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医疗卫生体系改革、针对医生的暴力伤害以及医务人员的工作满意度：中国东部地区浙江省的一项横断面调查

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英国医学杂志中文版 2015年第10期18卷 574-581页

作者： Dan Wu Yun Wang Kwok Fai Lam therese Hesketh 陈钟鸣肖月香港大学医学院家庭卫生和初级卫生保健学系香港大学社会科学学院自杀研究与预防中心香港大学社会科学学院统计与保险科学系伦敦大学学院全球卫生学会潍坊医学院管理学院国家卫生计生委卫生发展研究中心卫生政策与技术评估研究中心

目的研究新医疗卫生体系改革和医患关系恶化背景下医生工作满意度及士气的影响因素。设计运用自行设计的调查问卷进行横断面调查。地点调查开展于2012年3-5月，主要调查对象是中国浙江省的省级和县级医院以及基层医疗卫生机构。结果共调... 详细信息

目的研究新医疗卫生体系改革和医患关系恶化背景下医生工作满意度及士气的影响因素。设计运用自行设计的调查问卷进行横断面调查。地点调查开展于2012年3-5月，主要调查对象是中国浙江省的省级和县级医院以及基层医疗卫生机构。结果共调查202名医生。导致工作满意度低的主要原因是收入低、工作时间长。省级医院医生的满意度最低，基层医疗卫生机构医生的满意度最高。3％的医院医生以及27％的基层医疗卫生机构医生对工资满意。医院中仅有7％的医生对工作时间满意，基层医疗卫生机构中43％的医生对工作时间满意。医院只有不到10％的医生对带薪休假时间（3％）和带薪病假时间满意（5％），而基层医疗卫生机构人员对这两项的满意度则分别为38％和41％。总体而言，87％的医生表示患者投诉的可能性比以前更高了，针对医生的暴力事件不断增加。仅有4．5％的医生愿意自己的子女成为医生，在125个提供原因的医生中，34％表示因为收入太低，17％表示因为职业风险太高，9％考虑到患者暴力威胁和人身安全问题。结论总体而言医生的工作满意度较低。医生的招聘与保持成为中国医疗卫生系统的重大挑战。应采取相应的应对策略，以保障将来医生的招聘与保持。具体措施包括：减少医生的工作量，尤其是省级医院医生的工作量，可以通过鼓励患者到基层医疗卫生机构就诊来实现。提高医生工资以及有效的处理患者对医生的暴力伤害。

关键词：工作满意度体制改革医疗卫生暴力行为医疗行业横截面医生浙江

A Cross-Sectional Study of the Causes, Effects and Management Strategies for Stress and Burnout among Nurses in the Fako Division, Cameroon

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Journal of Biosciences and Medicines 2020年第7期8卷 17-27页

作者： Acha Anwi therese Ateh Stanislas Ketum Mohamed Isah Thiery Pechap Ayafor Agbornkwai Nyenty Agbor Acha therese Fomundam Anwi Malika Esembeson Nahyeni Bassah Esoh Department of Nursing Faculty of Health Sciences University of Buea Buea Cameroon Department of International Public Health Liverpool School of Tropical Medicine Liverpool UK Reach Out Buea Cameroon Department of Public Health and Hygiene Faculty of Health Sciences University of Buea Buea Cameroon Health Organisation Welfare Yaounde Central Region Cameroon Department of Epidemiology School of Public Health University of Alabama Birmingham USA Family Health International 360 Yaounde Cameroon Douala Gynoeco-Obstetrics and Pediatric Hospital Littoral Cameroon

Introduction: Stress and burnout are a reality which nurses encounter and try to cope with especially in the Emergency Department (ED) so that they can provide optimal patient care. Nurses who work in ED are front line providers of immediate medical care needed to stabilize patients. With the known critical shortage of health workforce in Cameroon, nurses are overloaded with work and often experience stress and burnout. Aim: This study aimed at determining the causes, effects and management strategies of stress and burnout among nurses working in the ED in hospitals in the Fako Division, Cameroon. Methods: This study was a descriptive cross-sectional study. The sample consisted of seventy nurses from five different hospitals. A purposive sampling technique was used and data was analyzed using SPSS version 16.0. Data was collected using a structured questionnaire developed from the International Stress Management Scale. Results: The highest reported cause of stress in this study was heavy workload (12.88%) and the least was no experience in handling the challenges of the department. The leading reported effect of stress was the development of musculoskeletal disorders such as joint and back pain (16.48%) and the least effect was contemplating quitting the profession (5.99%). The major management strategy used was humour (8.27%), while the least was crying out stress to feel relieved (2.18%). Conclusion: The major cause of stress and burnout among nurses in our study setting was heavy workload, which mostly results in joint and back pain. Moreover, humour was the prime management strategy for stress and burnout among nurses in the emergency department in the study setting. Thus more nurses should be employed and the working conditions of nurses improved to reduce the workload in the study hospitals.

关键词： Stress Burnout Nurses Causes Effect and Management Cameroon

Numerical Groundwater Flow Modeling of the Coastal Plain Sand Aquifer, Akwa Ibom State, SE Nigeria

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Journal of Water Resource and Protection 2014年第4期6卷 193-201页

作者： Aniekan Edet Ramadan Abdelaziz Broder Merkel Chiedu Okereke therese Nganje 1Department of Geology University of Calabar Calabar Nigeria 2Departement for Geology TU Bergakademie Freiberg Freiberg Germany Departement for Geology TU Bergakademie Freiberg Freiberg Germany Department of Geology University of Calabar Calabar Nigeria

Akwa Ibom State is located in the Niger delta region of Nigeria. The coastal plain sand aquifer, which underlies the area, is the major source of potable water for domestic, agricultural, and industrial use. The increase in demand for water has led to an increased exploitation of the aquifer in the last few years. Hence it is essential to quantify the amount of exploitable water in the aquifer. To achieve this goal, a regional numerical groundwater flow model using MODFLOW was calibrated under steady-state conditions to determine the aquifer’s hydraulic conductivity (K) and the recharge characteristics of the area. The hydraulic conductivity and recharge values from the pilot points calibration ranged from 1 to 75 m/d and 5.89 × 10-6 m3/d to1.23 × 10-4 m3/d. The calculations of the model showed that the average recharge rate amounts 0.40l/s/km2 or 12.60 mm/year. The estimated recharge suggests a high groundwater potential for the area. This is the first time that such a study has been carried out in the area, and it will serve as an important basis for future groundwater management and simulation of transient groundwater flow modeling in Akwa Ibom State.

关键词： Akwa Ibom Coastal Aquifer Modeling MODFLOW

Integrating big data and blockchain to manage energy smart grids—TOTEM framework

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Blockchain(Research and Applications) 2022年第3期3卷 36-45页

作者： Dhanya therese Jose Jørgen Holme Antorweep Chakravorty Chunming Rong Department of Computer Science Electrical Engineering University of Stavanger4036StavangerNorway

The demand for electricity is increasing exponentially day by day,especially with the arrival of electric *** the smart community neighborhood project,electricity should be produced at the household or community level and sold or bought according to the *** the actors can produce,sell,and buy according to the demands,thus the name *** solutions can contribute to this in several ways,such as machine learning for analyzing the household data for customer demand and peak hours for the usage of electricity,blockchain as a trustworthy platform for selling or buying,data hub,and ensuring data security and privacy of ***:Token for controlled computation is a framework that allows users to analyze the data without moving the data from the data owner's *** also ensures the data security and privacy of the ***,in this article,we will show the importance of the TOTEM architecture in the EnergiX project and how the extended version of TOTEM can be efficiently merged with the demands of the current and similar projects.

关键词： Blockchain Big data analytic Hyperledger fabric Hadoop Map Reduce Docker PIVT

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儿童龋病学中英文对照 1

Beliefs and Experiences of Fear of Hypoglycemia and Use of Uncooked Cornstarch before Bedtime in Persons with Type 1-Diabetes

丛书名：口腔临床要点快速掌握系列

2006年

作者： Chris Deery Marie therese Hosey Paula Waterhouse 秦满译

本书介绍了许多最新的儿童龋病治疗原则、修复方法及技术设备。具体包括：龋齿的诊断、治疗设计合止痛、预防龋齿的系列方法及其应用、操作简单的预成冠、乳牙牙髓治疗等。

ISBN: (纸本)7509101336

关键词：医药、卫生口腔科学儿童口腔疾病

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Open Journal of Nursing 2018年第11期8卷 795-810页

作者： therese Anderbro Erik Moberg Ulf Adamson Per-Eric Lins Unn-Britt Johansson Stockholm University Department of Psychology Stockholm Sweden Karolinska Institutet Department of Clinical Sciences Danderyd Hospital Stockholm Sweden Karolinska Institutet Department of Medicine Karolinska University Hospital Huddinge Stockholm Sweden Sophiahemmet University Stockholm Sweden Karolinska Institutet Department of Clinical Sciences and Education S&#246 dersjukhuset Stockholm Sweden

Introduction: Among persons living with type 1-diabetes hypoglycemia and fear of hypoglycemia remain limiting barriers for achieving optimal glucose control and a good quality of life. Fear of hypoglycemia has been found stable over time if not treated. Uncooked cornstarch has been found to reduce the risk of hypoglycemia but has not been studied in relation to fear of hypoglycemia. The aims of this study were to through clinical data, self-reported measures and clinical interviews explore subjects’ experience of using uncooked cornstarch before bedtime and their beliefs and experiences of fear of hypoglycemia. Methods: Mixed methods with both quantitative and qualitative data were used. Self-reported measures of hypoglycemia and fear of hypoglycemia were compared to subjects’ responses during a clinical interview. The interviews were analyzed with a functional behavior analytical approach. Results: A total of five subjects took part in the study. One subject perceived the uncooked cornstarch helpful in reducing hypoglycemia. Several subjects could recall frightening hypoglycemic episodes triggering their fear. Three out of the five subjects reported avoidance behaviors such as excessive self-monitoring of blood glucose or overeating related to fear of hypoglycemia. Conclusions: The uncooked cornstarch was found appetizing but was not perceived as having an effect on BG or hypoglycemia frequency. The clinical interviews confirmed previous research regarding experience of hypoglycemia and fear of hypoglycemia.

关键词： Adults Fear of Hypoglycemia Experiences Type 1 Diabetes Uncooked Cornstarch

Fitness and health benefits of team handball training for young untrained women--A cross-disciplinary RCT on physiological adaptations and motivational aspects

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Journal of Sport and Health Science 2018年第2期7卷 139-148页

作者： therese Hornstrup Johan M.Wikman Bjorn Fristrup Susana Povoas Eva W.Helge Signe H.Nielsen Jorn W.Helge Jesper L.Andersen Lars Nybo Peter Krustrup Department of Nutrition Exercise and Sports University of Copenhagen Copenhagen N 2200 Denmark Research Center in Sports Sciences Health Sciences and Human Development CIDESD University Institute of Maia ISMAI Maia 4475-690 Portugal Center of Healthy Aging Department of Biomedical Sciences University of Copenhagen Copenhagen N 2200 Denmark Institute of Sports Medicine Copenhagen Bispebjerg Hospital Copenhagen NV 2400 Denmark Department of Sports Science and Clinical Biomechanics SDU Sport and Health Sciences Cluster (SHSC) University of Southern Denmark Odense 3450 Denmark Sport and Health Sciences University of Exeter Exeter EX1 2LU UK

Purpose: The present study evaluated the effects of regular participation in small-sided team handball training on body composition, osteogenic response, physical performance, and cardiovascular risk factors, as well as well-being and motivation, in young untrained ***: Twenty-eight untrained 20- to 30-year-old women were randomized to a handball training group(HG; n = 14, height 170 ± 5 cm, weight 73 ± 11 kg, VO_(2peak) 37.7 ± 4.1 mL/min/kg) that trained 1.7 ± 0.3 times per week over 12 weeks(70 min 4 v 4 handball sessions) or an inactive control group(CG; n = 14, 169 ± 5 cm, 71 ± 12 kg, 38.1 ± 3.7 mL/min/kg). Physiological and psychological and motivational training adaptations were assessed pre-and post-intervention by dual-energy X-ray Absorptiometry(DXA) scans, blood sampling, physical tests, and ***: The average heart rate(HR) over all training sessions was equal to 85% ± 6% HR_(max). Between-group intervention effects were observed in favor of HG for muscle mass(2.1%, p = 0.024), proximal femur bone mineral density(0.8%, p = 0.041), Yo-Yo IE1 intermittent endurance test level 1(IE1) performance(35%, p < 0.001), and incremental treadmill test performance(11.5%, p = 0.003), but not total fat mass(p = 0.176),mean arterial blood pressure(p = 0.328), resting HR(p = 0.219), or blood lipids(p = 0.298—0.854). In CG, no changes were observed in any of the measured physiological variables after the training period. Compared to CG, HG had an increase in intrinsic motivation(p < 0.001) and in the well-being subscale "energy"(p = 0.010).Conclusion: Participation in regular recreational team handball training organized as small-sided games has marked beneficial effects on physical performance, musculoskeletal fitness, well-being, and motivation in untrained young women.

关键词： Bone mineral density (BMD) Intensity Intermittent Motivation Muscle mass Physical performance Recreational handball Well-being

Pharmacogenetic Treatments for Alcohol and Stimulants

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Pharmacogenetic Treatments for Alcohol and Stimulants

Purification and Characterisation of Xanthine Oxidoreductases from Local Bovids in Malta

自主创新与持续增长第十一届中国科协年会

作者： Thomas R.Kosten therese Kosten Colin Haile Menninger Department of Psychiatry and Behavioral Sciences Baylor College of Medicine

Pharmacogenetics uses genetic tests to predict the effectiveness of medication treatments for individual patients with drug dependence such as alcohol and opiates. An important shared neurobiological component of the reinforcement and dependence on alcohol and opiates is alcohol’s enhancement of β- endorphin release. The physiological and subjective effects of both alcohol and opiates are associated with β-endorphin and the mu opiate system. A pharmacotherapy that has been effective for both disorders is naltrexone, which increases baseline β-endorphin release blocking further release by alcohol. Naltrexone’s action as an alcohol pharmacotherapy is facilitated by a putative functional single nucleotide polymorphism (SNP) in the opioid mu receptor gene (Al18G) which alters its receptor function. Patients with this SNP have significantly lower relapse rates to alcoholism when treated with naltrexone. This SNP is particularly common among northern Chinese suggesting an important role for naltrexone treatment of alcoholism in China. Another important genetic polymorphism related to stimulant and perhaps other types of dependence frequently occurs (about 40% of the population) in the promoter region of the gene coding for dopamine beta hydroxylase (DβH). This polymorphism leads to 10 to 100 times lower levels of the DβH enzyme, which converts dopamine to norepinephrine in neurons. Stimulant abusers with normal levels of this enzyme show significant reductions in stimulant abuse when treated with DβH inhibitors, while those with the polymorphism for low DβH levels show no treatment efficacy with these medications. Pharmacogenetics has great potential for improving treatment outcome as we identify gene variants that affect pharmacodynamic as well as the more commonly studied pharmacokinetic factors. These mutations can guide pharmacotherapeutic agent choice for optimum treatment of alcohol and stimulant abuse and reduce relapse after successful initial abstinence.

关键词： pharmacogenetic treatments alcohol stimulants

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Advances in Enzyme Research 2014年第1期2卷 54-63页

作者： Marita Vella therese Hunter Claude Farrugia Arwen R. Pearson Gary Hunter Astbury Centre for Structural Molecular Biology University of Leeds Leeds UK Department of Chemistry University of Malta Msida Malta Department of Physiology and Biochemistry University of Malta Msida Malta

Xanthine oxidoreductase (XOR) is a molybdoflavoprotein mainly involved in purine catabolism. It exists in two forms, the oxidase (XO) and dehydrogenase (XDH) which are inter-convertible within mammalian cells. Although various researchers have reported the extraction of mammalian XOR, no extractions have yet been carried out in Malta and subsequently no characterizations are available. In this study, XOR was successfully purified from bovine, caprine and ovine milk through a multistep purification process involving both chemical and chromatographic techniques. The molecular weights of the native enzyme were found to be 295 kDa, 281 kDa and 275 kDa, representing the bovine, caprine and ovine XOR respectively. Western blot showed XOR to be represented on SDS-PAGE by a minimum of three major bands having molecular weights of 151 kDa, 131 kDa and 85 kDa. While all samples showed activity on native PAGE, spectrophotometric assays revealed the bovine XOR to be the most active. Surprisingly, the addition of NAD+ to the assay mixture inhibited enzyme activity of the bovine and caprine XOR whereas the ovine XOR doubled its activity in response to NAD+. The latter also showed a lower binding affinity to heparin. Following incubation with trypsin, XOR was irreversibly converted to its oxidase form in all samples as reflected by the observed increase in XO activity.

关键词： Xanthine Xanthine Dehydrogenase Xanthine Oxidase Milk Bovid Malta