Background:Parents of children with complex right ventricular outflow tract(RVOT)anomalies are confronted with their child’s need for heart surgery early in life and repeated reoperations later on.Preoperative assess...Background:Parents of children with complex right ventricular outflow tract(RVOT)anomalies are confronted with their child’s need for heart surgery early in life and repeated reoperations later on.Preoperative assessment needs to be performed whenever an indication for reoperation is suspected.The aim was to illuminate the experiences of parents of children diagnosed with RVOT anomalies,in particular,how they experience their child’s heart disease and everyday life during the assessment and after the decision on whether to perform a reoperation.Method:Individual interviews(n=27)were conducted with nine parents on three occasions between 2014 and 2016 and analyzed using reflexive thematic analysis.Results:The analysis resulted in the following five main coexisting themes:The heart surgery keeps my child alive illuminates parents’experiences during and after the assessment and emphasizes that heart surgery,although dreaded,is central for their child’s survival;Everyday struggles illuminates the different struggles parents had to face to ensure that their child would be in the best possible condition;the remaining three themes,Unconditional love,Trust in life,and Togetherness,illuminate the ways in which the parents gained inner strength and confidence in their everyday lives.Conclusion:Although the parents were grateful for the assessment and had learned to navigate among the fears it aroused,they experienced several distressing situations during the assessment process that should be addressed.By inviting both the parents and their child to participate in the child’s care,individualized support can take into account the needs of both parents and child.展开更多
Objective: To explore the feasibility of the nurse’ s prescription right in China, to develop the requirements for the qualification of the ap-plicant for the prescription right of nurse, and to determine the content...Objective: To explore the feasibility of the nurse’ s prescription right in China, to develop the requirements for the qualification of the ap-plicant for the prescription right of nurse, and to determine the content of certain prescriptions in the specific circumstances. Methods: Literature review on the relevant articles/material with the contents of the nurse’ s right of prescription home and a-broad. Semi-structured depth interview method was used to interview 18 experts on whether the nurses can participate in the graded nursing decision and whether nurses with certain ability can make the decision. Using the self-made questionnaire“Nur-ses involved in graded nursing decision-recognition questionnaire”, 553 nurses completed questionnaires on willingness to nurse decision-making grading. Using the analytic hierarchy process, the 23 experts’ judgment on the main body of the graded nurs-ing was rated. Using semi-structured depth interview method, 17 experts were interviewed on the graded nursing quality assess-ment and training outline. The form of expert personal judgment and the“grading nursing qualification experts predict question-naire”were used as a preliminary designing tool, 32 experts were asked to predict the graded nursing quality. The relatively im-portant factors that might promote implementation of right of Chinese nurse prescribing weights setting were obtained by analytic hierarchy process. Using Delphi method, 2 rounds of consultation to 291 experts/times were performed, and determined its con-tent on the fields of graded nursing decision, nurses’ job description, decision making nurse in graded nursing work process and related management system, decision-making main body of clinical nursing, nurse authority of prescription application qualifi-cation, clinical nurses, diabetes specialist nurses, tumor specialist nurses, nurses in emergency department, community nurses in certain circumstances writing prescription, and nursing undergraduate added with nurse authority of prescription related courses. Results: The physician is not considered to be the best decision-making main body of clinical nursing work and graded nurs-ing, nurses can participate in the work of decision-making. The qualification of hierarchical decision-making nurse and nurse prescribing applicants have been determined. The hierarchical nursing decision-making nurses’ position description and training outline have been compiled. Experts suggest that clinical nurses with certain qualifications should be given the rights of some prescription form ( independent prescription, prescription, prescription protocol extension) to prescribe specific drugs in high fe-ver, hypoglycemia, hypertension, anaphylactic shock and other 11 specific circumstances. The nurses of the diabetes should be given the right of prescribing sulfonylureas, biguanides, glucosidase inhibitor, and protamine zinc insulin, and the right to write the prescription and consultation for part of medical equipment, health education, and four routine tests, which contains blood sugar monitoring, urine glucose monitoring, glycosylated hemoglobin assay, and oral glucose tolerance test. Tumor specialist nurses should be given the right to write the prescription of 7 specific circumstances including blood routine tests, electrocardio-gram, blood biochemistry and other 9 laboratory tests, constipation, phlebitis, and cancer pain, and the right of 5 tumor emer-gency prescription including chemotherapy drug allergy, hemorrhagic shock, acute upper gastrointestinal bleeding. Nurses in e-mergency department with certain qualification should be given the right to prescribe specific drugs in 15 circumstances which include cardiac arrest, ventricular fibrillation, and acute cardiogenic chest pain. Community nurses with certain qualification should be given the right to write the prescriptions on 14 contents including disinfection and cleaning, sterile infusion type, and wound care products. Experts suggest that nursing undergraduate education in China should be added with 2 courses which are prescription rights related laws and regulations and nursing intervention, and that pharmacology course should be supplemented with related course in order to adapt to the implementation of nurse prescribing rights. Conclusions: China’ s nurses with certain qualification or after special training have the ability to accept and should be given the right of prescriptions in certain circumstance within the scope of their work.展开更多
There is uncertainty in the electricity price of spot electricity market,which makes load aggregators undertake price risks for their agent users.In order to allow load aggregators to reduce the spot market price risk...There is uncertainty in the electricity price of spot electricity market,which makes load aggregators undertake price risks for their agent users.In order to allow load aggregators to reduce the spot market price risk,scholars have proposed many solutions,such as improving the declaration decision-making model,signing power mutual insurance contracts,and adding energy storage and mobilizing demand-side resources to respond.In terms of demand side,calling flexible demand-side resources can be considered as a key solution.The user’s power consumption rights(PCRs)are core contents of the demand-side resources.However,there have been few studies on the pricing of PCR contracts and transaction decisions to solve the problem of price forecast deviation and to manage the uncertainty of spot market prices.In addition,in traditional PCR contracts,PCRs are mostly priced using a single price mechanism,that is,the power user is compensated for part of the electricity that was interrupted or reduced in power supply.However,some power users might engage in speculative behaviours under this mechanism.Further,for load aggregators,their price risk avoidance ability has not substantially improved.As a financial derivative,options can solve the above problems.In this article,firstly,the option method is used to build an option pricing optimization model for power consumption right contracts that can calculate the optimal option premium and strike price of option contracts of power consumption rights.Secondly,from the perspective of power users and load aggregators,a simulation model of power consumption right transaction decision-making is constructed.The results of calculation examples show that(1)Under the model in this article,the pricing of option contracts for power consumption rights with better risk aversion capabilities than traditional compensation contracts can be obtained.(2)The decision to sell or purchase the power consumption rights will converge at respective highvalue periods,and option contracts will expedite the process.(3)Option contracts can significantly reduce the loss caused by the uncertainty of spot electricity prices for load aggregators without reducing users’willingness to sell power consumption rights.展开更多
IN April of 1998, Li Cheng was taken to court. The month before, Li had tried to end the life of his own child, who was only three days old. The doctor’s attempts to stop him managed to prolong the child’s life for ...IN April of 1998, Li Cheng was taken to court. The month before, Li had tried to end the life of his own child, who was only three days old. The doctor’s attempts to stop him managed to prolong the child’s life for only two days. Consequently, Li must be punished by law for killing his own child. However, response to this case has varied. Li Cheng’s work unit posted bail for him. "We will respect the opinion of the court, no matter what the verdict," said the representative from his work unit. "However, if our application is refused, we do not intend to cease paying his salary." In the petition for bail, they maintained that Li Cheng was a talented, hard-working staff member. His act must have been commit-展开更多
基金This study was supported by the Pediatric Heart Center at Skåne University Hospital Lund and Lund University,and by the Swedish Children’s Heart Association.
文摘Background:Parents of children with complex right ventricular outflow tract(RVOT)anomalies are confronted with their child’s need for heart surgery early in life and repeated reoperations later on.Preoperative assessment needs to be performed whenever an indication for reoperation is suspected.The aim was to illuminate the experiences of parents of children diagnosed with RVOT anomalies,in particular,how they experience their child’s heart disease and everyday life during the assessment and after the decision on whether to perform a reoperation.Method:Individual interviews(n=27)were conducted with nine parents on three occasions between 2014 and 2016 and analyzed using reflexive thematic analysis.Results:The analysis resulted in the following five main coexisting themes:The heart surgery keeps my child alive illuminates parents’experiences during and after the assessment and emphasizes that heart surgery,although dreaded,is central for their child’s survival;Everyday struggles illuminates the different struggles parents had to face to ensure that their child would be in the best possible condition;the remaining three themes,Unconditional love,Trust in life,and Togetherness,illuminate the ways in which the parents gained inner strength and confidence in their everyday lives.Conclusion:Although the parents were grateful for the assessment and had learned to navigate among the fears it aroused,they experienced several distressing situations during the assessment process that should be addressed.By inviting both the parents and their child to participate in the child’s care,individualized support can take into account the needs of both parents and child.
基金supported by the Shanxi Science and Technology Development Fund(No.2009041063-02)
文摘Objective: To explore the feasibility of the nurse’ s prescription right in China, to develop the requirements for the qualification of the ap-plicant for the prescription right of nurse, and to determine the content of certain prescriptions in the specific circumstances. Methods: Literature review on the relevant articles/material with the contents of the nurse’ s right of prescription home and a-broad. Semi-structured depth interview method was used to interview 18 experts on whether the nurses can participate in the graded nursing decision and whether nurses with certain ability can make the decision. Using the self-made questionnaire“Nur-ses involved in graded nursing decision-recognition questionnaire”, 553 nurses completed questionnaires on willingness to nurse decision-making grading. Using the analytic hierarchy process, the 23 experts’ judgment on the main body of the graded nurs-ing was rated. Using semi-structured depth interview method, 17 experts were interviewed on the graded nursing quality assess-ment and training outline. The form of expert personal judgment and the“grading nursing qualification experts predict question-naire”were used as a preliminary designing tool, 32 experts were asked to predict the graded nursing quality. The relatively im-portant factors that might promote implementation of right of Chinese nurse prescribing weights setting were obtained by analytic hierarchy process. Using Delphi method, 2 rounds of consultation to 291 experts/times were performed, and determined its con-tent on the fields of graded nursing decision, nurses’ job description, decision making nurse in graded nursing work process and related management system, decision-making main body of clinical nursing, nurse authority of prescription application qualifi-cation, clinical nurses, diabetes specialist nurses, tumor specialist nurses, nurses in emergency department, community nurses in certain circumstances writing prescription, and nursing undergraduate added with nurse authority of prescription related courses. Results: The physician is not considered to be the best decision-making main body of clinical nursing work and graded nurs-ing, nurses can participate in the work of decision-making. The qualification of hierarchical decision-making nurse and nurse prescribing applicants have been determined. The hierarchical nursing decision-making nurses’ position description and training outline have been compiled. Experts suggest that clinical nurses with certain qualifications should be given the rights of some prescription form ( independent prescription, prescription, prescription protocol extension) to prescribe specific drugs in high fe-ver, hypoglycemia, hypertension, anaphylactic shock and other 11 specific circumstances. The nurses of the diabetes should be given the right of prescribing sulfonylureas, biguanides, glucosidase inhibitor, and protamine zinc insulin, and the right to write the prescription and consultation for part of medical equipment, health education, and four routine tests, which contains blood sugar monitoring, urine glucose monitoring, glycosylated hemoglobin assay, and oral glucose tolerance test. Tumor specialist nurses should be given the right to write the prescription of 7 specific circumstances including blood routine tests, electrocardio-gram, blood biochemistry and other 9 laboratory tests, constipation, phlebitis, and cancer pain, and the right of 5 tumor emer-gency prescription including chemotherapy drug allergy, hemorrhagic shock, acute upper gastrointestinal bleeding. Nurses in e-mergency department with certain qualification should be given the right to prescribe specific drugs in 15 circumstances which include cardiac arrest, ventricular fibrillation, and acute cardiogenic chest pain. Community nurses with certain qualification should be given the right to write the prescriptions on 14 contents including disinfection and cleaning, sterile infusion type, and wound care products. Experts suggest that nursing undergraduate education in China should be added with 2 courses which are prescription rights related laws and regulations and nursing intervention, and that pharmacology course should be supplemented with related course in order to adapt to the implementation of nurse prescribing rights. Conclusions: China’ s nurses with certain qualification or after special training have the ability to accept and should be given the right of prescriptions in certain circumstance within the scope of their work.
基金This research was funded by the National Natural Science Foundation of China,China(Grant No.72174062)the 2018 Key Projects of Philosophy and Social Sciences Research,Ministry of Education,China(Grant No.18JZD032).The completion of this articlewas accomplished with the help of many teachers and classmates.We sincerely thank them for their help and guidance.
文摘There is uncertainty in the electricity price of spot electricity market,which makes load aggregators undertake price risks for their agent users.In order to allow load aggregators to reduce the spot market price risk,scholars have proposed many solutions,such as improving the declaration decision-making model,signing power mutual insurance contracts,and adding energy storage and mobilizing demand-side resources to respond.In terms of demand side,calling flexible demand-side resources can be considered as a key solution.The user’s power consumption rights(PCRs)are core contents of the demand-side resources.However,there have been few studies on the pricing of PCR contracts and transaction decisions to solve the problem of price forecast deviation and to manage the uncertainty of spot market prices.In addition,in traditional PCR contracts,PCRs are mostly priced using a single price mechanism,that is,the power user is compensated for part of the electricity that was interrupted or reduced in power supply.However,some power users might engage in speculative behaviours under this mechanism.Further,for load aggregators,their price risk avoidance ability has not substantially improved.As a financial derivative,options can solve the above problems.In this article,firstly,the option method is used to build an option pricing optimization model for power consumption right contracts that can calculate the optimal option premium and strike price of option contracts of power consumption rights.Secondly,from the perspective of power users and load aggregators,a simulation model of power consumption right transaction decision-making is constructed.The results of calculation examples show that(1)Under the model in this article,the pricing of option contracts for power consumption rights with better risk aversion capabilities than traditional compensation contracts can be obtained.(2)The decision to sell or purchase the power consumption rights will converge at respective highvalue periods,and option contracts will expedite the process.(3)Option contracts can significantly reduce the loss caused by the uncertainty of spot electricity prices for load aggregators without reducing users’willingness to sell power consumption rights.
文摘IN April of 1998, Li Cheng was taken to court. The month before, Li had tried to end the life of his own child, who was only three days old. The doctor’s attempts to stop him managed to prolong the child’s life for only two days. Consequently, Li must be punished by law for killing his own child. However, response to this case has varied. Li Cheng’s work unit posted bail for him. "We will respect the opinion of the court, no matter what the verdict," said the representative from his work unit. "However, if our application is refused, we do not intend to cease paying his salary." In the petition for bail, they maintained that Li Cheng was a talented, hard-working staff member. His act must have been commit-
