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Chronic non-communicable disease

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Family Medicine and Community Health 2018年第1期6卷 1-2页

作者： Leon Piterman Hui Yang Department of general practice Monash UniversityMelbourneVictoriaAustralia China GP Programs Monash Institute of Health and Clinical EducationMelbourneVictoriaAustralia Shenzhen International Primary Health Care Research Institute ShenzhenGuangdongChina

Non-communicable disease(NCD),including chronic and at times complex disease has overtaken communicable or infectious disease as the number one cause of illness,disability and death *** this has been the case for decades in developed countries,NCD is also emerging as the major health problem in developing *** are a number of reasons for this change in disease *** include better control of infectious disease through sanitation,vaccination and judicious use of antibiotics(notwithstanding the emergence of antibiotic resistance).

关键词： death Chronic globally

AUTOMATIC AUGMENTED GALERKIN ALGORITHMS FOR FREDHOLM INTEGRAL EQUATIONS OF THE FIRST KIND

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Acta Mathematica Scientia 1997年第1期17卷 69-84页

作者： S.Abbasbandy E.Babolian Institute of Mathematics Teacher Training University Tehran 15614 IRAN

In recent papers, Babolian & Delves [2] and Belward[3] described a Chebyshev series method for the solution of first kind integral equations. The expansion coefficients of the solution are determined as the solution of a mathematical programming *** method involves two regularization parameters, Cf and r, but values assigned to these parameters are heuristic in nature. Essah & Delves[7] described an algorithm for setting these parameters automatically, but it has some difficulties. In this paper we describe three iterative algorithms for computing these parameters for singular and non-singular first kind integral equations. We give also error estimates which are cheap to compute. Finally, we give a number of numerical examples showing that these algorithms work well in practice.

关键词： Fredholm integral equations Galerkin method Regularization parameters Error estimation Ill-Posed problems Product of chebyshev series

Development of general practice education and training in China

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Chinese Medical Journal 2014年第17期127卷 3181-3184页

作者： Ren Wen Liu Ying Qiu Yan Ren Jingjing Department of general practice First Affiliated Hospital College of Medicine Zhejiang University Hangzhou Zhejiang 310003 China

general practice as a discipline has largely evolved over the past 30 years in the field of primary health care. It originated in the 18th century m Europe. It was established in the United States in the 1960s and introduced to China in the late 1980s. In earlier times, medicine was not specialized, and general physicians dominated the medical field. At the end of the 19th century, with the development of basic medical disciplines, such as biology and anatomy, the development of more specialized medical practices began.

关键词： general medicine general practice training mode education

Undergraduate paramedic students cannot do drug calculations

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World Journal of Emergency Medicine 2012年第3期3卷 221-226页

作者： Kathryn Eastwood Malcolm J Boyle Brett Williams Department of Community Emergency Health and Paramedic practice Monash UniversityFrankston 3199VictoriaAustralia

Previous investigation of drug calculation skills of qualified paramedics has highlighted poor mathematical ability with no published studies having been undertaken on undergraduate paramedics. There are three major error classifications. Conceptual errors involve an inability to formulate an equation from information given, arithmetical errors involve an inability to operate a given equation, and finally computation errors are simple errors of addition, subtraction, division and multiplication. The objective of this study was to determine if undergraduate paramedics at a large Australia university could accurately perform common drug calculations and basic mathematical equations normally required in the workplace. A cross-sectional study methodology using a paper-based questionnaire was administered to undergraduate paramedic students to collect demographical data, student attitudes regarding their drug calculation performance, and answers to a series of basic mathematical and drug calculation questions. Ethics approval was granted. The mean score of correct answers was 39.5% with one student scoring 100%, 3.3% of students （n=3） scoring greater than 90%, and 63% （n=58） scoring 50% or less, despite 62% （n=57） of the students stating they ＇did not have any drug calculations issues＇. On average those who completed a minimum of year 12 Specialist Maths achieved scores over 50%. Conceptual errors made up 48.5%, arithmetical 31.1 % and computational 17.4%. This study suggests undergraduate paramedics have deficiencies in performing accurate calculations, with conceptual errors indicating a fundamental lack of mathematical understanding. The results suggest an unacceptable level of mathematical competence to practice safely in the unpredictable prehospital environment.

关键词： Emergency medical technician Education Medication errors Safety management

The Association between Vitamin D and Hashimoto Thyroiditis:An Upto-date Systematic Review and Meta-analysis

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Food Materials Research 2022年第1期2卷 82-91页

作者： Zhengrong Liu Linfei Feng Yanfang He Sijie Yuan Chao Xu The Out Patient Department Nanfang HospitalSouthern Medical UniversityGuangzhou 510515China Psychology Department Nanfang HospitalSouthern Medical UniversityGuangzhou 510515China The Department of general practice Nanfang HospitalSouthern Medical UniversityGuangzhou 510515China Office of The Standardized Residents training in Hospitals Graduate SchoolSouthern Medical UniversityGuangzhou 510515China

The objective of the surrent study was to summarize the up-to-date studies to investigate the relationship between vitamin D and Hashimoto thyroiditis(HT).An online search of English and Chinese databases was *** studies concerned the investigation of the relationship between vitamin D and HT including meta-analysis,meanwhile the heterogeneities were revealed by subgroup *** six elated studies containing 15,336 participants(HT:6,138 versus control:9,198)were *** patients had lower levels of 25(OH)D_(3)(standardised mean difference,−1.09;95%CI:[−1.42,−0.75];P<0.01),and were more likely to be deficient in 25(OH)D_(3)(OR,2.77;95%CI,[1.88,3.91];P<0.05).Obvious heterogeneities in the results of meta-analysis were down to the difference of detection methods and criteria of vitamin D insufficiency among *** D deficiency was colncluded to have a significant relation with HT.

关键词： 25(OH)D_(3) vitamin insufficiency

Perioperative fluid management in major hepatic resection: an integrative review

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Hepatobiliary & Pancreatic Diseases International 2017年第5期16卷 458-469页

作者： Osamu Yoshino Marcos Vinicius Perini Christopher Christophi Laurence Weinberg Department of Surgery Austin Hospital and University of Melbourne Melbourne Victoria Australia Anaesthesia Perioperative Pain Medicine Unit University of Melbourne Melbourne Victoria Australia

BACKGROUND: Fluid intervention and vasoactive pharmacological support during hepatic resection depend on the preference of the attending clinician, institutional resources, and practice culture. Evidence-based recommendations to guide perioperative fluid management are currently limited. Therefore, we provide a contemporary clinical integrative overview of the fundamental principles underpinning fluid intervention and hemodynamic optimization for adult patients undergoing major hepatic resection. DATA SOURCES: A literature review was performed of MEDLINE, EMBASE and the Cochrane Central Registry of Controlled Trials using the terms 'surgery', 'anesthesia', 'starch', 'hydroxyethyl starch derivatives', 'albumin', 'gelatin', 'liver resection', 'hepatic resection', 'fluids', 'fluid therapy', 'crystalloid', 'colloid', 'saline', 'plasma-Lyte', 'plasmalyte', 'hartmann's', 'acetate', and 'lactate'. Search results for MEDLINE and EMBASE were additionally limited to studies on human populations that included adult age groups and publications in English. RESULTS: A total of 113 articles were included after appropriate inclusion criteria screening. Perioperative fluid management as it relates to various anesthetic and surgical techniques is ***: Clinicians should have a fundamental understanding of the surgical phases of the resection, hemodynamic goals, and anesthesia challenges in attempts to individualize therapy to the patient's underlying pathophysiological condition. Therefore, an ideal approach for perioperative fluid therapy is always individualized. Planning and designing large-scale clinical trials are imperative to define the optimal type and amount of fluid for patients undergoing major hepatic resection. Further clinical trials evaluating different intraoperative goal-directed strategies are also eagerly awaited.

关键词： hepatic resection liver resection fluid therapy anesthesia crystalloid colloid goal-directed therapy

general practice trainee,supervisor and educator perspectives on the transitions in postgraduate training:a scoping review

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Family Medicine and Community Health 2024年第4期12卷 17-28页

作者： Michael Tran Joel Rhee Wendy Hu Parker Magin Boaz Shulruf Discipline of general practice School of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia School of Medicine Western Sydney UniversitySydneyNew South WalesAustralia Discipline of general practice School of Medicine and Public HealthThe University of NewcastleNewcastleNew South WalesAustralia Office of Medical Education University of New South WalesSydneyNew South WalesAustralia

Transitions are a period and a process,through which there is a longitudinal adaptation in response to changing circumstances in clinical practice and *** the experience of the transition in medical student learning and in hospital-based specialty training programmes are well described and researched,the experience of the transition in community-based postgraduate general practitioner(GP)training has not been described *** We aimed to identify,and categorise,the formative experiences of transitions in GP training and their impacts on personal and professional *** We adopted Levac et al’s scoping review *** 1543 retrieved records,76 were selected for data *** on a combined model of the socioecological and multiple and multi-dimensional theories of transitions,data relating to the experiences of transitions were organised into contextual themes:being physical,psychosocial,organisational culture and *** criteria Empirical studies focused on general practice trainees or training,that discussed the transitions experienced in general practice training and that were published in English were *** sources PubMed,MEDLINE and Web of Science databases were searched in January 2024 with no date limits for empirical studies on the transition experiences of GP into,and through,*** Our findings describe context-dependent formative experiences which advance,or impede,learning and *** is a significant modulator of the factors contributing to more negative experiences,with some initially adverse experiences becoming more *** of the inflection point that represents a shift from initially adverse to more positive experiences of transitions may help moderate expectations for learning and performance at different stages of *** Challenges in training can either advance development and contribute positively to pr

关键词： finding initially programme

Factors associated with potentially inappropriate prescriptions and barriers to medicines optimisation among older adults in primary care settings:a systematic review

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Family Medicine and Community Health 2021年第4期9卷 87-101,I0028-I0078页

作者： Zhijie Xu Xujian Liang Yue Zhu Yiting Lu Yuanqu Ye Lizheng Fang Yi Qian Department of general practice The Second Affiliated HospitalZhejiang University School of MedicineHangzhouZhejiangChina Department of general practice Zhejiang University School of Medicine Sir Run Run Shaw HospitalHangzhouZhejiangChina Zhongdai Community Healthcare Center HuzhouChina Baili Community Healthcare Center The People's Hospital of LonghuaShenzhenChina School of Public Health Hangzhou Normal UniversityHangzhouZhejiangChina

Objective To identify factors that likely contribute to potentially inappropriate prescriptions(PIPs)among older adults in primary care settings,as well as barriers to medicines optimisation and recommended potential *** Systematic *** criteria Quantitative studies that analysed the factors associated with PIPs among older adults(≥65 years)in primary care settings,and qualitative studies that explored perceived barriers and potential solutions to medicines optimisation for this *** sources PubMed,EMBASE,Scopus,CINAHL,PsycINFO,Web of Science,CNKI and *** Of the 13167 studies identified,50 were included(14 qualitative,34 cross-sectional and 2 cohort).Nearly all quantitative studies examined patient-related non-clinical factors(eg,age)and clinical factors(eg,number of medications)and nine studies examined prescriber-related factors(eg,physician age).A greater number of medications were identified as positively associated with PIPs in 25 quantitative studies,and a higher number of comorbidities,physical comorbidities and psychiatric comorbidities were identified as patient-related clinical risk factors for ***,other factors showed inconsistent associations with the *** to medicines optimisation emerged within four analytical themes:prescriber related(eg,inadequate knowledge,concerns of adverse consequences,clinical inertia,lack of communication),patient related(eg,limited understanding,patient non-adherence,drug dependency),environment related(eg,lack of integrated care,insufficient investment,time constraints)and technology related(eg,complexity of implementation and inapplicable guidance).Recommended potential solutions were based on each theme of the barriers identified accordingly(eg,prescriber-related factors:incorporating training courses into continuing medical education).Conclusions Older adults with more drugs prescribed and comorbidities may have a greater risk of receiving PIPs in t

关键词： prescription qualitative medicines

From laboratory to the field: consistent effects of experience on host location by the fruit fly parasitoid Diachasmimorpha kraussii (Hymenoptera: Braconidae)

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Insect Science 2019年第5期26卷 863-872页

作者： Ayad Masry John P.Cunningham Anthony R.Clarke School of Earth Environmental and Biological SciencesQueensland University of Technology (QUT)BrisbaneQueenslandAustralia Agriculture victoria Research AgilBioCentre for AgriBioscienceBundooraVictoriaAustralia

Associative learning is well documented in Hymenopteran parasitoids, where it is thought to be an adaptive mechanism for increasing successful host location in complex environments. Based on this learning capacity, it has been suggested that providing prerelease training to parasitoids reared for inundative release may lead to a subsequent increase in their efficacy as biological control agents. Using the fruit fly parasitoid Diachasmimorpha krausii we tested this hypothesis in a series of associative learning experiments which involved the parasitoid, two host fruits (tomatoes and nectarine), and one host fly (Bactrocera ttyoni). In sequential Y-tube olfactometer studies, large field-cage studies, and then open field studies, naive wasps showed a consistent preference for nectarines over tomatoes. The preference for nectarines was retained, but not significantly increased, for wasps which had prior training exposure to nectarines. However, and again consistently at all three spatial scales, prior experience on tomatoes led to significantly increased attraction to this fruit by tomato-trained wasps, including those liberated freely in the environment. These results, showing consistency of learning at multiple spatial scales, gives confidence to the many laboratory-based learning studies which are extrapolated to the field without testing. The experiment also provides direct experimental support for the proposed practice of enhancing the quality of inundatively released parasitoids through associative learning.

关键词： biological control inundative release learning mass rearing Opiinae Tephritidae