Impact of a Nurse-Led Chronic Disease Management Intervention Model on Quality of Care and Satisfaction of Maintenance Hemodialysis Patients

Objective:To explore the impact of a nurse-led chronic disease management model on the quality of care and satisfaction of maintenance hemodialysis patients.Methods:72 patients who received maintenance hemodialysis(MHD)from June 2021 to March 2022 were selected to undergo the nurse-led chronic disease management model.The hemodialysis indexes,nutritional status,and the occurrence of adverse events were assessed after 24 weeks of the intervention,and patients’satisfaction was investigated and analyzed.Results:Comparing pre-intervention and after 24 weeks of intervention,urea reduction rate and urea clearance were improved but not statistically different(P>0.05),butβ2-microglobulin was significantly reduced compared with pre-intervention(P<0.05);after 24 weeks of intervention,the effect of decreasing blood calcium,parathyroid hormone,and potassium levels was not obvious(P>0.05),and the level of blood phosphorus decreased significantly compared with pre-intervention(P<0.01),albumin and hemoglobin levels were increased and better than before intervention(P<0.05);after 24 weeks of intervention,the incidence of intradialytic hypotension and hypertension was lower than before intervention(P<0.05),and the total incidence of complications was significantly lower than before intervention(P<0.01);there was no significant difference in the Self-Depression Scale scores after 24 weeks of intervention(P>0.05),and Self-Anxiety Scale scores were significantly lower and better than before intervention(P<0.01).Patient satisfaction was greatly improved,with a statistically significant difference(P<0.05).Conclusion:The chronic disease management intervention model led by specialized nurses is conducive to improving the psychological state and nutritional status of dialysis patients,enhancing the adequacy of dialysis for patients,reducing the incidence of related complications,and ultimately achieving the purpose of improving the quality of life of patients,which has significant clinical value.

Application of Specialized Group Management in the Quality Control of Perioperative Nursing

Objective:To explore the role of specialized group management in the quality control of perioperative nursing.Methods:45 surgical nurses from our hospital were selected as the research subjects.Traditional operating room management was adopted from July 2019 to June 2020,and specialized group management was adopted from July 2020 to June 2021.The surgeon’s satisfaction,surgical nurses’core professional competence,and surgical patients’satisfaction were obtained through surveys and the results were analyzed.Results:Surgeon satisfaction before the implementation of specialized group management was significantly lower than after its implementation(P<0.05).Besides,surgical nurses’core professional competency scores before the implementation of specialized group management were significantly lower than after its implementation(P<0.05).Lastly,surgical patients’satisfaction before the implementation of specialized group management was significantly lower than after its implementation(P<0.05).Conclusion:Specialized group management helps to improve the quality of perioperative care and should be applied in clinical practice.

Attributes of Specialized Households'Resilience and Its Impact on Rural Industrial Advancement:A Case Study of National Musical Instrument Production Specialized Households in Lankao County,Henan,China

Specialized households serve as the primary units within specialized villages in China,and their capacity to withstand risks and external influences significantly shapes the future trajectory of specialized villages and the overall vitality of the rural economy.In this study,we established a measurement indicator system based on the definition of specialized households’resilience,elucidating the logical connection between specialized households’resilience and rural industrial development in China.The musical instrument industry in Lankao County,Henan Province of China,was employed as a case;survey data,the entropy method,and an obstacle diagnosis model were used to examine how instrument production specialized households responded to the challenges posed by Corona Virus Disease 2019(COVID-19)and the tightening of national environmental protection policies,yielding the following key findings:1)there exists substantial variation in the comprehensive resilience levels among different specialized households;2)the ability to learn and adapt is the most significant contributor to the overall resilience level of specialized households;3)technological proficiency and access to skilled talent emerge as pivotal factors influencing specialized households’resilience;4)the positioning of specialized households within the industrial supply chain and the stability of their income have a direct bearing on their resilience level.The influence of specialized households’resilience on industrial development primarily manifests in the following ways:stronger resilience correlates with increased stability in production and sales,fostering a more proactive approach to future actions.However,heightened exposure to the external macroeconomic environment can lead to a higher rate of export reduction.To enhance the development resilience of entities like specialized households and family farms,and to invigorate rural economic development,escalating investments in rural science and technology and prioritizing the training of technical talent become imperative.

Impact of specialized nursing outpatient case management on postcoronary artery bypass grafting patients

BACKGROUND Some patients with coronary atherosclerotic heart disease experience major adverse cardiac events(MACE)and require readmission after Coronary Artery Bypass Grafting(CABG)surgery.This is often attributed to patients'unhealthy lifestyles and dietary habits,inadequate understanding of the disease,and poor disease management compliance.Thus,searching for more targeted nursing intervention models that can enhance patients'self-management abilities and reduce the risk of readmission after CABG surgery is significant.AIM To observe the impact of specialized nursing outpatient case management on patients after CABG surgery.METHODS A total of 103 patients who underwent CABG surgery in our hospital between April 2021 and April 2022 comprised the study sample.The patients were divided into two groups using an odd-even number grouping method.The control group received routine nursing care,while the case management group received specialized nursing outpatient case management.The differences in psychological status,adherence to medical treatment,self-care ability,knowledge mastery,quality of life scores,and the occurrence rate of MACE were compared between the two groups.RESULTS After the intervention,the case management group had lower scores on the selfrating depression scale and self-rating anxiety scale and lower MACE rate,as well as higher scores for adherence to a healthy diet,medication adherence,good lifestyle habits,regular exercise,and timely follow-up,higher scores on the Coronary Heart Disease Self-Management Scale,higher scores for managing adverse habits,symptoms,emotional cognition,emergency response,disease knowledge,general lifestyle,and treatment adherence,higher scores for understanding coronary heart disease,recognizing the importance of medication adherence,understanding selfcare points after CABG surgery,and being aware of post-CABG precautions,higher scores for physical well-being,disease condition,general health,social-psychological well-being,and work-related aspects(P<0.05).CONCLUSION Specialized nursing outpatient case management can enhance patient adherence to medical treatment,knowledge mastery,psychological well-being,and overall quality of life in patients after CABG surgery.

Exploration and Practice of“Four Integration and Four Innovation”Specialized and Creative Integration Talent Cultivation Mode:Taking Chongqing Energy Vocational College as an Example

With the release of China Education Modernization 2035,education modernization has become a national strategic goal.In this context,Chongqing Energy Vocational College is actively exploring the“four integration and four innovation”specialized and creative integration talent cultivation mode,aiming at cultivating high-quality talents with innovative spirit and practical skills.This paper analyzes the status quo and challenges of talent cultivation in higher vocational education,puts forward the main practices of innovation-driven,creation and research,cross-border integration,and innovative practice,and has achieved remarkable results.Additionally,it summarizes the experience revelation and provides a reference for other higher vocational colleges and universities.

Teaching Practice of Integrating Labor Education into Specialized Courses:A Case Study of Plant Cultivation and Maintenance

Vocational colleges attach great importance to labor education.Specialized courses are an effective way to cultivate students labor quality,and the integration of labor education in specialized courses plays an important role in the overall cultivation of students moral quality and practical ability.Combined with the teaching practice of landscape technology specialty,labor education is integrated into the teaching of Plant Cultivation and Maintenance,and certain results have been achieved.In this paper,the course content"grafting propagation"was analyzed from the aspects of overall teaching design,teaching implementation process,teaching effect and reflection improvement,so as to provide reference for other contents of this major or other majors to carry out integrated teaching.

Clustering-Aided Supervised Malware Detection with Specialized Classifiers and Early Consensus

One of the most common types of threats to the digital world is malicious software.It is of great importance to detect and prevent existing and new malware before it damages information assets.Machine learning approaches are used effectively for this purpose.In this study,we present a model in which supervised and unsupervised learning algorithms are used together.Clustering is used to enhance the prediction performance of the supervised classifiers.The aim of the proposed model is to make predictions in the shortest possible time with high accuracy and f1 score.In the first stage of the model,the data are clustered with the k-means algorithm.In the second stage,the prediction is made with the combination of the classifier with the best prediction performance for the related cluster.While choosing the best classifiers for the given clusters,triple combinations of ten machine learning algorithms(kernel support vector machine,k-nearest neighbor,naive Bayes,decision tree,random forest,extra gradient boosting,categorical boosting,adaptive boosting,extra trees,and gradient boosting)are used.The selected triple classifier combination is positioned in two stages.The prediction time of the model is improved by positioning the classifier with the slowest prediction time in the second stage.The selected triple classifier combination is positioned in two tiers.The prediction time of the model is improved by positioning the classifier with the highest prediction time in the second tier.It is seen that clustering before classification improves prediction performance,which is presented using Blue Hexagon Open Dataset for Malware Analysis(BODMAS),Elastic Malware Benchmark for Empowering Researchers(EMBER)2018 and Kaggle malware detection datasets.The model has 99.74%accuracy and 99.77%f1 score for the BODMAS dataset,99.04%accuracy and 98.63%f1 score for the Kaggle malware detection dataset,and 96.77%accuracy and 96.77%f1 score for the EMBER 2018 dataset.In addition,the tiered positioning of classifiers shortened the average prediction time by 76.13%for the BODMAS dataset and 95.95%for the EMBER 2018 dataset.The proposed method’s prediction performance is better than the rest of the studies in the literature in which BODMAS and EMBER 2018 datasets are used.

Turnover of textile and apparel specialized market achieves recovery growth in H1 of 2023

In the first half of 2023,China’s textile and apparel specialized market withstood the huge pressure of insufficient domestic demand,industrial depression and weak consumption recovery,and adhered to stable scale,adjusted structure,and improved quality and efficiency.In the first half of 2023,the total turnover of 44 textile and apparel specialized markets(including market clusters)monitored by the China Commercial Circulation Association of Textile and Apparel(CATA)reached 677.078 billion yuan,an increase of 22.76%,and the specialized market achieved a recovery growth in turnover.

Effects of pooling,specialization,and discretionary task completion on queueing performance

Pooling,unpooling/specialization,and discretionary task completion are typical operational strategies in queueing systems that arise in healthcare,call centers,and online sales.These strategies may have advantages and disadvantages in different operational environments.This paper uses the M/M/1 and M/M/2 queues to study the impact of pooling,specialization,and discretionary task completion on the average queue length.Closed-form solutions for the average M/M/2 queue length are derived.Computational examples illustrate how the average queue length changes with the strength of pooling,specialization,and discretionary task completion.Finally,several conjectures are made in the paper.

The Oral Health Status of Person with Special Needs in Kumasi

Background: The most prevalent non-communicable disease worldwide is oral health-related disease, with dental caries and periodontal conditions being common. Oral health status significantly impacts overall health and quality of life. Barriers to dental care affect children with special needs. This study evaluates the oral health status and treatment requirements of people with special needs. Methodology: This descriptive cross-sectional study in Kumasi, Ghana examined oral health status among people, 121 children with special needs over two months, in June-July 2022. Dental caries, periodontal changes, malocclusion, and trauma were assessed. The data was analyzed using SPSS 20.0. Results: The oral health status among people with special needs in this study was generally moderate, with a range from very good to very poor. The prevalence of dental caries was 37%, with a mean DMFT score of 2.82. Periodontal health showed unsatisfactory indicators such as mobile teeth, poor gingival health, high plaque scores, and the presence of halitosis. Conclusion: This descriptive study aimed to provide baseline data on the oral health status of special needs students in Kumasi, addressing the lack of knowledge in this area. It highlighted the importance of dental care in maintaining good oral health and overall well-being in individuals with special needs. Coordinated efforts by dental professionals are needed to provide dental health education and preventive interventions for these children.

Nondestructive and active interrogation system for special nuclear material:proof of principle and initial results

Herein,we employ the threshold energy neutron analysis(TENA)technique to introduce the world's first active interrogation system to detect special nuclear materials(SNMs),including U-235 and Pu-239.The system utilizes a DD neutron generator based on inertial electrostatic confinement(IEC)to interrogate suspicious objects.To detect secondary neutrons produced during fission reactions induced in SNMs,a tensioned metastable fluid detector(TMFD)is employed.The current status of the system's development is reported in this paper,accompanied by the results from experiments conducted to detect 10 g of highly enriched uranium(HEU).Notably,the experimental findings demonstrate a distinct difference in the count rates of measurements with and without HEU.This difference in count rates surpasses two times the standard deviation,indicating a confidence level of more than 96% for identifying the presence of HEU.The paper presents and extensively discusses the proof-of-principle experimental results,along with the system's planned trajectory.

Empowering Rice Farmers in Nueva Ecija, Philippines: A Strategic Approach to Boosting Income through Special Purpose Rice Production

Low income is the main problem of millions of farmers who are cultivating 4.81 million hectares in the Philippines. This problem is attributed to challenges specifically low yield, low quality of produce, and significant post-harvest losses, particularly in a resource-scarce setting. This study aimed to help increase the farmers’ income in selected towns of Nueva Ecija through the promotion and use of special purpose rice production technology. Twenty (20) farmer-cooperators in three towns of Nueva Ecija were selected to demonstrate the production technology covering a total area of 4.75 hectares during the dry season, and 3.3 hectares during the wet season, both in 2023. Extension modalities such as training, techno-demo establishment, information material and technical assistance provision, and market linkage were undertaken to enhance their knowledge, attitude, and skills on special rice production and enterprise. The study utilized the descriptive quantitative method wherein the data were gathered through surveys, specifically personal interviews. Results showed that 70% of the farmer-cooperators were male and 60% were living below the poverty threshold. The farmers were 53 years old on average and engaged in farming as their primary source of income. The average yield of special purpose rice particularly the CLS-2 variety was higher (6.46 MT/ha and 6.22 MT/ha during dry and wet seasons, respectively) than that of inbred or non-special rice. The income per hectare from special purpose rice production per hectare was Php 75,420.00, which is higher than that of regular rice at Php 29,389.00, giving a higher benefit of Php 46,031.00. The technology adopters and area planted increased (from 6 to 9 and from 1.4 hectares to 2.75 hectares, respectively) in Licab, Nueva Ecija. The opposite was true in Sto. Domingo and Guimba, Nueva Ecija where farmers were discouraged by the marketing issues that arose.

Effect of special types of bread with select herbal components on postprandial glucose levels in diabetic patients

BACKGROUND Nutrition recommendations in patients with type 2 diabetes mellitus(T2DM)are to consume rye or integral bread instead of white bread.A positive effect on glucoregulation has been achieved by enriching food with various biologically active substances of herbal origin,so we formulated an herbal mixture that can be used as a supplement for a special type of bread(STB)to achieve better effects on postprandial glucose and insulin levels in patients with T2DM.AIM To compare organoleptic characteristics and effects of two types of bread on postprandial glucose and insulin levels in T2DM patients.METHODS This trial included 97 patients with T2DM.A parallel group of 16 healthy subjects was also investigated.All participants were given 50 g of rye bread and the same amount of a STB with an herbal mixture on 2 consecutive days.Postprandial blood glucose and insulin levels were compared at the 30^(th),60^(th),90^(th) and 120th min.A questionnaire was used for subjective estimation of the organoleptic and satiety features of the two types of bread.RESULTS Compared to patients who consumed rye bread,significantly lower postprandial blood glucose and insulin concentrations were found in T2DM patients who consumed STB.No relevant differences were found among the healthy subjects.Subjectively estimated organoleptic and satiety characteristics are better for STB than for rye bread.CONCLUSION STB have better effects than rye bread on postprandial glucoregulation in T2DM patients.Subjectively estimated organoleptic and satiety characteristics are better for STB than for rye bread.Therefore,STB can be recommended for nutrition in T2DM patients.

AGGREGATE SPECIAL FUNCTIONS TO APPROXIMATE PERMUTING TRI-HOMOMORPHISMS AND PERMUTING TRI-DERIVATIONS ASSOCIATED WITH A TRI-ADDITIVEψ-FUNCTIONAL INEQUALITY IN BANACH ALGEBRAS

In this paper,we define a new class of control functions through aggregate special functions.These class of control functions help us to stabilize and approximate a tri-additiveψ-functional inequality to get a better estimation for permuting tri-homomorphisms and permuting tri-derivations in unital C*-algebras and Banach algebras by the vector-valued alternative fixed point theorem.

Research on Disciplines in China’s Local Universities from the Perspective of Special Zones

China's local colleges and universities are the main force of China's higher education.Due to the limited construction funds,weak discipline foundation and other reasons,China's local colleges and universities generally face the embarrassment of weak discipline.How to break the constraints of the traditional management system,concentrate and efficiently allocate limited resources to achieve the overall improvement of the discipline construction level,the successful experience of China's special economic zones provides model reference and construction guidance for Chinese local universities.This study takes the subject special zones of local universities in China as the research object,chooses the theoretical system of economics and institutional theory as the logical starting point of the research,constructs the research framework of three dimensions of idea value,system design and action strategy,takes the reform of special economic zones as the institutional model and practice reference,and carries out the research from five dimensions of reform subject,logic,path,idea and strategy.Explore the effective development path of the rise of discipline construction.

Motion and Special Relativity in Complex Spaces

A natural extension of the Lorentz transformation to its complex version was constructed together with a parallel extension of the Minkowski M4 model for special relativity (SR) to complex C4 space-time. As the [signed] absolute values of complex coordinates of the underlying motion’s characterization in C4 one obtains a Newtonian-like type of motion whereas as the real parts of the complex motion’s description and of the complex Lorentz transformation, all the SR theory as modeled by M4 real space-time can be recovered. This means all the SR theory is preserved in the real subspace M4 of the space-time C4 while becoming simpler and clearer in the new complex model’s framework. Since velocities in the complex model can be determined geometrically, with no primary use of time, time turns out to be definable within the equivalent theory of the reduced complex C4 model to the C3 “para-space” model. That procedure allows us to separate time from the (para)space and consider all the SR theory as a theory of C3 alone. On the other hand, the complex time defined within the C3 theory is interpreted and modeled by the single separate C1 complex plane. The possibility for application of the C3 model to quantum mechanics is suggested. As such, the model C3 seems to have unifying abilities for application to different physical theories.

Design a Special Fixture for Tractor Lever

Aiming at the problems of long time and poor machining precision in processing the tractor lever workpiece,a special fixture suitable for the tractor lever workpiece is designed by analyzing the processing technology of the lever workpiece,and the workpiece is accurately positioned and tightened under the action of the special fixture.Efficient machining of the workpiece can be achieved by using a drill template.The fixture not only has the advantages of high production efficiency,low cost and high life,but also effectively improves the processing technology of the workpiece,and has certain reference value for the subsequent fixture improvement design.

Special Relativity’s “Newtonization” in Complex “Para-Space”: The Two Theories Equivalence Question

Complex model, say C3, of “para-space” as alternative to the real M4 Minkowski space-time for both relativistic and classical mechanics was shortly introduced as reference to our previous works on that subject. The actual aim, however, is an additional analysis of the physical and para-physical phenomena’ behavior as we formally transport observable mechanical phenomena [motion] to non-real interior of the complex domain. As it turns out, such procedure, when properly set, corresponds to transition from relativistic to more classic (or, possibly, just classic) kind of the motion. This procedure, we call the “Newtonization of relativistic physical quantities and phenomena”, first of all, includes the mechanical motion’s characteristics in the C3. The algebraic structure of vector spaces was imposed and analyzed on both: the set of all relativistic velocities and on the set of the corresponding to them “Galilean” velocities. The key point of the analysis is realization that, as a matter of fact, the relativistic theory and the classical are equivalent at least as for the kinematics. This conclusion follows the fact that the two defined structures of topological vector spaces i.e., the structure imposed on sets of all relativistic velocities and the structure on set of all “Galilean” velocities, are both diffeomorphic in their topological parts and are isomorphic as the vector spaces. As for the relativistic theory, the two approaches: the hyperbolic (“classical” SR) with its four-vector formalism and Euclidean, where SR is modeled by the complex para-space C3, were analyzed and compared.

On The Role Of Needs Analysis In ESP Course And Its Implications For Specialized EnglishReading Cour

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Effects of a nurse-led heart failure clinic on hospital readmission and mortality in Hong Kong

Background Heart failure （HF） is a physically and socially debilitating disease that carries the burden of hospital re-admission and mortality. As an aging society, Hong Kong urgently needs to find ways to reduce the hospital readmission of HF patients. This study evaluates the effects of a nurse-led HF clinic on the hospital readmission and mortality rates among older HF patients in Hong Kong. Methods This study is a retrospective data analysis that compares HF patient in a nurse-led HF clinic in Hong Kong compared with HF patients who did not attend the clinic. The nurses of this clinic provide education on lifestyle modification and symptom monitoring, as well as titrate the medications and measure biochemical markers by following established protocols. This analysis used the socio-demographic and clinical data of HF patients who were aged 〉 65 years old and stayed in the clinic over a six-month period. Results The data of a total of 78 HF patients were included in this data analysis. The mean age of the patients was 77.38 ± 6.80 years. Approximately half of the HF patients were male （51.3%）, almost half were smokers （46.2%）, and the majority received 〈 six years of formal education. Most of the HF patients （87.2%） belonged to classes II and III of the New York Heart Association Functional Classification, with a mean ejection fraction of 47.15± 20.31 mL. The HF patients who attended the clinic （n = 38, 75.13 ± 5.89 years） were significantly younger than those who did not attend the clinic （n = 40, 79.53 ± 6.96 years） （P = 0.04）, and had lower recorded blood pressure. No other statistically significant difference existed between the socio-demographic and clinical characteristics of the two groups. The HF patients who did not attend the nurse-led HF clinic demonstrated a significantly higher risk of hospital readmission [odd ratio （OR）： 7.40; P 〈 0.01] than those who attended after adjusting for the effect of age and blood pressure. In addition, HF patients who attended the clinic had lower mortality （n = 4） than those who did not attend （n = 14）. However, such a difference did not reach statistical significance when the effects of age and blood pressure were adjusted. A signifi- cant reduction in systolic blood pressure IF （2, 94） = 3.39, P = 0.04] and diastolic blood pressure [F （2, 94） = 8.48, P 〈 0.01] was observed among the HF patients who attended the clinic during the six-month period. Conclusions The finding of this study suggests the important role of nurse-led HF clinics in reducing healthcare burden and improving patient outcomes among HF patients in Hong Kong.