The reliable operation of high-speed wire rod finishing mills is crucial in the steel production enterprise.As complex system-level equipment,it is difficult for high-speed wire rod finishing mills to realize fault lo...The reliable operation of high-speed wire rod finishing mills is crucial in the steel production enterprise.As complex system-level equipment,it is difficult for high-speed wire rod finishing mills to realize fault location and real-time monitoring.To solve the above problems,an expert experience and data-driven-based hybrid fault diagnosis method for high-speed wire rod finishing mills is proposed in this paper.First,based on its mechanical structure,time and frequency domain analysis are improved in fault feature extraction.The approach of combining virtual value,peak value with kurtosis value index,is adopted in time domain analysis.Speed adjustment and side frequency analysis are proposed in frequency domain analysis to obtain accurate component characteristic frequency and its corresponding sideband.Then,according to time and frequency domain characteristics,fault location based on expert experience is proposed to get an accurate fault result.Finally,the proposed method is implemented in the equipment intelligent diagnosis system.By taking an equipment fault on site,for example,the effectiveness of the proposed method is illustrated in the system.展开更多
Introduction: Access to antiretroviral drugs has improved the survival of children infected with the Human Immunodeficiency Virus (HIV). As they reach adolescence, they are confronted with various constraints related ...Introduction: Access to antiretroviral drugs has improved the survival of children infected with the Human Immunodeficiency Virus (HIV). As they reach adolescence, they are confronted with various constraints related to the infection and its treatment, in addition to those of the growth period they are going through. The main aim of the study was to assess the acceptance and describe the experience of HIV infection by infected adolescents but also to investigate the factors associated with good acceptance and a positive experience. Methodology: The cross-sectional analytic study concerned HIV-infected adolescents aged 15 to 19 followed up at the Chantal Biya Foundation-Mother and Child Centre (CME-FCB) and the Yaoundé University Hospital Centre (CHUY) between February 2020 and June 2020. The study saw participants complete a questionnaire containing socio-demographic data and assessing acceptance and experience with the infection. Data analysis was accomplished using Epi info software version 7.2.2.6. Results: One hundred and thirteen HIV-infected adolescents were included in the study. The sex ratio was 0.68 and the mean age was 17 years. More than half of the adolescents had a good acceptance and positive experience with the infection. Related factors were the adolescent’s perception of good health and participation in an association with other infected adolescents. Conclusion: Emphasizing the psychological and educational follow-up of infected adolescents and encouraging their participation in associations for adolescents living with HIV could reduce the consequences of poor acceptance and ensure a better transition to adulthood. .展开更多
BACKGROUND This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and...BACKGROUND This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and care needs.Protecting the anus surgery combined with temporary colostomy has emerged as a prevalent treatment modality for low rectal cancer.However,the ileostomy is susceptible to peri-stoma skin complications,as well as fluid,electrolyte,and nutritional imbalances,posing challenges to effective management.The successful selfmanagement of patients is intricately linked to their adjustment to temporary colostomy;nonetheless,there remains a dearth of research examining the factors influencing self-care among temporary colostomy patients and the obstacles they confront.AIM To investigate the lived experiences,perceptions,and care requirements of temporary colostomy patients within their home environment,with the ultimate goal of formulating a standardized management protocol.METHODS Over the period of June to August 2023,a purposive sampling technique was utilized to select 12 patients with temporary intestinal stomas from a tertiary hospital in Shanghai,China.Employing a phenomenological research approach,a semi-structured interview guide was developed,and qualitative interviews were conducted using in-depth interview techniques.The acquired data underwent coding,analysis,organization,and summarization following Colaizzi’s seven-step method.RESULTS The findings of this study revealed that the experiences and needs of patients with temporary intestinal stomas can be delineated into four principal themes:Firstly,Temporary colostomy patients bear various burdens and concerns about the uncertainty of disease progression;secondly,patients exhibit limited self-care capabilities and face information deficits,resulting in heightened reliance on healthcare professionals;thirdly,patients demonstrate the potential for internal motivation through proactive self-adjustment;and finally,patients express a significant need for emotional and social support.CONCLUSION Home-living patients with temporary intestinal stomas confront multifaceted challenges encompassing burdens,inadequate self-care abilities,informational deficits,and emotional needs.Identifying factors influencing patients’self-care at home and proposing strategies to mitigate barriers can serve as a foundational framework for developing and implementing nursing interventions tailored to the needs of patients with temporary intestinal stomas.展开更多
Introduction: Acquired immunodeficiency syndrome is one of the leading causes of mortality among women of reproductive age and Mother to Child Transmission of Human immunodeficiency virus is still a challenge affectin...Introduction: Acquired immunodeficiency syndrome is one of the leading causes of mortality among women of reproductive age and Mother to Child Transmission of Human immunodeficiency virus is still a challenge affecting many countries. Globally, an estimation of 180,000 children under 15 years acquire the Human immunodeficiency virus every day, and more than 90% of those infections are due to Mother to Child Transmission. The study sought to explore the experiences of mothers on the Elimination of Mother to Child Transmission-HIV services at Mtendere Clinic, Lusaka. Materials and Methods: Qualitative interpretive phenomenology study design was employed using in-depth interviews to collect data from a sample that was selected using purposive sampling technique. Thirteen participants were recruited, and these were HIV-positive mothers at least between the ages of 15 and 49 years and enrolled in the Elimination of Mother To Child Transmission-HIV program. The in-depth interviews were audiotape recorded and transcribed verbatim. Data was analyzed using thematic method. Findings: Three main themes that emerged are;living with HIV, support system and barriers to utilization of Elimination of Mother To Child Transmission-HIV services. Most of the participants expressed having acquired knowledge from the program, and received counselling and support from spouses, family as well as health personnel at Mtendere health facility which culminated into a positive experience and enhanced their uptake of the Elimination of Mother to Child Transmission-HIV services. However, barriers to service utilization were identified and these included fear of stigma, negative attitudes from health workers, long waiting times, lack of support and lack of transport to the health facility. Conclusion: Interventions such as community awareness campaigns on Elimination of Mother To Child Transmission-HIV, male involvement and implementing mother-to-mother peer support strategies in Elimination of Mother To Child Transmission-HIV service utilization should be prioritized so as to alleviate stigma and enhancing a positive experience for these mothers thus reducing on the Mother to Child HIV Transmission burden and mortality rates.展开更多
Introduction: Sickle cell disease has physical and emotional repercussions on the child and his family. The aim of this study was to describe the psychosocial experiences of mothers of children with sickle cell diseas...Introduction: Sickle cell disease has physical and emotional repercussions on the child and his family. The aim of this study was to describe the psychosocial experiences of mothers of children with sickle cell disease in order to improve the overall care of the child. Methods: This was a descriptive cross-sectional study carried out in the pediatrics department of Bouaké University Teaching Hospital from June to September 2023. It focused on mothers of major sickle-cell-affected children followed up in the pediatrics department of the Bouaké University Teaching Hospital. The variables studied were sociodemographic, psychological, social and economic. Results: Of the 40 mothers surveyed, 15% were not in school and 32.5% were unemployed. For them, sickle cell disease was of natural (genetic) origin in 90% and supernatural in 10%. They stated that the child had an average age of 36 months (extremes 7 and 108 months) when the disease was discovered. And 52% of them were satisfied with the way the disease was clearly and completely announced. Following the announcement, the questioned mothers said they had felt shock (35%), sadness (31.7%), guilt (23.3%) and discouragement (10%). Anxiety and depression were experienced by 77.5% and 22.5% respectively. In 60% of cases, they stated that the disease was incurable, and the outcome was fatal in 2.5% of cases. The child’s illness was a source of problems in the home in 25% of cases, represented by arguments in 92% and divorce in 8%. In 97.5% of cases, the mother told her family and friends about the child’s illness. In 90% of cases, the mother and child benefited from psychological support from family and friends. Conclusion: Sickle cell disease is a serious illness with a psychological and social impact on mothers. We recommend psychological support for mothers from the moment of diagnosis and throughout follow-up.展开更多
Introduction: Priapism is a urological emergency defined as a prolonged penile erection for more than 6 hours, painful and sustained, occurring without any sexual stimulation. The diagnosis is essentially clinical. Ho...Introduction: Priapism is a urological emergency defined as a prolonged penile erection for more than 6 hours, painful and sustained, occurring without any sexual stimulation. The diagnosis is essentially clinical. However, the management is often late because of the delay in consultation, which is characteristic in our context. The purpose of our study is to describe the clinical and therapeutic aspects of patients who presented with priapism at the Yaoundé Central Hospital as well as to propose a present synthesis concerning the management of priapism. Methodology: We conducted a descriptive cross-sectional study with a retrospective recruitment method in the urology department of the YCH. It extended over a period of 6 months from January 2022 to June 2022. We reviewed the files of patients seen within a period spanning 10 years from January 1<sup>st</sup>, 2011 to January 31<sup>st</sup>, December 2021. The study population consisted of patients who had been hospitalized and treated for priapism. We carried out consecutive and non-exhaustive sampling. Results: During the study, we collected data from the medical files of 13 patients. The median age was 25 years, with extremes of 12 and 82 years. Most of the patients were between 20 and 30 years old (38.5%). Most of the patients were single (69.2%). Sickle cell disease was the main comorbidity encountered during the study (76.9%). The median time from onset of symptoms to consultation was 10 [6 - 20.5] hours, with extremes of 1 and 264 hours. All patients presented with painful penile erection (100%). There was concomitant multifocal pain in 38.5% of cases suggestive of vaso-occlusive crises (VOC). The symptoms occurred in a non-traumatic context in the majority of cases (92.3%). The T-shunt was the most used surgical technique (84.6%). The median duration of surgery was 36 [35 - 40] minutes with extremes of 25 and 60 minutes, the majority being operated in less than 45 minutes (84.6%). The frequency of postoperative complications was 46.2%, dominated by weak erections/loss of erections (38.5%). The median duration of hospitalisation was 4 [3 - 5.5] days, with extremes 2 and 20 days of hospitalisation. Resumption of sexual activity was reported in 8 patients (61.5%). The time to recovery was mostly greater than 6 weeks (62.5%). Conclusion: Priapism remains a urological emergency. The prognosis depends on the patients’ promptness in consulting. The T-Shunt is an effective surgical technique in the event of failure of medical treatment.展开更多
BACKGROUND Laparoscopic surgery has reduced morbidity and mortality rates,shorter post-operative recovery periods and lower complication rates than open surgery.It is routine practice in high-income countries and is b...BACKGROUND Laparoscopic surgery has reduced morbidity and mortality rates,shorter post-operative recovery periods and lower complication rates than open surgery.It is routine practice in high-income countries and is becoming increasingly common in countries with limited resources.However,introducing laparoscopic surgery in low-and-middle-income countries(LMIC)can be expensive and requires resour-ces,equipment,and trainers.AIM To report the challenges and benefits of introducing laparoscopic surgery in LMIC as well as to identify solutions to these challenges for countries with limited finances and resources.METHODS MEDLINE,EMBASE and Cochrane databases were searched for studies reporting first experience in laparoscopic surgery in LMIC.Included studies were published between 1996 and 2022 with full text available in English.Exclusion criteria were studies considering only open surgery,ear,nose,and throat,endoscopy,arthro-scopy,hysteroscopy,cystoscopy,transplant,or bariatric surgery.RESULTS Ten studies out of 3409 screened papers,from eight LMIC were eligible for inclusion in the final analysis,totaling 2497 patients.Most reported challenges were related to costs of equipment and training programmes,equipment pro-blems such as faulty equipment,and access to surgical kits.Training-related challenges were reliance on foreign trainers and lack of locally trained surgeons and theatre staff.The benefits of introducing laparoscopic surgery were economic and clinical,including a reduction in hospital stay,complications,and morbidi-ty/mortality.The introduction of laparoscopic surgery also provided training opportunities for junior doctors.CONCLUSION Despite financial and technical challenges,many studies emphasise the overall benefit of introducing laparoscopic surgery in LMICs such as reduced hospital stay and the related lower cost for patients.While many of the clinical centres in LMICs have proposed practical solutions to the challenges reported,more support is critically required,in particular regarding training.展开更多
This article explores the role of smart textiles in transforming healthcare environments into spaces that prioritize patient well-being. We will examine the advantages of smart textiles in healthcare settings, such as...This article explores the role of smart textiles in transforming healthcare environments into spaces that prioritize patient well-being. We will examine the advantages of smart textiles in healthcare settings, such as the real-time monitoring of vital signs through connected clothing. Additionally, we will introduce metadesign as a design approach that considers the interactions between users, healthcare environments, and technologies to create fulfilling experiences. By combining the advanced features of smart textiles with a patient-centered metadesign approach, it becomes possible to create care spaces that cater to patient needs. The objective of this article is to present the integration of metadesign in the design of smart textiles as a process aimed at enhancing the quality of the patient user experience. In this process, we will emphasize the collaborative approach and embrace technological innovation to harness the potential for ongoing improvement and provide users with high-quality experiences. Lastly, we will underscore the significance of adopting a multidimensional approach to evaluate the impact of smart textiles on the patient user experience.展开更多
Since the 18th National Congress of the Communist Party of China,the country has established 21 Free Trade Pilot Zones(FTZs),achieving significant pioneering results in reform and opening up and creating a strong demo...Since the 18th National Congress of the Communist Party of China,the country has established 21 Free Trade Pilot Zones(FTZs),achieving significant pioneering results in reform and opening up and creating a strong demonstrative effect nationwide.The basic experience from a decade of FTZs includes:adhering to the centralized and unified leadership of the CPC Central Committee;combining top-level design with encouragement of grassroots innovation;leveraging the distinct characteristics and strengths of FTZs to form a differentiated development pattern;maintaining the integration of opening up with domestic reforms;using openness to drive reforms;and organically combining openness with national security assurance.Under the current and future new circumstances,China’s FTZs face new challenges and tasks.In accordance with the directives of the 20th National Congress of the Communist Party of China,an enhancement strategy for the FTZs needs to be implemented.This involves the following:First,accurately understanding and responding to the changing situation to create strategic opportunities.Second,shifting paradigms to implement innovation-driven strategies,using the new development pattern concept to guide the reform experiments and construction of the FTZs.Third,granting more autonomy to FTZs for reforms,pursuing progress while maintaining stability,and solidly advancing the reform experiments in the FTZs.Fourth,orderly expanding the opening up of the service sector and cautiously advancing the internationalization of the renminbi.Fifth,promoting innovative development in trade to build a strong trade nation.Sixth,establishing synergy with bilateral FTZs,Belt and Road cooperation,and national diplomatic strategies to enhance the linkage effect.展开更多
The research aims to explore the transition from monolithic Digital Experience Platforms (DXPs) to Microservices-based DXPs, addressing scalability challenges. The study systematically decomposes monolithic structures...The research aims to explore the transition from monolithic Digital Experience Platforms (DXPs) to Microservices-based DXPs, addressing scalability challenges. The study systematically decomposes monolithic structures into Microservices, emphasizing business capability and subdomain decomposition. Concrete insights, challenges, and solutions encountered during this transformation process are presented. The research contributes valuable insights into the challenges and benefits of adopting Microservices in DXPs. Results highlight the importance of architectural patterns and strategic scaling dimensions for improved performance and scalability. The case study on Backbase’s Engagement Banking Platform showcases successful implementation, providing flexibility, integration, and efficient development in the evolving DXP landscape.展开更多
By systematically reviewing the practical experience of management of urban parks at home and abroad,the advanced experience in organization,management system,operation mechanism and social participation were summariz...By systematically reviewing the practical experience of management of urban parks at home and abroad,the advanced experience in organization,management system,operation mechanism and social participation were summarized,and the optimization and improvement measures for the construction and management of urban parks in Chengdu were proposed to provide reference for the high-level construction,high-quality experience and efficient management of urban parks in the construction of park city demonstration zone in Chengdu.展开更多
Establishing a sense of ritual within tourism consumption scenarios offers tourists the opportunity for interactive engagement.Drawing upon the value co-creation theory,this study constructed an influence mechanism mo...Establishing a sense of ritual within tourism consumption scenarios offers tourists the opportunity for interactive engagement.Drawing upon the value co-creation theory,this study constructed an influence mechanism model to examine tourists'active engagement in the process of co-creating tourism experience values.It employed Partial Least Squares Structural Equation Modeling(PLS-SEM)to empirically test the proposed hypotheses.The findings demonstrate that the model constructed in the present study exhibits robust reliability,validity,and explanatory power.The perception of the sense of ritual in tourism exerts a significant positive influence on tourists’co-creation of tourism experience values,thereby significantly enhancing both the communitas and flow experienced by tourists during their travels.Moreover,such communitas and flow can mediate the influence of the sense of ritual in tourism on tourists’co-creation of tourism experience values.This study contributes to advancing the current research on tourists’co-creation of tourism experience values and the sense of ritual in tourism,thereby providing theoretical foundations for cultivating a sense of ritual within tourism consumption scenarios.展开更多
Blended learning(BL)has been widely adopted to improve students’academic achievements in higher education.However,its success relies mainly on student engagement,which plays an essential role in active learning and p...Blended learning(BL)has been widely adopted to improve students’academic achievements in higher education.However,its success relies mainly on student engagement,which plays an essential role in active learning and provides a rich understanding of students’experiences.The study utilized three self-designed scales-the Teacher Support Scale,Student Engagement Scale,and Student Learning Experience Scale-to gauge and examine the impact and relationship between perceived teacher support,student behavioral engagement,and the intermediary role of learning experiences.A cohort of 899 college students undertaking the obligatory College English course through BL modes across five Chinese universities actively participated by completing a comprehensive questionnaire.The results showed significant correlations between perceived teacher support,learning experience,and behavioral engagement.Perceived teacher support significantly predicted students’behavioral engagement,with socio-affective support exerting the most substantial predictive effects.All predictive effects were partially mediated by learning experience(learning mode,online resources,overall LMS-based learning,interaction with their instructor and peers,and learning outcome).The influence of perceived teacher support on behavioral engagement differed between students who reported the most positive(vs.negative)learning experiences.Suggestions for further research are offered for consideration.展开更多
Reinforcement Learning(RL)based control algorithms can learn the control strategies for nonlinear and uncertain environment during interacting with it.Guided by the rewards generated by environment,a RL agent can lear...Reinforcement Learning(RL)based control algorithms can learn the control strategies for nonlinear and uncertain environment during interacting with it.Guided by the rewards generated by environment,a RL agent can learn the control strategy directly in a model-free way instead of investigating the dynamic model of the environment.In the paper,we propose the sampled-data RL control strategy to reduce the computational demand.In the sampled-data control strategy,the whole control system is of a hybrid structure,in which the plant is of continuous structure while the controller(RL agent)adopts a discrete structure.Given that the continuous states of the plant will be the input of the agent,the state–action value function is approximated by the fully connected feed-forward neural networks(FCFFNN).Instead of learning the controller at every step during the interaction with the environment,the learning and acting stages are decoupled to learn the control strategy more effectively through experience replay.In the acting stage,the most effective experience obtained during the interaction with the environment will be stored and during the learning stage,the stored experience will be replayed to customized times,which helps enhance the experience replay process.The effectiveness of proposed approach will be verified by simulation examples.展开更多
Carbon neutrality(or climate neutrality)has been a global consensus,and international experience exchange is essential.Given the differences in the degree of social development,resource endowment and technological lev...Carbon neutrality(or climate neutrality)has been a global consensus,and international experience exchange is essential.Given the differences in the degree of social development,resource endowment and technological level,each country should build a carbon-neutral plan based on its national conditions.Compared with other major developed countries(e.g.,Germany,the United States and Japan),China's carbon neutrality has much bigger challenges,including a heavy and time-pressured carbon reduction task and the current energy structure that is over-dependent on fossil fuels.Here we provide a comprehensive review of the status and prospects of the key technologies for low-carbon,near-zero carbon,and negative carbon emissions.Technological innovations associated with coal,oil-gas and hydrogen industries and their future potential in reducing carbon emissions are particularly explained and assessed.Based on integrated analysis of international experience from the world's major developed countries,in-depth knowledge of the current and future technologies,and China's energy and ecological resources potential,five lessons for the implementation of China's carbon neutrality are proposed:(1)transformation of energy production pattern from a coal-dominated pattern to a diversified renewable energy pattern;(2)renewable power-to-X and large-scale underground energy storage;(3)integration of green hydrogen production,storage,transport and utilization;(4)construction of clean energy systems based on smart sector coupling(ENSYSCO);(5)improvement of ecosystem carbon sinks both in nationwide forest land and potential desert in Northwest China.This paper provides an international perspective for a better understanding of the challenges and opportunities of carbon neutrality in China,and can serve as a theoretical foundation for medium-long term carbon neutral policy formulation.展开更多
AIM:To evaluate the efficacy and tolerability of administering a combined therapy in patients with dry eye syndrome(DES)and associated laryngopharyngeal reflux(LPR).METHODS:The study was retrospective,open,observation...AIM:To evaluate the efficacy and tolerability of administering a combined therapy in patients with dry eye syndrome(DES)and associated laryngopharyngeal reflux(LPR).METHODS:The study was retrospective,open,observational,and conducted in a real-life setting.Patients had pathological symptom assessment in dry eye(SANDE)and reflux symptom index(RSI)at baseline.Patients were re-assessed after 1mo and at the end of treatment.The treatment consisted of a three-month course based on the combined therapy:Gastroftal eye drops,one drop three times a day,and Gastroftal tablets,two tablets after lunch and two tablets after dinner.Tear break-up-time(TBUT)test,Schirmer test,RSI,and SANDE questionnaire were evaluated.RESULTS:The study included 253 patients.The mean age was 58±11.19y.TBUT test score and Schirmer’s test significantly increased(both P<0.001)after 1mo and at the end of treatment.The RSI score and SANDE scores significantly decreased(both P<0.001)after 1mo and at the end of treatment.CONCLUSION:The current,retrospective,and open study shows that combined therapy using Gastroftal eye drops and tablets could represent a valuable option in managing patients with DES associated with LPR.展开更多
Aqueous supercapacitors(SCs)have been regarded as a promising candidate for commercial energy storage device due to their superior safety,low cost,and environmental benignity.Unfortunately,an age-old challenge of achi...Aqueous supercapacitors(SCs)have been regarded as a promising candidate for commercial energy storage device due to their superior safety,low cost,and environmental benignity.Unfortunately,an age-old challenge of achieving both long electrode lifespan and qualified energy-storage property blocks their practical application.Herein,we develop an electrode-electrolyte integrated optimization strategy to fulfill the real-life device requirements.Electrode optimization simultaneously regulates the nanomorphology and surface chemistry of the tungsten oxide anode,resulting in superior electrochemical performance given by an ideal“bird-nest”structure with optimal oxygen vacancy status;the anodes interact with and are protected from dissolution and structural collapse by the rationally designed hybrid electrolyte with optimized pH and facilitated cation desorption behavior.Collaboratively,a record-breaking durability of no capacitive decay after 250000 cycles is achieved.On the basis of this integrated optimization,the first aqueous pouch SCs with real-life practicability were manufactured by a soft-package encapsulation technique,which can steadily power commercial 3 C products such as tablets and smartphones and maintain safely working against extreme conditions.This work demonstrates the possibility of using aqueous energy storage devices with enhanced safety and lower cost to replace the commercial organic counterparts for wide range of daily applications.展开更多
Purpose: Malaria continues to be a public health threat, especially in sub-Saharan Africa, including Uganda. While Batwa Indigenous People (IPs) face a higher burden of malaria, there is limited understanding of their...Purpose: Malaria continues to be a public health threat, especially in sub-Saharan Africa, including Uganda. While Batwa Indigenous People (IPs) face a higher burden of malaria, there is limited understanding of their malaria-lived experiences. We assessed and characterized malaria illness and accessing healthcare lived experiences of the Batwa in Kanungu district to inform contextually and culturally appropriate public health interventions. Methods: An exploratory qualitative study was conducted in 5 Batwa settlements where 5 Focus Group Discussions (n = 36) and 13 Key Informant Interviews (n = 13) were held. Data were collected using printed guides and voice recorders in April 2018. Transcripts from the data that captured the lived experiences of the symptoms, prevention, treatment and barriers to accessing formal healthcare services were applied to Atlas.ti a qualitative data analysis software and condensed into codes, categories, and themes. Results: Many Batwa have experienced malaria in their households, and they know its causes and risk factors, like not sleeping under insecticide-treated mosquito nets (ITNs), living near water bodies, prevention measures like the use of ITNs, and vector management. The lived experiences demonstrate malaria management by an Indigenous population in a rural setting and comprised detecting malaria symptoms, use of herbs as first line of treatment, buying medicines from drug shops, and village health teams (VHTs) treatment. For many Batwa accessing formal healthcare is normally a second option. Barriers for malaria treatment included: long distances to health facilities, geographically difficult terrain, economic constraints, irregular health outreaches, and stockouts of malaria medicines at health facilities. Conclusion: This study characterized Batwa’s malaria illness lived experiences and access to healthcare in rural remote settings. These experiences are essential in appreciating the ways in which Indigenous populations understand and manage common illnesses and how appropriate policies and interventions can be developed.展开更多
Introduction: Surgery can cause anxiety and worry, such as waking up in pain, being physically harmed or dying. This study aimed to assess the experience of patients undergoing planned gynaecological surgery in the Ob...Introduction: Surgery can cause anxiety and worry, such as waking up in pain, being physically harmed or dying. This study aimed to assess the experience of patients undergoing planned gynaecological surgery in the Obstetrics Gynaecology and Reproductive Medicine department of the University Hospital Centre of Bogodogo. Patients and methods: This was a cross-sectional study with prospective data collection during the period from June 1 to August 31, 2018. The study population consisted of patients who received scheduled gynaecological surgery during the period. Results: Seventy-six (76) patients underwent scheduled surgery and 62 were included. During discussion with the gynaecologist, 58 patients (93.55%) were satisfied. When the surgery was announced, 41 patients (66.13%) were anxious. At the consultation with the anaesthetist 59 patients (95.16%) were satisfied with the discussions. Fifty-five patients (88.7%) were anxious on admission to the operating theatre. The quality of care was satisfactory for 61 patients (98.39%) and all patients were satisfied with the care team. Conclusion: Periodic evaluation of patients’ experiences should therefore be incorporated into care evaluation policies in health facilities in order to contribute to continuous improvement in the quality of medical and surgical care.展开更多
基金the National Key Research and Development Program of China under Grant 2021YFB3301300the National Natural Science Foundation of China under Grant 62203213+1 种基金the Natural Science Foundation of Jiangsu Province under Grant BK20220332the Open Project Program of Fujian Provincial Key Laboratory of Intelligent Identification and Control of Complex Dynamic System under Grant 2022A0004.
文摘The reliable operation of high-speed wire rod finishing mills is crucial in the steel production enterprise.As complex system-level equipment,it is difficult for high-speed wire rod finishing mills to realize fault location and real-time monitoring.To solve the above problems,an expert experience and data-driven-based hybrid fault diagnosis method for high-speed wire rod finishing mills is proposed in this paper.First,based on its mechanical structure,time and frequency domain analysis are improved in fault feature extraction.The approach of combining virtual value,peak value with kurtosis value index,is adopted in time domain analysis.Speed adjustment and side frequency analysis are proposed in frequency domain analysis to obtain accurate component characteristic frequency and its corresponding sideband.Then,according to time and frequency domain characteristics,fault location based on expert experience is proposed to get an accurate fault result.Finally,the proposed method is implemented in the equipment intelligent diagnosis system.By taking an equipment fault on site,for example,the effectiveness of the proposed method is illustrated in the system.
文摘Introduction: Access to antiretroviral drugs has improved the survival of children infected with the Human Immunodeficiency Virus (HIV). As they reach adolescence, they are confronted with various constraints related to the infection and its treatment, in addition to those of the growth period they are going through. The main aim of the study was to assess the acceptance and describe the experience of HIV infection by infected adolescents but also to investigate the factors associated with good acceptance and a positive experience. Methodology: The cross-sectional analytic study concerned HIV-infected adolescents aged 15 to 19 followed up at the Chantal Biya Foundation-Mother and Child Centre (CME-FCB) and the Yaoundé University Hospital Centre (CHUY) between February 2020 and June 2020. The study saw participants complete a questionnaire containing socio-demographic data and assessing acceptance and experience with the infection. Data analysis was accomplished using Epi info software version 7.2.2.6. Results: One hundred and thirteen HIV-infected adolescents were included in the study. The sex ratio was 0.68 and the mean age was 17 years. More than half of the adolescents had a good acceptance and positive experience with the infection. Related factors were the adolescent’s perception of good health and participation in an association with other infected adolescents. Conclusion: Emphasizing the psychological and educational follow-up of infected adolescents and encouraging their participation in associations for adolescents living with HIV could reduce the consequences of poor acceptance and ensure a better transition to adulthood. .
基金The study was reviewed and approved by the Science and Research Office of Tong Ren Hospital(Shanghai), No. AF/SC-08/04.0.
文摘BACKGROUND This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and care needs.Protecting the anus surgery combined with temporary colostomy has emerged as a prevalent treatment modality for low rectal cancer.However,the ileostomy is susceptible to peri-stoma skin complications,as well as fluid,electrolyte,and nutritional imbalances,posing challenges to effective management.The successful selfmanagement of patients is intricately linked to their adjustment to temporary colostomy;nonetheless,there remains a dearth of research examining the factors influencing self-care among temporary colostomy patients and the obstacles they confront.AIM To investigate the lived experiences,perceptions,and care requirements of temporary colostomy patients within their home environment,with the ultimate goal of formulating a standardized management protocol.METHODS Over the period of June to August 2023,a purposive sampling technique was utilized to select 12 patients with temporary intestinal stomas from a tertiary hospital in Shanghai,China.Employing a phenomenological research approach,a semi-structured interview guide was developed,and qualitative interviews were conducted using in-depth interview techniques.The acquired data underwent coding,analysis,organization,and summarization following Colaizzi’s seven-step method.RESULTS The findings of this study revealed that the experiences and needs of patients with temporary intestinal stomas can be delineated into four principal themes:Firstly,Temporary colostomy patients bear various burdens and concerns about the uncertainty of disease progression;secondly,patients exhibit limited self-care capabilities and face information deficits,resulting in heightened reliance on healthcare professionals;thirdly,patients demonstrate the potential for internal motivation through proactive self-adjustment;and finally,patients express a significant need for emotional and social support.CONCLUSION Home-living patients with temporary intestinal stomas confront multifaceted challenges encompassing burdens,inadequate self-care abilities,informational deficits,and emotional needs.Identifying factors influencing patients’self-care at home and proposing strategies to mitigate barriers can serve as a foundational framework for developing and implementing nursing interventions tailored to the needs of patients with temporary intestinal stomas.
文摘Introduction: Acquired immunodeficiency syndrome is one of the leading causes of mortality among women of reproductive age and Mother to Child Transmission of Human immunodeficiency virus is still a challenge affecting many countries. Globally, an estimation of 180,000 children under 15 years acquire the Human immunodeficiency virus every day, and more than 90% of those infections are due to Mother to Child Transmission. The study sought to explore the experiences of mothers on the Elimination of Mother to Child Transmission-HIV services at Mtendere Clinic, Lusaka. Materials and Methods: Qualitative interpretive phenomenology study design was employed using in-depth interviews to collect data from a sample that was selected using purposive sampling technique. Thirteen participants were recruited, and these were HIV-positive mothers at least between the ages of 15 and 49 years and enrolled in the Elimination of Mother To Child Transmission-HIV program. The in-depth interviews were audiotape recorded and transcribed verbatim. Data was analyzed using thematic method. Findings: Three main themes that emerged are;living with HIV, support system and barriers to utilization of Elimination of Mother To Child Transmission-HIV services. Most of the participants expressed having acquired knowledge from the program, and received counselling and support from spouses, family as well as health personnel at Mtendere health facility which culminated into a positive experience and enhanced their uptake of the Elimination of Mother to Child Transmission-HIV services. However, barriers to service utilization were identified and these included fear of stigma, negative attitudes from health workers, long waiting times, lack of support and lack of transport to the health facility. Conclusion: Interventions such as community awareness campaigns on Elimination of Mother To Child Transmission-HIV, male involvement and implementing mother-to-mother peer support strategies in Elimination of Mother To Child Transmission-HIV service utilization should be prioritized so as to alleviate stigma and enhancing a positive experience for these mothers thus reducing on the Mother to Child HIV Transmission burden and mortality rates.
文摘Introduction: Sickle cell disease has physical and emotional repercussions on the child and his family. The aim of this study was to describe the psychosocial experiences of mothers of children with sickle cell disease in order to improve the overall care of the child. Methods: This was a descriptive cross-sectional study carried out in the pediatrics department of Bouaké University Teaching Hospital from June to September 2023. It focused on mothers of major sickle-cell-affected children followed up in the pediatrics department of the Bouaké University Teaching Hospital. The variables studied were sociodemographic, psychological, social and economic. Results: Of the 40 mothers surveyed, 15% were not in school and 32.5% were unemployed. For them, sickle cell disease was of natural (genetic) origin in 90% and supernatural in 10%. They stated that the child had an average age of 36 months (extremes 7 and 108 months) when the disease was discovered. And 52% of them were satisfied with the way the disease was clearly and completely announced. Following the announcement, the questioned mothers said they had felt shock (35%), sadness (31.7%), guilt (23.3%) and discouragement (10%). Anxiety and depression were experienced by 77.5% and 22.5% respectively. In 60% of cases, they stated that the disease was incurable, and the outcome was fatal in 2.5% of cases. The child’s illness was a source of problems in the home in 25% of cases, represented by arguments in 92% and divorce in 8%. In 97.5% of cases, the mother told her family and friends about the child’s illness. In 90% of cases, the mother and child benefited from psychological support from family and friends. Conclusion: Sickle cell disease is a serious illness with a psychological and social impact on mothers. We recommend psychological support for mothers from the moment of diagnosis and throughout follow-up.
文摘Introduction: Priapism is a urological emergency defined as a prolonged penile erection for more than 6 hours, painful and sustained, occurring without any sexual stimulation. The diagnosis is essentially clinical. However, the management is often late because of the delay in consultation, which is characteristic in our context. The purpose of our study is to describe the clinical and therapeutic aspects of patients who presented with priapism at the Yaoundé Central Hospital as well as to propose a present synthesis concerning the management of priapism. Methodology: We conducted a descriptive cross-sectional study with a retrospective recruitment method in the urology department of the YCH. It extended over a period of 6 months from January 2022 to June 2022. We reviewed the files of patients seen within a period spanning 10 years from January 1<sup>st</sup>, 2011 to January 31<sup>st</sup>, December 2021. The study population consisted of patients who had been hospitalized and treated for priapism. We carried out consecutive and non-exhaustive sampling. Results: During the study, we collected data from the medical files of 13 patients. The median age was 25 years, with extremes of 12 and 82 years. Most of the patients were between 20 and 30 years old (38.5%). Most of the patients were single (69.2%). Sickle cell disease was the main comorbidity encountered during the study (76.9%). The median time from onset of symptoms to consultation was 10 [6 - 20.5] hours, with extremes of 1 and 264 hours. All patients presented with painful penile erection (100%). There was concomitant multifocal pain in 38.5% of cases suggestive of vaso-occlusive crises (VOC). The symptoms occurred in a non-traumatic context in the majority of cases (92.3%). The T-shunt was the most used surgical technique (84.6%). The median duration of surgery was 36 [35 - 40] minutes with extremes of 25 and 60 minutes, the majority being operated in less than 45 minutes (84.6%). The frequency of postoperative complications was 46.2%, dominated by weak erections/loss of erections (38.5%). The median duration of hospitalisation was 4 [3 - 5.5] days, with extremes 2 and 20 days of hospitalisation. Resumption of sexual activity was reported in 8 patients (61.5%). The time to recovery was mostly greater than 6 weeks (62.5%). Conclusion: Priapism remains a urological emergency. The prognosis depends on the patients’ promptness in consulting. The T-Shunt is an effective surgical technique in the event of failure of medical treatment.
文摘BACKGROUND Laparoscopic surgery has reduced morbidity and mortality rates,shorter post-operative recovery periods and lower complication rates than open surgery.It is routine practice in high-income countries and is becoming increasingly common in countries with limited resources.However,introducing laparoscopic surgery in low-and-middle-income countries(LMIC)can be expensive and requires resour-ces,equipment,and trainers.AIM To report the challenges and benefits of introducing laparoscopic surgery in LMIC as well as to identify solutions to these challenges for countries with limited finances and resources.METHODS MEDLINE,EMBASE and Cochrane databases were searched for studies reporting first experience in laparoscopic surgery in LMIC.Included studies were published between 1996 and 2022 with full text available in English.Exclusion criteria were studies considering only open surgery,ear,nose,and throat,endoscopy,arthro-scopy,hysteroscopy,cystoscopy,transplant,or bariatric surgery.RESULTS Ten studies out of 3409 screened papers,from eight LMIC were eligible for inclusion in the final analysis,totaling 2497 patients.Most reported challenges were related to costs of equipment and training programmes,equipment pro-blems such as faulty equipment,and access to surgical kits.Training-related challenges were reliance on foreign trainers and lack of locally trained surgeons and theatre staff.The benefits of introducing laparoscopic surgery were economic and clinical,including a reduction in hospital stay,complications,and morbidi-ty/mortality.The introduction of laparoscopic surgery also provided training opportunities for junior doctors.CONCLUSION Despite financial and technical challenges,many studies emphasise the overall benefit of introducing laparoscopic surgery in LMICs such as reduced hospital stay and the related lower cost for patients.While many of the clinical centres in LMICs have proposed practical solutions to the challenges reported,more support is critically required,in particular regarding training.
文摘This article explores the role of smart textiles in transforming healthcare environments into spaces that prioritize patient well-being. We will examine the advantages of smart textiles in healthcare settings, such as the real-time monitoring of vital signs through connected clothing. Additionally, we will introduce metadesign as a design approach that considers the interactions between users, healthcare environments, and technologies to create fulfilling experiences. By combining the advanced features of smart textiles with a patient-centered metadesign approach, it becomes possible to create care spaces that cater to patient needs. The objective of this article is to present the integration of metadesign in the design of smart textiles as a process aimed at enhancing the quality of the patient user experience. In this process, we will emphasize the collaborative approach and embrace technological innovation to harness the potential for ongoing improvement and provide users with high-quality experiences. Lastly, we will underscore the significance of adopting a multidimensional approach to evaluate the impact of smart textiles on the patient user experience.
文摘Since the 18th National Congress of the Communist Party of China,the country has established 21 Free Trade Pilot Zones(FTZs),achieving significant pioneering results in reform and opening up and creating a strong demonstrative effect nationwide.The basic experience from a decade of FTZs includes:adhering to the centralized and unified leadership of the CPC Central Committee;combining top-level design with encouragement of grassroots innovation;leveraging the distinct characteristics and strengths of FTZs to form a differentiated development pattern;maintaining the integration of opening up with domestic reforms;using openness to drive reforms;and organically combining openness with national security assurance.Under the current and future new circumstances,China’s FTZs face new challenges and tasks.In accordance with the directives of the 20th National Congress of the Communist Party of China,an enhancement strategy for the FTZs needs to be implemented.This involves the following:First,accurately understanding and responding to the changing situation to create strategic opportunities.Second,shifting paradigms to implement innovation-driven strategies,using the new development pattern concept to guide the reform experiments and construction of the FTZs.Third,granting more autonomy to FTZs for reforms,pursuing progress while maintaining stability,and solidly advancing the reform experiments in the FTZs.Fourth,orderly expanding the opening up of the service sector and cautiously advancing the internationalization of the renminbi.Fifth,promoting innovative development in trade to build a strong trade nation.Sixth,establishing synergy with bilateral FTZs,Belt and Road cooperation,and national diplomatic strategies to enhance the linkage effect.
文摘The research aims to explore the transition from monolithic Digital Experience Platforms (DXPs) to Microservices-based DXPs, addressing scalability challenges. The study systematically decomposes monolithic structures into Microservices, emphasizing business capability and subdomain decomposition. Concrete insights, challenges, and solutions encountered during this transformation process are presented. The research contributes valuable insights into the challenges and benefits of adopting Microservices in DXPs. Results highlight the importance of architectural patterns and strategic scaling dimensions for improved performance and scalability. The case study on Backbase’s Engagement Banking Platform showcases successful implementation, providing flexibility, integration, and efficient development in the evolving DXP landscape.
基金the Scientific Research Project of Natural Resources Department of Sichuan Province(KJ-2023-032).
文摘By systematically reviewing the practical experience of management of urban parks at home and abroad,the advanced experience in organization,management system,operation mechanism and social participation were summarized,and the optimization and improvement measures for the construction and management of urban parks in Chengdu were proposed to provide reference for the high-level construction,high-quality experience and efficient management of urban parks in the construction of park city demonstration zone in Chengdu.
基金This study was supported by the Humanities and Social Sciences Project of the Ministry of Education(No.23YJA790070)the Graduate Innovation Research Project of Southwest Minzu University(No.YB2022621)the Research Project of BCIMY(No.BCIMY1910).
文摘Establishing a sense of ritual within tourism consumption scenarios offers tourists the opportunity for interactive engagement.Drawing upon the value co-creation theory,this study constructed an influence mechanism model to examine tourists'active engagement in the process of co-creating tourism experience values.It employed Partial Least Squares Structural Equation Modeling(PLS-SEM)to empirically test the proposed hypotheses.The findings demonstrate that the model constructed in the present study exhibits robust reliability,validity,and explanatory power.The perception of the sense of ritual in tourism exerts a significant positive influence on tourists’co-creation of tourism experience values,thereby significantly enhancing both the communitas and flow experienced by tourists during their travels.Moreover,such communitas and flow can mediate the influence of the sense of ritual in tourism on tourists’co-creation of tourism experience values.This study contributes to advancing the current research on tourists’co-creation of tourism experience values and the sense of ritual in tourism,thereby providing theoretical foundations for cultivating a sense of ritual within tourism consumption scenarios.
基金Zhejiang Provincial Philosophy and Social Sciences Planning Project from Zhejiang Office of Philosophy and Social Science(21NDJC092YB)Zhejiang Provincial Educational Science Plan Project(2021SCG166)。
文摘Blended learning(BL)has been widely adopted to improve students’academic achievements in higher education.However,its success relies mainly on student engagement,which plays an essential role in active learning and provides a rich understanding of students’experiences.The study utilized three self-designed scales-the Teacher Support Scale,Student Engagement Scale,and Student Learning Experience Scale-to gauge and examine the impact and relationship between perceived teacher support,student behavioral engagement,and the intermediary role of learning experiences.A cohort of 899 college students undertaking the obligatory College English course through BL modes across five Chinese universities actively participated by completing a comprehensive questionnaire.The results showed significant correlations between perceived teacher support,learning experience,and behavioral engagement.Perceived teacher support significantly predicted students’behavioral engagement,with socio-affective support exerting the most substantial predictive effects.All predictive effects were partially mediated by learning experience(learning mode,online resources,overall LMS-based learning,interaction with their instructor and peers,and learning outcome).The influence of perceived teacher support on behavioral engagement differed between students who reported the most positive(vs.negative)learning experiences.Suggestions for further research are offered for consideration.
基金supported by Imperial College London,UK,King’s College London,UK and Engineering and Physical Sciences Research Council(EPSRC),UK.
文摘Reinforcement Learning(RL)based control algorithms can learn the control strategies for nonlinear and uncertain environment during interacting with it.Guided by the rewards generated by environment,a RL agent can learn the control strategy directly in a model-free way instead of investigating the dynamic model of the environment.In the paper,we propose the sampled-data RL control strategy to reduce the computational demand.In the sampled-data control strategy,the whole control system is of a hybrid structure,in which the plant is of continuous structure while the controller(RL agent)adopts a discrete structure.Given that the continuous states of the plant will be the input of the agent,the state–action value function is approximated by the fully connected feed-forward neural networks(FCFFNN).Instead of learning the controller at every step during the interaction with the environment,the learning and acting stages are decoupled to learn the control strategy more effectively through experience replay.In the acting stage,the most effective experience obtained during the interaction with the environment will be stored and during the learning stage,the stored experience will be replayed to customized times,which helps enhance the experience replay process.The effectiveness of proposed approach will be verified by simulation examples.
基金supported by the Henan Institute for Chinese Development Strategy of Engineering&Technology(Grant No.2022HENZDA02)by the Science&Technology Department of Sichuan Province Project(Grant No.2021YFH0010).
文摘Carbon neutrality(or climate neutrality)has been a global consensus,and international experience exchange is essential.Given the differences in the degree of social development,resource endowment and technological level,each country should build a carbon-neutral plan based on its national conditions.Compared with other major developed countries(e.g.,Germany,the United States and Japan),China's carbon neutrality has much bigger challenges,including a heavy and time-pressured carbon reduction task and the current energy structure that is over-dependent on fossil fuels.Here we provide a comprehensive review of the status and prospects of the key technologies for low-carbon,near-zero carbon,and negative carbon emissions.Technological innovations associated with coal,oil-gas and hydrogen industries and their future potential in reducing carbon emissions are particularly explained and assessed.Based on integrated analysis of international experience from the world's major developed countries,in-depth knowledge of the current and future technologies,and China's energy and ecological resources potential,five lessons for the implementation of China's carbon neutrality are proposed:(1)transformation of energy production pattern from a coal-dominated pattern to a diversified renewable energy pattern;(2)renewable power-to-X and large-scale underground energy storage;(3)integration of green hydrogen production,storage,transport and utilization;(4)construction of clean energy systems based on smart sector coupling(ENSYSCO);(5)improvement of ecosystem carbon sinks both in nationwide forest land and potential desert in Northwest China.This paper provides an international perspective for a better understanding of the challenges and opportunities of carbon neutrality in China,and can serve as a theoretical foundation for medium-long term carbon neutral policy formulation.
文摘AIM:To evaluate the efficacy and tolerability of administering a combined therapy in patients with dry eye syndrome(DES)and associated laryngopharyngeal reflux(LPR).METHODS:The study was retrospective,open,observational,and conducted in a real-life setting.Patients had pathological symptom assessment in dry eye(SANDE)and reflux symptom index(RSI)at baseline.Patients were re-assessed after 1mo and at the end of treatment.The treatment consisted of a three-month course based on the combined therapy:Gastroftal eye drops,one drop three times a day,and Gastroftal tablets,two tablets after lunch and two tablets after dinner.Tear break-up-time(TBUT)test,Schirmer test,RSI,and SANDE questionnaire were evaluated.RESULTS:The study included 253 patients.The mean age was 58±11.19y.TBUT test score and Schirmer’s test significantly increased(both P<0.001)after 1mo and at the end of treatment.The RSI score and SANDE scores significantly decreased(both P<0.001)after 1mo and at the end of treatment.CONCLUSION:The current,retrospective,and open study shows that combined therapy using Gastroftal eye drops and tablets could represent a valuable option in managing patients with DES associated with LPR.
基金supported by the National Natural Science Foundation of China(Nos.52071171,52202248 and 22209064)Liaoning Revitalization Talents Program—Pan Deng Scholars(XLYC1802005)+9 种基金Liaoning Bai Qian Wan Talents Program(LNBQW2018B0048)Key Project of Scientific Research of the Education Department of Liaoning Province(LZD201902)Shenyang Science and Technology Project(21-108-9-04)Australian Research Council(ARC)through Future Fel owship(FT210100298,FT210100806)Discovery Project(DP220100603)Linkage Project(LP210100467,LP210200504,and LP210200345)Industrial Transformation Training Centre(IC180100005)schemes,CSIRO Energy Centre and Kick-Start ProjectStudy Melbourne Research Partnerships program has been made possible by funding from the Victorian Government through Study MelbourneShiyanjia Lab(www.shiyanjia.com)for the support of the XPS testsupport from the University of Calgary’s Canada First Research Excel ence Fund program,the Global Research Initiative for Sustainable Low-Carbon Unconventional Energy
文摘Aqueous supercapacitors(SCs)have been regarded as a promising candidate for commercial energy storage device due to their superior safety,low cost,and environmental benignity.Unfortunately,an age-old challenge of achieving both long electrode lifespan and qualified energy-storage property blocks their practical application.Herein,we develop an electrode-electrolyte integrated optimization strategy to fulfill the real-life device requirements.Electrode optimization simultaneously regulates the nanomorphology and surface chemistry of the tungsten oxide anode,resulting in superior electrochemical performance given by an ideal“bird-nest”structure with optimal oxygen vacancy status;the anodes interact with and are protected from dissolution and structural collapse by the rationally designed hybrid electrolyte with optimized pH and facilitated cation desorption behavior.Collaboratively,a record-breaking durability of no capacitive decay after 250000 cycles is achieved.On the basis of this integrated optimization,the first aqueous pouch SCs with real-life practicability were manufactured by a soft-package encapsulation technique,which can steadily power commercial 3 C products such as tablets and smartphones and maintain safely working against extreme conditions.This work demonstrates the possibility of using aqueous energy storage devices with enhanced safety and lower cost to replace the commercial organic counterparts for wide range of daily applications.
文摘Purpose: Malaria continues to be a public health threat, especially in sub-Saharan Africa, including Uganda. While Batwa Indigenous People (IPs) face a higher burden of malaria, there is limited understanding of their malaria-lived experiences. We assessed and characterized malaria illness and accessing healthcare lived experiences of the Batwa in Kanungu district to inform contextually and culturally appropriate public health interventions. Methods: An exploratory qualitative study was conducted in 5 Batwa settlements where 5 Focus Group Discussions (n = 36) and 13 Key Informant Interviews (n = 13) were held. Data were collected using printed guides and voice recorders in April 2018. Transcripts from the data that captured the lived experiences of the symptoms, prevention, treatment and barriers to accessing formal healthcare services were applied to Atlas.ti a qualitative data analysis software and condensed into codes, categories, and themes. Results: Many Batwa have experienced malaria in their households, and they know its causes and risk factors, like not sleeping under insecticide-treated mosquito nets (ITNs), living near water bodies, prevention measures like the use of ITNs, and vector management. The lived experiences demonstrate malaria management by an Indigenous population in a rural setting and comprised detecting malaria symptoms, use of herbs as first line of treatment, buying medicines from drug shops, and village health teams (VHTs) treatment. For many Batwa accessing formal healthcare is normally a second option. Barriers for malaria treatment included: long distances to health facilities, geographically difficult terrain, economic constraints, irregular health outreaches, and stockouts of malaria medicines at health facilities. Conclusion: This study characterized Batwa’s malaria illness lived experiences and access to healthcare in rural remote settings. These experiences are essential in appreciating the ways in which Indigenous populations understand and manage common illnesses and how appropriate policies and interventions can be developed.
文摘Introduction: Surgery can cause anxiety and worry, such as waking up in pain, being physically harmed or dying. This study aimed to assess the experience of patients undergoing planned gynaecological surgery in the Obstetrics Gynaecology and Reproductive Medicine department of the University Hospital Centre of Bogodogo. Patients and methods: This was a cross-sectional study with prospective data collection during the period from June 1 to August 31, 2018. The study population consisted of patients who received scheduled gynaecological surgery during the period. Results: Seventy-six (76) patients underwent scheduled surgery and 62 were included. During discussion with the gynaecologist, 58 patients (93.55%) were satisfied. When the surgery was announced, 41 patients (66.13%) were anxious. At the consultation with the anaesthetist 59 patients (95.16%) were satisfied with the discussions. Fifty-five patients (88.7%) were anxious on admission to the operating theatre. The quality of care was satisfactory for 61 patients (98.39%) and all patients were satisfied with the care team. Conclusion: Periodic evaluation of patients’ experiences should therefore be incorporated into care evaluation policies in health facilities in order to contribute to continuous improvement in the quality of medical and surgical care.