In Japan, the shortage of personnel is a problem in long-term care nursing and rehabilitative care prevention. Nevertheless, Japan has taken measures to compensate for these shortages by promoting medical and nursing ...In Japan, the shortage of personnel is a problem in long-term care nursing and rehabilitative care prevention. Nevertheless, Japan has taken measures to compensate for these shortages by promoting medical and nursing care activities using robotic technologies, and employing human resources from overseas. The purpose of this study was to determine potential legal issues and subsequent implications for care during prevention gymnastic exercises for the elderly using Pepper in long-term health facilities. The application program of Care-Prevention Gymnastics Exercises for Pepper (Pepper with CPGE) was made by the Xing Company Japan. Currently, care workers become intermediaries for the safe use of Pepper with CPGE. However, it was realized that some legal issues may arise if Pepper with CPGE alone will carry out these preventive care programs for the elderly without the presence of care workers as intermediaries. In this situation, using Pepper with CPGE alone to conduct care prevention gymnastics will require safety measures to prevent these possible practice issues and anticipate implications for care. In this regard, determining detailed target levels of rehabilitation exercise demands and environmental setting safety become essential factors. The use of humanoid robots in healthcare is expected to influence more practice protocols in contemporary and futurist rehabilitative human care. The identification of possible safety issues in performance and environmental situations, and implications for care are critical to ensure safe and valuable rehabilitative health care practices for the elderly population.展开更多
Designing technologies is a process that relies on multiple interactions between design and use contexts. These interactions are essential to the development and establishment of technologies. This article seeks to un...Designing technologies is a process that relies on multiple interactions between design and use contexts. These interactions are essential to the development and establishment of technologies. This article seeks to understand the attempts of healthcare organisations to integrate use contexts into the design of healthcare technologies following insights of the theoretical approaches of social learning and user representations. We present a multiple case study of three healthcare technologies involved in improving elderly care practice. These cases were part of a Dutch quality improvement collaborative program, which urged that development of these technologies was not “just” development, but should occur in close collaboration with other parts of the collaborative program, which were more focused on implementation. These cases illustrate different ways to develop technologies in interaction with use contexts and users. Despite the infrastructure of the collaborative program, interactions were not without problems. We conclude by arguing that interactions between design and use are not naturally occurring phenomena, but must be actively organised in order to create effects.展开更多
为应对可再生能源的供给不确定性给新能源发电企业中长期合同履约带来的挑战,本文提出了新能源发电企业与独立储能中长期合约电量确定方法。综合新能源发电的机会约束和独立储能运行约束,以发电企业和独立储能共同效益为目标,构建新能...为应对可再生能源的供给不确定性给新能源发电企业中长期合同履约带来的挑战,本文提出了新能源发电企业与独立储能中长期合约电量确定方法。综合新能源发电的机会约束和独立储能运行约束,以发电企业和独立储能共同效益为目标,构建新能源发电企业同独立储能签订中长期合约电量确定模型;通过引入条件风险价值(conditional value at risk,CVaR)和替换变量将模型重新表述为混合整数规划(mixed integer program,MIP)模型以便于求解。采用新能源发电企业月度合约电量分解曲线进行算例分析,验证了本文所提方法的有效性。同时考量新能源发电企业风险偏好、储能荷电状态等对共同效益的影响,研究表明储能荷电状态与共同收益负相关,而提高新能源发电企业风险偏好能够提高合约共同体预期收益。储能中长期双边合约电量确定方法的提出有助于促进新能源消纳和储能成本市场化疏导。展开更多
文摘In Japan, the shortage of personnel is a problem in long-term care nursing and rehabilitative care prevention. Nevertheless, Japan has taken measures to compensate for these shortages by promoting medical and nursing care activities using robotic technologies, and employing human resources from overseas. The purpose of this study was to determine potential legal issues and subsequent implications for care during prevention gymnastic exercises for the elderly using Pepper in long-term health facilities. The application program of Care-Prevention Gymnastics Exercises for Pepper (Pepper with CPGE) was made by the Xing Company Japan. Currently, care workers become intermediaries for the safe use of Pepper with CPGE. However, it was realized that some legal issues may arise if Pepper with CPGE alone will carry out these preventive care programs for the elderly without the presence of care workers as intermediaries. In this situation, using Pepper with CPGE alone to conduct care prevention gymnastics will require safety measures to prevent these possible practice issues and anticipate implications for care. In this regard, determining detailed target levels of rehabilitation exercise demands and environmental setting safety become essential factors. The use of humanoid robots in healthcare is expected to influence more practice protocols in contemporary and futurist rehabilitative human care. The identification of possible safety issues in performance and environmental situations, and implications for care are critical to ensure safe and valuable rehabilitative health care practices for the elderly population.
文摘Designing technologies is a process that relies on multiple interactions between design and use contexts. These interactions are essential to the development and establishment of technologies. This article seeks to understand the attempts of healthcare organisations to integrate use contexts into the design of healthcare technologies following insights of the theoretical approaches of social learning and user representations. We present a multiple case study of three healthcare technologies involved in improving elderly care practice. These cases were part of a Dutch quality improvement collaborative program, which urged that development of these technologies was not “just” development, but should occur in close collaboration with other parts of the collaborative program, which were more focused on implementation. These cases illustrate different ways to develop technologies in interaction with use contexts and users. Despite the infrastructure of the collaborative program, interactions were not without problems. We conclude by arguing that interactions between design and use are not naturally occurring phenomena, but must be actively organised in order to create effects.
文摘为应对可再生能源的供给不确定性给新能源发电企业中长期合同履约带来的挑战,本文提出了新能源发电企业与独立储能中长期合约电量确定方法。综合新能源发电的机会约束和独立储能运行约束,以发电企业和独立储能共同效益为目标,构建新能源发电企业同独立储能签订中长期合约电量确定模型;通过引入条件风险价值(conditional value at risk,CVaR)和替换变量将模型重新表述为混合整数规划(mixed integer program,MIP)模型以便于求解。采用新能源发电企业月度合约电量分解曲线进行算例分析,验证了本文所提方法的有效性。同时考量新能源发电企业风险偏好、储能荷电状态等对共同效益的影响,研究表明储能荷电状态与共同收益负相关,而提高新能源发电企业风险偏好能够提高合约共同体预期收益。储能中长期双边合约电量确定方法的提出有助于促进新能源消纳和储能成本市场化疏导。
文摘背景与目的中国易瑞沙(吉非替尼、ZD1839)扩大用药(EAP)项目开始于2001年,旨在为标准治疗失败后或不能耐受化疗的晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者提供吉非替尼单药治疗。本研究主要评估仍在EAP组长期生存者的生活质量、肿瘤控制情况、服药安全性、临床特点及基因测定。次要目标为探讨长期生存者的临床特征。方法这是一项描述性观察研究,数据收集依据流行病学研究方法。对于仍在EAP组中的患者,数据将采用横断面调查的方法;对于已从EAP组中退出的长期生存者和快速进展者,数据以回顾性方式收集。结果在EAP数据库中共筛选出符合条件的患者934例,其中59例为服用吉非替尼>3年的长期生存者,包括25例仍在EAP组,34例已退出EAP组,875例为快速进展者。59例长期生存者来自中国的15个临床中心。仍在EAP组的长期生存者,中位肺癌治疗功能评价量表(functional assessment of cancer therapy-lung,FACT-L)、试验结果系数(trial outcome index,TOI)和肺癌量表(lung cancer subscale,LCS)分值分别为64.5、37和12.5,91.6%患者的体力状态(performance status,PS)为0分-1分,客观有效率、疾病控制率和中位有效持续时间分别为37.5%、87.5%和68个月。在59例长期生存者中,没有发现严重或新的不良反应;其中<65岁者68.5%,腺癌81.4%,女性55.9%,从不吸烟者71%。与快速进展者比较,长期生存者中女性比例稍高(P=0.02)。本研究收集了3例患者的组织标本,其中1例EGFR突变阳性;2例Ki-67蛋白表达阳性,这2例患者生存期都超过73个月。同时收集了22例血浆标本,1例EGFR突变阳性。结论部分晚期NSCLC应用吉非替尼治疗可获3年以上长期生存,并为长期生存者提供了良好的生活质量、满意的疗效和药物耐受性。
