Spousal Involvement in the Workplace of Doctors: What Is Defined as Appropriate or Inappropriate

Background: Workers spend a significant amount of time in the workspace. Involvement of a spouse in a doctor’s workplace can take different forms and come with different intentions. Objectives: The survey aimed to determine the prevalence and extent of spousal involvement in physicians’ workplaces as well as the outcome of such involvement on doctor’ swell-being, productivity, and relationship with colleagues. Methods: This cross-sectional online survey on spousal involvement in the workplace of doctors was conducted among 83 responding doctors from July to August 2023. Results: Among the respondents, 60 (72.3%) had witnessed a doctor’s spouse being involved in the workplace. The most common reason for spousal involvement in the workplace was to protect the spouse from what they perceived as a threat 34 (54.0%). Spouse’s ignorance of boundaries in the workplace (OR: 6.09 (95% CI: 1.70, 21.79) P: 0.003) and exertion of control by the spouse (OR: 11.2 (95% CI: 2.26, 56.41) P: 0.002) were significantly associated with higher odds of inappropriate spousal involvement in the workplace, while expression of love for spouse with acts of kindness was significantly associated with a lowered odd of inappropriate spousal involvement (OR: 0.11 (95% CI: 0.03, 0.36) P: 0.0001). Conclusion: Spousal involvement in the workplace is relatively common. Ignorance of the boundaries of the workplace and exertion of control by the spouse were significant enablers of inappropriate spousal involvement in the workplace of doctors. The establishment of workplace policies that define the limits of spousal involvement in the doctor’s workplace can foster a healthy workspace environment, enhance doctors’ well-being, and improve patient care.

Appropriateness of Amikacin Dose Prescription, Monitoring and Safety during Hospitalization as an Impact of Clinical Pharmacologist Intervention, in the Israeli Regional Hospital

Background: Use of inappropriate amikacin dose is one of the most important factors in inducing toxicity, prolonged hospitalization as well as in increasing patient’s mortality. Objective: The aims of this study are the analysis of amikacin dose, serum level and the examination of the effectiveness of the clinical pharmacologist (CP) therapeutic drug monitoring (TDM) intervention to guarantee the safety of amikacin use. Methods: This is a one-year retrospective observational chart review study, which evaluates amikacin dose, serum drug level, development of adverse effects in patients on amikacin with or without CP TDM consultation. Results: Amikacin was prescribed for 393 complex patients, with median age 83. Amikacin group (AG) included 140 (32%) courses with CP consultation (AG1) and 292 (68%) courses without CP consultation (AG2). The distribution of most study characteristics in both groups was similar including amikacin dose (9-10 mg/kg/day), renal failure (14%) and mortality (12%). Acceptance for CP consultation was in 46% of amikacin courses and dose changes were done in 63% after CP intervention. Prolonged antibiotic course (4.6 ± 1.5 vs 3.8 ± 1.6 days, p < 0.0001) and the patient’s hemodynamic instability (15% vs 7%, p = 0.01) were more frequent in the AG1 compared to the AG2. There was a strong association between CP consultation and prolonged hospitalization (p = 0.005), while no association between it and amikacin adverse effects, renal failure or mortality. Conclusions: There was no trend to reducing amikacin toxicity, days of hospitaliza tion or mortality in patients with CP consultation. CP TDM intervention was more in the management of complicated clinical situations. However, it is necessary to optimize it.

Housing Typologies and Appropriation of the Urban Form in Alvalade＇s Neighborhood, Lisbon

The Alvalade＇s neighborhood （Lisbon, Portugal）, 1945, as a paradigm of Portuguese urbanism, can be distinguished by different housing cells that define it, as well as the different urban models, which relied on. It is possible to identify distinct occupational stains within the neighborhood, specifically in the cell one in this article, as a pioneer construction, due to housing dimension that corresponds to different housing typologies, residents and daily use areas, equipment. The objective is therefore, to understand how these three factors are reflected inside the cell, managing occupational stains which differ in space appropriation. How those different occupational stains that derive from the housing and urban morphology, may result in the occupation and experience of its inhabitants, not invalidating a cohesive structure of the neighborhood？

Examination of the Appropriateness of Teaching Materials for Preventing Dangers during Ablution and Bathing of Infants by Mothers and Family Members

Purpose: This study aimed to develop teaching materials to prevent the dangers of ablution and bathing infants, based on the dangerous experiences of mothers and family members, and examine their appropriateness. Methods: A total of 20 midwives and public health nurses were selected as participants. Teaching materials and anonymous self-administered questionnaires were distributed, and the participants were asked to view the teaching materials and fill in the questionnaires. Retrieval was done by mail. The teaching materials included digital content, such as videos, sounds, and characters, which incorporated dangerous situations, preventions, and innovations in ablution and bathing procedures. The analysis was conducted by simple tabulation for each survey item. The free description was coded to preserve anonymity. This study was conducted with the approval of the Research Ethics Review Board of the authors’ affiliated university. Results: The teaching materials were found to be appropriate in terms of suitability to purpose, degree of difficulty of content, ease of viewing the videos, validity of time, appropriateness of expression, and usability. Conclusions: Ablution teaching materials that are used at the present time do not focus on dangers, and to date, no resources on bathing have been used as teaching materials. The created teaching materials in this study can be viewed multiple times, and mothers and family members who are unfamiliar with ablution and bathing can acquire knowledge regarding dangers and danger prevention. The addition of specific preventive measures and countermeasures for the occurrence of danger, along with practice, would result in the development of further appropriate teaching materials to reduce danger and alleviate anxiety.

Transforming Molecules into Medicines: Role of CDMOS in Phase-Appropriate Technology Transfers in Advancing Pharmaceutical Innovation

CDMOs are emerging as critical drivers of innovation within the pharmaceutical and biotech industries. As the pharmaceutical industry continues to evolve, we can expect to see CDMOs play an increasingly important role in drug development and manufacturing. Many companies within these sectors are now leveraging the expertise of CDMOs through technology transfers to foster innovation and enhance the development of new drug products. In the extensive field of drug development, technology transfer plays a crucial role at multiple stages, ranging from preclinical phases to commercialization. By working closely with drug developers, CDMOs can ensure that technologies are transferred seamlessly between phases of drug development, allowing for a more efficient and cost-effective development process. CDMOs also bring a wealth of experience in various areas of drug development, including process development, analytical testing, quality control, and manufacturing. This expertise, combined with a focus on innovation, can help drug developers to overcome technical challenges and optimize their drug development programs. CDMOs can provide drug developers with various manufacturing capabilities, from small-scale clinical trials to large-scale commercial production. This flexibility allows drug developers to focus on their core competencies while relying on CDMOs to provide the necessary infrastructure and support for drug manufacturing. The critical role of CDMOs in advancing pharmaceutical innovation in phase-appropriate technology transfer where there will be a lot of effort and patience with strong technical expertise is required. This article explores the various types of Technology transfer from preclinical to commercial stages and successful strategies to foster innovation.

中医适宜技术在成人癌痛患者中应用的研究进展

对适用于成人癌痛患者的中医适宜技术进行综述,旨在为临床开展适合癌痛患者的中医适宜技术提供参考,为后续的相关研究提供依据和方向。

联合应用多种中医适宜技术干预阿片类药物相关性便秘的多中心临床研究

目的通过多中心临床研究,评价多项中医适宜技术联合干预对阿片类药物相关性便秘的临床疗效。方法2021年7月至2022年10月,在上海中医药大学附属岳阳中西医结合医院肿瘤科病房、利群医院安宁疗护病房、长征社区卫生服务中心安宁疗护病房选取符合阿片类药物相关性便秘诊断标准及便秘津亏肠燥证辨证标准的住院患者为研究对象,采用随机数字法分为对照组(n=164)与观察组(n=164)。两组患者均参照《阿片类药物相关性便秘中西医结合护理方案》开展常规护理工作。对照组在常规护理的基础上,给予乳果糖口服液(每日3次,每次10 mL空腹服用)及相应的用药指导;观察组在常规护理的基础上,采用中药贴敷、中药离子导入、耳穴压豆3项中医适宜技术联合干预。两组患者干预时间均为14 d,比较两组患者干预后的日均排便次数、平均排便间隔时间,干预前后的便秘症状、便秘相关生活质量及疼痛评分。结果观察组患者治疗便秘的显效率(31.71%)高于对照组(8.54%),且两组便秘症状疗效比较,差异有统计学意义(Z=-5.41,P<0.01);治疗后两组患者的日均排便次数及平均排便间隔时间差异均无统计学意义(P>0.05);两组患者治疗后便秘症状及相关生活质量较治疗前均有明显改善和提高,且观察组便秘症状及便秘相关生活质量评分的变化均比对照组更为明显,差异均有统计学意义(P<0.01);两组患者干预后疼痛评分均明显低于干预前,差异有统计学意义(P<0.01),但组间差异无统计学意义(P>0.05)。结论多种中医适宜技术联合干预可改善阿片类药物相关性便秘患者的便秘情况,同时可有效缓解患者的便秘不适症状、提高患者的生活质量,符合晚期肿瘤患者安宁疗护的理念,具有一定临床推广意义。

行政复议规范性文件审查的困境及功能优化

行政复议法规定了规范性文件审查制度,但该制度在实践中呈现出当事人申请意愿低、复议机关抵触情绪大、对规范性文件的监督效果差等诸多问题。上述问题产生的直接原因包括审查主体定位不当、审查标准与行政诉讼趋同、审查机制与审查后果不匹配等,而根本原因则在于该制度的功能定位偏离了行政复议制度的功能定位。根据行政复议法,复议规范性文件审查的首要功能是预防和纠正不合法、不适当的规范性文件,而不是辅助行政争议的解决;同时,该制度还需兼顾保护当事人合法权益和保障行政机关依法行使职权的目标。这与行政诉讼中的规范性文件审查制度以及备案审查制度的功能定位存在明显差异。复议规范性文件审查制度的功能应当与复议制度的整体功能保持协同。以此为指引,复议规范性文件审查主体应被限缩解释为对规范性文件有监督权的上级机关,审查标准应被扩张解释为广义合法性审查标准,审查程序应在考虑有效监督规范性文件的基础上作平衡性设计。

推动经济实现质的有效提升和量的合理增长的逻辑与路径

推动经济高质量发展,既需要实现质的有效提升,又需要实现量的合理增长。经济发展数量和质量是“一枚硬币的两面”,两者相互表征、相互反馈、相互转换,最终实现量质协同演化的高质量发展。从量质协同关系的角度观察中国经济发展实践,笔者发现:在经济加速阶段,中国经济发展数量和质量均有效提升,但是并未形成量质协同的正反馈机制;在经济减速阶段,中国经济发展数量和质量均面临下行压力,同时量质协同的负反馈机制逐渐显现;在转型发展阶段,面临经济转型与外生冲击的双重压力,宏观经济政策面临目标多元化难题,加剧了经济发展量质转型难度。推动经济实现质的有效提升和量的合理增长需要:优化宏观政策,推动实现质量效益型发展;深化供给侧结构性改革,提高供给质量;完善分配方式,提高消费需求质量;坚持“两个毫不动摇”,激发各类经营主体的内生动力和创新活力;增强国家能力,加快构建高水平社会主义市场经济体制。

民间文学类非物质文化遗产旅游开发适宜性评价——基于WSR系统方法论视角

旅游开发是民间文学类非物质文化遗产(非遗)顺应时代创新发展的重要途径,评估旅游开发适宜性是开发工作的首要前提。通过引入WSR系统方法论,建立民间文学类非遗旅游开发适宜性评价体系和应用性评分表,对湖北省内9项国家级非遗和7项省级非遗开展实证研究。结果表明:①第I类非遗得分较高,具有丰富的物理、事理和人理条件,适宜旅游开发;②第Ⅱ类非遗应在补齐产品衍生性、游客体验性和可展示性等短板的基础上进行旅游开发;③第Ⅲ类非遗需在强调“保护为先”的原则下,对其经济价值适度挖掘,同时探索非遗传承的多元途径。

和、合、节:传统和合思想的三重内涵

和合是中华优秀传统文化的基因之一。和合通常被理解为承认差异、对立(即“和”)与融合、统一(即“合”)这两重基本涵义,和合就是“融突”或对立(差异)间的统一。但是,传统和合思想还有第三重涵义——“节”:“以礼节和”,即作为融突、统一前提的“节”。和合是以“礼”作为“节”而对差异、对立因素的融通与整合,和、合、节三重内涵的“和合”,才是彰显和合这一传统文化独特精神和中国智慧的根本。

公平竞争审查制度与备案审查制度的衔接机制研究

公平竞争审查制度与备案审查制度是我国约束规范性文件制发的两种审查制度,但部门法之间的隔阂导致它们在理论上长期割裂。这两种审查制度在监督机制、审查能力、审查动力等方面具有互补性,使得建立它们之间的衔接机制具有现实可能性和必要性。在坚持公平竞争审查的事前自我审查这一基本定位的前提下,可以将事后审查部分纳入备案审查制度中,将公平竞争审查结论作为备案审查中合法性与适当性审查的参考文件。还可以适时扩张公平竞争审查对象,将部分涉及市场主体经济活动的党组织规范性文件以及人大及其常委会立法、决议和决定纳入公平竞争审查制度,并建立党委、人大、政府之间的公平竞争审查衔接联动机制。

月球站所的法律地位浅析

目前,月球活动正进入新的阶段——月球站所的筹备与建设。然而,现有相关国际法规范尚需完善,其中月球站所的法律地位是需首要考虑的问题。对月球站所法律地位问题的思考始于月球站所活动的特殊性:以人类社会的可持续发展为长远目标,开展于天体之上,将对天体表面固定区域进行使用且产生事实上的活动范围。合乎《外空条约》的月球站所建设是为全人类谋福利的自由探索和利用月球的活动,不存在既排他又永久地使用月球表面区域的情形,且在互惠基础上对他国开放。为此,建议在国际月球科研站活动中考虑“非排他”和“有时限”二者择一的规范路径以履行相应的国际法义务,并且明确国际月球科研站对他国开放的“互惠”前提与“参观”范畴。同时,需将月球站所的四个方面作为判断其法律地位的具体考量因素,即月球站所的使用目的与活动范围大小,月球站所的可移动性,月球站所的使用期限以及月球站所信息的通知、更新与公开。

适宜运动与过度训练调控肠道功能和肠-脑轴的作用机制

对运动介导肠道与大脑联络的相关文献进行综述,分析适宜运动与过度训练对肠道功能和肠-脑轴之间神经传导及生物信号分子的影响,以揭示其作用机制。发现:肠道与大脑之间关系密切,肠-脑轴之间的双向神经联系和相关生物信号分子是实现肠道与大脑之间对话的媒介。运动可通过调控肠道与大脑之间的神经联系和相关生物分子影响肠-脑轴,介导肠道与大脑的健康及神经、精神疾病的转归。肠道微生物是实现肠-脑轴之间信息沟通的重要参与者,运动对肠道功能与肠-脑轴的调节可通过调控肠道微生态,及其介导的神经传导途径和生物信号分子的变化发挥终端效应,进而影响高级神经功能。不同强度的运动对肠道微生态及肠-脑轴的调节效应差异颇大,适宜运动和过度训练引起的干预结果截然不同。

慢性病患者用药安全现状及影响因素分析

目的 :调查慢性病患者的用药安全现状并分析其影响因素,为改善慢性病患者用药安全提供理论依据。方法 :采取便利抽样方法,选取2023年8月—11月于湖南省4家三级甲等医院与4家社区卫生服务中心就诊的405例慢性病患者为调查对象,调查内容包括人口学资料、疾病情况、药物素养、合理用药自我效能和用药安全状况。采用多元线性回归分析慢性病患者用药安全影响因素。结果 :慢性病患者用药安全得分为(47.86±11.96)分,多元线性回归分析显示慢性病患者的药物素养、合理用药自我效能和运动锻炼情况越好,其用药安全得分越高。结论:慢性病患者用药安全状况有待提高。药物素养、合理用药自我效能和运动锻炼情况是慢性病患者用药安全的影响因素。

糖尿病患者应用中医适宜技术预后不良的危险因素分析与路径

目的分析糖尿病患者应用中医适宜技术预后不良的危险因素与路径研究。方法纳入120例应用中医适宜技术干预的糖尿病患者为研究对象,并将其按预后情况分成预后良好组80例、预后不良组40例,统计分析糖尿病患者的临床基本资料。比较2组健康调查简表(SF-36)、血糖相关指标(空腹血糖、餐后2 h血糖及糖化血红蛋白)水平,应用单因素分析及多因素Logistic回归分析糖尿病患者预后不良情况的主要危险因素。结果良好组SF-36各项评分均高于不良组患者(P<0.05)。良好组空腹血糖、餐后2 h血糖及糖化血红蛋白水平均低于不良组(P<0.05)。单因素分析显示,糖尿病患者预后不良情况发生与性别、高血压、吸烟、文化程度无关,比较差异无统计学意义(P>0.05);主要与年龄、体质量指数(BMI)、血脂异常、病程、糖尿病家族史、治疗依从性、科学运动、丙氨酸氨基转移酶(ALT)水平有关,比较差异有统计学意义(P<0.05)。Logistic回归分析结果发现,年龄≥70岁、BMI肥胖或超重、病程长短、血脂异常、糖尿病家族史、未科学运动、治疗依从性差、ALT升高为糖尿病患者发生预后不良情况的主要危险因素(P<0.05)。以糖尿病患者预后是否发生预后不良为因变量,发现病程、BMI、年龄、血脂异常、科学运动、治疗依从性、ALT、糖尿病家族史对糖尿病患者发生预后不良情况具有间接的中介作用。结论通过使用中医适宜技术对糖尿病患者进行干预,可有效改善患者的血糖指标及生活质量,糖尿病患者预后不良情况主要与年龄、病程、BMI指数、糖尿病家族史、血脂异常、ALT相关,为临床改善患者预后情况提供了参考。

谐音歇后语无序书写现象的调查与思考

谐音歇后语无序书写现象相当严重,以致不仅影响了有关它的机理探讨、学术交流、译注理解,同时也影响了有关它的语文教学。这背后既有客观原因亦有主观原因。整饬谐音歇后语无序书写势在必行,但首先需要做好基础工作,包括统一思想认识,明确主攻方向,说清应当怎样书写的根据所在。整饬无序书写应当从整饬词典入手,具体操作需要学界编写人员、出版社审校人员以及出版局管理人员齐心协力。

中医适宜技术联合盆底肌肉训练治疗产后压力性尿失禁临床观察

目的 对产后压力性尿失禁患者进行中医适宜技术干预治疗,并观察效果。方法 将60例患者随机分为治疗组和训练组,并对其进行相应治疗,观察2组1 h尿垫试验结果、Sandvik尿失禁指数和国际尿失禁咨询委员会尿失禁问卷简表(ICI-Q-SF)评分改善情况,以及临床疗效。结果 治疗后,治疗组1 h尿垫试验结果、Sandvik尿失禁指数和ICI-Q-SF评分改善均优于训练组。治疗结束时,治疗组总有效率为86.7%(26/30),高于对照组的63.3%(19/30)(P<0.05)。6个月随访时治疗组总有效率86.7%(26/30)亦高于对照组的56.7%(17/30)(P<0.05)。结论 在产后女性中,压力性尿失禁的发生是值得关注的问题。将中医适宜技术与凯格尔训练联用干预产后压力性尿失禁达到巩固、延长疗效的目的。

技术进步偏向、要素适宜性与环境治理效能——基于制造业面板数据的实证检验

技术进步偏向与要素禀赋结构适宜性是影响环境治理效能的关键因素。本文在阐明技术进步偏向对环境治理效能作用机制的基础上,使用2004-2020年制造业27个细分行业面板数据,构建技术进步偏向指数测度模型与环境治理效能动态模型,实证检验了技术进步偏向对制造业细分行业环境治理效能的影响,并通过质性检验验证研究结论的稳健性。实证结果显示,技术进步偏向与环境治理效能之间呈现正相关关系,技术进步偏向与要素禀赋结构适宜性越高,环境治理效能越高,技术进步偏向通过投资、需求、研发、资本配置效率共同作用于环境治理效能。

数字化转型与共同富裕:兼论“做大蛋糕”和“分好蛋糕”

文章基于2012—2022年A股非金融类上市企业数据,实证分析了企业数字化转型对共同富裕的影响及作用机制。研究发现:数字化转型既能显著促进企业“做大蛋糕”,又能促使其“分好蛋糕”,且这一促进作用存在企业产权性质、数字化转型类型、所处地区知识产权保护强度和贫困程度异质性;生产率提升效应是数字化转型助力企业“做大蛋糕”的重要路径,技能结构效应和信息曝光效应在促使企业“分好蛋糕”过程中发挥中介作用,并且数字金融在数字化转型促进企业共同富裕过程中起到正向调节作用;拓展分析发现,数字化转型能够在促进企业“做大蛋糕”的基础上进一步“分好蛋糕”,反向则不能。研究结论拓展了数字化转型助力企业共同富裕的相关理论,为数字化改革赋能共同富裕的路径探索提供经验支持。