Factors Affecting Cotrimoxazole Prophylactic Therapy Compliance in HIV Patients Attending a Care and Treatment Clinic at Bugando Medical Centre in Mwanza, Tanzania

Introduction: Cotrimoxazole Prophylactic Therapy (CPT) compliance lowers the risk of opportunistic infections and other Acquired Immune Deficiency Syndrome (AIDS)-related diseases. The aim of this study was to examine factors that influence compliance with CPT among HIV patients in the Care and Treatment Clinic (CTC) at Bugando Medical Centre (BMC) in Mwanza, Tanzania. Methods: A descriptive cross-sectional study was conducted at the BMC between April 1, 2021, and June 30, 2021. Data were collected using face-to-face interviews and a semi-structured questionnaire. Data are presented in frequency, percentages, and cross-tabulation tables. A P-value of less than 0.05 was considered statistically significant. Results: The prevalence of compliance with CPT by self-reported measurement was 158 (63.7%). Most CPT-compliant participants were more likely to have a spouse who is familiar with CPT, have a family member who is aware of their HIV status, and be aware of the benefits of CPT. The majority of participants who complied with CPT were more likely to have experienced counseling during refill, felt that the length of time spent seeing doctors for treatment was reasonable, and received accurate information from them. Conclusion: Most adult HIV patients attending CTC at BMC were reported to be in compliance with CPT. These findings suggest that improving social support and patient-provider communication may be effective strategies for improving compliance with CPT among HIV patients.

Total hip arthroplasty for sequelae of childhood hip disorders:Current review of management to achieve hip centre restoration

Adults requiring total hip arthroplasty(THA)for childhood disorder sequelae present with shortening,limp,pain,and altered gait.THA,which can be particularly challenging due to altered anatomy,requires careful planning,assessment,and computed tomography evaluation.Preoperative templating is essential to establish the appropriate acetabular and femoral size.Information regarding neck length and offset is needed to ensure the proper options are available at THA.Hip centre restoration must be planned preoperatively and achieved intraoperatively with appropriate exposure,identification,and stable fixation with optimum-size components.Identifying the actual acetabular floor is essential as changes include altered anatomy,distortion of the margins and version changes.Proximal femur changes include anatomical variation,decreased canal diameter,cortical thickness,changes in anteversion,and metaphyseal and diaphyseal mismatch.Preoperative assessment should consist of limb assessment for variations due to prior surgical procedures.Evaluation of the shortening pattern with the relationship of the lesser trochanter to the teardrop would help identify and plan for subtrochanteric shortening osteotomy,especially in high-riding hips.The surgical approach must ensure adequate exposure and soft tissue release to achieve restoration of the anatomical hip centre.The femoral components may require modularity to enable restoration of anteversion and optimum fixation.

THE HAUSDORFF CENTRED MEASURE OF THE SYMMETRY CANTOR SETS

Let 0<A≤1/3 ,K(λ) be the attractor of an iterated function system {ψ1,ψ2} on the line, where 1(x)= AT, ψ1(x) = 1-λ+λx, x∈[0,1]. We call K(λ) the symmetry Cantor sets. In this paper, we obtained the exact Hausdorff Centred measure of K(λ).

Monte Carlo study of the antiferromagnetical Ising model on a centred honeycomb lattice

We use the Monte Carlo method to study an antiferromagnetical Ising spin system on a centred honeycomb lattice, which is composed of two kinds of 1/2 spin particles A and B. There exist two different bond energies JA-A and JA--B in this lattice. Our study is focused on how the ratio of JA-B to JA--A influences the critical behaviour of this system by analysing the physical quantities, such as the energy, the order parameter, the specific heat, susceptibility, etc each as a function of temperature for a given ratio of JA-B to JA-A. Using these results together with the finite-size scaling method, we obtain a phase diagram for the ratio JA-B / JA--A. This work is helpful for studying the phase transition problem of crystals composed of compounds.

HAUSDORFF CENTRED MEASURE OF NON-SYMMETRY CANTOR SETS

Let 0<λ_1,λ_2<1 and 1-λ_1-λ_2≥max｛λ_1,λ_2｝.Let ~K(λ_1,λ_2) be the attractor of the iterated function system ｛φ_1,φ_2｝on the line,where φ_1(x)=λ_1x and φ_2(x)=1-λ_2+λ_2x,x∈R.~K(λ_1,λ_2) is called a non-symmetry Cantor set. In this paper,it is proved that the exact Hausdorff centred measure of K(λ_1,λ_2) equals 2s(1-λ)s,where λ=max｛λ_1,λ_2｝ and s is the Hausdorff dimension of K(λ_1,λ_2).

Extensive Pineapple Production Constraints and Land Suitability in the Centre Region of Cameroon

The low level of productivity observed in pineapple fields in Centre Came-roon must be sustainably reduced in order to increase producers’ income while using the same resources. The identification and control of production constraints are key steps in optimizing the use of limited resources. To this end, the FAO land assessment methodology following the Fuzzy-MCDM pro-tocol was used for the two pineapple production basins in the Centre, namely Awae and Bokito. It was found that the land in Awae Basin is moderately suitable S2sf with constraints imposed by texture, pH and base saturation. In the Bokito Basin, 25% of the land is suitable S1wf and 75% is moderately suitable S2wsf with constraints imposed by soil texture (27%), temporary soil water saturation (99%), pH, base saturation and exchangeable sodium. Constraint correction improves the land index (potential suitability) and re-mains limited by permanent constraints that cannot be corrected. Improve-ment of the technical itinerary through modification of plant densities, selec-tion of improved cultivars and balanced fertilization must be undertaken to optimize pineapple production in Centre Cameroon.

Rural nurses’ perceptions of a volunteer program in an acute setting: Volunteers delivering person-centred care for patients with dementia and delirium

Community volunteers were recruited and trained to deliver person-centred care to patients with dementia or delirium in an acute hospital setting, in a small rural Australian hospital. The volunteer program was grounded in action research methodology, and modelled on a previous research project. As a form of evaluation, interviews were conducted with nursing staff eight weeks after implementation of the volunteer program to explore their opinions. Data were analysed through a collaborative process and findings revealed strong benefits from the perspectives of the nursing staff. These benefits included overall improved patient care and improved time management for nursing tasks.

Serve the People or Serve the Consumer? The Dilemma of Patient-Centred Health Care in China

Patient-centred medicine is being adopted as national policies in many countries, encouraged by positive outcomes of the practice at clinical and organisational levels. This study examines the patient-centred health care reform in China, which has adopted the approach as a national policy for two decades but has yet to achieve the intended goals. Focusing on conflicting interpretations of the nature of patients at national, organisational, and individual levels, this article argues that such conflicts lead to clashes between the political agenda of the state, priorities of health organisations, professional choices of individual practitioners, and expectations of patients in the process of implementing, practicing, and receiving patient-centred health care in China. It reveals that the national health authority has intended patient-centredness as a universal, anti-market, people-centred approach, based on the health ideology of serving the people. But hospitals, compelled by financial restraints, have implemented it as a market approach centring on patients as consumers. Medical professionals and patients also possess contradictory views towards whether a patient should be perceived as a consumer. The discordance in the interpretation of the patient identity has caused great confusion in the implementation and provision of patient-centred health care. The study points out that the success of patient-centredness as national policy cannot be assumed on the basis of its success at clinical and organisational levels. More efforts are needed to coordinate the fundamental understanding of patient-centredness by different actors.

The effects of a patient-centred rehabilitation model of care targeting older adults with cognitive impairment on healthcare practitioners

Until recently, older adults with a cognitive impairment (CI) who experienced a hip fracture were filtered from being admitted into active rehabilitation units. The increased complexity of care required for older adults with a CI may negatively influence the attitudes and job satisfaction of healthcare practitioners working with this population. The current study is a part of a larger intervention study allowing patients with CI following a hip fracture access to rehabilitation care and implementing a patient-centred model to facilitate caring for this new population. This new model required a substantial change in the skillset and knowledge of healthcare practitioners. The focus of this study was to explore the impact on the healthcare practitioners of adopting this new model for providing care to older adults with a CI following a hip fracture. The attitudes, dementia knowledge, job satisfaction, and work stress of healthcare practitioners were the focus of evaluation. Key study findings showed that stress due to relationships with coworkers, workloads and scheduling, and the physical design and conditions at work were moderated post-intervention. Staff responses also improved for job satisfaction, biomedical knowledge of dementia, and degree of hopefulness about dementia. Although we cannot state conclusively that the our model was solely responsible for all the staff improvements observed post-intervention, our findings provide further support to the argument that patients with CI should be allowed access to rehabilitation care. Rehabilitation units need to provide education that utilizes a person-centred approach accepting of patients with CI, and focuses on areas that can bolster staff’s positive, dementia-sensitive attitudes. Ultimately, the aim is to create a culture that provides the highest standard of care for all patients, reduces work-related stress, increases job satisfaction, and leads to the highest quality of life for patients during and after rehabilitation.

The Influence of a User-Centred Design Focus on the Effectiveness of a User Interface for an Agricultural Machine

As agricultural machines become more complex, it is increasingly critical that special attention be directed to the design of the user interface to ensure that the operator will have an adequate understanding of the status of the machine at all times. A user-centred design focus was employed to develop two conceptual designs (UCD1 & UCD2) for a user interface for an agricultural air seeder. The two concepts were compared against an existing user interface (baseline condition) using the metrics of situation awareness (Situation Awareness Global Assessment Technique), mental workload (Integrated Workload Scale), reaction time, and subjective feedback. There were no statistically significant differences among the three user interfaces based on the metric of situation awareness;however, UCD2 was deemed to be significantly better than either UCD1 or the baseline interface on the basis of mental workload, reaction time and subjective feedback. The research has demonstrated that a user-centred design focus will generate a better user interface for an agricultural machine.

Inclusiveness in City Centre-A Case Study: 30-E-Tir Street in Tehran

City centres in today’s big cities,particularly in metropolises and megalopolises,play a crucial role in revival of human scale in an urban context.Nowadays,a city centre that corresponds to needs of various groups of users,contributes to creating a safe,healthy,vibrant,inclusive and sustainable city.Accordingly,identification of the major and minor groups of users of city centres as well as their likes,dislikes and preferences is a primary step.To this end,this paper investigates the city centre of Tehran and a recently pedestrianised street called 30-E-Tir.With a focus on the three indicators of age,gender and speed,this paper aims to elucidate the existing divergent groups of users of 30-E-Tir and their physical,mental,and spiritual expectations of this street.This 1.3-km street-as a linear path incorporating food&junk food kiosks and the associated small-scale canopies,and flagstone floorscaping-passes through many famous museums of Tehran.These specific features have converted 30-E-Tir Street into a convivial destination point for Tehranians.The existing problems,however,necessitate a detailed investigation of the current situation.The applied methodology for this qualitative-quantitative analysis of the present condition includes the literature review and the related analysis,direct appraisal,photography,and dot-based analysis.

排岩机履带行走装置接地比压分布规律研究

针对目前接地比压分布不均匀问题,本文以排岩机为例,建立了履带行走装置接地比压计算数学模型。基于Solidworks、MATLAB软件,对排岩机重心空间坐标值与其受料臂旋转角度、排料臂上仰角度及车体回转支承旋转角度进行了拟合。进一步通过ANSYS Workbench仿真软件,证明了所建接地比压计算模型的正确性。研究分析了接地比压随受料臂旋转角度、排料臂上仰角度、排岩机车体回转支承旋转角度的变化趋势。这里研究成果可为各种履带行走设备整机的设计及其工作地基的处理提供一定的参考。

讲好中国教育故事 服务人类教育发展——专访上海师范大学张民选教授

张民选教授一直致力于讲好中国教育故事、服务人类教育发展的崇高事业。为了贯彻联合国提出的教育可持续发展理念、响应国家参与全球教育治理倡议、推动上海全球城市建设计划实施,张民选教授带领团队建立了联合国教科文组织教师教育中心——现已发展成为重要的国际教育经验交流平台。张民选教授重点论述了“为什么要讲好故事”“如何吸引别人来听故事”“讲什么故事”“怎么讲故事”和“谁来讲故事”等5个问题,并主张中国要积极展现自己的教育成就,要在国际事务中增强教育影响力。张民选教授还总结概括了中国教育成就背后的核心教育经验,介绍了其他国家的教育发展需求,并倡导全世界的教育工作者共同讲述中国教育故事。张民选教授认为,要在讲好中国教育故事的过程中全面客观认识中国与世界,各国要在相互借鉴先进教育经验基础上实现共同进步。张民选教授指出,数字技术为教育带来了新的挑战和机遇,教育工作者要积极探索数字时代育人新途径。为此,教师要充分发挥数字技术优势来提高教学质量,如为学生整合多种教育资源、提供社会和情感支持、开展有前瞻性的指导等。张民选教授向广大青年学者寄语:要充分发挥自身优势深入文献研究,在教育实践中总结有价值的教育经验;要拥有宽广胸怀,以传播中国优秀教育经验与服务全球教育发展为己任。

北京冬奥会雪车雪橇项目医疗急救的保障

目的:对国家雪车雪橇中心的雪车、雪橇、钢架雪车赛道医疗保障情况进行分析及总结,为今后赛事举办及群众冰雪运动的医疗保障工作提供经验。方法:回顾性分析参加2021年10—11月雪车、雪橇、钢架雪车国际训练周和世界杯(以下简称“国际训练周”),及2022年2月北京冬奥会雪车、雪橇、钢架雪车项目(以下简称“北京冬奥会”)的运动员受伤、救治情况,参考和借鉴《冬季雪上运动项目医疗保障标准》制定具体的分类标准分析受伤部位、受伤类型、事故发生点位等。结果:参加国际训练周和北京冬奥会总计743名运动员,比赛期间共发生翻车、翻撬、碰撞事故58次,其中有28次(运动员28例)出现了运动员受伤,占事故总数的48.3%,占运动员总数3.8%,其中男性9例(32.1%),女性19例(67.9%),平均年龄(26.3±4.7)岁。28例受伤运动员中20例(71.4%)为Ⅰ类伤,在现场得到了救治处理,8例(28.6%)伤情较重的,其中Ⅱ类伤(7例)、Ⅲ类伤(1例)转诊至定点医院进行进一步处理。28例受伤运动员中有3例(10.7%)出现了多发损伤,其中2例为2部位受伤,1例为3部位受伤,最常见的受伤部位为脚踝及脚趾(10/32,31.3%)。28例受伤运动员中有1例(3.6%)同时出现了2种受伤类型,最常见的受伤类型为关节和(或)韧带损伤(11/29,37.9%)。赛道最容易发生事故的点位为第9弯道(18/58,31.0%)。结论:通过对医疗保障工作的分析和总结,能够更好地为今后我国开展雪车、雪橇、钢架雪车运动提供经验和参考,使国家雪车雪橇中心真正成为可持续发展的奥运资产。

气象管理数据中心设计与实现

为满足气象部门政务数据高效管理和共享应用需求,推动气象政务数据融入国家政务大数据体系,中国气象局依托国家级气象专有云设计、建设了气象部门首个一级集中、四级应用的集约统一的政务数据中心,直接支撑气象政务和业务应用。本文介绍了该数据中心系统的核心架构设计、主要业务功能、关键信息流程、基于气象政务数据特征的数据分类和分层数据体系、关键实现技术、应用成效等。系统的实现采用了一系列的新兴信息技术,包括支持多源异构的数据汇聚、基于策略的数据清洗和整合治理、全局统一的数据服务和接口管理、基于ElasticSearch引擎的全文检索、基于消息驱动的管理应用协同、主备中心数据同步等。作为气象部门政务管理数字化转型升级的数字底座,系统建成后为国省市县四级气象部门提供了一站式的政务数据管理和共享应用服务,在有力支撑中国气象局行政办公、科学决策和履行公共职能中发挥了良好效益。

托幼机构管理者自主选学式培训的作用:以加拿大阿尔伯塔省为例

赋予教育工作者以专业发展自主权被认为是影响培训质量和教育质量的重要一环。在高质量发展背景下托幼机构管理者在参与专业培训时能否实现赋权增能至关重要。基于人力资源管理的AMO理论模型,加拿大阿尔伯塔省的托幼机构管理者自主选学式培训从能力提升、动机激发、机会保障三个维度保障了托幼机构管理者的培训自主权:常态化的培训模式与灵活多样的培训内容与形式,帮助托幼机构管理者提升了专业素养和自主选学能力;自我晋升制度与自我评估机制,帮助托幼机构管理者实现了专业发展的自我驱动力;AECEA专业协会为自主选学式培训提供了规范引领和组织保障,专项经费投入与管理保障了托幼机构管理者自主专业发展的必要条件。自主选学式培训对提升托幼机构管理者专业培训的积极性和有效性具有一定的借鉴意义。

案例为基础教学法在生殖医学中心临床医学专业实习医生教学中的应用

目的:探讨案例为基础教学法(CBL)在生殖医学中心临床医学专业实习医生教学中的应用效果。方法:选取2019年2月—2021年6月在郑州大学第二附属医院生殖医学中心实习的65名临床医学专业实习医生为研究对象,按照随机数表法分为对照组32名和研究组33名。对照组采用传统教学法,研究组采用CBL,比较两组实习生理论考核成绩、技能考核成绩、自评结果(思维能力、自学能力、沟通能力、学习兴趣、团队协作能力)和教学满意度。结果:研究组实习医生的理论考核成绩高于对照组,差异有统计学意义(t=3.529,P<0.05);研究组实习医生的技能考核成绩高于对照组,差异有统计学意义(t=5.353,P<0.05);研究组实习医生的思维能力、自学能力、沟通能力、学习兴趣、团队协作能力得分均高于对照组,差异有统计学意义(t=6.126、4.612、8.495、7.344、11.813,P<0.05);研究组实习医生的教学满意度为93.94%,高于对照组的71.88%(χ^(2)=5.626,P<0.05)。结论:CBL教学法在生殖医学中心临床医学专业实习医生教学中的应用效果显著,不仅提升了医生的理论和技能考核成绩,还提高了实习医生的思维能力、自学能力、沟通能力、学习兴趣以及团队协作能力,而且大多数实习医生对该方法也表示满意。

乡绅之治:近代早期英国治安法官与地方社会治理

在从传统农业社会向近代工业社会转型的过程中,英国并未像法国、西班牙等欧洲大陆国家那样建立起庞大的官僚队伍和强大的常备军力量,在面对社会转型带来的诸多社会问题时,不得不仰赖乡绅等社会精英力量的合作。乡绅往往通过出任治安法官而获得一身二任的角色,他们不仅是中央政府在地方的“官员”,又是地方社会的“家长”。治安法官的职权在近代早期急剧膨胀,成为地方政府的司法和行政权力中枢,也是中央政府与地方政府的连接枢纽。治安法官虽由国王任命,但不领薪俸,因此治安法官在治理地方社会时,会在综合考量中央政令与地方实情的基础上,制定地方社会政策与行使“自由裁量权”。在中央政府的监督与地方官民的支持下,治安法官有力地维护地方社会的法律与秩序。治安法官治理地方社会的实践型塑了英国的司法治理模式,通过中央与地方的协商,实现中央集权与地方自治的平衡,达成追求秩序与善治的施政目的,为英国社会稳定转型和国家治理现代化奠定基础。

基于双卷积链的贴标机械手产品中心视觉定位方法

目前对于机械手产品视觉中心的定位主要采用的是被动双目立体视觉定位法,但由于缺乏场景坐标的匹配与预测,导致其视觉定位精度较差。为此,提出基于双卷积链的贴标机械手产品视觉中心定位方法。首先,对相机的内置参数与外置参数进行标定,构建视觉定位场景坐标系。然后,利用卷积神经网络中的双卷积网络结构,对视觉中心场景坐标进行预测。最后,通过匹配像素坐标与图像特征点实现贴标机械手产品中心视觉定位。在实验中,在40 mm×40 mm×40 mm小规模空间场景和180 mm×180 mm×180 mm大规模空间场景中对所提方法进行了定位精度的检验。实验结果表明,采用所提方法进行贴标机械手产品中心视觉定位时,定位方差较小,具备较为理想的定位精度。说明所提方法在机械手产品的定位领域具有较好的应用前景,有助于实现工业自动化生产。

英国开放大学在线课程设计与开发——学习设计的视角

在国际远程教育领域,课程设计视角已经发生了根本性转变,由促进教师“教”的教学设计转向了促进学生“学”的学习设计。作为国际上大规模倡导和实践学习设计的标杆——英国开放大学已将学习设计深度嵌入在线课程的设计与开发过程当中,其丰富经验值得我国同行学习和借鉴。研究基于学习设计的视角,从理念和实践两个层面对英国开放大学在线课程设计与开发进行系统介绍。在此基础上,结合我国高校在线课程建设现状,提出五个方面的转变:转变课程设计开发视角、转变课程设计开发理念、转变课程设计开发重点、转变课程设计开发方式、转变课程设计开发范式。以期为我国高校在线课程设计与开发提供完整、可操作的理论支撑和实践指导。