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1.
以上海市胸科医院为例,从总体架构、智能规则库、模型构建和计算等方面阐述基于智能分配规则的医院检查预约平台建设,选取对照组和观察组对平台使用前后预约情况进行对比,结果表明该平台有助于缩短检查等候时间,优化检查预约流程,提升患者满意度。  相似文献   
2.
Neurotrophic tyrosine receptor kinase gene fusions (NTRK) are oncogenic drivers present at a low frequency in most tumour types (<5%), and at a higher frequency (>80%) in a small number of rare tumours (e.g., infantile fibrosarcoma [IFS]) and considered mutually exclusive with other common oncogenic drivers. Health Canada recently approved two tyrosine receptor kinase (TRK) inhibitors, larotrectinib (for adults and children) and entrectinib (for adults), for the treatment of solid tumours harbouring NTRK gene fusions. In Phase I/II trials, these TRK inhibitors have demonstrated promising overall response rates and tolerability in patients with TRK fusion cancer who have exhausted other treatment options. In these studies, children appear to have similar responses and tolerability to adults. In this report, we provide a Canadian consensus on when and how to test for NTRK gene fusions and when to consider treatment with a TRK inhibitor for pediatric patients with solid tumours. We focus on three pediatric tumour types: non-rhabdomyosarcoma soft tissue sarcoma/unspecified spindle cell tumours including IFS, differentiated thyroid carcinoma, and glioma. We also propose a tumour-agnostic consensus based on the probability of the tumour harbouring an NTRK gene fusion. For children with locally advanced or metastatic TRK fusion cancer who have either failed upfront therapy or lack satisfactory treatment options, TRK inhibitor therapy should be considered.  相似文献   
3.
Crashes due to sleepiness account for a substantial proportion of road crash incidents. The purpose of the current study was to examine several sleep‐related factors and driving‐related factors for their association with self‐reports of continuing to drive while sleepy. In total 257 young drivers aged 18–25 years completed an online survey that assessed factors such as sleep quality, sleep duration and consistency, excessive daytime sleepiness, experiences with sleepiness and their driving‐related behaviours. The results demonstrate that being older, having a perceived ability to overcome sleepiness, committing more highway code violations and having experienced a sleep‐related close call were positively associated with an increased likelihood of continuing to drive while sleepy. The obtained results highlight the acceptance of risky driving behaviours among some younger drivers. Younger drivers’ risky driving behaviour is certainly a road safety concern given the impairment associated with sleepiness and their over‐representation in road crash incidents.  相似文献   
4.
Abstract

Background: Wheelchair users (WCUs) often rely on ramps for access to transit buses. Previous studies indicate WCUs have difficulty using ramps for bus ingress/egress and many transportation-related incidents occur on ramps. However, experiences of WCU ramp usage during ingress/egress have not been fully described.

Methods: Cross-sectional, internet-based survey of WCUs who ride transit buses was conducted. The participants were queried on frequency of bus usage, difficulty and incidents involving ramps, and factors contributing to difficulty and incidents. Wheelchair characteristics, primary condition, and whether participants received travel training were also captured. Chi-square was used to describe relationships between wheelchair type and frequency of difficulties and incidents, and odd ratios were used to determine likelihood of the incidents.

Results: The majority (55.7%) of 384 participants reported using public transportation ≥ 1 per week. Seventy-eight percent of WCUs had ≥ 1 ramp incident over the past 3?years, with an increased likelihood of incidents occurring during ingress (OR = 1.53; CI 1.21–1.86). Of those who had an incident, 22% were injured or had damage to their wheelchair. Over 60% of those who had an incident identified steep ramp slope as being the contributing factor. Steep ramp slope, exterior ramp thresholds and wet surfaces were the most common contributing factors to difficulty using ramps.

Conclusion: This is the first large-scale US study enabling WCUs to describe their experiences using transit bus ramps. Despite ADA guidelines, steep ramps remain the primary factor contributing to incidents and difficulty when using ramps to access transit buses.
  • Implications for rehabilitation
  • The discrepancy between ADA maximum allowable ramp slopes for the built environment and transit buses may require an increased level of effort that is a barrier to transportation accessibility for some wheelchair users.

  • Wheelchair users who access transit buses should be made aware of, and trained, to navigate ramp configurations found in the environment.

  • We suggest rehabilitation therapists provide skills training specific to navigating transit bus ramp slopes that may be steeper and narrower than building ramps.

  相似文献   
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Condom promotion has emerged as a mainstay of targeted HIV prevention interventions in India, with its emphasis on individual behaviour change and personal responsibility. However, such approaches often do not account for marginalised populations’ structural vulnerability to HIV, arising from social, economic and political factors in the lived environment. In this paper, I use a critical health communication framework to analyse how structure and agency interact in influencing condom use among long-distance truck drivers in India. Drawing on an abductive discourse analysis of condom-use discourses among truckers and peer educators in two Indian cities, findings reveal that while truckers understand the biomedical logic of condoms as barriers, they also express anxiety about condom breakage and experience structural barriers to condom use. The paper concludes by calling for greater attention to structural vulnerabilities in future HIV prevention efforts with truck drivers.  相似文献   
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During the past decade, livestock diseases have (re‐)emerged in areas where they had been previously eradicated or never been recorded before. Drivers (i.e. factors of (re‐)emergence) have been identified. Livestock diseases spread irrespective of borders, and therefore, reliable methods are required to help decision‐makers to identify potential threats and try stopping their (re‐)emergence. Ranking methods and multicriteria approaches are cost‐effective tools for such purpose and were applied to prioritize a list of selected diseases (N = 29 including 6 zoonoses) based on the opinion of 62 experts in accordance with 50 drivers‐related criteria. Diseases appearing in the upper ranking were porcine epidemic diarrhoea, foot‐and‐mouth disease, low pathogenic avian influenza, African horse sickness and highly pathogenic avian influenza. The tool proposed uses a multicriteria decision analysis approach to prioritize pathogens according to drivers and can be applied to other countries or diseases.  相似文献   
10.
目的 揭示公交驾驶员职业倦怠和心理健康现状,探索二者之间的关系,为减少公交驾驶员职业倦怠、提高其心理健康水平提供参考。方法 对成都市3个公交公司的995名公交驾驶员采用Maslach职业倦怠量表普适版(MBI-GS)及一般健康问卷(GHQ-12)进行调查。结果 成都市995名公交驾驶员在职业倦怠总分及情绪衰竭、玩世不恭、成就感低落维度上的中位数和四分位数间距分别为2.33(1.58)分、2.40(3.00)分、0.75(2.00)分及2.17(3.00)分,一般心理健康总分的中位数和四分位数间距为11.00(5.00)分。不同学历、锻炼情况驾驶员倦怠总分差异有统计学意义(P<0.05),心理健康总分在性别、驾龄及锻炼情况上差异有统计学意义(P<0.05)。因子分析共提取了自我否定、自我肯定、严重情绪反应3个因子。职业倦怠总分及各维度与一般心理健康总分及各因子间均呈正相关(P<0.05),自我否定和严重情绪反应因子对职业倦怠有较好的预测作用。结论 公交驾驶员职业倦怠现象较为严重且存在一定的心理健康问题。心理健康水平可以预测驾驶员的职业倦怠。  相似文献   
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