个性化护理干预措施在多发性肋骨骨折患者中应用效果

目的研究分析个性化护理干预措施对于多发性肋骨骨折患者的应用效果。方法将2011年5月~2013年6月收入我院的84例患者随机进行分配,组成对照组和研究组。然后对两组的患者进行观察,分析他们术后的恢复情况,有无并发症产生,以及考察患者平均的住院、胸管留置时间和费用。结果通过对两者的分析比较,研究组中,患者的恢复情况良好,各项指标正常,并且大大减少了平均住院费用,缩短了平均住院护理时间和平均的胸管留置时间。最终得出对照组的各项考察指标都没有研究组取得的效果明显。结论各种指标表明,研究组在个性化护理干预过程中对于多发性肋骨骨折的效果明显优于对照组,应用价值高,值得进行推广应用。

综合干预措施对ICU导管相关性血流感染发生率的影响分析

目的:观察和分析综合干预措施对ICU导管相关性血流感染发生率的临床影响.方法:选择我院2012年1月至2013年1月收治的600例ICU患者为研究对象,所有患者均给予综合干预护理措施,分为干预前、干预中、干预后几个阶段,观察患者干预前后血流感染发生率的情况.结果:600例ICU患者中使用导管的有487例,占总数的81.2%,发生血流感染的有16例,占2.7/1000d;干预后较干预前患者的血流感染发生率明显降低,两组数据差异显著,具有统计学意义(P<0.05).结论:对ICU患者进行综合干预护理,可以有效降低患者血流感染的发生率,对缓解患者的病情,提高患者的生活质量具有重要意义.

开展“阳光体育运动”的现状和干预措施的探析

为了全面贯彻落实教育部提出的“以人为本，健康第一”的指导思想，全国各地学校要广泛、深入地开展全国亿万学生阳光体育运动。通过调查研究“阳光体育运动”的开展还存在一些问题和不足。本研究对开展“阳光体育运动”的干预措施进行阐述，以确保我国中学阳光体育运动的目标顺利实现。

在治疗冠心病患者中采取护理干预措施的临床效果及对心绞痛发生率的影响分析

分析在治疗冠心病患者中采取护理干预措施的临床效果及对心绞痛发生率的影响。方法:于2018年5月-2021年5月在我院接收的冠心病患者予以搜集80例,抽选40例患者设为观察组(常规护理模式),另40例患者设为对照组(综合护理模式),对两组进行焦虑、抑郁自我测评、随访3个月进行生活质量评估、统计心绞痛发生率。结果:观察组患者的焦虑、抑郁自我测评结果低于对照组(P<0.05);观察组生活质量评估结果显著优于对照组(P<0.05);观察组发生心绞痛为1例(占总例数比为2.50%);对照组发生心绞痛为6例(占总例数比为15.00%),差异具有统计学意义(P<0.05)。结论:在治疗冠心病患者中采取有效的护理干预措施可减缓患者焦虑、抑郁等不良心理情绪,提升患者整体生活质量,降低心绞痛发生率,是一种值得临床应用的护理方式。

影响脑卒中护理者心理情绪的危险因素及干预的可能性

目的：探讨影响脑卒中护理者心理情绪的危险因素及进行干预的措施。方法：回顾性分析我市3个社区的86例脑卒中护理者，并进行调查问卷、面谈，分析判断患者和护理者的个性、财力、护理技巧、护理时间对护理者的压力、精神状态和耐力的影响，并分析干预的肯能性。结果：脑卒中患者有较为严重的认知、行为、情感的改变是护理者心理情绪的主要危险因素，大多数的护理者为女性、年龄小、体质弱同样也是影响脑卒中护理者心理情绪的危险因素。结论：女性、年龄小、体质弱、面对脑卒中较为严重的病情的时候，护理者更容易受到心理情绪的影响，在干预上要增强护理者的自信心，加强社会上的支持进行综合干预，提高护理者的积极性，提高脑卒中患者的生活质量。

Trend in gastric cancer:35 years of surgical experience in Japan

AIM:To investigate the trend in gastric cancer surgery in the context of rapid therapeutic advancement in Japan and East Asia.METHODS:A retrospective analysis was performed on 4163 patients who underwent gastric resection for gastric cancer with histological confirmation between 1971 and 2007 at the surgical unit in Kitasato University Hospital,to determine the trend in gastric cancer requiring surgery.RESULTS:Gastric cancer requiring surgical resection increased in our hospital,but the incidence adjusted for population was constant during the observed pe-riod.Interestingly,the ratio of diffuse type/intestinal type gastric cancer was unexpectedly unchanged,and that of advanced/early gastric cancer(EGC)was,however,markedly reduced,while the actual incidence of potentially curative advanced gastric cancer tended to decrease.The incidence of EGC requiring surgery tended to increase as a whole,which is consistent with increased prevalence of endoscopic surveillance.As a result,overall survival and mortality of gastric cancer requiring gastric resection has recently markedly improved.CONCLUSION:In Japan,planned interventions may improve surgical gastric cancer mortality,but an unexpected trend of persistent existence of intestinal type cancer suggests the need for more robust medical intervention.

Exercise and children's cognition:The role of exercise characteristics and a place for metacognition

Definitive conclusions concerning the impact of exercise interventions on children＇s mental functioning are difficult to ascertain because of procedural differences among studies. A narrative review of studies was conducted to evaluate the role of two types of exercise interventions on children＇s cognition. Acute and chronic exercise interventions were classified as quantitative or qualitative on the basis of manipulations of task complexity and, by inference, mental engagement. Both types of interventions enhance aspects of children＇s cognition; however, their effects on metacognitive processes are unknown. The role of metacognitive processes and their regulation of children＇s behavior and academic performance are highlighted.

Symptom clusters and quality of life among patients with advanced heart failure

Objectives To identify symptom clusters among patients with advanced heart failure （HF） and the independent relationships with their quality of life （QoL）. Methods This is the secondary data analysis of a cross-sectional study which interviewed 119 patients with advanced HF in the geriatric unit of a regional hospital in Hong Kong. The symptom profile and QoL were assessed by using the Edmonton Symptom Assessment Scale （ESAS） and the McGill QoL Questionnaire. Exploratory factor analysis was used to identify the symptom clusters. Hier- archical regression analysis was used to examine the independent relationships with their QoL, after adjusting the effects of age, gender, and comorbidities. Results The patients were at an advanced age （82.9± 6.5 years）. Three distinct symptom clusters were identified： they were the distress cluster （including shortness of breath, anxiety, and depression）, the decondition cluster （fatigue, drowsiness, nausea, and reduced appetite）, and the discomfort cluster （pain, and sense of generalized discomfort）. These three symptom clusters accounted for 63.25% of variance of the patients＇ symptom experience. The small to moderate correlations between these symptom clusters indicated that they were rather independent of one another. After adjusting the age, gender and comorbidities, the distress （β = -0.635, P 〈 0.001）, the decondition （β = -0.148, P = 0.01）, and the discomfort （β = -0.258, P 〈 0.001） symptom clusters independently predicted their QoL. Conclusions This study identified the distinctive symptom clusters among patients with advanced HF. The results shed light on the need to develop palliative care interventions for optimizing the symptom control for this life-limiting disease.

Effects of acute aerobic exercise on response preparation in a Go/No Go Task in children with ADHD:An ERP study

Purpose： The purpose of this study was to investigate the impact of acute exercise on reaction time and response preparation during a Go/No Go Task in children with attention deficit hyperactivity disorder （ADHD）. Methods： Nineteen children with ADHD （aged between 8 and 12 years old） undertook a 30-min intervention that consisted of treadmill running or video-watching presented in a counterbalanced order on different days. A Go/No Go Task was administrated after exercise or video-watching. Results： The results indicated a shorter reaction time and smaller contingent negative variation （CNV） 2 amplitude following exercise relative to the video-watching. For event related potential （ERP） analyses, greater CNV l and CNV 2 amplitudes in response to No Go stimuli in com- parison to Go stimuli was observed in the video-watching session only. Conclusion： These findings suggest that acute exercise may benefit children with ADHD by developing appropriate response preparation, particularly in maintaining a stable motor preparatory set prior to performing the given task.

Natural orifice transluminal endoscopy surgery:A review

Minimally invasive surgery started spreading worldwide in 1987,when the first laparoscopic cholecystectomy was performed.Meanwhile,improvement of endoscopic equipment and instruments allowed gastroenterologists to attempt more aggressive endoluminal interventions,even beyond the wall barrier.The first transgastric peri-toneoscopy,in 2004,brought to light the concept of natural orifice transluminal endoscopic surgery(NOTES).The idea of incisionless surgery is attractive and has become a new goal for both surgeons and other people interested in this field of investigation.The authors present a review of all developments concerning NOTES,including animal studies and human experience.

Big Data for Precision Medicine

This article focuses on the potential impact of big data analysis to improve health, prevent and detect disease at an earlier stage, and personalize interventions. The role that big data analytics may have in interrogating the patient electronic health record toward improved clinical decision support is discussed. Weexamine developments in pharmacogenetics that have increased our appreciation of the reasons why patients respond differently to chemotherapy. We also assess the expansion of online health communications and the way in which this data may be capitalized on in order to detect public health threats and control or contain epidemics. Finally, we describe how a new generation of wearable and implantable body sensors may improve wellbeing, streamline management of chronic diseases, and improve the quality of surgical implants.

Management strategies of Barrett's esophagus

Barrett's esophagus is a condition resulting from chronic gastro-esophageal reflux disease with a documented risk of esophageal adenocarcinoma. Current strategies for improved survival in patients with Barrett's adenocarcinoma focus on detection of dysplasia. This can be obtained by screening programs in high-risk cohorts of patients and/or endoscopic biopsy surveillance of patients with known Barrett's esophagus (BE). Several therapies have been developed in attempts to reverse BE and reduce cancer risk. Aggressive medical management of acid reflux, lifestyle modifications, antireflux surgery, and endoscopic treatments have been recommended for many patients with BE. Whether these interventions are cost-effective or reduce mortality from esophageal cancer remains controversial. Current treatment requires combinations of endoscopic mucosal resection techniques to eliminate visible lesions followed by ablation of residual metaplastic tissue. Esophagectomy is currently indicated in multifocal high-grade neoplasia or mucosal Barrett's carcinoma which cannot be managed by endoscopic approach.

Enhanced recovery for non-colorectal surgery

In recent years the advent of programs for enhanced recovery after major surgery (ERAS) has led to modifications of long-standing and well-established perioperative treatments. These programs are used to target factors that have been shown to delay postoperative recovery (pain, gut dysfunction, immobility) and combine a series of interventions to reduce perioperative stress and organ dysfunction. With due differences, the programs of enhanced recovery are generally based on the preoperative amelioration of the patient's clinical conditions with whom they present for the operation, on the intraoperative and postoperative avoidance of medications that could slow the resumption of physiological activities, and on the promotion of positive habits in the early postoperative period. Most of the studies were conducted on elective patients undergoing colorectal procedures (either laparotomic or laparoscopic surgery). Results showed that ERAS protocols significantly improved the lung function and reduced the time to resumption of oral diet, mobilization and passage of stool, hospital stay and return to normal activities. ERAS' acceptance is spreading quickly among major centers, as well as district hospitals. With this in mind, is there also a role for ERAS in non-colorectal operations?

Analysis on psychological disorder and related factors in 98 patients with cancer and intervention measures thereon

Objective： The aim of this study was to analyze factors of psychological disorder experienced by 98 cancer patients and to probe into intervention measures in accordance with the corresponding bad psychological factors. Methods： A questionnaire survey was conducted in the test group （n = 98） by filling out a symptom checklist 90 （SCL-90）. And then the survey result was compared with the normal group （n = 1388） contained in relevant references. Results： Except for hostile factor that was similar to normal level （P 〉 0.05）, other 8 factors were higher than in normal group （P 〈 0.01）. And the cancer patients were classified with the survey results. Conclusion： Compared with normal persons, cancer patients have more psychological problems and related intervention measures are sought necessarily to improve the quality of life, to advance the immune function and to prolong the survival time of patients.

Analysis of Causes Leading to High Bromine Number of C_8^+ Aromatics and Short Clay Service Life and Countermeasures Proposed

After comparing the operating status of other catalytic reforming units and evaluation of the side-cut stream tests, the refinery investigated the influence of the feedstock property, clay types, and operating regime of the clay tower and catalytic reforming unit on the service life of the clay. Test results had revealed that the low potential aromatic content of the reformer feed and high operating severity were the critical causes leading to high bromine number of the C8^＋ aromatics feed for the PX unit and the shortened service life of clay. This article also puts forward the corresponding remedial measures.

Stopping and Remaking Approaches to Degradation of the Black Sea Coast in the Romanian Seaside Area

There is presented a degradation case study of the Romanian shoreline belonging to the seaside of the Black Sea. The Romanian coastal Black Sea is in a continuously degradation due to the destructive action exerted by waves on the shore and, respectively, to the instability phenomena that manifest itself in the area. There are presented the influences of different causes of the degradation, the characteristics of the seaside shoreline and the interventions already made. There are done evolution foresights of the ground instability phenomena as well as shoreline degradation and recommend measures for rehabilitation.

Constraints on Camel Meat and Milk Marketing and Strategies for Its Improvement in Northern Kenya

A survey to identify constraints and design strategies to improve the camel milk and meat value chains was conducted in northern Kenya using Participatory Integrated Community Development （PICD）, Focus Group Discussions （FGD）, among other methods. In a second step, field testing of an intervention on milk and meat hygiene was carried out at household level. Survey results indicated that about 50% of marketable camel milk was not sold, 30% of marketed camel milk per annum was sold in sour state at US$ 0.13 lower that the price of a litre of fresh milk while processed meat got spoiled along the chain. Annual economic losses associated with milk spoilage were estimated at US$ 961,538.5. Preliminary findings of the field testing indicated that an additional 3 million litres of camel milk was sold in fresh state, giving an annual saving of US$ 384,615.4. Increased profitability of up to 60% compared to 30% before the intervention was reported among nyirinyiri processors. In conclusion, economic potential of the camel could be fully exploited by facilitating adoption of interventions such as hygiene, among others at all levels of the camel milk and meat value chains.

Versatile Leadership, LVI and Their Application in Skoda Auto a.s.

The paper starts with a presentation of the versatile leadership model developed by Kaplan and Kaiser and of their 360 feedback tool Leadership Versatility Index （LVI）. Versatility can be generally defined as a mastery of opposites, as the ability to play multiple roles, even contradictory ones, without emphasizing some at the expense of others. The LVI has been designed to help managers understand their repertoire and how they can become more versatile leaders. It employs an innovative rating scale on which ideal score ＂0＂ is in the middle of it （the right amount）, flanked by underdoing to the left （too little） and overdoing to the right （too much）. The idea is to avoid the ＂more is better＂ design trap by providing a way for raters to indicate when managers go to counterproductive extremes. The LVI works with two-sided view of leadership based on two major pairs of opposites： directive vs. supportive leadership and execution vs. strategy. Interventions based on the LVI results help to overcome traditional behaviorism as they combine the outer work （behavioral change） with the inner work （personal change） of development. Application of the LV1 on a sample of the managers from Skoda Auto a.s. and verification of its practical value represented the core of the SAVS IGA project MM/O7/02. The last part of the paper is devoted to a presentation of the findings from this project. The LVI has been found to be both original and a very useful 360 feedback tool which can be addressed to two general groups of clients： （1） experienced senior managers; and （2） young perspective managers in the beginning of their career.

The Basilica of Santa Maria di Collemaggio in L＇Aquila： Modern Provisional Measures

The case in analysis is Santa Maria di Collemaggio, the church symbol of the town of L＇Aquila and the most important example of Romanesque style in Abruzzi, tragically damaged by the earthquake in 2009. The following paper starts with an accurate analysis of the Basilica, whose historical, stylistical cultural characteristics make it an unicum in the whole urban environment. The authors tried to identify in which way these values have been compromised or altered after the earthquake through several analysis （surveys, historical researches etc.） aiming at the recognition of collapses, the cracks profile, the structural transformations caused by the provisional measures： the goal is to provide a kind of Basilica ＂cognitive manual＂ that will be useful for the future interventions. This first analysis allowed to understand many aspects： on the one hand, the constructive phases and which damages were caused by past careless interventions of restoration, drawing attention to the vulnerability elements of the Basilica; on the other hand, the innovative technologies and materials of the post-seismic provisional measures and their exact location.

Spanish National Monuments with Traditional Timber Roofs： Restoration versus Reconstruction

We prioritize interventions in the roof structure in order to prevent subsequent deterioration of the monument. This presentation refers to interventions in two Spanish National Monuments： the Collegiate Church of Roa de Duero and San Esteban＇s church of Los Balbases. The Collegiate Church was built during the 16th century. It is considered the jewel of the villa. It is a ＂hallenkirche＂ model with three big naves of the same height covered by beautiful starry vaults. The intervention consisted of restoring the wooden roof structure, preserving the original 16th centary structure, by replacing the damaged elements. It was restored according to archaeological criteria. San Esteban＇s church is a 13 century Gothic style church with a Latin cross plan. It has three naves with a transept of great slenderness. It preserves Romanesque remains. Opposite to the previous intervention we decided to rebuild the roof because the former roof was totally distorted due to bad executed works during the past Century. In this way we regain the original shape of the church. These interventions aim to improve constructive and structural conditions as well as retrieve the image of both monuments. We have studied the visual impact of interventions through virtual recreations. The intervention criteria are very different, restoration versus structttral reconstruction.