BACKGROUND The need for an emergency upgrade of a hospitalized trauma patient from the floor to the trauma intensive care unit(ICU)is an unanticipated event with possible life-threatening consequences.Unplanned ICU ad...BACKGROUND The need for an emergency upgrade of a hospitalized trauma patient from the floor to the trauma intensive care unit(ICU)is an unanticipated event with possible life-threatening consequences.Unplanned ICU admissions are associated with increased morbidity and mortality and are an indicator of trauma service quality.Two different types of unplanned ICU admissions include upgrades(patients admitted to the floor then moved to the ICU)and bounce backs(patients admitted to the ICU,discharged to the floor,and then readmitted to the ICU).Previous studies have shown that geriatric trauma patients are at higher risk for unfavorable outcomes.AIM To analyze the characteristics,management and outcomes of trauma patients who had an unplanned ICU admission during their hospitalization.METHODS This institutional review board approved,retrospective cohort study examined 203 adult trauma patients with unplanned ICU admission at an urban level 1 trauma center over a six-year period(2017-2023).This included 134 upgrades and 69 bounce backs.Analyzed variables included:(1)Age;(2)Sex;(3)Comorbidities;(4)Mechanism of injury(MOI);(5)Injury severity score(ISS);(6)Glasgow Coma Scale(GCS);(7)Type of injury;(8)Transfusions;(9)Consultations;(10)Timing and reason for unplanned admission;(11)Intubations;(12)Surgical interventions;(13)ICU and hospital lengths of stay;and(14)Mortality.RESULTS Unplanned ICU admissions comprised 4.2%of total ICU admissions.Main MOI was falls.Mean age was 70.7 years,ISS was 12.8 and GCS was 13.9.Main injuries were traumatic brain injury(37.4%)and thoracic injury(21.7%),and main reason for unplanned ICU admission was respiratory complication(39.4%).The 47.3%underwent a surgical procedure and 46.8%were intubated.Average timing for unplanned ICU admission was 2.9 days.Bounce backs occurred half as often as upgrades,however had higher rates of transfusions(63.8%vs 40.3%,P=0.002),consultations(4.8 vs 3.0,P<0.001),intubations(63.8%vs 38.1%%,P=0.001),longer ICU lengths of stay(13.2 days vs 6.4 days,P<0.001)and hospital lengths of stay(26.7 days vs 13.0 days,P<0.001).Mortality was 25.6%among unplanned ICU admissions,31.9%among geriatric unplanned ICU admissions and 11.9%among all trauma ICU patients.CONCLUSION Unplanned ICU admissions constituted 4.2%of total ICU admissions.Respiratory complications were the main cause of unplanned ICU admissions.Bounce backs occurred half as often as upgrades,but were associated with worse outcomes.展开更多
BACKGROUND Pedicle screw instrumentation is a critical technique in spinal surgery,offering effective stabilization for various spinal conditions.However,the impact of intraoperative imaging quality—specifically the ...BACKGROUND Pedicle screw instrumentation is a critical technique in spinal surgery,offering effective stabilization for various spinal conditions.However,the impact of intraoperative imaging quality—specifically the use of both anteroposterior(AP)and lateral views—on surgical outcomes remains insufficiently studied.Evaluating whether the adequacy of these imaging modalities affects the risk of unplanned returns to theatre(URTT)within 90 days due to screw malplacement is essential for refining surgical practices and improving patient care.AIM To evaluate how intraoperative imaging adequacy influences unplanned returnto-theatre rates,focusing on AP and lateral fluoroscopic views.METHODS This retrospective cohort study analyzed 1335 patients who underwent thoracolumbar and sacral pedicle screw instrumentation between January 2013 and December 2022.Data on intraoperative imaging adequacy,screw placement,and URTT events were collected and statistically analyzed using IBM SPSS v23.Imaging adequacy was assessed based on the presence of both AP and lateral views,and outcomes were compared between imaging groups.RESULTS A total of 9016 pedicle screws were inserted,with 82 screws identified as malplaced in 52 patients.Of these,46 patients required URTT due to screw malplacement,with 37 returning within 90 days(URTT90).Patients with both AP and lateral imaging saved intraoperatively had significantly lower URTT90 rates compared to those with only lateral imaging saved,demonstrating the critical role of imaging adequacy in improving surgical outcomes.CONCLUSION This study underscores that comprehensive intraoperative imaging with both AP and lateral views reduces unplanned returns,improves outcomes,enhances precision,and offers a cost-effective approach for better spinal surgery results.展开更多
From the perspective of unplanned readmission in patients with enterostomy,this study reviewed the incidence,influencing factors and intervention measures,to provide reference for increasing the attention of medical s...From the perspective of unplanned readmission in patients with enterostomy,this study reviewed the incidence,influencing factors and intervention measures,to provide reference for increasing the attention of medical staff,early detection of risk factors and formulation of personalized intervention measures.展开更多
BACKGROUND Colorectal cancer significantly impacts global health,with unplanned reoperations post-surgery being key determinants of patient outcomes.Existing predictive models for these reoperations lack precision in ...BACKGROUND Colorectal cancer significantly impacts global health,with unplanned reoperations post-surgery being key determinants of patient outcomes.Existing predictive models for these reoperations lack precision in integrating complex clinical data.AIM To develop and validate a machine learning model for predicting unplanned reoperation risk in colorectal cancer patients.METHODS Data of patients treated for colorectal cancer(n=2044)at the First Affiliated Hospital of Wenzhou Medical University and Wenzhou Central Hospital from March 2020 to March 2022 were retrospectively collected.Patients were divided into an experimental group(n=60)and a control group(n=1984)according to unplanned reoperation occurrence.Patients were also divided into a training group and a validation group(7:3 ratio).We used three different machine learning methods to screen characteristic variables.A nomogram was created based on multifactor logistic regression,and the model performance was assessed using receiver operating characteristic curve,calibration curve,Hosmer-Lemeshow test,and decision curve analysis.The risk scores of the two groups were calculated and compared to validate the model.RESULTS More patients in the experimental group were≥60 years old,male,and had a history of hypertension,laparotomy,and hypoproteinemia,compared to the control group.Multiple logistic regression analysis confirmed the following as independent risk factors for unplanned reoperation(P<0.05):Prognostic Nutritional Index value,history of laparotomy,hypertension,or stroke,hypoproteinemia,age,tumor-node-metastasis staging,surgical time,gender,and American Society of Anesthesiologists classification.Receiver operating characteristic curve analysis showed that the model had good discrimination and clinical utility.CONCLUSION This study used a machine learning approach to build a model that accurately predicts the risk of postoperative unplanned reoperation in patients with colorectal cancer,which can improve treatment decisions and prognosis.展开更多
BACKGROUND Critical patients often had various types of tubes,unplanned extubation of any kind of tube may cause serious injury to the patient,but previous reports mainly focused on endotracheal intubation.The limitat...BACKGROUND Critical patients often had various types of tubes,unplanned extubation of any kind of tube may cause serious injury to the patient,but previous reports mainly focused on endotracheal intubation.The limitations or incorrect use of the unplanned extubation risk assessment tool may lead to improper identification of patients at a high risk of unplanned extubation and cause delay or nonimplementation of unplanned extubation prevention interventions.To effectively identify and manage the risk of unplanned extubation,a comprehensive and universal unplanned extubation risk assessment tool is needed.AIM To assess the predictive value of the Huaxi Unplanned Extubation Risk Assessment Scale in inpatients.METHODS This was a retrospective validation study.In this study,medical records were extracted between October 2020 and September 2021 from a tertiary comprehensive hospital in southwest China.For patients with tubes during hospitalization,the following information was extracted from the hospital information system:age,sex,admission mode,education,marital status,number of tubes,discharge mode,unplanned extubation occurrence,and the Huaxi Unplanned Extubation Risk Assessment Scale(HUERAS)score.Only inpatients were included,and those with indwelling needles were excluded.The best cut-off value and the area under the curve(AUC)of the Huaxi Unplanned Extubation Risk Assessment Scale were been identified.RESULTS A total of 76033 inpatients with indwelling tubes were included in this study,and 26 unplanned extubations occurred.The patients’HUERAS scores were between 11 and 30,with an average score of 17.25±3.73.The scores of patients with or without unplanned extubation were 22.85±3.28 and 17.25±3.73,respectively(P<0.001).The results of the correlation analysis showed that the correlation coefficients between each characteristic and the total score ranged from 0.183 to 0.843.The best cut-off value was 21,and there were 14135 patients with a high risk of unplanned extubation,accounting for 18.59%.The Cronbach’sα,sensitivity,specificity,positive predictive value,and negative predictive value of the Huaxi Unplanned Extubation Risk Assessment Scale were 0.815,84.62%,81.43%,0.16%,and 99.99%,respectively.The AUC of HUERAS was 0.851(95%CI:0.783-0.919,P<0.001).CONCLUSION The HUERAS has good reliability and predictive validity.It can effectively identify inpatients at a high risk of unplanned extubation and help clinical nurses carry out risk screening and management.展开更多
Objective To analyze factors associated with unplanned revascularization(UR) risk in patients with coronary artery disease(CAD) who underwent percutaneous coronary intervention(PCI).Methods A total of 10,640 cases wit...Objective To analyze factors associated with unplanned revascularization(UR) risk in patients with coronary artery disease(CAD) who underwent percutaneous coronary intervention(PCI).Methods A total of 10,640 cases with CAD who underwent PCI were analyzed. Multivariate COX regressions and competing risk regressions were applied.Results The patients who underwent UR following PCI in 30 days, 1, and 2 years accounted for 0.3%,6.5%, and 8.7%, respectively. After multivariate adjustment, the number of target lesions [hazard ratio(HR) = 2.320;95% confidence interval(CI): 1.643–3.277;P < 0.001], time of procedure(HR = 1.006;95%CI: 1.001–1.010;P = 0.014), body mass index(HR = 1.104;95% CI: 1.006–1.210;P = 0.036), incomplete revascularization(ICR)(HR = 2.476;95% CI: 1.030–5.952;P = 0.043), and age(HR = 1.037;95% CI:1.000–1.075;P = 0.048) were determined as independent risk factors of 30-day UR. Factors, including low-molecular-weight heparin or fondaparinux(HR = 0.618;95% CI: 0.531–0.719;P < 0.001), secondgeneration durable polymer drug-eluting stent(HR = 0.713;95% CI: 0.624–0.814;P < 0.001), left anterior descending artery involvement(HR = 0.654;95% CI: 0.530–0.807;P < 0.001), and age(HR = 0.992;95%CI: 0.985–0.998;P = 0.014), were independently associated with decreased two-year UR risk. While,Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery score(HR =1.024;95% CI: 1.014–1.033;P < 0.001) and ICR(HR = 1.549;95% CI: 1.290–1.860;P < 0.001) were negatively associated with two-year UR risk.Conclusion Specific factors were positively or negatively associated with short-and medium-long-term UR following PCI.展开更多
Introduction: Performance monitoring and performance improvement (PI) are increasingly important. Little is known regarding unplanned re-admission (UPR) in trauma patients. This study characterizes UPRs at one institu...Introduction: Performance monitoring and performance improvement (PI) are increasingly important. Little is known regarding unplanned re-admission (UPR) in trauma patients. This study characterizes UPRs at one institution. Methods: Retrospective descriptive review of UPR to a Level I Trauma Center Information was obtained on: initial trauma diagnoses, diagnosis precipitating UPR, discharge interval, treatment rendered and length of stay (LOS) during both encounters, and PI committee judgments. Characteristics of UPR patients were determined and compared to those of all discharged patients. Descriptive statistics were applied. Results: Over 2.5 years there were 2827 discharges and 58 UPR(2%). The majority of original diagnoses were related to blunt trauma and head injuries. UPR occurred at a median of 3 days, with 54% re-admitted to the trauma service. Operative rate for UPR patients during the initial admission was 48% with 28%requiring operation on the UPR. Headache and wound issues were responsible for 42% of UPR. Diagnosis precipitating UPR was primarily related to post-operative complications in 26% of all UPR and 57% of those undergoing operation on the initial admission. Median LOS for UPR was 3days with ICU care being required by 13%. Of all UPRs,33% were attributable to opportunities for improved care (OFI) during the first admission. Identified OFIs were related to errors in technique (53%), errors in judgment (27%), and system issues (20%). Of UPR without OFI, 87% were related to disease and13% systems issues. Conclusion: UPR at a Level I trauma center is rare, occurs shortly after discharge, is brief in duration and usually related to postoperative wound issues or headache. Post operative patients seem at greater risk for UPR. While most UPR are considered non-preventable, attention to discharge instructions,patient education, resident education and supervisionand outpatient support, may obviate a number of preventable UPRs.展开更多
Unplanned pregnancy is a pregnancy that is either mistimed or unwanted at the time of conception. It is a core concept in understanding the fertility of populations and the unmet need for contraception. Unintended pre...Unplanned pregnancy is a pregnancy that is either mistimed or unwanted at the time of conception. It is a core concept in understanding the fertility of populations and the unmet need for contraception. Unintended pregnancy is associated with an increased risk of morbidity for women, and with health behaviors during pregnancy with adverse effects. And the aim of this study is to establish the level of effect of the unplanned pregnancy in women college in Wadajir district. This study used a cross-sectional study design. And the aim of this study is to establish the level of effect of the unplanned pregnancy on women college in Wadajir district. This study was being used cross sectional study design. This research had undertaken Wadajir district in Banadir region Mogadishu-Somalia. The sample size was 60 participating in the data collection phase from 1-30 Jun 2020. This study used primary data. This was collected from respondents in the area of study. Data was collected using a pre-cod structured questionnaire for the survey. Data showed that: 39 (65%) of the respondents answered yes that lack of education caused most unplanned pregnancy, 40 (66%) said that low-income countries are the risk factor of unplanned pregnancy, 47 (78%) of the respondents answered family planning is most common preventive for unplanned pregnancy, and 0 (67%) said that school dropout is the most compilation of unplanned pregnancy. Based on the findings of this research, the knowledge of the majority of respondents about unplanned pregnancy among women college replied yes, and they also replied that the most cause of unplanned pregnancy among women college is lack of education.展开更多
A grid connected microgrid connects to the grid at a point of common coupling. Due to the great inertia of the grid which accelerates and decelerates the generator when its frequency tends to deviate, the grid connect...A grid connected microgrid connects to the grid at a point of common coupling. Due to the great inertia of the grid which accelerates and decelerates the generator when its frequency tends to deviate, the grid connected microgrid operates at a frequency of the infinity bus. Frequency instability is one of the major challenges facing the grid connected microgrid during islanding. The power demand variation causes the variation in rotor speed, resulting to frequency deviation. Frequency can be brought back to standard by varying the power generation to match with the varying load. The performance of the frequency stability control system at Mwenga hydroelectric microgrid has been studied. Through site visitation, the power demand and generation status data were collected and analysed for model preparation. The results of the study indicate that, during islanding, the Mwenga rural electrification project is observed to be subjected to power imbalance which leads to frequency instability. Although the frequency control system tries to keep the system at a nominal frequency by maintaining the continuous balance between generation and varying load demand, however the system still operates with large magnitude of overshoot, undershoot and longer settling time.展开更多
Objective: to analyze the influence of intensive nursing intervention on the prevention of unplanned extubation of ICU patients. Methods: 72 inpatients in ICU from September 2020 to October 2021 were selected as the r...Objective: to analyze the influence of intensive nursing intervention on the prevention of unplanned extubation of ICU patients. Methods: 72 inpatients in ICU from September 2020 to October 2021 were selected as the research object, and they were randomly divided into the observation group and the control group, with 36 cases in each group. The control group was given routine nursing care, and the observation group was given intensive nursing intervention, and the relevant indicators were compared. Results: the scores of nursing satisfaction in the observation group were higher than those in the control group (P0.05);The incidence of unplanned extubation in the observation group was significantly lower than that in the control group (8.33% vs 25.00%) (P0.05);The time spent in ICU in the observation group was significantly shorter than that in the control group (P0.05);The sleep time in the observation group was significantly higher than that in the control group (P0.05). Conclusion: intensive nursing intervention can effectively prevent unplanned extubation of ICU patients, prolong their sleep time and shorten their stay in ICU.展开更多
Objective:To investigate the application effect of quality control circle activities in reducing the rate of unplanned extubation of venous access in perioperative patients.Methods:The quality control circle method wa...Objective:To investigate the application effect of quality control circle activities in reducing the rate of unplanned extubation of venous access in perioperative patients.Methods:The quality control circle method was used to analyze the causes,identify the actual causes of unplanned out-of-control,take corresponding measures,formulate corresponding countermeasures,implement standardized management,and carry out continuous improvement.Results:Following the implementation of quality control circle activities,the rate of unplanned extubation of venous access in perioperative patients decreased from 27.35%before improvement to 3.42%after improvement.Conclusion:The use of quality control circle activities in the safety management of venous access in perioperative patients is conducive to reducing the rate of unplanned extubation of venous access in perioperative patients.展开更多
Background Unplanned extubation is associated with adverse outcomes in intensive care unit. The massive burn patient differs from other critically ill patients in many ways. However, little is known about the unplanne...Background Unplanned extubation is associated with adverse outcomes in intensive care unit. The massive burn patient differs from other critically ill patients in many ways. However, little is known about the unplanned decannulation （UD） in Burn Intensive Care Unit. This paper describes the special features of the circumstances and outcome of UD of tracheotomy tube in massive burn patients. Methods A case series study was performed between January 1999 and December 2008 and UD of tracheotomy tube was analyzed retrospectively. A total of 21 patients with 29 UD events were identified. Demographic data, diagnosis, intervention, UD events and outcome of UD patients were collected. Differences in proportions were compared using the chi-square （X2） or Fisher＇s exact test. Results Patients with UD were often burned with head and neck （67%） and combined with inhalation injury （62%）. The majority of them （76%） were transferred patients, occurred early （55%） and were accidental UD （79%）. UD events tended to happen in day shift （90%） and to be associated with the medical procedure that was performing by caregivers at besides （79%）. Loose of the stabilizing rope, medical procedure and tracheotomy malposition were the main causes of UD. Early UD and reintubation failure were associated with patients＇ death. Conclusions UD happened to massive burn patients can lead to patient death. Careful management of respiratory tract was essential for massive burn patients.展开更多
Objective:To describe the rates and temporal trends of inpatient end-of-life care among patients hospitalized with metastatic cancer in the United States.Methods:We used data from the Nationwide Inpatient Sample to co...Objective:To describe the rates and temporal trends of inpatient end-of-life care among patients hospitalized with metastatic cancer in the United States.Methods:We used data from the Nationwide Inpatient Sample to conduct a cross-sectional analysis of unplanned inpatient hospitalizations of patients aged 18 years or older with metastatic cancer from 2002 to 2011.Multivariable logistic regression was used to assess patient-and hospital-level predictors of discharge to hospice care,palliative care,and in-hospital mortality.Temporal trends in outcomes were characterized with use of joinpoint regression.Results:There were an estimated 350,241 unplanned hospitalizations per year of patients with a diagnosis of metastatic cancer.During their inpatient stay,5.8%of patients received palliative care,and among those discharged alive,12.2%were referred to hospice care.The rate of inpatient palliative care increased from 2.3%to 13.6%,the rate of discharge to hospice care increased from 4.1%to 15.6%,and the in-hospital mortality rate decreased from more than 14.0%to 9.8%.These patterns were consistent across cancer subtypes,and were most pronounced among patients with extreme risk of mortality.Conclusion:Despite increases in the provision of comfort-oriented care to patients with meta-static cancer,few receive such services.We recommend screening protocols in hospitals to identify patients who are good candidates for palliative care consultation and hospice referral.展开更多
Steeply dipping,vein and tabular orebodies are traditionally extracted with longitudinal retreat mining methods such as Eureka and Avoca in a bottom-up sequence with delayed backfill.To increase productivity,sill pill...Steeply dipping,vein and tabular orebodies are traditionally extracted with longitudinal retreat mining methods such as Eureka and Avoca in a bottom-up sequence with delayed backfill.To increase productivity,sill pillars in the orebody are used to separate mining zones thus allowing production to take place simultaneously in two or more zones.While such mining methods are productive,they may be accompanied with high volumes of hanging wall overbreak causing significant unplanned ore dilution.In this work,it is shown through a mine design case study of a narrow vein deposit that a sill pillar could also play a significant role in limiting hanging wall overbreak.To demonstrate the role of sill pillar,a novel numerical modelling scheme is proposed to account for progressive stope wall overbreak.A numerical modelling approach of element death and rebirth is developed to allow for the detected stope overbreak to be immediately removed and replaced with backfill material before upper-level stope extraction.It is further shown that the average overbreak volume could be reduced by as much as 33%when the sill pillar is strategically placed in the lower half of a mine plan.展开更多
In order to ascertain prevalence rate of premarital sexual intercourse,unintended pregnancy and abortion,and evaluate associated factors of unintended pregnancy among undergraduates from all over China,the representat...In order to ascertain prevalence rate of premarital sexual intercourse,unintended pregnancy and abortion,and evaluate associated factors of unintended pregnancy among undergraduates from all over China,the representative sample of unmarried undergraduates was obtained by using a multi-stage,stratified,probability cluster design,and data were collected by using a survey questionnaire.62 326 available responders were gained.11.6% of them acknowledged having experiences of premarital sexual intercourse（standardized prevalence rate of sexual intercourse was 13.8%）.31.5% of students active in premarital sex acknowledged undergoing unintended pregnancy.76.2% of pregnant students selected abortion to end it.Of students active in premarital sex,46.2% used contraception at the first sexual intercourse,28.2% replied ＂always＂ using contraception in sexual intercourse.The rate of using condoms,oral contraceptives（OCs）,and withdrawal among students who had used contraception was 52.0%,31.0%,and 27.2% respectively.＂No preparation for sex＂（40.3%）,＂pleasure decrement＂（32.1%）,＂won＇t-be-pregnancy in occasional sexual intercourse＂（30.2%） were their common excuses for using no contraception.The identified risk factors for unintended pregnancy among students active in premarital sex by multivariate analysis were as follows：having no steady lover [having no steady lover vs having a steady lover：odds ratio（OR）,1.875;95% confidence interval（CI）,1.629-2.158],unaware of the course of conception（unaware vs aware：OR,2.023;95% CI,1.811-2.260）,considering abortion not endanger women＇s physical and mental health（no endangerment vs endangerment：OR,2.659;95% CI,2.265-3.121）,nonuse of contraception（never use vs always use：OR,1.682;95% CI,1.295-2.185）.Medical students were not less likely to experience an unintended pregnancy than nonmedical students（OR,1.111;95% CI,0.906-1.287）.The substantial proportion of unintended pregnancy among undergraduates indicates a need for convenient and targeted contraceptive education and services.展开更多
One of the most serious conundrum facing the stope production in underground metalliferous mining is uneven break （UB： unplanned dilution and ore-loss）. Although the UB has a huge economic fallout to the entire min...One of the most serious conundrum facing the stope production in underground metalliferous mining is uneven break （UB： unplanned dilution and ore-loss）. Although the UB has a huge economic fallout to the entire mining process, it is practically unavoidable due to the complex causing mechanism. In this study, the contribution of ten major UB causative parameters ha,; been scrutinised based on a published UB predicting artificial neuron network （ANN） model to put UB under the engineering management. Two typical ANN sensitivity analysis methods, i.e., connection weight algorithm （CWA） and profile method （PM） have been applied. As a result of CWA and PM applications, adjusted Qrate （AQ） revealed as the most influential parameter to UB with contribution of 22,40% in CWA and 20,48% in PM respectively. The findings of this study can be used as an important reference in stope design, production, and reconciliation stages on underground stoping mine.展开更多
Introduction: As far as adult and married women were concerned, when they occurred to “unplanned pregnancy”, they felt so surprised and concussive all the time. Besides, the unplanned pregnancy also affects the othe...Introduction: As far as adult and married women were concerned, when they occurred to “unplanned pregnancy”, they felt so surprised and concussive all the time. Besides, the unplanned pregnancy also affects the other members in the family system. Therefore, when married women have to face the choice: “birth” or “abortion”, they’ll consider lots of thoughts and different decision criteria and decision pattern under various influences on physician, mind, mental and society. The purpose of this study was to investigate the criteria considered and the decision patterns involved when adult married women decide whether to terminate or continue an unplanned pregnancy. Methods: The study uses the method—“Ethnographic Decision Tree Modeling” [1] to build model of the decision criteria and decision patterns involved when adult married women make a decision about their unplanned pregnancy. There are three process in the research method: “Pilot Study”—interview two groups, every group distinct 4 married adult women with unplanned pregnancies, which decide whether to terminate or continue an unplanned pregnancy, what is the items of decision characters affect to the choice: “birth” or “abortion”. “Building of the Model”, displays the importance in proper order of those items and build the modeling with these two groups of women. “Testing of the Model”: investigate the criteria considered and the decision patterns involved when adult married women decide whether to terminate or continue an unplanned pregnancy. The study interviewed 34 married adult women with 43 unplanned pregnancies totally. Results: The result of the study finds out 12 items of decision characters, including planning to get pregnant or not, stability of feelings for married partner, the points of view on life, was affected by mother, mother-in-law, an husband’s emphasis on male, the meanings of children, the financial burden, the plan an assignment of career and time, the past pregnant experiences, the status of raising children, the health of parents and fetus, the effect of living environment, and social and cultural vision. Besides, there are four decision patterns of married adult women with unplanned pregnancy are “receiving abortion positively”;“giving birth as long as getting pregnancy naturally”;“ the minds are hesitative and changeable”, and “being forced by important others.” Conclusion: By setting the decision model tree, we found several decision criteria and patterns, and possible modes actions to be taken, could offer to see the adult married women’s decision-making and struggles in mind about unplanned pregnancy.展开更多
Purpose: The purpose of this review was to identify evidence about determinants of male engagement in family planning. Methods: An integrative review was used to assess the determinants of male engagement in family pl...Purpose: The purpose of this review was to identify evidence about determinants of male engagement in family planning. Methods: An integrative review was used to assess the determinants of male engagement in family planning. Data search was between 2014 and 2019 using Google Scholar, Scopus, Web of Science, Science Direct, Pub Med, Medline, CINAHL, EBSCO, Cochrane, and EBSCO host. A total of 14 articles met the eligibility criteria. Results: The fourteen reviewed articles were adopted with mixed method designs, randomized controlled trial, quazi-experimental, and survey. Themes were: determinant of male engagement in family planning, women perception of male enrolment in family planning, and methods to enhance male use of family planning. Conclusion: Religion, large family size, culture, fear of side effect, access and exposure to information, attitudes, norms and self-efficacy and interaction with a health care provider are determinants of male involvement in family planning use. Interventional programs by health care providers and intensive education to men will positively increase prevalence of family planning use. It’s recommended to involve religious leaders in education. Implication: More attention is needed at community and governmental level to identify strategies to promote gender equity, shared decision making, shared responsibility and positive participation of men, empowering women, and to increase effectiveness of male participation.展开更多
Background: Unsafe abortion is a commonly neglected sexual and reproductive health and rights issue despite the serious health problems it causes to women and girls in their reproductive ages. It is classified as a ma...Background: Unsafe abortion is a commonly neglected sexual and reproductive health and rights issue despite the serious health problems it causes to women and girls in their reproductive ages. It is classified as a main cause of maternal mortality and morbidity. This paper has considered questions that have the greatest potential to successfully reduce unsafe abortions in the resource poor settings. Methods: We adapted the Child Health and Nutrition Research Initiative (CHNRI) to identify and prioritize many competing sexual and reproductive health and rights research ideas that impact the health of the populations. The implementation was done in three phases which included generation and collection of research ideas from various experts virtually in August 2019 consolidation of the potential questions through thematic analysis conducted in September 2019. Finally, scoring and ranking of the research questions was done in a workshop of experts. Results: Out of a list of 45 priority research questions, two questions were ranked the highest scoring 28 out of the possible 30. The research priorities include: “The effectiveness of interventions (e.g. counseling or incentives or home visits) to increase post abortion uptake and continuance”, “Reducing repeat abortion on improving maternal health outcomes” and “Evaluation of community-based awareness programs to reduce unwanted pregnancies and encourage women to seek help early”. Conclusions: Ten key research priorities in preventing unsafe abortion were identified. The priority list covers areas of focus that could effectively impact preventing unsafe abortions while also acting as a knowledge base for researchers, policy makers and other interested stakeholders who would want to invest in this area.展开更多
文摘BACKGROUND The need for an emergency upgrade of a hospitalized trauma patient from the floor to the trauma intensive care unit(ICU)is an unanticipated event with possible life-threatening consequences.Unplanned ICU admissions are associated with increased morbidity and mortality and are an indicator of trauma service quality.Two different types of unplanned ICU admissions include upgrades(patients admitted to the floor then moved to the ICU)and bounce backs(patients admitted to the ICU,discharged to the floor,and then readmitted to the ICU).Previous studies have shown that geriatric trauma patients are at higher risk for unfavorable outcomes.AIM To analyze the characteristics,management and outcomes of trauma patients who had an unplanned ICU admission during their hospitalization.METHODS This institutional review board approved,retrospective cohort study examined 203 adult trauma patients with unplanned ICU admission at an urban level 1 trauma center over a six-year period(2017-2023).This included 134 upgrades and 69 bounce backs.Analyzed variables included:(1)Age;(2)Sex;(3)Comorbidities;(4)Mechanism of injury(MOI);(5)Injury severity score(ISS);(6)Glasgow Coma Scale(GCS);(7)Type of injury;(8)Transfusions;(9)Consultations;(10)Timing and reason for unplanned admission;(11)Intubations;(12)Surgical interventions;(13)ICU and hospital lengths of stay;and(14)Mortality.RESULTS Unplanned ICU admissions comprised 4.2%of total ICU admissions.Main MOI was falls.Mean age was 70.7 years,ISS was 12.8 and GCS was 13.9.Main injuries were traumatic brain injury(37.4%)and thoracic injury(21.7%),and main reason for unplanned ICU admission was respiratory complication(39.4%).The 47.3%underwent a surgical procedure and 46.8%were intubated.Average timing for unplanned ICU admission was 2.9 days.Bounce backs occurred half as often as upgrades,however had higher rates of transfusions(63.8%vs 40.3%,P=0.002),consultations(4.8 vs 3.0,P<0.001),intubations(63.8%vs 38.1%%,P=0.001),longer ICU lengths of stay(13.2 days vs 6.4 days,P<0.001)and hospital lengths of stay(26.7 days vs 13.0 days,P<0.001).Mortality was 25.6%among unplanned ICU admissions,31.9%among geriatric unplanned ICU admissions and 11.9%among all trauma ICU patients.CONCLUSION Unplanned ICU admissions constituted 4.2%of total ICU admissions.Respiratory complications were the main cause of unplanned ICU admissions.Bounce backs occurred half as often as upgrades,but were associated with worse outcomes.
文摘BACKGROUND Pedicle screw instrumentation is a critical technique in spinal surgery,offering effective stabilization for various spinal conditions.However,the impact of intraoperative imaging quality—specifically the use of both anteroposterior(AP)and lateral views—on surgical outcomes remains insufficiently studied.Evaluating whether the adequacy of these imaging modalities affects the risk of unplanned returns to theatre(URTT)within 90 days due to screw malplacement is essential for refining surgical practices and improving patient care.AIM To evaluate how intraoperative imaging adequacy influences unplanned returnto-theatre rates,focusing on AP and lateral fluoroscopic views.METHODS This retrospective cohort study analyzed 1335 patients who underwent thoracolumbar and sacral pedicle screw instrumentation between January 2013 and December 2022.Data on intraoperative imaging adequacy,screw placement,and URTT events were collected and statistically analyzed using IBM SPSS v23.Imaging adequacy was assessed based on the presence of both AP and lateral views,and outcomes were compared between imaging groups.RESULTS A total of 9016 pedicle screws were inserted,with 82 screws identified as malplaced in 52 patients.Of these,46 patients required URTT due to screw malplacement,with 37 returning within 90 days(URTT90).Patients with both AP and lateral imaging saved intraoperatively had significantly lower URTT90 rates compared to those with only lateral imaging saved,demonstrating the critical role of imaging adequacy in improving surgical outcomes.CONCLUSION This study underscores that comprehensive intraoperative imaging with both AP and lateral views reduces unplanned returns,improves outcomes,enhances precision,and offers a cost-effective approach for better spinal surgery results.
文摘From the perspective of unplanned readmission in patients with enterostomy,this study reviewed the incidence,influencing factors and intervention measures,to provide reference for increasing the attention of medical staff,early detection of risk factors and formulation of personalized intervention measures.
基金This study has been reviewed and approved by the Clinical Research Ethics Committee of Wenzhou Central Hospital and the First Hospital Affiliated to Wenzhou Medical University,No.KY2024-R016.
文摘BACKGROUND Colorectal cancer significantly impacts global health,with unplanned reoperations post-surgery being key determinants of patient outcomes.Existing predictive models for these reoperations lack precision in integrating complex clinical data.AIM To develop and validate a machine learning model for predicting unplanned reoperation risk in colorectal cancer patients.METHODS Data of patients treated for colorectal cancer(n=2044)at the First Affiliated Hospital of Wenzhou Medical University and Wenzhou Central Hospital from March 2020 to March 2022 were retrospectively collected.Patients were divided into an experimental group(n=60)and a control group(n=1984)according to unplanned reoperation occurrence.Patients were also divided into a training group and a validation group(7:3 ratio).We used three different machine learning methods to screen characteristic variables.A nomogram was created based on multifactor logistic regression,and the model performance was assessed using receiver operating characteristic curve,calibration curve,Hosmer-Lemeshow test,and decision curve analysis.The risk scores of the two groups were calculated and compared to validate the model.RESULTS More patients in the experimental group were≥60 years old,male,and had a history of hypertension,laparotomy,and hypoproteinemia,compared to the control group.Multiple logistic regression analysis confirmed the following as independent risk factors for unplanned reoperation(P<0.05):Prognostic Nutritional Index value,history of laparotomy,hypertension,or stroke,hypoproteinemia,age,tumor-node-metastasis staging,surgical time,gender,and American Society of Anesthesiologists classification.Receiver operating characteristic curve analysis showed that the model had good discrimination and clinical utility.CONCLUSION This study used a machine learning approach to build a model that accurately predicts the risk of postoperative unplanned reoperation in patients with colorectal cancer,which can improve treatment decisions and prognosis.
基金Supported by West China Nursing Discipline Development Special Fund Project,Sichuan University,No.HXHL19059。
文摘BACKGROUND Critical patients often had various types of tubes,unplanned extubation of any kind of tube may cause serious injury to the patient,but previous reports mainly focused on endotracheal intubation.The limitations or incorrect use of the unplanned extubation risk assessment tool may lead to improper identification of patients at a high risk of unplanned extubation and cause delay or nonimplementation of unplanned extubation prevention interventions.To effectively identify and manage the risk of unplanned extubation,a comprehensive and universal unplanned extubation risk assessment tool is needed.AIM To assess the predictive value of the Huaxi Unplanned Extubation Risk Assessment Scale in inpatients.METHODS This was a retrospective validation study.In this study,medical records were extracted between October 2020 and September 2021 from a tertiary comprehensive hospital in southwest China.For patients with tubes during hospitalization,the following information was extracted from the hospital information system:age,sex,admission mode,education,marital status,number of tubes,discharge mode,unplanned extubation occurrence,and the Huaxi Unplanned Extubation Risk Assessment Scale(HUERAS)score.Only inpatients were included,and those with indwelling needles were excluded.The best cut-off value and the area under the curve(AUC)of the Huaxi Unplanned Extubation Risk Assessment Scale were been identified.RESULTS A total of 76033 inpatients with indwelling tubes were included in this study,and 26 unplanned extubations occurred.The patients’HUERAS scores were between 11 and 30,with an average score of 17.25±3.73.The scores of patients with or without unplanned extubation were 22.85±3.28 and 17.25±3.73,respectively(P<0.001).The results of the correlation analysis showed that the correlation coefficients between each characteristic and the total score ranged from 0.183 to 0.843.The best cut-off value was 21,and there were 14135 patients with a high risk of unplanned extubation,accounting for 18.59%.The Cronbach’sα,sensitivity,specificity,positive predictive value,and negative predictive value of the Huaxi Unplanned Extubation Risk Assessment Scale were 0.815,84.62%,81.43%,0.16%,and 99.99%,respectively.The AUC of HUERAS was 0.851(95%CI:0.783-0.919,P<0.001).CONCLUSION The HUERAS has good reliability and predictive validity.It can effectively identify inpatients at a high risk of unplanned extubation and help clinical nurses carry out risk screening and management.
基金National Natural Science Foundation of China No. 81770365National Key Research and Development Program of China No. 2016YFC1301301Beijing United Heart Foundation No. BJUHFCSOARF201901-19。
文摘Objective To analyze factors associated with unplanned revascularization(UR) risk in patients with coronary artery disease(CAD) who underwent percutaneous coronary intervention(PCI).Methods A total of 10,640 cases with CAD who underwent PCI were analyzed. Multivariate COX regressions and competing risk regressions were applied.Results The patients who underwent UR following PCI in 30 days, 1, and 2 years accounted for 0.3%,6.5%, and 8.7%, respectively. After multivariate adjustment, the number of target lesions [hazard ratio(HR) = 2.320;95% confidence interval(CI): 1.643–3.277;P < 0.001], time of procedure(HR = 1.006;95%CI: 1.001–1.010;P = 0.014), body mass index(HR = 1.104;95% CI: 1.006–1.210;P = 0.036), incomplete revascularization(ICR)(HR = 2.476;95% CI: 1.030–5.952;P = 0.043), and age(HR = 1.037;95% CI:1.000–1.075;P = 0.048) were determined as independent risk factors of 30-day UR. Factors, including low-molecular-weight heparin or fondaparinux(HR = 0.618;95% CI: 0.531–0.719;P < 0.001), secondgeneration durable polymer drug-eluting stent(HR = 0.713;95% CI: 0.624–0.814;P < 0.001), left anterior descending artery involvement(HR = 0.654;95% CI: 0.530–0.807;P < 0.001), and age(HR = 0.992;95%CI: 0.985–0.998;P = 0.014), were independently associated with decreased two-year UR risk. While,Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery score(HR =1.024;95% CI: 1.014–1.033;P < 0.001) and ICR(HR = 1.549;95% CI: 1.290–1.860;P < 0.001) were negatively associated with two-year UR risk.Conclusion Specific factors were positively or negatively associated with short-and medium-long-term UR following PCI.
文摘Introduction: Performance monitoring and performance improvement (PI) are increasingly important. Little is known regarding unplanned re-admission (UPR) in trauma patients. This study characterizes UPRs at one institution. Methods: Retrospective descriptive review of UPR to a Level I Trauma Center Information was obtained on: initial trauma diagnoses, diagnosis precipitating UPR, discharge interval, treatment rendered and length of stay (LOS) during both encounters, and PI committee judgments. Characteristics of UPR patients were determined and compared to those of all discharged patients. Descriptive statistics were applied. Results: Over 2.5 years there were 2827 discharges and 58 UPR(2%). The majority of original diagnoses were related to blunt trauma and head injuries. UPR occurred at a median of 3 days, with 54% re-admitted to the trauma service. Operative rate for UPR patients during the initial admission was 48% with 28%requiring operation on the UPR. Headache and wound issues were responsible for 42% of UPR. Diagnosis precipitating UPR was primarily related to post-operative complications in 26% of all UPR and 57% of those undergoing operation on the initial admission. Median LOS for UPR was 3days with ICU care being required by 13%. Of all UPRs,33% were attributable to opportunities for improved care (OFI) during the first admission. Identified OFIs were related to errors in technique (53%), errors in judgment (27%), and system issues (20%). Of UPR without OFI, 87% were related to disease and13% systems issues. Conclusion: UPR at a Level I trauma center is rare, occurs shortly after discharge, is brief in duration and usually related to postoperative wound issues or headache. Post operative patients seem at greater risk for UPR. While most UPR are considered non-preventable, attention to discharge instructions,patient education, resident education and supervisionand outpatient support, may obviate a number of preventable UPRs.
文摘Unplanned pregnancy is a pregnancy that is either mistimed or unwanted at the time of conception. It is a core concept in understanding the fertility of populations and the unmet need for contraception. Unintended pregnancy is associated with an increased risk of morbidity for women, and with health behaviors during pregnancy with adverse effects. And the aim of this study is to establish the level of effect of the unplanned pregnancy in women college in Wadajir district. This study used a cross-sectional study design. And the aim of this study is to establish the level of effect of the unplanned pregnancy on women college in Wadajir district. This study was being used cross sectional study design. This research had undertaken Wadajir district in Banadir region Mogadishu-Somalia. The sample size was 60 participating in the data collection phase from 1-30 Jun 2020. This study used primary data. This was collected from respondents in the area of study. Data was collected using a pre-cod structured questionnaire for the survey. Data showed that: 39 (65%) of the respondents answered yes that lack of education caused most unplanned pregnancy, 40 (66%) said that low-income countries are the risk factor of unplanned pregnancy, 47 (78%) of the respondents answered family planning is most common preventive for unplanned pregnancy, and 0 (67%) said that school dropout is the most compilation of unplanned pregnancy. Based on the findings of this research, the knowledge of the majority of respondents about unplanned pregnancy among women college replied yes, and they also replied that the most cause of unplanned pregnancy among women college is lack of education.
文摘A grid connected microgrid connects to the grid at a point of common coupling. Due to the great inertia of the grid which accelerates and decelerates the generator when its frequency tends to deviate, the grid connected microgrid operates at a frequency of the infinity bus. Frequency instability is one of the major challenges facing the grid connected microgrid during islanding. The power demand variation causes the variation in rotor speed, resulting to frequency deviation. Frequency can be brought back to standard by varying the power generation to match with the varying load. The performance of the frequency stability control system at Mwenga hydroelectric microgrid has been studied. Through site visitation, the power demand and generation status data were collected and analysed for model preparation. The results of the study indicate that, during islanding, the Mwenga rural electrification project is observed to be subjected to power imbalance which leads to frequency instability. Although the frequency control system tries to keep the system at a nominal frequency by maintaining the continuous balance between generation and varying load demand, however the system still operates with large magnitude of overshoot, undershoot and longer settling time.
文摘Objective: to analyze the influence of intensive nursing intervention on the prevention of unplanned extubation of ICU patients. Methods: 72 inpatients in ICU from September 2020 to October 2021 were selected as the research object, and they were randomly divided into the observation group and the control group, with 36 cases in each group. The control group was given routine nursing care, and the observation group was given intensive nursing intervention, and the relevant indicators were compared. Results: the scores of nursing satisfaction in the observation group were higher than those in the control group (P0.05);The incidence of unplanned extubation in the observation group was significantly lower than that in the control group (8.33% vs 25.00%) (P0.05);The time spent in ICU in the observation group was significantly shorter than that in the control group (P0.05);The sleep time in the observation group was significantly higher than that in the control group (P0.05). Conclusion: intensive nursing intervention can effectively prevent unplanned extubation of ICU patients, prolong their sleep time and shorten their stay in ICU.
文摘Objective:To investigate the application effect of quality control circle activities in reducing the rate of unplanned extubation of venous access in perioperative patients.Methods:The quality control circle method was used to analyze the causes,identify the actual causes of unplanned out-of-control,take corresponding measures,formulate corresponding countermeasures,implement standardized management,and carry out continuous improvement.Results:Following the implementation of quality control circle activities,the rate of unplanned extubation of venous access in perioperative patients decreased from 27.35%before improvement to 3.42%after improvement.Conclusion:The use of quality control circle activities in the safety management of venous access in perioperative patients is conducive to reducing the rate of unplanned extubation of venous access in perioperative patients.
文摘Background Unplanned extubation is associated with adverse outcomes in intensive care unit. The massive burn patient differs from other critically ill patients in many ways. However, little is known about the unplanned decannulation （UD） in Burn Intensive Care Unit. This paper describes the special features of the circumstances and outcome of UD of tracheotomy tube in massive burn patients. Methods A case series study was performed between January 1999 and December 2008 and UD of tracheotomy tube was analyzed retrospectively. A total of 21 patients with 29 UD events were identified. Demographic data, diagnosis, intervention, UD events and outcome of UD patients were collected. Differences in proportions were compared using the chi-square （X2） or Fisher＇s exact test. Results Patients with UD were often burned with head and neck （67%） and combined with inhalation injury （62%）. The majority of them （76%） were transferred patients, occurred early （55%） and were accidental UD （79%）. UD events tended to happen in day shift （90%） and to be associated with the medical procedure that was performing by caregivers at besides （79%）. Loose of the stabilizing rope, medical procedure and tracheotomy malposition were the main causes of UD. Early UD and reintubation failure were associated with patients＇ death. Conclusions UD happened to massive burn patients can lead to patient death. Careful management of respiratory tract was essential for massive burn patients.
文摘Objective:To describe the rates and temporal trends of inpatient end-of-life care among patients hospitalized with metastatic cancer in the United States.Methods:We used data from the Nationwide Inpatient Sample to conduct a cross-sectional analysis of unplanned inpatient hospitalizations of patients aged 18 years or older with metastatic cancer from 2002 to 2011.Multivariable logistic regression was used to assess patient-and hospital-level predictors of discharge to hospice care,palliative care,and in-hospital mortality.Temporal trends in outcomes were characterized with use of joinpoint regression.Results:There were an estimated 350,241 unplanned hospitalizations per year of patients with a diagnosis of metastatic cancer.During their inpatient stay,5.8%of patients received palliative care,and among those discharged alive,12.2%were referred to hospice care.The rate of inpatient palliative care increased from 2.3%to 13.6%,the rate of discharge to hospice care increased from 4.1%to 15.6%,and the in-hospital mortality rate decreased from more than 14.0%to 9.8%.These patterns were consistent across cancer subtypes,and were most pronounced among patients with extreme risk of mortality.Conclusion:Despite increases in the provision of comfort-oriented care to patients with meta-static cancer,few receive such services.We recommend screening protocols in hospitals to identify patients who are good candidates for palliative care consultation and hospice referral.
基金financially supported by the Natural Science and Engineering Research Council(NSERC)-Discovery Grants Program。
文摘Steeply dipping,vein and tabular orebodies are traditionally extracted with longitudinal retreat mining methods such as Eureka and Avoca in a bottom-up sequence with delayed backfill.To increase productivity,sill pillars in the orebody are used to separate mining zones thus allowing production to take place simultaneously in two or more zones.While such mining methods are productive,they may be accompanied with high volumes of hanging wall overbreak causing significant unplanned ore dilution.In this work,it is shown through a mine design case study of a narrow vein deposit that a sill pillar could also play a significant role in limiting hanging wall overbreak.To demonstrate the role of sill pillar,a novel numerical modelling scheme is proposed to account for progressive stope wall overbreak.A numerical modelling approach of element death and rebirth is developed to allow for the detected stope overbreak to be immediately removed and replaced with backfill material before upper-level stope extraction.It is further shown that the average overbreak volume could be reduced by as much as 33%when the sill pillar is strategically placed in the lower half of a mine plan.
基金supported by a grant from The Chinese"11th" Five-Year Plan" Supporting Science and Technology Project (No. 2006BAI15B04)
文摘In order to ascertain prevalence rate of premarital sexual intercourse,unintended pregnancy and abortion,and evaluate associated factors of unintended pregnancy among undergraduates from all over China,the representative sample of unmarried undergraduates was obtained by using a multi-stage,stratified,probability cluster design,and data were collected by using a survey questionnaire.62 326 available responders were gained.11.6% of them acknowledged having experiences of premarital sexual intercourse（standardized prevalence rate of sexual intercourse was 13.8%）.31.5% of students active in premarital sex acknowledged undergoing unintended pregnancy.76.2% of pregnant students selected abortion to end it.Of students active in premarital sex,46.2% used contraception at the first sexual intercourse,28.2% replied ＂always＂ using contraception in sexual intercourse.The rate of using condoms,oral contraceptives（OCs）,and withdrawal among students who had used contraception was 52.0%,31.0%,and 27.2% respectively.＂No preparation for sex＂（40.3%）,＂pleasure decrement＂（32.1%）,＂won＇t-be-pregnancy in occasional sexual intercourse＂（30.2%） were their common excuses for using no contraception.The identified risk factors for unintended pregnancy among students active in premarital sex by multivariate analysis were as follows：having no steady lover [having no steady lover vs having a steady lover：odds ratio（OR）,1.875;95% confidence interval（CI）,1.629-2.158],unaware of the course of conception（unaware vs aware：OR,2.023;95% CI,1.811-2.260）,considering abortion not endanger women＇s physical and mental health（no endangerment vs endangerment：OR,2.659;95% CI,2.265-3.121）,nonuse of contraception（never use vs always use：OR,1.682;95% CI,1.295-2.185）.Medical students were not less likely to experience an unintended pregnancy than nonmedical students（OR,1.111;95% CI,0.906-1.287）.The substantial proportion of unintended pregnancy among undergraduates indicates a need for convenient and targeted contraceptive education and services.
文摘One of the most serious conundrum facing the stope production in underground metalliferous mining is uneven break （UB： unplanned dilution and ore-loss）. Although the UB has a huge economic fallout to the entire mining process, it is practically unavoidable due to the complex causing mechanism. In this study, the contribution of ten major UB causative parameters ha,; been scrutinised based on a published UB predicting artificial neuron network （ANN） model to put UB under the engineering management. Two typical ANN sensitivity analysis methods, i.e., connection weight algorithm （CWA） and profile method （PM） have been applied. As a result of CWA and PM applications, adjusted Qrate （AQ） revealed as the most influential parameter to UB with contribution of 22,40% in CWA and 20,48% in PM respectively. The findings of this study can be used as an important reference in stope design, production, and reconciliation stages on underground stoping mine.
文摘Introduction: As far as adult and married women were concerned, when they occurred to “unplanned pregnancy”, they felt so surprised and concussive all the time. Besides, the unplanned pregnancy also affects the other members in the family system. Therefore, when married women have to face the choice: “birth” or “abortion”, they’ll consider lots of thoughts and different decision criteria and decision pattern under various influences on physician, mind, mental and society. The purpose of this study was to investigate the criteria considered and the decision patterns involved when adult married women decide whether to terminate or continue an unplanned pregnancy. Methods: The study uses the method—“Ethnographic Decision Tree Modeling” [1] to build model of the decision criteria and decision patterns involved when adult married women make a decision about their unplanned pregnancy. There are three process in the research method: “Pilot Study”—interview two groups, every group distinct 4 married adult women with unplanned pregnancies, which decide whether to terminate or continue an unplanned pregnancy, what is the items of decision characters affect to the choice: “birth” or “abortion”. “Building of the Model”, displays the importance in proper order of those items and build the modeling with these two groups of women. “Testing of the Model”: investigate the criteria considered and the decision patterns involved when adult married women decide whether to terminate or continue an unplanned pregnancy. The study interviewed 34 married adult women with 43 unplanned pregnancies totally. Results: The result of the study finds out 12 items of decision characters, including planning to get pregnant or not, stability of feelings for married partner, the points of view on life, was affected by mother, mother-in-law, an husband’s emphasis on male, the meanings of children, the financial burden, the plan an assignment of career and time, the past pregnant experiences, the status of raising children, the health of parents and fetus, the effect of living environment, and social and cultural vision. Besides, there are four decision patterns of married adult women with unplanned pregnancy are “receiving abortion positively”;“giving birth as long as getting pregnancy naturally”;“ the minds are hesitative and changeable”, and “being forced by important others.” Conclusion: By setting the decision model tree, we found several decision criteria and patterns, and possible modes actions to be taken, could offer to see the adult married women’s decision-making and struggles in mind about unplanned pregnancy.
文摘Purpose: The purpose of this review was to identify evidence about determinants of male engagement in family planning. Methods: An integrative review was used to assess the determinants of male engagement in family planning. Data search was between 2014 and 2019 using Google Scholar, Scopus, Web of Science, Science Direct, Pub Med, Medline, CINAHL, EBSCO, Cochrane, and EBSCO host. A total of 14 articles met the eligibility criteria. Results: The fourteen reviewed articles were adopted with mixed method designs, randomized controlled trial, quazi-experimental, and survey. Themes were: determinant of male engagement in family planning, women perception of male enrolment in family planning, and methods to enhance male use of family planning. Conclusion: Religion, large family size, culture, fear of side effect, access and exposure to information, attitudes, norms and self-efficacy and interaction with a health care provider are determinants of male involvement in family planning use. Interventional programs by health care providers and intensive education to men will positively increase prevalence of family planning use. It’s recommended to involve religious leaders in education. Implication: More attention is needed at community and governmental level to identify strategies to promote gender equity, shared decision making, shared responsibility and positive participation of men, empowering women, and to increase effectiveness of male participation.
文摘Background: Unsafe abortion is a commonly neglected sexual and reproductive health and rights issue despite the serious health problems it causes to women and girls in their reproductive ages. It is classified as a main cause of maternal mortality and morbidity. This paper has considered questions that have the greatest potential to successfully reduce unsafe abortions in the resource poor settings. Methods: We adapted the Child Health and Nutrition Research Initiative (CHNRI) to identify and prioritize many competing sexual and reproductive health and rights research ideas that impact the health of the populations. The implementation was done in three phases which included generation and collection of research ideas from various experts virtually in August 2019 consolidation of the potential questions through thematic analysis conducted in September 2019. Finally, scoring and ranking of the research questions was done in a workshop of experts. Results: Out of a list of 45 priority research questions, two questions were ranked the highest scoring 28 out of the possible 30. The research priorities include: “The effectiveness of interventions (e.g. counseling or incentives or home visits) to increase post abortion uptake and continuance”, “Reducing repeat abortion on improving maternal health outcomes” and “Evaluation of community-based awareness programs to reduce unwanted pregnancies and encourage women to seek help early”. Conclusions: Ten key research priorities in preventing unsafe abortion were identified. The priority list covers areas of focus that could effectively impact preventing unsafe abortions while also acting as a knowledge base for researchers, policy makers and other interested stakeholders who would want to invest in this area.
