Introduction: Internet has become an increasingly popular source of reference for patients to learn about their medical problems. It is easily accessible, and a large number of uncensored information is available onli...Introduction: Internet has become an increasingly popular source of reference for patients to learn about their medical problems. It is easily accessible, and a large number of uncensored information is available online written from various sources and perspectives. However, the role of internet and its impact on patient’s care and understanding of the disease remains unclear. The purpose of this study is to evaluate the role and effect of internet use for patients seeking consultation for hip and knee arthritis. More specifically, the relationship between patient’s education level, internet use, motives for doing background readings, perception of internet information, and reactions to the available information will be studied. Method: Patients seeking orthopaedic consultation for knee or hip arthritis at the Toronto Western Hospital were identified and invited to fill out a questionnaire on their first visit. The questionnaire was designed to assess the patients’ pre-consultation reading habits, their use of internet, and their reaction to what they have read on the internet. The questionnaire also included questions about the respondent’s background.Results: In comparing patients holding college/university degree (CU) with patients having no college/university education (NoCU), the CU group were associated with increased internet use (CU vs. NoCU: 71.0% vs. 48.3%;p 0.01) and background reading (CU vs. NoCU: 82.2% vs. 17.8%;p 0.001) prior to consultation;fewer incidence of anxiety following internet use (CU vs. NoCU: 29.9% vs. 53.6%;p 0.05);and higher rates of decisions influenced by internet use (CU vs. NoCU: 20.8% vs. 3.6%, p 0.05). Internet users demonstrated a higher confidence in gathering and understanding medical information (Internet users vs. non-internet users: 6.59 ± 2.05 vs. 5.03 ± 2.78;p 0.001) and rated the accuracy of information on internet at 7.18 ± 2.01 (max = 10). Conclusion: Internet use can influence patient’s treatment decision, anxiety level, and understanding of their disease. Caregivers must recognize the growing trend of internet use and should counsel and educate their patients appropriately based on what they have read to help them accurately appreciate the nature of their disease.展开更多
Background: In our study, researching the distribution of the consultations other than anaesthesia in compliance with the disciplines and ages of the patients and its effect on the assessment cost has been aimed. Meth...Background: In our study, researching the distribution of the consultations other than anaesthesia in compliance with the disciplines and ages of the patients and its effect on the assessment cost has been aimed. Methods: Our study has been conducted during 8 months by the retrospective assessment of the records of 3844 cases on which an elective surgical procedure was planned in the anesthesiology polyclinic of Firat University Hospital. The records of patients have been obtained through examining their files from the hospital record system. Results: The total number of patients whose consultations have been demanded was 367 (9.5%) and the number of male/female was 192/175. The number of cases about which more than one consultation has been demanded was determined as 87 (2.2%). The number of cases on which a method change for the anaesthesia was applied was 21 (5.7%), and the number of cases whose surgery was cancelled was 3 (0.81%). Requested consultation for each patient, the consultations of cardiology, chest diseases and internal medicine bring an additional cost on the total sum respectively as 37.2 TL (28.61 $), 29.8 TL (22.92 $) and 19.9 TL (15.30 $). Conclusions: We suggest that the cost analysis should be absolutely taken into consideration during the pre-anaesthetic assessment for the requirement of routine examinations.展开更多
BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has resulted in seismic changes in healthcare delivery.As a result of this,hospital footfall required to be reduced due to increased risk of transmission of in...BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has resulted in seismic changes in healthcare delivery.As a result of this,hospital footfall required to be reduced due to increased risk of transmission of infection.To ensure patients can safely access healthcare,we introduced orthopaedic clinic telephone consultations in our busy district general hospital.AIM To investigate patients’and clinicians’perspective of telephone consultations during COVID-19,and whether this method of consultation could be a viable option in the post-pandemic future.METHODS This is a single centre,prospective study conducted in a busy National Health Service district general hospital.In May 2020,100 non-consecutive adult patients were contacted by independent investigators within 48 h of their orthopaedic clinic telephone consultation to complete a telephone satisfaction questionnaire.The questions assessed satisfaction regarding various aspects of the consultation including overall satisfaction and willingness to use this approach long term.Satisfaction and perspective of 25 clinicians conducting these telephone consultations was also assessed via an online survey tool.RESULTS 93%of patients were overall satisfied with telephone consultations and 79%were willing to continue this method of consultation post-pandemic.Patients found telephone consultations to reduce personal cost and inconvenience associated with attending a hospital appointment.72%of clinicians reported overall satisfaction with this service and 80%agreed that telephone consultations should be used in the future.The majority found it less laborious in time and administration in comparison to face to face consultations.Patients and clinicians expressed their desire for video consultations as a method of further improving their experience with remote consultations.CONCLUSION Our study has shown that telephone consultations are a safe and rapid method of adaptation to the COVID-19 pandemic,achieving the aim of reducing hospital footfall.This method of consultation has resulted in immense clinician and patient satisfaction.Our findings suggest that this tool has benefits in post pandemic healthcare delivery.It has also highlighted that telephone consultations can act as a steppingstone to the introduction of the more complex platform of video consulting.展开更多
Aim: Nurses must develop good problem-solving skills (PSS) to work in the complex health care environment. This study explored PHNs’ use of analogy in PSS development. The purposes of the study were to clarify how PS...Aim: Nurses must develop good problem-solving skills (PSS) to work in the complex health care environment. This study explored PHNs’ use of analogy in PSS development. The purposes of the study were to clarify how PSS developed in one area (i.e., mental health) could be applied to another area (i.e., maternal health) and whether new PSS could develop in response to PSS gained in another area. Methods: A multiple case study was conducted using interviews. We interviewed 27 consultations from eight Japanese PHNs who consulted in mental health departments before transferring to maternal health departments. The data on how PHNs applied PSS in the selection, mapping, evaluation, and learning stages of the analogy process were extracted from transcribed interviewed data and compared. Results: PHNs provided 59 PSS used in 27 consultations. All PHNs applied past mental health PSS to solve new problems in maternal health. They tended to select past PSS based on structural similarity and to apply PSS via low-level abstraction in serious situations or preventively to avoid causing the current situation to worsen. Notably, PHNs developed maternal health PSS by using past mental health PSS;these new PSS were derived through analogy from various failures and successes. Conclusions: PSS developed in one area can be applied in another area, and new PSS can develop through applying these previous PSS. Identification of structural similarities and preventive analogies must be included in nursing education, especially for nurses working in public health fields.展开更多
Antenatal care is a safe way to prevent pregnancy-related health problems, difficult deliveries and even further to anticipate low birth weight [1]. But pregnant women, especially in Africa, do not attend antenatal cl...Antenatal care is a safe way to prevent pregnancy-related health problems, difficult deliveries and even further to anticipate low birth weight [1]. But pregnant women, especially in Africa, do not attend antenatal clinics as recommended by the WHO. The general objective of this study was to study the norm in terms of Antenatal Consultation (ANC) frequency as well as the determinants of the frequency among women who gave birth in the maternity hospitals of Agbangnizoun. Our research was a cross-sectional, descriptive, retrospective and quantitative type, which was carried out among 335 women in Agbangnizoun, Benin from 1 February to 3 April 2020 (3 months), in order to find out the general or specific characteristics of women that we associate with the frequency of prenatal consultation. At the end of the study, we found that 60%, 68% and 15% of the surveyed population had received ANC in the first, second and third trimesters, respectively. Ethnicity, income level of spouses over the three trimesters as well as the level of their knowledge and overall practice of ANC are determinants of the frequency of prenatal consultation.展开更多
The City of Calgary’s Nose Creek Sanitary Sewer Trunk Phase B project has been constructed over several years to accommodate future population growth and open more developable lands in northern Calgary.The project wa...The City of Calgary’s Nose Creek Sanitary Sewer Trunk Phase B project has been constructed over several years to accommodate future population growth and open more developable lands in northern Calgary.The project was divided into three phases,Phase A,B,and C,with each phase delivered by a separate consultant.Phase A was the downstream section of this project and was undertaken by Stantec Consulting.Phase B was the upstream section designed by CH2MHILL(now Jacobs)and further divided into different contracts(1 through 5).Phase C was a separate sewer called the Saddleridge Trunk sewer and this was designed by Associated Engineering.This paper covers Phase B,Contract 4,which had several unique challenges and included many innovative design and procurement solutions.One procurement strategy included a two-phase qualification package,with the initial phase to select a tunnelling contractor with the experience to deliver technical installations under rail and creeks,and the second phase,a RFP(request for proposal),to select a general contractor,with broader experience in open-cut and stormwater drainage,which were other aspects included within the project.This approach ensured that The City had the most qualified team available to complete the project.Technical challenges discussed in this paper include an oblique CPKC(Canadian Pacific Kansas City)rail and Nose Creek crossing that required independent review,and CFD(computational fluid dynamics)and hydrogen sulfide modelling to confirm conditions within the trunk sewer.展开更多
The aim of this study is to explore and summarize the development trajectory,current research landscape,and emerging trends of medication consultation in China,providing a valuable reference for future investigations ...The aim of this study is to explore and summarize the development trajectory,current research landscape,and emerging trends of medication consultation in China,providing a valuable reference for future investigations in this domain.Relevant articles on medication consultation were systematically collected,and bibliometric software such as CiteSpace 6.4R1 was employed to analyze author and institutional collaborations,keyword co-occurrence,clustering,and emerging trends.This approach helped elucidate key themes and hot topics in the field.A total of 1267 articles were included,with the peak number of publications recorded in 2011,followed by a steady decline in subsequent years.The most prolific author was Zhen Jiancun,contributing eight publications,while the First Affiliated Hospital of Sun Yat-sen University emerged as the leading institution with 11 publications.High-frequency identified keywords included medication consultation,rational drug use,pharmaceutical services,clinical pharmacists,and outpatient pharmacies.Cluster analysis revealed 12 significant themes,while emergent analysis highlighted that recent research hotspots centered on the Pareto chart,pregnancy,and traditional Chinese patent medicine.As a critical aspect of pharmaceutical services,the practice of medication consultation in China requires further advancement,with a particular need for enhanced collaboration among researchers and institutions.Moving forward,expanding the scope of medication consultation,improving the quality of related research,and fostering cross-regional collaboration among teams with diverse research focuses will be essential in deepening and broadening this field of study.展开更多
BACKGROUND Systemic lupus erythematosus(SLE)can affect multiple organs or systems.The involvement of the central nervous system can result in the manifestation of epilepsy,an acute confusional state,and other rare neu...BACKGROUND Systemic lupus erythematosus(SLE)can affect multiple organs or systems.The involvement of the central nervous system can result in the manifestation of epilepsy,an acute confusional state,and other rare neuropsychiatric presentations,such as catatonia.CASE SUMMARY We present a case of an adolescent male patient with first-onset SLE who presented with neuropsychiatric symptoms including epilepsy and delirium.The initial utilization of olanzapine to alleviate symptoms of agitation precipitated the emergence of catatonia,which was mitigated by discontinuing olanzapine and supplementing with lorazepam.In this case,whether the catatonia was secondary to the utilization of antipsychotics or to an organic disease is a question that warrants differential diagnosis.CONCLUSION Multidisciplinary collaborative management is the cornerstone for the successful management of severe cases of SLE.展开更多
A seasoned business consultant’s insightful reflection on two decades of navigating China’s dynamic market.TWENTY years ago,when the Spain-China Comprehensive Strategic Partnership Agreement was signed,few could hav...A seasoned business consultant’s insightful reflection on two decades of navigating China’s dynamic market.TWENTY years ago,when the Spain-China Comprehensive Strategic Partnership Agreement was signed,few could have foreseen the profound transformation that this bilateral relationship would undergo.展开更多
The rapid development and increasing popularity of smartphones have led to their gradual integration as essential aids in medical examinations and teaching tools.The smartphone ophthalmoscope(SO)is one of them.Specifi...The rapid development and increasing popularity of smartphones have led to their gradual integration as essential aids in medical examinations and teaching tools.The smartphone ophthalmoscope(SO)is one of them.Specifically,SO is comprised of a smartphone and an attachment.The smartphone serves as a versatile device for recording and transmitting information,while the attachment functions as a tool for phone fixation as well as focus adjustment and providing light resources,albeit with slight variations across different devices.Presently,the convenience,universality,and transferability of SO have greatly expanded its potential in fields of clinical practice and ocular teaching.The review provides a concise overview of the contemporary SO devices,elucidates the diseases amenable to assessment via SO,and outlines the various applications of SO in clinical practice and teaching.展开更多
During the National People's Congress(NPC)and the Chinese People's Political Consultative Conference(CPPCC)in 2025,ESG-related issues have received widespread attention.Several NPC deputies and CPPCC members h...During the National People's Congress(NPC)and the Chinese People's Political Consultative Conference(CPPCC)in 2025,ESG-related issues have received widespread attention.Several NPC deputies and CPPCC members have put forward suggestions on ESG policies,green finance,corporate ESG practices and other topics,aiming to promote China's ESG development to a new stage.展开更多
Despite government incentives,developers are reluctant to invest in green building initiatives due to their perceived extra costs-in particular additional consultant and construction implementation costs.This paper ex...Despite government incentives,developers are reluctant to invest in green building initiatives due to their perceived extra costs-in particular additional consultant and construction implementation costs.This paper examines the issues preventing the integration of Green Building Index(GBI)consultancy with residential building development in the Malaysian construction industry.Following a literature review of the challenges involving GBI consultancy at the early stage of green residential development,a semi-structured interview method was used to elicit opinion on perceived barriers to integrating the GBI process from 30 interviewees;mainly developers,GBI consultants,building consultants and regulators in the Malaysian construction industry with involvement in green building.The study found that a lack of communication between design team members and GBI consultants was a major barrier.This reduced the opportunity for a more collaborative effort to minimise costs and wastage during the design stages.Lack of insight into the impact of integrating the GBI consultancy into design process within the project time frames was evident.Effective coordination is necessary if the involvement of GBI consultants,particularly at early design stage,is to be successfully managed.It is recommended that work coordination among design team members and GBI consultants needs periodic review.展开更多
Objective To study the current situation and corresponding characteristics of internet pharmacy services and summarize their core connotations,and to make some suggestions for their future development based on nationa...Objective To study the current situation and corresponding characteristics of internet pharmacy services and summarize their core connotations,and to make some suggestions for their future development based on national policies.Methods The literature of the last 20 years that fully or partially matched the theme of internet pharmacy services in China was studied to summarize the status of research and development of remote pharmacy services by combining the web survey method.Results and Conclusion China’s internet pharmacy services include online consultation,science education,information enquiry,follow-up and intervention,and other functions.The main service providers are medical institutions,Internet enterprises,and online drug sales platforms.Internet pharmacy services can improve patients’compliance with medication and the convenience of medical treatment,which better play the role of pharmacists.However,they also face problems such as the varying service qualities,the small number of users,the difficulty in popularizing services in remote areas,and the lack of supervision and protection of patients’rights.展开更多
BACKGROUND Not all neuropsychiatric(NP)manifestations in patients with systemic lupus erythematosus(SLE)are secondary to lupus.The clarification of the cause of NP symptoms influences therapeutic strategies for SLE.AI...BACKGROUND Not all neuropsychiatric(NP)manifestations in patients with systemic lupus erythematosus(SLE)are secondary to lupus.The clarification of the cause of NP symptoms influences therapeutic strategies for SLE.AIM To understand the attribution of psychiatric manifestations in a cohort of Chinese patients with SLE.METHODS This retrospective single-center study analyzed 160 inpatient medical records.Clinical diagnosis,which is considered the gold standard,was used to divide the subjects into a psychiatric SLE(PSLE)group(G1)and a secondary psychiatric symptoms group(G2).Clinical features were compared between these two groups.The sensitivity and specificity of the Italian attribution model were explored.RESULTS A total of 171 psychiatric syndromes were recorded in 138 patients,including 87 cases of acute confusional state,40 cases of cognitive dysfunction,18 cases of psychosis,and 13 cases each of depressive disorder and mania or hypomania.A total of 141(82.5%)syndromes were attributed to SLE.In contrast to G2 patients,G1 patients had higher SLE Disease Activity Index-2000 scores(21 vs 12,P=0.001),a lower prevalence of anti-beta-2-glycoprotein 1 antibodies(8.6%vs 25.9%,P=0.036),and a higher prevalence of anti-ribosomal ribonucleoprotein particle(rRNP)antibodies(39.0%vs 22.2%,P=0.045).The Italian attribution model exhibited a sensitivity of 95.0%and a specificity of 70.0%when the threshold value was set at 7.CONCLUSION Patients with PSLE exhibited increased disease activity.There is a correlation between PSLE and anti-rRNP antibodies.The Italian model effectively assesses multiple psychiatric manifestations in Chinese SLE patients who present with NP symptoms.展开更多
This paper explores whole-process engineering consulting,including its application models in public buildings and elderly-friendly projects,such as service integration and whole lifecycle management.It also addresses ...This paper explores whole-process engineering consulting,including its application models in public buildings and elderly-friendly projects,such as service integration and whole lifecycle management.It also addresses the construction of multi-dimensional collaborative theoretical models,public space streamline organization,and other aspects,emphasizing the importance of multi-dimensional collaboration.Additionally,it highlights the role of talent cultivation and digital transformation in enhancing project efficiency.展开更多
CCPIT The 2025 Business Forum of the Shanghai Cooperation Organization Held in Beijing On July 17,the Shanghai Cooperation Organization(SCO)held its Business Forum in Beijing.Vice Chairman of the National Committee of...CCPIT The 2025 Business Forum of the Shanghai Cooperation Organization Held in Beijing On July 17,the Shanghai Cooperation Organization(SCO)held its Business Forum in Beijing.Vice Chairman of the National Committee of the Chinese People’s Political Consultative Conference(CPPCC)and Chairman of the All-China Federation of Industry and Commerce,Gao Yunlong,attended and addressed the opening ceremony.展开更多
The annual Two Sessions,the meetings of the National People’s Congress(NPC)and the National Committee of the Chinese People’s Political Consultative Conference(CPPCC),were held in Beijing from March 4 to 11,2025.Thi...The annual Two Sessions,the meetings of the National People’s Congress(NPC)and the National Committee of the Chinese People’s Political Consultative Conference(CPPCC),were held in Beijing from March 4 to 11,2025.This year’s meetings raised considerable concern as the year 2025 is the final year for implementing the 14th Five-Year Plan(2021-2025),which is decisive for making the 15th Five-Year Plan(2026-2030),and also very important for further deepening reform comprehensively.展开更多
An annual event in March in China is the Two Sessions,the meetings of the National People’s Congress(NPC)and the National Committee of the Chinese People’s Political Consultative Conference(CPPCC).The SPOTLIGHT colu...An annual event in March in China is the Two Sessions,the meetings of the National People’s Congress(NPC)and the National Committee of the Chinese People’s Political Consultative Conference(CPPCC).The SPOTLIGHT column of the issue displays the speech highlights of Luo Wen,SAMR Minister,and the insights into standards of representatives during the meetings.展开更多
Introduction Patients with acute ischaemic strokes(AIS),on average,fare better with timely neurologist consultation,and a growing proportion of them receive one.However,little is known about trends in the characterist...Introduction Patients with acute ischaemic strokes(AIS),on average,fare better with timely neurologist consultation,and a growing proportion of them receive one.However,little is known about trends in the characteristics of neurologists who treat AIS.Methods We identified AIS and transient ischaemic attack(TIA)episodes with neurologist consults in fee-for service Medicare from January 2008 to September 2021.For each episode,we determined whether the neurologist was a vascular neurologist,was a high-volume provider,whether the patient was transferred between hospitals and the distance between the patient’s home and physician’s practice.Results From 2008 to 2021,the share of AIS/TIA episodes(n=5073294)with neurologist consults increased(52.9%to 61.7%).Among episodes with consults,the fraction conducted by a vascular neurologist(5.2%to 13.7%)or by a high-volume neurologist(13.2%to 14.9%)also increased.The fraction with the patient’s home and neurologist greater than 100 miles apart(4.8%to 9.6%)or in different states(5.1%to 8.1%)increased,as did the fraction with transfers(4.2%to 8.5%).Discussion Over the study period,the proportion of AIS/TIA episodes with consultations from neurologists with either vascular neurology certifications or high volumes increased substantially.展开更多
文摘Introduction: Internet has become an increasingly popular source of reference for patients to learn about their medical problems. It is easily accessible, and a large number of uncensored information is available online written from various sources and perspectives. However, the role of internet and its impact on patient’s care and understanding of the disease remains unclear. The purpose of this study is to evaluate the role and effect of internet use for patients seeking consultation for hip and knee arthritis. More specifically, the relationship between patient’s education level, internet use, motives for doing background readings, perception of internet information, and reactions to the available information will be studied. Method: Patients seeking orthopaedic consultation for knee or hip arthritis at the Toronto Western Hospital were identified and invited to fill out a questionnaire on their first visit. The questionnaire was designed to assess the patients’ pre-consultation reading habits, their use of internet, and their reaction to what they have read on the internet. The questionnaire also included questions about the respondent’s background.Results: In comparing patients holding college/university degree (CU) with patients having no college/university education (NoCU), the CU group were associated with increased internet use (CU vs. NoCU: 71.0% vs. 48.3%;p 0.01) and background reading (CU vs. NoCU: 82.2% vs. 17.8%;p 0.001) prior to consultation;fewer incidence of anxiety following internet use (CU vs. NoCU: 29.9% vs. 53.6%;p 0.05);and higher rates of decisions influenced by internet use (CU vs. NoCU: 20.8% vs. 3.6%, p 0.05). Internet users demonstrated a higher confidence in gathering and understanding medical information (Internet users vs. non-internet users: 6.59 ± 2.05 vs. 5.03 ± 2.78;p 0.001) and rated the accuracy of information on internet at 7.18 ± 2.01 (max = 10). Conclusion: Internet use can influence patient’s treatment decision, anxiety level, and understanding of their disease. Caregivers must recognize the growing trend of internet use and should counsel and educate their patients appropriately based on what they have read to help them accurately appreciate the nature of their disease.
文摘Background: In our study, researching the distribution of the consultations other than anaesthesia in compliance with the disciplines and ages of the patients and its effect on the assessment cost has been aimed. Methods: Our study has been conducted during 8 months by the retrospective assessment of the records of 3844 cases on which an elective surgical procedure was planned in the anesthesiology polyclinic of Firat University Hospital. The records of patients have been obtained through examining their files from the hospital record system. Results: The total number of patients whose consultations have been demanded was 367 (9.5%) and the number of male/female was 192/175. The number of cases about which more than one consultation has been demanded was determined as 87 (2.2%). The number of cases on which a method change for the anaesthesia was applied was 21 (5.7%), and the number of cases whose surgery was cancelled was 3 (0.81%). Requested consultation for each patient, the consultations of cardiology, chest diseases and internal medicine bring an additional cost on the total sum respectively as 37.2 TL (28.61 $), 29.8 TL (22.92 $) and 19.9 TL (15.30 $). Conclusions: We suggest that the cost analysis should be absolutely taken into consideration during the pre-anaesthetic assessment for the requirement of routine examinations.
文摘BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has resulted in seismic changes in healthcare delivery.As a result of this,hospital footfall required to be reduced due to increased risk of transmission of infection.To ensure patients can safely access healthcare,we introduced orthopaedic clinic telephone consultations in our busy district general hospital.AIM To investigate patients’and clinicians’perspective of telephone consultations during COVID-19,and whether this method of consultation could be a viable option in the post-pandemic future.METHODS This is a single centre,prospective study conducted in a busy National Health Service district general hospital.In May 2020,100 non-consecutive adult patients were contacted by independent investigators within 48 h of their orthopaedic clinic telephone consultation to complete a telephone satisfaction questionnaire.The questions assessed satisfaction regarding various aspects of the consultation including overall satisfaction and willingness to use this approach long term.Satisfaction and perspective of 25 clinicians conducting these telephone consultations was also assessed via an online survey tool.RESULTS 93%of patients were overall satisfied with telephone consultations and 79%were willing to continue this method of consultation post-pandemic.Patients found telephone consultations to reduce personal cost and inconvenience associated with attending a hospital appointment.72%of clinicians reported overall satisfaction with this service and 80%agreed that telephone consultations should be used in the future.The majority found it less laborious in time and administration in comparison to face to face consultations.Patients and clinicians expressed their desire for video consultations as a method of further improving their experience with remote consultations.CONCLUSION Our study has shown that telephone consultations are a safe and rapid method of adaptation to the COVID-19 pandemic,achieving the aim of reducing hospital footfall.This method of consultation has resulted in immense clinician and patient satisfaction.Our findings suggest that this tool has benefits in post pandemic healthcare delivery.It has also highlighted that telephone consultations can act as a steppingstone to the introduction of the more complex platform of video consulting.
文摘Aim: Nurses must develop good problem-solving skills (PSS) to work in the complex health care environment. This study explored PHNs’ use of analogy in PSS development. The purposes of the study were to clarify how PSS developed in one area (i.e., mental health) could be applied to another area (i.e., maternal health) and whether new PSS could develop in response to PSS gained in another area. Methods: A multiple case study was conducted using interviews. We interviewed 27 consultations from eight Japanese PHNs who consulted in mental health departments before transferring to maternal health departments. The data on how PHNs applied PSS in the selection, mapping, evaluation, and learning stages of the analogy process were extracted from transcribed interviewed data and compared. Results: PHNs provided 59 PSS used in 27 consultations. All PHNs applied past mental health PSS to solve new problems in maternal health. They tended to select past PSS based on structural similarity and to apply PSS via low-level abstraction in serious situations or preventively to avoid causing the current situation to worsen. Notably, PHNs developed maternal health PSS by using past mental health PSS;these new PSS were derived through analogy from various failures and successes. Conclusions: PSS developed in one area can be applied in another area, and new PSS can develop through applying these previous PSS. Identification of structural similarities and preventive analogies must be included in nursing education, especially for nurses working in public health fields.
文摘Antenatal care is a safe way to prevent pregnancy-related health problems, difficult deliveries and even further to anticipate low birth weight [1]. But pregnant women, especially in Africa, do not attend antenatal clinics as recommended by the WHO. The general objective of this study was to study the norm in terms of Antenatal Consultation (ANC) frequency as well as the determinants of the frequency among women who gave birth in the maternity hospitals of Agbangnizoun. Our research was a cross-sectional, descriptive, retrospective and quantitative type, which was carried out among 335 women in Agbangnizoun, Benin from 1 February to 3 April 2020 (3 months), in order to find out the general or specific characteristics of women that we associate with the frequency of prenatal consultation. At the end of the study, we found that 60%, 68% and 15% of the surveyed population had received ANC in the first, second and third trimesters, respectively. Ethnicity, income level of spouses over the three trimesters as well as the level of their knowledge and overall practice of ANC are determinants of the frequency of prenatal consultation.
文摘The City of Calgary’s Nose Creek Sanitary Sewer Trunk Phase B project has been constructed over several years to accommodate future population growth and open more developable lands in northern Calgary.The project was divided into three phases,Phase A,B,and C,with each phase delivered by a separate consultant.Phase A was the downstream section of this project and was undertaken by Stantec Consulting.Phase B was the upstream section designed by CH2MHILL(now Jacobs)and further divided into different contracts(1 through 5).Phase C was a separate sewer called the Saddleridge Trunk sewer and this was designed by Associated Engineering.This paper covers Phase B,Contract 4,which had several unique challenges and included many innovative design and procurement solutions.One procurement strategy included a two-phase qualification package,with the initial phase to select a tunnelling contractor with the experience to deliver technical installations under rail and creeks,and the second phase,a RFP(request for proposal),to select a general contractor,with broader experience in open-cut and stormwater drainage,which were other aspects included within the project.This approach ensured that The City had the most qualified team available to complete the project.Technical challenges discussed in this paper include an oblique CPKC(Canadian Pacific Kansas City)rail and Nose Creek crossing that required independent review,and CFD(computational fluid dynamics)and hydrogen sulfide modelling to confirm conditions within the trunk sewer.
文摘The aim of this study is to explore and summarize the development trajectory,current research landscape,and emerging trends of medication consultation in China,providing a valuable reference for future investigations in this domain.Relevant articles on medication consultation were systematically collected,and bibliometric software such as CiteSpace 6.4R1 was employed to analyze author and institutional collaborations,keyword co-occurrence,clustering,and emerging trends.This approach helped elucidate key themes and hot topics in the field.A total of 1267 articles were included,with the peak number of publications recorded in 2011,followed by a steady decline in subsequent years.The most prolific author was Zhen Jiancun,contributing eight publications,while the First Affiliated Hospital of Sun Yat-sen University emerged as the leading institution with 11 publications.High-frequency identified keywords included medication consultation,rational drug use,pharmaceutical services,clinical pharmacists,and outpatient pharmacies.Cluster analysis revealed 12 significant themes,while emergent analysis highlighted that recent research hotspots centered on the Pareto chart,pregnancy,and traditional Chinese patent medicine.As a critical aspect of pharmaceutical services,the practice of medication consultation in China requires further advancement,with a particular need for enhanced collaboration among researchers and institutions.Moving forward,expanding the scope of medication consultation,improving the quality of related research,and fostering cross-regional collaboration among teams with diverse research focuses will be essential in deepening and broadening this field of study.
基金Supported by STI2030-Major Projects,No.2021ZD0202001Capital Funds for Health Improvement and Research,No.CFH 2022-2-4012.
文摘BACKGROUND Systemic lupus erythematosus(SLE)can affect multiple organs or systems.The involvement of the central nervous system can result in the manifestation of epilepsy,an acute confusional state,and other rare neuropsychiatric presentations,such as catatonia.CASE SUMMARY We present a case of an adolescent male patient with first-onset SLE who presented with neuropsychiatric symptoms including epilepsy and delirium.The initial utilization of olanzapine to alleviate symptoms of agitation precipitated the emergence of catatonia,which was mitigated by discontinuing olanzapine and supplementing with lorazepam.In this case,whether the catatonia was secondary to the utilization of antipsychotics or to an organic disease is a question that warrants differential diagnosis.CONCLUSION Multidisciplinary collaborative management is the cornerstone for the successful management of severe cases of SLE.
文摘A seasoned business consultant’s insightful reflection on two decades of navigating China’s dynamic market.TWENTY years ago,when the Spain-China Comprehensive Strategic Partnership Agreement was signed,few could have foreseen the profound transformation that this bilateral relationship would undergo.
基金Supported by the National Natural Science Foundation of China(No.81600757)the Natural Science Foundation of Hunan Province of China(No.2021JJ40880)the Health Commission Foundation of Hunan Province of China(No.D202307027020).
文摘The rapid development and increasing popularity of smartphones have led to their gradual integration as essential aids in medical examinations and teaching tools.The smartphone ophthalmoscope(SO)is one of them.Specifically,SO is comprised of a smartphone and an attachment.The smartphone serves as a versatile device for recording and transmitting information,while the attachment functions as a tool for phone fixation as well as focus adjustment and providing light resources,albeit with slight variations across different devices.Presently,the convenience,universality,and transferability of SO have greatly expanded its potential in fields of clinical practice and ocular teaching.The review provides a concise overview of the contemporary SO devices,elucidates the diseases amenable to assessment via SO,and outlines the various applications of SO in clinical practice and teaching.
文摘During the National People's Congress(NPC)and the Chinese People's Political Consultative Conference(CPPCC)in 2025,ESG-related issues have received widespread attention.Several NPC deputies and CPPCC members have put forward suggestions on ESG policies,green finance,corporate ESG practices and other topics,aiming to promote China's ESG development to a new stage.
文摘Despite government incentives,developers are reluctant to invest in green building initiatives due to their perceived extra costs-in particular additional consultant and construction implementation costs.This paper examines the issues preventing the integration of Green Building Index(GBI)consultancy with residential building development in the Malaysian construction industry.Following a literature review of the challenges involving GBI consultancy at the early stage of green residential development,a semi-structured interview method was used to elicit opinion on perceived barriers to integrating the GBI process from 30 interviewees;mainly developers,GBI consultants,building consultants and regulators in the Malaysian construction industry with involvement in green building.The study found that a lack of communication between design team members and GBI consultants was a major barrier.This reduced the opportunity for a more collaborative effort to minimise costs and wastage during the design stages.Lack of insight into the impact of integrating the GBI consultancy into design process within the project time frames was evident.Effective coordination is necessary if the involvement of GBI consultants,particularly at early design stage,is to be successfully managed.It is recommended that work coordination among design team members and GBI consultants needs periodic review.
基金2021 General Scientific Research Project of Liaoning Provincial Department of Education(No.LJKR0298)Liaoning Provincial Social Science Planning。
文摘Objective To study the current situation and corresponding characteristics of internet pharmacy services and summarize their core connotations,and to make some suggestions for their future development based on national policies.Methods The literature of the last 20 years that fully or partially matched the theme of internet pharmacy services in China was studied to summarize the status of research and development of remote pharmacy services by combining the web survey method.Results and Conclusion China’s internet pharmacy services include online consultation,science education,information enquiry,follow-up and intervention,and other functions.The main service providers are medical institutions,Internet enterprises,and online drug sales platforms.Internet pharmacy services can improve patients’compliance with medication and the convenience of medical treatment,which better play the role of pharmacists.However,they also face problems such as the varying service qualities,the small number of users,the difficulty in popularizing services in remote areas,and the lack of supervision and protection of patients’rights.
基金Supported by STI2030-Major Projects,No.2021ZD0202001National Natural Science Foundation of China,No.T2341003Capital Funds for Health Improvement and Research,No.CFH 2022-2-4012.
文摘BACKGROUND Not all neuropsychiatric(NP)manifestations in patients with systemic lupus erythematosus(SLE)are secondary to lupus.The clarification of the cause of NP symptoms influences therapeutic strategies for SLE.AIM To understand the attribution of psychiatric manifestations in a cohort of Chinese patients with SLE.METHODS This retrospective single-center study analyzed 160 inpatient medical records.Clinical diagnosis,which is considered the gold standard,was used to divide the subjects into a psychiatric SLE(PSLE)group(G1)and a secondary psychiatric symptoms group(G2).Clinical features were compared between these two groups.The sensitivity and specificity of the Italian attribution model were explored.RESULTS A total of 171 psychiatric syndromes were recorded in 138 patients,including 87 cases of acute confusional state,40 cases of cognitive dysfunction,18 cases of psychosis,and 13 cases each of depressive disorder and mania or hypomania.A total of 141(82.5%)syndromes were attributed to SLE.In contrast to G2 patients,G1 patients had higher SLE Disease Activity Index-2000 scores(21 vs 12,P=0.001),a lower prevalence of anti-beta-2-glycoprotein 1 antibodies(8.6%vs 25.9%,P=0.036),and a higher prevalence of anti-ribosomal ribonucleoprotein particle(rRNP)antibodies(39.0%vs 22.2%,P=0.045).The Italian attribution model exhibited a sensitivity of 95.0%and a specificity of 70.0%when the threshold value was set at 7.CONCLUSION Patients with PSLE exhibited increased disease activity.There is a correlation between PSLE and anti-rRNP antibodies.The Italian model effectively assesses multiple psychiatric manifestations in Chinese SLE patients who present with NP symptoms.
文摘This paper explores whole-process engineering consulting,including its application models in public buildings and elderly-friendly projects,such as service integration and whole lifecycle management.It also addresses the construction of multi-dimensional collaborative theoretical models,public space streamline organization,and other aspects,emphasizing the importance of multi-dimensional collaboration.Additionally,it highlights the role of talent cultivation and digital transformation in enhancing project efficiency.
文摘CCPIT The 2025 Business Forum of the Shanghai Cooperation Organization Held in Beijing On July 17,the Shanghai Cooperation Organization(SCO)held its Business Forum in Beijing.Vice Chairman of the National Committee of the Chinese People’s Political Consultative Conference(CPPCC)and Chairman of the All-China Federation of Industry and Commerce,Gao Yunlong,attended and addressed the opening ceremony.
文摘The annual Two Sessions,the meetings of the National People’s Congress(NPC)and the National Committee of the Chinese People’s Political Consultative Conference(CPPCC),were held in Beijing from March 4 to 11,2025.This year’s meetings raised considerable concern as the year 2025 is the final year for implementing the 14th Five-Year Plan(2021-2025),which is decisive for making the 15th Five-Year Plan(2026-2030),and also very important for further deepening reform comprehensively.
文摘An annual event in March in China is the Two Sessions,the meetings of the National People’s Congress(NPC)and the National Committee of the Chinese People’s Political Consultative Conference(CPPCC).The SPOTLIGHT column of the issue displays the speech highlights of Luo Wen,SAMR Minister,and the insights into standards of representatives during the meetings.
基金Supported by grant R01-NS111952 from the National Institute of Neurological Disorders and Stroke.
文摘Introduction Patients with acute ischaemic strokes(AIS),on average,fare better with timely neurologist consultation,and a growing proportion of them receive one.However,little is known about trends in the characteristics of neurologists who treat AIS.Methods We identified AIS and transient ischaemic attack(TIA)episodes with neurologist consults in fee-for service Medicare from January 2008 to September 2021.For each episode,we determined whether the neurologist was a vascular neurologist,was a high-volume provider,whether the patient was transferred between hospitals and the distance between the patient’s home and physician’s practice.Results From 2008 to 2021,the share of AIS/TIA episodes(n=5073294)with neurologist consults increased(52.9%to 61.7%).Among episodes with consults,the fraction conducted by a vascular neurologist(5.2%to 13.7%)or by a high-volume neurologist(13.2%to 14.9%)also increased.The fraction with the patient’s home and neurologist greater than 100 miles apart(4.8%to 9.6%)or in different states(5.1%to 8.1%)increased,as did the fraction with transfers(4.2%to 8.5%).Discussion Over the study period,the proportion of AIS/TIA episodes with consultations from neurologists with either vascular neurology certifications or high volumes increased substantially.
