Forest vegetation management has evolved as a recognized component of intensive forest management practice. It involves the management of competing vegetation necessary to obtain the high yields expected in modern for...Forest vegetation management has evolved as a recognized component of intensive forest management practice. It involves the management of competing vegetation necessary to obtain the high yields expected in modern forest plantations via control of interfering plants that influence regeneration outcome, impact timber stand development, and limit native plant and wildlife diversity. It includes cultural control, fire control, mechanical control, biological control, and chemical control. The public perception of forest vegetation management, especially chemical control, is sometimes negative due to health and environmental concerns. It is an important tool in the forest management alternatives available to consulting foresters managing family forest lands (the vast majority of private forest land in the United States). We report on a study that addresses the motivations of family forest owners that implement forest vegetation management practices and the motivation of those who chose not to implement after forester recommendations to do so. For those who do implement forest vegetation management, improvement of wildlife habitat and increased timber growth was the main motivation. For those who did not, cost was the main concern. Size of forest holding plays a major role in determining who will practice intensive forestry.展开更多
This paper first introduces the basic connotation of China’s whole-process engineering consulting.Immediately,analyze the organization model,service procurement model and charging standards of foreign whole-process e...This paper first introduces the basic connotation of China’s whole-process engineering consulting.Immediately,analyze the organization model,service procurement model and charging standards of foreign whole-process engineering consulting(international terminology full-life cycle engineering consultant).Second,discuss the government’s role in the development of engineering consulting from two aspects:service management and market access.Finally,combined with the above analysis,the specific problems faced in the implementation process of the whole process engineering consulting are compared.Provide relevant suggestions on how companies and individuals respond to industry development trends.展开更多
Background:China’s accelerating development and increasingly important role in global health engagement create a great demand for global health professionals including international consulting experts.This study repo...Background:China’s accelerating development and increasingly important role in global health engagement create a great demand for global health professionals including international consulting experts.This study reported the detailed development and evaluation of an international consulting training for global health workforce.Methods:Based on Kirkpatrick’s model,a mixed-methods approach was used to evaluate the effectiveness of the training.Quantitative and qualitative data on participants’reaction,learning,and application of the learned knowledge and skills were collected by a training evaluation survey at the ending of training and a follow-up interview in three months after the training.Results:Thirty-six participants attended the training and 34 of them completed quantitative investigation.The training satisfaction evaluations were positive,for which participants rated the training program highly and over 90%of them agreed with the usefulness of the training.About knowledge and skills change,participants showed improved consulting knowledge and skills from pre-to post-training(P<0.001).A total of 23 participants accepted follow-up interview,and most participants applied knowledge and skills learned from the training in their daily work or study.However,only 30.4%of participants applied their learning in the consulting program.The largest barrier of application was the lack of consulting opportunities.In addition,almost all the participants reported that they would be glad to attend more training courses in the future.Conclusion:The international consulting training program was well-received,and was feasible to improve the consulting service competence of global health professionals.According to participants’feedback,it is essential to develop and expand consulting training in the field of global health.展开更多
Knowledge transfer(KT)from the consultant to the client is an important area that needs to be repeatedly addressed and thoroughly understood.The aim of this research was to examine the assumption that client character...Knowledge transfer(KT)from the consultant to the client is an important area that needs to be repeatedly addressed and thoroughly understood.The aim of this research was to examine the assumption that client characteristics and consultant competencies play a defining role in the effective transfer of knowledge to the client party.The authors examined the critical aspects and competencies required of the consultant,and the characteristics and attitudes required of the client,which would contribute to a successful transfer of knowledge,through unstructured in-depth interviews and concise questionnaires.Eighty consulting assignments were studied from both the client side and the consultant side.A conceptual model is presented,factor analysis was used to validate the constructs,and partial least squares were used to test the model.The findings showed that the consultants’professionalism,skills,and behavior were significant contributors to KT to the client.Surprisingly,neither the consultant knowledge nor client characteristics had any significance to the KT to the client.展开更多
Intelligent patent consulting service platform is an integrated service platform based on Android and IOS operating system. It can achieve the customized service at the mobile end and can provide intelligent search se...Intelligent patent consulting service platform is an integrated service platform based on Android and IOS operating system. It can achieve the customized service at the mobile end and can provide intelligent search service, intelligent service delivery, interactive learning and collaborative consulting and other multi-dimensional services, to meet the needs of a large number of users. This paper provides a mobile platform for the applicant side of the functional modules of the design.展开更多
It is very powerful for constructing nearly saturated factorial designs to characterize fractional factorial (FF) designs through their consulting designs when the consulting designs are small. Mukerjee and Fang emplo...It is very powerful for constructing nearly saturated factorial designs to characterize fractional factorial (FF) designs through their consulting designs when the consulting designs are small. Mukerjee and Fang employed the projective geometry theory to find the secondary wordlength pattern of a regular symmetrical fractional factorial split-plot (FFSP) design in terms of its complementary subset, but not in a unified form. In this paper, based on the connection between factorial design theory and coding theory, we obtain some general and unified combinatorial identities that relate the secondary wordlength pattern of a regular symmetrical or mixed-level FFSP design to that of its consulting design. According to these identities, we further establish some general and unified rules for identifying minimum secondary aberration, symmetrical or mixed-level, FFSP designs through their consulting designs.展开更多
Air curtains is promising in reducing the short-range infection risk in hospitals.To quantitatively evaluate its performance,this paper explores air curtains equipped on normal consulting desk to avoid doctor’s direc...Air curtains is promising in reducing the short-range infection risk in hospitals.To quantitatively evaluate its performance,this paper explores air curtains equipped on normal consulting desk to avoid doctor’s direct exposure to the patient exhaled pollutants.A numerical investigation is conducted to evaluate the effects of supply air velocity and angle on cutting off performance.Simulation results show that the average mass fraction of exhaled pollutants decreases significantly(70%–90%)in the consulting ward,indicating satisfying performance of air curtains.Increasing supply air velocity is demonstrated to be conducive in forming full air curtains,whereas an excessively high supply air velocity may be of adverse effects by entraining exhaled flow.Besides,the supply air angle is also critical due to its coupling with supply air velocity.It is found that larger angle(0°–40°)is better where velocity is less than 3 m/s,otherwise a small angle(20°)is preferable where velocity is larger than 3 m/s.Exhaled flow could be well suppressed at the supply air angle 20°but moves over air curtains at 40°.This study can provide effective and intuitive guidance in applying air curtains in consulting wards.展开更多
For many years,project management maturity models(PMMM)derived from the software industry have brought immeasurable benefits.However,the adoption and investigation of PMMM in the construction field have been weak and ...For many years,project management maturity models(PMMM)derived from the software industry have brought immeasurable benefits.However,the adoption and investigation of PMMM in the construction field have been weak and insufficient,particularly in construction consulting services(CCS).Moreover,professionals have gradually realized the importance of non-process factors(e.g.,teamwork,culture,leadership)in the evaluation of PMMM.This study describes the construction of PMMM for CCS that considers non-process factors and combines them with CCS-specific process factors.To verify the effectiveness of the proposed model,we conduct a case study on the overall project management consultancy for China’s 2010 Winter Expo.The results would fill in the PMMM research gap in CCS and provide practitioners with ideas to improve their performance.展开更多
BACKGROUND Venovenous extracorporeal membrane oxygenation(V-V ECMO)has become an important treatment for severe pneumonia,but there are various complications during the treatment.This article describes a case with sev...BACKGROUND Venovenous extracorporeal membrane oxygenation(V-V ECMO)has become an important treatment for severe pneumonia,but there are various complications during the treatment.This article describes a case with severe pneumonia success-fully treated by V-V ECMO,but during treatment,the retrovenous catheter,which was supposed to be in the right internal vein,entered the superior vena cava directly in the mediastinum.The ECMO was safely withdrawn after multidiscip-linary consultation.Our experience with this case is expected to provide a reference for colleagues who will encounter similar situations.CASE SUMMARY A 64-year-old man had severe pulmonary infection and respiratory failure.He was admitted to our hospital and was given ventilation support(fraction of inspired oxygen 100%).The respiratory failure was not improved and he was treated by V-V ECMO,during which the venous return catheter,which was supposed to be in the right internal vein,entered the superior vena cava directly in the mediastinum.There was a risk of massive mediastinal bleeding if the catheter was removed directly when the ECMO was withdrawn.Finally,the patient underwent vena cava angiography+balloon attachment+ECMO with-drawal in the operating room(prepared for conversion to thoracotomy for vascular exploration and repair at any time during surgery)after multidiscip-linary consultation.ECMO was safely withdrawn,and the patient recovered and was discharged.CONCLUSION Patients may have different vascular conditions.Multidisciplinary cooperation can ensure patient safety.Our experience will provide a reference for similar cases.展开更多
Ulcerative colitis(UC)is a chronic inflammatory disease with a high impact.In order to improve patient outcomes,the clinician-patient relationship in daily practice is critical.Clinical guidelines provide a framework ...Ulcerative colitis(UC)is a chronic inflammatory disease with a high impact.In order to improve patient outcomes,the clinician-patient relationship in daily practice is critical.Clinical guidelines provide a framework for UC diagnosis and treatment.However,standard procedures and the medical content focused upon medical consultations in UC patients has not yet been defined.Moreover,UC is a complex disease,given that patient characteristics and patient needs have been proven to vary during clinical consultation since establishing the diagnosis and upon the course of the disease.In this article,we have discussed the key elements and specific objectives to consider in medical consultation,such as diagnosis,first visits,follow-up visits,active disease patients,patients on topical therapies,new treatment initiation,refractory patients,extra-intestinal manifestations,as well as challenging situations.The key elements have been mentioned to comprise effective communication techniques,motivational interviewing(MI),as well as information and educational aspects,or organizational issues.The key elements to be implemented in daily practice were reported to comprise several general principles like duly prepared consultations,in addition to honesty and empathy with patients,as well as effective communication techniques,MI,information and educational points,or organizational issues.The role of other healthcare professionals such as specialized nurses,psychologists,or the use of checklists was also discussed and commented on.展开更多
BACKGROUND Hip fractures(HF)are common among the aging population,and surgery within 48 h is recommended.Patients can be hospitalized for surgery through different pathways,either trauma or medicine admitting services...BACKGROUND Hip fractures(HF)are common among the aging population,and surgery within 48 h is recommended.Patients can be hospitalized for surgery through different pathways,either trauma or medicine admitting services.AIM To compare management and outcomes among patients admitted through the trauma pathway(TP)vs medical pathway(MP).METHODS This Institutional Review Board-approved retrospective study included 2094 patients with proximal femur fractures(AO/Orthopedic Trauma Association Type 31)who underwent surgery at a level 1 trauma center between 2016-2021.There were 69 patients admitted through the TP and 2025 admitted through the MP.To ensure comparability between groups,66 of the 2025 MP patients were propensity matched to 66 TP patients by age,sex,HF type,HF surgery,and American Society of Anesthesiology score.The statistical analyses included multivariable analysis,group characteristics,and bivariate correlation comparisons with theχ^(2)test and t-test.RESULTS After propensity matching,the mean age in both groups was 75-years-old,62%of both groups were females,the main HF type was intertrochanteric(TP 52%vs MP 62%),open reduction internal fixation was the most common surgery(TP 68%vs MP 71%),and the mean American Society of Anesthesiology score was 2.8 for TP and 2.7 for MP.The majority of patients in TP and MP(71%vs 74%)were geriatric(≥65-years-old).Falls were the main mechanism of injury in both groups(77%vs 97%,P=0.001).There were no significant differences in pre-surgery anticoagulation use(49%vs 41%),admission day of the week,or insurance status.The incidence of comorbidities was equal(94%for both)with cardiac comorbidities being dominant in both groups(71%vs 73%).The number of preoperative consultations was similar for TP and MP,with the most common consultation being cardiology in both(44%and 36%).HF displacement occurred more among TP patients(76%vs 39%,P=0.000).Time to surgery was not statistically different(23 h in both),but length of surgery was significantly longer for TP(59 min vs 41 min,P=0.000).Intensive care unit and hospital length of stay were not statistically different(5 d vs 8 d and 6 d for both).There were no statistical differences in discharge disposition and mortality(3%vs 0%).CONCLUSION There were no differences in outcomes of surgeries between admission through TP vs MP.The focus should be on the patient’s health condition and on prompt surgical intervention.展开更多
Antenatal care is a safe way to prevent pregnancy-related health problems, difficult deliveries and even further to anticipate low birth weight [1]. But pregnant women, especially in Africa, do not attend antenatal cl...Antenatal care is a safe way to prevent pregnancy-related health problems, difficult deliveries and even further to anticipate low birth weight [1]. But pregnant women, especially in Africa, do not attend antenatal clinics as recommended by the WHO. The general objective of this study was to study the norm in terms of Antenatal Consultation (ANC) frequency as well as the determinants of the frequency among women who gave birth in the maternity hospitals of Agbangnizoun. Our research was a cross-sectional, descriptive, retrospective and quantitative type, which was carried out among 335 women in Agbangnizoun, Benin from 1 February to 3 April 2020 (3 months), in order to find out the general or specific characteristics of women that we associate with the frequency of prenatal consultation. At the end of the study, we found that 60%, 68% and 15% of the surveyed population had received ANC in the first, second and third trimesters, respectively. Ethnicity, income level of spouses over the three trimesters as well as the level of their knowledge and overall practice of ANC are determinants of the frequency of prenatal consultation.展开更多
Purpose: To contribute to the improvement of the quality of prenatal consultation at the reference health center of the commune IV of the district of Bamako. Patients Methods: This was a qualitative cross-sectional st...Purpose: To contribute to the improvement of the quality of prenatal consultation at the reference health center of the commune IV of the district of Bamako. Patients Methods: This was a qualitative cross-sectional study to assess the quality of prenatal consultation that took place from December 1, 2017 to January 31, 2018. It included 139 pregnant women whose consultations were monitored by the investigator and then the women were interviewed upon discharge from the facility to collect their opinions on the services they received. Results: The age group of 20 to 29 years was the most represented with 60.44%. In our study, 50% of our patients were managed by midwives. Among the antecedents constituting the risk factors sought in pregnant women, scar uterus was more frequent with 33.93% followed by arterial hypertension with 14.28% and multiparity with 7.14%. Conclusion: This study shows that the evaluation of the quality of services is an absolute necessity for the improvement of services in integrated reproductive health care centers.展开更多
Introduction: Torsion of the spermatic cord is an emergency whose delay in treatment conditions the functional prognosis of the testicle. The aim of this study was to analyze the management of spermatic cord torsion i...Introduction: Torsion of the spermatic cord is an emergency whose delay in treatment conditions the functional prognosis of the testicle. The aim of this study was to analyze the management of spermatic cord torsion in the Urology Andrology Department of the Ignace Deen National Hospital in Conakry. Material and methods: This was a ten-year retrospective descriptive study from January 1, 2012 to December 31, 2021. It involved all patients admitted for torsion of the spermatic cord, confirmed at surgical exploration. Results: We identified 21 cases of torsion of the spermatic cord. The mean age of the patients was 17.9 ± 4.4 years. The average consultation time was 19.2 ± 21.4 hours with extremes of [2 h and 98 h]. Only 6 patients (28.6%) consulted before the sixth hour. All patients presented with scrotal swelling. At scrototomy, all torsions were intravaginal with two turns of spiral in 13 cases and three turns in 8 cases. Orchiectomy followed by contralateral orchidopexy was performed in 6 cases. In the other cases, bilateral orchidopexy was performed after detorsion. The average hospital stay was 4.5 days. We recorded 4 cases of testicular atrophy after orchidopexy. Conclusion: Spermatic cord torsion is an infrequent emergency in our department. The delay in consultation remains the main predictive factor of testicular necrosis. Emergency exploratory scrotomy should be the rule.展开更多
文摘Forest vegetation management has evolved as a recognized component of intensive forest management practice. It involves the management of competing vegetation necessary to obtain the high yields expected in modern forest plantations via control of interfering plants that influence regeneration outcome, impact timber stand development, and limit native plant and wildlife diversity. It includes cultural control, fire control, mechanical control, biological control, and chemical control. The public perception of forest vegetation management, especially chemical control, is sometimes negative due to health and environmental concerns. It is an important tool in the forest management alternatives available to consulting foresters managing family forest lands (the vast majority of private forest land in the United States). We report on a study that addresses the motivations of family forest owners that implement forest vegetation management practices and the motivation of those who chose not to implement after forester recommendations to do so. For those who do implement forest vegetation management, improvement of wildlife habitat and increased timber growth was the main motivation. For those who did not, cost was the main concern. Size of forest holding plays a major role in determining who will practice intensive forestry.
文摘This paper first introduces the basic connotation of China’s whole-process engineering consulting.Immediately,analyze the organization model,service procurement model and charging standards of foreign whole-process engineering consulting(international terminology full-life cycle engineering consultant).Second,discuss the government’s role in the development of engineering consulting from two aspects:service management and market access.Finally,combined with the above analysis,the specific problems faced in the implementation process of the whole process engineering consulting are compared.Provide relevant suggestions on how companies and individuals respond to industry development trends.
基金funded by the China-UK Global Health Support Program(No.GHSP-CS-OP3-V04).
文摘Background:China’s accelerating development and increasingly important role in global health engagement create a great demand for global health professionals including international consulting experts.This study reported the detailed development and evaluation of an international consulting training for global health workforce.Methods:Based on Kirkpatrick’s model,a mixed-methods approach was used to evaluate the effectiveness of the training.Quantitative and qualitative data on participants’reaction,learning,and application of the learned knowledge and skills were collected by a training evaluation survey at the ending of training and a follow-up interview in three months after the training.Results:Thirty-six participants attended the training and 34 of them completed quantitative investigation.The training satisfaction evaluations were positive,for which participants rated the training program highly and over 90%of them agreed with the usefulness of the training.About knowledge and skills change,participants showed improved consulting knowledge and skills from pre-to post-training(P<0.001).A total of 23 participants accepted follow-up interview,and most participants applied knowledge and skills learned from the training in their daily work or study.However,only 30.4%of participants applied their learning in the consulting program.The largest barrier of application was the lack of consulting opportunities.In addition,almost all the participants reported that they would be glad to attend more training courses in the future.Conclusion:The international consulting training program was well-received,and was feasible to improve the consulting service competence of global health professionals.According to participants’feedback,it is essential to develop and expand consulting training in the field of global health.
文摘Knowledge transfer(KT)from the consultant to the client is an important area that needs to be repeatedly addressed and thoroughly understood.The aim of this research was to examine the assumption that client characteristics and consultant competencies play a defining role in the effective transfer of knowledge to the client party.The authors examined the critical aspects and competencies required of the consultant,and the characteristics and attitudes required of the client,which would contribute to a successful transfer of knowledge,through unstructured in-depth interviews and concise questionnaires.Eighty consulting assignments were studied from both the client side and the consultant side.A conceptual model is presented,factor analysis was used to validate the constructs,and partial least squares were used to test the model.The findings showed that the consultants’professionalism,skills,and behavior were significant contributors to KT to the client.Surprisingly,neither the consultant knowledge nor client characteristics had any significance to the KT to the client.
文摘Intelligent patent consulting service platform is an integrated service platform based on Android and IOS operating system. It can achieve the customized service at the mobile end and can provide intelligent search service, intelligent service delivery, interactive learning and collaborative consulting and other multi-dimensional services, to meet the needs of a large number of users. This paper provides a mobile platform for the applicant side of the functional modules of the design.
基金supported by the National Natural Science Foundation of China(Grant Nos.10231030&10571093)Specialized Research Fund for the Doctoral Program of Higher Education(Grant No.20050055038).
文摘It is very powerful for constructing nearly saturated factorial designs to characterize fractional factorial (FF) designs through their consulting designs when the consulting designs are small. Mukerjee and Fang employed the projective geometry theory to find the secondary wordlength pattern of a regular symmetrical fractional factorial split-plot (FFSP) design in terms of its complementary subset, but not in a unified form. In this paper, based on the connection between factorial design theory and coding theory, we obtain some general and unified combinatorial identities that relate the secondary wordlength pattern of a regular symmetrical or mixed-level FFSP design to that of its consulting design. According to these identities, we further establish some general and unified rules for identifying minimum secondary aberration, symmetrical or mixed-level, FFSP designs through their consulting designs.
基金This work is jointed supported by the National Natural Science Foundation of China(No.51778128)the National Key Research and Development Program of China(No.2018YFC1200100)+1 种基金the Entrepreneurship Leadership Project in Guangzhou Development Zone of China(No.CY2018-003)the Scientific Research Foundation of Graduate School of Southeast University(No.YBPY1903).
文摘Air curtains is promising in reducing the short-range infection risk in hospitals.To quantitatively evaluate its performance,this paper explores air curtains equipped on normal consulting desk to avoid doctor’s direct exposure to the patient exhaled pollutants.A numerical investigation is conducted to evaluate the effects of supply air velocity and angle on cutting off performance.Simulation results show that the average mass fraction of exhaled pollutants decreases significantly(70%–90%)in the consulting ward,indicating satisfying performance of air curtains.Increasing supply air velocity is demonstrated to be conducive in forming full air curtains,whereas an excessively high supply air velocity may be of adverse effects by entraining exhaled flow.Besides,the supply air angle is also critical due to its coupling with supply air velocity.It is found that larger angle(0°–40°)is better where velocity is less than 3 m/s,otherwise a small angle(20°)is preferable where velocity is larger than 3 m/s.Exhaled flow could be well suppressed at the supply air angle 20°but moves over air curtains at 40°.This study can provide effective and intuitive guidance in applying air curtains in consulting wards.
文摘For many years,project management maturity models(PMMM)derived from the software industry have brought immeasurable benefits.However,the adoption and investigation of PMMM in the construction field have been weak and insufficient,particularly in construction consulting services(CCS).Moreover,professionals have gradually realized the importance of non-process factors(e.g.,teamwork,culture,leadership)in the evaluation of PMMM.This study describes the construction of PMMM for CCS that considers non-process factors and combines them with CCS-specific process factors.To verify the effectiveness of the proposed model,we conduct a case study on the overall project management consultancy for China’s 2010 Winter Expo.The results would fill in the PMMM research gap in CCS and provide practitioners with ideas to improve their performance.
文摘BACKGROUND Venovenous extracorporeal membrane oxygenation(V-V ECMO)has become an important treatment for severe pneumonia,but there are various complications during the treatment.This article describes a case with severe pneumonia success-fully treated by V-V ECMO,but during treatment,the retrovenous catheter,which was supposed to be in the right internal vein,entered the superior vena cava directly in the mediastinum.The ECMO was safely withdrawn after multidiscip-linary consultation.Our experience with this case is expected to provide a reference for colleagues who will encounter similar situations.CASE SUMMARY A 64-year-old man had severe pulmonary infection and respiratory failure.He was admitted to our hospital and was given ventilation support(fraction of inspired oxygen 100%).The respiratory failure was not improved and he was treated by V-V ECMO,during which the venous return catheter,which was supposed to be in the right internal vein,entered the superior vena cava directly in the mediastinum.There was a risk of massive mediastinal bleeding if the catheter was removed directly when the ECMO was withdrawn.Finally,the patient underwent vena cava angiography+balloon attachment+ECMO with-drawal in the operating room(prepared for conversion to thoracotomy for vascular exploration and repair at any time during surgery)after multidiscip-linary consultation.ECMO was safely withdrawn,and the patient recovered and was discharged.CONCLUSION Patients may have different vascular conditions.Multidisciplinary cooperation can ensure patient safety.Our experience will provide a reference for similar cases.
文摘Ulcerative colitis(UC)is a chronic inflammatory disease with a high impact.In order to improve patient outcomes,the clinician-patient relationship in daily practice is critical.Clinical guidelines provide a framework for UC diagnosis and treatment.However,standard procedures and the medical content focused upon medical consultations in UC patients has not yet been defined.Moreover,UC is a complex disease,given that patient characteristics and patient needs have been proven to vary during clinical consultation since establishing the diagnosis and upon the course of the disease.In this article,we have discussed the key elements and specific objectives to consider in medical consultation,such as diagnosis,first visits,follow-up visits,active disease patients,patients on topical therapies,new treatment initiation,refractory patients,extra-intestinal manifestations,as well as challenging situations.The key elements have been mentioned to comprise effective communication techniques,motivational interviewing(MI),as well as information and educational aspects,or organizational issues.The key elements to be implemented in daily practice were reported to comprise several general principles like duly prepared consultations,in addition to honesty and empathy with patients,as well as effective communication techniques,MI,information and educational points,or organizational issues.The role of other healthcare professionals such as specialized nurses,psychologists,or the use of checklists was also discussed and commented on.
文摘BACKGROUND Hip fractures(HF)are common among the aging population,and surgery within 48 h is recommended.Patients can be hospitalized for surgery through different pathways,either trauma or medicine admitting services.AIM To compare management and outcomes among patients admitted through the trauma pathway(TP)vs medical pathway(MP).METHODS This Institutional Review Board-approved retrospective study included 2094 patients with proximal femur fractures(AO/Orthopedic Trauma Association Type 31)who underwent surgery at a level 1 trauma center between 2016-2021.There were 69 patients admitted through the TP and 2025 admitted through the MP.To ensure comparability between groups,66 of the 2025 MP patients were propensity matched to 66 TP patients by age,sex,HF type,HF surgery,and American Society of Anesthesiology score.The statistical analyses included multivariable analysis,group characteristics,and bivariate correlation comparisons with theχ^(2)test and t-test.RESULTS After propensity matching,the mean age in both groups was 75-years-old,62%of both groups were females,the main HF type was intertrochanteric(TP 52%vs MP 62%),open reduction internal fixation was the most common surgery(TP 68%vs MP 71%),and the mean American Society of Anesthesiology score was 2.8 for TP and 2.7 for MP.The majority of patients in TP and MP(71%vs 74%)were geriatric(≥65-years-old).Falls were the main mechanism of injury in both groups(77%vs 97%,P=0.001).There were no significant differences in pre-surgery anticoagulation use(49%vs 41%),admission day of the week,or insurance status.The incidence of comorbidities was equal(94%for both)with cardiac comorbidities being dominant in both groups(71%vs 73%).The number of preoperative consultations was similar for TP and MP,with the most common consultation being cardiology in both(44%and 36%).HF displacement occurred more among TP patients(76%vs 39%,P=0.000).Time to surgery was not statistically different(23 h in both),but length of surgery was significantly longer for TP(59 min vs 41 min,P=0.000).Intensive care unit and hospital length of stay were not statistically different(5 d vs 8 d and 6 d for both).There were no statistical differences in discharge disposition and mortality(3%vs 0%).CONCLUSION There were no differences in outcomes of surgeries between admission through TP vs MP.The focus should be on the patient’s health condition and on prompt surgical intervention.
文摘Antenatal care is a safe way to prevent pregnancy-related health problems, difficult deliveries and even further to anticipate low birth weight [1]. But pregnant women, especially in Africa, do not attend antenatal clinics as recommended by the WHO. The general objective of this study was to study the norm in terms of Antenatal Consultation (ANC) frequency as well as the determinants of the frequency among women who gave birth in the maternity hospitals of Agbangnizoun. Our research was a cross-sectional, descriptive, retrospective and quantitative type, which was carried out among 335 women in Agbangnizoun, Benin from 1 February to 3 April 2020 (3 months), in order to find out the general or specific characteristics of women that we associate with the frequency of prenatal consultation. At the end of the study, we found that 60%, 68% and 15% of the surveyed population had received ANC in the first, second and third trimesters, respectively. Ethnicity, income level of spouses over the three trimesters as well as the level of their knowledge and overall practice of ANC are determinants of the frequency of prenatal consultation.
文摘Purpose: To contribute to the improvement of the quality of prenatal consultation at the reference health center of the commune IV of the district of Bamako. Patients Methods: This was a qualitative cross-sectional study to assess the quality of prenatal consultation that took place from December 1, 2017 to January 31, 2018. It included 139 pregnant women whose consultations were monitored by the investigator and then the women were interviewed upon discharge from the facility to collect their opinions on the services they received. Results: The age group of 20 to 29 years was the most represented with 60.44%. In our study, 50% of our patients were managed by midwives. Among the antecedents constituting the risk factors sought in pregnant women, scar uterus was more frequent with 33.93% followed by arterial hypertension with 14.28% and multiparity with 7.14%. Conclusion: This study shows that the evaluation of the quality of services is an absolute necessity for the improvement of services in integrated reproductive health care centers.
文摘Introduction: Torsion of the spermatic cord is an emergency whose delay in treatment conditions the functional prognosis of the testicle. The aim of this study was to analyze the management of spermatic cord torsion in the Urology Andrology Department of the Ignace Deen National Hospital in Conakry. Material and methods: This was a ten-year retrospective descriptive study from January 1, 2012 to December 31, 2021. It involved all patients admitted for torsion of the spermatic cord, confirmed at surgical exploration. Results: We identified 21 cases of torsion of the spermatic cord. The mean age of the patients was 17.9 ± 4.4 years. The average consultation time was 19.2 ± 21.4 hours with extremes of [2 h and 98 h]. Only 6 patients (28.6%) consulted before the sixth hour. All patients presented with scrotal swelling. At scrototomy, all torsions were intravaginal with two turns of spiral in 13 cases and three turns in 8 cases. Orchiectomy followed by contralateral orchidopexy was performed in 6 cases. In the other cases, bilateral orchidopexy was performed after detorsion. The average hospital stay was 4.5 days. We recorded 4 cases of testicular atrophy after orchidopexy. Conclusion: Spermatic cord torsion is an infrequent emergency in our department. The delay in consultation remains the main predictive factor of testicular necrosis. Emergency exploratory scrotomy should be the rule.