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基于Biclustering的跨病种症状群分析研究

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基于Biclustering的跨病种症状群分析研究

作者： niyongabo edouard 北京交通大学

学位级别：硕士

症状是疾病诊断与治疗的重要表征,症状在疾病以及患者表现中具有特定的规律,以往的相关研究一般重点关注症状与疾病的关系,以发现疾病特异性的症状为主要研究目标。但十余年来,医学研究人员发现某些症状往往在不同疾病和患者中同时出现... 详细信息

症状是疾病诊断与治疗的重要表征,症状在疾病以及患者表现中具有特定的规律,以往的相关研究一般重点关注症状与疾病的关系,以发现疾病特异性的症状为主要研究目标。但十余年来,医学研究人员发现某些症状往往在不同疾病和患者中同时出现,形成具有显著同现规律的症状群(Symptom Cluster)。鉴于症状管理的重要性,症状群的确认及其分子机理的发现已经成为医学研究的热点问题。传统的症状群分析方法以主成分和隐类模型等为主,并且目前研究人员主要关注于某种特定的疾病下症状群的规律。但在跨病种的症状群分析中往往还需要确认关联的疾病信息,因此,存在显著不足。本文采用Biclustering的方法进行跨病种的症状群分析,利用一个具有较全疾病谱的疾病症状关系数据行研究,确认特定的症状群结构及分子机理。本文主要研究工作包括以下两个方面:为了研究跨病种症状群规律,首先我们利用来自疾病本体论,人类表型本体论,OrphaNet,MalaCards和统一医学语言系统库中搜集并集成共计16,383种高质量疾病-症状关系数据。该数据包含如糖尿病,艾滋病毒,肺疾病,心脏疾病,黄热病,失调,慢性肝炎,发炎等常见疾病.此外,还包含如疼痛,疲劳,恶心,麻木,咳嗽,呕吐,食欲不振,虚弱,痛苦等症状.数据集共计包含13,532疾病和2,378症状,基于此数据集我们采用了三种经典的Biclustering算法:BIMAX(Binary inclusion-maximal),QUBIC(Qualitative Biclustering)和Spectral Clustering进行症状群的聚类分析,发现并确认了多种具有临床意义的症状群。这些症状群在不同的病种中同时出现,反映了不同疾病的共性临床表型模式和规律。例如,如下三个症状群:疼痛、抑郁和疲劳;恶心和呕吐;疼痛、疲劳、睡眠障碍、嗜睡、食欲不振,他们在真实临床中也是常见的伴随症状群,确实与现实临床经验吻合.基于此结果,我们结合371,422种症状-基因关系,共计有2834种症状和16728种基因数据,并利用841,068条相互作用组网络数据(来自大规模整合数据库STRING 11)。并采用共享基因、最短路径和GO分析等分析方法进行分析,与此同时,我们通过随机取样与实验结果相同的症状群样本作为症状群的实验对照组。实验分析对比结果表明,通过Biclustering相关算法实验得到的这些症状群具有较高的共享基因可能性、较短的蛋白质相互作用分子路径等共享的分子机制(与随机症状组合相比,p值<0.05)。进一步的比较分析表明,在以上三种方法中,我们发现QUBIC方法获得了具有较好生物学意义的聚类结果,而谱聚类则在共享分子机制方面获得了最好的症状聚类结果。此外,基于Biclustering算法取得的症状群在GO、pathway方面每个注释簇的富集得分具有统计学意义在后续研究中,我们将进一步探索不同聚类方法对跨病种症状群分析的性能优劣。

关键词：症状聚类跨病种症状群双聚类症状基因关系蛋白质相互作用网络

Infection Control Measures among Healthcare Workers: Knowledge, Attitude and Practice

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Open Journal of Nursing 2020年第11期10卷 1068-1080页

作者： Emmanuel Gasaba Jonathan Niciza Daniel Muhayimana edouard niyongabo Hope Africa University faculty of Health Sciences Master of Science in Nursing BI-Bujumbura Burundi National Institute of Public Health Department of Public Health Sciences Bujumbura Burundi

Background: Nosocomial infections are some of public health problems globally and continue to be increased regardless of the hospital’s efforts on infection control measures and are contributing significantly to morbidity, mortality and cost. The absence of infection control policies, guidelines and trained professionals also contributes to the magnitude of the problem. The aim of this study was to assess the Knowledge, attitude and practices towards infection control measures among healthcare workers at Old Mutare Hospital. Methods: A cross-sectional survey design was used to acquire information. A purposive sampling method was used to select 22 nurses, 15 nurse Aids and 2 laboratory technicians (Lab Tech). A self-administered questionnaire with four components addressing demographic data, knowledge, attitudes and practices was used to collect data that was completed by a checklist. Results: The study findings revealed a poor knowledge of infection control measures among the nurse’s aide. The attitude and practices among participants were impartially good in all variables. The participants had scored over 50% towards their attitude and their practices on infection control. A significant statistical difference was found between the professional status of the participants and the ability to explain how one can get Hospital Acquired Infections (HAIs) and awareness of infection control programs in their hospital (rs = 0.640, 0.645) with P Conclusion: Despite of having a fair attitude and practice towards infection control, the participants had presented poor knowledge;therefore, it had been recommended that in service training and workshop should be planned by the administration to update their knowledge and attain full compliance towards their practice.

关键词： Infection Control Hospital Acquired Infections Nurse Nurse’s Aide Laboratory Technicians

Pediatric Nursing Care and Its Practices in Three Health Care Facilities

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Open Journal of Nursing 2020年第12期10卷 1275-1293页

作者： Daniel Muhayimana Doriane Arakaza David Ndayegamiye Jovithe Bamboneyeho Tkachuk Anna edouard niyongabo Faculty of Health sciences Hope Africa University BI-Bujumbura Burundi University of the Incarnate Word San Antonio Texas USA Hope Africa University BI-Bujumbura Burundi Department of Public Health Sciences Easter Africa Health Center National Institute of Public Health (INSP) Bujumbura-Burundi

Introduction: Pediatric nursing cares are among the most important care needed referring to the category of patients. A gap of the best practice in Pediatric Nursing Care (PNC) had been publically a major problem of health and raises the rate of morbidity and mortality. The lack of nursing guidelines, low level of studies, experience at work and low economic status of Health Care Facilities (HCFs) were the main problems assessed in these three HCFs (HUCK, VNC and MHK) in this study. The purpose of this study is to assess the knowledge of nurses during their practices in Pediatric Wards of HCFs and to provide a better contribution. Method: A descriptive study design was used in this study during the period of one month. 43, 25 and 30 nurses were selected among 98 nurses by using Dilman formula. A questionnaire with 5 parameters was distributed. Data were typed using Microsoft ward and analyzed using Statistical Package for Social Scientists version 16 software (SPSS). Results: The current study found that the majority of nurses don’t know to make the best nursing diagnosis neither the factors related to the implementation of EBP in PNC. The nurses have shown different barriers often met during their practices. The all process of nursing diagnosis was not recognized with the average of 97.6% of nurses. Conclusion: Even if the nurses have some experience at work they express their weakness based on low level of study, lack of knowledge and trained professionals on work and the pediatric nursing guidelines.

关键词： Pediatric Nursing Nursing Theories Pediatric Nurse Role of Pediatric Nurse Evidence Based Practice

Women’s Attitudes and Knowledge towards the Use of Contraceptive Methods

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Open Journal of Nursing 2021年第1期11卷 17-27页

作者： Emmanuel Gasaba Fiona Niyomana Felicité Irakoze Edith Baramana Anitha Ndayizeye Ismaël Nicoyishimiye edouard niyongabo Faculty of Business and Professional Sciences Hope Africa University Bujumbura Burundi Faculty of Health Sciences Hope Africa University Bujumbura Burundi Faculty of Business and Professional Sciences Hope Africa University Bujumbura Burundi Department of Public Health Sciences National Institute of Public Health Bujumbura Burundi

Background: Contraceptive use reduces the need for abortion by preventing unwanted pregnancies, and the causes of maternal death worldwide. Contraceptive use helps women to plan their pregnancies and contributes for population growth. This study aims to analyze the attitudes and knowledge of the women attending Van Norma Clinic for the use of contraceptive methods. Methods: A cross-sectional study was used to analyze the information. A convenience sampling method has been used to select the 100 women who attended Van Norman Clinic in Family planning service in the period of the study of four months (April to July, 2020). A self-administered questionnaire with four parameters addressing importance of using contraceptive methods, the factors affecting the women’s attitudes for not using contraceptive methods, types of contraceptive methods currently used, advantages and disadvantages of using contraceptive methods was used to collect data. Results: Research findings show that the majority of respondents knew the importance of using contraceptive methods like preventing unwanted pregnancies (97%), spacing pregnancies (96%), planning pregnancies (92%), and getting well (70%). Two factors affecting women for not using contraceptive methods had been identified such as religion (73%) and fear (70%). In addition, the women attending Van Norman Clinic prefer using implants (99%) and injectable (99%). It is clear that women do not know the consequences related to the nonuse of contraceptive methods. Some recommendations have been made to the health care facilities, parents, women themselves, churches’ leaders and government in general. Conclusion: Factors which influence women’s attitudes for not using contraceptive methods were notified in our study such as religion (73.0%) and fear (70.0%) which was explained by the fact that in Burundi most people are catholic which is the most religion prohibiting the use

关键词： Contraceptive Method Family Planning Women Attitude Knowledge

Nursing Theory and Its Practices in Two Health Care Facilities of Bujumbura

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Open Journal of Nursing 2021年第9期11卷 757-771页

作者： Emmanuel Gasaba Bosco Ntiranyibagira Iranyishuye Joseph Thérèse Uwamariya Emmanuel Nkurikiye Pierre Hategekimana Emmanuel Ndarusanze edouard niyongabo Faculty of Health Sciences Hope Africa University Bujumbura Burundi Hope Africa University Bujumbura Burundi Department of Public Health Sciences National Institute of Public Health Bujumbura Burundi

Introduction: Nursing theory provides a systematic explanation and description of nursing phenomena. It is very important during nursing practice in healthcare facilities (HCFs) because it guides nurses on how to collect data, which data to collect, decide how to interpret the data through the perspective of the theorist, how to plan and implement care, how to make a change and how to evaluate the patient’s outcomes. This study aims to illustrate how nursing theory can be applied during the implementation of nursing care in HCFs of Burundi by orienting the nurses to understand its application during practice. Methods: A cross-sectional study design was used to assess the use of nursing theories in healthcare facilities. A purposive sampling method was used also to select 81 nurses working full and part by applying Alain Bouchard’s formula and the questionnaire was used as the data collection instrument. Results: The current study had revealed a poor knowledge among the participants on the use of nursing theory in these two HCFs as for all variables, their average scores were almost 24.1% whilst those who had no notion related to nursing theory reach a percentage of 75.9%. Conclusion: The study findings were slightly poor as for all variables, they scored less than 40%. Therefore, the use of theories to guide their practice was highly recommended to enhance the patients’ outcomes based on the use of scientific-based experts which could result from continuous education.

关键词： Nursing Nursing Theory Nursing Practice Healthcare Facilities (HCFs)

Clinical Preceptor’s Role in the Development of Nursing Training Based on Professional and Competency Frameworks in Two Health Care Facilities of Bujumbura

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Open Journal of Nursing 2021年第6期11卷 528-541页

作者： Ismaël Nicoyishimiye Emmanuel Gasaba Jackson Niyonzima Claudine Nshimirimana Jeanine Ndayizeye Médiatrice Nkurunziza Le Béni Bugingo edouard niyongabo Faculty of Health Sciences Hope Africa University Bujumbura Burundi Department of Public Health Sciences National Institute of Public Health Bujumbura Burundi

Background: The aim of clinical preceptors is to support the development of expertise related to the preceptorship of groups of trainees among nurses in clinical settings by the acquisition and use of theoretical knowledge, know-how and know-that. The support of students remains a major problem in hospitals, because the requirements of the preceptors according to the standards are not considered. The lack of guidelines on nursing preceptorships, theoretical application based on the professional curriculum, and professional expertise were the main problems assessed in the two Health Care (HUCK, VNC) in this study. The purpose of this study is to assess the knowledge of nurses and learners during their preceptorship practices and to contribute to the direction of evidence-based preceptorship. Method: A descriptive cross-sectional study design was used in this study during the 3-month period. A sample of 121 nurses as well as 56 learners were selected from 381 nurses and 80 learners using Alain Bouchard’s formula. A questionnaire developed according to the guidelines of Ernestine Wiedenbach’s theory of care, was distributed. The data were analyzed using the Microsoft Excel and the software program version 16 (SPSS-16). Results: The current study found that the majority of nurses do not know the importance of the clinical tutor. The results state that students experience clinical practice problems, thus clinical preceptorship is required. Nurses showed that there are different barriers often encountered during their practices. The overall nurse preceptorship process is not optimal and the average of 97.6% of nurses does not have expertise in coaching interns in clinical settings. Conclusion: Although that nurses have some experience at work, they express their weakness based on a low level of education, a lack of knowledge and trained professionals on the job, and clinical preceptorship guidelines.

关键词： Clinical Preceptor Clinical Support Nursing Training Healthcare Facilities

Nurses’ Knowledge, Attitudes and Practice regarding Pressure Ulcers Prevention and Treatment

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Open Journal of Nursing 2022年第5期12卷 316-333页

作者： edouard niyongabo Emmanuel Gasaba Pascal Niyonsenga Marius Ndayizeye Jean Bosco Ninezereza Désiré Nsabimana Annonciate Nshimirimana Schadrypeluth Abakundanye Faculty of Health Sciences Hope Africa University Bujumbura Burundi Department of Public Health Sciences National Institute of Public Health Bujumbura Burundi

Pressure ulcers (PU) are one of the most common hospital-acquired problems that occur in patients with mobility limitations. Such wounds can produce pain and deterioration of the underlying condition. Sometimes, they can be life-threatening, and their treatment can impose a financial burden on both the patient’s family and society. Nurses’ knowledge, attitude, and practice are the most important weapons to fight this preventable burden of PU among patients with impaired mobility. The purpose of this study was to assess nurses’ knowledge, attitude, and practice regarding PU prevention and treatment at Clinique Prince Louis Rwagasore (CPLR) in Bujumbura, Burundi. A cross-sectional study design was used. Convenience sampling was used to invite all 28 qualified nurses and nurses’ aids who work in the services where critically ill patients are admitted to participate. A questionnaire was created, and underwent evaluation of face validity before using it to collect data which was analysed using SPSS 21.0. Results revealed that nurses’ knowledge and practice scores were low as participants scored less than 50% on the six knowledge items and the six practice items. However, the attitude scores were greater than 65% on the five items used to evaluate attitude. A strong negative correlation was found between nurses’ knowledge and their attitude scores (r = ?0.479, p = 0.015). Education level was negatively associated with nurses’ knowledge and practice scores of PU prevention and treatment. A high attitude score did not correlate with a higher practice score which might be explained by low knowledge scores (less than 50% on knowledge items). Continuous professional development (CPD) was recommended to improve nurses’ knowledge scores and implementation of PU preventive practices at CPLR.

关键词： Pressure Ulcers Nurses Prevention Treatment Knowledge Attitude Practice

Assessment of Nurses’ Knowledge of the Management of Pre-Eclampsia in a Hospital Setting: The Case of the Van Norman Clinic. Bujumbura-Burundi

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Open Journal of Nursing 2023年第5期13卷 294-313页

作者： Prudence Bukuru Gilberte Manirambona Liliane Butoyi Alphonsine Nahimana Médiatrice Ntakarutimana Ezéchiel Kwizera Suzanne Nduwayo Messie Nsengiyumva edouard niyongabo Faculty of Health Sciences Hope Africa University Bujumbura Burundi Faculty of Community Development Hope Africa University Bujumbura Burundi

Background: Pre-eclampsia is one of the pathologies of pregnancy that causes serious maternal and fetal complications. Good nursing management of pre-eclampsia could stabilize and limit possible maternal and fetal complication. Aim: This study aims to assess nurses’ knowledge of the management of pre-eclampsia. This is a descriptive prospective study conducted at the Van Norman Clinic over three-month period from November 1st, 2020 to January 31st, 2021 to assess the knowledge of nurses assigned to the Patient reception service, Emergency service, Gynecological-Obstetrics service and Community Medicine department on the management of pre-eclampsia. Data were treated using Microsoft Word and analyzed by Statistical Package for Social Scientists version 16 (SPSS). During the period of our study, we collected 40 nurses out of 44 nurses, which represents 90.9% (n = 40) of the nurses assigned to the Patient reception service, Emergency service, Gynecological-Obstetrics service and Community Medicine department. Among the 40 cases collected, 30% respondents did not give the true definition of pre-eclampsia. Our study also showed that 70% of nurses had not been trained on the management of pre-eclampsia and 90% had not used nursing theories in their practice while the Inquiry-Based Practice (IBP) and Evidence-Based Practice (EBP) applications were known in 7.5% of cases. With regard to the nursing management of pre-eclampsia, 62.5% of cases knew the first gestures of management while 90% of cases did not know the overall nursing management of pre-eclampsia. Last of continuing education, use of nursing theories and lack of resuscitation were the main obstacles observed in the nursing management of pre-eclampsia. For better nursing management of pre-eclampsia, emphasis should be placed on building staff capacity and executing the care plan by applying nursing theories.

关键词： Pre-Eclampsia Eclampsia Nursing Theories Nurse Management Hypertension Nursing

Inquiry Based on Evidence and its Practices in Two Healthcare Facilities of Bujumbura

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Open Journal of Nursing 2021年第3期11卷 170-183页

作者： Emmanuel Gasaba Jean Paul Nshimiyimana Le Beni Bugingo Ismaël Twiyubare Marie Jeanine Ndayishimiye Jonathan Niciza Emmanuel Ndarusanze Clovis Ntahondahurira edouard niyongabo Faculty of Health Sciences Hope Africa University Bujumbura Burundi Department of Public Health Sciences National Institute of Public Health Bujumbura Burundi

Background: Inquiry evidence-based practice (IBP) improves healthcare quality, reliability, and patient outcomes as well as reduces variations in care and costs. IBP and its practice in health care promote also many advantages, such as improvements of practices based on the attitudes and cognitive ideas. This study aims to assess the inquiry based on evidence (IBP) and its practices in two Health Care Facilities (HCFs) of Bujumbura to help the practitioners to understand its importance. Methods: A cross-sectional study design was used to analyze the importance of IBP and its practice in these two hospitals. The probability-sampling technique was used also to select 104 nurses from the Military Hospital of Kamenge and 55 nurses from the Van Norman Clinic. A questionnaire was used to collect data with two mains components, demographic data and knowledge and attitudes addressing the following parameters: evidence practice during inquiry, nursing theory, current analysis in nursing care oriented the evidence, prioritization of care, rational diagnostic, monitoring and assessment. Results: The findings from this study revealed a poor knowledge and attitude among participants towards Inquiry Based Practice. In all variables, participants were scoring less than 10%. However, majority of participants (76.5%) know the indicators of patients’ satisfaction with nursing interventions through survey-based practice and 74.1% argued to analyze their information collected. Conclusion: This study revealed a weak awareness on IBP and its importance during nursing practice among participants as for almost all variables, participants were scoring less than 10%, except for the indicators of patients’ satisfaction with nursing interventions through survey-based practice (76.5%). Therefore, in-service training and curriculum revision had been highlighted and recommended another to provide the best rational diagnosis and a

关键词： Inquiry Evidence-Based Practice Evidence-Based Practice Healthcare Facilities Rational Diagnosis