When studying the phenomenon of the induced electromotive force, which originates from Faraday’s unipolar inductor, the contrast between Faraday’s view of the magnetic field dynamic lines and the theory of relativit...When studying the phenomenon of the induced electromotive force, which originates from Faraday’s unipolar inductor, the contrast between Faraday’s view of the magnetic field dynamic lines and the theory of relativity is revealed. In order to remove this contradiction, this phenomenon was studied in depth, theoretically and experimentally, using an experimental setup similar to Faraday’s. Calculations of the induced electromotive force, based on relativity on the one hand and on Faraday’s view on the other were made with the help of measurements of the magnetic field components. Accurate magnetic field measurements are confirmed by analytical calculations. Precise-induced electromotive force measurements confirmed Faraday’s view and contradicted the theory of relativity.展开更多
In William Golding' s Darkness Visible,Sophy' s experience of " hysterical hallucination" plays an important role in the the matic expression.They point directly to the evil nature of man.Although th...In William Golding' s Darkness Visible,Sophy' s experience of " hysterical hallucination" plays an important role in the the matic expression.They point directly to the evil nature of man.Although the specific content of hallucinations is different,they possess a common characteristic-mystical experience.They worth further research.This paper examines Sophy' s mystical experience in her hyster ical hallucination,so as to find out the functions of mystical experience and its influences on the novel' s thematic expression.展开更多
AIM: To prospectively assess the impact of time of endoscopy and endoscopist's experience on the outcome of non-variceal acute upper gastrointestinal (GI) bleeding patients in a large teaching hospital.METHODS: Al...AIM: To prospectively assess the impact of time of endoscopy and endoscopist's experience on the outcome of non-variceal acute upper gastrointestinal (GI) bleeding patients in a large teaching hospital.METHODS: All patients admitted for non-variceal acute upper GI bleeding for over a 2-year period were potentially eligible for this study. They were managed by a team of seven endoscopists on 24-h call whose experience was categorized into two levels (high and low) according to the number of endoscopic hemostatic procedures undertaken before the study. Endoscopic treatment was standardized according to Forrest classification of lesions as well as the subsequent medical therapy. Time of endoscopy was subdivided into two time periods: routine (8 a.m.-5 p.m.) and on-call (5 p.m.-8 a.m.). For each category of experience and time periods rebleeding rate, transfusion requirement, need for surgery, length of hospital stay and mortality we compared. Multivariate analysis was used to discriminate the impact of different variables on the outcomes that were considered.RESULTS: Study population consisted of 272 patients (mean age 67.3 years) with endoscopic stigmata of hemorrhage. The patients were equally distributed among the endoscopists, whereas only 19% of procedures were done out of working hours. Rockall score and Forrest classification at admission did not differ between time periods and degree of experience.Univariate analysis showed that higher endoscopist's experience was associated with significant reduction in rebleeding rate (14% vs 37%), transfusion requirements (1.8±0.6 vs 3.0±1.7 units) as well as surgery (4% vs 10%), but not associated with the length of hospital stay nor mortality. By contrast, outcomes did not significantly differ between the two time periods of endoscopy.On multivariate analysis, endoscopist's experience was independently associated with rebleeding rate and transfusion requirements. Odds ratios for low experienced endoscopist were 4.47 for rebleeding and 6.90 for need of transfusion after the endoscopy.CONCLUSION: Endoscopist's experience is an important independent prognostic factor for non-variceal acute upper GI bleeding. Urgent endoscopy should be undertaken preferentially by a skilled endoscopist as less expert staff tends to underestimate some risk lesions with a negative influence on hemostasis.展开更多
Objective:Post-stroke urinary incontinence(UI)is one of the sequelae of stroke.This situation affects all aspects of the patient’s life–physically,psychologically,socially,and spiritually.This study aimed to investi...Objective:Post-stroke urinary incontinence(UI)is one of the sequelae of stroke.This situation affects all aspects of the patient’s life–physically,psychologically,socially,and spiritually.This study aimed to investigate the experience of patients’success in facing a post-stroke UI.Methods:A qualitative study using the Rapid Assessment Procedure(RAP)approach was used in this study.Informants were selected using purposive sampling.In-depth interviews with as many as 8 patients who had recovered from post-stroke UI and living in the greater area of Southeast Sulawesi(Indonesia)were conducted.In-depth interviews were also conducted with 8 caregivers and 2 nurses.Data were analyzed using a thematic analysis approach and interpretation of data was based on Humanbecoming theory and Self-care deficit theory of nursing.Results:Five successful things the patients experienced during post-stroke UI were identified.The five successes were as follows:they provided information to get to know and understand post-stroke UI,followed the procedures to overcome post-stroke UI,conducted self-control exercises and stayed motivated,performed daily activities independently according to ability,and made use of family suppor t and peers’attention.Conclusions:These findings indicated that persistence,belief,independence,and social support(family and peer)made patients to successfully face their post-stroke UI and improved their quality of life.These findings also became the basis for developing a poststroke UI management model based on Humanbecoming theory and Self-care deficit theory of nursing.展开更多
Yan Si Xue(咽四穴)refer to four points in the throat summarized by Prof.Sheng Canruo in his long-year clinical experience based on the combination of TCM theory and the knowledge of modernmedical anatomy.By taking “Y...Yan Si Xue(咽四穴)refer to four points in the throat summarized by Prof.Sheng Canruo in his long-year clinical experience based on the combination of TCM theory and the knowledge of modernmedical anatomy.By taking “Yan Si Xue” as main points,and other differential adjunct points,Prof.Sheng has obtained satisfactory therapeutic results in treating various throat diseases such ashoarseness,paralysis of vocal cord,dysphonia after radiotherapy on throat tumor,vocal nodules,disorder of the glossopharyngeal nerve,hysteric aphasia,and acute or chronic laryngopharyngitis.展开更多
In many instances, care for the elderly, especially in long-term care institutions, is provided under minimal supervision by caregivers who are lay people. This can lead to poor quality care or neglect of the elderly....In many instances, care for the elderly, especially in long-term care institutions, is provided under minimal supervision by caregivers who are lay people. This can lead to poor quality care or neglect of the elderly. The research question was: “How competent are lay caregivers for the elderly in old age homes, who often lack the opportunity for training to improve their knowledge and skills, in delivering care to the elderly? The aims of the study were to explore and describe the experiences of both the caregivers and the elderly in respect of caring for the elderly in old age homes. The objectives of the study were to explore and describe the experiences of the caregivers and the elderly with respect to caring for the elderly and in respect of nursing care they received. A qualitative, explorative, descriptive, contextual and phenomenology design was used to perform this study. In the situational analysis, the experiences and needs of the caregivers were described. Themes in terms of interpersonal relationships that could be positive or negative regarding the elderly were identified. These included lack of regular in-service training sessions for caregivers. Likewise, sub-themes like communication, support and caring for elderly people were revealed. Inadequate knowledge of caregivers in caring procedures, a shortage of staff, equipment and absence of policies which should support and guide the work of caregivers impacts negatively on the care of the elderly. From the experiences of the elderly and caregivers, the competencies under scrutiny emerged and were measured qualitatively by the perceptions of the elderly, in respect of the caring they were exposed to.展开更多
Background Breast conserving surgery along with adjuvant radiotherapy is effective in terms of local control and survival for early- stage breast cancer （1）. External beam radiotherapy （EBRT） following breast cons...Background Breast conserving surgery along with adjuvant radiotherapy is effective in terms of local control and survival for early- stage breast cancer （1）. External beam radiotherapy （EBRT） following breast conserving surgery has been shown to improve survival by preventing local recurrence, in the Early Breast Cancer Trialists＇ Collaborative Group meta-analysis （2）. Standard radiotherapy typically requires numerous fractions over a 3-5 week period and is performed weeks or months after surgery or chemotherapy.展开更多
Objectives: The aim of this study was to evaluate how Swedish women describe their emotional state of being during the eighth week through the eleventh week after they have become pregnant again after suffering a prev...Objectives: The aim of this study was to evaluate how Swedish women describe their emotional state of being during the eighth week through the eleventh week after they have become pregnant again after suffering a previous miscarriage. Method: A qualitative content analysis with an inductive approach has been used to analyze fourteen interviews that served as the data base for this study. The content analysis resulted in the development of five categories which evolved into one primary theme. Findings: The five categories identified were Worry and preoccupation;Distance;managing their feelings;Mourning what is lost;Guarded happiness and expectations. These categories were compiled into a main theme, “Worry consumes a lot of energy, but on the other side lies happiness”. This theme focused on whether the women could feel any happiness about being pregnant again despite their concerns with the previous miscarriage. Conclusions: The emotional states of the women when they get pregnant again are typically characterized by anxiety, worry and concerns about their current pregnancy. The women have a tendency to distance themselves emotionally from their pregnancy but also strive to find the joy of being pregnant again. During the new pregnancy they find themselves in need of support from their family and friends as well as in need of support from the healthcare system.展开更多
Objective To report outcomes of nonsurgical and surgical management of Menire＇s disease at Beijing Tiantan Hospital. Methods Patients with Menire＇s disease were categorized into groups based on hearing and quality o...Objective To report outcomes of nonsurgical and surgical management of Menire＇s disease at Beijing Tiantan Hospital. Methods Patients with Menire＇s disease were categorized into groups based on hearing and quality of life. Individualized management was provided, including life style modification, drug therapies, endolymphatic sac decompression and labyrin- thectomy. Treatment outcomes were evaluated during up to 24 months follow up. Results Eighty seven patients underwent life style modification and drug therapies. The vertigo control rate of Grade A and B was 76.9% and 83.8% respectively. Six patients received surgical management, including endolymphatic sac decompression （n = 5） and labyrinthecto- my （n = 1）. For these patients, the vertigo control rate of Grade A and B was 80% and 100%, respectively. Conclu- lsions Management of Meni6re＇s disease depends on several factors, i.e. severities of vertigo and hearing loss, quality of life, surgical contraindications and patient subjective desire. The treatment is drug therapies for the majority of patients, as well as life style modification. Surgical indications are rare and the least invasive procedures should be considered first. The results of surgery are generally satisfying.展开更多
This paper makes an appraisal of the successful experience of China, a country with the largest agricultural population in the world, in the reduction of rural poverty. We conclude that it is an indispensible strategy...This paper makes an appraisal of the successful experience of China, a country with the largest agricultural population in the world, in the reduction of rural poverty. We conclude that it is an indispensible strategy to give priority to the development of urban sectors to promote economic growth and reduce rural poverty, and that the development of low value-added agriculture yields few, if any, benefits in decreasing rural poverty. By first adopting urban-biased policies and promoting industrialization, China has created new sources of economic growth and urban employment opportunities to absorb the surplus rural workforce. Entering labor-intensive industrial sectors for higher incomes has thus become a critical avenue for the rural poor to benefit from economic growth and escape poverty.展开更多
<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> Patient’s acceptability of dental implant prostheses may be influenced...<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> Patient’s acceptability of dental implant prostheses may be influenced the fact that a surgical procedure is involved. Adequate relevant information by the dental professionals pre-surgery, is therefore, paramount to alleviating the fear of surgery and contribute positively to patient’s ability to cope with post-surgical experience. This study, therefore, aimed at evaluating </span><span style="font-family:Verdana;">the postsurgical experience of the dental implant patients. As against what was</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">expected, and relate this with the information given pre surgery. </span><b><span style="font-family:Verdana;">Methodology:</span></b><span style="font-family:Verdana;"> Post treatment self-completed questionnaires were administered to consented </span><span style="font-family:Verdana;">patients that had dental implants placed between July 2017 and December 2019. The surgical procedure followed the standard protocol and </span><span style="font-family:Verdana;">data related to post-surgical experience were collected one week after the surgery</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">to obtain </span><span style="font-family:Verdana;">information on the level of pain/discomfort and amount of swelling experienced f</span><span style="font-family:Verdana;">ollowing surgery. The effect of the information on coping ability following surgery was also assessed. Data were analyzed using descriptive statistics (</span><span style="font-family:Verdana;">p</span><span style="font-family:Verdana;"> value ≤</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">0.05)</span><span style="font-family:Verdana;">.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Twenty-seven patients received 44 implants to replace 48 teeth. The mean age of the patients was 45</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">±</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">16.3</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">(SD) years. Teeth mostly replaced were the maxillary central incisors (39.6%). </span><span style="font-family:Verdana;">The majority of the patients 77.7% reported to experience less pain/discomfort </span><span style="font-family:Verdana;">than expected and 66.6% had less swelling than expected. While 29.6% felt they had excellent explanation of what to expect,</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">51.9% said they had good explanation.</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">The post-surgical experience between males and females was not statistically significant</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">(pain</span><span style="font-family:Verdana;">:</span><span style="font-family:Verdana;"> p</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">= 0.08, swelling</span><span style="font-family:Verdana;">:</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">p</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">= 0.64). However, the majority </span><span style="font-family:Verdana;">(8/12) that had good to excellent information preoperatively, had significa</span><span style="font-family:Verdana;">ntly </span><span style="font-family:Verdana;">less discomfort than expected. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">Positive, encouraging and satisfactor</span><span style="font-family:Verdana;">y experience of patients following implant surgical procedure is related to adequate and correct information pre-surgery.</span>展开更多
Reoccurring symptoms and persistent problems that continue post treatment can be characteristic of the vaginal infections Bacterial Vaginosis (BV) and recurrent vulvovaginal candidiasis (RVVC). The purpose of this stu...Reoccurring symptoms and persistent problems that continue post treatment can be characteristic of the vaginal infections Bacterial Vaginosis (BV) and recurrent vulvovaginal candidiasis (RVVC). The purpose of this study was to describe women’s life experiences in managing the symptoms of bacterial vaginosis and Candida. Sixteen women were recruited and participated in an interview study when they contacted a Swedish gynecology clinic with vaginal complaints that ranged from and included abnormal discharge, irritation itching along with serious malodor. An interpretive phenomenological approach was used with an individual interview to get a more intimate understanding of the women experiencing these problems. The finding of this study shows that managing the recurrent symptoms of the infections remains to be a challenge for women as it has a clearly negative impact on the quality of their lives. Four themes developed: frustration and mood disorders, intimacy changes in the relationship, exposure, hope and relief. The women had high hopes of eliminating the symptoms within the six-month study period. The treatment program, with its well-developed guidelines and continuity of care within the context of the study greatly improved the quality of life of these women. Women had feelings of frustration and anxiety when nothing could cure their problem while they had also a great hope to get rid of the symptoms with a long striking treatment. Well-developed guidelines and continuity of care can help these women to have an improved quality of life.展开更多
The article introduces China Unicom's valuable experience obtained in the construction and operation of its IP-based data and fixed services network. In the construction of the network,China Unicom aimed at the qu...The article introduces China Unicom's valuable experience obtained in the construction and operation of its IP-based data and fixed services network. In the construction of the network,China Unicom aimed at the quick deployment of telecom-level integrated services by building up multi-level metropolitan area networks and access networks;in the operation of the network,China Unicorn made great efforts with equipment manufactures, software developers and system integration providers and achieved stable and improved network performance.展开更多
With the globalization of sports event, sports marketing has become a promotion strategy of more and more enterprises. Chinese enterprises have also gradually realized the commercial val^e of sports. Sports marketing ...With the globalization of sports event, sports marketing has become a promotion strategy of more and more enterprises. Chinese enterprises have also gradually realized the commercial val^e of sports. Sports marketing has been paid increasing attention by enterprises as a means of brand promotion. Through the analysis of the sports marketing experience of five representative enterprises, Intel, Coca-cola, Herbalife, Omega and Babycare, this paper explores their successful experience, so as to assist Chinese enterprises in ＂going global＂ with the help of sports marketing.展开更多
AIM: To evaluate and compare the patients opinion on the two types of anti- TNF-α therapies in a Hungarian cohort of IBD patients. METHODS: This was a prospective, multicentre, questionnaire-based observational study...AIM: To evaluate and compare the patients opinion on the two types of anti- TNF-α therapies in a Hungarian cohort of IBD patients. METHODS: This was a prospective, multicentre, questionnaire-based observational study carried out in three Hungarian tertiary centres. From April to September 2014, an anonymous questionnaire was distributed to patients diagnosed with ulcerative colitis (UC) or Crohn’s disease (CD), who have received infliximab (IFX) and/or adalimumab (ADA). The survey focused on the preferences of the two anti-TNF-α therapies on the basis of the efficacy, the administration routes and the side effects. RESULTS: 292 IBD patients, 216 CD, 75 UC and 1 indeterminate colitis patient completed the questionnaire. The mean duration of biological therapy was 1.7 (1 - 7) years. IFX treated patients noticed improvement of symptoms at 4 - 5 weeks while ADA treated patients noticed at 5 - 6 weeks. There was no difference between the patients’ satisfaction regarding the types of anti-TNF-α therapy if they received both. However, subcutaneous administration was preferred by ADA-treated patients previously receiving IFX (p = 0.007) compared to intravenous route and they did not intend to change the mode of therapy (p = 0.040). 90% of the patients, receiving only IFX or ADA were satisfied with their present therapy. The majority of patients (186/292, 63.7%) would not switch therapy. 63 of 291, 22% of the patients reported to have some concern with biological therapy—the majority (32/63, 50.8%) due to fear from side effects. CONCLUSION: Generally, patients preferred and would not change the present anti-TNF-α therapy, however, subcutaneous administration was preferred among those patients who had have experience with both.展开更多
Pension funds remain scarce no matter what institutional design is adopted. China has a host of unique issues facing its pension system,issues that must be confronted; for instance,the disappearance of its demographic...Pension funds remain scarce no matter what institutional design is adopted. China has a host of unique issues facing its pension system,issues that must be confronted; for instance,the disappearance of its demographic dividends and legacy costs incurred due to institutional transition. Such features determine that China’s pension system is merely passable at the present time. In this article,Professor Cai Fang offers new and incisive perspectives on this issue,such as the potential stimulus for economic growth by ageing people’s desire to save money for old-age provisions.展开更多
Asthma is characterized by paroxysmaldyspnea,rales in the throat,difficulty in breathing,and inability to lie horizontally.It is commonly seenin children with a weak body constitution,and tendsto be intractable,thus b...Asthma is characterized by paroxysmaldyspnea,rales in the throat,difficulty in breathing,and inability to lie horizontally.It is commonly seenin children with a weak body constitution,and tendsto be intractable,thus being harmful to the展开更多
Background:Unfavorable fractures are among the most common complications of bilateral sagittal split ramus osteotomy(BSSRO).This study aimed to evaluate unfavorable fracture patterns during BSSRO and assess the relate...Background:Unfavorable fractures are among the most common complications of bilateral sagittal split ramus osteotomy(BSSRO).This study aimed to evaluate unfavorable fracture patterns during BSSRO and assess the related risk factors and treatment measures.Methods:The clinical records and radiographs of 679 patients(1358 sides)who underwent BSSRO at Shanghai Ninth People’s Hospital between September 2013 and December 2021 were examined.Results:Patients with unfavorable fractures who underwent surgical restoration were studied.The incidence of unfavorable fractures was 0.8%(n¼11),with the highest rate in the third year.The unfavorable fractures were divided into three types by location and clinical treatment:(1)SSRO could still be completed after buccal/lingual plate unfavorable fracture(0.6%,n=8);(2)condylar/coronoid process fractures/intermaxillary fixation needed(0.1%,n=2);(3)additional osteotomy required(0.07%,n=1).Conclusion:These results suggest that as a surgeon’s experience increases,the rate of unfavorable fractures may decrease.The novel classification of unfavorable fractures for SSRO might be useful for surgeons to make appropriate treatment choices during orthognathic surgery.展开更多
Objective: An inverse relationship between volume and mortality in some cardiothoracic surgical procedures has been previously established, leading to suggestions that acute aortic dissection should not be operated in...Objective: An inverse relationship between volume and mortality in some cardiothoracic surgical procedures has been previously established, leading to suggestions that acute aortic dissection should not be operated in community or low volume heart centers. We therefore reviewed our experience to compare with published data. Methods: Retrospective review of 27 patients who underwent proximal aortic surgery by a single surgeon at an inner city community hospital between May 2004 and April 2015. 16 patients, mean age 51.7 ± 13.6 years old, 75.0% males underwent emergency surgery for acute Stanford type A aortic dissection, while 9 with root or ascending aortic aneurysm, mean age 50.3 ± 15.0 years old, 88.9% males had elective proximal aortic surgery. 2 patients with arch aneurysm were excluded. Results: Four (25.0%) patients with acute dissection were in Penn class A, 3 (18.7%) Penn B, 3 (18.7%) Penn C and 6 (37.5%) Penn B+C. 10 (62.5%) patients underwent emergency root replacement with 60.0% (6/10) mortality all related to malperfusion including 2 patients with bloody stools, while 6 (37.5%) underwent supracoronary graft replacement with 16.6% (1/6) mortality from cardiac tamponade. The 5-year survival was 89.0%. In patients with aortic aneurysm, 8 (88.9%) underwent elective root replacement and 1 (11.1%) supracoronary graft replacement with zero mortality. Conclusion: Supracoronary graft replacement is performed for the majority of uncomplicated acute type A dissections and can be undertaken by the average general cardiac surgeon with acceptable results. Visceral malperfusion especially when associated with bloody stools portends a poor prognosis, and aortic dissection should be excluded in any Marfan patient presenting with acute abdomen. Delaying intervention in attempting transfer to a tertiary hospital can potentially increase preoperative mortality, known to rise with each passing hour from onset of acute dissection. Patients presenting therefore to community hospitals should probably undergo surgery there to avoid complications associated with delay.展开更多
文摘When studying the phenomenon of the induced electromotive force, which originates from Faraday’s unipolar inductor, the contrast between Faraday’s view of the magnetic field dynamic lines and the theory of relativity is revealed. In order to remove this contradiction, this phenomenon was studied in depth, theoretically and experimentally, using an experimental setup similar to Faraday’s. Calculations of the induced electromotive force, based on relativity on the one hand and on Faraday’s view on the other were made with the help of measurements of the magnetic field components. Accurate magnetic field measurements are confirmed by analytical calculations. Precise-induced electromotive force measurements confirmed Faraday’s view and contradicted the theory of relativity.
文摘In William Golding' s Darkness Visible,Sophy' s experience of " hysterical hallucination" plays an important role in the the matic expression.They point directly to the evil nature of man.Although the specific content of hallucinations is different,they possess a common characteristic-mystical experience.They worth further research.This paper examines Sophy' s mystical experience in her hyster ical hallucination,so as to find out the functions of mystical experience and its influences on the novel' s thematic expression.
文摘AIM: To prospectively assess the impact of time of endoscopy and endoscopist's experience on the outcome of non-variceal acute upper gastrointestinal (GI) bleeding patients in a large teaching hospital.METHODS: All patients admitted for non-variceal acute upper GI bleeding for over a 2-year period were potentially eligible for this study. They were managed by a team of seven endoscopists on 24-h call whose experience was categorized into two levels (high and low) according to the number of endoscopic hemostatic procedures undertaken before the study. Endoscopic treatment was standardized according to Forrest classification of lesions as well as the subsequent medical therapy. Time of endoscopy was subdivided into two time periods: routine (8 a.m.-5 p.m.) and on-call (5 p.m.-8 a.m.). For each category of experience and time periods rebleeding rate, transfusion requirement, need for surgery, length of hospital stay and mortality we compared. Multivariate analysis was used to discriminate the impact of different variables on the outcomes that were considered.RESULTS: Study population consisted of 272 patients (mean age 67.3 years) with endoscopic stigmata of hemorrhage. The patients were equally distributed among the endoscopists, whereas only 19% of procedures were done out of working hours. Rockall score and Forrest classification at admission did not differ between time periods and degree of experience.Univariate analysis showed that higher endoscopist's experience was associated with significant reduction in rebleeding rate (14% vs 37%), transfusion requirements (1.8±0.6 vs 3.0±1.7 units) as well as surgery (4% vs 10%), but not associated with the length of hospital stay nor mortality. By contrast, outcomes did not significantly differ between the two time periods of endoscopy.On multivariate analysis, endoscopist's experience was independently associated with rebleeding rate and transfusion requirements. Odds ratios for low experienced endoscopist were 4.47 for rebleeding and 6.90 for need of transfusion after the endoscopy.CONCLUSION: Endoscopist's experience is an important independent prognostic factor for non-variceal acute upper GI bleeding. Urgent endoscopy should be undertaken preferentially by a skilled endoscopist as less expert staff tends to underestimate some risk lesions with a negative influence on hemostasis.
基金the Faculty of Nursing,Universitas Indonesia,Depok-Indonesia,for all valuable support。
文摘Objective:Post-stroke urinary incontinence(UI)is one of the sequelae of stroke.This situation affects all aspects of the patient’s life–physically,psychologically,socially,and spiritually.This study aimed to investigate the experience of patients’success in facing a post-stroke UI.Methods:A qualitative study using the Rapid Assessment Procedure(RAP)approach was used in this study.Informants were selected using purposive sampling.In-depth interviews with as many as 8 patients who had recovered from post-stroke UI and living in the greater area of Southeast Sulawesi(Indonesia)were conducted.In-depth interviews were also conducted with 8 caregivers and 2 nurses.Data were analyzed using a thematic analysis approach and interpretation of data was based on Humanbecoming theory and Self-care deficit theory of nursing.Results:Five successful things the patients experienced during post-stroke UI were identified.The five successes were as follows:they provided information to get to know and understand post-stroke UI,followed the procedures to overcome post-stroke UI,conducted self-control exercises and stayed motivated,performed daily activities independently according to ability,and made use of family suppor t and peers’attention.Conclusions:These findings indicated that persistence,belief,independence,and social support(family and peer)made patients to successfully face their post-stroke UI and improved their quality of life.These findings also became the basis for developing a poststroke UI management model based on Humanbecoming theory and Self-care deficit theory of nursing.
文摘Yan Si Xue(咽四穴)refer to four points in the throat summarized by Prof.Sheng Canruo in his long-year clinical experience based on the combination of TCM theory and the knowledge of modernmedical anatomy.By taking “Yan Si Xue” as main points,and other differential adjunct points,Prof.Sheng has obtained satisfactory therapeutic results in treating various throat diseases such ashoarseness,paralysis of vocal cord,dysphonia after radiotherapy on throat tumor,vocal nodules,disorder of the glossopharyngeal nerve,hysteric aphasia,and acute or chronic laryngopharyngitis.
文摘In many instances, care for the elderly, especially in long-term care institutions, is provided under minimal supervision by caregivers who are lay people. This can lead to poor quality care or neglect of the elderly. The research question was: “How competent are lay caregivers for the elderly in old age homes, who often lack the opportunity for training to improve their knowledge and skills, in delivering care to the elderly? The aims of the study were to explore and describe the experiences of both the caregivers and the elderly in respect of caring for the elderly in old age homes. The objectives of the study were to explore and describe the experiences of the caregivers and the elderly with respect to caring for the elderly and in respect of nursing care they received. A qualitative, explorative, descriptive, contextual and phenomenology design was used to perform this study. In the situational analysis, the experiences and needs of the caregivers were described. Themes in terms of interpersonal relationships that could be positive or negative regarding the elderly were identified. These included lack of regular in-service training sessions for caregivers. Likewise, sub-themes like communication, support and caring for elderly people were revealed. Inadequate knowledge of caregivers in caring procedures, a shortage of staff, equipment and absence of policies which should support and guide the work of caregivers impacts negatively on the care of the elderly. From the experiences of the elderly and caregivers, the competencies under scrutiny emerged and were measured qualitatively by the perceptions of the elderly, in respect of the caring they were exposed to.
文摘Background Breast conserving surgery along with adjuvant radiotherapy is effective in terms of local control and survival for early- stage breast cancer （1）. External beam radiotherapy （EBRT） following breast conserving surgery has been shown to improve survival by preventing local recurrence, in the Early Breast Cancer Trialists＇ Collaborative Group meta-analysis （2）. Standard radiotherapy typically requires numerous fractions over a 3-5 week period and is performed weeks or months after surgery or chemotherapy.
文摘Objectives: The aim of this study was to evaluate how Swedish women describe their emotional state of being during the eighth week through the eleventh week after they have become pregnant again after suffering a previous miscarriage. Method: A qualitative content analysis with an inductive approach has been used to analyze fourteen interviews that served as the data base for this study. The content analysis resulted in the development of five categories which evolved into one primary theme. Findings: The five categories identified were Worry and preoccupation;Distance;managing their feelings;Mourning what is lost;Guarded happiness and expectations. These categories were compiled into a main theme, “Worry consumes a lot of energy, but on the other side lies happiness”. This theme focused on whether the women could feel any happiness about being pregnant again despite their concerns with the previous miscarriage. Conclusions: The emotional states of the women when they get pregnant again are typically characterized by anxiety, worry and concerns about their current pregnancy. The women have a tendency to distance themselves emotionally from their pregnancy but also strive to find the joy of being pregnant again. During the new pregnancy they find themselves in need of support from their family and friends as well as in need of support from the healthcare system.
文摘Objective To report outcomes of nonsurgical and surgical management of Menire＇s disease at Beijing Tiantan Hospital. Methods Patients with Menire＇s disease were categorized into groups based on hearing and quality of life. Individualized management was provided, including life style modification, drug therapies, endolymphatic sac decompression and labyrin- thectomy. Treatment outcomes were evaluated during up to 24 months follow up. Results Eighty seven patients underwent life style modification and drug therapies. The vertigo control rate of Grade A and B was 76.9% and 83.8% respectively. Six patients received surgical management, including endolymphatic sac decompression （n = 5） and labyrinthecto- my （n = 1）. For these patients, the vertigo control rate of Grade A and B was 80% and 100%, respectively. Conclu- lsions Management of Meni6re＇s disease depends on several factors, i.e. severities of vertigo and hearing loss, quality of life, surgical contraindications and patient subjective desire. The treatment is drug therapies for the majority of patients, as well as life style modification. Surgical indications are rare and the least invasive procedures should be considered first. The results of surgery are generally satisfying.
文摘This paper makes an appraisal of the successful experience of China, a country with the largest agricultural population in the world, in the reduction of rural poverty. We conclude that it is an indispensible strategy to give priority to the development of urban sectors to promote economic growth and reduce rural poverty, and that the development of low value-added agriculture yields few, if any, benefits in decreasing rural poverty. By first adopting urban-biased policies and promoting industrialization, China has created new sources of economic growth and urban employment opportunities to absorb the surplus rural workforce. Entering labor-intensive industrial sectors for higher incomes has thus become a critical avenue for the rural poor to benefit from economic growth and escape poverty.
文摘<b><span style="font-family:Verdana;">Background:</span></b><span style="font-family:Verdana;"> Patient’s acceptability of dental implant prostheses may be influenced the fact that a surgical procedure is involved. Adequate relevant information by the dental professionals pre-surgery, is therefore, paramount to alleviating the fear of surgery and contribute positively to patient’s ability to cope with post-surgical experience. This study, therefore, aimed at evaluating </span><span style="font-family:Verdana;">the postsurgical experience of the dental implant patients. As against what was</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">expected, and relate this with the information given pre surgery. </span><b><span style="font-family:Verdana;">Methodology:</span></b><span style="font-family:Verdana;"> Post treatment self-completed questionnaires were administered to consented </span><span style="font-family:Verdana;">patients that had dental implants placed between July 2017 and December 2019. The surgical procedure followed the standard protocol and </span><span style="font-family:Verdana;">data related to post-surgical experience were collected one week after the surgery</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">to obtain </span><span style="font-family:Verdana;">information on the level of pain/discomfort and amount of swelling experienced f</span><span style="font-family:Verdana;">ollowing surgery. The effect of the information on coping ability following surgery was also assessed. Data were analyzed using descriptive statistics (</span><span style="font-family:Verdana;">p</span><span style="font-family:Verdana;"> value ≤</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">0.05)</span><span style="font-family:Verdana;">.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Twenty-seven patients received 44 implants to replace 48 teeth. The mean age of the patients was 45</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">±</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">16.3</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">(SD) years. Teeth mostly replaced were the maxillary central incisors (39.6%). </span><span style="font-family:Verdana;">The majority of the patients 77.7% reported to experience less pain/discomfort </span><span style="font-family:Verdana;">than expected and 66.6% had less swelling than expected. While 29.6% felt they had excellent explanation of what to expect,</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">51.9% said they had good explanation.</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">The post-surgical experience between males and females was not statistically significant</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">(pain</span><span style="font-family:Verdana;">:</span><span style="font-family:Verdana;"> p</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">= 0.08, swelling</span><span style="font-family:Verdana;">:</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">p</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">= 0.64). However, the majority </span><span style="font-family:Verdana;">(8/12) that had good to excellent information preoperatively, had significa</span><span style="font-family:Verdana;">ntly </span><span style="font-family:Verdana;">less discomfort than expected. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">Positive, encouraging and satisfactor</span><span style="font-family:Verdana;">y experience of patients following implant surgical procedure is related to adequate and correct information pre-surgery.</span>
文摘Reoccurring symptoms and persistent problems that continue post treatment can be characteristic of the vaginal infections Bacterial Vaginosis (BV) and recurrent vulvovaginal candidiasis (RVVC). The purpose of this study was to describe women’s life experiences in managing the symptoms of bacterial vaginosis and Candida. Sixteen women were recruited and participated in an interview study when they contacted a Swedish gynecology clinic with vaginal complaints that ranged from and included abnormal discharge, irritation itching along with serious malodor. An interpretive phenomenological approach was used with an individual interview to get a more intimate understanding of the women experiencing these problems. The finding of this study shows that managing the recurrent symptoms of the infections remains to be a challenge for women as it has a clearly negative impact on the quality of their lives. Four themes developed: frustration and mood disorders, intimacy changes in the relationship, exposure, hope and relief. The women had high hopes of eliminating the symptoms within the six-month study period. The treatment program, with its well-developed guidelines and continuity of care within the context of the study greatly improved the quality of life of these women. Women had feelings of frustration and anxiety when nothing could cure their problem while they had also a great hope to get rid of the symptoms with a long striking treatment. Well-developed guidelines and continuity of care can help these women to have an improved quality of life.
文摘The article introduces China Unicom's valuable experience obtained in the construction and operation of its IP-based data and fixed services network. In the construction of the network,China Unicom aimed at the quick deployment of telecom-level integrated services by building up multi-level metropolitan area networks and access networks;in the operation of the network,China Unicorn made great efforts with equipment manufactures, software developers and system integration providers and achieved stable and improved network performance.
文摘With the globalization of sports event, sports marketing has become a promotion strategy of more and more enterprises. Chinese enterprises have also gradually realized the commercial val^e of sports. Sports marketing has been paid increasing attention by enterprises as a means of brand promotion. Through the analysis of the sports marketing experience of five representative enterprises, Intel, Coca-cola, Herbalife, Omega and Babycare, this paper explores their successful experience, so as to assist Chinese enterprises in ＂going global＂ with the help of sports marketing.
基金supported by the Janos Bolyai Research Scholarship of the Hugarian Academy of Sciences(BO/00632/13/5)
文摘AIM: To evaluate and compare the patients opinion on the two types of anti- TNF-α therapies in a Hungarian cohort of IBD patients. METHODS: This was a prospective, multicentre, questionnaire-based observational study carried out in three Hungarian tertiary centres. From April to September 2014, an anonymous questionnaire was distributed to patients diagnosed with ulcerative colitis (UC) or Crohn’s disease (CD), who have received infliximab (IFX) and/or adalimumab (ADA). The survey focused on the preferences of the two anti-TNF-α therapies on the basis of the efficacy, the administration routes and the side effects. RESULTS: 292 IBD patients, 216 CD, 75 UC and 1 indeterminate colitis patient completed the questionnaire. The mean duration of biological therapy was 1.7 (1 - 7) years. IFX treated patients noticed improvement of symptoms at 4 - 5 weeks while ADA treated patients noticed at 5 - 6 weeks. There was no difference between the patients’ satisfaction regarding the types of anti-TNF-α therapy if they received both. However, subcutaneous administration was preferred by ADA-treated patients previously receiving IFX (p = 0.007) compared to intravenous route and they did not intend to change the mode of therapy (p = 0.040). 90% of the patients, receiving only IFX or ADA were satisfied with their present therapy. The majority of patients (186/292, 63.7%) would not switch therapy. 63 of 291, 22% of the patients reported to have some concern with biological therapy—the majority (32/63, 50.8%) due to fear from side effects. CONCLUSION: Generally, patients preferred and would not change the present anti-TNF-α therapy, however, subcutaneous administration was preferred among those patients who had have experience with both.
文摘Pension funds remain scarce no matter what institutional design is adopted. China has a host of unique issues facing its pension system,issues that must be confronted; for instance,the disappearance of its demographic dividends and legacy costs incurred due to institutional transition. Such features determine that China’s pension system is merely passable at the present time. In this article,Professor Cai Fang offers new and incisive perspectives on this issue,such as the potential stimulus for economic growth by ageing people’s desire to save money for old-age provisions.
文摘Asthma is characterized by paroxysmaldyspnea,rales in the throat,difficulty in breathing,and inability to lie horizontally.It is commonly seenin children with a weak body constitution,and tendsto be intractable,thus being harmful to the
基金the University-Industry Collaborative Education Program of the Ministry of Education of China(grant no.201801301030).
文摘Background:Unfavorable fractures are among the most common complications of bilateral sagittal split ramus osteotomy(BSSRO).This study aimed to evaluate unfavorable fracture patterns during BSSRO and assess the related risk factors and treatment measures.Methods:The clinical records and radiographs of 679 patients(1358 sides)who underwent BSSRO at Shanghai Ninth People’s Hospital between September 2013 and December 2021 were examined.Results:Patients with unfavorable fractures who underwent surgical restoration were studied.The incidence of unfavorable fractures was 0.8%(n¼11),with the highest rate in the third year.The unfavorable fractures were divided into three types by location and clinical treatment:(1)SSRO could still be completed after buccal/lingual plate unfavorable fracture(0.6%,n=8);(2)condylar/coronoid process fractures/intermaxillary fixation needed(0.1%,n=2);(3)additional osteotomy required(0.07%,n=1).Conclusion:These results suggest that as a surgeon’s experience increases,the rate of unfavorable fractures may decrease.The novel classification of unfavorable fractures for SSRO might be useful for surgeons to make appropriate treatment choices during orthognathic surgery.
文摘Objective: An inverse relationship between volume and mortality in some cardiothoracic surgical procedures has been previously established, leading to suggestions that acute aortic dissection should not be operated in community or low volume heart centers. We therefore reviewed our experience to compare with published data. Methods: Retrospective review of 27 patients who underwent proximal aortic surgery by a single surgeon at an inner city community hospital between May 2004 and April 2015. 16 patients, mean age 51.7 ± 13.6 years old, 75.0% males underwent emergency surgery for acute Stanford type A aortic dissection, while 9 with root or ascending aortic aneurysm, mean age 50.3 ± 15.0 years old, 88.9% males had elective proximal aortic surgery. 2 patients with arch aneurysm were excluded. Results: Four (25.0%) patients with acute dissection were in Penn class A, 3 (18.7%) Penn B, 3 (18.7%) Penn C and 6 (37.5%) Penn B+C. 10 (62.5%) patients underwent emergency root replacement with 60.0% (6/10) mortality all related to malperfusion including 2 patients with bloody stools, while 6 (37.5%) underwent supracoronary graft replacement with 16.6% (1/6) mortality from cardiac tamponade. The 5-year survival was 89.0%. In patients with aortic aneurysm, 8 (88.9%) underwent elective root replacement and 1 (11.1%) supracoronary graft replacement with zero mortality. Conclusion: Supracoronary graft replacement is performed for the majority of uncomplicated acute type A dissections and can be undertaken by the average general cardiac surgeon with acceptable results. Visceral malperfusion especially when associated with bloody stools portends a poor prognosis, and aortic dissection should be excluded in any Marfan patient presenting with acute abdomen. Delaying intervention in attempting transfer to a tertiary hospital can potentially increase preoperative mortality, known to rise with each passing hour from onset of acute dissection. Patients presenting therefore to community hospitals should probably undergo surgery there to avoid complications associated with delay.
