In order to fully understand the development trends and achievements of tourism suitability evaluation at home and abroad, this paper reviews the relevant literature of tourism suitability evaluation from five aspects...In order to fully understand the development trends and achievements of tourism suitability evaluation at home and abroad, this paper reviews the relevant literature of tourism suitability evaluation from five aspects-tourism climate, tourism environment, tourism resources, tourism destination and evaluation indicator, and gives discussions.展开更多
Screening and early diagnosis of gastric cancer play important roles in reducing the mortality of gastric cancer. A vast amount of study data on gastric cancer screening and early diagnosis has been accumulated in and...Screening and early diagnosis of gastric cancer play important roles in reducing the mortality of gastric cancer. A vast amount of study data on gastric cancer screening and early diagnosis has been accumulated in and out of China in the past decades. The practice of gastric cancer screening has also been efficiently carried out in different countries and regions. However, no widely accepted principle of population screening for gastric cancer has been developed yet. Screening for gastric cancer requires extensive exploration both theoretically and practically. This article focuses on the method and program of gastric cancer screening based on population. Moreover, the current situation of gastric cancer screening and its evaluation are evaluated.展开更多
Objectives:This study was conducted to investigate the current status of handoffs,perception of patient safety culture,and degrees of handoff evaluation in small and medium-sized hospitals and identified factors that ...Objectives:This study was conducted to investigate the current status of handoffs,perception of patient safety culture,and degrees of handoff evaluation in small and medium-sized hospitals and identified factors that make a difference in handoff evaluation.Methods:This is a descriptive study.425 nurses who work at small and medium-sized hospitals in South Korea were included in our study.They completed a set of self-reporting questionnaires that evaluated demographic data,handoff-related characteristics,perception of patient safety culture,and handoff evaluation.Results:Results showed that the overall score of awareness of a patient safety culture was 3.65±0.45,the level was moderate.The score of handoff evaluation was 5.24±0.85.Most nurses experienced errors in handoff and most nurses had no guidelines and checklist in the ward.Handoff evaluation differed significantly according to the level of education,work patterns,duration of hospital employment,handoff method,degree of satisfaction with the current handoff method,errors occurring at the time of handoff,handoff guidelines,and appropriateness of handoff education time(P<0.05).Conclusion:For handoff improvement,guidelines and standards should be established.It is necessary to develop a structured handoff education system.And formal handoff education should be implemented to spread knowledge uniformly.展开更多
BACKGROUND:In Hong Kong, the reorganization of healthcare frame work for better utilization of resources has led to an increase in the frequency of inter-facility transport in recent years. An Inter-Facility Transpor...BACKGROUND:In Hong Kong, the reorganization of healthcare frame work for better utilization of resources has led to an increase in the frequency of inter-facility transport in recent years. An Inter-Facility Transport Triage Guideline (IFTTG) was introduced and evaluated on its compliance and performance. This study aimed to evaluate the compliance to the IFTTG and performance of inter-facility transport after the IFTTG was implemented. METHODS: The patients who required emergency IFT with accompanying personnel in two consecutive periods (pre-implementation period: January 1,2006 to April 30, 2006; post-implementation period: May 1,2006 to August 31,2006) were included. The compliance to pre-transport triage and transport team configuration was evaluated by a review panel with eight performance indicators identified. The performance indicators were compared individually and as an overall score. RESULTS:Sixty-eight (26 in the pre-implementation period and 42 in the post-implementation period) IFTs were reviewed. There was demonstrable improvement on compliance to the IFTTG. The appropriateness of pre-transport triage increased from 34.6% to 54.8% whereas appropriateness of transport team configuration rose significantly from 73.1% to 92.9% (P〈0.05). Staff performance on individual IFT performance indicator was satisfactory in both periods and the means of overall score on performance indicators were 7.12 and 7.29 respectively. The most improved performance indicator was the appropriateness of transport team configuration. CONCLUSIONS: The compliance and performance with the newly implemented IFTTG were satisfactory. However, staff comment and satisfaction with the use of the new guideline should be collected so as to achieve continuous quality improvement.展开更多
Thirty cases of cervical spondylotic myelopathy (CSM) were treated by a maneuver-dominated non-surgical therapy. Eighteen cases were recovered to grade E according to the criteria set by the American Spinal Injury Ass...Thirty cases of cervical spondylotic myelopathy (CSM) were treated by a maneuver-dominated non-surgical therapy. Eighteen cases were recovered to grade E according to the criteria set by the American Spinal Injury Association. The effect was definite. Indications and contraindications of the maneuver were proposed on the basis of the pathogenesis of CSM and the principles of this manual method.展开更多
The continuous assessment of child health services generates knowledge about the real needs of health services and actions in order to achieve better results and indicators. Thus, this study proposes to analyze child ...The continuous assessment of child health services generates knowledge about the real needs of health services and actions in order to achieve better results and indicators. Thus, this study proposes to analyze child health indicators, based on the information systems of health services. This is a descriptive, ecological epidemiological study carried out using secondary data from the following information systems: Information System on Live Births and Mortality Information System, in a historical series of ten years (2005-2014) of the state of Rio Grande do Norte and its health micro regions. It was observed a decrease in infant, neonatal, preterm, late neonatal and postnatal mortality coefficients when compared to the first and last year of the observed period, as well as the concentration of these in micro-regions of health. There was also a positive association between the early neonatal component and infant death. In this perspective, it is important to evaluate the quality of prenatal care, childbirth, puerperium, the first week of integral health and follow-up of the child’s growth and development, as well as to relate the socio-demographic conditions that may be associated with infant morbimortality. Therefore, the importance of situational health assessment studies for the effectiveness of care provided is highlighted, identifying weaknesses and monitoring the effectiveness of strategies.展开更多
Objective: To try to give an objective evaluation on the clinical research situation about acupuncture treatment of facial paralysis in the past 50 years and try to provide a possible evidence for clinical practice. M...Objective: To try to give an objective evaluation on the clinical research situation about acupuncture treatment of facial paralysis in the past 50 years and try to provide a possible evidence for clinical practice. Methods: All papers are searched and assessed according to the international standards and clinical epidemiology. Results: There is no systematic review (SR) on acupuncture treatment of facial palsy in a total of 1021 articles enlisted in the present paper. Comparing with the quantity of the descriptive studies and expert opinions (constituting 84.84%), that of the randomized controlled trials (RCTs) and clinical controlled trials (CCTs) is smaller (constituting 15.16%), besides, the quality of RCTs and CCTs is unsatisfactory. Conclusion: At present, the quantity and quality of studies with RCTs about acupuncture treatment of facial paralysis can’t meet the need of clinical practice, and in order to improve the therapeutic effect, a higher quality of RCTs and SR is required.展开更多
The problems of environmental geology refer to the geologic phenomena, incidents or accidents arising from action of environmental geology. The action is mainly the mutual influence between human activity and geologic...The problems of environmental geology refer to the geologic phenomena, incidents or accidents arising from action of environmental geology. The action is mainly the mutual influence between human activity and geologic environment. When human activity is uncoordinated with objective laws of the geologic environment, the problems of environmental geology or economic loss would occur.Therefore,the level and the changing orientation of geologic environmental quality are relative to the types of human activity,particularly relative to human intentional-activities of geologic environmental exploitation project. The geologic environment fitting to mining may not fit to urban construction,and fitting to water conservancy and hydroelectric projects may not fit to communication,and so on.Economy evaluation on the profit and loss of geologic environmental quality is exactly to depict the level of the profit and loss of geologic environmental quality about geologic environmental exploitation projects and the展开更多
AIM: To investigate the conformity of management practices of gastrointestinal hemorrhage in cirrhotic patients with relevant guidelines. METHODS: A questionnaire on the management of digestive bleeding was completed ...AIM: To investigate the conformity of management practices of gastrointestinal hemorrhage in cirrhotic patients with relevant guidelines. METHODS: A questionnaire on the management of digestive bleeding was completed for all consecutive cirrhotic patients admitted to 31 French hospitals. RESULTS: One hundred and twenty-six bleeding events were recorded. It was the first bleeding episode in 79 patients (63%), of whom 40 (51%) had a prior diagnosis of cirrhosis and 25 (32%) had previously undergone an endoscopy. The bleeding episode was a recurrence in 46 patients (37%). The median time between onset and admission was 4 h, but exceeded 12 h in 42% of cases. There was an agreement between centers forearly vasoactive drug administration (87% of cases), association with ligation (42%) more often than sclerosis (21%) at initial endoscopy, and antibiotic prophylaxis (64%). By contrast, prescription of beta-blockade alone or in combination (0 to 100%, P = 0.003) for secondary prophylaxis and lactulose (26% to 86%, P = 0.04), differed among centers. CONCLUSION: In French hospitals, management of bleeding related to portal hypertension in cirrhotic patients is generally in keeping with the consensus. Broad variability still remains concerning beta-blockade use for secondary prophylaxis. Screening for esophageal varices, the use of antibiotic prophylaxis and patients information need to be improved.展开更多
In the 1990s,the American Nurses Association established a certification program called the Magnet Recognition Program through the American Nurses Credentialing Centre(ANCC)to complement the quality care provided to p...In the 1990s,the American Nurses Association established a certification program called the Magnet Recognition Program through the American Nurses Credentialing Centre(ANCC)to complement the quality care provided to patients by hospitals.After the program was recognised,hospitals were identified as magnet hospitals[1].Some studies show that magnet hospitals provide a healthier working environment for nurses,accompanied by higher nurse satisfaction and better patient prognosis than non-magnet hospitals[2e5].The nursing work environment is the sum of various elements that directly or indirectly affect the patient care system[6].Improving the nursing work environment is a focal point and challenge for nursing administrators.Therefore,administrators in magnet hospitals usually apply a variety of assessment tools for effective evaluation of the nursing work environment to maintain and improve the health of the environment.展开更多
Purpose: This study is in an attempt to assess the diagnostic accuracy of infrared lightscanning by comparing with that of mammograpby- Methods: A total of 104 patients had been examined by both mammography and infrar...Purpose: This study is in an attempt to assess the diagnostic accuracy of infrared lightscanning by comparing with that of mammograpby- Methods: A total of 104 patients had been examined by both mammography and infrared lightscanning before surgery.All Patients were divided into two groups: cancer and non cancer. The diagnostic accuracy of these two modalities were calculated. Results: Of 104 Patients, 43 had breast cancer and 61 had benign lesions, the sensitivity and specificity for mammography were 84% and 83%, 82% and 77% for infrared lightscanning. The predictive values of positivity for mammograpby and lightscanning were 80% and 70%, the negative Predictive value for these two modalities were both 87%. Conclusion: Infrared lightscanning,being of assistance to mammography, could enhance sensitivity and predictive values of positivity in detecting breast cancer, especially, in mammographically dense breast.展开更多
BACKGROUND Believing or“credition”refers to psychological processes that integrate the cognitions and emotions that influence our behavior.In the credition model by Angel and Seitz,four parameters are postulated:pro...BACKGROUND Believing or“credition”refers to psychological processes that integrate the cognitions and emotions that influence our behavior.In the credition model by Angel and Seitz,four parameters are postulated:proposition,certainty,emotion and mightiness.It is assumed that believing processes are influenced by both the individual as well as socio-cultural factors and external circumstances.External or environmental circumstances can include threatening situations such as the ongoing pandemic.It has been hypothesized that believing processes related to the pandemic differ between individuals with bipolar disorder(BD)and healthy controls(HC).AIM To investigate credition in individuals with BD during the coronavirus disease 2019(COVID-19)pandemic.METHODS Psychiatrically stable individuals with BD(n=52)and age-and sex matched HC(n=52)participated in an online survey during the first lockdown of the COVID-19 pandemic.The survey took place between April 9^(th) and June 4^(th),2020,in Austria.Participants completed the Brief Symptom Inventory-18,the Beck Depression Inventory-Ⅱ,the Altman Self-Rating Mania Scale,the Pittsburgh Sleep Quality Index and a dedicated Believing Questionnaire assessing four parameters of credition(proposition,certainty,emotion and mightiness).The MAXQDA software was used to analyze the qualitative data.Statistical analyses included analyses of variance,a multivariate analysis of variance and a multivariate analysis of co-variance.RESULTS Individuals with BD reported significantly more negative propositions[F(1,102)=8.89,P=0.004,η2 p=0.08]and negative emotions[Welch´s F(1,82.46)=18.23,P<0.001,η2 p=0.18],while HC showed significantly more positive propositions[F(1,102)=7.78,P=0.006,η2 p=0.07]and emotions[F(1,102)=14.31,P<0.001,η2 p=0.12].In addition,individuals with BD showed a higher incongruence between their propositions and their emotions[F(1,102)=9.42,P=0.003,η2 p=0.08]and showed strong correlations between the parameters of the Believing Questionnaire and their psychiatric symptoms(r=0.51-0.77,all P<0.001).Positive as well as negative emotions and propositions were associated with scores measuring symptoms of depression,anxiety and sleep quality.CONCLUSION Believing parameters were associated with psychiatric symptoms in BD during the pandemic.Findings broaden knowledge about the susceptibility of believing processes for ambient challenges in individuals with BD.展开更多
Objective: TO evaluate the clinical value of MR multi-imaging technique in diagnosing and assessing the resectability of pancreato-biliary tumor. Methods The prospective diagnosis and resectability of 17 patients with...Objective: TO evaluate the clinical value of MR multi-imaging technique in diagnosing and assessing the resectability of pancreato-biliary tumor. Methods The prospective diagnosis and resectability of 17 patients with suspicious pancreato-biliary tumors were evaluated. Surgical findings and pathologic results confirmed pancreatic adenocarcinoma in 11 cases, cholangiocarcinoma in 4, and non-neoplastic lesion in 2. MR multi-imaging protocol, including MR cross-sectional imaging, us cholangiopancreatography (MRCP ), and three-dimensional dynamic contrast-enhanced MR portography (3D DCE MRP), were performed in all patients. Results MR multi-imaging technique allowed-correct diagnosing 15 of 17 (88. 2% ) patients with pancreato-biliary tumors. The accuracy in detecting the range of tumor invasion was 64. 4%. The sensitivity, speificity, accuracy, positive, and negative predictive value of MR multi-imaging technique in assessing the resectability of pancreato-biliary tumors were 83. 3%, 77. 8%, 80. 0%, 71. 4%, and 87. 5%, respectively. Conclusion MR multi-imaging technique can not only improve the diagnostic ability of pancreato-biliary tumor, but also assess the surgical reartability of the tumor. With the fast development of MR techniques, the diagnosing and pre-operative assessment of aoncreato-biliary tumor may be more simplified and efficient by using the non-invasive "all-in-one" method.展开更多
Acoustic Barkhausen Emission (ABE) and Electromagnetic Barkhausen Emission (EBE) have been measured. Explanations of the response of nickel to an applied magnetic field are considered using energy density diagrams and...Acoustic Barkhausen Emission (ABE) and Electromagnetic Barkhausen Emission (EBE) have been measured. Explanations of the response of nickel to an applied magnetic field are considered using energy density diagrams and critical fields deduced using Kersten's modified theory. These theoretical models are correlated with ABE and EBE measurements, providing further confirmation of the origins of ABE being non-180° domain wall motion. This paper also shows that the motion of domain walls, on increasing the magnetising fields from saturation to satu -ration, follows the sequence of 71°-180° - 109°. Values of critical fields correponding to 71°, 180° and 109° wall motions in nickel are determined using these techniques .展开更多
Objective. To evaluate the applicability of Porthsmouth modified physiological and operative severity score for the enumeration of mortality and morbidity ( P- POSSUM) in predicting the mortality of the patients und...Objective. To evaluate the applicability of Porthsmouth modified physiological and operative severity score for the enumeration of mortality and morbidity ( P- POSSUM) in predicting the mortality of the patients undergoing hip joint arthroplasty. Methods: A total of 141 patients (75 males and 66 females, aged 63.22 years ± 14.45 years on an average ) undergoing hip joint arthroplasty during January 2002 and March 2005 were studied retrospectively with P-POSSUM. Their average physiological score and operative severity score were 17.48 ±5.16 and 12.43 ±3.05, respectively. The predicted postoperative mortality with P-POSSUM was compared with the observed value. Subgroup analysis was performed to investigate the predictive capability of P- POSSUM. POSSUM scoring system was used as the control. Results: Three patients died after operation in this study actually. The average physiological scores were 32.33±9.87 in the death group and 17.16±4.56 in the survival group. The former was obviously higher than the latter, which showed statistical difference between the two groups (Wilcoxon rank sum test, P〈0.05). Perfect agreement was found between the observed death number and the predicted death number calculated by P-POSSUM ( Cochran-ManteI-Haenszel %2 test, P 〉 0.05), though POSSUM overestimated the overall mortality. Conclusions : P-POSSUM can predict the mortality accurately in the patients undergoing hip joint arthroplasty, which is superior to POSSUM.展开更多
Objective: To review year 1957-2005 literature on acupuncture and moxibustion and explore point selection and methods for acupuncture-moxibustion treatment of diarrhea in order to provide objective and reliable data ...Objective: To review year 1957-2005 literature on acupuncture and moxibustion and explore point selection and methods for acupuncture-moxibustion treatment of diarrhea in order to provide objective and reliable data for research on acupuncture and moxibustion standardization. Methods: A comprehensive analysis was made by a method of metrological analysis according to the data from "China modem acupuncture-moxibustion information database". Results: Points Zusanli (ST 36), Tianshu (ST 25) and Shenque (CV 8) were the most frequently used and the optimal combination for acupuncture-moxibustion treatment of diarrhea. Chronic adult diarrhea was often treated by moxibustion. Acute childhood diarrhea was often treated by point application and injection. Conclusion: Diarrhea is often treated by needling and moxaing methods in acupuncture-moxibustion treatment. It is proposed to use Zusanli (ST 36) and Tianshu (ST 25) as a basic prescription for acupuncture-moxibustion treatment of diarrhea and to select points according to the syndrome.展开更多
Recent rapid industrialization and urbanization in the Pearl River Delta (PRD) is character-ized by broad geographical dispersion, diversities of scales and technological levels, and the proliferation of small-scale t...Recent rapid industrialization and urbanization in the Pearl River Delta (PRD) is character-ized by broad geographical dispersion, diversities of scales and technological levels, and the proliferation of small-scale township and individual enterprises. Such a pattern of fast development has brought widespread environmental perturbation that is becoming difficult to contain or control. This study surveys the present environmental status in urban areas of PRD, assesses the trends of environmental quality, and evaluates the ecological impacts of development in the region.展开更多
基金Supported by Regional Project of National Natural Science Foundation of China (72064020).
文摘In order to fully understand the development trends and achievements of tourism suitability evaluation at home and abroad, this paper reviews the relevant literature of tourism suitability evaluation from five aspects-tourism climate, tourism environment, tourism resources, tourism destination and evaluation indicator, and gives discussions.
文摘Screening and early diagnosis of gastric cancer play important roles in reducing the mortality of gastric cancer. A vast amount of study data on gastric cancer screening and early diagnosis has been accumulated in and out of China in the past decades. The practice of gastric cancer screening has also been efficiently carried out in different countries and regions. However, no widely accepted principle of population screening for gastric cancer has been developed yet. Screening for gastric cancer requires extensive exploration both theoretically and practically. This article focuses on the method and program of gastric cancer screening based on population. Moreover, the current situation of gastric cancer screening and its evaluation are evaluated.
基金supported by the National Research Foundation of Korea(NRF-2019R1I1A3A01059093)。
文摘Objectives:This study was conducted to investigate the current status of handoffs,perception of patient safety culture,and degrees of handoff evaluation in small and medium-sized hospitals and identified factors that make a difference in handoff evaluation.Methods:This is a descriptive study.425 nurses who work at small and medium-sized hospitals in South Korea were included in our study.They completed a set of self-reporting questionnaires that evaluated demographic data,handoff-related characteristics,perception of patient safety culture,and handoff evaluation.Results:Results showed that the overall score of awareness of a patient safety culture was 3.65±0.45,the level was moderate.The score of handoff evaluation was 5.24±0.85.Most nurses experienced errors in handoff and most nurses had no guidelines and checklist in the ward.Handoff evaluation differed significantly according to the level of education,work patterns,duration of hospital employment,handoff method,degree of satisfaction with the current handoff method,errors occurring at the time of handoff,handoff guidelines,and appropriateness of handoff education time(P<0.05).Conclusion:For handoff improvement,guidelines and standards should be established.It is necessary to develop a structured handoff education system.And formal handoff education should be implemented to spread knowledge uniformly.
文摘BACKGROUND:In Hong Kong, the reorganization of healthcare frame work for better utilization of resources has led to an increase in the frequency of inter-facility transport in recent years. An Inter-Facility Transport Triage Guideline (IFTTG) was introduced and evaluated on its compliance and performance. This study aimed to evaluate the compliance to the IFTTG and performance of inter-facility transport after the IFTTG was implemented. METHODS: The patients who required emergency IFT with accompanying personnel in two consecutive periods (pre-implementation period: January 1,2006 to April 30, 2006; post-implementation period: May 1,2006 to August 31,2006) were included. The compliance to pre-transport triage and transport team configuration was evaluated by a review panel with eight performance indicators identified. The performance indicators were compared individually and as an overall score. RESULTS:Sixty-eight (26 in the pre-implementation period and 42 in the post-implementation period) IFTs were reviewed. There was demonstrable improvement on compliance to the IFTTG. The appropriateness of pre-transport triage increased from 34.6% to 54.8% whereas appropriateness of transport team configuration rose significantly from 73.1% to 92.9% (P〈0.05). Staff performance on individual IFT performance indicator was satisfactory in both periods and the means of overall score on performance indicators were 7.12 and 7.29 respectively. The most improved performance indicator was the appropriateness of transport team configuration. CONCLUSIONS: The compliance and performance with the newly implemented IFTTG were satisfactory. However, staff comment and satisfaction with the use of the new guideline should be collected so as to achieve continuous quality improvement.
文摘Thirty cases of cervical spondylotic myelopathy (CSM) were treated by a maneuver-dominated non-surgical therapy. Eighteen cases were recovered to grade E according to the criteria set by the American Spinal Injury Association. The effect was definite. Indications and contraindications of the maneuver were proposed on the basis of the pathogenesis of CSM and the principles of this manual method.
文摘The continuous assessment of child health services generates knowledge about the real needs of health services and actions in order to achieve better results and indicators. Thus, this study proposes to analyze child health indicators, based on the information systems of health services. This is a descriptive, ecological epidemiological study carried out using secondary data from the following information systems: Information System on Live Births and Mortality Information System, in a historical series of ten years (2005-2014) of the state of Rio Grande do Norte and its health micro regions. It was observed a decrease in infant, neonatal, preterm, late neonatal and postnatal mortality coefficients when compared to the first and last year of the observed period, as well as the concentration of these in micro-regions of health. There was also a positive association between the early neonatal component and infant death. In this perspective, it is important to evaluate the quality of prenatal care, childbirth, puerperium, the first week of integral health and follow-up of the child’s growth and development, as well as to relate the socio-demographic conditions that may be associated with infant morbimortality. Therefore, the importance of situational health assessment studies for the effectiveness of care provided is highlighted, identifying weaknesses and monitoring the effectiveness of strategies.
文摘Objective: To try to give an objective evaluation on the clinical research situation about acupuncture treatment of facial paralysis in the past 50 years and try to provide a possible evidence for clinical practice. Methods: All papers are searched and assessed according to the international standards and clinical epidemiology. Results: There is no systematic review (SR) on acupuncture treatment of facial palsy in a total of 1021 articles enlisted in the present paper. Comparing with the quantity of the descriptive studies and expert opinions (constituting 84.84%), that of the randomized controlled trials (RCTs) and clinical controlled trials (CCTs) is smaller (constituting 15.16%), besides, the quality of RCTs and CCTs is unsatisfactory. Conclusion: At present, the quantity and quality of studies with RCTs about acupuncture treatment of facial paralysis can’t meet the need of clinical practice, and in order to improve the therapeutic effect, a higher quality of RCTs and SR is required.
文摘The problems of environmental geology refer to the geologic phenomena, incidents or accidents arising from action of environmental geology. The action is mainly the mutual influence between human activity and geologic environment. When human activity is uncoordinated with objective laws of the geologic environment, the problems of environmental geology or economic loss would occur.Therefore,the level and the changing orientation of geologic environmental quality are relative to the types of human activity,particularly relative to human intentional-activities of geologic environmental exploitation project. The geologic environment fitting to mining may not fit to urban construction,and fitting to water conservancy and hydroelectric projects may not fit to communication,and so on.Economy evaluation on the profit and loss of geologic environmental quality is exactly to depict the level of the profit and loss of geologic environmental quality about geologic environmental exploitation projects and the
基金Supported by grants from the French Society of Gastroenterology
文摘AIM: To investigate the conformity of management practices of gastrointestinal hemorrhage in cirrhotic patients with relevant guidelines. METHODS: A questionnaire on the management of digestive bleeding was completed for all consecutive cirrhotic patients admitted to 31 French hospitals. RESULTS: One hundred and twenty-six bleeding events were recorded. It was the first bleeding episode in 79 patients (63%), of whom 40 (51%) had a prior diagnosis of cirrhosis and 25 (32%) had previously undergone an endoscopy. The bleeding episode was a recurrence in 46 patients (37%). The median time between onset and admission was 4 h, but exceeded 12 h in 42% of cases. There was an agreement between centers forearly vasoactive drug administration (87% of cases), association with ligation (42%) more often than sclerosis (21%) at initial endoscopy, and antibiotic prophylaxis (64%). By contrast, prescription of beta-blockade alone or in combination (0 to 100%, P = 0.003) for secondary prophylaxis and lactulose (26% to 86%, P = 0.04), differed among centers. CONCLUSION: In French hospitals, management of bleeding related to portal hypertension in cirrhotic patients is generally in keeping with the consensus. Broad variability still remains concerning beta-blockade use for secondary prophylaxis. Screening for esophageal varices, the use of antibiotic prophylaxis and patients information need to be improved.
文摘In the 1990s,the American Nurses Association established a certification program called the Magnet Recognition Program through the American Nurses Credentialing Centre(ANCC)to complement the quality care provided to patients by hospitals.After the program was recognised,hospitals were identified as magnet hospitals[1].Some studies show that magnet hospitals provide a healthier working environment for nurses,accompanied by higher nurse satisfaction and better patient prognosis than non-magnet hospitals[2e5].The nursing work environment is the sum of various elements that directly or indirectly affect the patient care system[6].Improving the nursing work environment is a focal point and challenge for nursing administrators.Therefore,administrators in magnet hospitals usually apply a variety of assessment tools for effective evaluation of the nursing work environment to maintain and improve the health of the environment.
文摘Purpose: This study is in an attempt to assess the diagnostic accuracy of infrared lightscanning by comparing with that of mammograpby- Methods: A total of 104 patients had been examined by both mammography and infrared lightscanning before surgery.All Patients were divided into two groups: cancer and non cancer. The diagnostic accuracy of these two modalities were calculated. Results: Of 104 Patients, 43 had breast cancer and 61 had benign lesions, the sensitivity and specificity for mammography were 84% and 83%, 82% and 77% for infrared lightscanning. The predictive values of positivity for mammograpby and lightscanning were 80% and 70%, the negative Predictive value for these two modalities were both 87%. Conclusion: Infrared lightscanning,being of assistance to mammography, could enhance sensitivity and predictive values of positivity in detecting breast cancer, especially, in mammographically dense breast.
文摘BACKGROUND Believing or“credition”refers to psychological processes that integrate the cognitions and emotions that influence our behavior.In the credition model by Angel and Seitz,four parameters are postulated:proposition,certainty,emotion and mightiness.It is assumed that believing processes are influenced by both the individual as well as socio-cultural factors and external circumstances.External or environmental circumstances can include threatening situations such as the ongoing pandemic.It has been hypothesized that believing processes related to the pandemic differ between individuals with bipolar disorder(BD)and healthy controls(HC).AIM To investigate credition in individuals with BD during the coronavirus disease 2019(COVID-19)pandemic.METHODS Psychiatrically stable individuals with BD(n=52)and age-and sex matched HC(n=52)participated in an online survey during the first lockdown of the COVID-19 pandemic.The survey took place between April 9^(th) and June 4^(th),2020,in Austria.Participants completed the Brief Symptom Inventory-18,the Beck Depression Inventory-Ⅱ,the Altman Self-Rating Mania Scale,the Pittsburgh Sleep Quality Index and a dedicated Believing Questionnaire assessing four parameters of credition(proposition,certainty,emotion and mightiness).The MAXQDA software was used to analyze the qualitative data.Statistical analyses included analyses of variance,a multivariate analysis of variance and a multivariate analysis of co-variance.RESULTS Individuals with BD reported significantly more negative propositions[F(1,102)=8.89,P=0.004,η2 p=0.08]and negative emotions[Welch´s F(1,82.46)=18.23,P<0.001,η2 p=0.18],while HC showed significantly more positive propositions[F(1,102)=7.78,P=0.006,η2 p=0.07]and emotions[F(1,102)=14.31,P<0.001,η2 p=0.12].In addition,individuals with BD showed a higher incongruence between their propositions and their emotions[F(1,102)=9.42,P=0.003,η2 p=0.08]and showed strong correlations between the parameters of the Believing Questionnaire and their psychiatric symptoms(r=0.51-0.77,all P<0.001).Positive as well as negative emotions and propositions were associated with scores measuring symptoms of depression,anxiety and sleep quality.CONCLUSION Believing parameters were associated with psychiatric symptoms in BD during the pandemic.Findings broaden knowledge about the susceptibility of believing processes for ambient challenges in individuals with BD.
文摘Objective: TO evaluate the clinical value of MR multi-imaging technique in diagnosing and assessing the resectability of pancreato-biliary tumor. Methods The prospective diagnosis and resectability of 17 patients with suspicious pancreato-biliary tumors were evaluated. Surgical findings and pathologic results confirmed pancreatic adenocarcinoma in 11 cases, cholangiocarcinoma in 4, and non-neoplastic lesion in 2. MR multi-imaging protocol, including MR cross-sectional imaging, us cholangiopancreatography (MRCP ), and three-dimensional dynamic contrast-enhanced MR portography (3D DCE MRP), were performed in all patients. Results MR multi-imaging technique allowed-correct diagnosing 15 of 17 (88. 2% ) patients with pancreato-biliary tumors. The accuracy in detecting the range of tumor invasion was 64. 4%. The sensitivity, speificity, accuracy, positive, and negative predictive value of MR multi-imaging technique in assessing the resectability of pancreato-biliary tumors were 83. 3%, 77. 8%, 80. 0%, 71. 4%, and 87. 5%, respectively. Conclusion MR multi-imaging technique can not only improve the diagnostic ability of pancreato-biliary tumor, but also assess the surgical reartability of the tumor. With the fast development of MR techniques, the diagnosing and pre-operative assessment of aoncreato-biliary tumor may be more simplified and efficient by using the non-invasive "all-in-one" method.
文摘Acoustic Barkhausen Emission (ABE) and Electromagnetic Barkhausen Emission (EBE) have been measured. Explanations of the response of nickel to an applied magnetic field are considered using energy density diagrams and critical fields deduced using Kersten's modified theory. These theoretical models are correlated with ABE and EBE measurements, providing further confirmation of the origins of ABE being non-180° domain wall motion. This paper also shows that the motion of domain walls, on increasing the magnetising fields from saturation to satu -ration, follows the sequence of 71°-180° - 109°. Values of critical fields correponding to 71°, 180° and 109° wall motions in nickel are determined using these techniques .
文摘Objective. To evaluate the applicability of Porthsmouth modified physiological and operative severity score for the enumeration of mortality and morbidity ( P- POSSUM) in predicting the mortality of the patients undergoing hip joint arthroplasty. Methods: A total of 141 patients (75 males and 66 females, aged 63.22 years ± 14.45 years on an average ) undergoing hip joint arthroplasty during January 2002 and March 2005 were studied retrospectively with P-POSSUM. Their average physiological score and operative severity score were 17.48 ±5.16 and 12.43 ±3.05, respectively. The predicted postoperative mortality with P-POSSUM was compared with the observed value. Subgroup analysis was performed to investigate the predictive capability of P- POSSUM. POSSUM scoring system was used as the control. Results: Three patients died after operation in this study actually. The average physiological scores were 32.33±9.87 in the death group and 17.16±4.56 in the survival group. The former was obviously higher than the latter, which showed statistical difference between the two groups (Wilcoxon rank sum test, P〈0.05). Perfect agreement was found between the observed death number and the predicted death number calculated by P-POSSUM ( Cochran-ManteI-Haenszel %2 test, P 〉 0.05), though POSSUM overestimated the overall mortality. Conclusions : P-POSSUM can predict the mortality accurately in the patients undergoing hip joint arthroplasty, which is superior to POSSUM.
文摘Objective: To review year 1957-2005 literature on acupuncture and moxibustion and explore point selection and methods for acupuncture-moxibustion treatment of diarrhea in order to provide objective and reliable data for research on acupuncture and moxibustion standardization. Methods: A comprehensive analysis was made by a method of metrological analysis according to the data from "China modem acupuncture-moxibustion information database". Results: Points Zusanli (ST 36), Tianshu (ST 25) and Shenque (CV 8) were the most frequently used and the optimal combination for acupuncture-moxibustion treatment of diarrhea. Chronic adult diarrhea was often treated by moxibustion. Acute childhood diarrhea was often treated by point application and injection. Conclusion: Diarrhea is often treated by needling and moxaing methods in acupuncture-moxibustion treatment. It is proposed to use Zusanli (ST 36) and Tianshu (ST 25) as a basic prescription for acupuncture-moxibustion treatment of diarrhea and to select points according to the syndrome.
文摘Recent rapid industrialization and urbanization in the Pearl River Delta (PRD) is character-ized by broad geographical dispersion, diversities of scales and technological levels, and the proliferation of small-scale township and individual enterprises. Such a pattern of fast development has brought widespread environmental perturbation that is becoming difficult to contain or control. This study surveys the present environmental status in urban areas of PRD, assesses the trends of environmental quality, and evaluates the ecological impacts of development in the region.