incorporating focus group and interactive techniques to learn about barriers and acceptable practices for this population. The program was implemented at an African-American church in Nashville, Tennessee. Results: Thirty-four participants (aged 56.1 ± 11 years, body mass index (BMI) 36.7 ± 6.6 kg/m2) completed the intervention. Lifestyle changes after the 12 weekly sessions showed some positive trends including reduced sodium intake (from 2725.3 ± 326.5 to 2132 ± 330, mg/day, P = 0.008), increased walking steps (from 4392.1 ± 497.2 to 4895.3 ± 497.9, steps/day, not significant), and slightly decreased Perceived Stress Scale (PSS) scores (from 13.7 ± 1.4 to 12.4 ± 1.5, not significant). Body fat % among male participants decreased significantly (from 33.8 ± 2.6 to 28 ± 2.6, %, P = 0.043). Among cardiometabolic risk biomarkers, hemoglobin A1c (HbA1c) decreased significantly (from 6.6 ± 0.2 to 6.1 ± 0.2, %, P β = 2.4, P = 0.006). Twenty-one participants took part in focus groups during the program to identify barriers to healthy lifestyle changes. Primary barriers reported were price, time for preparing healthy meals, unfamiliarity with mindfulness activities, their health condition, and daily schedule available for physical activities. Conclusions: This church-based pilot intervention was proven feasible by showing modest progress in reducing adiposity and decreasing HbA1c levels. The focus group and interactive methods facilitated program direction. Future full-scale studies are warranted to identify key strategies that provide more personalized approaches and supportive environments to sustain a healthy lifestyle among these at risk minorities with limited resources.展开更多
国际中文教育已经开启了一个普及化的新时代,构建一支高水平的师资队伍是推动国际中文教育长期稳定发展的必要条件。为了提升教师质量和数量,亟需构建更为完善的国际中文师资培训体系。美国TESOL(Teaching English to Speakers of Other...国际中文教育已经开启了一个普及化的新时代,构建一支高水平的师资队伍是推动国际中文教育长期稳定发展的必要条件。为了提升教师质量和数量,亟需构建更为完善的国际中文师资培训体系。美国TESOL(Teaching English to Speakers of Other Language)教师培训模式较为成熟,已经得到全球英语教师和用人单位的高度认可。通过对TESOL项目的培训理念、教学对象、课程培训目标、课程设置和资格认证等方面的深入分析,可以帮助国内学界了解美国TESOL项目的特点,为国际中文师资培训提供切实可行的参考,构建一套专业化、规范化、国际化、统一的国际中文师资培训模式。展开更多
文章通过对美国公共图书馆Born to Read(出生即阅读)婴幼儿早期阅读推广活动的产生背景、服务内容、服务特点及价值内涵进行分析,探讨美国公共图书馆开展婴幼儿早期阅读推广活动的经验和启示。Born to Read早期阅读推广具有主体多元化...文章通过对美国公共图书馆Born to Read(出生即阅读)婴幼儿早期阅读推广活动的产生背景、服务内容、服务特点及价值内涵进行分析,探讨美国公共图书馆开展婴幼儿早期阅读推广活动的经验和启示。Born to Read早期阅读推广具有主体多元化、关注0岁婴幼儿、以培养阅读能力和阅读兴趣为主等特点,对引导亲子阅读、保障婴幼儿阅读权利、推动婴幼儿早期阅读等具有价值。我国公共图书馆应引导家长开展0岁婴幼儿早期阅读活动,为弱势群体家庭提供早期阅读服务,推广婴幼儿早期阅读的品牌活动。展开更多
文摘Objective:We conducted an analysis of the American College of Surgeons National Surgical Quality Improvement Program database for minimally-invasive partial nephrectomy cases reported with the goal to identify pre-and peri-operative variables associated with length of stay(LOS)greater than 3 days and readmission within 30 days.Methods:Records from 2008 to 2018 for“laparoscopy,surgical;partial nephrectomy”for prolonged LOS and readmission cohorts were compiled.Univariate analysis with Chi-square,t-tests,and multivariable logistic regression analysis with odds ratios(ORs),p-values,and 95%confidence intervals assessed statistical associations.Results:Totally,20306 records for LOS greater than 3 days and 15854 for readmission within 30 days were available.Univariate and multivariable analysis exhibited similar results.For LOS greater than 3 days,undergoing non-elective surgery(OR=5.247),transfusion of greater than four units within 72 h prior to surgery(OR=5.072),pre-operative renal failure or dialysis(OR=2.941),and poor pre-operative functional status(OR=2.540)exhibited the strongest statistically significant associations.For hospital readmission within 30 days,loss in body weight greater than 10%in 6 months prior to surgery(OR=2.227)and bleeding disorders(OR=2.081)exhibited strongest statistically significant associations.Conclusion:Multiple pre-and peri-operative risk factors are independently associated with prolonged LOS and hospital readmission within 30 days of surgery using the American College of Surgeons National Surgical Quality Improvement Program data.Recognizing the risks factors that can potentially be improved prior to minimally-invasive partial nephrectomy is crucial to informing patient selection,optimization strategies,and patient education.
文摘Objective: The pilot study was intended to test the feasibility of a multiple-component lifestyle intervention targeting African American adults in a weight control and cardiometabolic risk reduction program on diet, activity, and stress, using community-engagement principles. Methods: Applying mixed qualitative and quantitative measures, the intervention had a two-part sequential study design consisting of 12 weekly small group sessions that provided individual and group counseling in nutrition, exercise, and mindfulness, while incorporating focus group and interactive techniques to learn about barriers and acceptable practices for this population. The program was implemented at an African-American church in Nashville, Tennessee. Results: Thirty-four participants (aged 56.1 ± 11 years, body mass index (BMI) 36.7 ± 6.6 kg/m2) completed the intervention. Lifestyle changes after the 12 weekly sessions showed some positive trends including reduced sodium intake (from 2725.3 ± 326.5 to 2132 ± 330, mg/day, P = 0.008), increased walking steps (from 4392.1 ± 497.2 to 4895.3 ± 497.9, steps/day, not significant), and slightly decreased Perceived Stress Scale (PSS) scores (from 13.7 ± 1.4 to 12.4 ± 1.5, not significant). Body fat % among male participants decreased significantly (from 33.8 ± 2.6 to 28 ± 2.6, %, P = 0.043). Among cardiometabolic risk biomarkers, hemoglobin A1c (HbA1c) decreased significantly (from 6.6 ± 0.2 to 6.1 ± 0.2, %, P β = 2.4, P = 0.006). Twenty-one participants took part in focus groups during the program to identify barriers to healthy lifestyle changes. Primary barriers reported were price, time for preparing healthy meals, unfamiliarity with mindfulness activities, their health condition, and daily schedule available for physical activities. Conclusions: This church-based pilot intervention was proven feasible by showing modest progress in reducing adiposity and decreasing HbA1c levels. The focus group and interactive methods facilitated program direction. Future full-scale studies are warranted to identify key strategies that provide more personalized approaches and supportive environments to sustain a healthy lifestyle among these at risk minorities with limited resources.
文摘国际中文教育已经开启了一个普及化的新时代,构建一支高水平的师资队伍是推动国际中文教育长期稳定发展的必要条件。为了提升教师质量和数量,亟需构建更为完善的国际中文师资培训体系。美国TESOL(Teaching English to Speakers of Other Language)教师培训模式较为成熟,已经得到全球英语教师和用人单位的高度认可。通过对TESOL项目的培训理念、教学对象、课程培训目标、课程设置和资格认证等方面的深入分析,可以帮助国内学界了解美国TESOL项目的特点,为国际中文师资培训提供切实可行的参考,构建一套专业化、规范化、国际化、统一的国际中文师资培训模式。
文摘文章通过对美国公共图书馆Born to Read(出生即阅读)婴幼儿早期阅读推广活动的产生背景、服务内容、服务特点及价值内涵进行分析,探讨美国公共图书馆开展婴幼儿早期阅读推广活动的经验和启示。Born to Read早期阅读推广具有主体多元化、关注0岁婴幼儿、以培养阅读能力和阅读兴趣为主等特点,对引导亲子阅读、保障婴幼儿阅读权利、推动婴幼儿早期阅读等具有价值。我国公共图书馆应引导家长开展0岁婴幼儿早期阅读活动,为弱势群体家庭提供早期阅读服务,推广婴幼儿早期阅读的品牌活动。
