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Ethics of Human Resources Management in the Cameroonian Health System, Medical Nomadism and the Ineffectiveness of the Fight against High Blood Pressure
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作者 Jean Ndibi Abanda Anicet Onana Akoa +2 位作者 Désiré Tchoffo Ulrich Dama Pierre Yassa Yoniene 《Health》 2024年第1期9-21,共13页
Context/objectives: The fight against Chronic Non-Communicable Diseases (NCDs) is a long-term undertaking, which requires available, motivated and well-managed human resources (HR). The administrative management of sk... Context/objectives: The fight against Chronic Non-Communicable Diseases (NCDs) is a long-term undertaking, which requires available, motivated and well-managed human resources (HR). The administrative management of skills on both qualitative and quantitative levels is one of the essential functions of a health system. To better implement policies of fight against High Blood Pressure (HBP) and other chronic diseases, it is important to establish strategies to retain health personnel. This loyalty requires favorable working conditions and consideration of the contribution-reward couple. Good working conditions are likely to reduce the phenomenon of medical nomadism;conversely, poor HR management can contribute to their exodus towards exotic “green pastures”, thus leading to an additional crisis in the Cameroonian health system. The fight against HBP is a complex, multifaceted and multifactorial reality that requires appropriate management model for all types of resources mainly HR. The main objective of this research is to show the impact of poor management of human resources in Cameroon health system on medical nomadism and the ineffectiveness of the fight against High Blood Pressure. Method: A cross-sectional descriptive survey among five hundred (500) health facilities in the center region of Cameroon has been conducted. A stratified probabilistic technique has been used, and the number of health facilities to be surveyed has been determined using the “sample size estimation table” of Depelteau. The physical questionnaires have been printed and then distributed to data collectors. After data collection, the latter were grouped during processing in Excel sheets. The Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value to assess the normality and reliability of data. The Crochach’s Alpha reliability test allowed us to have a summary of the means and variances and then to search for intragroup correlations between variables. Descriptive analysis was possible with the XLSTAT 2016 software. Results: 43.60% of Health Facilities (HF) managers were unqualified. 82.20% of HF managers have staff in a situation of professional insecurity. They are mainly contractual (49.00), decision-making agents (24.40%), casual agents (08.80). The proportion of unstable personnel is average of 22.00% and very unstable, 12.00%. 展开更多
关键词 ETHICS Human Resources management Cameroonian Health system Medical Nomadism Ineffectiveness High Blood Pressure
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Reinforcement Learning-Based Energy Management for Hybrid Power Systems:State-of-the-Art Survey,Review,and Perspectives
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作者 Xiaolin Tang Jiaxin Chen +4 位作者 Yechen Qin Teng Liu Kai Yang Amir Khajepour Shen Li 《Chinese Journal of Mechanical Engineering》 SCIE EI CAS CSCD 2024年第3期1-25,共25页
The new energy vehicle plays a crucial role in green transportation,and the energy management strategy of hybrid power systems is essential for ensuring energy-efficient driving.This paper presents a state-of-the-art ... The new energy vehicle plays a crucial role in green transportation,and the energy management strategy of hybrid power systems is essential for ensuring energy-efficient driving.This paper presents a state-of-the-art survey and review of reinforcement learning-based energy management strategies for hybrid power systems.Additionally,it envisions the outlook for autonomous intelligent hybrid electric vehicles,with reinforcement learning as the foundational technology.First of all,to provide a macro view of historical development,the brief history of deep learning,reinforcement learning,and deep reinforcement learning is presented in the form of a timeline.Then,the comprehensive survey and review are conducted by collecting papers from mainstream academic databases.Enumerating most of the contributions based on three main directions—algorithm innovation,powertrain innovation,and environment innovation—provides an objective review of the research status.Finally,to advance the application of reinforcement learning in autonomous intelligent hybrid electric vehicles,future research plans positioned as“Alpha HEV”are envisioned,integrating Autopilot and energy-saving control. 展开更多
关键词 New energy vehicle Hybrid power system Reinforcement learning Energy management strategy
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AI-Driven Learning Management Systems:Modern Developments, Challenges and Future Trends during theAge of ChatGPT
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作者 Sameer Qazi Muhammad Bilal Kadri +4 位作者 Muhammad Naveed Bilal AKhawaja Sohaib Zia Khan Muhammad Mansoor Alam Mazliham Mohd Su’ud 《Computers, Materials & Continua》 SCIE EI 2024年第8期3289-3314,共26页
COVID-19 pandemic restrictions limited all social activities to curtail the spread of the virus.The foremost and most prime sector among those affected were schools,colleges,and universities.The education system of en... COVID-19 pandemic restrictions limited all social activities to curtail the spread of the virus.The foremost and most prime sector among those affected were schools,colleges,and universities.The education system of entire nations had shifted to online education during this time.Many shortcomings of Learning Management Systems(LMSs)were detected to support education in an online mode that spawned the research in Artificial Intelligence(AI)based tools that are being developed by the research community to improve the effectiveness of LMSs.This paper presents a detailed survey of the different enhancements to LMSs,which are led by key advances in the area of AI to enhance the real-time and non-real-time user experience.The AI-based enhancements proposed to the LMSs start from the Application layer and Presentation layer in the form of flipped classroom models for the efficient learning environment and appropriately designed UI/UX for efficient utilization of LMS utilities and resources,including AI-based chatbots.Session layer enhancements are also required,such as AI-based online proctoring and user authentication using Biometrics.These extend to the Transport layer to support real-time and rate adaptive encrypted video transmission for user security/privacy and satisfactory working of AI-algorithms.It also needs the support of the Networking layer for IP-based geolocation features,the Virtual Private Network(VPN)feature,and the support of Software-Defined Networks(SDN)for optimum Quality of Service(QoS).Finally,in addition to these,non-real-time user experience is enhanced by other AI-based enhancements such as Plagiarism detection algorithms and Data Analytics. 展开更多
关键词 Learning management systems chatbots ChatGPT online education Internet of Things(IoT) artificial intelligence(AI) convolutional neural networks natural language processing
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Design and analysis of an advanced thermal management system for the solar close observations and proximity experiments spacecraft
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作者 Liu Liu Kangli Bao +4 位作者 Jianchao Feng Xiaofei Zhu Haoyu Wang Xiaofeng Zhang Jun Lin 《Astronomical Techniques and Instruments》 CSCD 2024年第1期52-61,共10页
In this paper,the mission and the thermal environment of the Solar Close Observations and Proximity Experiments(SCOPE)spacecraft are analyzed,and an advanced thermal management system(ATMS)is designed for it.The relat... In this paper,the mission and the thermal environment of the Solar Close Observations and Proximity Experiments(SCOPE)spacecraft are analyzed,and an advanced thermal management system(ATMS)is designed for it.The relationship and functions of the integrated database,the intelligent thermal control system and the efficient liquid cooling system in the ATMS are elaborated upon.For the complex thermal field regulation system and extreme space thermal environment,a modular simulation and thermal field planning method are proposed,and the feasibility of the planning algorithm is verified by numerical simulation.A solar array liquid cooling system is developed,and the system simulation results indicate that the temperatures of the solar arrays meet the requirements as the spacecraft flies by perihelion and aphelion.The advanced thermal management study supports the development of the SCOPE program and provides a reference for the thermal management in other deep-space exploration programs. 展开更多
关键词 Solar Close Observations and Proximity Experiments Adaptive thermal control method thermal field planning method Pumped liquid cooling system Advanced thermal management system
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Overview of the immunological mechanisms in hepatitis B virus reactivation:Implications for disease progression and management strategies 被引量:1
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作者 Hui Ma Qing-Zhu Yan +2 位作者 Jing-Ru Ma Dong-Fu Li Jun-Ling Yang 《World Journal of Gastroenterology》 SCIE CAS 2024年第10期1295-1312,共18页
Hepatitis B virus(HBV)reactivation is a clinically significant challenge in disease management.This review explores the immunological mechanisms underlying HBV reactivation,emphasizing disease progression and manageme... Hepatitis B virus(HBV)reactivation is a clinically significant challenge in disease management.This review explores the immunological mechanisms underlying HBV reactivation,emphasizing disease progression and management.It delves into host immune responses and reactivation’s delicate balance,spanning innate and adaptive immunity.Viral factors’disruption of this balance,as are interac-tions between viral antigens,immune cells,cytokine networks,and immune checkpoint pathways,are examined.Notably,the roles of T cells,natural killer cells,and antigen-presenting cells are discussed,highlighting their influence on disease progression.HBV reactivation’s impact on disease severity,hepatic flares,liver fibrosis progression,and hepatocellular carcinoma is detailed.Management strategies,including anti-viral and immunomodulatory approaches,are critically analyzed.The role of prophylactic anti-viral therapy during immunosuppressive treatments is explored alongside novel immunotherapeutic interventions to restore immune control and prevent reactivation.In conclusion,this compre-hensive review furnishes a holistic view of the immunological mechanisms that propel HBV reactivation.With a dedicated focus on understanding its implic-ations for disease progression and the prospects of efficient management stra-tegies,this article contributes significantly to the knowledge base.The more profound insights into the intricate interactions between viral elements and the immune system will inform evidence-based approaches,ultimately enhancing disease management and elevating patient outcomes.The dynamic landscape of management strategies is critically scrutinized,spanning anti-viral and immunomodulatory approaches.The role of prophylactic anti-viral therapy in preventing reactivation during immunosuppressive treatments and the potential of innovative immunotherapeutic interventions to restore immune control and proactively deter reactivation. 展开更多
关键词 Hepatitis B virus reactivation Immunological mechanisms Disease progression management strategies Immune response
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Species’ geographical range, environmental range and traits lead to specimen collection preference of dominant plant species of grasslands in Northern China
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作者 Jingya Zhang Cui Xiao +5 位作者 Xiaoyu Duan Xin Gao Hao Zeng Rong'an Dong Gang Feng Keping Ma 《Plant Diversity》 SCIE CAS CSCD 2024年第3期353-361,共9页
Many different factors,such as species traits,socio-economic factors,geographical and environmental factors,can lead to specimen collection preference.This study aims to determine whether grassland specimen collection... Many different factors,such as species traits,socio-economic factors,geographical and environmental factors,can lead to specimen collection preference.This study aims to determine whether grassland specimen collection in China is preferred by species traits(i.e.,plant height,flowering and fruiting period),environmental range(i.e.,the temperature and precipitation range)and geographical range(i.e.,distribution range and altitudinal range).Ordinary least squares models and phylogenetic generalized linear mixed models were used to analyze the relationships between specimen number and the explanatory variables.Random Forest models were then used to find the most parsimonious multivariate model.The results showed that interannual variation in specimen number between 1900 and 2020 was considerable.Specimen number of these species in southeast China was notably lower than that in northwest China.Environmental range and geographical range of species had significant positive correlations with specimen number.In addition,there were relatively weak but significant associations between specimen number and species trait(i.e.,plant height and flowering and fruiting period).Random Forest models indicated that distribution range was the most important variable,followed by flowering and fruiting period,and altitudinal range.These findings suggest that future floristic surveys should pay more attention to species with small geographical range,narrow environmental range,short plant height,and short flowering and fruiting period.The correction of specimen collection preference will also make the results of species distribution model,species evolution and other works based on specimen data more accurate. 展开更多
关键词 Biological specimen collection preference Dominant plant species Environmental range Geographical range Species traits
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Etiology and management of urethral calculi:A systematic review of contemporary series
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作者 Andrew Morton Arsalan Tariq +2 位作者 Nigel Dunglison Rachel Esler Matthew J.Roberts 《Asian Journal of Urology》 CSCD 2024年第1期10-18,共9页
Objective:To conduct a systematic literature review on urethral calculi in a contemporary cohort describing etiology,investigation,and management patterns.Methods:A systematic search of MEDLINE and Cochrane Central Re... Objective:To conduct a systematic literature review on urethral calculi in a contemporary cohort describing etiology,investigation,and management patterns.Methods:A systematic search of MEDLINE and Cochrane Central Register of Controlled Trials(CENTRAL)databases was performed.Articles,including case reports and case series on urethral calculi published between January 2000 and December 2019,were included.Full-text manuscripts were reviewed for clinical parameters including symptomatology,etiology,medical history,investigations,treatment,and outcomes.Data were collated and analyzed with univariate methods.Results:Seventy-four publications met inclusion criteria,reporting on 95 cases.Voiding symptoms(41.1%),pain(40.0%),and acute urinary retention(32.6%)were common presenting features.Urethral calculi were most often initially investigated using plain X-ray(63.2%),with almost all radio-opaque(98.3%).Urethral calculi were frequently associated with coexistent bladder or upper urinary tract calculi(16.8%)and underlying urethral pathology(53.7%)including diverticulum(33.7%)or stricture(13.7%).Urethral calculi were most commonly managed with external urethrolithotomy(31.6%),retrograde manipulation(22.1%),and endoscopic in situ lithotripsy(17.9%).Conclusion:This unique systematic review of urethral calculi provided a summary of clinical features and treatment trends with a suggested treatment algorithm.Management in contemporary urological practice should be according to calculus size,shape,anatomical location,and presence of urethral pathology. 展开更多
关键词 Urinary calculi URETHRA Urethral calculi management algorithm
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Role of outdoor trees on pedestrian wind and thermal conditions around a pre-education building for sustainable energy management
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作者 LI Xiao-jie TANG Hui-li 《Journal of Central South University》 SCIE EI CAS CSCD 2024年第6期2039-2053,共15页
Finding sustainable energy resources is essential to face the increasing energy demand.Trees are an important part of ancient architecture but are becoming rare in urban areas.Trees can control and tune the pedestrian... Finding sustainable energy resources is essential to face the increasing energy demand.Trees are an important part of ancient architecture but are becoming rare in urban areas.Trees can control and tune the pedestrian-level wind velocity and thermal condition.In this study,a numerical investigation is employed to assess the role of trees planted in the windward direction of the building complex on the thermal and pedestrian wind velocity conditions around/inside a pre-education building located in the center of the complex.Compared to the previous studies(which considered only outside buildings),this work considers the effects of trees on microclimate change both inside/outside buildings.Effects of different parameters including the leaf area density and number of trees,number of rows,far-field velocity magnitude,and thermal condition around the main building are assessed.The results show that the flow velocity in the spacing between the first-row buildings is reduced by 30%-40% when the one-row trees with 2 m height are planted 15 m farther than the buildings.Furthermore,two rows of trees are more effective in higher velocities and reduce the maximum velocity by about 50%.The investigation shows that trees also could reduce the temperature by about 1℃around the building. 展开更多
关键词 sustainable management energy trees urban area thermal condition building
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Uncovering the Challenges of Faecal Sludge Management in Benin’s Urban Hubs: The Cases of Abomey-Calavi and Natitingou
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作者 Nikita Topanou Blaise Agbatchi +2 位作者 Gouvidé Jean Gbaguidi Jacques Fatombi Fidèle Paul Tchobo 《Journal of Environmental Protection》 2024年第7期767-780,共14页
The issue of faecal sludge management in developing countries remains a significant challenge due to the indiscriminate discharge of sludge into the environment. This practice generates more environmental problems tha... The issue of faecal sludge management in developing countries remains a significant challenge due to the indiscriminate discharge of sludge into the environment. This practice generates more environmental problems than it solves. This study aims to assess the management of household faecal sludge in the communes of Abomey-Calavi and Natitingou, Benin, in order to optimise the best storage conditions for subsequent more effective treatment. To this end, a sociological survey was conducted among households in Abomey-Calavi and Natitingou, as well as among manual emptiers. The results of our studies revealed that two types of latrines are used in households. 20.55% of households use traditional latrines, while 59.83% use ordinary latrines. 7.97% of households use both types of latrine. Moreover, the depth of the latrines varies from 2.5 m to 7 m in Abomey-Calavi and from 2.5 m to 8 m in Natitingou. Among households with a latrine, 28.26% empty their pit at least once, while 71.74% have never emptied it. The emptying cost varies between 35,000 FCFA and 90,000 FCFA. The mixing of faecal sludge with solid waste, including plastic materials, makes emptying difficult due to the obstruction of the vacuum pump. The results obtained will serve as a reliable database to facilitate decision-making in the context of faecal sludge management. 展开更多
关键词 management Faecal Sludge VALORIZATION BENIN
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The Role of Impulsivity and Addiction in Gambling Behaviors: How Applied Neuroscience Research Can Help in the Monitoring and Management of Mental Health Issues
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作者 Yingzhen Jia Kimberly Rose Clark 《Open Journal of Medical Psychology》 2024年第1期11-24,共14页
One in five Americans experience symptoms associated with at least one mental health disorder every year. These include behavioral addictions, which have long been overlooked despite their similar neural bases with su... One in five Americans experience symptoms associated with at least one mental health disorder every year. These include behavioral addictions, which have long been overlooked despite their similar neural bases with substance addictions. Gambling addiction, a type of behavioral addiction, deserves particular attention given the significant negative effects, this addiction has on financial and interpersonal health. The purpose of this paper is to review the available literature concerning the behavioral and neural processes involved in gambling addiction, including: the anticipation of reward, the role of dopamine, and the neural substrates of the decision-making processes involved in gambling addiction. Market research has also identified solutions that integrate applied neuroscience and self-tracking systems to monitor and manage mental health issues associated with gambling addiction. The authors then propose a gambling treatment-focused mobile app solution that addresses outstanding issues with a special design aimed at reversing plasticity in order to relieve the effects of gambling addiction. . 展开更多
关键词 Applied Neuroscience GAMBLING ADDICTION Mental Health management
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Knowledge,management,and complications of sepsis and septic shock:A significant therapeutic challenge in the intensive care unit
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作者 Jakub Mizera Adrian Bystroń +2 位作者 Karolina Matuszewska Justyna Pilch Ugo Giordano 《Journal of Acute Disease》 2024年第2期53-59,共7页
Sepsis and septic shock are life-threatening conditions that are globally responsible for almost 20%of mortality,especially in low and middle-income countries.This review was conducted on PubMed and Google Scholar dat... Sepsis and septic shock are life-threatening conditions that are globally responsible for almost 20%of mortality,especially in low and middle-income countries.This review was conducted on PubMed and Google Scholar databases with keywords sepsis,septic shock,sepsis management,and sepsis complications.Articles published up to July 2023 in English were included.Diagnosis and management should be carried out without unnecessary delay.Cooperation between various medical specialties including intensive care doctors,neurologists,hepatologists,cardiologists,and pediatric doctors is needed if a child is affected.New strategies have to be implemented in low and middle-income countries to decrease the sepsis incidence and reduce mortality in the population. 展开更多
关键词 SEPSIS Septic shock management COMPLICATIONS Diagnosis Review
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Security Monitoring and Management for the Network Services in the Orchestration of SDN-NFV Environment Using Machine Learning Techniques
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作者 Nasser Alshammari Shumaila Shahzadi +7 位作者 Saad Awadh Alanazi Shahid Naseem Muhammad Anwar Madallah Alruwaili Muhammad Rizwan Abid Omar Alruwaili Ahmed Alsayat Fahad Ahmad 《Computer Systems Science & Engineering》 2024年第2期363-394,共32页
Software Defined Network(SDN)and Network Function Virtualization(NFV)technology promote several benefits to network operators,including reduced maintenance costs,increased network operational performance,simplified ne... Software Defined Network(SDN)and Network Function Virtualization(NFV)technology promote several benefits to network operators,including reduced maintenance costs,increased network operational performance,simplified network lifecycle,and policies management.Network vulnerabilities try to modify services provided by Network Function Virtualization MANagement and Orchestration(NFV MANO),and malicious attacks in different scenarios disrupt the NFV Orchestrator(NFVO)and Virtualized Infrastructure Manager(VIM)lifecycle management related to network services or individual Virtualized Network Function(VNF).This paper proposes an anomaly detection mechanism that monitors threats in NFV MANO and manages promptly and adaptively to implement and handle security functions in order to enhance the quality of experience for end users.An anomaly detector investigates these identified risks and provides secure network services.It enables virtual network security functions and identifies anomalies in Kubernetes(a cloud-based platform).For training and testing purpose of the proposed approach,an intrusion-containing dataset is used that hold multiple malicious activities like a Smurf,Neptune,Teardrop,Pod,Land,IPsweep,etc.,categorized as Probing(Prob),Denial of Service(DoS),User to Root(U2R),and Remote to User(R2L)attacks.An anomaly detector is anticipated with the capabilities of a Machine Learning(ML)technique,making use of supervised learning techniques like Logistic Regression(LR),Support Vector Machine(SVM),Random Forest(RF),Naïve Bayes(NB),and Extreme Gradient Boosting(XGBoost).The proposed framework has been evaluated by deploying the identified ML algorithm on a Jupyter notebook in Kubeflow to simulate Kubernetes for validation purposes.RF classifier has shown better outcomes(99.90%accuracy)than other classifiers in detecting anomalies/intrusions in the containerized environment. 展开更多
关键词 Software defined network network function virtualization network function virtualization management and orchestration virtual infrastructure manager virtual network function Kubernetes Kubectl artificial intelligence machine learning
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Development and Application of Procedures for the Management of Skin Toxicity Related to Immune Checkpoint Inhibitors in Patients with Lung Cancer
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作者 Qianru Xu Qiong Wen 《Journal of Biosciences and Medicines》 2024年第7期289-300,共12页
Objective: To establish the procedures for the management of skin toxicity related to immune checkpoint inhibitors in patients with lung cancer and explore the effect of application. Methods: A total of 24 evidence-ba... Objective: To establish the procedures for the management of skin toxicity related to immune checkpoint inhibitors in patients with lung cancer and explore the effect of application. Methods: A total of 24 evidence-based evidences were collected from 7 aspects, including risk factors, baseline screening, ICIs monitoring, daily skin care, multidisciplinary management, symptom management and health education. A total of 157 lung cancer patients and 94 nurses from 8 wards of the Oncology department of our hospital from November 2022 to May 2023 were selected by convenience sampling. A total of 77 patients and 46 nurses from ward 1 - 4 were divided into the baseline group. There were 80 patients and 48 nurses in Ward 5 - 8 as the evidence-based practice group. In the baseline group, patients were treated with routine methods such as assessing skin symptoms, taking medication according to symptoms, guiding to keep skin clean and moist, eating a light diet, and avoiding scratching. The evidence-based practice group adopts an evidence-based continuous improvement model for nursing. The differences in the severity of symptoms of skin toxicity in the second cycle of medication and the knowledge and practice of self-care of skin toxicity were compared between the two groups before and after the use of the syndrome, as well as the differences in the implementation rate of review indicators, evidence-based ability and knowledge and practice of skin toxicity care before and after the use of the syndrome. Results: The incidence and severity of cutaneous toxicity were significantly lower after treatment than before treatment (P P < 0.05). Conclusion: The implementation of immune checkpoint inhibitor-related skin toxicity management procedures can effectively reduce the incidence and severity of skin toxicity symptoms, optimize the clinical pathway, and improve the quality of care. 展开更多
关键词 Lung Cancer Immune Checkpoint Inhibitors Skin Toxicity Process management NURSE
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Ruptured Ectopic Pregnancy: Epidemiology and Management in the General Surgery Department of the Ignace Deen National Hospital, Conakry University Hospital
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作者 Barry Mamadou Sakoba Barry Boubacar +2 位作者 Guirassy Mariam Touré Aboubacar Diallo Aissatou Taran 《Open Journal of Obstetrics and Gynecology》 2024年第4期503-508,共6页
Introduction: The aim of this study was to contribute to improving the quality of GEUR management in the general surgery department and in the maternity ward of the Ignace Deen national hospital, Conakry University Ho... Introduction: The aim of this study was to contribute to improving the quality of GEUR management in the general surgery department and in the maternity ward of the Ignace Deen national hospital, Conakry University Hospital. Methodology: This was a retrospective, descriptive study lasting two years (January 1, 2020 to December 31, 2022), carried out in the general surgery and gyneco-obstetrics departments of the Ignace Deen national hospital, Conakry University Hospital. We included all patients with a ruptured ectopic pregnancy who received surgical treatment during the study period. Results: We collected 13,524 cases of surgical interventions in the two services, among them, we recorded 89 cases or 0.66% GEUR. The average age of the patients was 24.26 years. Brides were the most represented with 80.96% of cases. Women practicing a liberal profession were 51.69% (n = 46) and housewives 26.97% (n = 24). Clinically, amenorrhea was noted in all patients, i.e. 100%, abdominal-pelvic pain in 95.2% (n = 85) of cases, metrorrhagia in 94.08% (n = 84), abdominal-pelvic sensitivity in 97.44% (n = 87) of cases and anemia in 85.39% of cases. The GEUR was ampullary in 69.66% (n = 62) cases. Salpingectomy was performed in 90.72% (n = 81). The surgical outcomes were satisfactory in 98.87% (n = 88) of cases. We recorded one case of surgical site infection. We have not recorded any deaths. The average length of hospitalization was 4 days. Conclusion: GEUR is relatively high in our context. A good understanding of the prognostic factors of GEUR, awareness and family planning could reduce GEUR. 展开更多
关键词 Ruptured Ectopic Pregnancy Epidemiology and management
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Development and Application of Integrated Indicators for Assessing Healthcare Waste Management Systems in Kenyan Hospitals
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作者 Muriithi Jackson Githinji Paul Mwangi Njogu +1 位作者 Zipporah Nganga Mohamed Karama 《Open Journal of Applied Sciences》 2024年第4期1080-1120,共41页
Healthcare waste management (HCWM) is an important aspect of healthcare delivery globally because of its hazardous and infectious components that have potential for adverse health and environmental impacts. The paper ... Healthcare waste management (HCWM) is an important aspect of healthcare delivery globally because of its hazardous and infectious components that have potential for adverse health and environmental impacts. The paper introduces a set of indicators for assessing HCWM systems in hospitals. These indicators are: HCWM policies and standard operating procedures, management and oversight, logistics and budget support, training and occupational health and safety, and treatment, disposal and waste treatment equipment housing. By plotting a mark on a continuum which is defined as good and poor on the extremes and is connected with all other marks in a spoke arrangement, it’s possible to describe a baseline for HCWM in any specific hospital. This baseline can be used to improve awareness of the actors and policy-makers, compare the same hospital at a different point in time, to compare observations by different evaluators and to track improvements. Results suggest that in Kenya, the application of such indicators is useful for evaluating which priorities should be addressed to improve outcomes in HCWM systems. Systematic sampling technique was used to identify and collect data by use of observational checklist, interviews, visual verification and review of documents and a HCWM assessment tool. The objective is to suggest an integrated management tool as a method to identify prevailing problems with a HCWM system. The method can be replicated in other contexts worldwide, with a focus on the developing world. The integrated indicators focus on management of HCW and not its potential impact on human health and environment, an area recognized to be critical for future research. 展开更多
关键词 Developing Countries HCW management Indicators management Tools
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Improvement of the nutritional support management system for patients in intensive care units
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作者 Yuan-Yuan Zhang Chun-Yi Wang +5 位作者 Dong-Xian Guo Hai-Nu Gao Xian-Shan Jin Yan-Li Wu Lu-Han Chen Zhi-Xian Feng 《World Journal of Psychiatry》 SCIE 2024年第1期44-52,共9页
BACKGROUND Nutritional support for patients hospitalized in the intensive care unit(ICU)is an important part of clinical treatment and care,but there are significant implementation difficulties.AIM To introduce a modi... BACKGROUND Nutritional support for patients hospitalized in the intensive care unit(ICU)is an important part of clinical treatment and care,but there are significant implementation difficulties.AIM To introduce a modified nutritional support management system for ICU patients based on closed-loop information management and psychological counseling.METHODS The division of functions,personnel training,system construction,development of an intelligent decision-making software system,quality control,and improvement of the whole process were carried out to systematically manage nutritional support for ICU patients.RESULTS Following the implementation of the whole process management system,the scores of ICU medical staff’s knowledge,attitudes/beliefs,and practices regarding nutritional support were comprehensively enhanced.The proportion of hospital bed-days of total enteral nutrition(EN)in ICU patients increased from 5.58%to 11.46%,and the proportion of EN plus parenteral nutrition increased from 42.71%to 47.07%.The rate of EN initiation within 48 h of ICU admission increased from 37.50%to 48.28%,and the EN compliance rate within 72 h elevated from 20.59%to 31.72%.After the implementation of the project,the Self-rating Anxiety Scale score decreased from 61.07±9.91 points to 52.03±9.02 points,the Self-rating Depression Scale score reduced from 62.47±10.50 points to 56.34±9.83 points,and the ICU stay decreased from 5.76±2.77 d to 5.10±2.12 d.CONCLUSION The nutritional support management system based on closed-loop information management and psychological counseling achieved remarkable results in clinical applications in ICU patients. 展开更多
关键词 Closed-loop information Psychological counseling Intensive care unit patients Nutritional support management system
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The Improving Effects of Diabetes Education on Diabetes Awareness and Management in Children and Adolescents with T1DM
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作者 Salah Alzawahreh Candan Ozturk 《Open Journal of Nursing》 2024年第4期164-175,共12页
Background: Diabetes education is crucial in empowering persons with Type 1 diabetes (T1DM) and their families to properly manage the condition by providing comprehensive knowledge, tools, and support. It boosts one’... Background: Diabetes education is crucial in empowering persons with Type 1 diabetes (T1DM) and their families to properly manage the condition by providing comprehensive knowledge, tools, and support. It boosts one’s belief in their ability to succeed, encourages following medical advice, and adds to the general enhancement of health. Objective: This study is to investigate the effectiveness of diabetes education in empowering individuals with Type 1 Diabetes Mellitus (T1DM) and their families to effectively manage the condition. Furthermore, it strives to improve nursing care for families whose children have been diagnosed with Type 1 Diabetes Mellitus (T1DM). Design: This research study investigates the efficacy of diabetes education in empowering individuals with Type 1 Diabetes Mellitus (T1DM) and their families to effectively handle the condition. Materials and Methods: A systematic search was conducted between the years 2000 and 2022, utilizing the Medline and Google Scholar databases. The purpose of the search was to uncover relevant papers pertaining to diabetes education, management of Type 1 Diabetes Mellitus (T1DM), nurse care, and empowerment. The search focused on peer-reviewed research, clinical trials, and scholarly articles that evaluated the efficacy of diabetes education in empowering individuals and families. Results: Diabetes education is crucial for understanding and controlling T1DM. It includes personalized sessions, webinars, group classes, and clinics that provide customized therapies. Comprehensive education enhances glycemic control and family dynamics. Nevertheless, the implementation of diabetes education for families requires specific standards, especially in the field of nursing. Conclusion: Diabetes education is essential for effectively managing Type 1 Diabetes Mellitus (T1DM), providing patients and families with crucial knowledge, resources, and confidence. It encourages independence in-home care and provides explicit guidelines for diabetic nurses to improve nursing care. 展开更多
关键词 Diabetes Education Family-Centered Empowerment Model Self-Care management SELF-EFFICACY Type 1 Diabetes (T1D)
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Systematic review of risk factors,prognosis,and management of colorectal signet-ring cell carcinoma
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作者 Frederiek Nuytens Vincent Drubay +2 位作者 Clarisse Eveno Florence Renaud Guillaume Piessen 《World Journal of Gastrointestinal Oncology》 SCIE 2024年第5期2141-2158,共18页
BACKGROUND Colorectal signet-ring cell carcinoma(CSRCC)is a rare clinical entity which accounts for approximately 1%of all colorectal cancers.Although multiple studies concerning this specific topic have been publishe... BACKGROUND Colorectal signet-ring cell carcinoma(CSRCC)is a rare clinical entity which accounts for approximately 1%of all colorectal cancers.Although multiple studies concerning this specific topic have been published in the past decades,the pathogenesis,associated risk factors,and potential implications on treatment are still poorly understood.Besides the low incidence,historically confusing histological criteria have resulted in confusing data.Nevertheless,the rising incidence of CSRCC along with relatively young age at presentation and associated dismal prognosis,highlight the actual interest to synthesize the known literature regarding CSRCC.AIM To provide an updated overview of risk factors,prognosis,and management of CSRCC.METHODS A literature search in the MEDLINE/PubMed database was conducted with the following search terms used:‘Signet ring cell carcinoma’and‘colorectal’.Studies in English language,published after January 1980,were included.Studies included in the qualitative synthesis were evaluated for content concerning epidemiology,risk factors,and clinical,diagnostic,histological,and molecular features,as well as metastatic pattern and therapeutic management.If possible,presented data was extracted in order to present a more detailed overview of the literature.RESULTS In total,67 articles were included for qualitative analysis,of which 54 were eligible for detailed data extraction.CSRCC has a reported incidence between 0.1%-2.4%and frequently presents with advanced disease stage at the time of diagnosis.CSRCC is associated with an impaired overall survival(5-year OS:0%-46%)and a worse stagecorrected outcome compared to mucinous and not otherwise specified adenocarcinoma.The systematic use of exploratory laparoscopy to determine the presence of peritoneal metastases has been advised.Surgery is the mainstay of treatment,although the rates of curative resection in CSRCC(21%-82%)are lower compared to those in other histological types.In case of peritoneal metastasis,cytoreductive surgery with hyperthermic intraperitoneal chemotherapy should only be proposed in selected patients.CONCLUSION CSRCC is a rare clinical entity most often characterized by young age and advanced disease at presentation.As such,diagnostic modalities and therapeutic approach should be tailored accordingly. 展开更多
关键词 Colorectal cancer Signet-ring cell histology Poorly cohesive cells systematic review Risk factors PROGNOSIS therapeutic management
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Land Use and Forest Dynamics in the Context of Redd+: Pathway to Sustainable Environmental Management*
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作者 Princewill Odum 《Open Journal of Forestry》 2024年第1期117-126,共10页
Reverting to nature as a major arsenals in a universal fight against Climate Change impact and loss of biodiversity, the United Nations Convention to Combat Desertification (UNCCD), views sustainable Land use and Fore... Reverting to nature as a major arsenals in a universal fight against Climate Change impact and loss of biodiversity, the United Nations Convention to Combat Desertification (UNCCD), views sustainable Land use and Forest (the main crux of the Glasgow declaration 2021) as the way to go. Forest conservation, protection and management in the context of REDD+ would guarantee sustainable ecosystem and mitigate climate change impacts. At National and subnational levels, the Nigerian REDD+ readiness scheme holds out hope for environmental sustainability. This study throws light into the historical background of trends in land use forest change in Nigeria, and places Nigeria on a “red” stage 3 (Low Forest Cover, High Deforestation Rate-LFHD) status while maintaining optimism that with REDD+ properly implemented in Nigeria, Stage 4: Low forest cover, Low Deforestation Rates (LFLD) and Stage 5: Low forest cover, Negative Deforestation Rates (LFND) can be achieved by 2030 and 2050 respectively, if the trio of reforestation, afforestation and natural restoration is practiced as a matter of national policy and subnational implementation within the context of REDD+. Four (4) broad drivers of deforestation and forest degradation were identified as direct, indirect, pre-disposing and planned /unplanned. The paper concludes that a viable pathway to sustainable environmental management is appropriate monitoring and evaluation of land use and forest dynamics in the context of REDD+. 展开更多
关键词 Land Use FOREST REDD+ SUSTAINABLE ENVIRONMENT management
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Variable and Invariable,Explore the Value-Creation Techniques of Management Accounting by Benchmarking the Financial Management of Large Enterprises
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作者 Jie Jin Jiajie Mu 《Proceedings of Business and Economic Studies》 2024年第1期45-50,共6页
With the development of information technology such as ChatGPT,artificial intelligence,5G,and so on,technological innovation brings about a qualitative change in the economic business.This change is embodied in breakt... With the development of information technology such as ChatGPT,artificial intelligence,5G,and so on,technological innovation brings about a qualitative change in the economic business.This change is embodied in breakthroughs in the field of science and technology and the iterative upgrading process of products.The traditional business model undoubtedly fails to adapt to the management needs of modern enterprises,while traditional financial practices and knowledge reserves cannot meet these needs.Faced with sudden technological changes and the emergence of financial sharing,financial robots,etc.,there is an urgent need for financial practitioners to transform from traditional financial accounting to value-creating management accounting.In the future,financial professionals with the ability to embrace uncertainty,adapt to environmental changes,and find breakthroughs in uncertain environments will be the most sought-after by enterprises.This paper aims to benchmark the excellent financial management models of large enterprises and conduct thematic research on financial management in large enterprises.It seeks to explore,in the era of big data management accounting,the road and art of creating value in enterprises.The objective is to provide references for colleagues in the financial field and to explore effective ways to generate value for enterprise management ideas,thus serving as a reference point in the financial transformation journey. 展开更多
关键词 management accounting Industry-finance integration management reporting Cost management
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