A dynamic advanced planning and scheduling(DAPS)problem is addressed where new orders arrive on a continuous basis.A periodic policy with frozen interval is adopted to increase stability on the shop floor.A genetic al...A dynamic advanced planning and scheduling(DAPS)problem is addressed where new orders arrive on a continuous basis.A periodic policy with frozen interval is adopted to increase stability on the shop floor.A genetic algorithm is developed to find a schedule at each rescheduling point for both original orders and new orders that both production idle time and penalties on tardiness and earliness of orders are minimized.The proposed methodology is tested on a small example to illustrate the effect of the frozen interval.The results indicate that the suggested approach can improve the schedule stability while retaining efficiency.展开更多
This paper presents a case study for the advanced planning and scheduling （APS） problem encountered in a light source manufacturer. The APS problem explicitly considers due dates of products, operation sequences amo...This paper presents a case study for the advanced planning and scheduling （APS） problem encountered in a light source manufacturer. The APS problem explicitly considers due dates of products, operation sequences among items, and capacity constraints of the manufacturing system. The objective of the problem is to seek the minimum cost of both production idle time and tardiness or earliness penalty of an order. An intelligent heuristic is applied to the problem, and the results demonstrate that significant production performances can be achieved while ensuring customer satisfaction as opposed to normal oractices followed in the company relying on human expertise.展开更多
Objective:This study aimed to explore the readiness for advance care planning(ACP)among older adults in Macao’s day service centers and investigate the influencing factors.Methods:A cross-sectional study was conducte...Objective:This study aimed to explore the readiness for advance care planning(ACP)among older adults in Macao’s day service centers and investigate the influencing factors.Methods:A cross-sectional study was conducted from October to December 2022 using a convenience sampling method.A total of 312 older adults were selected from 13 day service centers for older adults in Macao,China.The Advance Care Planning Acceptance Questionnaire and the Family Adaptation,Partnership,Growth,Affection,Resolve(APGAR)Scale were used to survey the older adults.Results:A total of 306 older adults completed the survey.The score for advance care planning readiness was 65.55±10.69,and 59.5%of participants(n=182)were willing to participate in ACP.The family function score was 7.24±2.51,while 70.3%of participants were from a highly functional family.The higher family function indicating a higher readiness for advance care planning(r=0.396,P<0.001).The multiple linear regression analysis indicated that the variables“age,”“knowledge of ACP,”“experience with ACP,”and“received resuscitation of yourself,relatives or friends”combined with“family function”can influence advance care planning readiness among older adults(R^(2)=0.317,F=27.898,P<0.001).Conclusions:Older adults in Macao’s day service centers were willing to engage in ACP.The importance of family involvement is highlighted in the ACP readiness.Health education and improved family communication are vital for promoting ACP,which ensures individuals receive care when they lack the capacity to make that choice.Additionally,healthcare professionals should enhance communication and education with older adults during the medical care process.展开更多
Background:The goal of this study was to conduct a meta-synthesis of advanced cancer patients’and their relatives’experiences with advanced care planning(ACP)and to provide evidence-based guidance for the developmen...Background:The goal of this study was to conduct a meta-synthesis of advanced cancer patients’and their relatives’experiences with advanced care planning(ACP)and to provide evidence-based guidance for the development and implementation of ACP in advanced cancer patients.Methods:We searched databases including China Knowledge Network,Wanfang database,VIP database,China Biomedical Literature Database,PubMed,Web of Science,Embase,Cochrane Library,and Cinahl from inception to April 2022 to collect qualitative studies on advanced cancer patients and families'experience about ACP.We use Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research to evaluate the quality of literature.After quality assessment,meta-synthesis was used to summarize and explain the results.Results:Eleven qualitative studies were included involving 29 results and ten categories.Three integrated themes were extracted:facilitators and barriers to the implementation of advanced medical care programs as perceived by patients and families with advanced cancer;attitudes of patients with advanced cancer and their families towards pre-existing medical care programs;suggestions from patients with advanced cancer and their families on the implementation elements of the pre-existing medical care program.Conclusion:ACP is a complex social process and influenced by many factors.It requires joint efforts of different stakeholders to achieve high-quality and successful ACP.展开更多
Objective:This study aimed to describe the implementation of advance care planning(ACP)in patients with stroke.Methods:A scoping review was conducted according to the Arksey and O'Malley framework.Accordingly,we s...Objective:This study aimed to describe the implementation of advance care planning(ACP)in patients with stroke.Methods:A scoping review was conducted according to the Arksey and O'Malley framework.Accordingly,we searched for articles published in ScienceDirect,PubMed,Scopus,ProQuest,and Medline.The inclusion criteria were original research on ACP among adult or elderly stroke patients,hospital-or community-based studies,and those published in English or Indonesian.Qualitative analysis was then used to identify keywords,categories,and themes.Results:Among the 1,050 articles identified,only 8 satisfied the inclusion criteria,indicating that limited studies were available for ACP interventions among stroke patients.Four themes were ultimately identified:the strategy implementation of AC,the challenges of ACP implementation,the benefits of ACP,and the factors influencing ACP.Strategy ACP implementation included the ACP method,the communication style,participation role,media used,and ACP documentation.Lack of information about ACP,facilities,incapacitated patients,and reluctance to implement have become challenges to implementation in stroke.The benefits of ACP,particularly the outcomes of the ACP program,included awareness of ACP engagement,patients can express their wishes,and increased advance directive(AD)documentation.The factors influencing ACP included patient condition,knowledge,and appropriate ACP methods.Conclusion:ACP has not been widely used when providing interventions for stroke patients.The implementation of ACP in stroke patients is full of challenges due to various patient conditions.Effective strategies are needed to improve ACP in stroke patients.It is necessary to develop an ACP for stroke patients'method that involves interprofessional collaboration,and studies on AcP in stroke patients need to be further conducted through interprofessional collaboration.展开更多
This paper systematically reviews the research progress of Advance Care Planning(ACP)in the field of lung cancer,and discusses its implementation status,key influencing factors and future development direction,includi...This paper systematically reviews the research progress of Advance Care Planning(ACP)in the field of lung cancer,and discusses its implementation status,key influencing factors and future development direction,including deepening of theoretical research,innovation of practice mode,optimization of policy support and cultural adaptation research.展开更多
Manufacturing system, with high level of complexity and with a mix of semi-repetitive and repetitive products, to become productive, should seek the standardization of products and processes to obtain the optimization...Manufacturing system, with high level of complexity and with a mix of semi-repetitive and repetitive products, to become productive, should seek the standardization of products and processes to obtain the optimization of use of production resources. However, it is necessary to measure the productivity, so that the system of measurement and control of manufacturing processes are an element critical as to ensure greater visibility of the flow＇s restrictions, minimized when detected properly. In this case, the automation of factory＇s measurement process can effectively contribute to ensuring the effectiveness of the function control of a manufacturing system. It is important to consider that the automation of the system of measurement and control of manufacturing processes, of complex environment, is heavily dependent of IT tools applied directly in the interface computational between the operation systems and the corporate systems. This heavy reliance, if exploited technically properly, allows that automation of the system of measurement and control of production makes the access to time real of availability of manufacturing process＇s data, such as processing time and setup time that it can export to a specialist software in programming production, for example, feasible. In this paper, the automation of the system of measurement and control of production is approached, in order to identify the main possibilities of the design of an information system capable to integrate the flow of information in an environment internal on manufacturing organizations, with emphasis in the digital manufacturing paradigm.展开更多
Advance care planning is a process of discussion in which patients can communicate their end-of-life care preferences to family members and health care providers for consideration.Readiness for advance care planning i...Advance care planning is a process of discussion in which patients can communicate their end-of-life care preferences to family members and health care providers for consideration.Readiness for advance care planning is a patient's preparedness to engage in advance care planning.This review aims to develop the conceptual framework for advance care planning readiness for Chinese older people.The current knowledge from the published studies was identified and synthesized by an integrative review.The conceptual framework was developed based on the social-ecological model and the theory of planned behavior.The factors from the social environment/community,health care professionals,and individual/family layers were defined.These factors may influence an individual's medical decision-making,which in turn triggers individual behavioral mechanisms that arise from interactions between motivations,attitudes,and beliefs.Relevant factors should be considered when assessing the behavior of personnel engaged in advance care planning or formulating appropriate intervention measures to improve advance care planning par ticipation in China.This framework can be used to guide studies that explore how the social/familial/individual factors predict the readiness for advance care planning among Chinese older people,and to design intervention studies to test the effect of family function on the readiness for advance care planning.展开更多
Backgroud:To provide a reference for the further development of the field of the advance care planning(ACP),through the visual analysis of the related literature on the ACP.Methods:Taking the core collection database ...Backgroud:To provide a reference for the further development of the field of the advance care planning(ACP),through the visual analysis of the related literature on the ACP.Methods:Taking the core collection database of Web of ScienceTM as data sources,the method of subject word retrieval is adopted.Literature metrology and CiteSpaceⅤinformation visualization software were used to analyze the literature on ACP published from inception to September 2019.Results:A total of 1,981 literature were included.The number of ACP studies increased,USA published the most literature in the world,followed by Australia,Britain,Canada and the Netherlands and so on.The most leading published journal was the Journal of Palliative Medicine,and the highest impact factor was Palliative Medicine(4.956).Sudore,Rebecca L and Hillary D Lum are the key researcher networks with the largest amount of articles published in ACP field.The research content mainly included the definition,implementation process and implementation effect of ACP.Research focused on palliative care,hospice care,decision-making,communication,patient preference and so on.Conclusion:The studies on ACP is on the rise,the research content is deepening,which suggests that we can learn from the research results of foreign countries in this field and continue to deepen the research in the field of ACP in China.展开更多
Aim:To comprehensively synthesize and compare the effect of advance care planning for dementia patients.Design:Systematic review and meta-analysis.Methods:Ten electronic databases will be searched:the Cochrane Library...Aim:To comprehensively synthesize and compare the effect of advance care planning for dementia patients.Design:Systematic review and meta-analysis.Methods:Ten electronic databases will be searched:the Cochrane Library,PubMed,Medline,Embase,PsycINFO,CINAHL PLUS,Scopus,Web of Science,British Nursing Index,clinical Trials,and grey literature sources.Individually or cluster randomized controlled trials that evaluated advance care planning in people with dementia will be incorporated.The research screening flow diagrams will be detailed in the PRISMA flow chart.Data extraction will be carried out in Microsoft Excel 2019 independently by two researchers,any disagreements will be discussed with the third researcher and resolved.We will use the Cochrane Risk of Bias tool to assess the methodological quality.Review Manager 5.3 Software will be used for data synthesis.If sufficient data from studies are available,we will conduct a subgroup analysis of the main outcomes.Conclusion:The systematic review will combine existing trials which may contribute to more convincing conclusions,providing new ideas for medical workers to implement palliative therapy in dementia patients,and further promoting the application of advance care planning for dementia patients.展开更多
Objective:To assess the ACP acceptance among patients with malignant tumor in China and factors affecting adoption and timing.Methods:Quantitative study:The convenience sampling method was adopted from October 2020 to...Objective:To assess the ACP acceptance among patients with malignant tumor in China and factors affecting adoption and timing.Methods:Quantitative study:The convenience sampling method was adopted from October 2020 to October 2021 to investigate 200 oncology patients by a general information questionnaire,patient's advance care planning acceptance questionnaire(ACPQ).Multiple linear stepwise regression was used to analyze the influencing factors of ACP acceptance.Qualitative study:A purposive sampling method was used to select 31 oncology patients and 13 clinical nurses for semi-structured interviews.The data were analyzed using Colaizzi's seven steps.Results:The quantitative study revealed that patients with malignancy had an upper-middle acceptance score of(66.15±7.684)for ACP,with attitude(11.26±2.064),feelings(36.64±4.208),and intention(18.25±3.275)scores.Multiple linear regression analysis showed that religious beliefs,education,monthly income,bereavement experience and notification of condition were independent risk factors for acceptance of ACP(P<0.05).The qualitative study showed that(1)oncology patients have low awareness,high demand,and low acceptability of ACP intervention;(2)they preferred to discuss ACP when medical condition or treatment plan changes;(3)family members were usually involved in ACP discussions,followed by medical personnel;(4)economy,environment,companion,and doctor-patient relationship will all influence ACP implementation.As for nurses,they(1)were unsure about the dynamic changes of ACP content and its optimal timing;(2)had limited ACP knowledge;(3)were affected by environmental factors and nurse-patient relationships;(4)were prone to have disagreements due to inadequate organization department assistance.Conclusions:clinical practitioners should discuss ACP with patients in specific conditions to increase patient acceptance.ACP development requires updated legislation,professional training,and a standardized ACP system.展开更多
The paper points out that the science and technology, social productivity and economic form are the decisive strengths in facilitating the reformation of the production method of the manufacturing industry. This kind ...The paper points out that the science and technology, social productivity and economic form are the decisive strengths in facilitating the reformation of the production method of the manufacturing industry. This kind of strength happens through making an influence on the theory of management and science. It analyses the stage and the characteristic of the development model of manufacturing industry of human society, and on this basis does the detailed research on the several patterns of the advanced manufacturing theory and practice： the computer integrated making, concurrent engineering, lean production, agile manufacturing, planning of enterprise resources, global manufacturing. Finally, it thinks that the development model of the advanced manufacture theory and practice embodies a continuous curve of the technical innovation, which is on the basis of the theory of management science.展开更多
在生命的长河中,我们经常会遇到诸多选择,有些选择仅仅关乎日常生活的琐碎,有些则可能对我们的未来与生活质量具有决定性影响。其中,“预立医疗照护计划”(Advance Care Planning,ACP)是一个特别重要的概念,其不仅与个人的生命质量密切...在生命的长河中,我们经常会遇到诸多选择,有些选择仅仅关乎日常生活的琐碎,有些则可能对我们的未来与生活质量具有决定性影响。其中,“预立医疗照护计划”(Advance Care Planning,ACP)是一个特别重要的概念,其不仅与个人的生命质量密切相关,还会对家庭成员的情感体验和心理负担产生很大的影响。展开更多
There has been a significant decline in cardiovascular morbidity and mortality amidst pervasive advances in care, including percutane- ous revascularization, mechanical circulatory support, and transcatheter valvular ...There has been a significant decline in cardiovascular morbidity and mortality amidst pervasive advances in care, including percutane- ous revascularization, mechanical circulatory support, and transcatheter valvular therapies. While advancing therapies may add significant longevity, they also bring about new end-of-life decision-making challenges for patients and their families who also must weigh the advan- tages of reduced mortality to the possibility of longer lives consisting of high morbidity, frailty, pain, and poor quality of living. Advance care entails options of withholding or withdrawing therapies, and has become a familiar part of cardiovascular care for older patients in Western countries. However, as advanced cardiovascular practices extend to developing countries, the interrelated concept of advance care is rarely straight forward as it is affected by local cultural traditions and mores, and can lead to very different inferences and use. This paper discusses the concepts of advance care planning, surrogate decision-making, orders for resuscitation and futility in patients with cardiac dis- ease with comparisons of West to East, focusing particularly on the United States versus India.展开更多
Coronavirus disease 2019 (COVID-19) often has multifaceted presentations, even in young adults, which poses a significant challenge to clinicians who are caring for older adults. Older patients often present with subt...Coronavirus disease 2019 (COVID-19) often has multifaceted presentations, even in young adults, which poses a significant challenge to clinicians who are caring for older adults. Older patients often present with subtle atypical manifestations, and failure to recognize these may lead to a cascade of negative events. Age-related immune system changes, comorbidities, and atypical presentations often make early diagnosis of COVID-19 difficult. Here, we report a case of an 82-year-old moderately frail male patient who presented with generalized body weakness and tested positive for COVID-19. On the second day of admission, he developed unilateral body weakness and aphasia, and computed tomography of the brain revealed acute right frontal spontaneous intracerebral hemorrhage with no vascular anomaly. He did not have any traditional risk factors for intracerebral hemorrhage and was not on any anticoagulants. The course of this case illustrates the delicate balance between the atypical presentations of COVID-19, the importance of a comprehensive geriatric assessment, and the management of older adults during the COVID-19 pandemic.展开更多
Epilepsy is the most common neurological disorder of the brain that affects people worldwide at any age from newborn to adult. It is characterized by recurrent seizures, which are brief episodes of signs or symptoms d...Epilepsy is the most common neurological disorder of the brain that affects people worldwide at any age from newborn to adult. It is characterized by recurrent seizures, which are brief episodes of signs or symptoms due to abnormal excessive or synchronous neuronal activity in the brain. The electroencephalogram, or EEG, is a physiological method to measure and record the electrical展开更多
基金This project is supported by the Hong Kong Polytechnic University,China(No,G-RGF9).
文摘A dynamic advanced planning and scheduling(DAPS)problem is addressed where new orders arrive on a continuous basis.A periodic policy with frozen interval is adopted to increase stability on the shop floor.A genetic algorithm is developed to find a schedule at each rescheduling point for both original orders and new orders that both production idle time and penalties on tardiness and earliness of orders are minimized.The proposed methodology is tested on a small example to illustrate the effect of the frozen interval.The results indicate that the suggested approach can improve the schedule stability while retaining efficiency.
基金supported by National Natural Science Foundation of China under the project of 70901021, 61174171 and 71171040Social Science Foundation of the Ministry of Education of China under the project of 10YJC630139 Foundation for University Outstanding Young Researchers of Fujian Province of China under the project of JA10023S
文摘This paper presents a case study for the advanced planning and scheduling （APS） problem encountered in a light source manufacturer. The APS problem explicitly considers due dates of products, operation sequences among items, and capacity constraints of the manufacturing system. The objective of the problem is to seek the minimum cost of both production idle time and tardiness or earliness penalty of an order. An intelligent heuristic is applied to the problem, and the results demonstrate that significant production performances can be achieved while ensuring customer satisfaction as opposed to normal oractices followed in the company relying on human expertise.
文摘Objective:This study aimed to explore the readiness for advance care planning(ACP)among older adults in Macao’s day service centers and investigate the influencing factors.Methods:A cross-sectional study was conducted from October to December 2022 using a convenience sampling method.A total of 312 older adults were selected from 13 day service centers for older adults in Macao,China.The Advance Care Planning Acceptance Questionnaire and the Family Adaptation,Partnership,Growth,Affection,Resolve(APGAR)Scale were used to survey the older adults.Results:A total of 306 older adults completed the survey.The score for advance care planning readiness was 65.55±10.69,and 59.5%of participants(n=182)were willing to participate in ACP.The family function score was 7.24±2.51,while 70.3%of participants were from a highly functional family.The higher family function indicating a higher readiness for advance care planning(r=0.396,P<0.001).The multiple linear regression analysis indicated that the variables“age,”“knowledge of ACP,”“experience with ACP,”and“received resuscitation of yourself,relatives or friends”combined with“family function”can influence advance care planning readiness among older adults(R^(2)=0.317,F=27.898,P<0.001).Conclusions:Older adults in Macao’s day service centers were willing to engage in ACP.The importance of family involvement is highlighted in the ACP readiness.Health education and improved family communication are vital for promoting ACP,which ensures individuals receive care when they lack the capacity to make that choice.Additionally,healthcare professionals should enhance communication and education with older adults during the medical care process.
文摘Background:The goal of this study was to conduct a meta-synthesis of advanced cancer patients’and their relatives’experiences with advanced care planning(ACP)and to provide evidence-based guidance for the development and implementation of ACP in advanced cancer patients.Methods:We searched databases including China Knowledge Network,Wanfang database,VIP database,China Biomedical Literature Database,PubMed,Web of Science,Embase,Cochrane Library,and Cinahl from inception to April 2022 to collect qualitative studies on advanced cancer patients and families'experience about ACP.We use Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research to evaluate the quality of literature.After quality assessment,meta-synthesis was used to summarize and explain the results.Results:Eleven qualitative studies were included involving 29 results and ten categories.Three integrated themes were extracted:facilitators and barriers to the implementation of advanced medical care programs as perceived by patients and families with advanced cancer;attitudes of patients with advanced cancer and their families towards pre-existing medical care programs;suggestions from patients with advanced cancer and their families on the implementation elements of the pre-existing medical care program.Conclusion:ACP is a complex social process and influenced by many factors.It requires joint efforts of different stakeholders to achieve high-quality and successful ACP.
基金funded by the Center for Education Financial Service(Puslapdik)and the Indonesia Endowment Fund for Education(LPDP)(Grant number:02651/J5.2.3/BPI.06/9/2022).
文摘Objective:This study aimed to describe the implementation of advance care planning(ACP)in patients with stroke.Methods:A scoping review was conducted according to the Arksey and O'Malley framework.Accordingly,we searched for articles published in ScienceDirect,PubMed,Scopus,ProQuest,and Medline.The inclusion criteria were original research on ACP among adult or elderly stroke patients,hospital-or community-based studies,and those published in English or Indonesian.Qualitative analysis was then used to identify keywords,categories,and themes.Results:Among the 1,050 articles identified,only 8 satisfied the inclusion criteria,indicating that limited studies were available for ACP interventions among stroke patients.Four themes were ultimately identified:the strategy implementation of AC,the challenges of ACP implementation,the benefits of ACP,and the factors influencing ACP.Strategy ACP implementation included the ACP method,the communication style,participation role,media used,and ACP documentation.Lack of information about ACP,facilities,incapacitated patients,and reluctance to implement have become challenges to implementation in stroke.The benefits of ACP,particularly the outcomes of the ACP program,included awareness of ACP engagement,patients can express their wishes,and increased advance directive(AD)documentation.The factors influencing ACP included patient condition,knowledge,and appropriate ACP methods.Conclusion:ACP has not been widely used when providing interventions for stroke patients.The implementation of ACP in stroke patients is full of challenges due to various patient conditions.Effective strategies are needed to improve ACP in stroke patients.It is necessary to develop an ACP for stroke patients'method that involves interprofessional collaboration,and studies on AcP in stroke patients need to be further conducted through interprofessional collaboration.
基金Supported by National Natural Science Foundation of China(71774049).
文摘This paper systematically reviews the research progress of Advance Care Planning(ACP)in the field of lung cancer,and discusses its implementation status,key influencing factors and future development direction,including deepening of theoretical research,innovation of practice mode,optimization of policy support and cultural adaptation research.
文摘Manufacturing system, with high level of complexity and with a mix of semi-repetitive and repetitive products, to become productive, should seek the standardization of products and processes to obtain the optimization of use of production resources. However, it is necessary to measure the productivity, so that the system of measurement and control of manufacturing processes are an element critical as to ensure greater visibility of the flow＇s restrictions, minimized when detected properly. In this case, the automation of factory＇s measurement process can effectively contribute to ensuring the effectiveness of the function control of a manufacturing system. It is important to consider that the automation of the system of measurement and control of manufacturing processes, of complex environment, is heavily dependent of IT tools applied directly in the interface computational between the operation systems and the corporate systems. This heavy reliance, if exploited technically properly, allows that automation of the system of measurement and control of production makes the access to time real of availability of manufacturing process＇s data, such as processing time and setup time that it can export to a specialist software in programming production, for example, feasible. In this paper, the automation of the system of measurement and control of production is approached, in order to identify the main possibilities of the design of an information system capable to integrate the flow of information in an environment internal on manufacturing organizations, with emphasis in the digital manufacturing paradigm.
文摘Advance care planning is a process of discussion in which patients can communicate their end-of-life care preferences to family members and health care providers for consideration.Readiness for advance care planning is a patient's preparedness to engage in advance care planning.This review aims to develop the conceptual framework for advance care planning readiness for Chinese older people.The current knowledge from the published studies was identified and synthesized by an integrative review.The conceptual framework was developed based on the social-ecological model and the theory of planned behavior.The factors from the social environment/community,health care professionals,and individual/family layers were defined.These factors may influence an individual's medical decision-making,which in turn triggers individual behavioral mechanisms that arise from interactions between motivations,attitudes,and beliefs.Relevant factors should be considered when assessing the behavior of personnel engaged in advance care planning or formulating appropriate intervention measures to improve advance care planning par ticipation in China.This framework can be used to guide studies that explore how the social/familial/individual factors predict the readiness for advance care planning among Chinese older people,and to design intervention studies to test the effect of family function on the readiness for advance care planning.
基金supported by the Key Program of Tianjin Municipal Education Commission(171006301C),Nation Natural Science Foundation Program(81603565).
文摘Backgroud:To provide a reference for the further development of the field of the advance care planning(ACP),through the visual analysis of the related literature on the ACP.Methods:Taking the core collection database of Web of ScienceTM as data sources,the method of subject word retrieval is adopted.Literature metrology and CiteSpaceⅤinformation visualization software were used to analyze the literature on ACP published from inception to September 2019.Results:A total of 1,981 literature were included.The number of ACP studies increased,USA published the most literature in the world,followed by Australia,Britain,Canada and the Netherlands and so on.The most leading published journal was the Journal of Palliative Medicine,and the highest impact factor was Palliative Medicine(4.956).Sudore,Rebecca L and Hillary D Lum are the key researcher networks with the largest amount of articles published in ACP field.The research content mainly included the definition,implementation process and implementation effect of ACP.Research focused on palliative care,hospice care,decision-making,communication,patient preference and so on.Conclusion:The studies on ACP is on the rise,the research content is deepening,which suggests that we can learn from the research results of foreign countries in this field and continue to deepen the research in the field of ACP in China.
文摘Aim:To comprehensively synthesize and compare the effect of advance care planning for dementia patients.Design:Systematic review and meta-analysis.Methods:Ten electronic databases will be searched:the Cochrane Library,PubMed,Medline,Embase,PsycINFO,CINAHL PLUS,Scopus,Web of Science,British Nursing Index,clinical Trials,and grey literature sources.Individually or cluster randomized controlled trials that evaluated advance care planning in people with dementia will be incorporated.The research screening flow diagrams will be detailed in the PRISMA flow chart.Data extraction will be carried out in Microsoft Excel 2019 independently by two researchers,any disagreements will be discussed with the third researcher and resolved.We will use the Cochrane Risk of Bias tool to assess the methodological quality.Review Manager 5.3 Software will be used for data synthesis.If sufficient data from studies are available,we will conduct a subgroup analysis of the main outcomes.Conclusion:The systematic review will combine existing trials which may contribute to more convincing conclusions,providing new ideas for medical workers to implement palliative therapy in dementia patients,and further promoting the application of advance care planning for dementia patients.
基金supported by Zhou's Nursing Research Project(No.HLYJ-Z-2018-07).
文摘Objective:To assess the ACP acceptance among patients with malignant tumor in China and factors affecting adoption and timing.Methods:Quantitative study:The convenience sampling method was adopted from October 2020 to October 2021 to investigate 200 oncology patients by a general information questionnaire,patient's advance care planning acceptance questionnaire(ACPQ).Multiple linear stepwise regression was used to analyze the influencing factors of ACP acceptance.Qualitative study:A purposive sampling method was used to select 31 oncology patients and 13 clinical nurses for semi-structured interviews.The data were analyzed using Colaizzi's seven steps.Results:The quantitative study revealed that patients with malignancy had an upper-middle acceptance score of(66.15±7.684)for ACP,with attitude(11.26±2.064),feelings(36.64±4.208),and intention(18.25±3.275)scores.Multiple linear regression analysis showed that religious beliefs,education,monthly income,bereavement experience and notification of condition were independent risk factors for acceptance of ACP(P<0.05).The qualitative study showed that(1)oncology patients have low awareness,high demand,and low acceptability of ACP intervention;(2)they preferred to discuss ACP when medical condition or treatment plan changes;(3)family members were usually involved in ACP discussions,followed by medical personnel;(4)economy,environment,companion,and doctor-patient relationship will all influence ACP implementation.As for nurses,they(1)were unsure about the dynamic changes of ACP content and its optimal timing;(2)had limited ACP knowledge;(3)were affected by environmental factors and nurse-patient relationships;(4)were prone to have disagreements due to inadequate organization department assistance.Conclusions:clinical practitioners should discuss ACP with patients in specific conditions to increase patient acceptance.ACP development requires updated legislation,professional training,and a standardized ACP system.
文摘The paper points out that the science and technology, social productivity and economic form are the decisive strengths in facilitating the reformation of the production method of the manufacturing industry. This kind of strength happens through making an influence on the theory of management and science. It analyses the stage and the characteristic of the development model of manufacturing industry of human society, and on this basis does the detailed research on the several patterns of the advanced manufacturing theory and practice： the computer integrated making, concurrent engineering, lean production, agile manufacturing, planning of enterprise resources, global manufacturing. Finally, it thinks that the development model of the advanced manufacture theory and practice embodies a continuous curve of the technical innovation, which is on the basis of the theory of management science.
文摘在生命的长河中,我们经常会遇到诸多选择,有些选择仅仅关乎日常生活的琐碎,有些则可能对我们的未来与生活质量具有决定性影响。其中,“预立医疗照护计划”(Advance Care Planning,ACP)是一个特别重要的概念,其不仅与个人的生命质量密切相关,还会对家庭成员的情感体验和心理负担产生很大的影响。
文摘There has been a significant decline in cardiovascular morbidity and mortality amidst pervasive advances in care, including percutane- ous revascularization, mechanical circulatory support, and transcatheter valvular therapies. While advancing therapies may add significant longevity, they also bring about new end-of-life decision-making challenges for patients and their families who also must weigh the advan- tages of reduced mortality to the possibility of longer lives consisting of high morbidity, frailty, pain, and poor quality of living. Advance care entails options of withholding or withdrawing therapies, and has become a familiar part of cardiovascular care for older patients in Western countries. However, as advanced cardiovascular practices extend to developing countries, the interrelated concept of advance care is rarely straight forward as it is affected by local cultural traditions and mores, and can lead to very different inferences and use. This paper discusses the concepts of advance care planning, surrogate decision-making, orders for resuscitation and futility in patients with cardiac dis- ease with comparisons of West to East, focusing particularly on the United States versus India.
文摘Coronavirus disease 2019 (COVID-19) often has multifaceted presentations, even in young adults, which poses a significant challenge to clinicians who are caring for older adults. Older patients often present with subtle atypical manifestations, and failure to recognize these may lead to a cascade of negative events. Age-related immune system changes, comorbidities, and atypical presentations often make early diagnosis of COVID-19 difficult. Here, we report a case of an 82-year-old moderately frail male patient who presented with generalized body weakness and tested positive for COVID-19. On the second day of admission, he developed unilateral body weakness and aphasia, and computed tomography of the brain revealed acute right frontal spontaneous intracerebral hemorrhage with no vascular anomaly. He did not have any traditional risk factors for intracerebral hemorrhage and was not on any anticoagulants. The course of this case illustrates the delicate balance between the atypical presentations of COVID-19, the importance of a comprehensive geriatric assessment, and the management of older adults during the COVID-19 pandemic.
文摘Epilepsy is the most common neurological disorder of the brain that affects people worldwide at any age from newborn to adult. It is characterized by recurrent seizures, which are brief episodes of signs or symptoms due to abnormal excessive or synchronous neuronal activity in the brain. The electroencephalogram, or EEG, is a physiological method to measure and record the electrical
