A High Order Bound Preserving Finite Difference Linear Scheme for Incompressible Flows

We propose a high order finite difference linear scheme combined with a high order bound preserving maximum-principle-preserving (MPP) flux limiter to solve the incompressible flow system. For such problem with highly oscillatory structure but not strong shocks, our approach seems to be less dissipative and much less costly than a WENO type scheme, and has high resolution due to a Hermite reconstruction. Spurious numerical oscillations can be controlled by the weak MPP flux limiter. Numerical tests are performed for the Vlasov-Poisson system, the 2D guiding-center model and the incompressible Euler system. The comparison between the linear and WENO type schemes, with and without the MPP flux limiter, will demonstrate the good performance of our proposed approach.     

Moment-Based Multi-Resolution HWENO Scheme for Hyperbolic Conservation Laws

In this paper, a high-order moment-based multi-resolution Hermite weighted essentially non-oscillatory (HWENO) scheme is designed for hyperbolic conservation laws. The main idea of this scheme is derived from our previous work [J. Comput. Phys., 446 (2021) 110653], in which the integral averages of the function and its first order derivative are used to reconstruct both the function and its first order derivative values at the boundaries. However, in this paper, only the function values at the Gauss-Lobatto points in the one or two dimensional case need to be reconstructed by using the information of the zeroth and first order moments. In addition, an extra modification procedure is used to modify those first order moments in the troubled-cells, which leads to an improvement of stability and an enhancement of resolution near discontinuities. To obtain the same order of accuracy, the size of the stencil required by this moment-based multi-resolution HWENO scheme is still the same as the general HWENO scheme and is more compact than the general WENO scheme. Moreover, the linear weights are not unique and are independent of the node position, and the CFL number can still be 0.6 whether for the one or two dimensional case, which has to be 0.2 in the two dimensional case for other HWENO schemes. Extensive numerical examples are given to demonstrate the stability and resolution of such moment-based multi-resolution HWENO scheme.     

Climate Change: Effects on the Older Adult

The effects of climate change include floods, hurricanes, heat waves, and fires; these natural disasters can result in respiratory, cardiovascular, and psychological harm in older adults, who experience the highest morbidity and mortality during heat waves. Advanced practice registered nurses (APRNs) need education on preparing, assessing, and treating older adults for climate-change disasters, especially heat waves. This article will help APRNs understand the effects of climate-change events on the vulnerable older adults and advocates for the need to integrate health effects of climate change into curricula, practicums, policy, and research agendas.     

Traditional Food Practices,Attitudes, and Beliefs in Urban Alaska Native Women Receiving WIC Assistance

Objective

To identify practices, attitudes, and beliefs associated with intake of traditional foods among Alaska Native women.

华蟾素胶囊联合TN化疗方案对中晚期宫颈癌放疗患者血清SCC、TSGF水平及生存质量的影响

目的:探讨华蟾素胶囊联合TN化疗方案(紫杉醇+奈达铂)在中晚期宫颈癌放疗患者中的应用效果。方法:选取中晚期宫颈癌放疗患者71例，按照随机数字表法分组，对照组35例给予TN化疗方案治疗，观察组36例给予TN化疗方案+华蟾素胶囊治疗，观察比较两组临床疗效及治疗前后血清鳞状细胞癌相关抗原（SCC）、肿瘤特异性生长因子（TSGF）水平及生存质量各维度评分变化情况，并统计两组毒副反应发生情况及1年、2年、3年生存率。结果:观察组临床缓解率为83.33%（30/36），高于对照组57.14%（20/35）（P＜0.05）；治疗4个疗程后观察组血清SCC、TSGF水平低于对照组（P＜0.05）；观察组便秘、腹泻及恶心呕吐发生率与对照组比较，差异无统计学意义（P＞0.05）；观察组白细胞下降发生率为11.11%（4/36），低于对照组31.43%（11/35）（P＜0.05）；治疗4个疗程后观察组认知、角色、躯体、社会及情绪功能生存质量评分高于对照组（P＜0.05）；观察组1年生存率为91.67%（33/36）、2年生存率为86.11%（31/36）、3年生存率为77.78%（28/36），与对照组（91.43%、85.71%、74.29%）比较，差异无统计学意义（P＞0.05）。结论:TN化疗方案联合华蟾素胶囊可降低中晚期宫颈癌放疗患者血清TSGF、SCC水平，提高其生存质量，疗效确切，安全性高。     

贵州省县级和城市公立医院卫生资源比较

目的 了解贵州省县级和城市公立医院的卫生资源配置现状及比较变化情况。方法 收集2015—2017年贵州省县级和城市公立医院的卫生人力、财力、物力等卫生资源配置资料,采用统计学方法进行比较分析。结果 贵州省县级和城市公立医院注册护士占卫生技术人员的百分比分别为49.11%、49.76,执业医师占比分别为24.77%、34.66%,执业助理医师占比分别为1.91%、0.72%;县级和城市公立医院医疗收入占比分别为80.28%、87.93%,财政补助收入占比分别为16.75%、9.86%;万元以上设备均主要集中在10万元以下;县级公立医院医护比逐年上升,城市公立医院略降低,2017年医护比分别为1∶1.84、1∶1.41,床位使用率均下降,分别为88.23%、94.20%;每千人口床位数逐年增加,县级和城市公立医院县级和城市公立医院分别为2.23、2.63张,每千人口卫生人员拥有量逐年增加,每千人口注册护士分别为1.11人、1.25人,每千人口执业医师分别为0.67、0.78人,每千人口卫生技术人员分别为2.11、2.44人;县级和城市公立医院卫生资源配置情况经统计分析差异有统计学意义( P<0.05)。结论 贵州省县级和城市公立医院卫生资源拥有量均低于全国,财政投入不足,县级公立医院医护比、床护比逐年上升,城市公立医院与之相反。     

城市社区在“新冠肺炎”疫情防控中的基础作用与思考

近期新型冠状病毒肺炎肆虐,正在严重威胁人们的身体健康和生命安全。政府作为应对突发公共卫生事件的主体,在疫情爆发初期存在信息沟通不畅、防控工作效率不高和民众依从性不理想等局限性,因此政府需要充分发挥社会力量。社区作为疫情防控的第一道防线,在疫情防控中具有信息收集及时准确、防控措施执行精准和社会动员效率高等优势,在应对突发公共卫生事件中的作用日渐显现。应充分发挥社区在疫情防控中的基础作用,完善城市社区防控体系建设,使其成为预防与控制疾病的重要堡垒,意义重大。     

扶正化痰固本方对早期非小细胞肺癌术后患者免疫功能的影响

目的:观察扶正化痰固本方运用于早期非小细胞肺癌术后的临床疗效及其对患者免疫功能的影响。方法:将70例早期非小细胞肺癌患者按照随机数字表法分为对照组和观察组,每组各35例。两组患者均接受肺癌切除术治疗,对照组术后3周开始接受MVP方案化疗,观察组在对照组的基础上加用扶正化痰固本方治疗。比较两组患者的临床疗效及治疗前后中医证候积分、卡氏评分(karnofsky performance status,KPS)及生活质量评分变化情况。检测两组患者治疗前后免疫功能指标、血清肿瘤标志物[癌胚抗原(carcinoembryonic antigen,CEA)、糖类抗原153(carbohydrate antigen 153,CA153)]水平。结果:观察组有效率为91.43%,对照组有效率为71.43%,两组患者有效率比较,差异具有统计学意义(P<0.05)。两组患者治疗后中医证候积分低于本组治疗前,且观察组治疗后低于对照组治疗后,差异具有统计学意义(P<0.05)。两组患者治疗后免疫功能指标检测结果低于本组治疗前,且观察组治疗后低于对照组治疗后,差异具有统计学意义(P<0.05)。两组患者治疗后血清CEA、CA153水平低于治疗前,KPS评分、QLQ-C30评分均高于治疗前,且观察组治疗后血清CEA、CA153水平低于对照组,KPS评分、QLQ-C30评分均高于对照组,差异具有统计学意义(P<0.05)。观察组胃肠道反应及骨髓抑制发生率均低于对照组,差异具有统计学意义(P<0.05)。结论:扶正化痰固本方运用于早期肺癌术后,能够有效改善患者免疫功能,减轻毒副反应,提高患者生活质量。     

Responsiveness of the urban primary health care delivery system in Bangladesh: A comparative analysis

This study analyses the responsiveness of outpatient care to assess the quality of urban primary health care among all 5 types of health care providers in Bangladesh, namely, the Urban Primary Health Care Services Delivery Project, the NGO Health Services Delivery Project (NHSDP), NGOs, private hospitals, and the Ministry of Health and Family Welfare (MOHFW). Other than some public‐private comparisons, there is an absolute knowledge gap regarding responsiveness in urban health systems, particularly in the context of Bangladesh, and this gap motivates this study. The study used primary data collected from 810 randomly selected outpatients. The survey used a structured questionnaire on all 7 domains of responsiveness of outpatient care suggested by the World Health Organization. The estimated mean responsiveness score reveals that overall, approximately 33% of the patients rated the responsiveness of the system as poor. In reported responsiveness, the NHSDP was ranked at the top and the MOHFW at the bottom. The latter is quite expected. Overall, prompt attention and autonomy were the worst‐performing domains, and choice of provider, dignity, and clear communication were the better‐performing ones. The results suggest the need to improve the degree of responsiveness of all domains, especially those that are more concerned with access to health care, namely, prompt attention, dignity, clear communication, and confidentiality. The Ministry of Health and Family Welfare facilities should give additional consideration to promote prompt attention, autonomy, and quality of basic amenities. Private facilities should also provide additional stress on improving prompt attention and autonomy. The nontherapeutic quality of health care needs to be emphasized in the medical education system. Further research based on household surveys could be worthwhile to measure responsiveness more comprehensively.