The present moment is not the first time that America has found itself at war with a pathogen during a time of international conflict. Between crowded barracks at home and trenches abroad, wartime conditions helped en...The present moment is not the first time that America has found itself at war with a pathogen during a time of international conflict. Between crowded barracks at home and trenches abroad, wartime conditions helped enable the spread of influenza in the fall of 1918 during World War I such that an estimated 20%–40% of U.S. military members were infected. While the coronavirus disease 2019(COVID-19) pandemic is unparalleled for most of today's population, it is essential to not view it as unprecedented lest the lessons of past pandemics and their effect on the American military be forgotten. This article provides a historical perspective on the effect of the most notable antecedent pandemic, the Spanish Influenza epidemic, on American forces with the goal of understanding the interrelationship of global pandemics and the military, highlighting the unique challenges of the current pandemic, and examining how the American military has fought back against pandemics both at home and abroad, both 100 years ago and today.展开更多
Objective: Although HR activities are known to enhance performance, this seems an often overlooked domain amongst physicians. Therefore, this cross-disciplinary interview study explores how physicians perceive high pe...Objective: Although HR activities are known to enhance performance, this seems an often overlooked domain amongst physicians. Therefore, this cross-disciplinary interview study explores how physicians perceive high performance and what activities they find contributing to such performance. Methods: Drawing on HR and healthcare literature, we analysed in-depth interviews with 28 physicians and 7 HR professionals and hospital management representatives, following the grounded theory approach. Results: Our findings demonstrate physicians perceive high performance as a balance between quality of medical care and patient satisfaction and dedication and collaboration are indicated vital dimensions of high performance. Physicians offered suggestions regarding activities contributing to high performance. Conclusion: This cross-disciplinary study recognized dedication and collaboration as crucial elements for physicians to perform to the best of their abilities. These findings suggest that high performance can only flourish when doctors are seen as committed professionals, with strong humanistic values rather than just as providers of medical care. The results of this research furthermore indicate that people management is critical, it is recommended that this should be executed through close collaboration of all those responsible.展开更多
Background: After more than a decade of the nursing profession contending that healthcare reform based almost exclusively on cost cutting was creating an array of serious ethical issues for nurses, healthcare organiza...Background: After more than a decade of the nursing profession contending that healthcare reform based almost exclusively on cost cutting was creating an array of serious ethical issues for nurses, healthcare organizations and other providers are now facing increasing demands primarily from payers to demonstrate improvement in both quality of care and patient experience along with continued cost reduction. Research Question: Have efforts by healthcare organizations to comply with these recently imposed requirements influenced the ethical environment faced by nurses and nurse leaders and if so, how? Materials and Methods: Data for assessing the current ethical environment was gathered with a close-ended survey mailed in October 2012 to a random sample of 3000 members of the American Organization of Nurse Executives. Results and Discussion: Statistical analysis of the data and comparison with the findings of a similar study conducted in 2000 indicated that along with five highly rated issues in the earlier study attributed largely to economic constraints imposed by healthcare organizations, the top-10 key ethical issues today included five issues primarily attributable to interprofessional conflict. Conclusion: Given the success of many ongoing efforts aimed at weakening these key sources of ethical conflict that have blocked many proposals to improve the quality of care, opportunities should arise for the nursing profession to more fully achieve its goals of improving the quality of care, safety and patient satisfaction and enhancing nurses’ work environments essential to that effort.展开更多
With the nursing profession continuing to face an array of ethical issues, the article reports the findings of a survey of members of the American Organization of Nurse Executives conducted in 2012 to determine the ex...With the nursing profession continuing to face an array of ethical issues, the article reports the findings of a survey of members of the American Organization of Nurse Executives conducted in 2012 to determine the extent to which nurse leaders at different organization levels perceive various factors in their personal, professional and organizational environments to be helpful in resolving ethical dilemmas. After their personal values, nurse leaders perceive factors related to their organization to be more helpful than those related to their profession, including, among others, the American Nurses Association Code of Ethics. The two highest rated business-related factors deal with the absence of pressure to compromise one’s own ethical standards which suggests that one way healthcare organizations can assist nurses and their leaders is by neither explicitly nor implicitly pressuring them to go against their own ethical values. Other key factors related to the organization include formal organizational factors such as the existence of an ethics committee or a person to whom unethical activity can be reported as well as more informal factors related to organizational climate such as the actions and responsiveness of one’s immediate boss, the ability to go beyond one’s boss if necessary, the organizational culture, management philosophy, and management’s communication of appropriate ethical behavior. Comparison of the findings of the 2012 survey with those of a similar study conducted in 2000 indicated the four factors perceived as most helpful in both studies were identical with the same rank order and the top-10 factors were identical with some differences in ranking. Further analysis indicated the relative degree of helpfulness of the 17 help factors common to both studies was perceived by responding nurse leaders as quite similar overall. The authors also discuss the implications for the profession and the healthcare industry today and in the future.展开更多
Consensus is evident among influential professional organizations （American Nurses Association, American College of Nurses, Institute of Medicine, National Council of State Boards of Nursing, World Health Organizatio...Consensus is evident among influential professional organizations （American Nurses Association, American College of Nurses, Institute of Medicine, National Council of State Boards of Nursing, World Health Organization, National Institute of Health, Quality Safety and Education for Nursing and the American Association of Critical Care Nurses） as to essential core competencies for healthcare providers. Although there is agreement among them, assessment and measurement of competence for RN＇s in transition is overly complex. Eleven benchmarks were developed as foundational criteria to determine readiness to practice through research of national healthcare organizations position statements on competency and subsequently cross walked with identified core competeneies. This article introduces the concept of evidence-based benchmarks as a mechanism to determine readiness to practice safely, competently and independently among novice and experienced nurses who are in transition.展开更多
Researchers and extensionists would pursue their interests to develop new inventions and encourage rubber smallholders to adopt new technology and practices to increase production of their holdings. Three interrelated...Researchers and extensionists would pursue their interests to develop new inventions and encourage rubber smallholders to adopt new technology and practices to increase production of their holdings. Three interrelated systems, research and development （R＆D） system, extension/delivery system and client （smallholders） system, are responsible to make the rubber industry viable and dynamic. The extension system is also encouraged to identify and carry out related research activities besides its own core function to enhance clients＇ understanding and to use the findings as basis to plan effective strategies for implementation. Knowledge acquisition among clients is critical in capacity building process. With knowledge, clients tend to develop favorable attitude and use it to develop specific skill to practice recommended technology and new practices. Necessity is the mother of invention in times of need, especially when rubber price is low. Researchers, extensionists and smallholders are ＂forced＂ to collaborate and become creative to fred alternative ways and uses of natural rubber to increase demand of the commodity. When natural rubber price is low, funding for research needs to be maintained at current level, or in some cases, funding is increased to ensure that the industry is not void of new technology and new products. The main goal of the rubber industry is to ensure that new technology and practices are continuously being generated and developed by researchers to be adopted by rubber smallholders. The adoption of new technology and practices by smallholders ensures that production of natural rubber continues to increase, while income of smallholders is maintained or increased at an appreciative level to offset low rubber prices. There is an inclination in the rubber industry that when the commodity＇s price is low, activities and programs related to research and dissemination of research results would follow to be reduced, resulting in stagnation and opportunities for future growth of the industry. The National Blue Ocean Strategy （NBOS） should be used to harness expertise in research among researchers of local universities, as well as to cooperate among extensionists from agencies at state and national levels to help disseminate research results. The NBOS can reduce cost, and has bigger impacts and wider applications of natural rubber for local and international markets.展开更多
As global economic integration development enters a realization era,English holds a very important position in China's diplomacy as the language is an internationally-used language.Besides,English also plays a ver...As global economic integration development enters a realization era,English holds a very important position in China's diplomacy as the language is an internationally-used language.Besides,English also plays a very important role in our daily life.Colleges and universities should pay more attention in strengthening the development of English teaching courses as they are an important base for cultivating high-quality talents.In the modern teaching of English and American literature courses,college English majors do not only need to teach students English language knowledge but are also required need to strengthen students'knowledge and study of national culture.In this journal,the author investigates and analyses the current situation and existing problems of the modern teaching of English and American literature courses in English majors of colleges and universities.Then,puts forward the implementation strategies such as modern teaching of English and American literature courses in English majors’colleges and universities,aiming to help in implementing the teaching of English and American literature courses successfully.展开更多
As global economic integration development enters a realization era,English holds a very important position in China's diplomacy as the language is an internationally-used language.Besides,English also plays a ver...As global economic integration development enters a realization era,English holds a very important position in China's diplomacy as the language is an internationally-used language.Besides,English also plays a very important role in our daily life.Colleges and universities should pay more attention in strengthening the development of English teaching courses as they are an important base for cultivating high-quality talents.In the modern teaching of English and American literature courses,college English majors do not only need to teach students English language knowledge but are also required need to strengthen students'knowledge and study of national culture.In this journal,the author investigates and analyses the current situation and existing problems of the modern teaching of English and American literature courses in English majors of colleges and universities.Then,puts forward the implementation strategies such as modern teaching of English and American literature courses in English majors’colleges and universities,aiming to help in implementing the teaching of English and American literature courses successfully.展开更多
Background: Medications non-adherence is responsible for treatment failure and a reason of higher cost of medical care. It had been proved that, in general, diabetic patients are non-adherent to their treatment and on...Background: Medications non-adherence is responsible for treatment failure and a reason of higher cost of medical care. It had been proved that, in general, diabetic patients are non-adherent to their treatment and only a small number of them were found to be adhering with all aspects of diabetic care. Objectives: To assess and evaluate the most common factors associated with medications adherence among Type 2 Diabetes Mellitus (DM) patients attending Ribat University Hospital Diabetic Clinic (RUHDC) Khartoum state, Sudan. Methods: Single Centre Descriptive cross sectional hospital based study was carried out among 351 patients using structured questionnaire and patients cards. Results: A total of 351 patients were recruited in the study;65.8% were females. About 64.4% were on oral medications and 35.6% on insulin. Adherence to medications among total Type 2 DM patients was 45%. Main barriers to medication adherence were drugs unavailability (34.3%) and forgetfulness (30.7%). Medications knowledge was 41.2% for patients on oral medications and 38.4% for insulin users. Conclusion: Adherence to anti-diabetic drugs in this study was found to be sub-optimal but considered reasonable in comparison with that reported by many African countries. Poor medications knowledge, drug brand unavailability and forgetfulness were the main reasons for medications non adherence. Family support, improving healthcare system and changing patents’ behavior will be needed to improve medications adherence.展开更多
Primary education,guided by the cultivation of disciplinary core literacy,places a greater emphasis on students’autonomy and is committed to promoting students’all-round development.English reading is one of the mai...Primary education,guided by the cultivation of disciplinary core literacy,places a greater emphasis on students’autonomy and is committed to promoting students’all-round development.English reading is one of the main ways for students to acquire English knowledge.Although it is a fundamental learning point in English teaching,it poses challenges to English teaching in primary schools.This paper makes a detailed analysis of the current state of English reading education for primary school students from the perspective of core literacy,and then proposes effective strategies for improving students’English reading skills.展开更多
Background:South Africa has one of the world’s worst tuberculosis(TB)(520 per 100000 population)and TB-human immunodefciency virus(HIV)epidemics(~56%TB/HIV co-infected).While individual-and system-level factors infue...Background:South Africa has one of the world’s worst tuberculosis(TB)(520 per 100000 population)and TB-human immunodefciency virus(HIV)epidemics(~56%TB/HIV co-infected).While individual-and system-level factors infuencing progression along the TB cascade have been identifed,the impact of stigma is underexplored and underappreciated.We conducted an exploratory study to 1)describe diferences in perceived community-level TB stigma among community members,TB presumptives,and TB patients,and 2)identify factors associated with TB stigma levels among these groups.Methods:A cross sectional study was conducted in November 2017 at public health care facilities in Bufalo City Metro(BCM)and Zululand health districts,South Africa.Community members,TB presumptives,and TB patients were recruited.Data were collected on sociodemographic characteristics,TB knowledge,health and clinical history,social support,and both HIV and TB stigma.A validated scale assessing perceived community TB stigma was used.Univariate and multivariate linear regression models were used to describe diferences in perceived community TB stigma by participant type and to identify factors associated with TB stigma.Results:We enrolled 397 participants.On a scale of zero to 24,the mean stigma score for TB presumptives(14.7±4.4)was statistically higher than community members(13.6±4.8)and TB patients(13.3±5.1).Community members from Zululand(β=5.73;95%CI 2.19,9.72)had higher TB stigma compared to those from BCM.Previously having TB(β=−2.19;95%CI−4.37,0.0064)was associated with reduced TB stigma among community members.Understanding the relationship between HIV and TB disease(β=2.48;95%CI 0.020,4.94),and having low social support(β=−0.077;95%CI−0.14,0.010)were associated with increased TB stigma among TB presumptives.Among TB Patients,identifying as Black African(β=−2.90;95%CI−4.74,−1.04)and knowing the correct causes of TB(β=−2.93;95%CI−4.92,−0.94)were associated with decreased TB stigma,while understanding the relationship between HIV and TB disease(β=2.48;95%CI 1.05,3.90)and higher HIV stigma(β=0.32;95%CI 0.21,0.42)were associated with increased TB stigma.Conclusions:TB stigma interventions should be developed for TB presumptives,as stigma may increase initial-lossto-follow up.Given that stigma may be driven by numerous factors throughout the TB cascade,adaptive stigma reduction interventions may be required.展开更多
Importance:Urinary tract infection(UTI)is one of the most common infections encountered in infancy and childhood.Despite the emerging problem of antibiotic resistance in recent years,the use of antibiotics for better ...Importance:Urinary tract infection(UTI)is one of the most common infections encountered in infancy and childhood.Despite the emerging problem of antibiotic resistance in recent years,the use of antibiotics for better management of UTIs is inevitable.Objective:This study aims to explore the efficacy and adverse effects of the available antimicrobial agents that are used in pediatric UTIs in low-and middle-income countries(LMICs).Methods:Five electronic databases were searched to identify relevant articles.Two reviewers independently performed screening,data extraction,and quality assessment of the available literature.Randomized controlled trials providing antimicrobial interventions in both male and female participants within the age range of 3 months to 17 years in LMICs were included.Results:Six randomized controlled trials from 13 LMICs were included in this review(four trials explored the efficacy).Due to high heterogeneity across the studies,a meta-analysis was not performed.Other than attrition and reporting bias,the risk of bias was moderate to high due to poor study designs.The differences in the efficacy and adverse events of different antimicrobials were not found to be statistically significant.Interpretation:This review indicates the necessity for additional clinical trials on children from LMICs with more significant sample numbers,adequate intervention periods,and study design.展开更多
The goal of the present study is to investigate the relationship between pupils’problem posing and problem solving abilities,their beliefs about problem posing and problem solving,and their general mathematics abilit...The goal of the present study is to investigate the relationship between pupils’problem posing and problem solving abilities,their beliefs about problem posing and problem solving,and their general mathematics abilities,in a Chinese context.Five instruments,i.e.,a problem posing test,a problem solving test,a problem posing questionnaire,a problem solving questionnaire,and a standard achievement test,were administered to 69 Chinese fifth-grade pupils to assess these five variables and analyze their mutual relationships.Results revealed strong correlations between pupils’problem posing and problem solving abilities and beliefs,and their general mathematical abilities.展开更多
Chronic obstructive pulmonary disease(COPD)has recently become the third leading cause of death following heart disease and cancer.Acute exacerbation of COPD(AECOPD)can be prevented by early detection of deterioration...Chronic obstructive pulmonary disease(COPD)has recently become the third leading cause of death following heart disease and cancer.Acute exacerbation of COPD(AECOPD)can be prevented by early detection of deterioration and timely treatment,which can effectively lower the severity of exacerbation and prevent hospitalization.展开更多
文摘The present moment is not the first time that America has found itself at war with a pathogen during a time of international conflict. Between crowded barracks at home and trenches abroad, wartime conditions helped enable the spread of influenza in the fall of 1918 during World War I such that an estimated 20%–40% of U.S. military members were infected. While the coronavirus disease 2019(COVID-19) pandemic is unparalleled for most of today's population, it is essential to not view it as unprecedented lest the lessons of past pandemics and their effect on the American military be forgotten. This article provides a historical perspective on the effect of the most notable antecedent pandemic, the Spanish Influenza epidemic, on American forces with the goal of understanding the interrelationship of global pandemics and the military, highlighting the unique challenges of the current pandemic, and examining how the American military has fought back against pandemics both at home and abroad, both 100 years ago and today.
文摘Objective: Although HR activities are known to enhance performance, this seems an often overlooked domain amongst physicians. Therefore, this cross-disciplinary interview study explores how physicians perceive high performance and what activities they find contributing to such performance. Methods: Drawing on HR and healthcare literature, we analysed in-depth interviews with 28 physicians and 7 HR professionals and hospital management representatives, following the grounded theory approach. Results: Our findings demonstrate physicians perceive high performance as a balance between quality of medical care and patient satisfaction and dedication and collaboration are indicated vital dimensions of high performance. Physicians offered suggestions regarding activities contributing to high performance. Conclusion: This cross-disciplinary study recognized dedication and collaboration as crucial elements for physicians to perform to the best of their abilities. These findings suggest that high performance can only flourish when doctors are seen as committed professionals, with strong humanistic values rather than just as providers of medical care. The results of this research furthermore indicate that people management is critical, it is recommended that this should be executed through close collaboration of all those responsible.
文摘Background: After more than a decade of the nursing profession contending that healthcare reform based almost exclusively on cost cutting was creating an array of serious ethical issues for nurses, healthcare organizations and other providers are now facing increasing demands primarily from payers to demonstrate improvement in both quality of care and patient experience along with continued cost reduction. Research Question: Have efforts by healthcare organizations to comply with these recently imposed requirements influenced the ethical environment faced by nurses and nurse leaders and if so, how? Materials and Methods: Data for assessing the current ethical environment was gathered with a close-ended survey mailed in October 2012 to a random sample of 3000 members of the American Organization of Nurse Executives. Results and Discussion: Statistical analysis of the data and comparison with the findings of a similar study conducted in 2000 indicated that along with five highly rated issues in the earlier study attributed largely to economic constraints imposed by healthcare organizations, the top-10 key ethical issues today included five issues primarily attributable to interprofessional conflict. Conclusion: Given the success of many ongoing efforts aimed at weakening these key sources of ethical conflict that have blocked many proposals to improve the quality of care, opportunities should arise for the nursing profession to more fully achieve its goals of improving the quality of care, safety and patient satisfaction and enhancing nurses’ work environments essential to that effort.
文摘With the nursing profession continuing to face an array of ethical issues, the article reports the findings of a survey of members of the American Organization of Nurse Executives conducted in 2012 to determine the extent to which nurse leaders at different organization levels perceive various factors in their personal, professional and organizational environments to be helpful in resolving ethical dilemmas. After their personal values, nurse leaders perceive factors related to their organization to be more helpful than those related to their profession, including, among others, the American Nurses Association Code of Ethics. The two highest rated business-related factors deal with the absence of pressure to compromise one’s own ethical standards which suggests that one way healthcare organizations can assist nurses and their leaders is by neither explicitly nor implicitly pressuring them to go against their own ethical values. Other key factors related to the organization include formal organizational factors such as the existence of an ethics committee or a person to whom unethical activity can be reported as well as more informal factors related to organizational climate such as the actions and responsiveness of one’s immediate boss, the ability to go beyond one’s boss if necessary, the organizational culture, management philosophy, and management’s communication of appropriate ethical behavior. Comparison of the findings of the 2012 survey with those of a similar study conducted in 2000 indicated the four factors perceived as most helpful in both studies were identical with the same rank order and the top-10 factors were identical with some differences in ranking. Further analysis indicated the relative degree of helpfulness of the 17 help factors common to both studies was perceived by responding nurse leaders as quite similar overall. The authors also discuss the implications for the profession and the healthcare industry today and in the future.
文摘Consensus is evident among influential professional organizations （American Nurses Association, American College of Nurses, Institute of Medicine, National Council of State Boards of Nursing, World Health Organization, National Institute of Health, Quality Safety and Education for Nursing and the American Association of Critical Care Nurses） as to essential core competencies for healthcare providers. Although there is agreement among them, assessment and measurement of competence for RN＇s in transition is overly complex. Eleven benchmarks were developed as foundational criteria to determine readiness to practice through research of national healthcare organizations position statements on competency and subsequently cross walked with identified core competeneies. This article introduces the concept of evidence-based benchmarks as a mechanism to determine readiness to practice safely, competently and independently among novice and experienced nurses who are in transition.
文摘Researchers and extensionists would pursue their interests to develop new inventions and encourage rubber smallholders to adopt new technology and practices to increase production of their holdings. Three interrelated systems, research and development （R＆D） system, extension/delivery system and client （smallholders） system, are responsible to make the rubber industry viable and dynamic. The extension system is also encouraged to identify and carry out related research activities besides its own core function to enhance clients＇ understanding and to use the findings as basis to plan effective strategies for implementation. Knowledge acquisition among clients is critical in capacity building process. With knowledge, clients tend to develop favorable attitude and use it to develop specific skill to practice recommended technology and new practices. Necessity is the mother of invention in times of need, especially when rubber price is low. Researchers, extensionists and smallholders are ＂forced＂ to collaborate and become creative to fred alternative ways and uses of natural rubber to increase demand of the commodity. When natural rubber price is low, funding for research needs to be maintained at current level, or in some cases, funding is increased to ensure that the industry is not void of new technology and new products. The main goal of the rubber industry is to ensure that new technology and practices are continuously being generated and developed by researchers to be adopted by rubber smallholders. The adoption of new technology and practices by smallholders ensures that production of natural rubber continues to increase, while income of smallholders is maintained or increased at an appreciative level to offset low rubber prices. There is an inclination in the rubber industry that when the commodity＇s price is low, activities and programs related to research and dissemination of research results would follow to be reduced, resulting in stagnation and opportunities for future growth of the industry. The National Blue Ocean Strategy （NBOS） should be used to harness expertise in research among researchers of local universities, as well as to cooperate among extensionists from agencies at state and national levels to help disseminate research results. The NBOS can reduce cost, and has bigger impacts and wider applications of natural rubber for local and international markets.
文摘As global economic integration development enters a realization era,English holds a very important position in China's diplomacy as the language is an internationally-used language.Besides,English also plays a very important role in our daily life.Colleges and universities should pay more attention in strengthening the development of English teaching courses as they are an important base for cultivating high-quality talents.In the modern teaching of English and American literature courses,college English majors do not only need to teach students English language knowledge but are also required need to strengthen students'knowledge and study of national culture.In this journal,the author investigates and analyses the current situation and existing problems of the modern teaching of English and American literature courses in English majors of colleges and universities.Then,puts forward the implementation strategies such as modern teaching of English and American literature courses in English majors’colleges and universities,aiming to help in implementing the teaching of English and American literature courses successfully.
文摘As global economic integration development enters a realization era,English holds a very important position in China's diplomacy as the language is an internationally-used language.Besides,English also plays a very important role in our daily life.Colleges and universities should pay more attention in strengthening the development of English teaching courses as they are an important base for cultivating high-quality talents.In the modern teaching of English and American literature courses,college English majors do not only need to teach students English language knowledge but are also required need to strengthen students'knowledge and study of national culture.In this journal,the author investigates and analyses the current situation and existing problems of the modern teaching of English and American literature courses in English majors of colleges and universities.Then,puts forward the implementation strategies such as modern teaching of English and American literature courses in English majors’colleges and universities,aiming to help in implementing the teaching of English and American literature courses successfully.
文摘Background: Medications non-adherence is responsible for treatment failure and a reason of higher cost of medical care. It had been proved that, in general, diabetic patients are non-adherent to their treatment and only a small number of them were found to be adhering with all aspects of diabetic care. Objectives: To assess and evaluate the most common factors associated with medications adherence among Type 2 Diabetes Mellitus (DM) patients attending Ribat University Hospital Diabetic Clinic (RUHDC) Khartoum state, Sudan. Methods: Single Centre Descriptive cross sectional hospital based study was carried out among 351 patients using structured questionnaire and patients cards. Results: A total of 351 patients were recruited in the study;65.8% were females. About 64.4% were on oral medications and 35.6% on insulin. Adherence to medications among total Type 2 DM patients was 45%. Main barriers to medication adherence were drugs unavailability (34.3%) and forgetfulness (30.7%). Medications knowledge was 41.2% for patients on oral medications and 38.4% for insulin users. Conclusion: Adherence to anti-diabetic drugs in this study was found to be sub-optimal but considered reasonable in comparison with that reported by many African countries. Poor medications knowledge, drug brand unavailability and forgetfulness were the main reasons for medications non adherence. Family support, improving healthcare system and changing patents’ behavior will be needed to improve medications adherence.
文摘Primary education,guided by the cultivation of disciplinary core literacy,places a greater emphasis on students’autonomy and is committed to promoting students’all-round development.English reading is one of the main ways for students to acquire English knowledge.Although it is a fundamental learning point in English teaching,it poses challenges to English teaching in primary schools.This paper makes a detailed analysis of the current state of English reading education for primary school students from the perspective of core literacy,and then proposes effective strategies for improving students’English reading skills.
文摘Background:South Africa has one of the world’s worst tuberculosis(TB)(520 per 100000 population)and TB-human immunodefciency virus(HIV)epidemics(~56%TB/HIV co-infected).While individual-and system-level factors infuencing progression along the TB cascade have been identifed,the impact of stigma is underexplored and underappreciated.We conducted an exploratory study to 1)describe diferences in perceived community-level TB stigma among community members,TB presumptives,and TB patients,and 2)identify factors associated with TB stigma levels among these groups.Methods:A cross sectional study was conducted in November 2017 at public health care facilities in Bufalo City Metro(BCM)and Zululand health districts,South Africa.Community members,TB presumptives,and TB patients were recruited.Data were collected on sociodemographic characteristics,TB knowledge,health and clinical history,social support,and both HIV and TB stigma.A validated scale assessing perceived community TB stigma was used.Univariate and multivariate linear regression models were used to describe diferences in perceived community TB stigma by participant type and to identify factors associated with TB stigma.Results:We enrolled 397 participants.On a scale of zero to 24,the mean stigma score for TB presumptives(14.7±4.4)was statistically higher than community members(13.6±4.8)and TB patients(13.3±5.1).Community members from Zululand(β=5.73;95%CI 2.19,9.72)had higher TB stigma compared to those from BCM.Previously having TB(β=−2.19;95%CI−4.37,0.0064)was associated with reduced TB stigma among community members.Understanding the relationship between HIV and TB disease(β=2.48;95%CI 0.020,4.94),and having low social support(β=−0.077;95%CI−0.14,0.010)were associated with increased TB stigma among TB presumptives.Among TB Patients,identifying as Black African(β=−2.90;95%CI−4.74,−1.04)and knowing the correct causes of TB(β=−2.93;95%CI−4.92,−0.94)were associated with decreased TB stigma,while understanding the relationship between HIV and TB disease(β=2.48;95%CI 1.05,3.90)and higher HIV stigma(β=0.32;95%CI 0.21,0.42)were associated with increased TB stigma.Conclusions:TB stigma interventions should be developed for TB presumptives,as stigma may increase initial-lossto-follow up.Given that stigma may be driven by numerous factors throughout the TB cascade,adaptive stigma reduction interventions may be required.
文摘Importance:Urinary tract infection(UTI)is one of the most common infections encountered in infancy and childhood.Despite the emerging problem of antibiotic resistance in recent years,the use of antibiotics for better management of UTIs is inevitable.Objective:This study aims to explore the efficacy and adverse effects of the available antimicrobial agents that are used in pediatric UTIs in low-and middle-income countries(LMICs).Methods:Five electronic databases were searched to identify relevant articles.Two reviewers independently performed screening,data extraction,and quality assessment of the available literature.Randomized controlled trials providing antimicrobial interventions in both male and female participants within the age range of 3 months to 17 years in LMICs were included.Results:Six randomized controlled trials from 13 LMICs were included in this review(four trials explored the efficacy).Due to high heterogeneity across the studies,a meta-analysis was not performed.Other than attrition and reporting bias,the risk of bias was moderate to high due to poor study designs.The differences in the efficacy and adverse events of different antimicrobials were not found to be statistically significant.Interpretation:This review indicates the necessity for additional clinical trials on children from LMICs with more significant sample numbers,adequate intervention periods,and study design.
基金This research was supported by Grant Education Sciences Planning(JG10DB223)“Experimental research on the development of pupils’problem posing ability in Shenyang City”from the Research Fund of the Shenyang Educational Committeeby Grant GOA 2012/10“Number sense:Analysis and improvement”from the Research Fund of the Katholieke Universiteit Leuven,Belgium.
文摘The goal of the present study is to investigate the relationship between pupils’problem posing and problem solving abilities,their beliefs about problem posing and problem solving,and their general mathematics abilities,in a Chinese context.Five instruments,i.e.,a problem posing test,a problem solving test,a problem posing questionnaire,a problem solving questionnaire,and a standard achievement test,were administered to 69 Chinese fifth-grade pupils to assess these five variables and analyze their mutual relationships.Results revealed strong correlations between pupils’problem posing and problem solving abilities and beliefs,and their general mathematical abilities.
基金supported by grants from the National Key Research and Development Program of China(No.2018YFC1313602)Major International(Regional)Joint Research Project(No.81820108001)+4 种基金National Natural Science Foundation of China(No.81670029)Jiangsu Key Principal Investigator of Medicine(No.ZDRCA2016018)Project 333 for Cultivation of Young and Middle-aged Leading Talents(No.BRA2019078)Jiangsu Key Program of Social Development(No.BE2015651)Nanjing Key Project of Science and Technology(No.2019060002)to L.Zhou.
文摘Chronic obstructive pulmonary disease(COPD)has recently become the third leading cause of death following heart disease and cancer.Acute exacerbation of COPD(AECOPD)can be prevented by early detection of deterioration and timely treatment,which can effectively lower the severity of exacerbation and prevent hospitalization.
