The school placement processes of students from immigrant backgrounds considered to be in“difficulty”is an international concern at the intersection of works relating to special education and those concerning the sc...The school placement processes of students from immigrant backgrounds considered to be in“difficulty”is an international concern at the intersection of works relating to special education and those concerning the school experiences of students from immigrant backgrounds or racialized groups.The research problem of this article concerns the identification of these students as disabled or as having adjustment or learning difficulties.From a perspective anchored in Disability Critical Race Studies,this ethnographic study documents different interpretations of perceived difficulties made by school actors with regard to seven primary school students from immigrant backgrounds.Five interpretation types are presented:(1)medicalization by dismissal of cultural markers,(2)medicalization by professional constraint,(3)medicalization by cultural deficit,(4)precautionary wait,and(5)cultural differentialism.Our results help to shed light on the special education overrepresentation phenomenon regarding these students and to understand how ableism and(neo)racism contribute to it.展开更多
Background: Unsafe abortions are one of the leading causes of maternal mortality, especially in developing countries. In Cameroon, the maternal mortality rate remains high, and the scarcity of data on abortions leads ...Background: Unsafe abortions are one of the leading causes of maternal mortality, especially in developing countries. In Cameroon, the maternal mortality rate remains high, and the scarcity of data on abortions leads to a lack of solid evidence to advocate on the extent of the abortions related complications. Our objective was to evaluate the unsafe abortions related complications, and to assess the difficulties of accessing safe abortions in our setting. Methods: We carried out a meta-analytic and systematic review in the biomedical databases MEDLINE (Pubmed), Google Scholar and African Journal Online concerning unsafe abortions and/or difficulties in accessing safe abortions in Cameroon. The keywords used for the search are seen in table I. Selection of studies was simultaneously done by two authors. Data were extracted through a form designed on Google Form. We used a random-effect model for proportion estimation, and The I<sup>2</sup> and Q statistics to assess the extent of heterogeneity. Results: A total of 430 studies were identified, from which 28 were included and analysed. About 5% (95% CI: 3 - 7) of unsafe abortions leads to death. The contribution of unsafe abortions in maternal deaths was 23% (95% CI: 20 - 27). The rate of severe bleeding and/or anemia were 40% (95% CI: 18 - 63) and the rate of infection was 17% (95% CI: 7 - 28), dominated by pelvic infections, pelviperitonitis, severe sepsis, and septic shock. Case reports described uterine perforations, uterine rupture during the following pregnancy. Abortion was performed in the practitioner’s or patient’s home in 41.4% of cases, in a health center in 35.1% of cases, in a private clinic in 21.2% of cases, drugs selling places and in traditional healer clinics. The restriction of abortion laws, the stigma surrounding abortion and its consequences at any level of the society, lead to the underreporting of unsafe abortions and a deep reluctance to advocate for safe abortion services. Conclusion: The strengthening of awareness campaigns for provider behavior change communication, family planning, the de-stigmatization of abortions, the training of health personnel in post-abortion care, a multidisciplinary and multicentric action would contribute to the reduction in morbidity and mortality due to abortions.展开更多
Glucose-6-phosphate dehydrogenase deficiency is the most common enzymopathy worldwide. The precise prevalence of G6PD is unknown in Burkina Faso. The objective of the study was to describe the difficulties to diagnose...Glucose-6-phosphate dehydrogenase deficiency is the most common enzymopathy worldwide. The precise prevalence of G6PD is unknown in Burkina Faso. The objective of the study was to describe the difficulties to diagnose this disease at the Souro Sanou University hospital (CHUSS) in Bobo-Dioulasso. It involved five patients comprising one child with homozygous SS sickle cell disease, one adolescent screened following a family investigation, and three adults including a man and two women. Blood smear stained with May Grunwald Giemsa was performed to look for specific signs of G6PD-deficient red blood cell and brilliant cresyl Blue for Heinz Bodies. A microscope Olympus BX53 equipped with a Camera (XC10) and connected to a computer was used to read blood smears and capture images. Genes sequencing by Sanger method were performed in a specialized laboratory in molecular genetics. For each analysis, the protocol and instructions of the equipment and reagent manufacturer were applied. Of the five patients, three had anemia and only one had hyperreticulocytosis. Two patients had biological signs of hemolysis and one patient had an elevated CRP. Blood smear stained with MGG and cresyl blue showed specific signs of G6PD-deficient red blood cells and Heinz bodies in all patients. Biochemical analysis and molecular typing confirmed G6PD deficiency. The presence of G6PD-deficient red blood cells in the blood smear guides the diagnosis of G6PD deficiency. The diagnosis is biochemical and is based on the combined measurement of G6PD plus pyruvate kinase and/or hexokinase.展开更多
The objective of this study was to determine the difficulties experienced in trauma nursing practice by expert emergency nurses in Japan. Ten nurses who worked at emergency and critical care centers in Japan were dire...The objective of this study was to determine the difficulties experienced in trauma nursing practice by expert emergency nurses in Japan. Ten nurses who worked at emergency and critical care centers in Japan were directly involved in nursing patients were selected by purposive sampling and underwent semi-structured interviews regarding the difficulties they experienced in trauma nursing. The nurses were specialists in critical care nursing or were certified emergency nurses. The interview responses were analyzed by the qualitative descriptive method. The following six categories of difficulties associated with the direct care of trauma patients and their family members encountered in trauma nursing practice were identified: [Initial handling of highly urgent trauma patients], [Understanding and observing the condition of patients who are in the treatment stage], [Judging when to transition to end-stage care for patients difficult to save], [Mitigating suffering and expanding safe activities of daily living for trauma patients], [Transitional care with a long-term perspective for trauma patients], and [Relationships with the family members of patients who died]. Three categories of difficulties related to the role of the expert nurse in trauma nursing practice were identified: [Person-to-person coordination and cooperation for a trauma patient], [Playing an educational role for the nursing staff], and [Pursuing expertise in trauma nursing and gaining empirical knowledge]. The findings suggested a need to establish systems for training and consultative support and opportunities to create meaning by reflecting on fulfillment and nursing practice.展开更多
With the enrollment expansion of college and continuous reform of college education system and college charging system,the number of college students with financial difficulties is increasing. The college students wit...With the enrollment expansion of college and continuous reform of college education system and college charging system,the number of college students with financial difficulties is increasing. The college students with family financial difficulties not only bear the huge economic burden,but also bear the huge pressure of learning and mental stress,and they have many kinds of psychological problems including psychological distress of tension and anxiety,psychological conflict of self-respect and self-abasement,conflict of desire for interpersonal interaction and self-containment and strong vanity and dependence mentality. This paper puts forward the corresponding recommendations to solve these problems.展开更多
This paper is composed of three parts.The first part presents Gile’s effort model and memory mechanism in consecutive interpreting.In the second part and the third part,the author analyzes the psychological factors t...This paper is composed of three parts.The first part presents Gile’s effort model and memory mechanism in consecutive interpreting.In the second part and the third part,the author analyzes the psychological factors that cause memory difficulties and proposes corresponding strategies on the basis of the analysis.At last,the author draws a conclusion based on the discussion of the whole paper that sufficient preparation,appropriate pressure and perceived memory can avoid memory difficulties caused by psychological factors.展开更多
The Strengths and Difficulties Questionnaire (SDQ) is a brief screening measure of emotional and behavioural difficulties in children and adolescents. The aim of this study was to assess reliability and validity of th...The Strengths and Difficulties Questionnaire (SDQ) is a brief screening measure of emotional and behavioural difficulties in children and adolescents. The aim of this study was to assess reliability and validity of the Greek version of the SDQ. A representative Greek sample of 1194 adolescents (aged 11 to 17 years) and their parents completed the SDQ along with other measures. Internal consistency reliability was determined by calculation of the Cronbach α coefficient. Varimax Orthogonal Transformation was conducted to test the factor structure of the questionnaire. Validity was further examined by investigating the correlation of the SDQ with the KIDSCREEN questionnaire and its association with demographic factors. The inter-rater agreement between parent and self-reports was analyzed with Pearson’s correlation coefficient. Intra-class correlation coefficients (ICCs) were computed to determine test-retest stability. For both parent and the self-report SDQ versions, most items loaded onto their predicted factors in consistency with the originally proposed five-factor structure. Internal consistency reliability was acceptable with a Cronbach α above 0.70 for all SDQ scales except for conduct and peer problems. Inter-rater correlations ranged from 0.33 to 0.45. Test-retest stability was good (ICCs > 0.60). Correlation coefficients between the SDQ and KIDSCREEN questionnaire were significant. Small effect sizes (d > 0.5) of the socioeconomic status were found for all of the SDQ scale mean scores. In conclusion, the SDQ was found to have satisfying psychometric properties and could be suitable for assessing emotional and behavioural problems in Greek adolescents.展开更多
Background: Male sexual or coital difficulties are among the factors contributing to infertility in couples seeking fertility as this may result in low coital frequency. Aims/Objectives: To evaluate the causes of male...Background: Male sexual or coital difficulties are among the factors contributing to infertility in couples seeking fertility as this may result in low coital frequency. Aims/Objectives: To evaluate the causes of male sexual or coital difficulties among couples attending the infertility clinic at BSUTH, Makurdi over a 2 year period. Methodology: This was a cross-sectional study involving all males attending the infertility clinic at Benue State University Teaching Hospital (BSUTH) who consent to participate in the study. A pretested structured questionnaire was administered and analyzed with statistical package for social sciences (version 23.0) and the results were presented in simple proportions. Results: There were several factors responsible for male coital difficulties. The most common was male erectile dysfunction 33 (32.4%), vaginismus 11 (10.8%), penile pain 14 (13.7%), poor response from the female partner 8 (7.8%) and severe dyspareunia 18 (17.1%). Conclusion: Coital difficulties resulting to low frequency of sexual exposure constitutes a major cause of infertility among males attending the infertility clinic at BSUTH, Makurdi. Therefore efforts should be made to evaluate these factors while assessing infertility couples in order to mitigate the effect.展开更多
Through in-depth interviews and questionnaires,we take Mianyang City,Aba Prefecture,and Suining City in Sichuan Province as the study object,to analyze the relationship between the basic situation of farmers and the s...Through in-depth interviews and questionnaires,we take Mianyang City,Aba Prefecture,and Suining City in Sichuan Province as the study object,to analyze the relationship between the basic situation of farmers and the supply mechanism implementation of rural public goods.The research results show that the younger the farmers,the higher the educational level,the higher the annual household income,and the higher the enthusiasm in participating the discussion of the supply of rural public goods.And the correlation between farmers'annual household income and participation in the supply of public goods is the highest.Finally corresponding countermeasures and proposals are put forth based on farmers' educational level and annual household income,the two difficulties in supply mechanism implementation of rural public goods.展开更多
Environmental pollution has caused wide social concern,and it demands immediate attention to striking at the crime in the environmental pollution. At present,there are difficulties of putting a case on file,collecting...Environmental pollution has caused wide social concern,and it demands immediate attention to striking at the crime in the environmental pollution. At present,there are difficulties of putting a case on file,collecting evidence,judicial identification,and presumption of causal relationship in investigation of environmental pollution cases. In accordance with current situations,it came up following recommendations:(i) widely collecting case clues to solve the difficulty of putting a case on file;(ii) improving the ability of collecting evidence and standardizing the evidence collection,to solve the difficulty of evidence collection.(iii) including the environmental pollution judicial identification system,and unifying the identification standards,to solve the difficulty in identification. It is recommended to use the epidemiological causal relationship theory combined with enough high-quality evidences to solve the difficulty in presumption of causal relationship.展开更多
Introduction: Complex post-traumatic facial disfigurements are caused by civilian or ballistic trauma. Their repercussions are functional, aesthetic and psychological. The initial emergency or secondary management of ...Introduction: Complex post-traumatic facial disfigurements are caused by civilian or ballistic trauma. Their repercussions are functional, aesthetic and psychological. The initial emergency or secondary management of facial damage is difficult. The objective is to report, through the clinical observation of three patients, the results of the management of complex facial dislocations in a context of limited technical resources. Patients and methods: Three complex post-traumatic facial dislocations were managed between May 2006 and June 2017. Results: Primary treatment and secondary repair were established on a case-by-case basis. Local autoplasty was the indication of choice. Multidisciplinary management resulted in satisfactory functional and cosmetic outcomes. Two of the patients were lost to follow-up before the end of treatment. Discussion: The complete management of facial dislocations remains difficult and complex, in an extreme exercise situation. In an emergency, the priority is to save the life of the injured person. Several factors are involved in the therapeutic decision: the choice of the maxillofacial reconstruction technique, the availability of the technical platform, the financial capacity and the psychological state of the patient and his entourage. Sequential and multidisciplinary treatment gives satisfactory results in terms of morphology, function and aesthetics, despite the limited technical resources available. Psychological support is an essential complement for successful socio-professional and family reintegration.展开更多
This paper expounds the great significance of irrigation and water conservancy for the agricultural development. Vigorously developing irrigation and water conservancy can promote high yield and stable yield of grain,...This paper expounds the great significance of irrigation and water conservancy for the agricultural development. Vigorously developing irrigation and water conservancy can promote high yield and stable yield of grain, effectively increase farmers' income, alleviate the impact of drought on agricultural production, be conducive to the adjustment of agricultural production structure, and promote county economic development. The difficulties of developing irrigation and water conservancy in new era are analyzed as follows: the subject of liabilities defaults seriously; it lacks effective input security system; the quality of project degenerates badly; the agricultural technological development is slow. Corresponding policy suggestions are put forward as follows: make the input subject of irrigation and water conservancy clear; form stable investment channels; strengthen the organizing and guiding functions of grass-roots government; reinforce the coordination and management of capital; strengthen the promotion of agricultural technology; quicken the pace of reform of irrigation and water conservancy.展开更多
This research develops from clinical practice. Our aim is to provide a precise description of mental functioning of adolescents with learning difficulties (LDs) in order to improve the knowledge of this kind of proble...This research develops from clinical practice. Our aim is to provide a precise description of mental functioning of adolescents with learning difficulties (LDs) in order to improve the knowledge of this kind of problems and consequently to get better therapeutic approaches. We focus on narrative representations and we study how these adolescents construct and build stories. We assess 40 adolescents through the use of two kind of tests: Thematic Apperception Test (TAT) and Wechsler Intelligence Scale for Children (WISC-III). In addition, we compare this group with another clinical sample of adolescents. In our sample, learning difficulties are not linked to lower cognitive level, but can be understood as a maturational gap. In the narratives of the adolescents with LDs, we find a typical adolescent narrative: In most cases, the protagonist starts from a position of dependence finally reaching a position of greater autonomy. There are significant differences between the males and females in our sample, which suggest a different mode of learning ability and disability for each sex.展开更多
The U. S. A will succeed militarily in the Iraq war. However, it is far away from the true meaning of victory in war defined by distinguished strategic thinker B. H. Liddell Hart, even inaccessible. Using Hart’s own ...The U. S. A will succeed militarily in the Iraq war. However, it is far away from the true meaning of victory in war defined by distinguished strategic thinker B. H. Liddell Hart, even inaccessible. Using Hart’s own word, the true victory in war is to attain a better state of peace and improve the quality of life for the survivors after the war is over. What await America after the basic success in Iraq are grave military and political difficulties. Moreover, there may be bigger economic and financial troubles as well.展开更多
Objective: To determine the perceived difficulties in providing HIV/AIDS services among public health nurses and to identify their correlates, we carried out a cross-sectional study in the Kinki region of western Japa...Objective: To determine the perceived difficulties in providing HIV/AIDS services among public health nurses and to identify their correlates, we carried out a cross-sectional study in the Kinki region of western Japan. Methods: Structured self-administered questionnaires were distributed to all public health nurses in the region, and 1535 valid questionnaires were retrieved (valid response rate 78.7%). Results: More than half of the participants (52.8%) reported difficulties with HIV/AIDS services. The factors associated with perceived difficulties were having a negative attitude towards consultations on sexual matters (adjusted odds ratio [AOR] 2.2, p p = 0.002 and AOR 1.8, p p p = 0.016), and low permissiveness of the diversity of sexual behavior (AOR 2.0, p Conclusions: Overall, our results suggest that nursing and public health nursing education in Japan should cover sexual issues and HIV/AIDS in a more systematic way.展开更多
Programming difficulties are one of the common problems faced by software engineering students,which can lead to a rapid decline in motivation and even drop out.Probing students’programming difficulties is a crucial ...Programming difficulties are one of the common problems faced by software engineering students,which can lead to a rapid decline in motivation and even drop out.Probing students’programming difficulties is a crucial step in understanding their current programming situation and implementing appropriate instructional interventions.However,how to detect students’programming difficulties accurately without students’awareness remains a big challenge.Address the issues above;this paper adopts a sensor-free difficulties detecting method based on a deep neural network which employs a recurrent neural network(RNN)model and uses the sequential timing data from programming behaviour.The method can detect students’programming difficulties in real-time with 93%accuracy without interference in the programming process.In the long term,this method is the first step for establishing an automated intelligent programming environment.At the same time,it can assist teachers in noticing the difficulties that students encounter.Then,teachers can adjust their teaching plans and provide manual tutoring intervention more quickly.展开更多
Objective: Home hospice is one of the most important places to spend time at the end of life. It is necessary to clarify the perception of home hospice for family caregivers in order to choose home hospice. The aim of...Objective: Home hospice is one of the most important places to spend time at the end of life. It is necessary to clarify the perception of home hospice for family caregivers in order to choose home hospice. The aim of the study was to examine the perceptions of family caregivers about the reasons of decision making for home hospice care, benefits, difficulties with home hospice, and copings. Methods: Ten family caregivers who were taking care of a patient with a terminal illness at home at the time of the study participated voluntary. They participated in two interviews in the narrative approach. In the first session, they narrated reasons of decision making for home hospice, benefits, difficulties, and copings. In the second session, they narrated importance or growth in self. We analyzed narratives in the first session using qualitative analysis. This study was approved by the Ethical Board at St. Mary’s College. Results: Categories of the reasons for the decision making to undergo home hospice were “Being natural to take care of a loved one at home” or “Home hospice matching a family caregiver’s life”. Categories of benefits at home hospice were “To strengthen family’s ties” or “Both a loved one and a family spending time together”. Categories of difficulties were “Difficulty of economic problems” or “Difficulties of mental and physical symptoms”. Conclusion: We concluded that family caregivers perceived benefits and difficulties, and they could cope with difficulties, though spiritual pain remained. We need continuous support for family caregivers at home hospice.展开更多
First described embryo fetopathy, congenital syphilis remains a public health problem mostly in developing countries. The diagnosis mainly based on bacteriological and immunological evidence of mother-child couple is ...First described embryo fetopathy, congenital syphilis remains a public health problem mostly in developing countries. The diagnosis mainly based on bacteriological and immunological evidence of mother-child couple is not always easy, as it is shown in our three clinical cases. Those three clinical observations demonstrate the difficulties encountered in the diagnosis of congenital syphilis in our country where only the TPHA (Treponema Pallidum Haemaglutination Assay) and VDRL (Venereal Disease Research Laboratory) tests are the only ones to be routinely carried out. Actually, these tests can be negative at the earliest stage of the syphilis or in case of zonal phenomenon. In addition, maternal antibodies could be found in child blood, even if the baby is in good health. At last, the child could have been contaminated belatedly while tests were negative at the third month of pregnancy. Congenital syphilis still exists in our developing countries and, in order to better manage this pathology, a proposition of an efficient algorithm is submitted.展开更多
Unsafe abortions constitute a public health problem. It is one of the causes of maternal mortality in the world and particularly in developing countries. Despite the progress made, maternal mortality remains high in C...Unsafe abortions constitute a public health problem. It is one of the causes of maternal mortality in the world and particularly in developing countries. Despite the progress made, maternal mortality remains high in Cameroon. The scarcity and disparity of data on abortions lead to a lack of strong evidence to advocate to decision-makers on the extent of the problems associated with abortions in Cameroon. Our objective is to estimate the rates of mortalities and complications related to unsafe abortions, as well as the difficulties of accessing safe abortions in Cameroon. We will carry out a systematic and meta-analytical review in the biomedical databases MEDLINE (Pubmed), Google Scholar and African Journal Online (AJOL) concerning unsafe abortions and/or difficulties in accessing safe abortions in Cameroon, without date or language restriction. Gray literature will be also consulted. Two authors will simultaneously select the studies and data extraction will be done using a Google Form. Proportions will be estimated on a random-effect model. The I<sup>2</sup> and Q statistics will be used to assess the extent of heterogeneity across the studies. The outcome of both the quantitative and qualitative parts of the study will be commented. Death and morbidity due to abortions can be prevented. A concerted multidisciplinary and multicentric action would be essential.展开更多
Hikikomori is a recent phenomenon among young adults in which they isolate themselves from social contacts and responsibility for more than 6 months. This problem has assumed epidemic proportions in Japan and has been...Hikikomori is a recent phenomenon among young adults in which they isolate themselves from social contacts and responsibility for more than 6 months. This problem has assumed epidemic proportions in Japan and has been widely discussed across disciplines. Previous studies have associated hikikomori with a maladaptation to structural change, an emergent mental problem that needs new diagnosis, or an under-diagnosed schizophrenic disorder. Most previous work has adopted a clinical perspective, and there have been no qualitative studies exploring the individual feelings of people suffering from the syndrome. We adopted a qualitative method using a grounded theory approach. Data collection and analysis took place between September 2006 and August 2008. Theoretical sampling included eight informants from snowball sampling and an online observation consisting of 160 online participants. Analysis focused on informants’ first- and second-person experiences of hikikomori. Data analysis revealed one overriding theme: coping difficulties consisting of the two categories stasis and expression. As a result of conflicting demands and reduced autonomy, respondents experienced stasis, which prevented them from moving forward;“hiding” or “avoiding” heightened the expression of their behaviors. This is the first study to explore the in-depth experience of individuals suffering from hikikomori syndrome in a non-clinical setting. We argue that hikikomoriis not a result of asocial behavior, but rather an anomic response to a situation that informants felt powerless to change and from which they could see no way out. We also observed that feelings of hopelessness and relationship fatigue might be overcome by introducing a relaxed social environment that people can control during rehabilitation.展开更多
文摘The school placement processes of students from immigrant backgrounds considered to be in“difficulty”is an international concern at the intersection of works relating to special education and those concerning the school experiences of students from immigrant backgrounds or racialized groups.The research problem of this article concerns the identification of these students as disabled or as having adjustment or learning difficulties.From a perspective anchored in Disability Critical Race Studies,this ethnographic study documents different interpretations of perceived difficulties made by school actors with regard to seven primary school students from immigrant backgrounds.Five interpretation types are presented:(1)medicalization by dismissal of cultural markers,(2)medicalization by professional constraint,(3)medicalization by cultural deficit,(4)precautionary wait,and(5)cultural differentialism.Our results help to shed light on the special education overrepresentation phenomenon regarding these students and to understand how ableism and(neo)racism contribute to it.
文摘Background: Unsafe abortions are one of the leading causes of maternal mortality, especially in developing countries. In Cameroon, the maternal mortality rate remains high, and the scarcity of data on abortions leads to a lack of solid evidence to advocate on the extent of the abortions related complications. Our objective was to evaluate the unsafe abortions related complications, and to assess the difficulties of accessing safe abortions in our setting. Methods: We carried out a meta-analytic and systematic review in the biomedical databases MEDLINE (Pubmed), Google Scholar and African Journal Online concerning unsafe abortions and/or difficulties in accessing safe abortions in Cameroon. The keywords used for the search are seen in table I. Selection of studies was simultaneously done by two authors. Data were extracted through a form designed on Google Form. We used a random-effect model for proportion estimation, and The I<sup>2</sup> and Q statistics to assess the extent of heterogeneity. Results: A total of 430 studies were identified, from which 28 were included and analysed. About 5% (95% CI: 3 - 7) of unsafe abortions leads to death. The contribution of unsafe abortions in maternal deaths was 23% (95% CI: 20 - 27). The rate of severe bleeding and/or anemia were 40% (95% CI: 18 - 63) and the rate of infection was 17% (95% CI: 7 - 28), dominated by pelvic infections, pelviperitonitis, severe sepsis, and septic shock. Case reports described uterine perforations, uterine rupture during the following pregnancy. Abortion was performed in the practitioner’s or patient’s home in 41.4% of cases, in a health center in 35.1% of cases, in a private clinic in 21.2% of cases, drugs selling places and in traditional healer clinics. The restriction of abortion laws, the stigma surrounding abortion and its consequences at any level of the society, lead to the underreporting of unsafe abortions and a deep reluctance to advocate for safe abortion services. Conclusion: The strengthening of awareness campaigns for provider behavior change communication, family planning, the de-stigmatization of abortions, the training of health personnel in post-abortion care, a multidisciplinary and multicentric action would contribute to the reduction in morbidity and mortality due to abortions.
文摘Glucose-6-phosphate dehydrogenase deficiency is the most common enzymopathy worldwide. The precise prevalence of G6PD is unknown in Burkina Faso. The objective of the study was to describe the difficulties to diagnose this disease at the Souro Sanou University hospital (CHUSS) in Bobo-Dioulasso. It involved five patients comprising one child with homozygous SS sickle cell disease, one adolescent screened following a family investigation, and three adults including a man and two women. Blood smear stained with May Grunwald Giemsa was performed to look for specific signs of G6PD-deficient red blood cell and brilliant cresyl Blue for Heinz Bodies. A microscope Olympus BX53 equipped with a Camera (XC10) and connected to a computer was used to read blood smears and capture images. Genes sequencing by Sanger method were performed in a specialized laboratory in molecular genetics. For each analysis, the protocol and instructions of the equipment and reagent manufacturer were applied. Of the five patients, three had anemia and only one had hyperreticulocytosis. Two patients had biological signs of hemolysis and one patient had an elevated CRP. Blood smear stained with MGG and cresyl blue showed specific signs of G6PD-deficient red blood cells and Heinz bodies in all patients. Biochemical analysis and molecular typing confirmed G6PD deficiency. The presence of G6PD-deficient red blood cells in the blood smear guides the diagnosis of G6PD deficiency. The diagnosis is biochemical and is based on the combined measurement of G6PD plus pyruvate kinase and/or hexokinase.
文摘The objective of this study was to determine the difficulties experienced in trauma nursing practice by expert emergency nurses in Japan. Ten nurses who worked at emergency and critical care centers in Japan were directly involved in nursing patients were selected by purposive sampling and underwent semi-structured interviews regarding the difficulties they experienced in trauma nursing. The nurses were specialists in critical care nursing or were certified emergency nurses. The interview responses were analyzed by the qualitative descriptive method. The following six categories of difficulties associated with the direct care of trauma patients and their family members encountered in trauma nursing practice were identified: [Initial handling of highly urgent trauma patients], [Understanding and observing the condition of patients who are in the treatment stage], [Judging when to transition to end-stage care for patients difficult to save], [Mitigating suffering and expanding safe activities of daily living for trauma patients], [Transitional care with a long-term perspective for trauma patients], and [Relationships with the family members of patients who died]. Three categories of difficulties related to the role of the expert nurse in trauma nursing practice were identified: [Person-to-person coordination and cooperation for a trauma patient], [Playing an educational role for the nursing staff], and [Pursuing expertise in trauma nursing and gaining empirical knowledge]. The findings suggested a need to establish systems for training and consultative support and opportunities to create meaning by reflecting on fulfillment and nursing practice.
基金Supported by Basic Scientific Research Project on Ideological and Political Theory in Northwest Forestry and Forestry University in 2017(2017RWSZ01)Fine Student Project in Northwest Forestry and Forestry University in 2016(2016JP002)
文摘With the enrollment expansion of college and continuous reform of college education system and college charging system,the number of college students with financial difficulties is increasing. The college students with family financial difficulties not only bear the huge economic burden,but also bear the huge pressure of learning and mental stress,and they have many kinds of psychological problems including psychological distress of tension and anxiety,psychological conflict of self-respect and self-abasement,conflict of desire for interpersonal interaction and self-containment and strong vanity and dependence mentality. This paper puts forward the corresponding recommendations to solve these problems.
文摘This paper is composed of three parts.The first part presents Gile’s effort model and memory mechanism in consecutive interpreting.In the second part and the third part,the author analyzes the psychological factors that cause memory difficulties and proposes corresponding strategies on the basis of the analysis.At last,the author draws a conclusion based on the discussion of the whole paper that sufficient preparation,appropriate pressure and perceived memory can avoid memory difficulties caused by psychological factors.
文摘The Strengths and Difficulties Questionnaire (SDQ) is a brief screening measure of emotional and behavioural difficulties in children and adolescents. The aim of this study was to assess reliability and validity of the Greek version of the SDQ. A representative Greek sample of 1194 adolescents (aged 11 to 17 years) and their parents completed the SDQ along with other measures. Internal consistency reliability was determined by calculation of the Cronbach α coefficient. Varimax Orthogonal Transformation was conducted to test the factor structure of the questionnaire. Validity was further examined by investigating the correlation of the SDQ with the KIDSCREEN questionnaire and its association with demographic factors. The inter-rater agreement between parent and self-reports was analyzed with Pearson’s correlation coefficient. Intra-class correlation coefficients (ICCs) were computed to determine test-retest stability. For both parent and the self-report SDQ versions, most items loaded onto their predicted factors in consistency with the originally proposed five-factor structure. Internal consistency reliability was acceptable with a Cronbach α above 0.70 for all SDQ scales except for conduct and peer problems. Inter-rater correlations ranged from 0.33 to 0.45. Test-retest stability was good (ICCs > 0.60). Correlation coefficients between the SDQ and KIDSCREEN questionnaire were significant. Small effect sizes (d > 0.5) of the socioeconomic status were found for all of the SDQ scale mean scores. In conclusion, the SDQ was found to have satisfying psychometric properties and could be suitable for assessing emotional and behavioural problems in Greek adolescents.
文摘Background: Male sexual or coital difficulties are among the factors contributing to infertility in couples seeking fertility as this may result in low coital frequency. Aims/Objectives: To evaluate the causes of male sexual or coital difficulties among couples attending the infertility clinic at BSUTH, Makurdi over a 2 year period. Methodology: This was a cross-sectional study involving all males attending the infertility clinic at Benue State University Teaching Hospital (BSUTH) who consent to participate in the study. A pretested structured questionnaire was administered and analyzed with statistical package for social sciences (version 23.0) and the results were presented in simple proportions. Results: There were several factors responsible for male coital difficulties. The most common was male erectile dysfunction 33 (32.4%), vaginismus 11 (10.8%), penile pain 14 (13.7%), poor response from the female partner 8 (7.8%) and severe dyspareunia 18 (17.1%). Conclusion: Coital difficulties resulting to low frequency of sexual exposure constitutes a major cause of infertility among males attending the infertility clinic at BSUTH, Makurdi. Therefore efforts should be made to evaluate these factors while assessing infertility couples in order to mitigate the effect.
基金Supported by the 11th Five-Year Plan Key Program of Philosophy and Social Sciences in Sichuan Province in 2010(SC10A014)
文摘Through in-depth interviews and questionnaires,we take Mianyang City,Aba Prefecture,and Suining City in Sichuan Province as the study object,to analyze the relationship between the basic situation of farmers and the supply mechanism implementation of rural public goods.The research results show that the younger the farmers,the higher the educational level,the higher the annual household income,and the higher the enthusiasm in participating the discussion of the supply of rural public goods.And the correlation between farmers'annual household income and participation in the supply of public goods is the highest.Finally corresponding countermeasures and proposals are put forth based on farmers' educational level and annual household income,the two difficulties in supply mechanism implementation of rural public goods.
文摘Environmental pollution has caused wide social concern,and it demands immediate attention to striking at the crime in the environmental pollution. At present,there are difficulties of putting a case on file,collecting evidence,judicial identification,and presumption of causal relationship in investigation of environmental pollution cases. In accordance with current situations,it came up following recommendations:(i) widely collecting case clues to solve the difficulty of putting a case on file;(ii) improving the ability of collecting evidence and standardizing the evidence collection,to solve the difficulty of evidence collection.(iii) including the environmental pollution judicial identification system,and unifying the identification standards,to solve the difficulty in identification. It is recommended to use the epidemiological causal relationship theory combined with enough high-quality evidences to solve the difficulty in presumption of causal relationship.
文摘Introduction: Complex post-traumatic facial disfigurements are caused by civilian or ballistic trauma. Their repercussions are functional, aesthetic and psychological. The initial emergency or secondary management of facial damage is difficult. The objective is to report, through the clinical observation of three patients, the results of the management of complex facial dislocations in a context of limited technical resources. Patients and methods: Three complex post-traumatic facial dislocations were managed between May 2006 and June 2017. Results: Primary treatment and secondary repair were established on a case-by-case basis. Local autoplasty was the indication of choice. Multidisciplinary management resulted in satisfactory functional and cosmetic outcomes. Two of the patients were lost to follow-up before the end of treatment. Discussion: The complete management of facial dislocations remains difficult and complex, in an extreme exercise situation. In an emergency, the priority is to save the life of the injured person. Several factors are involved in the therapeutic decision: the choice of the maxillofacial reconstruction technique, the availability of the technical platform, the financial capacity and the psychological state of the patient and his entourage. Sequential and multidisciplinary treatment gives satisfactory results in terms of morphology, function and aesthetics, despite the limited technical resources available. Psychological support is an essential complement for successful socio-professional and family reintegration.
文摘This paper expounds the great significance of irrigation and water conservancy for the agricultural development. Vigorously developing irrigation and water conservancy can promote high yield and stable yield of grain, effectively increase farmers' income, alleviate the impact of drought on agricultural production, be conducive to the adjustment of agricultural production structure, and promote county economic development. The difficulties of developing irrigation and water conservancy in new era are analyzed as follows: the subject of liabilities defaults seriously; it lacks effective input security system; the quality of project degenerates badly; the agricultural technological development is slow. Corresponding policy suggestions are put forward as follows: make the input subject of irrigation and water conservancy clear; form stable investment channels; strengthen the organizing and guiding functions of grass-roots government; reinforce the coordination and management of capital; strengthen the promotion of agricultural technology; quicken the pace of reform of irrigation and water conservancy.
文摘This research develops from clinical practice. Our aim is to provide a precise description of mental functioning of adolescents with learning difficulties (LDs) in order to improve the knowledge of this kind of problems and consequently to get better therapeutic approaches. We focus on narrative representations and we study how these adolescents construct and build stories. We assess 40 adolescents through the use of two kind of tests: Thematic Apperception Test (TAT) and Wechsler Intelligence Scale for Children (WISC-III). In addition, we compare this group with another clinical sample of adolescents. In our sample, learning difficulties are not linked to lower cognitive level, but can be understood as a maturational gap. In the narratives of the adolescents with LDs, we find a typical adolescent narrative: In most cases, the protagonist starts from a position of dependence finally reaching a position of greater autonomy. There are significant differences between the males and females in our sample, which suggest a different mode of learning ability and disability for each sex.
文摘The U. S. A will succeed militarily in the Iraq war. However, it is far away from the true meaning of victory in war defined by distinguished strategic thinker B. H. Liddell Hart, even inaccessible. Using Hart’s own word, the true victory in war is to attain a better state of peace and improve the quality of life for the survivors after the war is over. What await America after the basic success in Iraq are grave military and political difficulties. Moreover, there may be bigger economic and financial troubles as well.
文摘Objective: To determine the perceived difficulties in providing HIV/AIDS services among public health nurses and to identify their correlates, we carried out a cross-sectional study in the Kinki region of western Japan. Methods: Structured self-administered questionnaires were distributed to all public health nurses in the region, and 1535 valid questionnaires were retrieved (valid response rate 78.7%). Results: More than half of the participants (52.8%) reported difficulties with HIV/AIDS services. The factors associated with perceived difficulties were having a negative attitude towards consultations on sexual matters (adjusted odds ratio [AOR] 2.2, p p = 0.002 and AOR 1.8, p p p = 0.016), and low permissiveness of the diversity of sexual behavior (AOR 2.0, p Conclusions: Overall, our results suggest that nursing and public health nursing education in Japan should cover sexual issues and HIV/AIDS in a more systematic way.
基金supported by the 2018-2020 Higher Education Talent Training Quality and Teaching Reform Project of Sichuan Province(Grant No.JG2018-46)the Science and Technology Planning Program of Sichuan University and Luzhou(Grant No.2017CDLZG30)the Postdoctoral Science fund of Sichuan University(Grant No.2019SCU12058).
文摘Programming difficulties are one of the common problems faced by software engineering students,which can lead to a rapid decline in motivation and even drop out.Probing students’programming difficulties is a crucial step in understanding their current programming situation and implementing appropriate instructional interventions.However,how to detect students’programming difficulties accurately without students’awareness remains a big challenge.Address the issues above;this paper adopts a sensor-free difficulties detecting method based on a deep neural network which employs a recurrent neural network(RNN)model and uses the sequential timing data from programming behaviour.The method can detect students’programming difficulties in real-time with 93%accuracy without interference in the programming process.In the long term,this method is the first step for establishing an automated intelligent programming environment.At the same time,it can assist teachers in noticing the difficulties that students encounter.Then,teachers can adjust their teaching plans and provide manual tutoring intervention more quickly.
文摘Objective: Home hospice is one of the most important places to spend time at the end of life. It is necessary to clarify the perception of home hospice for family caregivers in order to choose home hospice. The aim of the study was to examine the perceptions of family caregivers about the reasons of decision making for home hospice care, benefits, difficulties with home hospice, and copings. Methods: Ten family caregivers who were taking care of a patient with a terminal illness at home at the time of the study participated voluntary. They participated in two interviews in the narrative approach. In the first session, they narrated reasons of decision making for home hospice, benefits, difficulties, and copings. In the second session, they narrated importance or growth in self. We analyzed narratives in the first session using qualitative analysis. This study was approved by the Ethical Board at St. Mary’s College. Results: Categories of the reasons for the decision making to undergo home hospice were “Being natural to take care of a loved one at home” or “Home hospice matching a family caregiver’s life”. Categories of benefits at home hospice were “To strengthen family’s ties” or “Both a loved one and a family spending time together”. Categories of difficulties were “Difficulty of economic problems” or “Difficulties of mental and physical symptoms”. Conclusion: We concluded that family caregivers perceived benefits and difficulties, and they could cope with difficulties, though spiritual pain remained. We need continuous support for family caregivers at home hospice.
文摘First described embryo fetopathy, congenital syphilis remains a public health problem mostly in developing countries. The diagnosis mainly based on bacteriological and immunological evidence of mother-child couple is not always easy, as it is shown in our three clinical cases. Those three clinical observations demonstrate the difficulties encountered in the diagnosis of congenital syphilis in our country where only the TPHA (Treponema Pallidum Haemaglutination Assay) and VDRL (Venereal Disease Research Laboratory) tests are the only ones to be routinely carried out. Actually, these tests can be negative at the earliest stage of the syphilis or in case of zonal phenomenon. In addition, maternal antibodies could be found in child blood, even if the baby is in good health. At last, the child could have been contaminated belatedly while tests were negative at the third month of pregnancy. Congenital syphilis still exists in our developing countries and, in order to better manage this pathology, a proposition of an efficient algorithm is submitted.
文摘Unsafe abortions constitute a public health problem. It is one of the causes of maternal mortality in the world and particularly in developing countries. Despite the progress made, maternal mortality remains high in Cameroon. The scarcity and disparity of data on abortions lead to a lack of strong evidence to advocate to decision-makers on the extent of the problems associated with abortions in Cameroon. Our objective is to estimate the rates of mortalities and complications related to unsafe abortions, as well as the difficulties of accessing safe abortions in Cameroon. We will carry out a systematic and meta-analytical review in the biomedical databases MEDLINE (Pubmed), Google Scholar and African Journal Online (AJOL) concerning unsafe abortions and/or difficulties in accessing safe abortions in Cameroon, without date or language restriction. Gray literature will be also consulted. Two authors will simultaneously select the studies and data extraction will be done using a Google Form. Proportions will be estimated on a random-effect model. The I<sup>2</sup> and Q statistics will be used to assess the extent of heterogeneity across the studies. The outcome of both the quantitative and qualitative parts of the study will be commented. Death and morbidity due to abortions can be prevented. A concerted multidisciplinary and multicentric action would be essential.
文摘Hikikomori is a recent phenomenon among young adults in which they isolate themselves from social contacts and responsibility for more than 6 months. This problem has assumed epidemic proportions in Japan and has been widely discussed across disciplines. Previous studies have associated hikikomori with a maladaptation to structural change, an emergent mental problem that needs new diagnosis, or an under-diagnosed schizophrenic disorder. Most previous work has adopted a clinical perspective, and there have been no qualitative studies exploring the individual feelings of people suffering from the syndrome. We adopted a qualitative method using a grounded theory approach. Data collection and analysis took place between September 2006 and August 2008. Theoretical sampling included eight informants from snowball sampling and an online observation consisting of 160 online participants. Analysis focused on informants’ first- and second-person experiences of hikikomori. Data analysis revealed one overriding theme: coping difficulties consisting of the two categories stasis and expression. As a result of conflicting demands and reduced autonomy, respondents experienced stasis, which prevented them from moving forward;“hiding” or “avoiding” heightened the expression of their behaviors. This is the first study to explore the in-depth experience of individuals suffering from hikikomori syndrome in a non-clinical setting. We argue that hikikomoriis not a result of asocial behavior, but rather an anomic response to a situation that informants felt powerless to change and from which they could see no way out. We also observed that feelings of hopelessness and relationship fatigue might be overcome by introducing a relaxed social environment that people can control during rehabilitation.
