This September is the season of sweet osmanthus.The 2024 China Daily Chemical Product Managers Basic Knowledge Training Session was successfully hosted in Qingyuan,Guangdong province between September 9th and Septembe...This September is the season of sweet osmanthus.The 2024 China Daily Chemical Product Managers Basic Knowledge Training Session was successfully hosted in Qingyuan,Guangdong province between September 9th and September 11th,2024.It was held by China Research Institute of Daily Chemical and organized by China Information Center of Daily Chemical Industry and The China National Productivity Promotion Center of Surfactant and Detergent and co-hosted by Guangdong Jiaxiya Daily Necessities Technology Co.,Ltd.展开更多
A prestigious conference claimed recently a revolution in neuroscience to understand consciousness.In this paper it is shown that this revolution already came,revealing the determinant role of information for human an...A prestigious conference claimed recently a revolution in neuroscience to understand consciousness.In this paper it is shown that this revolution already came,revealing the determinant role of information for human and living structures,both for their structuration and behavior,explaining consciousness at human as the result of the activity of the Informational System of Human and Living Structures.For this,it is emphasized and discussed the informational structure of the eukaryotic cell,the basic/representative composing unit of the multicellular body of human,animals,and plants,showing that the composition and functions of the informational system are basically similar with that of human.To reveal the driving role of informational mechanisms in human and subhuman organisms,it is introduced the concept of matter-related information,showing that information can be hidden/“embodied”or released/“disembodied”in or from the elemental micro/macro components of the body,during the multiple chain/cascade interactions including transduction processes.It is shown that such interactions are initiated from two main categories of informational sources:implicit(genetic)and explicit(external/internal)sources,the first category leading to structuration of the body and the second the reactive behavior.Consciousness in human and subhuman organisms,expressed by two corresponding informational relations,is the result of the release of information by the mind,acting as an informational operator/device,the development degree of mind and consciousness depending on the complexity degree and adaptation.An analogy of this Informational Model of Human and Living Structures(IMHLS)with the ancient model of chakras is highlighted,showing that these models support each other,applied with beneficial effects in Reiki technique and music-based cognitive multi-task therapy for neuro-rehabilitation.展开更多
Kawasaki disease(KD)is a significant pediatric vasculitis known for its potential to cause severe coronary artery complications.Despite the effectiveness of initial treatments,such as intravenous immunoglobulin,KD pat...Kawasaki disease(KD)is a significant pediatric vasculitis known for its potential to cause severe coronary artery complications.Despite the effectiveness of initial treatments,such as intravenous immunoglobulin,KD patients can experience long-term cardiovascular issues,as evidenced by a recent case report of an adult who suffered a ST-segment elevation myocardial infarction due to previous KD in the World Journal of Clinical Cases.This editorial emphasizes the critical need for long-term management and regular surveillance to prevent such complications.By drawing on recent research and case studies,we advocate for a structured approach to follow-up care that includes routine cardiac evaluations and preventive measures.展开更多
Objective:This study aimed to explain the criteria of managers at different levels of nursing in selecting effective nursing diagnosis.Methods:In conventional content analysis,10 nursing managers at different levels i...Objective:This study aimed to explain the criteria of managers at different levels of nursing in selecting effective nursing diagnosis.Methods:In conventional content analysis,10 nursing managers at different levels including head nurse,supervisor,and nursing manager were interviewed.Data was collected with semi-structured interviews and a narrative approach.Data analysis was performed using the Zhang–Wildemuth method simultaneously with sampling.Results:Four head nurses,four supervisors(educational,clinical),and two nursing managers were interviewed.The results of the a nalysis led to the extraction of two main categories:centrality of the nursing profession,with the sub-categories compatibility with nursing p ractices and compliance with organizational and professional principles of nursing,and covering the patient care aspect,with s ub-categories of having potential to facilitate and adapting to patient care conditions.Conclusions:The analysis of the views of nursing managers shows that health managers should consider various management aspects such as functional and organizational to increase the efficiency of nursing interventions in the selection of nursing diagnostic systems.From the point of view of health managers,nursing diagnoses should cover the considerations of patients,nurses,and work environments.展开更多
This work explores the axiology of consciousness in Mocombe’s consciousness field in the material world.The paper critically assesses Mocombe’s consciousness field theory(CFT)within the larger body of contemporary o...This work explores the axiology of consciousness in Mocombe’s consciousness field in the material world.The paper critically assesses Mocombe’s consciousness field theory(CFT)within the larger body of contemporary ontological debates regarding the nature,origin,and constitution of consciousness in the universe.The work goes on to highlight the manifestation of Mocombe’s consciousness field in the material resource framework that is the earth,and the nature and origins of ethics and values.展开更多
Objective:To explore the effectiveness of the competency model for nursing managers in the training of newly appointed head nurses.Methods:Eighteen newly appointed head nurses from Yichang Central People’s Hospital,s...Objective:To explore the effectiveness of the competency model for nursing managers in the training of newly appointed head nurses.Methods:Eighteen newly appointed head nurses from Yichang Central People’s Hospital,selected between August 2023 and July 2024,were chosen as the research subjects.Based on the nursing manager competency model,corresponding training programs were developed,and these 18 head nurses were trained accordingly.Results:After the training,all newly appointed head nurses passed the theoretical assessments,with a pass rate of 100.00%.The pass rates for two rounds of assessment were 100.00%and 94.54%,respectively.There was no significant difference in the performance evaluation scores between new and senior head nurses in terms of standardized services,nursing quality,nursing research and teaching,and patient satisfaction(P>0.05).Conclusion:The competency model for nursing managers has a significant effect on the training of newly appointed head nurses.It effectively enhances management awareness,facilitates role transition,and,to some extent,improves the management and leadership capabilities of head nurses.It holds high value for broader implementation.展开更多
Objective: The purpose of this study was to clarify the collaborative activities and mutual recognition between community comprehensive care unit nurses (Ns) and care managers (CM) in supporting the discharge of the e...Objective: The purpose of this study was to clarify the collaborative activities and mutual recognition between community comprehensive care unit nurses (Ns) and care managers (CM) in supporting the discharge of the elderly from the hospital. Methods: A total of 300 nurses working in community comprehensive care wards and 360 care managers working in B City in A Prefecture were surveyed using an anonymous self-administered questionnaire. Results: The highest percentage of responses regarding necessary collaborative activities with multiple professions in supporting hospital discharge were the same for Ns and CMs. The items regarding practice with the highest percentages were “relationship as a team” for Ns, and “user-centered awareness” for CM. While these professionals were willing to share information about their patients’ lives after discharge, the percentage of those explaining their expertise was low. It is thought that collaborative activities focusing on these aspects would lead to more appropriate discharge support.展开更多
This article provides a comprehensive analysis of the study by Hou et al,focusing on the complex interplay between psychological and physical factors in the postoperative recovery(POR)of patients with perianal disease...This article provides a comprehensive analysis of the study by Hou et al,focusing on the complex interplay between psychological and physical factors in the postoperative recovery(POR)of patients with perianal diseases.The study sheds light on how illness perception,anxiety,and depression significantly influence recovery outcomes.Hou et al developed a predictive model that demonstrated high accuracy in identifying patients at risk of poor recovery.The article explores the critical role of pre-operative psychological assessment,highlighting the need for mental health support and personalized recovery plans in enhancing POR quality.A multidisciplinary approach,integrating mental health professionals with surgeons,anesthesiologists,and other specialists,is emphasized to ensure comprehensive care for patients.The study’s findings serve as a call to integrate psychological care into surgical practice to optimize outcomes for patients with perianal diseases.展开更多
Diabetic retinopathy(DR)remains a leading cause of vision impairment and blindness among individuals with diabetes,necessitating innovative approaches to screening and management.This editorial explores the transforma...Diabetic retinopathy(DR)remains a leading cause of vision impairment and blindness among individuals with diabetes,necessitating innovative approaches to screening and management.This editorial explores the transformative potential of artificial intelligence(AI)and machine learning(ML)in revolutionizing DR care.AI and ML technologies have demonstrated remarkable advancements in enhancing the accuracy,efficiency,and accessibility of DR screening,helping to overcome barriers to early detection.These technologies leverage vast datasets to identify patterns and predict disease progression with unprecedented precision,enabling clinicians to make more informed decisions.Furthermore,AI-driven solutions hold promise in personalizing management strategies for DR,incorpo-rating predictive analytics to tailor interventions and optimize treatment path-ways.By automating routine tasks,AI can reduce the burden on healthcare providers,allowing for a more focused allocation of resources towards complex patient care.This review aims to evaluate the current advancements and applic-ations of AI and ML in DR screening,and to discuss the potential of these techno-logies in developing personalized management strategies,ultimately aiming to improve patient outcomes and reduce the global burden of DR.The integration of AI and ML in DR care represents a paradigm shift,offering a glimpse into the future of ophthalmic healthcare.展开更多
This editorial highlights a recently published study examining the effectiveness of music therapy combined with motivational interviewing(MI)in addressing an-xiety and depression among young and middle-aged patients f...This editorial highlights a recently published study examining the effectiveness of music therapy combined with motivational interviewing(MI)in addressing an-xiety and depression among young and middle-aged patients following percuta-neous coronary intervention.It further explores existing evidence and potential future research directions for MI in postoperative rehabilitation and chronic disease management.MI aims to facilitate behavioral change and promote healthier lifestyles by fostering a trusting relationship with patients and enhan-cing intrinsic motivation.Research has demonstrated its effectiveness in posto-perative recovery for oncological surgery,stroke,organ transplants,and gastroin-testinal procedures,as well as in managing chronic conditions such as diabetes,obesity,and periodontal disease.The approach is patient-centered,adaptable,cost-effective,and easily replicable,though its limitations include reliance on the therapist’s expertise,variability in individual responses,and insufficient long-term follow-up studies.Future research could focus on developing individualized and precise intervention models,exploring applications in digital health management,and confirming long-term outcomes to provide more compre-hensive support for patient rehabilitation.展开更多
Colonoscopy represents a safe procedure that is widely used in medical practice either to diagnose or treat various gastrointestinal diseases.During the last few years,the incidence rate of perforations in colonoscopi...Colonoscopy represents a safe procedure that is widely used in medical practice either to diagnose or treat various gastrointestinal diseases.During the last few years,the incidence rate of perforations in colonoscopic procedures has increased,especially in therapeutic colonoscopies.The recent advancements in endoscopic techniques and gastrointestinal tumoral resection procedures such as endoscopic mucosal resection,endoscopic full-thickness resection,and endoscopic submucosal dissection(ESD)could be a risk factor for this increased risk.The incidence rate of mortality of serious colonoscopic perforations is 7.1%.The management plan for these perforations starts with conservative treatment in mild cases,endoscopic closure,and surgical management in severe cases.Recently,endoluminal vacuum therapy was found to be effective in the management of colorectal perforations and this has been reported in multiple case reports.This editorial provides an overview of the current guidelines for the management of iatrogenic colorectal perforations.These insights are from the perspectives of endoscopists and gastroenterologists.We also present a management algorithm based on the guidelines of the European Society of Gastrointestinal Endoscopy,the American Gastroenterological Association,and the World Society of Emergency Surgery.We also discussed in brief the use of endoluminal vacuum therapy in colorectal perforations.展开更多
BACKGROUND Inadequate glycemic control in patients with type 2 diabetes(T2DM)is a major public health problem and a significant risk factor for the progression of diabetic complications.AIM To evaluate the effects of ...BACKGROUND Inadequate glycemic control in patients with type 2 diabetes(T2DM)is a major public health problem and a significant risk factor for the progression of diabetic complications.AIM To evaluate the effects of intensive and supportive glycemic management strategies over a 12-month period in individuals with T2DM with glycated hemoglobin(HbA1c)≥10%and varying backgrounds of glycemic control.METHODS This prospective observational study investigated glycemic control in patients with poorly controlled T2DM over 12 months.Participants were categorized into four groups based on prior glycemic history:Newly diagnosed,previously well controlled with recent worsening,previously off-target but now worsening,and HbA1c consistently above 10%.HbA1c levels were monitored quarterly,and patients received medical,educational,and dietary support as needed.The analysis focused on the success rates of good glycemic control and the associated factors within each group.RESULTS The study showed significant improvements in HbA1c levels in all participants.The most significant improvement was observed in individuals newly diagnosed with diabetes:65%achieved an HbA1c target of≤7%.The results varied between participants with different glycemic control histories,followed by decreasing success rates:39%in participants with previously good glycemic control,21%in participants whose glycemic control had deteriorated compared to before,and only 10%in participants with persistently poor control,with mean HbA1c levels of 6.3%,7.7%,8.2%,and 9.7%,respectively.After one year,65.2%of the“newly diagnosed patients”,39.3%in the“previously controlled group”,21.9%in the“previously off-target but now worsened'”group and 10%in the“poorly controlled from the start”group had achieved HbA1c levels of 7 and below.CONCLUSION In poorly controlled diabetes,the rate at which treatment goals are achieved is associated with the glycemic background characteristics,emphasizing the need for tailored strategies.Therefore,different and comprehensive treatment approaches are needed for patients with persistent uncontrolled diabetes.展开更多
The dramatic rise in the number of people living in cities has made many environmental and social problems worse.The search for a productive method for disposing of solid waste is the most notable of these problems.Ma...The dramatic rise in the number of people living in cities has made many environmental and social problems worse.The search for a productive method for disposing of solid waste is the most notable of these problems.Many scholars have referred to it as a fuzzy multi-attribute or multi-criteria decision-making problem using various fuzzy set-like approaches because of the inclusion of criteria and anticipated ambiguity.The goal of the current study is to use an innovative methodology to address the expected uncertainties in the problem of solid waste site selection.The characteristics(or sub-attributes)that decision-makers select and the degree of approximation they accept for various options can both be indicators of these uncertainties.To tackle these problems,a novel mathematical structure known as the fuzzy parameterized possibility single valued neutrosophic hypersoft expert set(ρˆ-set),which is initially described,is integrated with a modified version of Sanchez’s method.Following this,an intelligent algorithm is suggested.The steps of the suggested algorithm are explained with an example that explains itself.The compatibility of solid waste management sites and systems is discussed,and rankings are established along with detailed justifications for their viability.This study’s strengths lie in its application of fuzzy parameterization and possibility grading to effectively handle the uncertainties embodied in the parameters’nature and alternative approximations,respectively.It uses specific mathematical formulations to compute the fuzzy parameterized degrees and possibility grades that are missing from the prior literature.It is simpler for the decisionmakers to look at each option separately because the decision is uncertain.Comparing the computed results,it is discovered that they are consistent and dependable because of their preferred properties.展开更多
It is the matter for achievement of the low carbon transport system that the excessive use of private vehicles can be controlled appropriately.Not only improvement of service level of modes except private vehicle,but ...It is the matter for achievement of the low carbon transport system that the excessive use of private vehicles can be controlled appropriately.Not only improvement of service level of modes except private vehicle,but also consciousness for environmental problem of individual trip maker is important for eco-commuting promotion.On the other hand,consciousness for environment would be changed by influence of other person.Accordingly,it is aimed in the study that the structure of decision-making process for modal shift to the eco-commuting mode in the local city is described considering environmental consciousness and social interaction.For the purpose,the consciousness for the environment problem and the travel behavior of the commuter at the suburban area in the local city are investigated by the questionnaire survey.The covariance structure about the eco-consciousness is analyzed with the database of the questionnaire survey by structural equation modeling.As the result,it can be confirmed with the structural equation model that the individual environmental consciousness is strongly related with the intention of self-sacrifice and is influenced with the local interaction of the individual connections.On the other hand,the intention of modal shift for the commuting mode is analyzed with the database of the questionnaire survey.It can be found out that the environmental consciousness is not statistically significant for commuting mode choice with the present poor level of service of public transport.However,the intention of self-sacrifice for the prevention of the global warming is statistically confirmed as the factor of modal shift with the operation of eco-commuting bus service with the RP/SP integrated estimation method.As the result,the multi-agent simulation system with social interaction model for eco consciousness is developed to measure the effect of the eco-commuting promotion.For the purpose,the carbon dioxide emission is estimated based on traffic demand and road network condition in the traffic environment model.On the other hand,the relation between agents is defined based on the small world network.The proposed multi-agent simulation is applied to measure the effect of the eco-commuting promotion such as improvement of level of service on the public transport or education of eco-consciousness.The effect of the promotion plan can be observed with the proposed multi-agent system.Finally,it can be concluded that the proposed multi-agent simulation with social interaction for eco-consciousness is useful for planning of eco-commuting promotion.展开更多
BACKGROUND Coronavirus disease 2019(COVID-19)is strongly associated with an increased risk of thrombotic events,including severe outcomes such as pulmonary embolism.Elevated D-dimer levels are a critical biomarker for...BACKGROUND Coronavirus disease 2019(COVID-19)is strongly associated with an increased risk of thrombotic events,including severe outcomes such as pulmonary embolism.Elevated D-dimer levels are a critical biomarker for assessing this risk.In Gabon,early implementation of anticoagulation therapy and D-dimer testing has been crucial in managing COVID-19.This study hypothesizes that elevated Ddimer levels are linked to increased COVID-19 severity.AIM To determine the impact of D-dimer levels on COVID-19 severity and their role in guiding clinical decisions.METHODS This retrospective study analyzed COVID-19 patients admitted to two hospitals in Gabon between March 2020 and December 2023.The study included patients with confirmed COVID-19 diagnoses and available D-dimer measurements at admission.Data on demographics,clinical outcomes,D-dimer levels,and healthcare costs were collected.COVID-19 severity was classified as non-severe(outpatients)or severe(inpatients).A multivariable logistic regression model was used to assess the relationship between D-dimer levels and disease severity,with adjusted odds ratios(OR)and 95%CI.RESULTS A total of 3004 patients were included,with a mean age of 50.17 years,and the majority were female(53.43%).Elevated D-dimer levels were found in 65.81%of patients,and 57.21%of these experienced severe COVID-19.Univariate analysis showed that patients with elevated D-dimer levels had 3.33 times higher odds of severe COVID-19(OR=3.33,95%CI:2.84-3.92,P<0.001),and this association remained significant in the multivariable analysis,adjusted for age,sex,and year of collection.The financial analysis revealed a substantial burden,particularly for uninsured patients.CONCLUSION D-dimer predicts COVID-19 severity and guides treatment,but the high cost of anticoagulant therapy highlights the need for policies ensuring affordable access in resource-limited settings like Gabon.展开更多
This article aims to study the psychological base of the stream of consciousness through an analysis of William James' principles and Freud's theories.
This study consists of three parts. PartⅠ, entitled ' Nabokov’ s Women,' concentrates on the analysis of Nabokov’ s major women identities of different types. My purpose is to demonstrate that in his creati...This study consists of three parts. PartⅠ, entitled ' Nabokov’ s Women,' concentrates on the analysis of Nabokov’ s major women identities of different types. My purpose is to demonstrate that in his creation of the women characters, Nabokov’ s political consciousness—mainly his vindication of individual freedom—is unmistakably, although indirectly, exemplified. Due to the different types of women discussed in this study, and also due to the different aspect of his political consciousness that is emphasized in different women identities, this part is subdivided into three chapters. Chapter One, entitled 'Women in the Triangle: Martha and Margot,' focuses on the two women characters in Nabokov’ s early novels. King, Queen, Knave and Laughter in the Dark, aiming to provide an in-depth analysis of the two, and to show that Nabokov has be stowed his special purpose on the creation of Martha and Margot, that is, his condemnation on those who reduce the free and active individual into objects, and such condemnation echoing with Nabokov’ s later direct vindication of individual freedom. Chapter Two, entitled 'The Eternal Feminine:Lolita and Ada,' analyzes the two title characters in Lolita and Ada, or Ardor:A Family Chronicle, illustrating that Lolita is the victim in that her free consciousness is purposefully neglected by the other, man in that case;while Ada enjoys her life totally because she can conduct her free consciousness in her own life. Chapter Three, entitled ' Other Types and Women in His Mind’ s Eye,' deals with Elisabeth, another woman character in Laughter in the Dark, who is a good traditional wife, and Liza, ex-wife of Pnin in Pnin, who is what Nabokov terms as poshlost. In addition, this chapter also provides an examination of Nabokov’ s attitude toward women. Through this analysis, Nabokov’ s Russian Complex is to a degree illustrated.展开更多
Jane Eyre,rebellious woman in the Victorian Age,holds her remarkable status in the English literature as the one who dare to fight against the patriarchal society.Unlike her contemporaries,Jane Eyre believes that men ...Jane Eyre,rebellious woman in the Victorian Age,holds her remarkable status in the English literature as the one who dare to fight against the patriarchal society.Unlike her contemporaries,Jane Eyre believes that men and women are born to be equal and women should never be tamed by the male-centered world or feminist ego.Under the tremendous pressure,she still guards her own dignity and determines to achieve self-actualization instead of being an accessory of men.It’s her female consciousness that lead her to be an unusual figure that enjoys both the financial self-reliance and social equality.Self-respect,selfreliance and self-actualization comprise Jane’s female consciousness that is instructive to women and worths a further exploration.展开更多
In English classroom of higher vocational colleges,there exist two essential factors:teachers'reflective consciousness and students'reflective consciousness.The former is teachers'awareness of learning act...In English classroom of higher vocational colleges,there exist two essential factors:teachers'reflective consciousness and students'reflective consciousness.The former is teachers'awareness of learning activities and effect,and it contains the teacher's reflections on the classroom practice,the presentation of learning tasks,the participation of students and the interaction between teachers and students in the classroom.The latter refers to students'awareness of self-improvement and the growing process.It focuses on the self-realization of students and their professional ability,method ability and social ability.The two factors are interactive to each other;in the interaction,the former is dominated,and the latter is strongly influenced;through the interaction,a harmonious classroom is constructed so as to achieve the effective teaching.展开更多
文摘This September is the season of sweet osmanthus.The 2024 China Daily Chemical Product Managers Basic Knowledge Training Session was successfully hosted in Qingyuan,Guangdong province between September 9th and September 11th,2024.It was held by China Research Institute of Daily Chemical and organized by China Information Center of Daily Chemical Industry and The China National Productivity Promotion Center of Surfactant and Detergent and co-hosted by Guangdong Jiaxiya Daily Necessities Technology Co.,Ltd.
文摘A prestigious conference claimed recently a revolution in neuroscience to understand consciousness.In this paper it is shown that this revolution already came,revealing the determinant role of information for human and living structures,both for their structuration and behavior,explaining consciousness at human as the result of the activity of the Informational System of Human and Living Structures.For this,it is emphasized and discussed the informational structure of the eukaryotic cell,the basic/representative composing unit of the multicellular body of human,animals,and plants,showing that the composition and functions of the informational system are basically similar with that of human.To reveal the driving role of informational mechanisms in human and subhuman organisms,it is introduced the concept of matter-related information,showing that information can be hidden/“embodied”or released/“disembodied”in or from the elemental micro/macro components of the body,during the multiple chain/cascade interactions including transduction processes.It is shown that such interactions are initiated from two main categories of informational sources:implicit(genetic)and explicit(external/internal)sources,the first category leading to structuration of the body and the second the reactive behavior.Consciousness in human and subhuman organisms,expressed by two corresponding informational relations,is the result of the release of information by the mind,acting as an informational operator/device,the development degree of mind and consciousness depending on the complexity degree and adaptation.An analogy of this Informational Model of Human and Living Structures(IMHLS)with the ancient model of chakras is highlighted,showing that these models support each other,applied with beneficial effects in Reiki technique and music-based cognitive multi-task therapy for neuro-rehabilitation.
文摘Kawasaki disease(KD)is a significant pediatric vasculitis known for its potential to cause severe coronary artery complications.Despite the effectiveness of initial treatments,such as intravenous immunoglobulin,KD patients can experience long-term cardiovascular issues,as evidenced by a recent case report of an adult who suffered a ST-segment elevation myocardial infarction due to previous KD in the World Journal of Clinical Cases.This editorial emphasizes the critical need for long-term management and regular surveillance to prevent such complications.By drawing on recent research and case studies,we advocate for a structured approach to follow-up care that includes routine cardiac evaluations and preventive measures.
文摘Objective:This study aimed to explain the criteria of managers at different levels of nursing in selecting effective nursing diagnosis.Methods:In conventional content analysis,10 nursing managers at different levels including head nurse,supervisor,and nursing manager were interviewed.Data was collected with semi-structured interviews and a narrative approach.Data analysis was performed using the Zhang–Wildemuth method simultaneously with sampling.Results:Four head nurses,four supervisors(educational,clinical),and two nursing managers were interviewed.The results of the a nalysis led to the extraction of two main categories:centrality of the nursing profession,with the sub-categories compatibility with nursing p ractices and compliance with organizational and professional principles of nursing,and covering the patient care aspect,with s ub-categories of having potential to facilitate and adapting to patient care conditions.Conclusions:The analysis of the views of nursing managers shows that health managers should consider various management aspects such as functional and organizational to increase the efficiency of nursing interventions in the selection of nursing diagnostic systems.From the point of view of health managers,nursing diagnoses should cover the considerations of patients,nurses,and work environments.
文摘This work explores the axiology of consciousness in Mocombe’s consciousness field in the material world.The paper critically assesses Mocombe’s consciousness field theory(CFT)within the larger body of contemporary ontological debates regarding the nature,origin,and constitution of consciousness in the universe.The work goes on to highlight the manifestation of Mocombe’s consciousness field in the material resource framework that is the earth,and the nature and origins of ethics and values.
文摘Objective:To explore the effectiveness of the competency model for nursing managers in the training of newly appointed head nurses.Methods:Eighteen newly appointed head nurses from Yichang Central People’s Hospital,selected between August 2023 and July 2024,were chosen as the research subjects.Based on the nursing manager competency model,corresponding training programs were developed,and these 18 head nurses were trained accordingly.Results:After the training,all newly appointed head nurses passed the theoretical assessments,with a pass rate of 100.00%.The pass rates for two rounds of assessment were 100.00%and 94.54%,respectively.There was no significant difference in the performance evaluation scores between new and senior head nurses in terms of standardized services,nursing quality,nursing research and teaching,and patient satisfaction(P>0.05).Conclusion:The competency model for nursing managers has a significant effect on the training of newly appointed head nurses.It effectively enhances management awareness,facilitates role transition,and,to some extent,improves the management and leadership capabilities of head nurses.It holds high value for broader implementation.
文摘Objective: The purpose of this study was to clarify the collaborative activities and mutual recognition between community comprehensive care unit nurses (Ns) and care managers (CM) in supporting the discharge of the elderly from the hospital. Methods: A total of 300 nurses working in community comprehensive care wards and 360 care managers working in B City in A Prefecture were surveyed using an anonymous self-administered questionnaire. Results: The highest percentage of responses regarding necessary collaborative activities with multiple professions in supporting hospital discharge were the same for Ns and CMs. The items regarding practice with the highest percentages were “relationship as a team” for Ns, and “user-centered awareness” for CM. While these professionals were willing to share information about their patients’ lives after discharge, the percentage of those explaining their expertise was low. It is thought that collaborative activities focusing on these aspects would lead to more appropriate discharge support.
基金Supported by National Research Foundation of Korea,No.NRF-2021S1A5A8062526.
文摘This article provides a comprehensive analysis of the study by Hou et al,focusing on the complex interplay between psychological and physical factors in the postoperative recovery(POR)of patients with perianal diseases.The study sheds light on how illness perception,anxiety,and depression significantly influence recovery outcomes.Hou et al developed a predictive model that demonstrated high accuracy in identifying patients at risk of poor recovery.The article explores the critical role of pre-operative psychological assessment,highlighting the need for mental health support and personalized recovery plans in enhancing POR quality.A multidisciplinary approach,integrating mental health professionals with surgeons,anesthesiologists,and other specialists,is emphasized to ensure comprehensive care for patients.The study’s findings serve as a call to integrate psychological care into surgical practice to optimize outcomes for patients with perianal diseases.
文摘Diabetic retinopathy(DR)remains a leading cause of vision impairment and blindness among individuals with diabetes,necessitating innovative approaches to screening and management.This editorial explores the transformative potential of artificial intelligence(AI)and machine learning(ML)in revolutionizing DR care.AI and ML technologies have demonstrated remarkable advancements in enhancing the accuracy,efficiency,and accessibility of DR screening,helping to overcome barriers to early detection.These technologies leverage vast datasets to identify patterns and predict disease progression with unprecedented precision,enabling clinicians to make more informed decisions.Furthermore,AI-driven solutions hold promise in personalizing management strategies for DR,incorpo-rating predictive analytics to tailor interventions and optimize treatment path-ways.By automating routine tasks,AI can reduce the burden on healthcare providers,allowing for a more focused allocation of resources towards complex patient care.This review aims to evaluate the current advancements and applic-ations of AI and ML in DR screening,and to discuss the potential of these techno-logies in developing personalized management strategies,ultimately aiming to improve patient outcomes and reduce the global burden of DR.The integration of AI and ML in DR care represents a paradigm shift,offering a glimpse into the future of ophthalmic healthcare.
文摘This editorial highlights a recently published study examining the effectiveness of music therapy combined with motivational interviewing(MI)in addressing an-xiety and depression among young and middle-aged patients following percuta-neous coronary intervention.It further explores existing evidence and potential future research directions for MI in postoperative rehabilitation and chronic disease management.MI aims to facilitate behavioral change and promote healthier lifestyles by fostering a trusting relationship with patients and enhan-cing intrinsic motivation.Research has demonstrated its effectiveness in posto-perative recovery for oncological surgery,stroke,organ transplants,and gastroin-testinal procedures,as well as in managing chronic conditions such as diabetes,obesity,and periodontal disease.The approach is patient-centered,adaptable,cost-effective,and easily replicable,though its limitations include reliance on the therapist’s expertise,variability in individual responses,and insufficient long-term follow-up studies.Future research could focus on developing individualized and precise intervention models,exploring applications in digital health management,and confirming long-term outcomes to provide more compre-hensive support for patient rehabilitation.
文摘Colonoscopy represents a safe procedure that is widely used in medical practice either to diagnose or treat various gastrointestinal diseases.During the last few years,the incidence rate of perforations in colonoscopic procedures has increased,especially in therapeutic colonoscopies.The recent advancements in endoscopic techniques and gastrointestinal tumoral resection procedures such as endoscopic mucosal resection,endoscopic full-thickness resection,and endoscopic submucosal dissection(ESD)could be a risk factor for this increased risk.The incidence rate of mortality of serious colonoscopic perforations is 7.1%.The management plan for these perforations starts with conservative treatment in mild cases,endoscopic closure,and surgical management in severe cases.Recently,endoluminal vacuum therapy was found to be effective in the management of colorectal perforations and this has been reported in multiple case reports.This editorial provides an overview of the current guidelines for the management of iatrogenic colorectal perforations.These insights are from the perspectives of endoscopists and gastroenterologists.We also present a management algorithm based on the guidelines of the European Society of Gastrointestinal Endoscopy,the American Gastroenterological Association,and the World Society of Emergency Surgery.We also discussed in brief the use of endoluminal vacuum therapy in colorectal perforations.
文摘BACKGROUND Inadequate glycemic control in patients with type 2 diabetes(T2DM)is a major public health problem and a significant risk factor for the progression of diabetic complications.AIM To evaluate the effects of intensive and supportive glycemic management strategies over a 12-month period in individuals with T2DM with glycated hemoglobin(HbA1c)≥10%and varying backgrounds of glycemic control.METHODS This prospective observational study investigated glycemic control in patients with poorly controlled T2DM over 12 months.Participants were categorized into four groups based on prior glycemic history:Newly diagnosed,previously well controlled with recent worsening,previously off-target but now worsening,and HbA1c consistently above 10%.HbA1c levels were monitored quarterly,and patients received medical,educational,and dietary support as needed.The analysis focused on the success rates of good glycemic control and the associated factors within each group.RESULTS The study showed significant improvements in HbA1c levels in all participants.The most significant improvement was observed in individuals newly diagnosed with diabetes:65%achieved an HbA1c target of≤7%.The results varied between participants with different glycemic control histories,followed by decreasing success rates:39%in participants with previously good glycemic control,21%in participants whose glycemic control had deteriorated compared to before,and only 10%in participants with persistently poor control,with mean HbA1c levels of 6.3%,7.7%,8.2%,and 9.7%,respectively.After one year,65.2%of the“newly diagnosed patients”,39.3%in the“previously controlled group”,21.9%in the“previously off-target but now worsened'”group and 10%in the“poorly controlled from the start”group had achieved HbA1c levels of 7 and below.CONCLUSION In poorly controlled diabetes,the rate at which treatment goals are achieved is associated with the glycemic background characteristics,emphasizing the need for tailored strategies.Therefore,different and comprehensive treatment approaches are needed for patients with persistent uncontrolled diabetes.
文摘The dramatic rise in the number of people living in cities has made many environmental and social problems worse.The search for a productive method for disposing of solid waste is the most notable of these problems.Many scholars have referred to it as a fuzzy multi-attribute or multi-criteria decision-making problem using various fuzzy set-like approaches because of the inclusion of criteria and anticipated ambiguity.The goal of the current study is to use an innovative methodology to address the expected uncertainties in the problem of solid waste site selection.The characteristics(or sub-attributes)that decision-makers select and the degree of approximation they accept for various options can both be indicators of these uncertainties.To tackle these problems,a novel mathematical structure known as the fuzzy parameterized possibility single valued neutrosophic hypersoft expert set(ρˆ-set),which is initially described,is integrated with a modified version of Sanchez’s method.Following this,an intelligent algorithm is suggested.The steps of the suggested algorithm are explained with an example that explains itself.The compatibility of solid waste management sites and systems is discussed,and rankings are established along with detailed justifications for their viability.This study’s strengths lie in its application of fuzzy parameterization and possibility grading to effectively handle the uncertainties embodied in the parameters’nature and alternative approximations,respectively.It uses specific mathematical formulations to compute the fuzzy parameterized degrees and possibility grades that are missing from the prior literature.It is simpler for the decisionmakers to look at each option separately because the decision is uncertain.Comparing the computed results,it is discovered that they are consistent and dependable because of their preferred properties.
基金The research is granted by Japanese Ministry of Education as a part of Grants-in-Aid for Scientific Research,No.(C)22560533.The author records here warmest appreciation to the Resident Conference for Environment of Tokushima Prefecture for collecting the data in the field of actual travel behavior on the social experiment.
文摘It is the matter for achievement of the low carbon transport system that the excessive use of private vehicles can be controlled appropriately.Not only improvement of service level of modes except private vehicle,but also consciousness for environmental problem of individual trip maker is important for eco-commuting promotion.On the other hand,consciousness for environment would be changed by influence of other person.Accordingly,it is aimed in the study that the structure of decision-making process for modal shift to the eco-commuting mode in the local city is described considering environmental consciousness and social interaction.For the purpose,the consciousness for the environment problem and the travel behavior of the commuter at the suburban area in the local city are investigated by the questionnaire survey.The covariance structure about the eco-consciousness is analyzed with the database of the questionnaire survey by structural equation modeling.As the result,it can be confirmed with the structural equation model that the individual environmental consciousness is strongly related with the intention of self-sacrifice and is influenced with the local interaction of the individual connections.On the other hand,the intention of modal shift for the commuting mode is analyzed with the database of the questionnaire survey.It can be found out that the environmental consciousness is not statistically significant for commuting mode choice with the present poor level of service of public transport.However,the intention of self-sacrifice for the prevention of the global warming is statistically confirmed as the factor of modal shift with the operation of eco-commuting bus service with the RP/SP integrated estimation method.As the result,the multi-agent simulation system with social interaction model for eco consciousness is developed to measure the effect of the eco-commuting promotion.For the purpose,the carbon dioxide emission is estimated based on traffic demand and road network condition in the traffic environment model.On the other hand,the relation between agents is defined based on the small world network.The proposed multi-agent simulation is applied to measure the effect of the eco-commuting promotion such as improvement of level of service on the public transport or education of eco-consciousness.The effect of the promotion plan can be observed with the proposed multi-agent system.Finally,it can be concluded that the proposed multi-agent simulation with social interaction for eco-consciousness is useful for planning of eco-commuting promotion.
文摘BACKGROUND Coronavirus disease 2019(COVID-19)is strongly associated with an increased risk of thrombotic events,including severe outcomes such as pulmonary embolism.Elevated D-dimer levels are a critical biomarker for assessing this risk.In Gabon,early implementation of anticoagulation therapy and D-dimer testing has been crucial in managing COVID-19.This study hypothesizes that elevated Ddimer levels are linked to increased COVID-19 severity.AIM To determine the impact of D-dimer levels on COVID-19 severity and their role in guiding clinical decisions.METHODS This retrospective study analyzed COVID-19 patients admitted to two hospitals in Gabon between March 2020 and December 2023.The study included patients with confirmed COVID-19 diagnoses and available D-dimer measurements at admission.Data on demographics,clinical outcomes,D-dimer levels,and healthcare costs were collected.COVID-19 severity was classified as non-severe(outpatients)or severe(inpatients).A multivariable logistic regression model was used to assess the relationship between D-dimer levels and disease severity,with adjusted odds ratios(OR)and 95%CI.RESULTS A total of 3004 patients were included,with a mean age of 50.17 years,and the majority were female(53.43%).Elevated D-dimer levels were found in 65.81%of patients,and 57.21%of these experienced severe COVID-19.Univariate analysis showed that patients with elevated D-dimer levels had 3.33 times higher odds of severe COVID-19(OR=3.33,95%CI:2.84-3.92,P<0.001),and this association remained significant in the multivariable analysis,adjusted for age,sex,and year of collection.The financial analysis revealed a substantial burden,particularly for uninsured patients.CONCLUSION D-dimer predicts COVID-19 severity and guides treatment,but the high cost of anticoagulant therapy highlights the need for policies ensuring affordable access in resource-limited settings like Gabon.
文摘This article aims to study the psychological base of the stream of consciousness through an analysis of William James' principles and Freud's theories.
文摘This study consists of three parts. PartⅠ, entitled ' Nabokov’ s Women,' concentrates on the analysis of Nabokov’ s major women identities of different types. My purpose is to demonstrate that in his creation of the women characters, Nabokov’ s political consciousness—mainly his vindication of individual freedom—is unmistakably, although indirectly, exemplified. Due to the different types of women discussed in this study, and also due to the different aspect of his political consciousness that is emphasized in different women identities, this part is subdivided into three chapters. Chapter One, entitled 'Women in the Triangle: Martha and Margot,' focuses on the two women characters in Nabokov’ s early novels. King, Queen, Knave and Laughter in the Dark, aiming to provide an in-depth analysis of the two, and to show that Nabokov has be stowed his special purpose on the creation of Martha and Margot, that is, his condemnation on those who reduce the free and active individual into objects, and such condemnation echoing with Nabokov’ s later direct vindication of individual freedom. Chapter Two, entitled 'The Eternal Feminine:Lolita and Ada,' analyzes the two title characters in Lolita and Ada, or Ardor:A Family Chronicle, illustrating that Lolita is the victim in that her free consciousness is purposefully neglected by the other, man in that case;while Ada enjoys her life totally because she can conduct her free consciousness in her own life. Chapter Three, entitled ' Other Types and Women in His Mind’ s Eye,' deals with Elisabeth, another woman character in Laughter in the Dark, who is a good traditional wife, and Liza, ex-wife of Pnin in Pnin, who is what Nabokov terms as poshlost. In addition, this chapter also provides an examination of Nabokov’ s attitude toward women. Through this analysis, Nabokov’ s Russian Complex is to a degree illustrated.
文摘Jane Eyre,rebellious woman in the Victorian Age,holds her remarkable status in the English literature as the one who dare to fight against the patriarchal society.Unlike her contemporaries,Jane Eyre believes that men and women are born to be equal and women should never be tamed by the male-centered world or feminist ego.Under the tremendous pressure,she still guards her own dignity and determines to achieve self-actualization instead of being an accessory of men.It’s her female consciousness that lead her to be an unusual figure that enjoys both the financial self-reliance and social equality.Self-respect,selfreliance and self-actualization comprise Jane’s female consciousness that is instructive to women and worths a further exploration.
文摘In English classroom of higher vocational colleges,there exist two essential factors:teachers'reflective consciousness and students'reflective consciousness.The former is teachers'awareness of learning activities and effect,and it contains the teacher's reflections on the classroom practice,the presentation of learning tasks,the participation of students and the interaction between teachers and students in the classroom.The latter refers to students'awareness of self-improvement and the growing process.It focuses on the self-realization of students and their professional ability,method ability and social ability.The two factors are interactive to each other;in the interaction,the former is dominated,and the latter is strongly influenced;through the interaction,a harmonious classroom is constructed so as to achieve the effective teaching.