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Evaluating the average access to care and continuity of care patients in Tehran teaching hospitals

Health 2013年第12期5卷 2110-2115页

作者： Fereshteh Farzianpour searajadein gray Abbas Rahimi Foroushani Mohammad Arab Shadi Hosseini Department of Epidemiology and Biostatistics School of Public Health Tehran University of Medical Sciences Tehran Iran Department of Health Management and Economic School of Public Health Tehran University of Medical Sciences Tehran Iran Department of Management Management Faculty Tehran University Tehran Iran

Background: Standards of Joint Commission International emphasize on the organizational performance level in basic functional domains including patient right, patient care, medical safety and infection control. These standards are focused on two principles: expectations of the actual organizational performance and assessment of organizational capabilities to provide high quality and safe health care services. The aim of this study is to evaluate the possibility of improvement in Access to Care and Continuity of Care for patients (ACC) in teaching hospitals of Tehran University of Medical Sciences. Methods: This cross-sectional study was conducted in hospitals affiliated to Tehran University of Medical Sciences during 2012. Data collection was performed using author-designed questionnaire of “Access to Care and Continuity of Care patients” based on JCI standards (2013). A total of 171 questionnaires were sent to 26 hospitals and 154 (90%) questionnaires were successfully completed and used for data analysis. The questionnaire was reviewed by experts and the Cronbach’s alpha was calculated to be 0.967. The effects of the two variables of hospital type (general, specialty) and the number of beds on mean scores of ACC standards and each of its domains were analyzed using T-test or Mann-Whitney test depending on the distribution due to Kolmogorov-Smirnov test result. Results: In general, the mean of ACC standards was found comprehendible and applicable by 82.3 (SD = 11) of the respondents. The highest and lowest mean scores of ACC questions belonged to hospitals H21 (90 ± 6) and H14 (67 ± 12), respectively. There were not any significant effects of hospital type and the number of beds on the ACC scores. Conclusion: There was not any important effect of hospital type and bed numbers on ACC, although there was a 9%-15% possibility of improvement in accreditation scores of ACC standards in hospitals of Tehran University of Medical Sciences. A complete accreditation score in

关键词： Accreditation Access to Care and Continuity of Care Patients Joint Commission International Hospitals of Tehran University of Medical Sciences

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Historic,pre-stock enhancement,demographic conditions of exploited populations of dusky flathead,Platycephalus fuscus,in eastern Australia

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Aquaculture and Fisheries 2024年第2期9卷 314-323页

作者： Charles A.gray WildFish Research Grays PointSydney2232Australia

Responsible stock enhancement initiatives require baseline data of wild population demographic conditions that can be used in testing management *** study provides the first fishery-independent assessment of length-and age-based biological characteristics of exploited populations of Platycephalus fuscus in eastern Australia prior to stock *** was conducted over seven estuaries spanning seven degrees of latitude and the geographical range of proposed stock *** in all estuaries showed evidence of length and age truncation,especially those subject to commercial fisheries where young individuals of both sexes dominated *** longevities were 12 and 11 years for females and males respectively,but few females>5 years and males>3 years were generally *** dominated populations,and on average,the mean lengths and ages of females were greater than males within each estuary and across all age *** dimorphic variation in growth was evident across all estuaries,with females attaining greater maximum lengths than ***-specific differences in individual growth were not *** average,over 50%of females sampled in each estuary were>the minimum legal length(MLL),but the opposite was evident for *** contrast,over 25%of males in each estuary were>the mean length at maturity(L50),whereas in all but one estuarythe *** male and female *** should recruit to the fishery in 2 and 3 years,and contribute to the spawning stock in 1.5 and 4.5 years,*** study provides important historical baseline data that can contribute to testing stock enhancement outcomes on populations.

关键词： Baseline data Fishery enhancement Management evaluation Platycephalidae Recreational fishing Restocking Stock assessment

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Peacebuilding Is Social Work:From Political Science to Social Psychology

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Sociology Study 2024年第2期14卷 91-97页

作者： Alexandra gray Basilio Monteiro St.John’s University New YorkU.S.

For the longest time,peacemaking and peacekeeping were the only post-factum interventions to resolve armed conflicts usually related to a nation-state’s borders or *** has its origins in sociology(Galtung,1969;1975)and is used today as a preferred concept in matters of ***,this paper explores why peacebuilding,as the Secretary General of the United Nations advocates in A New Agenda for Peace,must become a nonlinear and contextual process that promotes the prevention of conflict and invites a transformative approach to addressing the linkages between peace,security,and ***,this paper advocates that peacebuilding grounded in social psychology and social anthropology will bring about transformative outcomes as it will build relationships at the community level and become a preventive tool to address incipient tensions within the *** as social work will benefit the community and lay the necessary foundations for a sustainable *** workers are equipped to assess,analyze,and solve *** capacity to do ongoing social diagnosis is a critical tool to prevent skirmishes degenerating into *** work could be the much-needed resource to further develop theory and practice that contributes to active peacebuilding.

关键词： peacebuilding peacekeeping social work conflict prevention reconciliation

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Stubborn Hypoxia in Neonates with D-Transposition of the Great Arteries after Arterial Switch Operation: Central Sleep Apnea as the Cause and Potential Indicator of Brain Immaturity

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Congenital Heart Disease 2024年第2期19卷 185-195页

作者： Camden L.Hebson Kyle Bliton Amr Y.Hammouda Kaitlyn Barr W.Hampton gray Mohini Gunnett Waldemar F.Carlo Department of Pediatrics Division of Pediatric CardiologyUniversity of Alabama BirminghamBirmingham35233USA Department of Pediatrics Division of Pediatric PulmonologyUniversity of Alabama BirminghamBirmingham35233USA Department of Pediatrics University of Alabama BirminghamBirmingham35233USA Department of Surgery Division of Cardiothoracic SurgeryUniversity of Alabama BirminghamBirmingham35233USA

D-transposition of the great arteries(d-TGA)is surgically repaired with the arterial switch operation(ASO)with excellent results,however short and long-term morbidities still develop including neurocognitive *** significant central sleep apnea is uncommon in non-premature infants,but when present indicates immature autonomic control of respiration likely due to a neurologic *** report the unanticipatedfinding of central sleep apnea in four-term neonates with d-TGA after uncomplicated ASO,with the short-term complication of delayed hospital discharge and long-term concerns regarding this early marker of brain immaturity and its hindrance to normal *** this report,we will review each patient’s clinical course and then examine the literature on pediatric central sleep apnea,neurodevelopmental outcomes after ASO,and the important overlap of these entities in the care of patients going forward.

关键词： Transposition congenital heart disease sleep apnea polysomnography

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Percutaneous decannulation of extracorporeal membrane oxygenation using MANTA device:A real-world single-center experience

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World Journal of Cardiology 2024年第10期16卷 574-579页

作者： Ioannis Milioglou Alice Qian Pedro Rafael Vieira de Oliveira Salerno Gabriel Tensol Rodrigues Pereira Luis Augusto Palma Dallan Kelsey E gray Michael Morrison Yasir Abu-Omar Mohammad Eldiasty Cristian Baeza Department of Cardiology University Hospitals Cleveland Medical CenterClevelandOH 44106United States Department of Surgery University Hospitals Cleveland Medical Center and Case Western Reserve University School of MedicineClevelandOH 44106United States

BACKGROUND The MANTA vascular closure device(VCD)represents a novel approach to achieving hemostasis after large-bore femoral access *** clinical studies have evaluated the efficacy of the MANTA device across a range of patient populations undergoing different ***,there is still a paucity of data available concerning the use of MANTA devices in aiding the decannulation of venoarterial extracorporeal membrane oxygenation(VAECMO).AIM To present our single-center experience of utilizing the MANTA VCD in patients undergoing this *** This single-center study included all patients undergoing percutaneous decannulation of femoral VA-ECMO using the MANTA plug-based VCD between January 2021 and October 2023 at University Hospitals Cleveland Medical *** criteria were adult patients who required prolonged(>24 hours)hemodynamic support with *** included all-cause mortality,hemostasis,bleeding,limb ischemia,and site *** This is a retrospective cohort study of 19 patients with a mean age of 56.8 *** of them were males with a mean body mass index of *** most common extracorporeal membrane oxygenation indication was acute coronary syndrome complicated by cardiogenic shock at 36.8%.The mean length of intensive care unit stay for these patients was 18.8±8.42 *** out of 19 patients survived to *** MANTA device was successfully deployed in 19 patients,with 10 procedures conducted at the bedside and 9 in an operating room *** hemostasis was achieved within 5 minutes of MANTA deployment in 17 out of 19 *** 2 patients manual compression after Manta deployment was required to achieve adequate ***,acute lower extremity ischemia was noted in two patients,necessitating endovascular *** infections were reported at the site of MANTA *** Overall,based on our experience and that of other centers,the MANTA VCD

关键词： Extracorporeal membrane oxygenation MANTA Decannulation Hemostasis Ischemia

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住院患者认知障碍识别和信息管理的整合性综述

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International Journal of Nursing Sciences 2024年第1期11卷 120-132页

作者：熊蓓蓓 Daniel X.Bailey Paul Prudon Elaine M.Pascoe Leonard C.gray Frederick Graham Amanda Henderson Melinda Martin-Khan Centre for Health Services Research Faculty of MedicineThe University of QueenslandBrisbaneAustralia Centre for Clinical Research Faculty of MedicineThe University of QueenslandRoyal Brisbane&Women’s HospitalBrisbaneAustralia Dementia and Delirium Division of MedicinePrincess Alexandra HospitalBrisbaneAustralia School of Nursing Faculty of HealthQueensland University of TechnologyBrisbaneAustralia Nursing Practice Development Unit Princess Alexandra HospitalBrisbaneAustralia School of Nursing Midwifery and Social SciencesCentral Queensland UniversityBrisbaneAustralia Griffith Health Griffith UniversityBrisbaneAustralia School of Nursing Midwifery and ParamedicineThe University of the Sunshine CoastBrisbaneAustralia Department of Health and Life Sciences University of ExeterExeterUnited Kingdom School of Nursing University of Northern British ColumbiaPrince GeorgeCanada

目的旨在对目前提供急性照护的医院识别认知障碍患者以及在病历中记录和管理认知相关信息的实际情况及政策要求和推荐方法进行综述。方法采用Whittemore和Knaf1的五步法,系统检索Medline,CINAHL和Scopus数据库,并检索了灰色文献来源。... 详细信息

目的旨在对目前提供急性照护的医院识别认知障碍患者以及在病历中记录和管理认知相关信息的实际情况及政策要求和推荐方法进行综述。方法采用Whittemore和Knaf1的五步法,系统检索Medline,CINAHL和Scopus数据库,并检索了灰色文献来源。纳人了提供急性照护的医院已实施的患者认知障碍识别和认知信息管理相关的文献。采用混合方法评价工具和灰色文献质量评估清单对文章质量进行评价。采用主题分析法呈现和整合结果。该综述已在PROSPERO预注册(CRD42022343577)。结果共22篇原始研究文献和10篇政府/行业文件被纳人分析。结果显示,实践和政策之间存在差距。尽管在政策层面上高度重视认知障碍的识别、认知相关信息的透明度,以及与患者、家属和照顾者(如适用)之间的互动,但有时在临床实践中,认知评估是非正式的,患者的认知相关信息未作记录,与患者、家属和照顾者的互动也存在不足。结论.通过整合认知评估,利用信息技术开发信息管理综合系统,建立相关法律法规,提供教育与和培训,并采用国家层面的策略,有可能显著改善对认知障碍患者的识别和护理。

关键词：急性照护认知功能障碍数据透明度谵妄痴呆健康信息管理与患者互动.

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罗布乐思或沦为儿童性侵犯罪温床

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商业周刊（中文版） 2024年第15期 58-67页

作者： Olivia Carville Cecilia D'Anastasio Elliot gray(图) 王湛(译) 不详

DoctorRofatnik(意为“罗法特尼克博士”)被粉丝们称为“Doc”,他戴着高高的白色帽子,系着红领带,别着美国国旗徽章,看起来好像是一位市长。当他在价值数十亿美元的儿童游戏平台罗布乐思(Roblox)上漫游时,脸上总是带着一丝笑意。他的名... 详细信息

DoctorRofatnik(意为“罗法特尼克博士”)被粉丝们称为“Doc”,他戴着高高的白色帽子,系着红领带,别着美国国旗徽章,看起来好像是一位市长。当他在价值数十亿美元的儿童游戏平台罗布乐思(Roblox)上漫游时,脸上总是带着一丝笑意。他的名字取自于世嘉公司(Sega)游戏《刺猬索尼克》(Sonic the Hedgehog)里的反派,但在新冠疫情暴发的第一个夏天,对成千上万的玩家来说,他是个英雄。

关键词：乐思美国国旗游戏平台

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Disability management and rehabilitation for persons with multiple sclerosis

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Neural Regeneration Research 2010年第4期5卷 301-309页

作者： Fary Khan Orla gray Department of Medicine University of MelbourneParkville Department of Rehabilitation Medicine Royal Melbourne HospitalParkville

Multiple sclerosis is the commonest cause of chronic neurological disability in young adults. Patients typically have a normal life span, though with accrued time multiple disabilities with a significant impact on quality of life. This article presents the current literature on symptomatic treatment and rehabilitation for persons with multiple sclerosis. A comprehensive multidisciplinary approach addresses the acute, intermediate and long-term medical, psychological and social issues faced by these individuals. Prevention of medical complications, maintenance and restoration of functional independence, addressing psychosocial factors and issues relating to quality of life are integral to the rehabilitation processes.

关键词： multiple sclerosis disability management rehabilitation multidisciplinary effectiveness literature review neurodegenerative disease neural regeneration

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The effect of gas phase polydimethylsiloxane surface treatment of metallic aluminum particles： Surface characterization and flow behavior

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Particuology 2017年第1期15卷 92-101页

作者： Bellamarie Ludwia Jennifer L. gray Applied Research Laboratory The Pennsylvania State University North Atherton Street State College PA 16801 USA Materials Research Institute The Pennsylvania State University USA

Aluminum particles were exposed to gaseous polydimethylsiloxane （PDMS） to produce a hydropho- bic surface coating for enhanced flow and fluidity. Surface retention of the intact PDMS was confirmed through infrared and X-ray photoelectron spectroscopy. Transmission electron microscopy was used to image cross-sections of the treated particles and energy dispersive spectroscopy element maps demon- strated the presence of a surface layer consisting of silicon and oxygen. Density measurements provided evidence for improvements in the Hausner ratio and Carr index of the PDMS-treated aluminum, indicating a reduction in inter-particulate cohesion through increased bulk density. Stability, compressibility, shear, aeration, and permeability of the particles were assessed by powder rheometer. The compressibility was reduced by approximately 32% following surface treatment, revealing a reduction in void space, while Mohr＇s circle analysis and shear testing determined that the extrapolated cohesion value was reduced by approximately 53% and the flow factor at 6 kPa was doubled. Aeration testing showed that the air velocity required to obtain a fluidized bed was on the order of 0.35 mm/s for the treated powder, whereas the raw powder could not be uniformly fluidized. PDMS may be a viable option for the large-scale treatment of aluminum powder for flow applications.

关键词： Aluminum powder Polydimethylsiloxane X-ray photoelectron spectroscopy Diffuse reflectance infrared Fourier transform spectroscopy Flowability FT4 powder rheometer

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The Triple Combination of Meropenem,Avibactam,and a Metallo-β-Lactamase Inhibitor Optimizes Antibacterial Coverage Against Different β-Lactamase Producers

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Engineering 2024年第7期38卷 124-132页

作者： Zhuoren Ling Alistair James Macdonald Farley Aditya Lankapalli Yanfang Zhang Shonnette Premchand-Branker Kate Cook Andrei Baran Charlotte gray-Hammerton Claudia Orbegozo Rubio Edgars Suna Jordan Mathias Jürgen Brem Kirsty Sands Maria Nieto-Rosado Maria Mykolaivna Trush Nadira Naznin Rakhi Willames Martins Yuqing Zhou Christopher Joseph Schofield Timothy Walsh Department of Biology&Ineos Oxford Institute for Antimicrobial Research University of OxfordOxford OX13REUK Chemistry Research Laboratory Department of Chemistry and the Ineos Oxford Institute for Antimicrobial ResearchUniversity of OxfordOxford OX13TAUK Latvian Institute of Organic Synthesis Riga LV-1006Latvia Department of Medical Microbiology Division of Infection and ImmunitySchool of MedicineCardiff UniversityCardiff CF144XNUK Enzymology and Applied Biocatalysis Research Center Faculty of Chemistry and Chemical EngineeringBabes-Bolyai UniversityCluj-Napoca 400028Romania

This work explores the potential of a triple combination of meropenem(MEM),a novel metallo-blactamase(MBL)inhibitor(indole-2-carboxylate 58(InC58)),and a serine-b-lactamase(SBL)inhibitor(avibactam(AVI))for broad-spectrum activity against carbapenemase-producing bacteria.A diverse panel comprising MBL-and SBL-producing strains was used for susceptibility testing of the triple combination using the agar dilution *** frequency of resistance(FoR)to MEM combined with InC58 was *** were sequenced and tested for cross resistance,fitness,and the stability of the resistance *** with the double combinations of MEM plus an SBL or MBL inhibitor,the triple combination extended the spectrum of activity to most of the isolates bearing SBLs(oxacillinase-48(OXA-48)and Klebsiella pneumoniae carbapenemase-2(KPC-2))and MBLs(New Delhi metallo-blactamases(NDMs)),although it was not effective against Verona integron-encoded metallo-blactamase(VIM)-carrying Pseudomonas aeruginosa(***)and OXA-23-carrying Acinetobacter baumannii(***).The FoR to MEM plus InC58 ranged from 2.22×10^(-7)to 1.13×10^(-6).The resistance correlated with mutations to ompC and comR,affecting porin C and copper permeability,*** mutants manifested a fitness cost,a decreased level of resistance during passage without antibiotic pressure,and cross resistance to another carbapenem(imipenem)and a b-lactamase inhibitor(taniborbactam).In conclusion,compared with the dual combinations,the triple combination of MEM with InC58 and AVI showed a much wider spectrum of activity against different carbapenemaseproducing bacteria,revealing a new strategy to combat b-lactamase-mediated antimicrobial resistance.

关键词： Carbapenemase Metallo/serine-b-lactamase inhibitor Avibactam Meropenem Antimicrobial resistance

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