目的设计短期培训干预方案,以参加安宁疗护培训的医务人员作为研究对象,在培训干预前后采用“医务人员安宁疗护知识态度行为调查表”(Knowledge,Attitude and Practice of Hospice Care,KAPHC)进行重复测量,分析评价教学干预对医务人员...目的设计短期培训干预方案,以参加安宁疗护培训的医务人员作为研究对象,在培训干预前后采用“医务人员安宁疗护知识态度行为调查表”(Knowledge,Attitude and Practice of Hospice Care,KAPHC)进行重复测量,分析评价教学干预对医务人员安宁疗护知识、威胁感、益处感、障碍感、主观规范、自我效能、行为意向的影响效果,为全国安宁疗护试点地区开展同类安宁疗护服务能力培训提供可参考借签的模式样板。方法采用问卷法进行干预前后的调查,采用描述统计、卡方检验、t检验进行干预前后的对比分析。结果通过重复测量发现,医务人员培训干预前后的知识(t=−14.07,P<0.001)、威胁感(t=−3.10,P<0.001)、益处感(t=−4.36,P<0.001)、障碍感(t=−3.03,P<0.001)、主观规范(t=−2.35,P=0.019)、自我效能(t=−7.44,P<0.001)维度的得分均有提高。结论短期教育培训可有效帮助和促进医务人员及时更新安宁疗护知识和技能,减轻医务人员提供安宁疗护服务的威胁感和障碍感,提升其益处感和自我效能,是当前推动安宁疗护开展和提高安宁疗护服务质量行之有效的干预手段。展开更多
考虑由“功能型物流服务提供商—物流服务集成商—客户”构成的物流服务供应链(Logistics Service Supply Chain, LSSC),针对链内提供商安全生产问题的动态性与复杂性,探究集成商不同管理策略对提供商安全生产行为的影响。采用计算实验...考虑由“功能型物流服务提供商—物流服务集成商—客户”构成的物流服务供应链(Logistics Service Supply Chain, LSSC),针对链内提供商安全生产问题的动态性与复杂性,探究集成商不同管理策略对提供商安全生产行为的影响。采用计算实验方法,抽象模拟出二者在选择与合作阶段的交互活动,分别进行集成商订单配置决策中安全因素权重、安全生产考评标准、安全风险抵押金对提供商安全生产行为的影响实验。研究结果表明:在客户具有安全偏好情况下,集成商通过合理的订单配置决策可实现提供商安全生产水平与自身收益的协同提升;当安全生产考评标准超过提供商可接受阈值时,其安全生产水平反而将会降低;收取安全风险抵押金可使提供商安全生产水平有所提高,但效果有限。展开更多
In a cloud computing environment, users using the pay-as-you-go billing model can relinquish their services at any point in time and pay accordingly. From the perspective of the Cloud Service Providers (CSPs), this is...In a cloud computing environment, users using the pay-as-you-go billing model can relinquish their services at any point in time and pay accordingly. From the perspective of the Cloud Service Providers (CSPs), this is not beneficial as they may lose the opportunity to earn from the relinquished resources. Therefore, this paper tackles the resource assignment problem while considering users relinquishment and its impact on the net profit of CSPs. As a solution, we first compare different ways to predict user behavior (i.e. how likely a user will leave the system before its scheduled end time) and deduce a better prediction technique based on linear regression. Then, based on the RACE (Relinquishment-Aware Cloud Economics) model proposed in [1], we develop a relinquishment-aware resource optimization model to estimate the amount of resources to assign on the basis of predicted user behavior. Simulations performed with CloudSim show that cloud service providers can gain more by estimating the amount of resources using better prediction techniques rather than blindly assigning resources to users. They also show that the proposed prediction-based resource assignment scheme typically generates more profit for a lower or similar utilization.展开更多
Patients with cardiovascular disease and their partners expect health care providers to provide sexual counseling to assist them in maintaining sexual quality of life. Evidence suggests however, that there is a gap in...Patients with cardiovascular disease and their partners expect health care providers to provide sexual counseling to assist them in maintaining sexual quality of life. Evidence suggests however, that there is a gap in integrating evidence into practice and that relatively few cardiac patients receive sexual counseling. This can result in negative psychological, physical, and quality of life outcomes for couples who may needlessly decide sexual activity is too risky and cease all sexual activity. Two scientific statements now exist that provide ample guidance to health care providers in discussing this important topic. Using a team approach that includes physicians, nurses, physical therapists, rehabilitation staff, and others is important to ensure that sexual counseling occurs throughout recovery. In addition, several trials using interventional approaches for sexual counseling provide insight into successful approaches for sexual counseling in practice. This article provides practical strategies and evidence-based approaches for assessment and sexual counseling for all cardiac patients and their partners, and specific counseling for those with ischemic conditions, heart failure, and implanted devices.展开更多
文摘目的设计短期培训干预方案,以参加安宁疗护培训的医务人员作为研究对象,在培训干预前后采用“医务人员安宁疗护知识态度行为调查表”(Knowledge,Attitude and Practice of Hospice Care,KAPHC)进行重复测量,分析评价教学干预对医务人员安宁疗护知识、威胁感、益处感、障碍感、主观规范、自我效能、行为意向的影响效果,为全国安宁疗护试点地区开展同类安宁疗护服务能力培训提供可参考借签的模式样板。方法采用问卷法进行干预前后的调查,采用描述统计、卡方检验、t检验进行干预前后的对比分析。结果通过重复测量发现,医务人员培训干预前后的知识(t=−14.07,P<0.001)、威胁感(t=−3.10,P<0.001)、益处感(t=−4.36,P<0.001)、障碍感(t=−3.03,P<0.001)、主观规范(t=−2.35,P=0.019)、自我效能(t=−7.44,P<0.001)维度的得分均有提高。结论短期教育培训可有效帮助和促进医务人员及时更新安宁疗护知识和技能,减轻医务人员提供安宁疗护服务的威胁感和障碍感,提升其益处感和自我效能,是当前推动安宁疗护开展和提高安宁疗护服务质量行之有效的干预手段。
文摘考虑由“功能型物流服务提供商—物流服务集成商—客户”构成的物流服务供应链(Logistics Service Supply Chain, LSSC),针对链内提供商安全生产问题的动态性与复杂性,探究集成商不同管理策略对提供商安全生产行为的影响。采用计算实验方法,抽象模拟出二者在选择与合作阶段的交互活动,分别进行集成商订单配置决策中安全因素权重、安全生产考评标准、安全风险抵押金对提供商安全生产行为的影响实验。研究结果表明:在客户具有安全偏好情况下,集成商通过合理的订单配置决策可实现提供商安全生产水平与自身收益的协同提升;当安全生产考评标准超过提供商可接受阈值时,其安全生产水平反而将会降低;收取安全风险抵押金可使提供商安全生产水平有所提高,但效果有限。
文摘In a cloud computing environment, users using the pay-as-you-go billing model can relinquish their services at any point in time and pay accordingly. From the perspective of the Cloud Service Providers (CSPs), this is not beneficial as they may lose the opportunity to earn from the relinquished resources. Therefore, this paper tackles the resource assignment problem while considering users relinquishment and its impact on the net profit of CSPs. As a solution, we first compare different ways to predict user behavior (i.e. how likely a user will leave the system before its scheduled end time) and deduce a better prediction technique based on linear regression. Then, based on the RACE (Relinquishment-Aware Cloud Economics) model proposed in [1], we develop a relinquishment-aware resource optimization model to estimate the amount of resources to assign on the basis of predicted user behavior. Simulations performed with CloudSim show that cloud service providers can gain more by estimating the amount of resources using better prediction techniques rather than blindly assigning resources to users. They also show that the proposed prediction-based resource assignment scheme typically generates more profit for a lower or similar utilization.
文摘Patients with cardiovascular disease and their partners expect health care providers to provide sexual counseling to assist them in maintaining sexual quality of life. Evidence suggests however, that there is a gap in integrating evidence into practice and that relatively few cardiac patients receive sexual counseling. This can result in negative psychological, physical, and quality of life outcomes for couples who may needlessly decide sexual activity is too risky and cease all sexual activity. Two scientific statements now exist that provide ample guidance to health care providers in discussing this important topic. Using a team approach that includes physicians, nurses, physical therapists, rehabilitation staff, and others is important to ensure that sexual counseling occurs throughout recovery. In addition, several trials using interventional approaches for sexual counseling provide insight into successful approaches for sexual counseling in practice. This article provides practical strategies and evidence-based approaches for assessment and sexual counseling for all cardiac patients and their partners, and specific counseling for those with ischemic conditions, heart failure, and implanted devices.
