Providence夜用型支具治疗青少年特发性脊柱侧凸的效果分析

目的评价Providence夜用型支具治疗青少年特发性脊柱侧凸(AIS)的临床效果。方法选取采用Providence夜用型支具治疗的19例AIS女性患者为P组,采用Boston全天佩戴型支具治疗19例的AIS患者为B组,随访18个月,每6个月复查1次,去除支具摄站立位全脊柱正侧位X线片。结果 P组治疗前后Cobb角分别为(29.8±4.1)°和(18.5±2.1)°,B组治疗前后Cobb角分别为(30.5±4.0)°和(20.1±2.3)°,两组治疗前后的Cobb角比较差异有统计学意义(P<0.05)。P组与B组的矫正率分别为37.9%和34.1%,两组比较差异无统计学意义(P>0.05)。P组的依从性、合并症、心理状况和社会适应情况均优于B组。结论 Providence夜用型支具治疗Cobb角<35°的腰段、胸腰段的AIS可取得满意效果,依从性好,正确的临床应用能有效避免手术治疗。

“Man Shall Find Grace”: A Biblical Reading of the “Eternal Providence” in Milton's Paradise Los

John Milton introduces the Biblical world into literature. Some modern critics think that in Paradise Lost, Milton makes Satan a hero while God a tyrant, yet, adopting the original Biblical perception, the reader will see the "Eternal Providence" of God and will agree that Milton has succeeded in justifying God as a Father Who says "Man Shall Find Grace". A Biblical reading of this epic will be done by focusing on its detail contents.

Mistreatment during Childbirth: Impact on Maternal Outcomes and Importance of Provider Perspectives

Background: Dying in childbirth is one of the most common causes of death for women. While maternal mortality rates, defined as deaths per 100,000 live births, have been steadily dropping in most countries worldwide, maternal mortality rates have doubled in the United States in the last twenty years. This commentary examines the various contributing factors to this trend. Methods: A literature review was performed using the keywords: maternal mortality, United States, disrespectful maternity care, obstetric violence, provider perspectives, and disparities. Maternal mortality statistics were obtained from the World Health Organization website. Results: Medical factors associated with maternal mortality include increased maternal age and cardiovascular conditions. Social factors include barriers to healthcare access, delays in receiving medical care, reduction in reproductive health services in some states, and non-obstetrical deaths such as accidents, domestic violence, and suicide. Racial inequities and disparities of care are reflected in higher maternal mortality rates for minorities and people of color. Disrespectful maternity care or obstetric violence has been reported worldwide as a factor in delay of lifesaving obstetrical care and reluctance by a pregnant person to access the healthcare system. About one in five US women has reported experiencing mistreatment, varying from verbal abuse to lack of privacy, from coerced procedures to neglect during childbirth. Conclusion: This commentary highlights the importance of inclusion of providers in research on respectful maternity care. Provider burnout, moral distress, limited time, and burden of clinical responsibilities are known challenges to respectful and comprehensive medical care. The association of disrespectful care with poor maternal outcomes needs to be studied. Exploring root causes of disrespectful childbirth care can empower nurses, midwives, and physicians to improve their environment and find solutions to reduce a potential cause of maternal mortality.

Evaluation of Clinician Training in Autism Screening, Care Management, and Patient Education

Objective: The demand for pediatric developmental evaluations has far exceeded the workforce available to perform them, which creates long significant wait times for services. A year-long clinician training using the Extension for Community Healthcare Outcomes (ECHO®) model with monthly meetings was conducted and evaluated for its impact on primary care clinicians’ self-reported self-efficacy, ability to administer autism screening and counsel families, professional fulfillment, and burnout. Methods: Participants represented six community health centers and a hospital-based practice. Data collection was informed by participant feedback and the Normalization Process Theory via online surveys and focus groups/interviews. Twelve virtual monthly trainings were delivered between November 2020 and October 2021. Results: 30 clinicians participated in data collection. Matched analyses (n = 9) indicated statistically significant increase in self-rated ability to counsel families about autism (Pre-test Mean = 3.00, Post-test Mean = 3.89, p = 0.0313), manage autistic patients’ care (Pre-test Mean = 2.56, Post-test Mean = 4.11, p = 0.0078), empathy toward patients (Pre-test Mean = 2.11, Post-test Mean = 1.22, p = 0.0156) and colleagues (Pre-test Mean = 2.33, Post-test Mean = 1.22, respectively, p = 0.0391). Unmatched analysis revealed increases in participants confident about educating patients about autism (70.59%, post-test n = 12 vs. 3.33%, pre-test n = 1, p = 0.0019). Focus groups found increased confidence in using the term “autism”. Conclusion: Participants reported increases in ability and confidence to care for autistic patients, as well as empathy toward patients and colleagues. Future research should explore long-term outcomes in participants’ knowledge retention, confidence in practice, and improvements to autism evaluations and care.

Leibniz and Clarke in Conflict： The Role of＂Force＂ and the Nature of God＇s Providence

The intellectual background of the concept of force in the dispute between Leibniz and Clarke has not received enough scholarly attention. Vailati＇s monograph, which is the most important study of the Leibniz-Clarke correspondence, focuses on a non-theological dimension in terms of the concept of force in this debate. Based on this perspective, Vailati＇s conclusion is that Clarke＇s understanding of force was totally different from that of Newton. However, the historical context shows that this is not the case. Clarke＇s concept of motive force bore a strong resemblance to that of Newton, according to which force was an active principle that had been endowed upon matter at the beginning of God＇s creation. Furthermore, the close link between force, matter and God＇s providence had a long tradition of debate between Cartesian and Gassendian philosophers since early modem times. The different concepts of force dividing Cartesian and Gassendian philosophers were actually related to, and conditioned by, their underlying fundamental theological differences. The concept of force in the Leibniz-Clarke controversy, accordingly, could be regarded as along the lines of the earlier disputes between Cartesian and Gassendian philosophers.

The Effectiveness of Peer Feedback on Second Language Writing

Peer feedback is a widely utilized practice in writing classrooms for second languages(L2)that has drawn a lot of attention.While some support the practice because of the clear advantages that peer feedback offers students,others doubt its efficacy.Comparing various forms of feedback is therefore necessary,as is determining the effects that peer feedback has on students and the variables that might affect how successful peer feedback is.This paper focuses on the usefulness of peer feedback for L2 writing,based on a review of studies on the subject.The findings imply that the functions of peer and teacher feedback are distinct,and that peer feedback is advantageous to both parties,particularly to the supplier.The attitudes and cultural backgrounds of the students are among the other factors that affect how effective peer feedback is.Lastly,some implications for future research and education are presented.

An Integrated and Comprehensive Fuzzy Multi-Criteria Model for Electronic Wallet Selection

Electronic wallet(E-wallet),which combines software,hardware,and human interaction,is a modern platform for electronic payment.Financial services managers can create more effective strategies for advancing existing positions by evaluating the success of e-wallet services.The objective of this research is to create an integrated model for assessing E-wallet services using the Fuzzy Analytic Hierarchy Process(FAHP)in conjunction with a technique for extent analysis and the ARAS approach(Additive Ratio Assessment).In this study,E-wallet service providers are ranked and evaluated using the ARAS approach and the FAHP priority weights.In addition,a case study from Vietnam illustrates how the methodology is used.The data shows that perceived usefulness,perceived usability,perceived simplicity of use,and perceived threat have the least impact on how acceptable an Ewallet is.As a result,the suggested model improves the efficiency of E-wallet service operations and assists in overcoming the challenges associated with the evaluation of E-wallet services.The case finding demonstrates that the suggested model is a reliable and useful tool for making decisions when assessing E-wallet service providers functioning in a complex and changing environment.

Light-Weighted Decision Support Framework for Selecting Cloud Service Providers

Multi-criteria decision making(MCDM)is a technique used to achieve better outcomes for some complex business-related problems,whereby the selection of the best alternative can be made in as many cases as possible.This paper proposes a model,the multi-criteria decision support method,that allows both service providers and consumers to maximize their profits while preserving the best matching process for resource allocation and task scheduling.The increasing number of service providers with different service provision capabilities creates an issue for consumers seeking to select the best service provider.Each consumer seeks a service provider based on various preferences,such as price,service quality,and time to complete the tasks.In the literature,the problem is viewed from different perspectives,such as investigating how to enhance task scheduling and the resource allocation process,improve consumers’trust,and deal with network problems.This paper offers a novel model that considers the preferences of both service providers and consumers to find the best available service provider for each consumer.First,the model adopts the best-worst method(BWM)to gather and prioritize tasks based on consumers’and service providers’preferences.Then,the model calculates and matches similarities between the sets of tasks from the consumer’s side with the sets of tasks from the provider’s side to select the best service provider for each consumer using the two proposed algorithms.The complexity of the two algorithms is found to be O(n3).

Towards Developing Privacy-Preserved Data Security Approach(PP-DSA)in Cloud Computing Environment

In the present scenario of rapid growth in cloud computing models,several companies and users started to share their data on cloud servers.However,when the model is not completely trusted,the data owners face several security-related problems,such as user privacy breaches,data disclosure,data corruption,and so on,during the process of data outsourcing.For addressing and handling the security-related issues on Cloud,several models were proposed.With that concern,this paper develops a Privacy-Preserved Data Security Approach(PP-DSA)to provide the data security and data integrity for the out-sourcing data in Cloud Environment.Privacy preservation is ensured in this work with the Efficient Authentication Technique(EAT)using the Group Signature method that is applied with Third-Party Auditor(TPA).The role of the auditor is to secure the data and guarantee shared data integrity.Additionally,the Cloud Service Provider(CSP)and Data User(DU)can also be the attackers that are to be handled with the EAT.Here,the major objective of the work is to enhance cloud security and thereby,increase Quality of Service(QoS).The results are evaluated based on the model effectiveness,security,and reliability and show that the proposed model provides better results than existing works.

Rationale of a Cross Sectional Descriptive Study on Knowledge and Practices of Healthcare Providers on Postpartum Hemorrhage Management in Kinshasa, the Democratic Republic of the Congo

Background: Healthcare Providers’ knowledge and practice of postpartum hemorrhage (PPH) management are essential to reduce maternal morbidity and mortality. PPH is a public health problem due to the high maternal mortality (MM) associated with it worldwide (25%). Improving the quality of PPH management is a major challenge in low-income countries where, despite the progress made in its management, PPH remains a major contributor to maternal morbidity and mortality. Objective: We will evaluate the level of knowledge and practices of providers in the PPH management in Kinshasa in the Democratic Republic of the Congo (DRC). Methods: This study will be descriptive and cross-sectional. The minimum sample size will be 86. Our study population will consist of delivery room care providers. Results will be reported as percentage proportion and mean plus or minus standard deviation. Comparisons of means between groups will be made using Student’s t-test and Pearson’s chi-square test. The test will be statistically significant for a p value 0.05. Data will be collected and processed anonymously and confidentially. Conclusion: Improving quality of care must be a priority in obstetrics. This evaluation requires us to determine the level of knowledge and practices of providers in the PPH management in Kinshasa.

The Extent of Partograph Use and Associated Factors among Obstetric Care Providers in Government Hospitals in Southern Ethiopia: A Cross-Sectional Study

Background: Prolonged labor is a significant contributor to maternal morbidity and mortality. The World Health Organization encourages using the partograph to keep track and solve this issue. The extent of partograph use in Ethiopia, however, is hardly understood. This study aimed to ascertain the level of partograph use and related variables among obstetric care providers in government hospitals in southern Ethiopia. Methods: A cross-sectional institutional study was conducted among obstetric care providers in government hospitals in southern Ethiopia, from March to December 2015. The data were collected using a pre-tested questionnaire and format. To establish a statistical relationship, an odds ratio with a 95% confidence interval was utilized. Results: A total of 212 (55.1%) obstetric providers reported routine use of partograph to monitor labor. Midwives [AOR: 3.4, 95% CI: (1.2, 9.4)], clinical nurses [AOR: 3.0, 95% CI: (1.1, 7.6)], knowledge of partographs [AOR: 2.0, 95% CI: (1.2, 3.5)], positive attitudes toward partograph use [AOR: 3.7, 95% CI: (1.7, 7.7)], service of 2 - 5 years [AOR: 3.4, 95% CI: (2.8, 4.4)] and service of more than five years [AOR: 2.3, 95% CI: (2.0, 3.3)] were associated with partograph use. Conclusion: This study has shown that the use of partographs to monitor labor among obstetricians is consistent with other studies from developing countries. However, this does not mean that obstetric care does not need to be strengthened, as a significant proportion of obstetricians still do not use the partograph for labor monitoring. Therefore, it is recommended that midwives and nurses be given preference in the delivery of obstetric services, the knowledge and attitudes of providers be improved, and mechanisms be developed that can help keep senior care providers.

Hand Hygiene by Ward Staff at Dapaong Regional Hospital in Togo

Introduction: Hand hygiene (HH) is an effective way to fight infections in healthcare settings. The general purpose of our study was to explore the knowledge, attitudes and practices of health care providers on HH at Dapaong regional hospital (DRH). Methodology: This was a prospective, descriptive cross-sectional study conducted from March to June 2022 in the DRH wards. Data were collected using a questionnaire and observation grid. Results: 90 care providers were surveyed. Males and non-physician personnel predominated with 57.8%, and 94.4% respectively. The survey on staff’s knowledge reported: 31.1% of practitioners did not wash their hands on arrival and departure in services. 24% did not know the difference between simple hand washing (SHW) and hygienic hand washing (HHW). 23.3% did not know the type of soap to use for HHW. The caregivers did not know the type of hand washing (HW) required after a septic and non-septic procedure in respectively 41.6%, and 37.8%. They did not know that there are two types of hand antiseptics (45.4%), nor the amount of antiseptic for HW (78.9%). The survey on staff’s attitude regarding HW found that: 70% did not remove all jewels prior HW, and 51.1% did not know that wearing gloves cannot replace the HW. For HW Staff Practice: 62.2% did not wash their hands before treatment. 91.1% did not spread the soap on their hands and forearms after wetting them. 65.55% did not rinse hands from nails to elbows. Conclusion: The HH was poorly known, the attitude of the staff was dangerous in relation to the HH and the practice of HH was very inadequate at the RHC-Dapaong. As a result, there is a need to retrain staff to increase their capacity to prevent care-related infections and enhance patient safety in the hospital.

News-Clips(2023.04-2023.05)

April 2023 Chinese doctors treat 290 million patients in foreign aid over six decades China has dispatched medical teams totaling 30,000 members to 76 countries and regions over the past six decades,providing 290 million diagnoses and treatments for local people,according to a symposium held in Beijing on April 6.

Examining Knowledge Decay in the Anesthesia Provider—An Integrative Review

Background: Knowledge decay can be present in a lot of different careers but it is especially important when affecting the anesthesia provider. Knowledge decay can lead to skill decay. Therefore, it leads to worse patient outcomes. It is important to know how knowledge decay occurs and to know how to prevent it. Purpose: The purpose of this review was to explore the contributing factors of knowledge decay while also examining how different learning activities can be used to prevent it from occurring. Methods: A systematic literature search was performed in PubMed, Cochrane databases, and Embase. The American Association of Nurse Anesthesiology website was also examined. Findings: Knowledge decay usually occurs when either the anesthesia provider is in a new area of practice or when the provider has had a significant amount of time pass since the latest implementation of an anesthesia skill. The type of activity shown to best combat knowledge decay is the use of a simulation-based learning activity. Classroom learning can also help combat knowledge decay, but not to the same extent. Conclusions: The most significant way to prevent knowledge decay in the anesthesia provider is to implement simulation-based learning activities, as well as keep anesthesia providers comfortable with the skills that they practice.

从援藏干部楷模孔繁森的家乡出发

【Editor's Note】Since the 3rd Central Symposiumon Tibet Work in 1994,when themajor decision of providing assistance to Tibet by the whole country was made,almost 12,000 officials in various sectors from different provinces and cities have been selected and dispatched to Tibet.With both feet on the ground,they rolled up their sleeves and got down to work.The experience in Tibet became their treasured memories.

Making Sense of Anything thru Analytics: Employees Provident Fund (EPF)

Employees Provident Fund (EPF) has always been a hot topic, from the previous Government permitted “withdrawals” during the pandemic to the present Government disallowing further withdrawals (afraid it would lead to a financial crisis) and allowing emergency loans through an EPF collateral agreement. The latter used median studies to “contribute” MYR 500 to EPF members with less than RM 10,000 in their accounts. Baffled/bewildered by the current Government’s generosity and highlighted in this paper, I used Monte Carlo simulation, a method used by analysts when determining the size of a client’s portfolio to support their desired retirement lifestyle, to establish a reference-type table displaying ideal savings when reaching 50. The Government could use the table mentioned above to give more meaningful contributions to EPF members, apart from EPF active and inactive members, knowing where they stand concerning their current EPF savings.

Accelerating Quantum Computing Readiness: Risk Management and Strategies for Sectors

The potential impact of quantum computing on various industries such as finance, healthcare, cryptography, and transportation is significant;therefore, sectors face challenges in understanding where to start because of the complex nature of this technology. Starting early to explore what is supposed to be done is crucial for providing sectors with the necessary knowledge, tools, and processes to keep pace with rapid advancements in quantum computing. This article emphasizes the importance of consultancy and governance solutions that aid sectors in preparing for the quantum computing revolution. The article begins by discussing the reasons why sectors need to be prepared for quantum computing and emphasizes the importance of proactive preparation. It illustrates this point by providing a real-world example of a partnership. Subsequently, the article mentioned the benefits of quantum computing readiness, including increased competitiveness, improved security, and structured data. In addition, this article discusses the steps that various sectors can take to achieve quantum readiness, considering the potential risks and opportunities in industries. The proposed solutions for achieving quantum computing readiness include establishing a quantum computing office, contracting with major quantum computing companies, and learning from quantum computing organizations. This article provides the detailed advantages and disadvantages of each of these steps and emphasizes the need to carefully evaluate their potential drawbacks to ensure that they align with the sector’s unique needs, goals, and available resources. Finally, this article proposes various solutions and recommendations for sectors to achieve quantum-computing readiness.

藏北羌塘中部绒玛地区蓝片岩岩石学、矿物学和^(40)Ar/^(39)Ar年代学

藏北羌塘中部沿龙木错-双湖-线出露一条低温高压变质带,目前已有多处蓝片岩的报道。然而,除冈玛错地区产有典型的蓝闪石外,多数地区并没有典型蓝闪石的报道。绒玛蓝片岩位于羌塘中部高压变质带的中段,是该带中规模最大、保存最好的蓝片岩,对蓝片岩进行了详细的岩石学和矿物学研究,钠质角闪石主要为蓝闪石、青铝闪石、钠闪石和镁钠闪石。对蓝片岩中蓝闪石和多硅白云母进行了^(40)Ar/^(39)Ar定年,获得了227.3±3.8Ma和215±1.5Ma的坪年龄,分别代表蓝片岩快速俯冲消减和俯冲作用结束开始折返抬升的时代。绒玛蓝片岩岩石学、矿物学和^(40)Ar/^(39)Ar年代学研究为羌塘中部高压变质带的研究提供了新的资料。

基于WBEM的统一管理系统

分析了WBEM的技术体系结构,对其两种模型体系结构作了阐述。设计并实现了一个基于WBEM的统一管理体系结构的原型。重点论述此原型系统的设计目标、功能结构和关键实现技术。实验证明该原型系统可以有效管理综合复杂的网络的系统,具有很好的应用前景。

新一代面向Internet的数据库访问技术研究

分析.Net环境下使用Oracle的现状,指出其中存在的问题,得出应用新技术的必要性。通过研究.NETFrameworkDataProviderforOracle技术,提出了解决方案,并以一个应用实例验证了其可行性与有效性。