The purpose of this paper is to examine the effect of the board of directors,namely board size,board independence,and CEO duality,as well as audit quality on the disclosure of internal control information.The sample c...The purpose of this paper is to examine the effect of the board of directors,namely board size,board independence,and CEO duality,as well as audit quality on the disclosure of internal control information.The sample consists of 164 European companies listed in the STOXX Europe 600.Based on positive agency theory,the authors posit that board of directors and audit quality influence corporate internal control disclosure practice.The content analysis and the design of the evaluation criterion were used to calculate the disclosure index of internal control.Thus,multiple regression analysis is utilized to analyze the results of this paper.The average internal control information disclosure index was 0.285,indicating that most of the companies in our sample do not disclose enough information about the internal control.This low level of forward-looking information disclosure makes it very difficult for corporate stakeholders to determine the future performance of the company.Multivariate results indicate that internal control disclosure is positively and significantly associated with board independence,CEO duality,and audit quality.This study contributes to the literature on the various governance characteristics and disclosure by showing that the disclosure of internal control information in European countries is positively and significantly associated with board independence,separation of duties,and audit quality.Our study was based on a sample of European companies including countries regulating IC disclosure as well as unregulated settings.As noted by Bedard and Graham(2014),regulatory differences in countries can contribute insights on the costs and benefits of disclosure.Findings also have policy implications for investors,managers,and regulators.展开更多
The major phytoplankton was investigated and analyzed in landscape water of six campuses in Nanjing Xianlin University Town,and water quality was evaluated by single factor assessment method and comprehensive weighted...The major phytoplankton was investigated and analyzed in landscape water of six campuses in Nanjing Xianlin University Town,and water quality was evaluated by single factor assessment method and comprehensive weighted evaluation method.The result showed that the major phytoplankton groups were Cyanophyta,Chlorophyta and Bacillariophyta.Besides,each evaluation indicator showed that waterbodies in four campuses were eutrophicated and result of single factor evaluation showed water quality all belonged to poor category V.The result of comprehensive weighted assessment showed that waters in Nanjing Normal University and Nanjing University of Posts and Telecommunications were seriously polluted,cyanobacterial bloom appearing.Waters in Nanjing University of Chinese Medicine and Nanjing Forest Police College hadn't been eutrophicated.展开更多
Heavy metal concentrations in agricultural soils of Zhejiang Province were monitored to indicate the status of heavy metal contamination and assess environmental quality of agricultural soils. A total of 908 soil samp...Heavy metal concentrations in agricultural soils of Zhejiang Province were monitored to indicate the status of heavy metal contamination and assess environmental quality of agricultural soils. A total of 908 soil samples were collected from 38 counties in Zbejiang Province and eight heavy metal (Cd, Cr, Pb, Hg, Cu, Zn, Ni and As) concentrations had been evaluated in agricultural soil. It was found 775 samples were unpolluted and 133 samples were slightly polluted and more respectively, that is approximately 14.65% agricultural soil samples had the heavy metal concentration above the threshold level in this province by means of Nemerow's synthetical pollution index method according to the second grade of Standards for Soil Environmental Quality of China (GB15618- 1995). Contamination of Cd was the highest, followed by Ni, As and Zn were lower correspondingly. Moreover, Inverse Distance Weighted (IDW) interpolation method was used to make an assessment map of soil environmental quality based on the Nemerow's pollution index and the soil environmental quality was categorized into five grades. Moreover, ten indices were calculated as input parameters for principal component analysis (PCA) and the principal components (PCs) were created to compare environmental quality of different soils and regions. The results revealed that environmental quality of tea soils was better than that of paddy soils, vegetable soils and fruit soils. This study indicated that GIS combined with multivariate statistical approaches proved to be effective and powerful tool in the mapping of soil contamination distribution and the assessment of soil environmental quality on provincial scale, which is beneficial to environmental protection and management decision-making by local government.展开更多
Field experiments were conducted at Cereal Crops Research Institute, Pirsabak, Nowshera, Pakistan, during winter 2003~2004; 2004~2005 to evaluate the effect of nitrogen; sulfur levels; methods of nitrogen applicatio...Field experiments were conducted at Cereal Crops Research Institute, Pirsabak, Nowshera, Pakistan, during winter 2003~2004; 2004~2005 to evaluate the effect of nitrogen; sulfur levels; methods of nitrogen application on canola (Brassica napus L. cv. Bulbul-98) under rainfed conditions. Four levels of S (0, 10, 20,; 30 kg/ha); three levels of N (40, 60,; 80 kg/ha); a control treatment with both nutrients at zero level were included in the experiments. Sulfur levels were applied at sowing while N levels were applied by three methods (100% soil application, 90% soil+10% foliar application,; 80% soil +20% foliar application). The experiments were laid out in randomized complete block (RCB) design having four replications. Oil content increased significantly up to 20 kg S/ha but further increase in S level did not enhance oil content. Glucosinolate content increased from 13.6 to 24.6 μmol/g as S rate was increased from 0 to 30 kg/ha. Protein content increased from 22.4% to 23.2% as S rate was increased from 0 to 20 kg/ha. Oil content responded negatively to the increasing N levels. The highest N level resulted in the highest values for protein (23.5%); glucosinolate (19.9 μmol/g) contents. Methods of N application had no significant impact on any parameters under study.展开更多
AIM: To investigate the symptom presentation and quality of life in obese Chinese patients with gastro- esophageal reflux disease (GERD). MKTHODS: Data from patients diagnosed with GERD according to the Montreal d...AIM: To investigate the symptom presentation and quality of life in obese Chinese patients with gastro- esophageal reflux disease (GERD). MKTHODS: Data from patients diagnosed with GERD according to the Montreal definition, were collected between January 2009 to March 2010. The enrolled patients were assigned to the normal [body mass in- dex (BMI) 〈 25 kg/m2], overweight (25-30 kg/m2), and obese (BMI 〉 30 kg/m2) groups. General demographic data, endoscopic findings, and quality of life of the three groups of patients were analyzed and compared.and 15 patients were classified in the normal, over- weight, and obese, respectively. There was significantly more erosive esophagitis (73.3% vs 64.3% vs 39.2%, P = 0.002), hiatal hernia (60% vs 33.9% vs 16.7%, P = 0.001), and males (73.3% vs 73.2% vs 32.4%, P = 0.001) in the obese cases. The severity and frequency of heartburn, not acid regurgitation, was positively cor- related with BMI, with a significant association in men, but not in women. Obese patients were prone to have low quality of life scores, with obese women having the lowest scores for mental health. CONCLUSION: In patients with GERD, obese men had the most severe endoscopic and clinical presenta- tion. Obese women had the poorest mental health.展开更多
AIM: To investigate the effect of vitamin D (VD) concentrations and VD supplementation on health related quality of life in inflammatory bowel disease (IBD) patients.
Over the past decade,there has been increasing focus on improving the quality of healthcare delivered to patients with chronic diseases,including inflammatory bowel disease.Inflammatory bowel disease is a complex,chro...Over the past decade,there has been increasing focus on improving the quality of healthcare delivered to patients with chronic diseases,including inflammatory bowel disease.Inflammatory bowel disease is a complex,chronic condition with associated morbidity,health care costs,and reductions in quality of life.The condition is managed primarily in the outpatient setting.The delivery of high quality of care is suboptimal in several ambulatory inflammatory bowel disease domains including objective assessments of disease activity,the use of steroid-sparing agents,screening prior to anti-tumor necrosis factor therapy,and monitoring thiopurine therapy.This review outlines these gaps in performance and provides potential initiatives aimed at improvement including reimbursement programs,quality improvement frameworks,collaborative efforts in quality improvement,and the use of healthcare information technology.展开更多
In recent years,pediatric health care has embraced the concept of quality improvement to improve patient outcomes.As quality improvement efforts are implemented,network collaboration(where multiple centers and practic...In recent years,pediatric health care has embraced the concept of quality improvement to improve patient outcomes.As quality improvement efforts are implemented,network collaboration(where multiple centers and practices implement standardized programs)is a popular option.In a collaborative network,improvement in the conduct of structural,process and outcome quality measures can lead to improvements in overall health,and benchmarks can be used to assess and compare progress.In this review article,we provided an overview of the quality improvement movement and the role of quality indicators in this movement.We reviewed current quality improvement efforts in pediatric inflammatory bowel disease (IBD),as well as other pediatric chronic illnesses.We discussed the need to standardize the development of quality indicators used in quality improvement networks to assess medical care,and the validation techniques which can be used to ensure that process indicators result in improved outcomes of clinical significance.We aimed to assess current quality improvement efforts in pediatric IBD and other diseases,such as childhood asthma,childhood arthritis,and neonatal health.By doing so,we hope to learn from their successes and failures and to move the field forward for future improvements in the care provided to children with IBD.展开更多
Reflection is a fundamental skill of health-care professionals and plays an important role in ensuring the quality of care in health-care practice. It is believed that undertaking reflection in practice can help nurse...Reflection is a fundamental skill of health-care professionals and plays an important role in ensuring the quality of care in health-care practice. It is believed that undertaking reflection in practice can help nurses develop an awareness of a sense of personal power and agency, cultivate their critical thinking ability and help them promote their professional development. However, reflection has not been introduced widely as a nursing curriculum in China, and literature shows that some clinical nurses lack critical thinking skills and critical reflective practice skills by reason of not receiving systematic education on reflection when they were at nursing college.Therefore, we present a series of seven articles focused on prevalent and interesting practice-based events to reflect on in this special issue. The main aim is to disseminate reflective methodology and techniques and present examples of reflective writing for nurses.It is expected that these articles will help to lead Chinese nurses to adopt critical emancipatory reflective processes to bring about transformative actions.展开更多
To assess the impact of disease characteristics on the quality of life (QOL) in children with inflammatory bowel diseases (IBD).METHODSThis was a cross-sectional study conducted at the First Department of Pediatrics o...To assess the impact of disease characteristics on the quality of life (QOL) in children with inflammatory bowel diseases (IBD).METHODSThis was a cross-sectional study conducted at the First Department of Pediatrics of the University of Athens at the “Aghia Sophia” Children’s Hospital. Children diagnosed with Crohn’s disease (CD) or ulcerative colitis (UC), who were followed as outpatients or during a hospitalization, participated, after informed consent was obtained from their legal representative. QOL was assessed by the IMPACT-III questionnaire. Demographic data and disease characteristics were also collected. Statistical analyses included parametric (Student’s t-test and Pearson’s r) and non-parametric (Mann-Whitney test, Fisher’s test and Spearman’s rho) procedures.RESULTSNinety-nine patients (UC: 37, 73.0% females, CD: 62, 51.6% females), aged 12.8 ± 2.6 years were included. Overall, as well as, sub-domain scores did not differ between UC and CD (overall score: 73.9 ± 13.3 vs 77.5 ± 11.2, respectively, P = 0.16). In the entire sample, total score was related to physician’s global assessment (PGA, patients classified as “mild/moderate” active disease had, on average, 14.8 ± 2.7 points lower total scores compared to those “in remission”, P < 0.001) and age at IMPACT completion (Pearson’s r = 0.29, P = 0.05). Disease activity assessed by the indices Pediatric Ulcerative Colitis activity index, Pediatric Crohn’s disease activity index or PGA was significantly associated with all subdomains scores. Presence of extraintestinal manifestations had a negative impact on emotional and social functioning domains.CONCLUSIONDisease activity is the main correlate of QOL in children with IBD, underlining the importance of achieving and sustaining clinical remission展开更多
The present work was carried out to evaluate the safety of shrimp(Solenocera crassicornis)treated with different concentrations of sodium metabisulfite(SMB)by soaking or spraying during frozen storage.Shrimps soaked i...The present work was carried out to evaluate the safety of shrimp(Solenocera crassicornis)treated with different concentrations of sodium metabisulfite(SMB)by soaking or spraying during frozen storage.Shrimps soaked in higher concentrations of SMB showed higher sensory scores,lower total color differences,and better anti-melanosis effects than shrimps in the control and other treatment groups throughout frozen storage(−18℃).Lower total volatile basic nitrogen and thiobarbituric acid reactive substances and higher salt soluble protein contents were detected in shrimp soaked with high doses of SMB compared with other samples.In addition,lower counts of total aerobic plates and psychrotrophic bacteria were observed in shrimp treated by soaking with higher doses of SMB than those in control shrimp and shrimp treated with other methods during frozen storage(−18℃).However,the SO2 content of 5%SMB-soaked samples exceeded the maximum allowable limit of 100mgkg−1.Overall,the use of 1.5%SMB soaking to treat shrimp results in good antioxidant and antimicrobial effects and,thus,may be suggested to preserve S.crassicornis under frozen conditions.The results of this study present important guidance on the use of SMB to maintain the quality of marine-trawling shrimp from manufacturing to consumption.展开更多
BACKGROUND Inflammatory bowel diseases(IBD)have been associated with a low quality of life(QoL)and a negative impact on work productivity compared to the general population.Information about disease control,patient-re...BACKGROUND Inflammatory bowel diseases(IBD)have been associated with a low quality of life(QoL)and a negative impact on work productivity compared to the general population.Information about disease control,patient-reported outcomes(PROs),treatment patterns and use of healthcare resources is relevant to optimizing IBD management.AIM To describe QoL and work productivity and activity impairment(WPAI),treatment patterns and use of healthcare resources among IBD patients in Brazil.METHODS A multicenter cross-sectional study included adult outpatients who were previously diagnosed with moderate to severe Crohn’s disease(CD)or ulcerative colitis(UC).At enrolment,active CD and UC were defined as having a Harvey Bradshaw Index≥8 or a CD Activity Index≥220 or calprotectin>200μg/g or previous colonoscopy results suggestive of inadequate control(per investigator criteria)and a 9-point partial Mayo score≥5,respectively.The PRO assessment included the QoL questionnaires SF-36 and EQ-5D-5L,the Inflammatory Bowel Disease Questionnaire(IBDQ),and the WPAI questionnaire.Information about healthcare resources and treatment during the previous 3 years was collected from medical records.Chi-square,Fisher’s exact and Student’s t-/Mann-Whitney U tests were used to compare PROs,treatment patterns and the use of healthcare resources by disease activity(α=0.05).RESULTS Of the 407 patients in this study(CD/UC:64.9%/35.1%,mean age 42.9/45.9 years,54.2%/56.6%female,38.3%/37.1%employed),44.7%/25.2%presented moderate-to-severe CD/UC activity,respectively,at baseline.Expressed in median values for CD/UC,respectively,the SF-36 physical component was 46.6/44.7 and the mental component was 45.2/44.2,the EQ-visual analog scale score was 80.0/70.0,and the IBDQ overall score was 164.0/165.0.Moderate to severe activity,female gender,being unemployed,a lower educational level and lower income were associated with lower QoL(P<0.05).Median work productivity impairment was 20%and 5%for CD and UC patients,respectively,and activity impairment was 30%,the latter being higher among patients with moderate to severe disease activity compared to patients with mild or no disease activity(75.0%vs 10.0%,P<0.001).For CD/UC patients,respectively,25.4%/2.8%had at least one surgery,38.3%/19.6%were hospitalized,and 70.7%/77.6%changed IBD treatment at least once during the last 3 years.The most common treatments at baseline were biologics(75.3%)and immunosuppressants(70.9%)for CD patients and 5-ASA compounds(77.5%)for UC patients.CONCLUSION Moderate to severe IBD activity,especially among CD patients,is associated with a substantial impact on QoL,work productivity impairment and an increased number of IBD surgeries and hospitalizations in Brazil.展开更多
AIM: To investigate the quality of care for a hospital based-cohort of patients with inflammatory bowel disease (IBD) from East China according to the current practice guidelines, METHODS: A retrospective review w...AIM: To investigate the quality of care for a hospital based-cohort of patients with inflammatory bowel disease (IBD) from East China according to the current practice guidelines, METHODS: A retrospective review was conducted, involving 177 patients with IBD admitted to Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University between June 2000 and June 2006. Data regarding demographic and clinical characteristics as well as medical therapy including use of oral aminosalisylates, topical therapy, corticosteroid agents, immunomodulatory agents (such as azathioprine) at admission and outpatient clinic visit were analyzed. RESULTS: A total of 177 eligible patients were evaluated in this study, including 71 patients with Crohn's disease (CD) and 106 with ulcerative colitis (UC). All were the Han nationality Chinese with active disease at baseline. All the 106 patients with ulcerative colitis received optimal doses of aminosalisylate while 27 of 68 (39.7%) patients with ileal or colonic CD received the suboptimal doses of aminosalisylate. The incidence of suboptimal dose of aminosalisylate was significantly higher in CD patients with small intestine involvement only (52.8% vs 25.0%, P = 0.019). Thirty-one (54.4%) patients with active distal or left-sided ulcerative colitis received topical therapy, and 27.8% of patients suffering from severe inflammatory bowel disease did not receive oral or intravenous steroid therapy. Among the 51 patients for whom thiopurine was indicated, only 10 (19.6%) received immunomodulatory agents, and more thanhalf of the 8 patients received a suboptimal dose of azathiopurine with no attempt to increase its dosage. CONCLUSION: The quality of care for IBD patients can be further improved. A suboptimal dose of aminosalicylate is used in treatment of patients with CD, especially in those with small intestine involved only. Topical mesalazine is inadequately used in patients with distal or left-sided colitis. Oral or intravenous steroid therapy is not used in some patients with severe IBD. Use of immunomodulatory medication is limited. Larger prospective studies are needed to investigate the quality of care for patients with IBD to establish our own evidence-based guidelines.展开更多
In order to evaluate the ride quality of the soil compactor cab supplemented by the auxiliary hydraulic mounts (AHM), a nonlinear dynamic model of the soil compactor interacting with the off-road deformable terrain is...In order to evaluate the ride quality of the soil compactor cab supplemented by the auxiliary hydraulic mounts (AHM), a nonlinear dynamic model of the soil compactor interacting with the off-road deformable terrain is established based on Matlab/Simulink sofware. The power spectral density (PSD) and the weighted root mean square (RMS) of acceleration responses of the vertical driver s seat, the cab s pitch and roll angle are chosen as objective functions in low-frequency range. Experimental investigation is also used to verify the accuracy of the model. The influence of the damping coefficients of the AHM on the cab s ride quality is analyzed, and damping coefficients are then optimized via a genetic algorithm program. The research results show that the cab s rubber mounts added by the AHM clearly improve the ride quality under various operating conditions. Particularly, with the optimal damping coefficients of the front-end mounts c a 1,2 = 1 500 N · s/m and of the rear-end mounts c a 3,4 =2 335 N · s/m, the weighted RMS values of the driver s seat, the cab s pitch and roll angle are reduced by 22.2%, 18.8%, 58.7%, respectively. Under the condition of the vehicle travelling, with the optimal damping coefficients of c a 1,2 = 1 500 N · s/m and c a 3,4 =1 882 N · s/m, the maximum PSD values of the driver s seat, the cab s pitch and roll angle are clearly decreased by 36.7%, 54.7% and 50.6% under the condition of the vehicle working.展开更多
AIM: To analyze the frequency and severity of faecal incontinence (FI) and its effect on the quality of life (QOL) in inflammatory bowel disease (IBD) patients. METHODS: All patients who attended surgical and medical ...AIM: To analyze the frequency and severity of faecal incontinence (FI) and its effect on the quality of life (QOL) in inflammatory bowel disease (IBD) patients. METHODS: All patients who attended surgical and medical gastroenterology outpatient clinics in a tertiary care center with an established diagnosis of either ulcerative colitis (UC) or Crohn’s disease (CD) over a period of 10 mo were included in this study. Before enrollment into the study, the patients were explained about the study and informed consent was obtained. The patients with unidentified colitis were excluded. The data on demographics, disease characteristics, FI (Vaizey score), and quality of life (IBD-Q) were collected. Data were analyzed using SPSS version 21. RESULTS: There were 184 patients (women = 101, 54.9%; UC = 153, 83.2%) with a female preponderance for UC (male/female ratio = 1:1.5) and a male preponderance for CD (male/female = 2:1). Forty-eight (26%) patients reported symptoms of FI. Among the patients with FI, 70.8% were women (n = 34) and 29.2% were men (n = 14) with an average age of 52.7 years (range, 20-78 years). Average age of onset of FI was 48.6 (range, 22-74) years. Ten percent (n = 5) reported regular FI. Incontinence to flatus was seen in 33.3% (n = 16), to liquid faeces in 56.2% (n = 27), to solid faeces in 6.2% (n = 3) and to all three in 4.1% (n = 2). Twenty-one percent (n = 10) complained of disruption of their physical and social activity. There was no association between FI and type of IBD. Significant associations were found between FI and age (P = 0.005) and gender (P CONCLUSION: In our study, nearly a quarter of patients reported FI. There was a significant correlation between FI and QOL. Therefore, enquiring about FI in IBD patients can lead to identification of this debilitating condition. This will enable early referral for continence care in this group of patients.展开更多
Hospitalized patients with inflammatory bowel disease(IBD)are at high risk for morbidity,mortality,and health care utilization costs.While the literature on trends in hospitalization rates for this disease is conflict...Hospitalized patients with inflammatory bowel disease(IBD)are at high risk for morbidity,mortality,and health care utilization costs.While the literature on trends in hospitalization rates for this disease is conflicting,there does appear to be significant variation in the delivery of care to this complex group,which may be a marker of suboptimal quality of care.There is a need for improvement in identifying patients at risk for hospitalization in an effort to reduce admissions.Moreover,appropriate screening for a number of hospital acquired complications such as venous thromboembolism and Clostridium difficile infection is suboptimal.This review discusses areas of inpatient care for IBD patients that are in need of improvement and outlines a number of potential quality improvement initiatives such as payfor-performance models,quality improvement frameworks,and healthcare information technology.展开更多
文摘The purpose of this paper is to examine the effect of the board of directors,namely board size,board independence,and CEO duality,as well as audit quality on the disclosure of internal control information.The sample consists of 164 European companies listed in the STOXX Europe 600.Based on positive agency theory,the authors posit that board of directors and audit quality influence corporate internal control disclosure practice.The content analysis and the design of the evaluation criterion were used to calculate the disclosure index of internal control.Thus,multiple regression analysis is utilized to analyze the results of this paper.The average internal control information disclosure index was 0.285,indicating that most of the companies in our sample do not disclose enough information about the internal control.This low level of forward-looking information disclosure makes it very difficult for corporate stakeholders to determine the future performance of the company.Multivariate results indicate that internal control disclosure is positively and significantly associated with board independence,CEO duality,and audit quality.This study contributes to the literature on the various governance characteristics and disclosure by showing that the disclosure of internal control information in European countries is positively and significantly associated with board independence,separation of duties,and audit quality.Our study was based on a sample of European companies including countries regulating IC disclosure as well as unregulated settings.As noted by Bedard and Graham(2014),regulatory differences in countries can contribute insights on the costs and benefits of disclosure.Findings also have policy implications for investors,managers,and regulators.
基金Supported by National Foundation for Fostering Talents in Basic Science(J0730650)~~
文摘The major phytoplankton was investigated and analyzed in landscape water of six campuses in Nanjing Xianlin University Town,and water quality was evaluated by single factor assessment method and comprehensive weighted evaluation method.The result showed that the major phytoplankton groups were Cyanophyta,Chlorophyta and Bacillariophyta.Besides,each evaluation indicator showed that waterbodies in four campuses were eutrophicated and result of single factor evaluation showed water quality all belonged to poor category V.The result of comprehensive weighted assessment showed that waters in Nanjing Normal University and Nanjing University of Posts and Telecommunications were seriously polluted,cyanobacterial bloom appearing.Waters in Nanjing University of Chinese Medicine and Nanjing Forest Police College hadn't been eutrophicated.
基金Project supported by the National Natural Science Foundation of China (No. 40001008) the Science and Technology Project of Zhejiang Province (No. 2004C32066).
文摘Heavy metal concentrations in agricultural soils of Zhejiang Province were monitored to indicate the status of heavy metal contamination and assess environmental quality of agricultural soils. A total of 908 soil samples were collected from 38 counties in Zbejiang Province and eight heavy metal (Cd, Cr, Pb, Hg, Cu, Zn, Ni and As) concentrations had been evaluated in agricultural soil. It was found 775 samples were unpolluted and 133 samples were slightly polluted and more respectively, that is approximately 14.65% agricultural soil samples had the heavy metal concentration above the threshold level in this province by means of Nemerow's synthetical pollution index method according to the second grade of Standards for Soil Environmental Quality of China (GB15618- 1995). Contamination of Cd was the highest, followed by Ni, As and Zn were lower correspondingly. Moreover, Inverse Distance Weighted (IDW) interpolation method was used to make an assessment map of soil environmental quality based on the Nemerow's pollution index and the soil environmental quality was categorized into five grades. Moreover, ten indices were calculated as input parameters for principal component analysis (PCA) and the principal components (PCs) were created to compare environmental quality of different soils and regions. The results revealed that environmental quality of tea soils was better than that of paddy soils, vegetable soils and fruit soils. This study indicated that GIS combined with multivariate statistical approaches proved to be effective and powerful tool in the mapping of soil contamination distribution and the assessment of soil environmental quality on provincial scale, which is beneficial to environmental protection and management decision-making by local government.
基金the Higher Education Commission (HEC) of Pakistan
文摘Field experiments were conducted at Cereal Crops Research Institute, Pirsabak, Nowshera, Pakistan, during winter 2003~2004; 2004~2005 to evaluate the effect of nitrogen; sulfur levels; methods of nitrogen application on canola (Brassica napus L. cv. Bulbul-98) under rainfed conditions. Four levels of S (0, 10, 20,; 30 kg/ha); three levels of N (40, 60,; 80 kg/ha); a control treatment with both nutrients at zero level were included in the experiments. Sulfur levels were applied at sowing while N levels were applied by three methods (100% soil application, 90% soil+10% foliar application,; 80% soil +20% foliar application). The experiments were laid out in randomized complete block (RCB) design having four replications. Oil content increased significantly up to 20 kg S/ha but further increase in S level did not enhance oil content. Glucosinolate content increased from 13.6 to 24.6 μmol/g as S rate was increased from 0 to 30 kg/ha. Protein content increased from 22.4% to 23.2% as S rate was increased from 0 to 20 kg/ha. Oil content responded negatively to the increasing N levels. The highest N level resulted in the highest values for protein (23.5%); glucosinolate (19.9 μmol/g) contents. Methods of N application had no significant impact on any parameters under study.
文摘AIM: To investigate the symptom presentation and quality of life in obese Chinese patients with gastro- esophageal reflux disease (GERD). MKTHODS: Data from patients diagnosed with GERD according to the Montreal definition, were collected between January 2009 to March 2010. The enrolled patients were assigned to the normal [body mass in- dex (BMI) 〈 25 kg/m2], overweight (25-30 kg/m2), and obese (BMI 〉 30 kg/m2) groups. General demographic data, endoscopic findings, and quality of life of the three groups of patients were analyzed and compared.and 15 patients were classified in the normal, over- weight, and obese, respectively. There was significantly more erosive esophagitis (73.3% vs 64.3% vs 39.2%, P = 0.002), hiatal hernia (60% vs 33.9% vs 16.7%, P = 0.001), and males (73.3% vs 73.2% vs 32.4%, P = 0.001) in the obese cases. The severity and frequency of heartburn, not acid regurgitation, was positively cor- related with BMI, with a significant association in men, but not in women. Obese patients were prone to have low quality of life scores, with obese women having the lowest scores for mental health. CONCLUSION: In patients with GERD, obese men had the most severe endoscopic and clinical presenta- tion. Obese women had the poorest mental health.
基金Supported by Grant from the Slovak APVV agency,No.APVV-0672-11
文摘AIM: To investigate the effect of vitamin D (VD) concentrations and VD supplementation on health related quality of life in inflammatory bowel disease (IBD) patients.
文摘Over the past decade,there has been increasing focus on improving the quality of healthcare delivered to patients with chronic diseases,including inflammatory bowel disease.Inflammatory bowel disease is a complex,chronic condition with associated morbidity,health care costs,and reductions in quality of life.The condition is managed primarily in the outpatient setting.The delivery of high quality of care is suboptimal in several ambulatory inflammatory bowel disease domains including objective assessments of disease activity,the use of steroid-sparing agents,screening prior to anti-tumor necrosis factor therapy,and monitoring thiopurine therapy.This review outlines these gaps in performance and provides potential initiatives aimed at improvement including reimbursement programs,quality improvement frameworks,collaborative efforts in quality improvement,and the use of healthcare information technology.
文摘In recent years,pediatric health care has embraced the concept of quality improvement to improve patient outcomes.As quality improvement efforts are implemented,network collaboration(where multiple centers and practices implement standardized programs)is a popular option.In a collaborative network,improvement in the conduct of structural,process and outcome quality measures can lead to improvements in overall health,and benchmarks can be used to assess and compare progress.In this review article,we provided an overview of the quality improvement movement and the role of quality indicators in this movement.We reviewed current quality improvement efforts in pediatric inflammatory bowel disease (IBD),as well as other pediatric chronic illnesses.We discussed the need to standardize the development of quality indicators used in quality improvement networks to assess medical care,and the validation techniques which can be used to ensure that process indicators result in improved outcomes of clinical significance.We aimed to assess current quality improvement efforts in pediatric IBD and other diseases,such as childhood asthma,childhood arthritis,and neonatal health.By doing so,we hope to learn from their successes and failures and to move the field forward for future improvements in the care provided to children with IBD.
文摘Reflection is a fundamental skill of health-care professionals and plays an important role in ensuring the quality of care in health-care practice. It is believed that undertaking reflection in practice can help nurses develop an awareness of a sense of personal power and agency, cultivate their critical thinking ability and help them promote their professional development. However, reflection has not been introduced widely as a nursing curriculum in China, and literature shows that some clinical nurses lack critical thinking skills and critical reflective practice skills by reason of not receiving systematic education on reflection when they were at nursing college.Therefore, we present a series of seven articles focused on prevalent and interesting practice-based events to reflect on in this special issue. The main aim is to disseminate reflective methodology and techniques and present examples of reflective writing for nurses.It is expected that these articles will help to lead Chinese nurses to adopt critical emancipatory reflective processes to bring about transformative actions.
文摘To assess the impact of disease characteristics on the quality of life (QOL) in children with inflammatory bowel diseases (IBD).METHODSThis was a cross-sectional study conducted at the First Department of Pediatrics of the University of Athens at the “Aghia Sophia” Children’s Hospital. Children diagnosed with Crohn’s disease (CD) or ulcerative colitis (UC), who were followed as outpatients or during a hospitalization, participated, after informed consent was obtained from their legal representative. QOL was assessed by the IMPACT-III questionnaire. Demographic data and disease characteristics were also collected. Statistical analyses included parametric (Student’s t-test and Pearson’s r) and non-parametric (Mann-Whitney test, Fisher’s test and Spearman’s rho) procedures.RESULTSNinety-nine patients (UC: 37, 73.0% females, CD: 62, 51.6% females), aged 12.8 ± 2.6 years were included. Overall, as well as, sub-domain scores did not differ between UC and CD (overall score: 73.9 ± 13.3 vs 77.5 ± 11.2, respectively, P = 0.16). In the entire sample, total score was related to physician’s global assessment (PGA, patients classified as “mild/moderate” active disease had, on average, 14.8 ± 2.7 points lower total scores compared to those “in remission”, P < 0.001) and age at IMPACT completion (Pearson’s r = 0.29, P = 0.05). Disease activity assessed by the indices Pediatric Ulcerative Colitis activity index, Pediatric Crohn’s disease activity index or PGA was significantly associated with all subdomains scores. Presence of extraintestinal manifestations had a negative impact on emotional and social functioning domains.CONCLUSIONDisease activity is the main correlate of QOL in children with IBD, underlining the importance of achieving and sustaining clinical remission
基金supported by the Science and Technology Plan Projects of Zhejiang Province, China (Nos. 2017 C37009, 2017F50018)
文摘The present work was carried out to evaluate the safety of shrimp(Solenocera crassicornis)treated with different concentrations of sodium metabisulfite(SMB)by soaking or spraying during frozen storage.Shrimps soaked in higher concentrations of SMB showed higher sensory scores,lower total color differences,and better anti-melanosis effects than shrimps in the control and other treatment groups throughout frozen storage(−18℃).Lower total volatile basic nitrogen and thiobarbituric acid reactive substances and higher salt soluble protein contents were detected in shrimp soaked with high doses of SMB compared with other samples.In addition,lower counts of total aerobic plates and psychrotrophic bacteria were observed in shrimp treated by soaking with higher doses of SMB than those in control shrimp and shrimp treated with other methods during frozen storage(−18℃).However,the SO2 content of 5%SMB-soaked samples exceeded the maximum allowable limit of 100mgkg−1.Overall,the use of 1.5%SMB soaking to treat shrimp results in good antioxidant and antimicrobial effects and,thus,may be suggested to preserve S.crassicornis under frozen conditions.The results of this study present important guidance on the use of SMB to maintain the quality of marine-trawling shrimp from manufacturing to consumption.
文摘BACKGROUND Inflammatory bowel diseases(IBD)have been associated with a low quality of life(QoL)and a negative impact on work productivity compared to the general population.Information about disease control,patient-reported outcomes(PROs),treatment patterns and use of healthcare resources is relevant to optimizing IBD management.AIM To describe QoL and work productivity and activity impairment(WPAI),treatment patterns and use of healthcare resources among IBD patients in Brazil.METHODS A multicenter cross-sectional study included adult outpatients who were previously diagnosed with moderate to severe Crohn’s disease(CD)or ulcerative colitis(UC).At enrolment,active CD and UC were defined as having a Harvey Bradshaw Index≥8 or a CD Activity Index≥220 or calprotectin>200μg/g or previous colonoscopy results suggestive of inadequate control(per investigator criteria)and a 9-point partial Mayo score≥5,respectively.The PRO assessment included the QoL questionnaires SF-36 and EQ-5D-5L,the Inflammatory Bowel Disease Questionnaire(IBDQ),and the WPAI questionnaire.Information about healthcare resources and treatment during the previous 3 years was collected from medical records.Chi-square,Fisher’s exact and Student’s t-/Mann-Whitney U tests were used to compare PROs,treatment patterns and the use of healthcare resources by disease activity(α=0.05).RESULTS Of the 407 patients in this study(CD/UC:64.9%/35.1%,mean age 42.9/45.9 years,54.2%/56.6%female,38.3%/37.1%employed),44.7%/25.2%presented moderate-to-severe CD/UC activity,respectively,at baseline.Expressed in median values for CD/UC,respectively,the SF-36 physical component was 46.6/44.7 and the mental component was 45.2/44.2,the EQ-visual analog scale score was 80.0/70.0,and the IBDQ overall score was 164.0/165.0.Moderate to severe activity,female gender,being unemployed,a lower educational level and lower income were associated with lower QoL(P<0.05).Median work productivity impairment was 20%and 5%for CD and UC patients,respectively,and activity impairment was 30%,the latter being higher among patients with moderate to severe disease activity compared to patients with mild or no disease activity(75.0%vs 10.0%,P<0.001).For CD/UC patients,respectively,25.4%/2.8%had at least one surgery,38.3%/19.6%were hospitalized,and 70.7%/77.6%changed IBD treatment at least once during the last 3 years.The most common treatments at baseline were biologics(75.3%)and immunosuppressants(70.9%)for CD patients and 5-ASA compounds(77.5%)for UC patients.CONCLUSION Moderate to severe IBD activity,especially among CD patients,is associated with a substantial impact on QoL,work productivity impairment and an increased number of IBD surgeries and hospitalizations in Brazil.
基金National Natural Science Foundation of China (No. 30500244)Funtional study of two new allele variants of NOD2 in Han nationality
文摘AIM: To investigate the quality of care for a hospital based-cohort of patients with inflammatory bowel disease (IBD) from East China according to the current practice guidelines, METHODS: A retrospective review was conducted, involving 177 patients with IBD admitted to Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University between June 2000 and June 2006. Data regarding demographic and clinical characteristics as well as medical therapy including use of oral aminosalisylates, topical therapy, corticosteroid agents, immunomodulatory agents (such as azathioprine) at admission and outpatient clinic visit were analyzed. RESULTS: A total of 177 eligible patients were evaluated in this study, including 71 patients with Crohn's disease (CD) and 106 with ulcerative colitis (UC). All were the Han nationality Chinese with active disease at baseline. All the 106 patients with ulcerative colitis received optimal doses of aminosalisylate while 27 of 68 (39.7%) patients with ileal or colonic CD received the suboptimal doses of aminosalisylate. The incidence of suboptimal dose of aminosalisylate was significantly higher in CD patients with small intestine involvement only (52.8% vs 25.0%, P = 0.019). Thirty-one (54.4%) patients with active distal or left-sided ulcerative colitis received topical therapy, and 27.8% of patients suffering from severe inflammatory bowel disease did not receive oral or intravenous steroid therapy. Among the 51 patients for whom thiopurine was indicated, only 10 (19.6%) received immunomodulatory agents, and more thanhalf of the 8 patients received a suboptimal dose of azathiopurine with no attempt to increase its dosage. CONCLUSION: The quality of care for IBD patients can be further improved. A suboptimal dose of aminosalicylate is used in treatment of patients with CD, especially in those with small intestine involved only. Topical mesalazine is inadequately used in patients with distal or left-sided colitis. Oral or intravenous steroid therapy is not used in some patients with severe IBD. Use of immunomodulatory medication is limited. Larger prospective studies are needed to investigate the quality of care for patients with IBD to establish our own evidence-based guidelines.
基金The Science and Technology Support Program of Jiangsu Province(No.BE2014133)the Prospective Joint Research Program of Jiangsu Province(No.BY2014127-01)
文摘In order to evaluate the ride quality of the soil compactor cab supplemented by the auxiliary hydraulic mounts (AHM), a nonlinear dynamic model of the soil compactor interacting with the off-road deformable terrain is established based on Matlab/Simulink sofware. The power spectral density (PSD) and the weighted root mean square (RMS) of acceleration responses of the vertical driver s seat, the cab s pitch and roll angle are chosen as objective functions in low-frequency range. Experimental investigation is also used to verify the accuracy of the model. The influence of the damping coefficients of the AHM on the cab s ride quality is analyzed, and damping coefficients are then optimized via a genetic algorithm program. The research results show that the cab s rubber mounts added by the AHM clearly improve the ride quality under various operating conditions. Particularly, with the optimal damping coefficients of the front-end mounts c a 1,2 = 1 500 N · s/m and of the rear-end mounts c a 3,4 =2 335 N · s/m, the weighted RMS values of the driver s seat, the cab s pitch and roll angle are reduced by 22.2%, 18.8%, 58.7%, respectively. Under the condition of the vehicle travelling, with the optimal damping coefficients of c a 1,2 = 1 500 N · s/m and c a 3,4 =1 882 N · s/m, the maximum PSD values of the driver s seat, the cab s pitch and roll angle are clearly decreased by 36.7%, 54.7% and 50.6% under the condition of the vehicle working.
文摘AIM: To analyze the frequency and severity of faecal incontinence (FI) and its effect on the quality of life (QOL) in inflammatory bowel disease (IBD) patients. METHODS: All patients who attended surgical and medical gastroenterology outpatient clinics in a tertiary care center with an established diagnosis of either ulcerative colitis (UC) or Crohn’s disease (CD) over a period of 10 mo were included in this study. Before enrollment into the study, the patients were explained about the study and informed consent was obtained. The patients with unidentified colitis were excluded. The data on demographics, disease characteristics, FI (Vaizey score), and quality of life (IBD-Q) were collected. Data were analyzed using SPSS version 21. RESULTS: There were 184 patients (women = 101, 54.9%; UC = 153, 83.2%) with a female preponderance for UC (male/female ratio = 1:1.5) and a male preponderance for CD (male/female = 2:1). Forty-eight (26%) patients reported symptoms of FI. Among the patients with FI, 70.8% were women (n = 34) and 29.2% were men (n = 14) with an average age of 52.7 years (range, 20-78 years). Average age of onset of FI was 48.6 (range, 22-74) years. Ten percent (n = 5) reported regular FI. Incontinence to flatus was seen in 33.3% (n = 16), to liquid faeces in 56.2% (n = 27), to solid faeces in 6.2% (n = 3) and to all three in 4.1% (n = 2). Twenty-one percent (n = 10) complained of disruption of their physical and social activity. There was no association between FI and type of IBD. Significant associations were found between FI and age (P = 0.005) and gender (P CONCLUSION: In our study, nearly a quarter of patients reported FI. There was a significant correlation between FI and QOL. Therefore, enquiring about FI in IBD patients can lead to identification of this debilitating condition. This will enable early referral for continence care in this group of patients.
文摘Hospitalized patients with inflammatory bowel disease(IBD)are at high risk for morbidity,mortality,and health care utilization costs.While the literature on trends in hospitalization rates for this disease is conflicting,there does appear to be significant variation in the delivery of care to this complex group,which may be a marker of suboptimal quality of care.There is a need for improvement in identifying patients at risk for hospitalization in an effort to reduce admissions.Moreover,appropriate screening for a number of hospital acquired complications such as venous thromboembolism and Clostridium difficile infection is suboptimal.This review discusses areas of inpatient care for IBD patients that are in need of improvement and outlines a number of potential quality improvement initiatives such as payfor-performance models,quality improvement frameworks,and healthcare information technology.