Background: Exposure to adverse childhood experiences (ACEs) is associated with a higher likelihood of developing psychological disorders among adolescents. The current study aimed to analyze the effect of independent...Background: Exposure to adverse childhood experiences (ACEs) is associated with a higher likelihood of developing psychological disorders among adolescents. The current study aimed to analyze the effect of independent and cumulative effects of ACEs exposure on the likelihood of Posttraumatic Stress Disorder (PTSD) and a Complex PTSD (CPSTD) diagnosis in Indian adolescents. Methods: A sample of 411 schoolchildren participated in the study. It was collected data on exposure to ACEs, PTSD, CPTSD, and attachment styles. Results: It was found that exposure to bullying and threats of violence was significantly associated with PTSD and CPTSD diagnosis, and exposure to physical violence and serious illness was associated with CPTSD diagnosis. Exposure to one ACE and exposure to 2 - 3 ACEs were associated with PTSD and CPTSD diagnosis, while exposure to 4 - 5 ACEs was associated with CPTSD diagnosis. Preoccupied and fearful attachment styles were significantly associated with PTSD and CPTSD diagnosis. Conclusion: The results of the study suggest that biological, psychological, and social factors interact and contribute to the differential prevalence of ACE, attachment styles, and PTSD/CPTSD. This study emphasizes the need of addressing childhood trauma as a public health priority in India.展开更多
Objective:To explore symptom experiences and self-coping patterns during the early and late stages of chemotherapy in these patients to provide a basis for developing targeted symptom management strategies.Methods:A t...Objective:To explore symptom experiences and self-coping patterns during the early and late stages of chemotherapy in these patients to provide a basis for developing targeted symptom management strategies.Methods:A total of 27 patients with pancreatic cancer undergoing chemotherapy at two medical institutions were recruited between November 2023 and August 2024.Semi-structured interviews were conducted in person or over the phone.Data were analyzed using traditional content and thematic analyses.Results:Three themes were identified:symptom experience,self-coping patterns,and existing obstacles.During the early stages of chemotherapy,patients reported a higher frequency of unpleasant symptoms and recognized these symptoms earlier in the treatment course.Patients in the early stages primarily relied on external support to cope with symptoms,while those in the later stages adopted self-care strategies.Several challenges related to unpleasant symptoms were observed,which appeared to correlate with the self-coping patterns employed.Conclusion:Patients with pancreatic cancer undergoing chemotherapy experience a complex and diverse range of symptoms,with varying coping patterns at different stages of treatment.Symptom management during chemotherapy presents significant challenges.Healthcare providers should improve the ongoing monitoring of symptoms post-chemotherapy.By linking patients’symptom experiences and self-coping patterns at different stages of chemotherapy to their specific challenges,personalized symptom management strategies can be developed to enhance care quality.展开更多
Objectives Nurses’clinical research activities have contributed to optimizing the care process and improving patient outcomes,and generative artificial intelligence(GAI)may help clinical nurses strengthen their resea...Objectives Nurses’clinical research activities have contributed to optimizing the care process and improving patient outcomes,and generative artificial intelligence(GAI)may help clinical nurses strengthen their research skills.To support research,this study aimed to explore the Chinese nurses’perceptions and experiences of GAI training.Methods This study used a descriptive qualitative design.The China Nurses Network conducted a three-day training session on“GAI for Nursing Research”theme,we selected 23 nurses by a convenience sampling method among participating in the training.The researchers conducted three focus group interviews at the end of each day.All focus groups were interviewed face-to-face to facilitate interaction,data collection,and observation.The data were analyzed using conventional content analysis and coded manually.Results The results showed that nurses’use of GAI to support scientific research was dynamic and characterized by evolving perceptions and practices.Four themes and 11 sub-themes emerged from the analysis:1)utilization efficacy:cope with research ability,affected by many factors;2)booster research:growth and challenges go hand in hand;3)role reversal:from GAI-dominated to nurse-dominated;4)beautiful dream:more features on research,more assistants on clinical care.Conclusions The effectiveness of GAI in supporting clinical nurses in conducting research is mainly limited by differences in personal research literacy,lack of ethical regulation,and information accuracy.In the future,it is necessary to improve nurses’relevant skills through specialized training and promote the standardization of technical regulations to ensure the appropriate application of GAI in nursing research.展开更多
Objective:To explore the self-management experiences and outpatient nursing needs of intestinal stoma patients during the post-discharge transition period,in order to provide a basis for scientific decision-making in ...Objective:To explore the self-management experiences and outpatient nursing needs of intestinal stoma patients during the post-discharge transition period,in order to provide a basis for scientific decision-making in patient self-care and improvements in specialized stoma outpatient services.Methods:Using purposive sampling,13 colorectal cancer patients in the post-discharge transition period who had undergone intestinal stoma surgery were selected from a tertiary hospital in Shandong Province between November 2024 and March 2025.Semi-structured interviews were conducted,and data were analyzed using Colaizzi’s seven-step method to extract themes.Results:Three core themes were identified:challenges in self-management during the transition period,outpatient nursing needs during the transition period,and gaps in doctor-patient information continuity.Conclusion:Future efforts should focus on high-risk groups of stoma patients during the transition period by building intelligent and systematic outpatient guidance and support systems to improve their quality of life.展开更多
Background:Adverse childhood experiences(ACEs)are a significant issue in adolescent health due to their robust correlation with deficits in executive functions(EF)and health risk behaviors(HRBs).This study aimed to ex...Background:Adverse childhood experiences(ACEs)are a significant issue in adolescent health due to their robust correlation with deficits in executive functions(EF)and health risk behaviors(HRBs).This study aimed to examine the association between ACEs and a range of HRBs,including substance use,sexual risk behavior,suicidal ideation,physical inactivity,and violence.Methods:This cross-sectional study used self-administered questionnaire and cluster sampling in seven junior high schools in Samarinda,Indonesia,with a sample size of 534 students.Data analysis using descriptive statistics,the Chi-square test,the independent t-test,ANOVA,binary logistic regression,and mediation analysis with macro-PROCESS.Results:The most common ACEs were community violence(68.0%),physical neglect(52.8%),psychological/emotional abuse(52.6%),physical abuse(50.4%),and peer bullying(45.9%).Adolescents with more than five ACEs showed significantly higher involvement in smoking/vaping(67.9%),suicidal ideation(75.2%),sexual risk behavior(57.7%),bullying(64.3%),and physical fighting(59.7%)(p<0.001).ACEs were significantly correlated with EF deficits(r=0.471,p<0.01)and HRB(r=0.578,p<0.01).Regression analysis confirmed that ACEs predicted EF deficits(β=0.466,p<0.001)and HRB(β=0.469,p<0.001),with EF deficits partially mediating this relationship(β=0.107,95%CI[0.045,0.094]).In addition,two subdomains of EF deficits,self-motivation(β=0.042)and self-regulation of emotion(β=0.032),significantlymediated the relationship between ACEs and HRBs.Conclusion:These findings suggest an important role for EF deficits in linking childhood adversity to engagement in risky behaviors.Addressing ACEs and EF deficits(self-motivation and self-regulation of emotion)through early intervention may be important in reducing long-term health risks among Indonesian adolescents.展开更多
With the intensifying global climate crisis,carbon emissions trading has emerged as a crucial market-based instrument for emissions reduction,attracting significant attention from government agencies and academia worl...With the intensifying global climate crisis,carbon emissions trading has emerged as a crucial market-based instrument for emissions reduction,attracting significant attention from government agencies and academia worldwide.As of January 2024,28 carbon trading markets have been established globally,encompassing approximately 17%of global greenhouse gas emissions and serving approximately 1/3 of the global population.With various nations setting carbon neutrality targets and delineating carbon reduction pathways,the con-struction,operation,and regulatory frameworks of carbon markets are becoming increasingly refined and comprehensive.This study elucidates the importance and necessity of establishing carbon markets from the perspective of energy system transformation and sus-tainable economic development.Second,it provides a comparative analysis of the operational mechanisms,trading scales,and emission reduction outcomes of major carbon markets in the European Union,United States,and New Zealand,systematically summarizing their development processes and recent advancements.Finally,this study addresses issues and challenges in the construction of China’s carbon market.Drawing on the successful experiences of leading global carbon markets in institutional design and market operations,we pro-pose development strategies and recommendations for a carbon market with Chinese characteristics.These strategies are intended to align with international standards while meeting China’s national conditions,thereby contributing insights into the global carbon market trading system.展开更多
The high incidence of gastric cancer has led to the initiation of cancer screening programs.As a result,the number of early gastric cancer cases has increased and consequentially,the cancer mortality rate has decrease...The high incidence of gastric cancer has led to the initiation of cancer screening programs.As a result,the number of early gastric cancer cases has increased and consequentially,the cancer mortality rate has decreased.Moreover,the development of minimally invasive endoscopic treatment has been introduced for these early lesions.Endoscopic submucosal dissection(ESD) is now recognized as one of the preferred treatment modalities for premalignant gastrointestinal epithelial lesions and early gastric cancer without lymph node metastasis.We review the results of ESD including experiences in Japan and Korea,as well as western countries.展开更多
BACKGROUND This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and...BACKGROUND This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and care needs.Protecting the anus surgery combined with temporary colostomy has emerged as a prevalent treatment modality for low rectal cancer.However,the ileostomy is susceptible to peri-stoma skin complications,as well as fluid,electrolyte,and nutritional imbalances,posing challenges to effective management.The successful selfmanagement of patients is intricately linked to their adjustment to temporary colostomy;nonetheless,there remains a dearth of research examining the factors influencing self-care among temporary colostomy patients and the obstacles they confront.AIM To investigate the lived experiences,perceptions,and care requirements of temporary colostomy patients within their home environment,with the ultimate goal of formulating a standardized management protocol.METHODS Over the period of June to August 2023,a purposive sampling technique was utilized to select 12 patients with temporary intestinal stomas from a tertiary hospital in Shanghai,China.Employing a phenomenological research approach,a semi-structured interview guide was developed,and qualitative interviews were conducted using in-depth interview techniques.The acquired data underwent coding,analysis,organization,and summarization following Colaizzi’s seven-step method.RESULTS The findings of this study revealed that the experiences and needs of patients with temporary intestinal stomas can be delineated into four principal themes:Firstly,Temporary colostomy patients bear various burdens and concerns about the uncertainty of disease progression;secondly,patients exhibit limited self-care capabilities and face information deficits,resulting in heightened reliance on healthcare professionals;thirdly,patients demonstrate the potential for internal motivation through proactive self-adjustment;and finally,patients express a significant need for emotional and social support.CONCLUSION Home-living patients with temporary intestinal stomas confront multifaceted challenges encompassing burdens,inadequate self-care abilities,informational deficits,and emotional needs.Identifying factors influencing patients’self-care at home and proposing strategies to mitigate barriers can serve as a foundational framework for developing and implementing nursing interventions tailored to the needs of patients with temporary intestinal stomas.展开更多
Professor Jiping ZHAO has unique thoughts on the diagnosis and treatment of peripheral facial paralysis.She pays the great attention to clinical differentiation in treatment with acupuncture, especially meridian diffe...Professor Jiping ZHAO has unique thoughts on the diagnosis and treatment of peripheral facial paralysis.She pays the great attention to clinical differentiation in treatment with acupuncture, especially meridian differentiation. She believes that the differentiation of lesion is core and the early judgment is critical for the better therapeutic effects on intractable facial paralysis. The local acupoints are selected in the guide of the theory of meridian sinew and stimulated on the base of three-needling theory. The distal acupoints are decided in light of the syndrome differentiation, of which, Hégǔ(合谷 LI 4), Zúsānlǐ(足三里ST 36) and Taichōng(太冲 LR 3) are the basic acupoints. Additionally, Professor ZHAO lays the emphasis on the 5 th branch of facial nerve(cervical branch) in diagnosis and treatment.展开更多
Clinical practice remains an integral part of nursing curriculum because clinical practice provides students with an opportunity to achieve professional competence. Creating a conducive learning environment for studen...Clinical practice remains an integral part of nursing curriculum because clinical practice provides students with an opportunity to achieve professional competence. Creating a conducive learning environment for students is responsibility of academic staff, clinical nurses and students alike. However, studies in Malawi have reported poor clinical learning environment for students. This study therefore aimed at exploring nurses’ experiences of clinical teaching environment in Malawi. The study used a qualitative research design utilizing a descriptive phenomenological approach. Participants were randomly identified from teaching hospitals across Malawi by nursing managers to attend a six week clinical preceptorship training at one University nursing college. Immediately before commencement of the training, participants were invited to voluntarily participate in a focus group discussion pertaining to their experiences with clinical environment. We conducted focus group discussions with 9 trainees in 2013 and 12 trainees in 2014 training cohorts. Findings reveal that nurses meet a number of challenges in teaching students in the clinical area. Four themes emerged from the study, namely, inadequate faculty support, poor clinical teaching environment, poor competence among nurses and unsupportive working conditions. Nurses require support from academic staff and their managers to ensure a conducive clinical teaching environment.展开更多
<strong>Background</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</stron...<strong>Background</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</strong></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> Cancer of the cervix is the commonest cancer in women seen at </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Cancer Diseases Hospital in Zambia and Pelvic Radiotherapy is the main</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> treatment </span><span style="font-family:Verdana;">modality used on cervical cancer patients. Radiotherapy to the pelvis has a</span><span style="font-family:Verdana;"> potential to causes vagina</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">l</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> stenosis but the stenosis can be pre</span><span style="font-family:Verdana;">vented by regular sexual intercourse or use of vaginal dilators as recom</span><span style="font-family:Verdana;">mended by cancer organizations. Despite the well-established benefits of vaginal dilators, there was reluctance by women to adopt this practice as seen by the number of survivors with vaginal stenosis at Cancer Diseases Hospital.</span><b> </b><span style="font-family:Verdana;">The objective of this study was to explore experiences with the use of vaginal dilators by cervical cancer women who received Pelvic Radiotherapy. </span><b><span style="font-family:Verdana;">Methodology:</span></b><span style="font-family:Verdana;"> A descriptive phenomenological design was used to explore experiences with the use of vaginal dilators by cervical cancer women. The study was conducted at Cancer Diseases Hospital in Lusaka District of Zambia. Participants were identified and purposefully sampled during the follow up clinics, they were then followed for interviews into their homes in Lusaka and data saturation was attained after interviewing 22 participants. Data w</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">ere</span></span></span><span><span><span style="font-family:""> <span><span style="font-family:Verdana;">analyzed using thematic analysis.</span><b><span style="font-family:Verdana;"> Results: </span></b><span style="font-family:Verdana;">Five themes from the study</span></span><span style="font-family:Verdana;"> emerged on how women with cervical cancer experienced the use of vaginal dilator;such as uncomfortable </span><span style="font-family:Verdana;">dilators, pity for the husband, changed lifestyle, embarrassment and fear. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> It was acknowledged that the use of vaginal dilator was associated with negative experiences such as uncomfortable dilators, pity for the hus</span><span style="font-family:Verdana;">band, changed lifestyle, fear and embarrassment. Therefore, this study re</span><span style="font-family:Verdana;">commends that Health care providers from CDH and other health institutions should give appropriate information to patients concerning the use of vaginal dilators and </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">the Ministry of Health to provide </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">vaginal dilators instead of 50 milliliter syringes currently in use.</span></span></span>展开更多
Objective: Nurses play important roles in caring for dying patients and their families. Difficulties students confronted when facing dying patients challenge the quality of nursing education. A better understanding of...Objective: Nurses play important roles in caring for dying patients and their families. Difficulties students confronted when facing dying patients challenge the quality of nursing education. A better understanding of students' experiences would enhance teachers' ability in helping students. This study aims to describe available evidence about nursing students' experiences when caring for dying patients and their families.Methods: A review of qualitative studies published between 2005 and 2017 was undertaken using the following databases: MEDLINE, CINAHL, ProQuest Central, ScienceDirect, and CNKI. The keywords included were nursing students, experience, care, end-of-life, and dying. Qualitative Assessment and Review Instrument was used to assess the quality of the studies by two independent reviewers. The data from the studies were analyzed by meta-synthesis.Results: Eighteen English and two Chinese studies were selected in this review. Four themes were emerged:(1) Students with dying patients: students did not have enough ability in symptoms control, comfort supply, and therapeutic communication for dying patients.(2) Students with the patients' families: students advocated more caring for patients' families.(3) Students with the surroundings: professional medical staffs, especially the nursing preceptors, were key roles in constructing a supporting system for students.(4) Students with themselves: nursing students underwent various negative feelings and adopted both negative and positive strategies to cope with such feelings;students experienced professional and personal development during the caring for dying patients.Conclusions: Nursing students' abilities in terminal symptom control, comfort supply, and therapeutic communication should be improved by more theoretic learning and simulation practice. The nursing preceptors were key roles in constructing a supporting system for students and helping them to control the negative emotions when facing dying patients.展开更多
Hepatocellular carcinoma （HCC） is the most common primary liver cancer （1）. The incidence is rising in the last decades due to many factors, especially hepatitis C, alcoholic liver disease and non-alcoholic steato...Hepatocellular carcinoma （HCC） is the most common primary liver cancer （1）. The incidence is rising in the last decades due to many factors, especially hepatitis C, alcoholic liver disease and non-alcoholic steatohepatitis. Moreover, the introduction of screening programs in patients with chronic liver disease has led to an increase in HCC diagnosis （1,2）. In the western world, 80% to 90% of HCC eases occur in patients with liver cirrhosis （3） while this proportion is lower in some regions in Asia and sub-Saharian Africa, where hepatitis B remains as an important etiologic factor for chronic liver disease （2,4）. In 1990, the annual world frequency of HCC was 437,000 cases/year （1）, and in 2012 the number reached 782,200 cases/year being responsible for 746,000 deaths （5）. Nowadays, HCC represents the 6th most frequent neoplastic disease in the world and the 3rd in mortality （5）.展开更多
Low maternal, gestational weight gain is associated with preterm birth, intrauterine growth restriction, low birthweight, small-for-gestational-age infants, neural tube defects, infant death, failure to initiate breas...Low maternal, gestational weight gain is associated with preterm birth, intrauterine growth restriction, low birthweight, small-for-gestational-age infants, neural tube defects, infant death, failure to initiate breastfeeding, and childhood asthma. The advantage of qualitative research is it can provide valuable insights for health care professionals into the experience and perceptions of low gestational weight gain from the vantage point of women with first-hand lived experience. In this Heideggarian interpretive phenomenological study, the meaning and experiences of weight gain for pregnant women with low gestational weight gain were explored. Data were collected through interviews with 10 pregnant women from Atlantic Canada. Conroy’s pathway for interpretive phenomenology was utilized. A hermeneutical spiral of interpretation identified six patterns or major themes: confronting one’s mortality;defending oneself against a permanent metamorphosis into a stranger;playing with fire and brimstone;slipping under the radar;trying to find peace;and riding an emotional roller coaster. The findings point to a war that is being waged over pregnant bodies with respect to weight that leaves pregnant women fending for themselves, apparently with little help from their health care providers. Implications of the findings for health practice, education, and research are discussed.展开更多
This study explores how overseas exchange opportunities might influence Chinese students ’engagement in L2 learning activities and how far such opportunities may satisfy their motivation to study abroad. The analysis...This study explores how overseas exchange opportunities might influence Chinese students ’engagement in L2 learning activities and how far such opportunities may satisfy their motivation to study abroad. The analysis of the data, collected and filtered from carefully designed questionnaires and interviews, showed that students ’ L2 learning activities and study-abroad motivations underwent changes after their overseas experiences. Regarding the former, the overseas environment was the cause of the change because it provided students with more chances to talk with native speakers and increased the frequency of their using L2 in their daily life. Regarding the latter, the decline of the students ’ major study-abroad motivations was partly because they tended to treat L2 learning as a tool for realizing other goals and partly because the students had got other important motivations. In view of these findings, suggestions were raised to help future students get better prepared for their overseas study or short-term exchange life.展开更多
Current research on the various forms of autoscopic phenomena addresses the clinical and neurological correlates of out-of-body experiences, autoscopic hallucinations, and heautoscopy. Yet most of this research is bas...Current research on the various forms of autoscopic phenomena addresses the clinical and neurological correlates of out-of-body experiences, autoscopic hallucinations, and heautoscopy. Yet most of this research is based on functional magnetic resonance imaging results and focuses predominantly on abnormal cortical activity. Previously we proposed that visual consciousness resulted from the dynamic retinogeniculo-cortical oscillations, such that the photoreceptors dynamically integrated with visual and other vision-associated cortices, and was theorized to be mapped out by photoreceptor discs and rich retinal networks which synchronized with the retinotopic mapping and the associated cortex. The feedback from neural input that is received from the thalamus and cortex via retinogeniculo-cortical oscillations and sent to the retina is multifold higher than feed-forward input to the cortex. This can effectively translate into out-of-body experiences projected onto the screen formed by the retina as it is perceived via feedback and feed-forward oscillations from the reticular thalamic nucleus, or “internal searchlight”. This article explores the role of the reticular thalamic nucleus and the retinogeniculo-cortical oscillations as pivotal internal components in vision and various autoscopic phenomena.展开更多
Considering the temperature difference of displacement cooking characterized by severe non-linearity, large time delay, and real-time control, a cascade PID adaptive control strategy composed of a single neuron is pro...Considering the temperature difference of displacement cooking characterized by severe non-linearity, large time delay, and real-time control, a cascade PID adaptive control strategy composed of a single neuron is proposed to ensure cooking temperature uniformity. The control strategy introduces expert experiences to adjust the single neuron gain K, while a single neuron PID self-learning and adaptive ability, as well as cascade advantage can be combined to realize the real-time and fast temperature difference control. In the Simulink, the s-function of this control strategy is used to carry out a dynamic simulation experiment with temperature difference characteristics and verify the robustness and response to model mismatch. Compared to conventional temperature difference-flow PID cascade control and single neuron PID cascade control, this control strategy has better robustness and stronger adaptability. The results of real-time control on the THJSK-1 experiment platform indicate this control strategy is feasible.展开更多
Hikikomori is a recent phenomenon among young adults in which they isolate themselves from social contacts and responsibility for more than 6 months. This problem has assumed epidemic proportions in Japan and has been...Hikikomori is a recent phenomenon among young adults in which they isolate themselves from social contacts and responsibility for more than 6 months. This problem has assumed epidemic proportions in Japan and has been widely discussed across disciplines. Previous studies have associated hikikomori with a maladaptation to structural change, an emergent mental problem that needs new diagnosis, or an under-diagnosed schizophrenic disorder. Most previous work has adopted a clinical perspective, and there have been no qualitative studies exploring the individual feelings of people suffering from the syndrome. We adopted a qualitative method using a grounded theory approach. Data collection and analysis took place between September 2006 and August 2008. Theoretical sampling included eight informants from snowball sampling and an online observation consisting of 160 online participants. Analysis focused on informants’ first- and second-person experiences of hikikomori. Data analysis revealed one overriding theme: coping difficulties consisting of the two categories stasis and expression. As a result of conflicting demands and reduced autonomy, respondents experienced stasis, which prevented them from moving forward;“hiding” or “avoiding” heightened the expression of their behaviors. This is the first study to explore the in-depth experience of individuals suffering from hikikomori syndrome in a non-clinical setting. We argue that hikikomoriis not a result of asocial behavior, but rather an anomic response to a situation that informants felt powerless to change and from which they could see no way out. We also observed that feelings of hopelessness and relationship fatigue might be overcome by introducing a relaxed social environment that people can control during rehabilitation.展开更多
文摘Background: Exposure to adverse childhood experiences (ACEs) is associated with a higher likelihood of developing psychological disorders among adolescents. The current study aimed to analyze the effect of independent and cumulative effects of ACEs exposure on the likelihood of Posttraumatic Stress Disorder (PTSD) and a Complex PTSD (CPSTD) diagnosis in Indian adolescents. Methods: A sample of 411 schoolchildren participated in the study. It was collected data on exposure to ACEs, PTSD, CPTSD, and attachment styles. Results: It was found that exposure to bullying and threats of violence was significantly associated with PTSD and CPTSD diagnosis, and exposure to physical violence and serious illness was associated with CPTSD diagnosis. Exposure to one ACE and exposure to 2 - 3 ACEs were associated with PTSD and CPTSD diagnosis, while exposure to 4 - 5 ACEs was associated with CPTSD diagnosis. Preoccupied and fearful attachment styles were significantly associated with PTSD and CPTSD diagnosis. Conclusion: The results of the study suggest that biological, psychological, and social factors interact and contribute to the differential prevalence of ACE, attachment styles, and PTSD/CPTSD. This study emphasizes the need of addressing childhood trauma as a public health priority in India.
基金supported by the State Key Laboratory of Ultrasonic Medical Engineering/the Chongqing Science and Technology Bureau(Project No.2022KFKT7011)the Postdoctoral Fellowship Program of CPSF(GZC20233357)+1 种基金the Health Commission of Sichuan Province Medical Science and Technology Program(24QNMP007)the Medical Research Program of Health Commission of Chengdu(2023535).
文摘Objective:To explore symptom experiences and self-coping patterns during the early and late stages of chemotherapy in these patients to provide a basis for developing targeted symptom management strategies.Methods:A total of 27 patients with pancreatic cancer undergoing chemotherapy at two medical institutions were recruited between November 2023 and August 2024.Semi-structured interviews were conducted in person or over the phone.Data were analyzed using traditional content and thematic analyses.Results:Three themes were identified:symptom experience,self-coping patterns,and existing obstacles.During the early stages of chemotherapy,patients reported a higher frequency of unpleasant symptoms and recognized these symptoms earlier in the treatment course.Patients in the early stages primarily relied on external support to cope with symptoms,while those in the later stages adopted self-care strategies.Several challenges related to unpleasant symptoms were observed,which appeared to correlate with the self-coping patterns employed.Conclusion:Patients with pancreatic cancer undergoing chemotherapy experience a complex and diverse range of symptoms,with varying coping patterns at different stages of treatment.Symptom management during chemotherapy presents significant challenges.Healthcare providers should improve the ongoing monitoring of symptoms post-chemotherapy.By linking patients’symptom experiences and self-coping patterns at different stages of chemotherapy to their specific challenges,personalized symptom management strategies can be developed to enhance care quality.
基金supported by a grant from the National Natural Science Foundation of China(No.72174130)。
文摘Objectives Nurses’clinical research activities have contributed to optimizing the care process and improving patient outcomes,and generative artificial intelligence(GAI)may help clinical nurses strengthen their research skills.To support research,this study aimed to explore the Chinese nurses’perceptions and experiences of GAI training.Methods This study used a descriptive qualitative design.The China Nurses Network conducted a three-day training session on“GAI for Nursing Research”theme,we selected 23 nurses by a convenience sampling method among participating in the training.The researchers conducted three focus group interviews at the end of each day.All focus groups were interviewed face-to-face to facilitate interaction,data collection,and observation.The data were analyzed using conventional content analysis and coded manually.Results The results showed that nurses’use of GAI to support scientific research was dynamic and characterized by evolving perceptions and practices.Four themes and 11 sub-themes emerged from the analysis:1)utilization efficacy:cope with research ability,affected by many factors;2)booster research:growth and challenges go hand in hand;3)role reversal:from GAI-dominated to nurse-dominated;4)beautiful dream:more features on research,more assistants on clinical care.Conclusions The effectiveness of GAI in supporting clinical nurses in conducting research is mainly limited by differences in personal research literacy,lack of ethical regulation,and information accuracy.In the future,it is necessary to improve nurses’relevant skills through specialized training and promote the standardization of technical regulations to ensure the appropriate application of GAI in nursing research.
文摘Objective:To explore the self-management experiences and outpatient nursing needs of intestinal stoma patients during the post-discharge transition period,in order to provide a basis for scientific decision-making in patient self-care and improvements in specialized stoma outpatient services.Methods:Using purposive sampling,13 colorectal cancer patients in the post-discharge transition period who had undergone intestinal stoma surgery were selected from a tertiary hospital in Shandong Province between November 2024 and March 2025.Semi-structured interviews were conducted,and data were analyzed using Colaizzi’s seven-step method to extract themes.Results:Three core themes were identified:challenges in self-management during the transition period,outpatient nursing needs during the transition period,and gaps in doctor-patient information continuity.Conclusion:Future efforts should focus on high-risk groups of stoma patients during the transition period by building intelligent and systematic outpatient guidance and support systems to improve their quality of life.
基金supported by the STI 2030-Major Projects(2021ZD0200500).
文摘Background:Adverse childhood experiences(ACEs)are a significant issue in adolescent health due to their robust correlation with deficits in executive functions(EF)and health risk behaviors(HRBs).This study aimed to examine the association between ACEs and a range of HRBs,including substance use,sexual risk behavior,suicidal ideation,physical inactivity,and violence.Methods:This cross-sectional study used self-administered questionnaire and cluster sampling in seven junior high schools in Samarinda,Indonesia,with a sample size of 534 students.Data analysis using descriptive statistics,the Chi-square test,the independent t-test,ANOVA,binary logistic regression,and mediation analysis with macro-PROCESS.Results:The most common ACEs were community violence(68.0%),physical neglect(52.8%),psychological/emotional abuse(52.6%),physical abuse(50.4%),and peer bullying(45.9%).Adolescents with more than five ACEs showed significantly higher involvement in smoking/vaping(67.9%),suicidal ideation(75.2%),sexual risk behavior(57.7%),bullying(64.3%),and physical fighting(59.7%)(p<0.001).ACEs were significantly correlated with EF deficits(r=0.471,p<0.01)and HRB(r=0.578,p<0.01).Regression analysis confirmed that ACEs predicted EF deficits(β=0.466,p<0.001)and HRB(β=0.469,p<0.001),with EF deficits partially mediating this relationship(β=0.107,95%CI[0.045,0.094]).In addition,two subdomains of EF deficits,self-motivation(β=0.042)and self-regulation of emotion(β=0.032),significantlymediated the relationship between ACEs and HRBs.Conclusion:These findings suggest an important role for EF deficits in linking childhood adversity to engagement in risky behaviors.Addressing ACEs and EF deficits(self-motivation and self-regulation of emotion)through early intervention may be important in reducing long-term health risks among Indonesian adolescents.
基金support of the SGCC Science and Technology Project“Cost Analysis,Market Bidding Mechanism Research and Validation of New Power Sys-tem Transformation under a Diversified Value System”(1400-202357380A-2-3-XG)for this article.
文摘With the intensifying global climate crisis,carbon emissions trading has emerged as a crucial market-based instrument for emissions reduction,attracting significant attention from government agencies and academia worldwide.As of January 2024,28 carbon trading markets have been established globally,encompassing approximately 17%of global greenhouse gas emissions and serving approximately 1/3 of the global population.With various nations setting carbon neutrality targets and delineating carbon reduction pathways,the con-struction,operation,and regulatory frameworks of carbon markets are becoming increasingly refined and comprehensive.This study elucidates the importance and necessity of establishing carbon markets from the perspective of energy system transformation and sus-tainable economic development.Second,it provides a comparative analysis of the operational mechanisms,trading scales,and emission reduction outcomes of major carbon markets in the European Union,United States,and New Zealand,systematically summarizing their development processes and recent advancements.Finally,this study addresses issues and challenges in the construction of China’s carbon market.Drawing on the successful experiences of leading global carbon markets in institutional design and market operations,we pro-pose development strategies and recommendations for a carbon market with Chinese characteristics.These strategies are intended to align with international standards while meeting China’s national conditions,thereby contributing insights into the global carbon market trading system.
文摘The high incidence of gastric cancer has led to the initiation of cancer screening programs.As a result,the number of early gastric cancer cases has increased and consequentially,the cancer mortality rate has decreased.Moreover,the development of minimally invasive endoscopic treatment has been introduced for these early lesions.Endoscopic submucosal dissection(ESD) is now recognized as one of the preferred treatment modalities for premalignant gastrointestinal epithelial lesions and early gastric cancer without lymph node metastasis.We review the results of ESD including experiences in Japan and Korea,as well as western countries.
基金The study was reviewed and approved by the Science and Research Office of Tong Ren Hospital(Shanghai), No. AF/SC-08/04.0.
文摘BACKGROUND This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and care needs.Protecting the anus surgery combined with temporary colostomy has emerged as a prevalent treatment modality for low rectal cancer.However,the ileostomy is susceptible to peri-stoma skin complications,as well as fluid,electrolyte,and nutritional imbalances,posing challenges to effective management.The successful selfmanagement of patients is intricately linked to their adjustment to temporary colostomy;nonetheless,there remains a dearth of research examining the factors influencing self-care among temporary colostomy patients and the obstacles they confront.AIM To investigate the lived experiences,perceptions,and care requirements of temporary colostomy patients within their home environment,with the ultimate goal of formulating a standardized management protocol.METHODS Over the period of June to August 2023,a purposive sampling technique was utilized to select 12 patients with temporary intestinal stomas from a tertiary hospital in Shanghai,China.Employing a phenomenological research approach,a semi-structured interview guide was developed,and qualitative interviews were conducted using in-depth interview techniques.The acquired data underwent coding,analysis,organization,and summarization following Colaizzi’s seven-step method.RESULTS The findings of this study revealed that the experiences and needs of patients with temporary intestinal stomas can be delineated into four principal themes:Firstly,Temporary colostomy patients bear various burdens and concerns about the uncertainty of disease progression;secondly,patients exhibit limited self-care capabilities and face information deficits,resulting in heightened reliance on healthcare professionals;thirdly,patients demonstrate the potential for internal motivation through proactive self-adjustment;and finally,patients express a significant need for emotional and social support.CONCLUSION Home-living patients with temporary intestinal stomas confront multifaceted challenges encompassing burdens,inadequate self-care abilities,informational deficits,and emotional needs.Identifying factors influencing patients’self-care at home and proposing strategies to mitigate barriers can serve as a foundational framework for developing and implementing nursing interventions tailored to the needs of patients with temporary intestinal stomas.
基金Supported by "Double Hundred Project" of Beijing Administration of Traditional Chinese MedicineThe Fund for Beijing Science & Technology Development of TCM:QN2016-13
文摘Professor Jiping ZHAO has unique thoughts on the diagnosis and treatment of peripheral facial paralysis.She pays the great attention to clinical differentiation in treatment with acupuncture, especially meridian differentiation. She believes that the differentiation of lesion is core and the early judgment is critical for the better therapeutic effects on intractable facial paralysis. The local acupoints are selected in the guide of the theory of meridian sinew and stimulated on the base of three-needling theory. The distal acupoints are decided in light of the syndrome differentiation, of which, Hégǔ(合谷 LI 4), Zúsānlǐ(足三里ST 36) and Taichōng(太冲 LR 3) are the basic acupoints. Additionally, Professor ZHAO lays the emphasis on the 5 th branch of facial nerve(cervical branch) in diagnosis and treatment.
文摘Clinical practice remains an integral part of nursing curriculum because clinical practice provides students with an opportunity to achieve professional competence. Creating a conducive learning environment for students is responsibility of academic staff, clinical nurses and students alike. However, studies in Malawi have reported poor clinical learning environment for students. This study therefore aimed at exploring nurses’ experiences of clinical teaching environment in Malawi. The study used a qualitative research design utilizing a descriptive phenomenological approach. Participants were randomly identified from teaching hospitals across Malawi by nursing managers to attend a six week clinical preceptorship training at one University nursing college. Immediately before commencement of the training, participants were invited to voluntarily participate in a focus group discussion pertaining to their experiences with clinical environment. We conducted focus group discussions with 9 trainees in 2013 and 12 trainees in 2014 training cohorts. Findings reveal that nurses meet a number of challenges in teaching students in the clinical area. Four themes emerged from the study, namely, inadequate faculty support, poor clinical teaching environment, poor competence among nurses and unsupportive working conditions. Nurses require support from academic staff and their managers to ensure a conducive clinical teaching environment.
文摘<strong>Background</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</strong></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> Cancer of the cervix is the commonest cancer in women seen at </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Cancer Diseases Hospital in Zambia and Pelvic Radiotherapy is the main</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> treatment </span><span style="font-family:Verdana;">modality used on cervical cancer patients. Radiotherapy to the pelvis has a</span><span style="font-family:Verdana;"> potential to causes vagina</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">l</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> stenosis but the stenosis can be pre</span><span style="font-family:Verdana;">vented by regular sexual intercourse or use of vaginal dilators as recom</span><span style="font-family:Verdana;">mended by cancer organizations. Despite the well-established benefits of vaginal dilators, there was reluctance by women to adopt this practice as seen by the number of survivors with vaginal stenosis at Cancer Diseases Hospital.</span><b> </b><span style="font-family:Verdana;">The objective of this study was to explore experiences with the use of vaginal dilators by cervical cancer women who received Pelvic Radiotherapy. </span><b><span style="font-family:Verdana;">Methodology:</span></b><span style="font-family:Verdana;"> A descriptive phenomenological design was used to explore experiences with the use of vaginal dilators by cervical cancer women. The study was conducted at Cancer Diseases Hospital in Lusaka District of Zambia. Participants were identified and purposefully sampled during the follow up clinics, they were then followed for interviews into their homes in Lusaka and data saturation was attained after interviewing 22 participants. Data w</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">ere</span></span></span><span><span><span style="font-family:""> <span><span style="font-family:Verdana;">analyzed using thematic analysis.</span><b><span style="font-family:Verdana;"> Results: </span></b><span style="font-family:Verdana;">Five themes from the study</span></span><span style="font-family:Verdana;"> emerged on how women with cervical cancer experienced the use of vaginal dilator;such as uncomfortable </span><span style="font-family:Verdana;">dilators, pity for the husband, changed lifestyle, embarrassment and fear. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> It was acknowledged that the use of vaginal dilator was associated with negative experiences such as uncomfortable dilators, pity for the hus</span><span style="font-family:Verdana;">band, changed lifestyle, fear and embarrassment. Therefore, this study re</span><span style="font-family:Verdana;">commends that Health care providers from CDH and other health institutions should give appropriate information to patients concerning the use of vaginal dilators and </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">the Ministry of Health to provide </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">vaginal dilators instead of 50 milliliter syringes currently in use.</span></span></span>
基金supported by the Macao Science and Technology Development Fund(No.FDCT 276/2017/P)
文摘Objective: Nurses play important roles in caring for dying patients and their families. Difficulties students confronted when facing dying patients challenge the quality of nursing education. A better understanding of students' experiences would enhance teachers' ability in helping students. This study aims to describe available evidence about nursing students' experiences when caring for dying patients and their families.Methods: A review of qualitative studies published between 2005 and 2017 was undertaken using the following databases: MEDLINE, CINAHL, ProQuest Central, ScienceDirect, and CNKI. The keywords included were nursing students, experience, care, end-of-life, and dying. Qualitative Assessment and Review Instrument was used to assess the quality of the studies by two independent reviewers. The data from the studies were analyzed by meta-synthesis.Results: Eighteen English and two Chinese studies were selected in this review. Four themes were emerged:(1) Students with dying patients: students did not have enough ability in symptoms control, comfort supply, and therapeutic communication for dying patients.(2) Students with the patients' families: students advocated more caring for patients' families.(3) Students with the surroundings: professional medical staffs, especially the nursing preceptors, were key roles in constructing a supporting system for students.(4) Students with themselves: nursing students underwent various negative feelings and adopted both negative and positive strategies to cope with such feelings;students experienced professional and personal development during the caring for dying patients.Conclusions: Nursing students' abilities in terminal symptom control, comfort supply, and therapeutic communication should be improved by more theoretic learning and simulation practice. The nursing preceptors were key roles in constructing a supporting system for students and helping them to control the negative emotions when facing dying patients.
文摘Hepatocellular carcinoma （HCC） is the most common primary liver cancer （1）. The incidence is rising in the last decades due to many factors, especially hepatitis C, alcoholic liver disease and non-alcoholic steatohepatitis. Moreover, the introduction of screening programs in patients with chronic liver disease has led to an increase in HCC diagnosis （1,2）. In the western world, 80% to 90% of HCC eases occur in patients with liver cirrhosis （3） while this proportion is lower in some regions in Asia and sub-Saharian Africa, where hepatitis B remains as an important etiologic factor for chronic liver disease （2,4）. In 1990, the annual world frequency of HCC was 437,000 cases/year （1）, and in 2012 the number reached 782,200 cases/year being responsible for 746,000 deaths （5）. Nowadays, HCC represents the 6th most frequent neoplastic disease in the world and the 3rd in mortality （5）.
文摘Low maternal, gestational weight gain is associated with preterm birth, intrauterine growth restriction, low birthweight, small-for-gestational-age infants, neural tube defects, infant death, failure to initiate breastfeeding, and childhood asthma. The advantage of qualitative research is it can provide valuable insights for health care professionals into the experience and perceptions of low gestational weight gain from the vantage point of women with first-hand lived experience. In this Heideggarian interpretive phenomenological study, the meaning and experiences of weight gain for pregnant women with low gestational weight gain were explored. Data were collected through interviews with 10 pregnant women from Atlantic Canada. Conroy’s pathway for interpretive phenomenology was utilized. A hermeneutical spiral of interpretation identified six patterns or major themes: confronting one’s mortality;defending oneself against a permanent metamorphosis into a stranger;playing with fire and brimstone;slipping under the radar;trying to find peace;and riding an emotional roller coaster. The findings point to a war that is being waged over pregnant bodies with respect to weight that leaves pregnant women fending for themselves, apparently with little help from their health care providers. Implications of the findings for health practice, education, and research are discussed.
基金supported by a General Research Fund (#4440713) from the Research Grants Council of Hong Kong。
文摘This study explores how overseas exchange opportunities might influence Chinese students ’engagement in L2 learning activities and how far such opportunities may satisfy their motivation to study abroad. The analysis of the data, collected and filtered from carefully designed questionnaires and interviews, showed that students ’ L2 learning activities and study-abroad motivations underwent changes after their overseas experiences. Regarding the former, the overseas environment was the cause of the change because it provided students with more chances to talk with native speakers and increased the frequency of their using L2 in their daily life. Regarding the latter, the decline of the students ’ major study-abroad motivations was partly because they tended to treat L2 learning as a tool for realizing other goals and partly because the students had got other important motivations. In view of these findings, suggestions were raised to help future students get better prepared for their overseas study or short-term exchange life.
文摘Current research on the various forms of autoscopic phenomena addresses the clinical and neurological correlates of out-of-body experiences, autoscopic hallucinations, and heautoscopy. Yet most of this research is based on functional magnetic resonance imaging results and focuses predominantly on abnormal cortical activity. Previously we proposed that visual consciousness resulted from the dynamic retinogeniculo-cortical oscillations, such that the photoreceptors dynamically integrated with visual and other vision-associated cortices, and was theorized to be mapped out by photoreceptor discs and rich retinal networks which synchronized with the retinotopic mapping and the associated cortex. The feedback from neural input that is received from the thalamus and cortex via retinogeniculo-cortical oscillations and sent to the retina is multifold higher than feed-forward input to the cortex. This can effectively translate into out-of-body experiences projected onto the screen formed by the retina as it is perceived via feedback and feed-forward oscillations from the reticular thalamic nucleus, or “internal searchlight”. This article explores the role of the reticular thalamic nucleus and the retinogeniculo-cortical oscillations as pivotal internal components in vision and various autoscopic phenomena.
文摘Considering the temperature difference of displacement cooking characterized by severe non-linearity, large time delay, and real-time control, a cascade PID adaptive control strategy composed of a single neuron is proposed to ensure cooking temperature uniformity. The control strategy introduces expert experiences to adjust the single neuron gain K, while a single neuron PID self-learning and adaptive ability, as well as cascade advantage can be combined to realize the real-time and fast temperature difference control. In the Simulink, the s-function of this control strategy is used to carry out a dynamic simulation experiment with temperature difference characteristics and verify the robustness and response to model mismatch. Compared to conventional temperature difference-flow PID cascade control and single neuron PID cascade control, this control strategy has better robustness and stronger adaptability. The results of real-time control on the THJSK-1 experiment platform indicate this control strategy is feasible.
文摘Hikikomori is a recent phenomenon among young adults in which they isolate themselves from social contacts and responsibility for more than 6 months. This problem has assumed epidemic proportions in Japan and has been widely discussed across disciplines. Previous studies have associated hikikomori with a maladaptation to structural change, an emergent mental problem that needs new diagnosis, or an under-diagnosed schizophrenic disorder. Most previous work has adopted a clinical perspective, and there have been no qualitative studies exploring the individual feelings of people suffering from the syndrome. We adopted a qualitative method using a grounded theory approach. Data collection and analysis took place between September 2006 and August 2008. Theoretical sampling included eight informants from snowball sampling and an online observation consisting of 160 online participants. Analysis focused on informants’ first- and second-person experiences of hikikomori. Data analysis revealed one overriding theme: coping difficulties consisting of the two categories stasis and expression. As a result of conflicting demands and reduced autonomy, respondents experienced stasis, which prevented them from moving forward;“hiding” or “avoiding” heightened the expression of their behaviors. This is the first study to explore the in-depth experience of individuals suffering from hikikomori syndrome in a non-clinical setting. We argue that hikikomoriis not a result of asocial behavior, but rather an anomic response to a situation that informants felt powerless to change and from which they could see no way out. We also observed that feelings of hopelessness and relationship fatigue might be overcome by introducing a relaxed social environment that people can control during rehabilitation.
