Design of Compliant Straight-line Mechanisms Using Flexural Joints

Straight-line compliant mechanisms are important building blocks to design a linear-motion stage, which is very useful in precision applications. However, only a few configurations of straight-line compliant mechanisms are applicable. To construct more kinds of them, an approach to design large-displacement straight-line flexural mechanisms with rotational flexural joints is proposed, which is based on a viewpoint that the straight-line motion is regarded as a compromise of rigid and compliant parasitic motion of a rotational flexural joint. An analytical design method based on the Taylor series expansion is proposed to quickly obtain an approximate solution. To illustrate and verify the proposed method, two kinds of flexural joints, cross-axis hinge and leaf-type isosceles-trapezoidal flexural（LITF） pivot are used to reconstruct straight-line flexural mechanisms. Their performances are obtained by analytic and FEA method respectively. The comparisons of the results show the accuracy of the approach. Both examples show that the proposed approach can convert a large-deflection flexural joint into approximate straight-line mechanism with a high linearity that is higher than 5 000 within 5 man displacement. This can lead to a new way to design, analyze or optimize straight-line flexure mechanisms.

Study on Numerical Comparison Method of Four-bar Straight-line Guidance Mechanism

In order to solve four-bar straight-line guidance mechanism synthesis problem for the arbitrarily given straight-line’s"angle requirement"and"point-position requirement",a numerical comparison synthesis method for single and double straight-line guidance mechanism is presented,which is convenient to realize by computer program.The basic idea of this method is:to select a four-bar linkage whose relative bar length of crank is 1 as a basic four-bar linkage.Then the other three relative bars’length is changed,and a lot of basic four-bar linkage can be obtained.There are many single and double ball-points of each basic four-bar linkage.With the motion of a basic four-bar linkage,there is straight-line segment of each Ball-point’s path.The data of these basic four-bar linkages is saved to a database.When designing a four-bar straight-line guidance mechanism,the design data is compared with the data in database and a satisfactory four-bar linkage can be obtained.The method effectively solves the straight-line guidance mechanism synthesis problem.

The Straight-Line Depreciation Method Used by Selected Companies and Educational Institutions in the Philippines

The straight-line method in computing for depreciation expense is the prevailing method used in the Philippines. This paper aims to determine the rationale behind the use of this method. The objective of the study is to determine the length of time within which the depreciation method is used, reasons in using the method, the rate of depreciation used by the companies, and the effects of the depreciation expense on their operating expenses. It also determines if the companies＇ decisions to use the straight-line method are influenced by the factors mentioned by Reynolds （196 I）----expected amount of services over the life of assets, the amount and timing of operating costs, the decline in the physical efficiency of the assets, and the rate of return--and if they considered capital investments and tax reduction in using this method. The study shows that companies and educational institutions use the straight-line method of computing depreciation expenses, because it is easy to use in computing the depreciation expenses, in comparing with previous years＇ computations, and in keeping track of the expenses. It is also convenient for tax administration and financial reporting. The rate of depreciation used varies, because the companies and educational institutions use their past experiences in determining the life of fixed assets. The percentage of depreciation to the operating expenses also varies. The companies and educational institutions adhered to the factors mentioned by Reynolds （1961） in choosing the straight-line method of depreciation. The companies did not consider reduction of tax in using the straight-line method.

Perceived stress among staff in Saudi Arabian dental colleges before and after an accreditation process: A cross-sectional study

BACKGROUND Accreditation processes are extensively employed to guarantee the quality of higher education institutions.However,this process can potentially generate a stressful atmosphere for staff,thus impacting their ability to perform optimally under pressure.AIM To examine the knowledge of the National Commission for Academic Assessment and Accreditation(NCAAA)and its effects on perceived stress among dental college staff before and after the program accreditation process.METHODS The present cross-sectional questionnaire-based study included 300 employees from three dental colleges.The same employees had to fill out the questionnaire 1 mo after the NCAAA process.RESULTS Approximately 51.33%of the included employees believed that NCAAA is essential to attract quality students to join the program before and after the program.A total of 44.67%felt that their stress was high before,and 31.33%had low stress levels before and after NCAAA.These findings were statistically significant(P≤0.05).CONCLUSION NCAAA raised the prestige of the institution and specific programmes and increased prospects to attract better students,staff,and money,according to the employees.In addition to their needed teaching,research,and other service responsibilities,this work requires a tremendous amount of faculty effort and may cause them stress.

The Impact of Nursing Staff’s Work Attitude on the Fear of Patients Recovering from Benign Tumors:Family Support as a Mediating Variable

The perception of nursing staff’s attitude influences patient fear.Understanding this dynamic is crucial for fostering a supportive environment conducive to patient well-being and effective healthcare practices.The purpose of this research is to investigate how the attitudes and behaviours of nursing staff influence the fear and anxiety levels of patients recovering from benign tumors,aiming to improve patient care and recovery outcomes.Data was collected from a sample of 100 participants,comprising 20 nursing staff and 80 patients recovering from benign tumors.Surveys were administered to gather quantitative data on attitudes and fear levels.Participants were selected randomly from hospital records and outpatient clinics.Our analysis encompassed nursing staff attitude,patient fear levels,the influence of family support,progression of tumor recovery,patient-reported satisfaction,and the quality of healthcare services provided.The quantitative aspect utilized PLS-SEM software to perform regression analysis,evaluating both direct and indirect effects.Statistical analysis assessed the relationships between nursing staff attitudes,patient fear during benign tumor recovery,and the mediating role of family support.The findings of the study demonstrate that better nurse attitudes(Hypothesis 1,β=0.45,p<0.001)and stronger family support(Hypothesis 2,β=0.32;p<0.001) are linked to lower levels of patient fear.Partially mediating the relationship between nurse attitudes and patient fear,according to Hypothesis 3(β=0.28,p<0.002),is family support.Patients’perceptions of family support are highly influenced by nursing behaviour,as demonstrated by Hypothesis 4(β=0.38;p<0.001).Our research showed a strong relationship between the attitudes of nursing personnel and patient fear levels.Family support demonstrated a strong mediating effect on patient fear.Patient-reported satisfaction is positively correlated with family support.However,no significant relationship was found between healthcare service quality and patient fear.

Research Progress on Career Development of Nursing Staff

There are few studies on career development as an exclusive concept in the field of nursing in China.Currently,research related to the career development of nursing staff primarily relies on inductive evaluation tools,and there is less systematic summarization of this research.This paper reviews the concept,evaluation tools,and influencing factors of nursing career development,aiming to provide a reference for future research in this area.

Analysis of The Impact of The Healthcare Roundtable Model on the Major Disease Perceptions and Competencies of Cardiovascular Medicine Nursing Staff

Objective: To analyze the impact of the healthcare roundtable model on the major disease perceptions and competencies of cardiovascular nursing staff. Methods: Forty female nursing staff working in the hospital from April to June 2023 were selected and were randomly divided into a control group and an observation group, with 20 in each group. For 60 days, the control group used the conventional learning and communication model and the observation group used the medical and nursing roundtable model. The cognitive scores of cardiovascular disease-related knowledge, competency scores, and satisfaction with the learning and communication model before and after the implementation of the model in both groups were compared. Results: After the implementation, the cognitive scores related to cardiovascular disease-related knowledge, competency scores, and satisfaction with the learning and communication model in the observation group were significantly higher than those in the control group (P < 0.05). Conclusion: The healthcare roundtable model improved the knowledge and competence of cardiovascular internal medicine nursing staff in major diseases, and it is worth popularizing.

网格化管理在护理人员突发公共卫生事件中的应用效果

目的观察网格化管理在护理人员突发公共卫生事件(EPHE)中的应用效果。方法选取2021年1月至2022年12月濮阳市安阳地区医院预防保健科和急诊科护理人员36名作为研究对象,对其开展网格化管理,评估网格化管理前后护理人员面对EPHE心理状况、应对能力、紧急事件处理效率及职业认同感变化。结果网格化管理后护理人员心理状况中情绪反应、认知反应、行为应对3个维度评分低于网格化管理前(P<0.05);网格化管理后护理人员应对能力中协调合作能力、急救技能、现场组织协调能力、文书书写能力、心理应对能力5个维度评分高于网格化管理前(P<0.05);网格化管理后护理人员院前接诊、检查、院内接诊、诊断评估、见效时间较网格化管理前均缩短(P<0.05);网格化管理后护理人员职业认同感中自我决定感、一致感、自我效力感、有意义感、把握感、患者影响感、组织影响感7个维度评分高于网格化管理前(P<0.05)。结论网格化管理能提升护理人员应对EPHE的能力和处理效率,有利于缓解护理人员心理状态,提升其职业认同感。

临床护理人员生物安全虚拟仿真演练系统培训内容的构建

目的:搭建临床护理人员生物安全虚拟仿真演练系统,为临床护理人员生物安全培训提供平台。方法:通过文献检索、专家小组会议、德尔菲函询等方法,搭建临床护理人员生物安全虚拟仿真演练系统知识库和案例库。结果:通过2轮德尔菲专家函询,专家意见一致性好,专家权威程度为0.910。第2轮一级指标、二级指标、三级指标的肯德尔协调系数分别为0.431,0.403,0.401(均P<0.01),最终形成包含生物安全概述、生物安全监测预警、生物安全防护感控、生物安全护理处置四大类别及28个知识条目的护理人员生物安全虚拟仿真演练系统知识内容;通过小组初审、专家函审、教学会审构建了涵盖28个生物安全救护的案例库。结论:构建的临床护理人员生物安全虚拟仿真演练系统培训内容形式多样、内容全面,可为临床护理人员生物安全培训提供参考。

医护人员医学科技伦理管理认知现状及改善建议——基于宁夏回族自治区5所三级医院的调查

目的 了解宁夏回族自治区5所三级医院医务人员医学科技伦理管理认知水平的现状、影响因素以及医学科技伦理管理建设方面存在的问题,为增强其医学科技伦理管理意识,提升临床研究质量提供参考。方法 采用自行设计并验证的《医务人员医学科技伦理管理认知问卷》,选择宁夏5个城市共5家三级医院医务人员作为研究对象进行调查。结果 最终回收有效问卷436份,其中医务人员医学科技伦理管理认知总平均分为(61.58±12.96)分,伦理制度认知、伦理委员会认知、伦理教育培训认知、伦理管理信息化认知得分分别为(14.18±2.84)分、(24.19±5.47)分、(15.07±4.00)分、(8.14±4.42)分。多元线性回归分析显示:年龄、工作城市、学历、职称、是否评估过医院伦理制度的执行、是否参与过医院伦理审查工作、是否组织或参与过医院伦理培训均是医务人员医学科技伦理管理认知得分的影响因素,可解释其51.00%的变异(P<0.05)。医务人员认为伦理制度宣传不到位、伦理审查程序和流程不透明、伦理培训时间和工作任务冲突以及没有专门的伦理审查信息平台是医学科技伦理建设存在的主要问题。结论 宁夏三级医院医务人员医学科技伦理管理认知水平普遍不高,其水平受多种因素的影响,医院管理者应加强伦理制度宣传与培训,完善其执行和监督机制;规范伦理审查程序和流程,建设伦理审查信息平台;加大伦理教育投入,合理安排培训时间等,以增强医务人员医学科技伦理管理意识,提高临床研究质量。

医患视角下妇科恶性肿瘤择期手术患者入院准备度感知的质性研究

目的了解妇科恶性肿瘤择期手术患者入院准备期间的体验及需求,为实施院前管理提供参考。方法采取描述性质性研究,目的抽样法对12例妇科恶性肿瘤患者及10名医护人员进行半结构式访谈,应用NVivo12软件对资料进行分析。结果共提炼出6个主题:失去控制感与寻求希望(疾病不确定感与手术决策困境、信任医疗)、健康素养异质化、复杂的心理状态(积极应对与负性情绪困扰并存)、患者角色适应障碍(女性角色创伤、角色转换障碍)、入院过渡期需求(缺乏院前护理服务、设立入院准备中心)和社会性支持需求高(渴望专业支持、期望获得经济援助)。结论妇科恶性肿瘤择期手术患者在入院准备期间的体验及需求有待进一步满足和提升。医护人员应注重患者院前服务,加强院前健康指导,为患者提供多维度社会支持以提高其就医体验。

Evaluating the impact of virtual reality on reducing restrictive practices in psychiatric wards

This manuscript critically evaluates the randomized controlled trial(RCT)conducted by Phiri et al,which assessed the effectiveness of virtual reality(VR)training for psychiatric staff in reducing restrictive practices(RPs).Specifically,this RCT investigated the impact of VR on the handling of aggressive patients by psychiatric staff compared to traditional training methods.Despite significant reductions in perceived discrimination in the VR group,there were no major improvements in self-efficacy or anxiety levels.The system usability scale rated the VR platform highly,but it did not consistently outperform traditional training methods.Indeed,the study shows the potential for VR to reduce RPs,although fluctuations in RP rates suggest that external factors,such as staff turnover,influenced the outcomes.This manuscript evaluates the study’s methodology,results,and broader implications for mental health training.Additionally,it highlights the need for more comprehensive research to establish VR as a standard tool for psychiatric staff education,focusing on patient care outcomes and real-world applicability.Finally,this study explores future research di-rections,technological improvements,and the potential impact of policies that could enhance the integration of VR in clinical training.

“双高”建设背景下高职院校涉农专业学生创新创业能力提升路径研究——以茶叶生产与加工技术专业为例

专创融合教育已成为“双高”建设中的关键,也是培养具备茶产业链高质量发展所必需的理论知识和核心技能的茶叶专业创新专业人才的必然要求。基于目前高职院校茶叶生产与加工技术专业学生创新创业能力培养中存在的问题,如思政融入不足、课程设计不完善、师资不完备、实践体系不完整、质量评价体系不健全及支持力度不够等,提出通过融入“爱农-重农-兴农”的“三农”情怀思政教育、设计“通-专-辅”三位一体课程体系、培育“专-兼-跨”协同育人师资队伍、打造“学-赛-训”深度融合实践体系、完善“内部与外部-定量与定性-过程与结果”多维评价体系及构建“政策-平台-文化”全面支持保障体系等路径,全面提升学生创新创业能力,以满足现代农业和乡村振兴对高质量茶产业创新创业人才的需求。

基于ERG理论的医务人员激励机制研究

医务人员的工作情况与医疗服务质量密切相关。该文基于ERG理论的激励管理,分析其对医务人员职业倦怠及岗位胜任力的影响。并通过案例医院的调查,在基于ERG理论的激励管理后,医务人员的职业倦怠感有所减缓,岗位胜任力有所提升,这对于促进医务人员提升职业幸福感、增强自我成就感均有重要意义。

区域比较视角下我国老年护理人力资源配置效率与公平性

目的:研究2012—2021年我国老年护理人力资源配置效率与公平性差异,为科学、合理配置我国护理人力资源提供科学依据。方法:以国家卫生健康委员会公布的2013—2022年《中国卫生健康统计年鉴》为数据来源,使用DEA-BCC模型对我国2012—2021年数据进行静态分析,运用Malmquist指数模型对2012—2021年数据进行动态分析,并采用基尼系数进行公平性研究。结果:我国2012—2021年千老年人口护士数年均增长率为2.725%,2021年我国老年护理人力资源配置的综合效率、纯技术效率和规模效率分别为0.772,0.840和0.918;2012—2021年全要素生产率指数均值为0.953,技术进步指数均值下降4%,基尼系数为0.311~0.347。结论:2012—2021年我国老年护理人力资源整体效率不高,存在区域性差异,并受到技术水平和管理水平的影响,整体公平性较好。建议政府宏观调控,提高对老年护理人力资源的重视,通过提升技术效率来优化老年护理人力资源配置。

习近平总书记关于教师重要论述的探析

党的十八大以来,习近平总书记就教师工作发表了一系列重要论述,涵盖了教师角色观、教师职责观、教师标准观、教师发展观和教师保障观等内容。在教师角色观上,从传承人类文明、推进教育改革和引领学生成长三个层面,对教师角色做出了新的阐释;在教师职责观上,指出教师要以服务中华民族伟大复兴为己任,以为党育人、为国育才为目标,以立德树人、教书育人为使命;在教师标准观上,集中体现在“四有”好老师、“四个相统一”和大力弘扬教育家精神三方面;在教师发展观上,强调要树立教师终身学习理念、建设高素质专业化教师队伍;在教师保障观上,提出要大力弘扬尊师风尚、维护教师合法权益和提高教师“三个地位”。习近平关于教师的重要论述内涵丰富、思想深刻,回答了建设什么样的教师队伍、怎么建设教师队伍等一系列重要问题,为新时代教师队伍建设指明了前进方向,提供了根本遵循。

Prevalence and related factors of post-traumatic stress disorder among medical staff members exposed to H7N9 patients

Objective: This study aimed to evaluate the prevalence and related factors of post-traumatic stress disorder (PTSD) symptoms among doctors and nurses who were exposed to H7N9 patients during the H7N9 influenza epidemic.To provide scientific basis for promoting the physical and psychological health of these staff members.Method: The 102 medical staff workers who were exposed to H7N9 patients were recruited through convenient sampling between January 2015 and May 2016.We used a self-reported questionnaire,the PTSD Checklist-Civilian Version (PCL-C),to evaluate the PTSD symptoms among doctors and nurses from an intensive care unit (n =61),a respiratory department (n =20),and an emergency department (n =21).We then analyzed the related factors.Results: Around 20.59% of the tested doctors and nurses showed PTSD symptoms.The sample had a mean PCL-C score of 30.00 ± 9.95.The differences in the scores of doctors and nurses with different genders,ages,professional titles,contact frequencies,trainings,and experiences were statistically significant (P < 0.05,P < 0.01).Moreover,t-tests and one-way analysis of variance showed that nurses received higher scores than doctors,female participants received higher scores than male participants,and the participants with low professional title and high contact frequency,aged between 20 years and 30 years,with less than five years of work experience,having not received related training and with no related experience obtained higher PCL-C scores than the others (P < 0.05,P < 0.01).Conclusion: The PTSD level of doctors and nurses after their exposure to H7N9 patients was high,which warrant further research.Health and medical institutions should pay attention to the physical and psychological health of these staff members.

Stress and sleep:a survey based on wearable sleep trackers among medical and nursing staff in Wuhan during the COVID-19 pandemic

Backgroud COVID-19 pandemic has significantly affected the sleep health of local medical and nursing staff.Aim We used wearable pulse oximeters to monitor and screen the medical and nursing staff working in hospitals designated for COVID-19 in the Wuhan area.This study aimed to establish a reliable basis to provide sleep intervention for the medical and nursing staff.Methods Thirty medical and nursing staff members with symptoms of insomnia were instructed to wear medical ring-shaped pulse oximeters to monitor their sleep overnight.We also used the Insomnia Severity Index(ISI)and the Chinese version of the Self-Reporting Questionnaire(SRQ-20)to evaluate the severity of insomnia and mental health status,respectively,for each participant.Results Among the 30 participants,only 26 completed the screening.Ten cases(38.5%)demonstrated moderate to severe sleep apnoea-hypopnea syndrome(SAHS)when using an oxygen desaturation index^15 times/hour as the cut-off value.Participants with comorbid moderate to severe SAHS had significantly higher ISI and SRQ scores(p values 0.034 and 0.016,respectively)than those in the insomnia group.Correlation analysis revealed that ISI was positively correlated with total sleep time(TST)(r=0.435,p=0.026),and negatively correlated with deep sleep(r=-0.495,p=0.010);furthermore,patient SRQ scores were positively correlated with TST,sleep efficiency(SE)and REM(rapid eyes movement)sleep%(r=0.454 and 0.389,0.512;p=0.020,0.050 and 0.008,respectively).Stepwise logistic regression indicated that SRQ-20 and sex were risk factors for insomnia with comorbid SAHS,and their OR values were 1.516 and 11.56(95%Cl 1.053 to 2.180 and 1.037 to 128.9),respectively.Conclusion Medical and nursing staff with insomnia showed clear signs of comorbid sleep apnoea attributable to stress.The wearable pulse oximeters accurately monitored the participants'breathing when asleep.

Are mindfulness and self-efficacy related to presenteeism among primary medical staff: A cross-sectional study

Objectives: In ensuring public welfare with primary medical and health services,the primary medical staff faces new tasks.Increasing workload,and therefore degrees of stress and burnout,can influence job satisfaction and lead to presenteeism,which is defined as the appearance to be on the job but not actually working.The purpose of this study is to investigate the current worling situation and the relationship between presenteeism and mindfulness of primary medical staff and determine the mediating effect of self-efficacy on this relationship.Method: A cross-sectional survey was performed with 580 primary medical staff from 9 hospitals in Shaanxi province,northwest China.Presenteeism,mindfulness,and self-efficacy were measured by using a general information questionnaire,the Five-Facet Mindfulness Questionnaire,the General Self-Efficacy Scale,and the Stanford Presenteeism Scale.Mediating effect was analyzed by a series of hierarchical multiple regressions.Results: A high level of presenteeism was found among 47.4% of the study participants.Presenteeism was negatively correlated with mindfulness(r--0.409,P < 0.001) and self-efficacy(r--0.678,P < 0.001).A positive correlation was found between mindfulness and self-efficacy(r-0.584,P< 0.001).When controlling for self-efficacy (β =-0.018,P> 0.05),the association was insignificant between presenteeism and mindfulness.Conclusion: The results identified the effect of mindfulness on presenteeism of primary medical staff is realized through self-efficacy,which also suggested to enhance self-efficacy on center location when developing management strategies for mental health education or training among primary medical staff.

Healthcare staff well-being and use of support services during COVID-19:a UK perspective

Background The COVID-19 pandemic has drastically increased demands on healthcare workers(HCWs)leaving them vulnerable to acute psychological distress,burnout and post-traumatic stress.In response,supportive services in a central London hospital mobilised mental health support specifically for HCWs.Aims This rapid evaluation assessed HCW psychological welfare during the acute phase of the COVID-19 pandemic and their use of supportive services made available.Methods During the acute phase of COVID-19(April to May 2020)all staff working for the hospital were invited to complete an online survey assessing well-being(self-rated health,moral distress exposure,symptoms of burnout and psychological distress)and use of available supportive services(awareness of,use and perceived helpfulness).Associations among personal characteristics and psychological well-being were explored using correlations and linear regression.Results A total of 1127 staff participated in the rapid evaluation.On average,psychological distress was high(mean(SD):22(7.57))regardless of role,with 84%of this sample scoring above the general population mean(14.5).Nearly half of the sample reported feeling emotionally drained and a profile emerged displaying higher levels of psychological distress and burnout in those who were younger and exposed to morally distressing situations,with this group also exhibiting greater support service use.Greater levels of burnout were associated with increased psychological distress when controlling for personal factors.During this acute phase of the pandemic,majority of staff used at least one service and rated it as helpful.Conclusion HCWs experienced high levels of psychological distress requiring continued support as the COVID-19 pandemic evolved.Although HCWs were aware of supportive services,uptake varied.In order to mitigate the risk of burnout and post-traumatic stress,long-term,effective strategies that facilitate staff accessing support are urgently required.