Effectiveness of Short Message Service Support on Adherence to Chemotherapy Treatment among Patients Attending Cancer Treatment Facilities in Kenya

Introduction: Cancer is a chronic debilitating disease that unnerves patients, communities, and nations. At some point in cancer patient’s disease experience, chemotherapy is used, and the patient is expected to adhere to treatment to improve survival and quality of life. Methods: This multisite Cluster Randomized Trial (CRT) evaluated the effectiveness of mobile phone Short Message Service (SMS) support on the adherence to treatment schedules among adult cancer patients in Kenya. Data was collected using questionnaires. Ethical approvals were obtained from relevant Ethical Review Boards (ERBs). Results: The mean adherence was 83%. There was a significant difference between treatment arms in relation to the adherence. The intervention arm had a higher mean adherence difference, M = 3.913, 95% CI 2.632-5.193, t (402) = 6.006, p ≤ 0.001), with Cohen’s d = 0.60. Although not significant, (χ2dd = 0.151, df = 1, p = 2.064), more women were perfect adheres than males. Perfect adherers were satisfied with SMS support (χ2dd = 7.620, df = 1, p = 0.06), were in the intervention arm (χ2dd = 22.942, df = 1, p ≤ 0.001), and had trust in the care provider (χ2dd = 10.591 p ≤ 0.001). SMS support was not significant in the multivariate analysis but had an estimated effect size of 0.958 (z = 1.424, p = 0.154, CI = 0.242-3.781), indicating that mean adherence was slightly better in the presence of the intervention. Conclusions: SMS-support intervention has demonstrated superiority in influencing adherence. Further, health system-related factors have a significant influence on the adherence to chemotherapy treatment. Interventions to re-design health systems that are responsive to unmet care needs of cancer patients must be explored. .

Master Curve Method of Cumulative Damage for Prediction of Service Life

目的研究固体火箭推进剂药柱贮存使用寿命预测的理论与方法．方法采用非接触测试技术和热加速老化累积损伤法，实测得出药柱空穴率随老化时间变化的等温线，根据时温等效原理求得使用寿命预测粘弹性主曲线．结果与结论预测得出ＨＭＸＣＭＤＢ固体火箭推进剂药柱的使用寿命．由于该方法中药柱贮存失效的临界点是实测的，所以大大地提高了火箭推进剂药柱使用寿命预测的精度．

Fatigue Life Prediction under Service Load Considering Strengthening Effect of Loads below Fatigue Limit

Lightweight design requires an accurate life prediction for structures and components under service loading histories. However, predicted life with the existing methods seems too conservative in some cases, leading to a heavy structure. Because these methods are established on the basis that load cycles would only cause fatigue damage, ignore the strengthening effect of loads. Based on Palmgren-Miner Rule （PMR）, this paper introduces a new method for fatigue life prediction under service loadings by taking into account the strengthening effect of loads below the fatigue limit. In this method, the service loadings are classified into three categories： damaging load, strengthening load and none-effect load, and the process for fatigue life prediction is divided into two stages： stage I and stage II, according to the best strengthening number of cycles. During stage I, fatigue damage is calculated considering both the strengthening and damaging effect of load cycles. While during stage II, only the damaging effect is considered. To validate this method, fatigue lives of automobile half shaft and torsion beam rear axle are calculated based on the new method and traditional methods, such as PMR and Modified Miner Rule （MMR）, and fatigue tests of the two components are conducted under service loading histories. The tests results show that the percentage errors of the predicted life with the new method to mean life of tests for the two components are –3.78% and –1.76% separately, much lesser than that with PMR and MMR. By considering the strengthening effect of loads below the fatigue limit, the new method can significantly improve the accuracy for fatigue life prediction. Thus lightweight design can be fully realized in the design stage.

Service Life Prediction of Lining Concrete of Subsea Tunnel under Combined Compressive Load and Carbonation

Qingdao Jiaozhou Bay subsea tunnel is the second self-built tunnel in China with the designed service life over 100 years.The durability of lining concrete are one of an important factors to determinate the service life of tunnel.Considering the main environmental loads and mechanical loads of subsea tunnel,the durability properties of lining concrete under combined action of compressive load and carbonation has been studied through the critical compressive load test,accelerated carbonation test,natural carbonation test and capillary suction test.The tests results show that critical compressive load apparently accelerates the carbonation and deteriorates the anti-permeability of concrete.Under the combined action of critical compressive load and carbonation,the durability of lining concrete decreases.Based on the carbonization life criteria and research results,for the high-performance concrete with proposed mix ratio,the predicted service life of lining concrete for Jiaozhou bay subsea tunnel is about 80 years which fails to reach the required service life.It is necessary to adopt other measurements simultaneously to improve the durability of lining concrete.

Reliability-based service life prediction of existing concrete structures under marine environment

Chloride-induced corrosion of the reinforcement is considered as one of the major mechanisms resulting in the reduction of structural resistance of reinforced concrete structural elements located in marine and other aggressive environments. A study of reinforced concrete structures located at the Fangcheng dock in the Beibu Gulf port, China, was present. The result from field survey indicates that the concrete cover depth and chloride diffusion coefficient fit best normal distribution and lognormal distribution, respectively. The service life of structure is about 55 a, while initiation time is 45 a. Sensitivity analysis indicates that the most influential factor of the structure service life prediction is concrete cover, followed by diffusion coefficient, diffusion decay index, critical chloride concentration, surface chloride concentration, current density and localized pitting corrosion. Finally, the effects of diffusion decay index and critical chloride concentration on structure service life prediction are discussed.

Improvement of Service Life of Small Furnace Covers on 150 t Refining Ladles

The factors restricting the life of the refining furnace cover were introduced,including the airflow erosion of the refining dust removal system,the melting loss caused by the arc radiation of the electrode,the chemical erosion and penetration of slag and gas,and the condition of refining slag.The improvement measures are adjusting the material of the small furnace cover from corundum to chrome corundum,using a large shaking table to vibrate,optimizing the size design of the small furnace cover,and appropriately thickening the weak areas in the triangular area.The average service life of the refining furnace cover has been increased from one week to two months,reaching 4 maintenance cycles,which meets the needs of the refining production.

Effects of Operation Conditions on Service Life of Ladle Lining

Effects of operation conditions such as ladle temperature, remining time of molten steel, slag basicity, slag oxidation, slag viscosity , vacuum treatment, ultra-high temperature, gas blowing and stirring, intermittent operation, and different refining equipment on service life of ladle lining refractories were researched. The following conclusions are drawn ： （1） molten steel temperature rising, remaiaing time prolonging, slag oxidation ability enhancing, slag viscosity and basicity decreasing can aecelerate the corrosion of ladle lining ; （2） ultra-high temperature and vacuum treatment of ladle not only acceler- ate the fusion corrasion of ladle lining, but also make the carbon containing refractories react forming gases leading to more corrosion, so carbon containing refractories are not stdtable.for the smelting conditions of long term vacuum treatment and ultra-high temperature, especially carbon containing refractories added with conventional additives such as A1 and Si powders ; （ 3 ） argon blowing does not accelerate the corrosion of ladle lining obvioasly, but oxygen blowing does; （4） the corrosion degree of refractories varies with the refining equipment, and the service life of ladle lining decreases according to a certain proportion with the refining ratio increasing.

Study on the mechanical properties and service life of H13 mandrels

The microstructures and mechanical properties of H13 mandrels made by Baosteel and foreign companies were investigated in this study. Based on the comparison research, the processes were optimized, such as steelmaking, heat treatment and multiple forging processes. The quality of Baosteel mandrels was greatly improved by increasing the homogenizing of an annealing temperature and refining processes. The results of the pilot trial showed that the average number of piercing steel tubes for Baosteel mandrels was over 3000 ,which reached the level of imported mandrels.

Service Life Design for Concrete Engineering in Marine Environments of Northern China Based on a Modified Theoretical Model of Chloride Diffusion and Large Datasets of Ocean Parameters

In this study,through experimental research and an investigation on large datasets of the durability parameters in ocean engineering,the values,ranges,and types of distribution of the durability parameters employed for the durability design in ocean engineering in northern China were confirmed.Based on a modified theoretical model of chloride diffusion and the reliability theory,the service lives of concrete structures exposed to the splash,tidal,and underwater zones were calculated.Mixed concrete proportions meeting the requirement of a service life of 100 or 120 years were designed,and a cover thickness requirement was proposed.In addition,the effects of the different time-varying relationships of the boundary condition(Cs)and diffusion coefficient(Df)on the service life were compared;the results showed that the time-varying relationships used in this study(i.e.,Cscontinuously increased and then remained stable,and Dfcontinuously decreased and then remained stable)were beneficial for the durability design of concrete structures in marine environment.

Overloading and Pavement Service Life <br/>—A Case Study on Narayanghat-Mugling Road, Nepal

The ability of a pavement structure in carrying out its function reduces in line with the increase of traffic load, especially if there are overloaded heavy vehicle passing through the road. This study was done to know the effect of overloading vehicles on the road pavement and remaining service life of the pavement. In this study, the service life of pavement due to overloaded vehicles was analyzed using the AASHTO 1993. In Narayanghat-Mugling road the composition of traffic seems to be 83.76% heavy vehicles, 9.18% medium vehicle and 7.05% light vehicle. For the direction of Narayanghat-Mugling, the pavement service life might be reduced by 59.90% due to overloading condition, while for the opposite direction, the service life would not reduced caused by the same factor. The impact of overload conditions on the road pavement showed premature failure;that is, a condition which the damage reduced the life of roads before the design life of the road is reached. From the results, it can be concluded that overloaded vehicles on the road are very influential to the reduction in pavement service life. Therefore, it is expected that road users to comply with existing regulations in the conduct of transportation. As overloading is increasing, it has to be controlled by rules and regulations with penalty to control the overloading. So fines must be associated with intensified enforcement when considered in further strategy. Regular monitoring, inspection and enforcement are the effective ways to control overloading. Use of technology (Automatic overloading information system) may be the effective way to control the overloading.

Sociodemographic Predictors of Health-Related Quality of Life and Healthcare Service Utilisation among Young Refugees in South Australia

Although refugee adolescents and children are recognised as a health risk population, few studies have explored their Health-related Quality of Life (HRQOL). The present study investigated 1) the sociodemographic predictors of HRQOL such as ethnicity, trauma exposure, and length of residency in Australia in a multiethnic paediatric population with refugee experiences and 2) the relationship between mental healthcare utilisation and HRQOL. Method: Participants were 458 adolescents and children, aged 4 - 17 years, living in South Australia. Parents provided data across the sample and adolescents also completed questionnaires. Overall HRQOL and its composite functional dimensions were assessed using the Paediatric Quality of Life (PedsQL) instrument. Questions from the Child and Adolescent Component of the Australian National Survey of Mental Health and Wellbeing were used to assess service utilisation. Results: Migration region/ethnicity predicted better HRQOL as well as physical, emotional and psychosocial functioning for both children and adolescents. African youths indicated higher HRQOL than those from the former Yugoslavia and the Middle East/South Asia respectively. Pre-migration trauma exposure was associated with lower HRQOL;and longer stay in Australia was related to lower emotional functioning in children. There was a negative association between healthcare service utilisation and PedsQL scores, with participants accessing services demonstrating lower HRQOL. Conclusion: Using more rigorous methods, future research is needed to investigate additional sociodemographic predictors of HRQOL, and protective/risk factors that impact on HRQOL of young refugees.

主动健康背景下公立医院全生命周期健康科普体系建设的探索及实践

健康科普是提升全民健康素养的关键手段。为进一步推进健康科普知识普及行动,传播主动健康理念,广西壮族自治区人民医院(广西医学科学院)对如何在公立医院中构建全人群、全生命周期、全方位的健康科普体系进行了实践探索。该文从健康科普体系的核心要素、构建要求、运行管理模式等方面进行了阐述,并就如何搭建科普资源共享信息化平台、制定科普规范标准、建设健康科普基地和应用推广等进行了策略分析,为进一步推动全民健康知识普及提供借鉴。

连续性肾脏替代治疗预防非计划下机过程管理的最佳证据总结

目的 整合连续性肾脏替代治疗预防非计划下机过程管理的最佳证据,为医护人员提供规范、科学的预防及管理循证依据。方法 根据证据资源“6S”模型,系统检索临床决策系统、指南及专业医学会网站、循证数据库及综合数据库中有关连续性肾脏替代治疗预防非计划下机过程管理的相关文献,检索时限为2017年8月15日至2023年8月15日。由4名研究者筛选文献并进行质量评价,提取并汇总证据。结果 共纳入18篇文献,其中指南2篇、临床决策5篇、JBI推荐实践1篇、共识4篇、证据总结3篇、系统评价3篇。从组织管理、上机前管理、运行管理及停机后管理4个方面汇总,共形成30条证据。结论 总结的最佳证据具有科学性和实用性,对预防非计划下机过程管理有指导意义。

生命叙事融入肿瘤患者关爱服务的实践研究

以广州医科大学附属第一医院“看见你的生命故事”——肿瘤患者关爱计划志愿服务项目为例,探讨了生命叙事在肿瘤患者关爱服务中的应用。该项目采用“医护+志愿者+社工+病友”的多维志愿服务模式,运用生命叙事方法,通过医疗志愿者引导肿瘤患者、患者照顾者、肿瘤科医护人员三个群体代表来叙说自己的生命故事,最终将这些生命故事以实体画册、采访小故事、分享会等多元化方式进行传递,以分享的形式促进病友之间的联结,使病友及照顾者获得支持,真正实现用生命去影响生命。选取了生命故事册中的案例,深入分析了生命叙事在促进肿瘤患者身心康复中的重要作用,为改善患者就医体验和推动公立医院文化发展提供了参考建议。

基于生活圈理论的收缩型村镇公共服务设施配置研究--以黑龙江省肇源县为例

乡村人口收缩是城镇化进程持续推进的必然,为满足村镇居民不断提升的需求并避免人口收缩造成的资源浪费,亟待对村镇公共服务设施配置体系进行优化与重构。以黑龙江省肇源县为例,引入生活圈理论探讨收缩型村镇公共服务设施配置优化方法。首先基于对村镇收缩类型与强度的分类,结合居民出行意愿的时距转换调查,将肇源县村镇划分为“县域—扩展—基本—基础”四级动态半径生活圈。然后通过筛选与生活圈等级对应的公共服务中心,并依据相关规范及居民实际需求,确定各级公共服务中心配置的项目内容和优化建议。

某在役铆接钢桁梁桥关键构件疲劳性能研究

精准评估现役钢桥的疲劳寿命对于桥梁结构的安全运营至关重要。该文以某在役铆接钢桁梁桥为研究对象,在对桥梁结构进行计算分析明确各构件的受力特点的基础上,针对原桥典型构件以及关键节点开展系列疲劳性能研究。数值计算结果表明,城B荷载作用下原桥典型构件以及关键节点均具有良好抗疲劳性能,疲劳寿命循环次数均大于200万次。

电磁脉冲强化中螺线管线圈缠绕的对比研究

为探索更好的螺线管线圈缠绕方式,从热力学、空间占有率和绕制角度考虑,分析得到矩形截面铜导线更适合绕制电磁脉冲螺线管线圈,运用有限元软件仿真模拟了5种缠绕形式的螺线管线圈在6 kV电压的电磁脉冲情况,对线圈及棒件受到的电磁力进行了对比分析。发现在单根导线中,平式缠绕导线的受力更小;在双根导线情况下,单层并联缠绕整体优于双层并联缠绕。在实验中采用棒件电磁脉冲表面强化技术,结果表明,在电磁力作用下导线的变形与电流热效应产生的温升是使螺线管线圈损坏的主要原因,双根导线单层并联缠绕的螺线管线圈性能更好且具有较长的使用寿命。电磁脉冲可以使钛棒的维氏硬度提升约15%,但过度加工会使硬度下降。

老城区社区生活圈测度及公共服务设施优化研究--以宜宾市为例

在我国城镇化的下半场,以人为本、存量规划和集约发展成为当下城市的主旋律,作为承载城市记忆的老城区社区生活圈亟待更新优化。以宜宾市老城组团为例,采用连锁网络模型和基于真实路网的设施可达性分析等方法,结合10大类公服设施POI数据、当地居民对设施的重要性评价数据,对研究区域进行了10分钟社区生活圈的测度探索,并在测度结果的基础上,以生活圈为视角提出了相应公服设施的优化及择址建议。研究结果表明:第一,宜宾老城共可划定出4个10分钟社区生活圈,平均用地规模较小于平原、省会、特大型城市;第二,4个生活圈整体都存在公园广场、社会福利、科教文化这3类设施数量较为欠缺及覆盖范围较小的共性问题;第三,各生活圈生活便利度差异明显,发展不均衡。未来宜侧重优化过渡区、边缘生活圈欠缺设施;第四,基于设施覆盖率及居民可达程度考虑,每个生活圈宜提供中心度前三的地块中心点作为10分钟层级设施的推荐设置点。

“互联网+居家护理”在志愿护理服务中的应用效果

目的探讨"互联网+居家护理"在志愿护理服务中的应用效果。方法选取2020年12月至2021年12月"党群服务365平台"82例需要服务人群作为研究对象,采用随机数字表法将其分为对照组(41例)和观察组(41例)。对照组实施常规医疗服务,观察组实施"互联网+居家护理"服务,两组均持续护理12个月。比较两组的医院看病次数、医疗花费情况、日常生活能力、精神状态、照护者照护技能水平以及生活满意度。结果观察组医院看病次数、医疗花费情况均少于对照组,差异有统计学意义(P<0.05);观察组护理后日常生活活动能力量表(ADL)评分低于对照组,简易精神状态检查量表(MMSE)评分、照护技能水平评分均高于对照组,差异有统计学意义(P<0.05);观察组护理后生活满意度调查表(LSR)各项评分均高于对照组,差异有统计学意义(P<0.05)。结论通过互联网平台,护理志愿者对服务人群进行居家护理,能够改善服务人群的精神状态,促使其保持身心健康,提高生活自理能力,还能提高照护者的护理技能,一定程度上减少看病次数和医疗花费,从而提升服务人员满意度。