Application effect of quality control circle in postoperative functional exercise compliance of breast neoplasms patients:a meta-analysis

Background:Good adherence to post-operative exercise is crucial for long-term exercise intervention programs aimed at improving compliance,motivation for functional exercise,and quality of life among breast cancer patients.This study aims to evaluate the application effect of quality control circles on postoperative functional exercise compliance in breast neoplasm patients.Methods:A comprehensive search was conducted in CNKI,Wanfang,VIP,CBM,PubMed,Cochrane Library,Web of Science and CINAHL databases from their establishment to May 06,2023.Manual search and backtracking of relevant literature were also conducted.The search terms included a combination of subject terms and free words.Meta-analysis was performed using RevMan 5.4 software on eligible literature.Results:Initially,517 papers were retrieved,and after removing duplicates 238 papers using NoteExpress software,279 titles and abstracts were reviewed.Subsequently,225 non-compliant papers were excluded,leaving 54 full texts to be read.After excluding 38 non-compliant papers,16 eligible papers were included for Meta-analysis.These papers comprised a total of 1,342 patients(679 in the test group and 663 in the control group).The heterogeneity test using a fixed effects model showed P=0.22 and I2=21%.The Meta-analysis results demonstrated that the implementation of quality control circles alongside usual care significantly improved compliance with postoperative functional exercise in breast cancer patients(odds ratio=6.68,95%confidence interval(4.97,8.98),P<0.00001).Conclusion:Quality control circles activities can effectively enhance compliance with post-operative functional exercise among breast cancer patients,aiding in the recovery of affected limb function,improvement of self-care ability,and early reintegration into society and normal life,thereby enhancing quality of life.It is important to continually accumulate experience in applying relevant quality control circles activities in clinical work and promptly enhance the level of care accordingly,as the functional exercise of breast cancer patients after surgery involves a long-term and gradual improvement process.

Hygienic and Dietary Measures in Cameroonian Hypertensive Patients Followed at the Douala General Hospital: Knowledge, Compliance and Effect on Blood Pressure Control

Introduction: The management of hypertension is mostly based on pharmacotherapy and hygienic and dietary measures (HDMs) for which little data is available in Cameroon. The concern to improve the quality of life of hypertensive patients led us to study the knowledge, compliance and effect of HDMs among Cameroonian hypertensive patients. Methods: This was a cross-sectional study carried out at the Douala General Hospital;the census of patients was carried out from 05 March to 10 May 2018. The data evaluated were knowledge and compliance with HDMs with an inference of their effect on blood pressure control. Results: We recruited 330 participants at mean age of 60 ± 11 years, 37.9% men;57.3% with blood pressure (BP) controlled. Out of 330 subjects, 308 (93.3%) who had been educated about dietary health measures for hypertension were assessed on knowledge, compliance and effect of these measures against 22 (6.7%) who had never heard about them. Around 85.7% of participants had good knowledge of HDMs and 78.9% had good compliance with them. There was no statistically significant influence of knowledge and compliance with HDMs on blood pressure control. Conclusion: The level of knowledge and adherence to HDMs of hypertensive patients at the Douala General Hospital was appreciable. It is however appropriate for physicians to intensify patient education on HDMs and BP control.

Impact of designed infection control educational program on nurses’knowledge and compliance with standard precautions at maternity hospitals

Objectives:This study aimed to assess the nurses’knowledge and compliance with infection control standard precautions and evaluate the impact of the designed infection control educational program on nurses’knowledge and compliance with standard precautions at the maternity hospital.Materials and Methods:A quasi‑experimental one‑group pretest‑posttest design was used on convenient sample of 60 nurses working at Obstetrics and Gynecological hospital in Cairo University Hospital,Kasr El Ainy,who received“designed infection control educational program”for 6 months.The data were collected through the questionnaire comprising demographics,knowledge,and compliance with standard precautions questionnaire.The nurses’knowledge and compliance score were compared before and after intervention.Results:The studied nurses had higher level of knowledge(85.3%)and compliance(92.8%)regarding infection control standard precautions after the educational program compared to before the program.The results revealed statistically significant difference between before and after the program regarding nurses’knowledge score(15.5±2.9 vs.17.1±1.6,P<0.001)and compliance score(58.5±13.2 vs.74.3±5.1,P<0.001).In addition,there was insignificant relation between nurses’knowledge and compliance with standard precautions both before(r=0.952,P=0.474)and after educational program(r=0.164,P=0.223).Conclusion:The nurses’level of knowledge and compliance regarding infection control standard precautions was significantly improved after the program.Therefore,it is recommended that periodical educational programs regarding the standard precautions of infection control are essential for nurses at maternity hospital.

Unified Vibration Suppression and Compliance Control for Flexible Joint Robot

An adaptive control scheme is presented,which can simultaneously realize vibration suppression and compliance control for flexible joint robot(FJR).The proposed control scheme provides a unified formulation for both vibration suppression mode,where FJR tracks the desired position with little vibration,and compliance mode,in which FJR presents passive.Instead of designing multiple controllers and switching between them,both modes are integrated into a single controller,and the transition between two modes is smooth and stable.The stability of the closed-loop system is theoretically proven via the Lyapunov method,with the considering the dynamics uncertainties in both link side and motor side.Simulation results are presented to illustrate good performances of the proposed control scheme.

Joint space compliance control for a hydraulic quadruped robot based on force feedback

In the realm of quadruped robot locomotion,compliance control is imperative to handle impacts when negotiating unstructured terrains.At the same time,kinematic tracking accuracy should be guaranteed during locomotion.To meet both demands,ajoint space compliance controller is designed,so that compliance can be achieved in stance phase while position tracking performance can be guaranteed in swing phase.Unlike operational space compliance control,the joint space compliance control method is easy to implement and does not depend on robot dynamics.As for each joint actuator,high performance force control is of great importance for compliance design.Therefore,a nonlinear PI controller based on feedback linearization is proposed for the hydraulic actuator force control.Besides,an outer position loop（compliance loop）is closed for each joint.Experiments are carried out to verify the force controller and compliance of the hydraulic actuator.The robot leg compliance is assessed by a virtual prototyping simulation.

Factors Associated with Compliance with Infection Control Guidelines in the Management of Labour by Healthcare Workers at Mulago Hospital, Uganda

Globally, infections acquired during childbirth contribute to one tenth of the maternal deaths annually [1] [2]. Factors predisposing to high risks of puerperal infections include non-compliance with Standard Precautions of Infection Control (SPIC), unhygienic births by unskilled birth attendants, multiple vaginal examinations, prolonged labour and premature rapture of membranes [1]. The main purpose of this study was to determine factors associated with compliance to standard precautions of infection control the management of labour by healthcare workers in Mulago Hospital to generate information, which may be used in infection control and prevention practices. A cross-sectional study utilizing a quantitative approach was conducted among 115 healthcare workers. Consecutive sampling was done to include respondents in the study. Data were collected by direct observation and researcher administered questionnaires. Data were coded and entered into the computer using SPSS version 20 with programmed quality control checks. Descriptive data analyses, frequencies, cross tabulations and logistic regression analysis were the major statistical methods used. 103 healthcare workers were involved in the study, where 74% were females. Overall compliance was at 52%, although it varied across domains. The majority of the healthcare workers (95.1%) did not comply with hand hygiene. Being a male was associated with low compliance scores a cross most domains. One of the hospital factors which was significantly associated with compliance to hand hygiene was having had an in-service training with p = 0.008 and p = 0.012 at multivariate analysis. Overall compliance to standard precautions of infection control was low compared to the Centre for Disease Control (CDC) recommendation. The findings in this study provide insight into individual and hospital related factors associated with compliance with standard precautions of infection control in the management of labour. There is an urgent need to put up interventions to improve on compliance with SPIC in management of labour among all healthcare workers.

Compliance motion control of the hydraulic dual-arm manipulator with adaptive mass estimation of unknown object

Given the limited operating ability of a single robotic arm,dual-arm collaborative operations have become increasingly prominent.Compared with the electrically driven dual-arm manipulator,due to the unknown heavy load,difficulty in measuring contact forces,and control complexity during the closed-chain object transportation task,the hydraulic dual-arm manipulator(HDM)faces more difficulty in accurately tracking the desired motion trajectory,which may cause object deformation or even breakage.To overcome this problem,a compliance motion control method is proposed in this paper for the HDM.The mass parameter of the unknown object is obtained by using an adaptive method based on velocity error.Due to the difficulty in obtaining the actual internal force of the object,the pressure signal from the pressure sensor of the hydraulic system is used to estimate the contact force at the end-effector(EE)of two hydraulic manipulators(HMs).Further,the estimated contact force is used to calculate the actual internal force on the object.Then,a compliance motion controller is designed for HDM closed-chain collaboration.The position and internal force errors of the object are reduced by the feedback of the position,velocity,and internal force errors of the object to achieve the effect of the compliance motion of the HDM,i.e.,to reduce the motion error and internal force of the object.The required velocity and force at the EE of the two HMs,including the position and internal force errors of the object,are inputted into separate position controllers.In addition,the position controllers of the two individual HMs are designed to enable precise motion control by using the virtual decomposition control method.Finally,comparative experiments are carried out on a hydraulic dual-arm test bench.The proposed method is validated by the experimental results,which demonstrate improved object position accuracy and reduced internal force.

Design and implementation of robot serial integrated rotary joint with safety compliance

In order to guarantee safety and stability during physical human-robot-interaction(p HRI) in the occasion of service or industrial operation, a serial integrated rotary joint with the characteristics of passive and active compliance is proposed. Passive compliance is achieved by a designed elastic element, such that the compliant joint may minimize large force which occurs during accidental impacts and, further, may offer more accurate and stable force control and a capacity for energy storage. Meanwhile, the modeling of the compliant joint is comprehensively analyzed, including the effect of the motor model on the overall control system. In order to realize the active compliance, a new method of impedance control is proposed. On the basis of PD control, a more compliant impedance controller is introduced. Experimental results show that the serial integrated rotary joint can provide more effective safety compliance during physical interaction, which has also been well applied in our designed massage robot and rehabilitation robot.

Force-feedback based active compliant position control strategy for a hydraulic quadruped robot

Most existing legged robots are developed under laboratory environments and, corre- spondingly, have good performance of locomotion. The robots＇ ability of walking on rough terrain is of great importance but is seldom achieved. Being compliant to external unperceived impacts is cru- cial since it is unavoidable that the slip, modeling errors and imprecise information of terrain will make planned trajectories to be followed with errors and unpredictable contacts. The impedance control gives an inspiration to realize an active compliance which allows the legged robots to follow reference trajectories and overcome external disturbances. In this paper, a novel impedance force/ position control scheme is presented, which is based on Cartesian force measurement of leg＇ s end effector for our hydraulic quadruped robot The simulation verifies the efficiency of the impedance model, and the experimental results at the end demonstrate the feasibility of the proposed control scheme.

Knowledge and awareness of infection control practices among nursing professionals:A cross-sectional survey from South Asia and the Middle East

BACKGROUND The proficiency of nursing professionals in the infection prevention and control(IPC)practices is a core component of the strategy to mitigate the challenge of healthcare associated infections.AIM To test knowledge of nurses working in intensive care units(ICU)in South Asia and Middle East countries on IPC practices.METHODS An online self-assessment questionnaire based on various aspects of IPC practices was conducted among nurses over three weeks.RESULTS A total of 1333 nurses from 13 countries completed the survey.The average score was 72.8%and 36%of nurses were proficient(mean score>80%).43%and 68.3%of respondents were from government and teaching hospitals,respectively.79.2%of respondents worked in<25 bedded ICUs and 46.5%in closed ICUs.Statistically,a significant association was found between the knowledge and expertise of nurses,the country’s per-capita income,type of hospitals,accreditation and teaching status of hospitals and type of ICUs.Working in high-and upper-middleincome countries(β=4.89,95%CI:3.55 to 6.22)was positively associated,and the teaching status of the hospital(β=-4.58,95%CI:-6.81 to-2.36)was negatively associated with the knowledge score among respondents.CONCLUSION There is considerable variation in knowledge among nurses working in ICU.Factors like income status of countries,public vs private and teaching status of hospitals and experience are independently associated with nurses’knowledge of IPC practices.

前馈控制理论护理在乙型肝炎肝硬化患者遵医行为及生存质量中的应用效果

目的探究前馈控制理论护理对乙型肝炎肝硬化患者遵医行为及生存质量的应用效果。方法选取2022年2月至2023年10月南通大学附属南通第三医院的110例乙型肝炎肝硬化患者作为研究对象,按照随机数字表法将其分为对照组和观察组,各55例。对照组采用常规护理,观察组采用前馈控制理论护理,干预2个月后比较两组遵医行为、心理状态评分及生存质量。结果干预后,两组遵医行为评分指标高于干预前,且观察组高于对照组,差异有统计学意义(P<0.05);干预后,两组90项症状自评量表评分低于干预前,且观察组低于对照组,差异有统计学意义(P<0.05)。干预后,两组肝病生存质量调查表评分高于干预前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论乙型肝炎肝硬化患者护理中接受前馈控制护理,提高遵医行为,改善患者心理状态的同时,患者生存质量有所提升,预后效果更佳,可广泛应用于临床中。

面向穴位按摩机械臂的阻抗控制算法研究

针对机械臂在穴位按摩使用场景中末端接触力的控制问题,提出了一种基于位置控制的自适应阻抗控制算法,并对该算法进行了相关的理论分析以及仿真平台实验验证。为解决机械臂在工作过程中环境刚度未知且干扰因素较多的问题,在自适应阻抗控制算法的基础上引入模糊控制器以调节阻抗参数,使机械臂在精确跟踪轨迹和期望力的基础上,动态性能得到进一步提高。仿真实验结果表明:该算法优化了机械臂在阻抗控制模式下末端力的跟踪精度,提高了系统的鲁棒性和稳定性,进而提升了机械臂完成穴位按摩工作的效果。

品管圈在提升低于3岁住院患儿雾化吸入依从率中的应用

目的探讨品管圈(Quality Control Circle,QCC)管理方法在提高住院患儿雾化吸入依从率的应用价值。方法济宁市第一人民医院儿科雾化吸入QCC管理实施时间自2020年6月开始,选取QCC实施前(2020年4月至2020年5月)0~3岁住院进行雾化吸入治疗的患儿454人以及QCC实施后(2020年11月至12月)0~3岁住院进行雾化吸入治疗的患儿496人进行研究,比较两组住院患儿在雾化吸入治疗中的哭闹发生率、按时雾化率、家属拒绝情况、雾化中断情况,以及总体雾化依从率。结果在QCC实施后,0~3岁住院患儿雾化吸入哭闹发生率下降(23.33%vs 5.04%)、未按时雾化率下降(16.08%vs 2.82%),总体雾化依从率提升(56.00%vs 88.90%),差异有统计学意义(P<0.001);QCC实施后患儿家属满意度评分提升(t=5.95,P<0.001)。结论实施QCC能够提升低于3岁住院患儿雾化吸入依从率,提升患者家属满意度。

临床药师对住院高血压患者实施标准化管理的实践

高血压是一种常见慢性病,若未及时有效治疗,可损伤心、脑、肾这些重要脏器的结构和功能,其导致的临床并发症不仅致残、致死率高,且消耗很多的医疗和社会资源,给家庭和社会造成巨大的负担。高血压患者通常需要长时间的标准化治疗方能达到控制血压,延缓、降低靶器官损害及临床并发症发生等目的;但由于患者难以得到科学、系统、标准化的药学服务,因此该类患者对疾病、药物治疗知识认知不足,不合理用药情况多见,存在大量误区,导致药物治疗的依从性差,最终无法达到降压目标,影响整体治疗效果。基于以上原因,笔者在住院高血压患者标准化管理方面进行了研究并进行总结,旨在探索建立针对高血压患者的药学服务模式,为今后临床药师开展慢病管理工作提供参考。

IMB模型框架下小组个性化干预对PE患者自护能力、血压控制的影响

目的:探究IMB模型框架下小组个性化干预对子痫前期(PE)患者自护能力、血压控制的影响。方法:随机数字表法将2021年3月-2023年2月本院就诊的PE患者200例分为观察组与对照组各100例,两组均予以常规护理干预,观察组同时予以信息-动机-行为技巧(IMB)模型框架下小组个性化护理干预,均干预至妊娠分娩。比较两组自护能力[自我护理能力测定量表(ESCA)评分]、负性心理[焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分]、治疗依从性、血压控制情况及分娩结局。结果:干预后观察组ESCA各维度评分均高于对照组,SDS(42.55±4.28分)、SAS(43.39±4.21分)评分均低于对照组(48.36±4.33分、47.57±4.36分),治疗依从性(94.0%)高于对照组(83.0%),收缩压及舒张压(127.6±7.5 mmHg、93.5±4.3 mmHg)低于对照组(142.5±8.4mmHg、104.6±5.5 mmHg),不良分娩结局低于对照组(均P<0.05)。结论:对PE患者实施IMB模型框架下小组个性化干预可提高患者的自护能力与治疗依从性,减轻负性心理,有利于血压控制及改善妊娠结局,提高了护理效果。

PDCA管理循环对医务人员手卫生及院感率的影响

目的探讨“计划-实施-检查-处理”(plan-docheck-act,PDCA)管理循环方式对医务人员手卫生依从性及院感发生率的影响。方法随机选取茂名市人民医院50名医务人员实施PDCA管理循环。比较实施前(2021年1—12月,对照组)、实施后(2022年1—12月,观察组)医务人员的手卫生依从性、手卫生知识考试成绩、合格率、院感发生率。结果观察组在手卫生依从性方面表现卓越,接触患者前后、周围环境后、无菌操作前、体液暴露后的洗手率分别为88.89%、93.06%、61.67%、83.89%、96.11%,显著高于对照组的76.94%、80.33%、44.44%、65.00%、88.89%(P<0.05)。观察组手卫生知识考试得分和合格率分别为(91.28±12.15)分和96.00%,高于对照组的(82.37±10.23)分和76.00%(P<0.05)。观察组的感染例次率(1.39%)明显低于对照组(6.39%)(P<0.05)。结论PDCA管理循环方式可提高医务人员手卫生依从性,同时可提升手卫生知识水平,降低院感发生率,为提升医疗安全水平提供了有效策略。

大型国有石化企业刑事领域合规风险管理探讨

基于石油化工行业安全生产、环境保护法律风险较大的突出特点,如何有效开展企业内部的刑事合规管理工作,达到防控刑事法律风险的实际效果,是一个重要的实务课题。与此同时,现有的企业刑事合规领域的理论和实务研究,针对国有大型石油化工企业合规方面的成果比较欠缺。文章综合采用法律分析和企业管理的方法,分析了国有大型石油化工企业外部合规环境的发展和变化,以及在刑事合规实务工作开展过程中存在的主要问题,对如何加强实务工作进行了探讨。

品管圈活动提高门诊哮喘患儿用药依从率应用效果分析

目的探索品管圈对门诊哮喘患儿用药依从率的应用效果。方法成立品管圈(2022年2~8月),以“提高门诊哮喘患儿用药依从率”为主题,运用质量管理工具开展活动。结果实施品管圈活动后,门诊哮喘儿童用药依从率由45%提高至72.5%,完成设定目标;患者满意度由92%提高到98%,健康教育知晓率由86%提高到98%;圈员们在解决问题能力、品管手法、沟通协调能力较前大幅上升。结论品管圈活动可有效提高门诊哮喘患儿用药依从率,同时能完善相关制度和流程,药师在专业能力及职业素养方面得到全面提升。

“互联网+”药学服务模式对哮喘患儿用药依从性及病情控制的影响

目的 探讨“互联网+”药学服务模式对哮喘患儿用药依从性及病情控制的影响。方法 本研究为随机对照试验,收集2020年6月至2023年6月在我院治疗的183例支气管哮喘患儿作为研究对象,按照随机数字表法平均分为对照组和观察组。对照组行常规药学服务,观察组接受“互联网+”药学服务模式,对比两组哮喘患儿用药依从性、儿童哮喘控制测试(C-ACT)评分、肺功能指标和血清生物标志物的变化。结果 与对照组相比,观察组治疗后用药依从性和C-ACT得分提升,肺功能指标改善,血清IgE、IL-4、TNF-α等指标降低,组间差异均具有统计学意义(P<0.05)。结论 “互联网+”药学服务模式可以改善哮喘患儿的用药依从性,改善哮喘控制水平,适合用于儿童哮喘的长期管理。

矛盾意向疗法与刺激控制疗法治疗大学生失眠对照研究

目的对照刺激控制疗法,探讨矛盾意向疗法(paradoxical intention therapy,PIT)用于大学生失眠的治疗体验、执行意愿和疗效。方法81例大学生失眠患者分两组,分别采用矛盾意向疗法(PIT组,41例)和刺激控制疗法(刺激控制组,40例)治疗。治疗1个月时以自编问卷调查患者的治疗体验和执行情况。两组患者治疗前和治疗1个月时以匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)、格拉斯哥睡眠努力度问卷(Glasgow sleep effort scale,GSES)和焦虑自评量表(self-rating anxiety scale,SAS)进行自评,以分值变化评估治疗效果。结果治疗1个月,PIT组治疗执行率≥50%者比例(32/41 vs.21/40)、治疗体验为“焦虑感减轻”者比例(30/41 vs.14/40)和执行意愿“积极”者比例(22/41 vs.7/40)较刺激控制组更高,差异有统计学意义(P<0.05)。PSQI、GSES、SAS经重复测量方差分析均表明,时间主效应有统计学意义(P<0.01),分组主效应和交互效应无统计学意义(P>0.05)。治疗前后相比较,PIT组PSQI(14.27±2.67 vs.6.16±2.27)、GSES(10.22±1.92 vs.5.25±1.63)、SAS(54.73±5.35 vs.44.78±4.33),刺激控制组PSQI(14.03±2.66 vs.6.67±2.01)、GSES(9.98±2.02 vs.5.43±1.21)、SAS(56.13±5.62 vs.46.52±5.68),均在治疗后降低(P<0.01)。PIT组中,执行率≥50%者治疗前后变化值△PSQI(8.19±3.30 vs.1.56±1.81)、△GSES(4.97±2.07 vs.3.11±2.52)和△SAS(10.22±5.34 vs.6.00±3.74)高于执行率<50%者(P<0.05)。结论在大学生失眠患者中,PIT治疗失眠较刺激控制疗法治疗体验和执行意愿更好,两种方法疗效相当,PIT执行率较高的患者疗效较好。