Quality indicators for the care of older adults with disabilities in longterm care facilities based on Maslow’s hierarchy of needs

Purpose:This study aimed to develop quality indicators for the care of older adults with disabilities in long-term care facilities(LTCFs)based on Maslow’s hierarchy of needs.Methods:The draft of the quality indicators was drawn up based on a literature review and research group discussion.The quality indicators were finalized by two rounds of expert consultation(involving 15 experts)using the Delphi method.The Analytic Hierarchy Process was applied to calculate the indicators’weight.Results:The response rates of the two rounds of consultation were 100%and 93%,and the expert authority coefficients were 0.86 and 0.87.After two rounds of consultation,the expert opinion coordination coefficients of the first-,second-and third-level indicators were 0.42,0.25,and 0.96,respectively(P<0.05),and the variation coefficient was0.25.The final quality indicators for the care of older adults with disabilities in LTCFs included 7 first-level,19 second-level,and 107 third-level indicators.Conclusion:The quality indicators for the care of older adults with disabilities in LTCFs are reliable,scientific,comprehensive,and practical and specify the content of person-centered care needs.This can provide a reference for evaluating and improving care quality in LTCFs.

Simulation and Modeling of a Reciprocating Plunger Steam Engine to Obtain Two Indicator Diagrams

Located at the National University in Bogotá,Colombia,this paper presents the development of the integration of kinematics,simplified kinetic and zero-dimensional models of indicator diagram of a double-acting,single-cylinder steam engine;the model integration is done for two configurations of the distribution system to simulate the instantaneous torque and the average.Two simulations are carried out at different steam entry conditions and an advance angle of 0°for the distribution system,fed with the data obtained from the characterization and metrological survey of the VE(vapor engine)parts in a CAD(computer-aided design)system.It is verified that integrating the models constitutes a simulation tool that allows for the instantaneous torque deliveries and average torque of the accurate operation’s VE.

宜居宜业和美乡村建设水平评价与分类施策——以重庆市璧山区七塘镇为例

“建设宜居宜业和美乡村”是党的二十大对全面推进乡村振兴作出的战略部署.在阐释宜居宜业和美乡村科学内涵的基础上构建评价指标体系,以璧山区七塘镇为例开展实证研究,探讨建设宜居宜业和美乡村的实施路径.结果表明:(1)七塘镇宜居宜业和美乡村建设水平呈现“北高南低”的空间分布格局,总体建设位于中等水平,不同维度水平有差距.(2)分维度看,七塘镇生活维度水平最高,治理、人文和环境维度水平其次,产业维度水平最低.(3)分村域看,将军村、喜观村建设水平较高,四合村、阳岫村建设水平中等,盐店村、跃进村、建设村和三步梯村建设水平较低.(4)依据优势与短板,将七塘镇8个村划分为综合发展型、主导发展型、极化发展型和欠缺发展型4类,针对性地提出各类乡村建设宜居宜业和美乡村的实施路径,以期为推进宜居宜业和美乡村建设提供理论与实践指导.

直播电商何以助推地理标志农产品消费溢价?——以安徽霍山黄芽为例

消费绿色转型与电子商务的迅速发展为地理标志农产品营销增添了新的渠道,成为提升农业高质量发展的有力抓手。作为传统电子商务的重构与升级,直播电商通过强交互性、强视听冲击的商品展示功能可以直观呈现地理标志农产品的声誉和品牌价值,有利于提高消费者的溢价支出。基于SOR理论,运用淘宝网2023年霍山黄芽新茶8773个实际交易数据,探究直播电商营销模式如何提高地理标志农产品的消费溢价及其产生机理。研究发现:在地理标志农产品电子商务市场中,与没有视频直播的卖家相比,直播电商可以显著正向影响消费者的溢价支付;农产品品级、包装、卖家服务、物流服务均能显著正向影响消费者对地理标志农产品的溢价支付,而产品描述真实性、好评数、差评数则负向影响消费者的溢价支付;直播电商显著正向调节一级农产品、礼盒包装农产品、产品描述真实性与消费溢价支付的关系。为提高农户和电商卖家的经济收益,加强直播电商对地理标志农产品的宣传和营销,同时重视对直播平台内、外部的监督,对实现农业高质量发展和农民共同富裕具有重要理论和现实意义。

珠江三角洲典型复杂河网区水系连通及调度研究

【目的】河流水系是城市重要的资源和环境载体,水系连通是保证河流系统健康完整和功能正常发挥的重要条件,而活水调度是提高水体流动性和改善水生态环境的重要手段。水系连通指标是分析和评价连通性的关键,【方法】针对珠江三角洲地区的复杂河网,首次提出将往复流河段和断头涌河段长度占比纳入水系连通评价指标体系,分析研究典型区域水系现存问题,提出水系连通与调度方案,采用数学模型评估方案效果,研究珠江三角洲复杂河网水系连通与活水调度工程问题。【结果】结果显示:现状良安水系水动力条件较差,存在往复流和水体交换周期长等问题,水质污染严重,通过清淤疏浚、水系连通和引水工程调度活水,使往复流变为单向流,将现状15.3 d的河道平均换水周期最小缩短至7.3 d,河道现状流速0.021 m/s最大增加至0.124 m/s,区域的水动力条件和区域水质得到明显改善。【结论】结果表明:珠江三角洲城市化程度较高地区的河涌常存在有复流河段和断头涌河段影响河道的水质,有针对性地提出水系连通评价指标体系,并采取合适的清疏引水工程调度等措施,加强水系内部循环,可以改善水系的水质,提升水系综合治理的效果。研究结果可为珠江三角洲复杂河网区水环境问题改善与解决提供典型案例参考。

带锁髓内钉内固定术与加压钢板内固定术对四肢创伤性骨折后骨不连患者的治疗效果比较

目的 对比四肢创伤性骨折后骨不连采用带锁髓内钉内固定术、加压钢板内固定术进行治疗的效果。方法 选择66例四肢创伤性骨折后骨不连患者,采用随机数字表法分为对照组与观察组,每组33例。对照组患者行加压钢板内固定术治疗,观察组患者行带锁髓内钉内固定术治疗。比较两组手术疗效、手术指标、术后恢复指标、术后并发症发生情况、运动功能、生活能力和膝关节功能。结果 观察组患者手术优良率90.91%(30/33)高于对照组的63.64%(21/33)(P<0.05)。观察组患者手术用时(131.50±15.50)min、切口长度(15.30±2.50)cm、术后住院时间(10.50±1.50)d、患肢恢复时间(22.05±2.20)周短于对照组的(164.50±16.05)min、(18.30±3.30)cm、(15.50±1.50)d、(35.50±2.50)周,术中出血量(365.50±22.50)ml少于对照组的(453.50±30.60)ml(P<0.05)。观察组患者术后并发症发生率6.06%低于对照组的24.24%(P<0.05)。治疗后,两组患者运动功能、生活能力、膝关节功能评分均高于治疗前,且观察组高于对照组(P<0.05)。结论 带锁髓内钉内固定术治疗四肢创伤性骨折后骨不连具有较高的安全性与有效性,手术损伤小、恢复快,能促进患者运动功能、生活能力、膝关节功能恢复。

直播电商对地理标志农产品购买意愿的影响机制——基于原产地形象的调节效应

为了探究直播电商平台的感知特性对地理标志农产品购买意愿的影响机制,采用构建模型,收集调查问卷,利用统计软件SPSS26.0与AMOS24.0对数据进行分析。研究结果表明:消费者对直播电商平台的感知互动性、感知娱乐性、感知专业性均对其感知价值产生正向影响;感知价值正向影响购买意愿;感知价值在感知娱乐性、感知专业性与购买意愿之间发挥中介效应;原产地形象在消费者感知价值与购买意愿之间起到正向调节作用。

高频局放带电指示器设计

文章首先分析高频局部放电(以下简称局放)的原理,其次探讨高频局放信号的特征和传播与衰减规律,最后阐述高频局放带电指示器的设计,包括总体架构设计、信号处理电路设计和信号处理算法与软件系统开发。所设计的高频局放带电指示器能够实现对设备带电状态的精准监测,可以快速响应设备带电状态的变化,为电力系统的安全监测和故障预警提供了有效手段。

无人机配网带电作业技术研究与展望

随着无人机技术在输电线路巡检领域的研究与应用逐步深入,其机动灵活、安全高效等优势得到了充分验证。而在配网带电作业领域,存在作业人员安全风险高、作业场景受作业平台限制大等问题,亟需引入无人机技术替代现有作业方式。本文首先对无人机带电作业的研究现状进行综述;然后重点介绍配网无人机带电作业系统方案设计,并以无人机带电安装故障指示器为例,进行方案论证;最后结合电力生产的实际,展望无人机配网带电作业的发展趋势,对相关技术的研究与发展提供一些参考。

Effects of long-term warming on the aboveground biomass and species diversity in an alpine meadow on the Qinghai-Tibetan Plateau of China

Ecosystems in high-altitude regions are more sensitive and respond more rapidly than other ecosystems to global climate warming.The Qinghai-Tibet Plateau(QTP)of China is an ecologically fragile zone that is sensitive to global climate warming.It is of great importance to study the changes in aboveground biomass and species diversity of alpine meadows on the QTP under predicted future climate warming.In this study,we selected an alpine meadow on the QTP as the study object and used infrared radiators as the warming device for a simulation experiment over eight years(2011-2018).We then analyzed the dynamic changes in aboveground biomass and species diversity of the alpine meadow at different time scales,including an early stage of warming(2011-2013)and a late stage of warming(2016-2018),in order to explore the response of alpine meadows to short-term(three years)and long-term warming(eight years).The results showed that the short-term warming increased air temperature by 0.31℃and decreased relative humidity by 2.54%,resulting in the air being warmer and drier.The long-term warming increased air temperature and relative humidity by 0.19℃and 1.47%,respectively,and the air tended to be warmer and wetter.The short-term warming increased soil temperature by 2.44℃and decreased soil moisture by 12.47%,whereas the long-term warming increased soil temperature by 1.76℃and decreased soil moisture by 9.90%.This caused the shallow soil layer to become warmer and drier under both short-term and long-term warming.Furthermore,the degree of soil drought was alleviated with increased warming duration.Under the long-term warming,the importance value and aboveground biomass of plants in different families changed.The importance values of grasses and sedges decreased by 47.56%and 3.67%,respectively,while the importance value of weeds increased by 1.37%.Aboveground biomass of grasses decreased by 36.55%,while those of sedges and weeds increased by 8.09%and 15.24%,respectively.The increase in temperature had a non-significant effect on species diversity.The species diversity indices increased at the early stage of warming and decreased at the late stage of warming,but none of them reached significant levels(P>0.05).Species diversity had no significant correlation with soil temperature and soil moisture under both short-term and long-term warming.Soil temperature and aboveground biomass were positively correlated in the control plots(P=0.014),but negatively correlated under the long-term warming(P=0.013).Therefore,eight years of warming aggravated drought in the shallow soil layer,which is beneficial for the growth of weeds but not for the growth of grasses.Warming changed the structure of alpine meadow communities and had a certain impact on the community species diversity.Our studies have great significance for the protection and effective utilization of alpine vegetation,as well as for the prevention of grassland degradation or desertification in high-altitude regions.

Adult-to-adult living donor liver transplantation for malignant metastatic melanoma to the liver

BACKGROUND. Metastases from malignant melanoma to the liver are rare in China, and surgical resection may be of potential benefit. Liver transplantation for this disease has never been reported. METHODS. We report a case of adult-to-adult living donor liver transplantation (A-A LDLT) for metastatic melanoma. With a surgical history of ocular melanoma, the recipient presented with emaciation from a large right hepatic mass which also probably had portal vein invasion. A-A mur was successfully performed and no postoperative complications were observed in either the donor or the recipient. Postoperative pathology confirmed the diagnosis of metastatic malignant melanoma; however no adjuvant chemotherapy was employed after transplantation. We also reviewed the literature on the surgical treatment of metastatic malignant melanoma to the liver and discussed the LDLT indications. RESULT: Recurrence occurred 6 months after surgery and the patient died from recurrence of the disease 8 months post-transplant. CONCLUSIONS. Review of the literature suggested that only a small subset of selected patients may benefit from liver resection. Large metastatic disease in the liver potentially involving a major vessel, as in this case, should be contraindicated for liver transplantation. (Hepatobiliary Pancreat Dis Int 2010; 9: 329-332)

Outcome of hepatocellular carcinoma treated by liver transplantation:comparison of living donor and deceased donor transplantation

BACKGROUND: Liver transplantation (LT) has been widely accepted as the treatment of choice for end-stage liver diseases. Due to the scarcity of cadaveric donors, adult-to-adult living donor liver transplantation (LDLT) is advocated as a practical alternative to deceased donor liver transplantation (DDLT). However, some reports suggest that the long-term and recurrence-free survival rates of LDLT are poorer than those of DDLT for hepatocellular carcinoma (HCC). This study aimed to compare the long-term and recurrence-free survival rates of HCC between LDLT and DDLT. METHODS: We retrospectively analyzed the clinical data of 150 patients with HCC from January 2005 to March 2009. Eleven patients who died of complications during the perioperative period were excluded. The remaining 139 eligible patients (101 DDLT and 38 LDLT) were regularly followed up to October 2009. The Chi-square test or Fisher's exact test were used to compare the characteristics of LDLT and DDLT. The long-term and recurrence-free survival curves of both groups were determined using the Kaplan-Meier method with comparisons performed using the log-rank test. One-way analysis of variance was performed to compare the waiting time of the two groups. RESULTS: Survival rates at 1, 2, 3, and 4 years for LDLT were 81%, 62%, 53%, and 45% and for DDLT were 86%, 60%, 50%, and 38%, respectively. The overall 1-, 2-, 3-, and 4-year recurrence-free rates for LDLT were 71%, 49%, 42%, and 38%, and for DDLT were 76%, 52%, 41%, and 37%, respectively. No significant differences were found by the log-rank test on both long-term and recurrence-free survival rates. CONCLUSIONS: The role of LDLT is reinforced by our study. It may expand the donor pool and achieve the same long-term and recurrence-free survival rates of DDLT.

Effect of donor age on graft function and longterm survival of recipients undergoing living donor liver transplantation

BACKGROUND： Donor shortage is the biggest obstacle in organ transplantation. Living donor liver transplantation（LDLT） has been considered as a valuable approach to shortening waiting time. The objectives of this study were to investigate the feasibility of utilizing donors older than 50 years in LDLT and to evaluate the graft function and recipient survival.METHODS： All LDLT cases（n=159） were divided into the older（donor age ≥50 years, n=10） and younger（donor age 〈50 years,n=149） donor groups. Donor graft and recipient condition pre-,intra- and post-operation were compared between the two groups.In particular, graft functions and recipient survivals were analyzed.RESULTS： The median donor age was 58.5（52.5-60.0） years in the older donor group and 25.0（23.0-32.0） in the younger donor group. There was no significant difference in cold ischemic time, anhepatic phase and operation time between the older and younger donor groups（P〉0.05）. However, the volume of red blood cell transfused in operation was greater in the older donor group than in the younger donor group（1900 vs 1200 m L, P=0.023）. The 1-, 3- and 5-year graft survival rates were 90%, 80% and 80% for the older donor group, and 92%, 87% and 87% for the younger donor group, respectively（P=0.459）.The 1-, 3- and 5-year survival rates were 100%, 90% and 90% for recipients with older grafts, and 93%, 87% and 87% for those with younger grafts, respectively（P=0.811）.CONCLUSION： It is safe for a LDLT recipient to receive liver from donors older than 50 years, and there is no significant adverse effect on graft function and long-term patients’ survival.

Systematic review of long-term Xingnao Kaiqiao needling efficacy in ischemic stroke treatment

OBJeCTIve：To systematically evaluate the long-term effect and safety ofXingnao Kaiqiao nee-dling method in ischemic stroke treatment. DATA ReTRIevAL： We retrieved relevant random and semi-random controlled trials that used theXingnao Kaiqiao needling method to treat ischemic stroke compared with various control treatments such as conventional drugs or other acupuncture therapies. Searched databases included China National Knowledge Infrastructure, Weipu Information Resources System, Wanfang Medical Data System, Chinese Biomedical Literature Database, Cochrane Library, and PubMed, from May 2006 to July 2014. SeLeCTION CRITeRIA： Two authors independently conducted literature screening, quality evaluation, and data extraction. The quality of articles was evaluated according to the Cochrane Reviewers’ Handbook 5.1, and the study was carried out using Cochrane system assessment methods. RevMan 5.2 was used for meta-analysis of the included studies. MAIN OUTCOMe MeASUReS： Mortality rate, recurrence rate, and disability rate were observed. ReSULTS：Nine randomized and semi-randomized controlled trials treating 931 cases of ischemic stroke were included in this review. Meta-analysis results showed that there were no sig-niifcant differences in mortality reduction （risk ratio （RR） = 0.58, 95% conifdence interval （CI）： 0.17–1.93,Z = 0.89,P = 0.37） or recurrence rate （RR = 0.55, 95%CI： 0.18–1.70,Z = 1.04,P = 0.30） of ischemic stroke patients between theXingnao Kaiqiao needling and control treatment groups. However, theXingnao Kaiqiao needling method had a tendency towards higher efifcacy in mor-tality reduction and recurrence rates. TheXingnao Kaiqiao needling method was signiifcantly better than that of the control treatment in reducing disability rate （RR = 0.51, 95%CI： 0.27–0.98, Z = 2.03,P 〈 0.05）. CONCLUSION：TheXingnao Kaiqiao needling method has a better effect than control treatment in reducing disability rate. The long-term effect ofXingnao Kaiqiao needling against ischemic stroke is better than that of control treatment. However, the limitations of this study limit the strength of the conclusions. Randomized controlled trials with a strict, reasonable design, and multi-center, large-scale samples and follow-up are necessary to draw conclusions aboutXingnao Kaiqiao needling.

Present status and recent advances in living donor liver transplantation for malignant hepatic tumors

BACKGROUND: Living donor liver transplantation (LDLT) has been increasingly used to treat hepatic tumors worldwide in recent years, and is currently the most effective alternative to deceased donor liver transplantation to overcome the problem of organ shortage. LDLT has played an enormous role in treating early malignant hepatic tumors. But the indication of LDLT for malignant hepatic tumors is based on indefinite criteria. This review summarizes the recent studies in LDLT for treating malignant hepatic tumors. DATA SOURCES: A literature research of the PubMed database was conducted and research articles were reviewed. RESULTS: The current data on LDLT for malignant hepatic tumors, combined with our hospital experience, indicated that if a patient with hepatocellular carcinoma (HCC) who meets with the conventional Milan criteria cannot undergo tumor resection because of poorly preserved liver function, and a cadaveric graft is difficult to obtain within six months, LDLT may be selected. In a patient with recurrence of HCC after conventional therapies, feasibility, optimal timing, and efficacy of LDLT as a second-line treatment should be determined. CONCLUSIONS: Tumor recurrence is related to the biological behavior and staging of the tumor. New immunosuppressors which have anti-tumor effects and inhibit the immune system need to be developed. The indications of LDLT for hepatic malignant tumors should be selected meticulously.

Influence Factors of Mobility-Related Activities of Daily Living in Chronic Dialysis Patients Needing Long-Term Care: Analysis of Long-Term Care Eligibility Assessment Survey Data

Background: In the near future in Japan, chronic dialysis patients will likely face a situation where the aging and the lengthening of hemodialysis treatment periods will adversely affect the mobility-related activities of daily living (MR-ADL). The aim of this study was to investigate chronological change in MR-ADL among chronic dialysis patients in need of long-term care and the effect of admission to long-term care facilities on their MR-ADL. Methods: Data were analyzed from a long-term care eligibility assessment survey conducted in late March 2009 of 1000 individuals residing in Niigata City, Japan who were approved to receive long-term care. Then data from those individuals who had undergone the assessment survey ≥4 times over a period of ≥4 years were statistically evaluated. To reveal change in MR-ADL, this study performed a three-way analysis of variance with mean survey scores from assessment categories 2 - 5 containing questions related to MR-ADL as the independent variable and the number of eligibility assessment surveys (within-subjects factor), facility admission, and dialysis therapy (between-subjects factors) as dependent variables. Results: We observed the effect of facility admission in individuals aged >70 years for categories 2 - 5, and observed the effect of the number of assessment surveys taken only in women ≥80 years for categories 2 and 5. Regarding the effect of dialysis therapy, female dialysis patients aged ≥80 years and in need of long-term care scored significantly higher on survey items for transferring, grooming, toileting, eating, and instrumental activities of daily living, all of which are indicators of a moderate decline in ADL. Conclusions: Because dialysis is often initiated in women aged around 80 years, ADL in this group of individuals can be improved by the initiation and proper provision of dialysis.

Spouses Who Donate Seem to Be the Winners – A Questionnaire Study of Kidney Donors Long-Term

Background:Living donor kidney transplantations have been performed at Sahlgrenska University Hospital in Gothenburg, Sweden since 1965. In this study we wanted to explore the living kidney donor’s long-term experiences of the donation. Methods: Of 1110 consecutive living donors throughout 1965-2005, 823 were available for our questionnaire study. Results:Totally 692 replied to the questionnaire, 65% were females. The most common relation to the recipients was siblings (284), parents (262) and spouses (96). Time since donation was median 15 years (2 - 43). The initiative to donate came from the donors themselves in 69%. The dominating motives for donation were a wish to help, worries about the recipient not receiving a transplant and the knowledge that one could live a normal life with one kidney. The majority of the donors, felt well informed about potential risks both short-term and long-term. Depression post donation was reported by few donors, 2.3% and persisting pain by 4.3%. Comparisons between sibling donors and spouse donors show a significant difference (p Conclusions:Our study shows that the donor population is in good psychosocial health. It is a positive progress that spouses can be living kidney donors - they seem to be the winners.

Long-term renal function, complications and life expectancy in living kidney donors

Living kidney transplantation is now a widely accepted treatment for end stage renal disease(ESRD) because it provides excellent outcomes for recipients. However, long-term outcomes of living kidney donors have not been well understood. Because securing the safety of the donor is essential to the continued success of this procedure, we reviewed articles discussing long-term outcomes of living kidney donors. Most studies found no decrease in long-term survival or progressive renal dysfunction in previous kidney donors. Moreover, the prevalence of hypertension was comparable to that expected in the general population, although some did report otherwise. Urinary protein showed small increases in this population and was associated with hypertension and a lower glomerular filtration rate. Quality of life following living kidney donation seems to be better than the national norm. We also encountered several reports of ESRD in previous living kidney donors. Regular follow-up of kidney donors is recommended and future controlled, prospective studies will better delineate risk factors which cause health problems following living kidney donation.

Effects of Sustained, Coordinated Activities Programming in Long-Term Care: The Memory in Rhythm® Program

Beneficial effects of providing engaging activities to long-term care residents have been well documented. However, it is important to determine the effects of activities when providing throughout the day, especially as they related to outcomes salient to administrators. We describe the creation and pilot testing of a sustained, coordinated activities program, Memory in Rhythm&#174(MIR), which incorporated Montessori-Based Dementia Programming&#153, in a skilled nursing facility (SNF). Effects of implementing MIR then were examined in memory care units in 16 aged care centers—9 SNFs and 7 assisted living residences in Ohio. For these centers, all data were collected over a period of one year before and one year after implementation of MIR. Results indicate that implementation of MIR was associated with reductions in medication use, increased census, decreased employee turnover, decreased wandering and agitation, and increased sleeping at night, eating and capacity for activities of daily living. In the SNFs, increases in RUGS case mix and use of Medicare Part B (rehabilitation services) were noted, while in assisted living implementation also was related to increased amount of time residents who were able to age in place. Implications of these findings are discussed.