The effect of globalization on family care traditions has emerged as a significant issue of academic debate in recent years. Globalization and the growth of liberal market economy in local areas has rapidly transforme...The effect of globalization on family care traditions has emerged as a significant issue of academic debate in recent years. Globalization and the growth of liberal market economy in local areas has rapidly transformed the traditional pattern of family structure, livelihood strategies of the family members, and care giving practices to the elderly in Nepal. Traditionally, the older people used to live in joint family comprised of their mamed son and their children. The reciprocal exchange of care between the parents and children was associated with the religious conception of virtue and vice. If the oft-springs would not take care for their parents, it was considered as a great sin. This tradition has been gradually eroding with the migration of youths to different destination in search of opportunities for their education and employment. This migratory process has weakened the traditional role of families as care giving institutions to old parents and disable member in the family. The old parents are now increasingly shelter to care homes for their caring. The children maintain their ties with their parents mainly by economic support for their maintenance. The old people have been unable to receive any moral care and support from other members of their family. This article examines the changes on the traditional responsibility of family as a care giving unit for the old people. It discusses the issues based on data gathered fllrough in-depfll interviews and case study of 37 senior citizens living in Siddhi Shaligram Senior Citizens Home （SSSCH） at Bhaktapur district. The secondary sources of information have also been used to shin-pen the conceptual issues related to this field展开更多
Background:Surgical management of adult slow-transit constipation(ASTC)can be effective for patients with intractable symptoms.This study aimed to evaluate whether barium-strip examination and selective colectomy impr...Background:Surgical management of adult slow-transit constipation(ASTC)can be effective for patients with intractable symptoms.This study aimed to evaluate whether barium-strip examination and selective colectomy improved post-operative outcomes in ASTC patients in comparison with subtotal colectomy.Methods:A retrospective cohort study of 53 cases with refractory ASTC was conducted between June 2008 and June 2014.Patients were evaluated by the barium-strip technique,colonoscopy,defecography and anorectal manometry.Patients in the standard group underwent laparoscopic subtotal colectomy and patients in the laparoscopic selective colectomy(LSC)group underwent LSC at the precise location identified by barium strip.Spontaneous bowel movements,the Wexner Constipation Scale and the Gastrointestinal Quality of Life Index(GIQLI)were assessed post-operatively at 3,6,12 and 24 months.Results:A total of 49 patients were included in the analysis.The median follow-up was 37 months(range,26–60 months).The mean post-operative hospital stay was 12 days and similar between groups(P=0.071).The length of colon resection,operative time and intra-operative blood loss were reduced in the LSC group(all P<0.05).No major complications occurred.A similar number of patients(24 in the standard group and 25 in the LSC group)exhibited hypoganglionosis or aganglionosis in the colon-wall muscle layer(P=0.986).Although there were no significant differences in post-operative spontaneous bowel movements and the Wexner Constipation Scale between the two groups,the mean GIQLI of the LSC group was significantly higher at 3,6 and 24 months post-operatively(all P<0.05).Conclusions:LSC based on barium-strip examination is an appropriate modality for treating ASTC.展开更多
文摘The effect of globalization on family care traditions has emerged as a significant issue of academic debate in recent years. Globalization and the growth of liberal market economy in local areas has rapidly transformed the traditional pattern of family structure, livelihood strategies of the family members, and care giving practices to the elderly in Nepal. Traditionally, the older people used to live in joint family comprised of their mamed son and their children. The reciprocal exchange of care between the parents and children was associated with the religious conception of virtue and vice. If the oft-springs would not take care for their parents, it was considered as a great sin. This tradition has been gradually eroding with the migration of youths to different destination in search of opportunities for their education and employment. This migratory process has weakened the traditional role of families as care giving institutions to old parents and disable member in the family. The old parents are now increasingly shelter to care homes for their caring. The children maintain their ties with their parents mainly by economic support for their maintenance. The old people have been unable to receive any moral care and support from other members of their family. This article examines the changes on the traditional responsibility of family as a care giving unit for the old people. It discusses the issues based on data gathered fllrough in-depfll interviews and case study of 37 senior citizens living in Siddhi Shaligram Senior Citizens Home （SSSCH） at Bhaktapur district. The secondary sources of information have also been used to shin-pen the conceptual issues related to this field
基金This study was supported by the National Science Foundation of China[No.81700751]the Scientific Research Foundation for the Returned Overseas Chinese Scholars[No.2110000021].
文摘Background:Surgical management of adult slow-transit constipation(ASTC)can be effective for patients with intractable symptoms.This study aimed to evaluate whether barium-strip examination and selective colectomy improved post-operative outcomes in ASTC patients in comparison with subtotal colectomy.Methods:A retrospective cohort study of 53 cases with refractory ASTC was conducted between June 2008 and June 2014.Patients were evaluated by the barium-strip technique,colonoscopy,defecography and anorectal manometry.Patients in the standard group underwent laparoscopic subtotal colectomy and patients in the laparoscopic selective colectomy(LSC)group underwent LSC at the precise location identified by barium strip.Spontaneous bowel movements,the Wexner Constipation Scale and the Gastrointestinal Quality of Life Index(GIQLI)were assessed post-operatively at 3,6,12 and 24 months.Results:A total of 49 patients were included in the analysis.The median follow-up was 37 months(range,26–60 months).The mean post-operative hospital stay was 12 days and similar between groups(P=0.071).The length of colon resection,operative time and intra-operative blood loss were reduced in the LSC group(all P<0.05).No major complications occurred.A similar number of patients(24 in the standard group and 25 in the LSC group)exhibited hypoganglionosis or aganglionosis in the colon-wall muscle layer(P=0.986).Although there were no significant differences in post-operative spontaneous bowel movements and the Wexner Constipation Scale between the two groups,the mean GIQLI of the LSC group was significantly higher at 3,6 and 24 months post-operatively(all P<0.05).Conclusions:LSC based on barium-strip examination is an appropriate modality for treating ASTC.
