다중혈관 관상동맥 환자에서 y-문합을 이용하여 양쪽 내흉동맥만을 사용한 우회술의 조기 성적

[신간의 별자리x] 우리/미술, 그리고 ‘슬픔의 박물관’

XI. STRATEGIES FOR IMPROVING DIABETES CARE D iabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. A large body of evidence exists that supports a range of interventions to improve diabetes outcomes. These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care. While individual preferences, comorbidities, and other patient factors may require modification of goals, targets that are desirable for most patients with diabetes are provided. These standards are not intended to preclude more extensive evaluation and management of the patient by other specialists as needed. For more detailed information, refer to Bode (Ed.): Medical Management of Type 1 Diabetes (1), Burant (Ed): Medical Management of Type 2 Diabetes (2), and Klingensmith (Ed): Intensive Diabetes Management (3). The recommendations included are diagnostic and therapeutic actions that are known or believed to favorably affect health outcomes of patients with diabetes. A grading system (Table 1), developed by the American Diabetes Association (ADA) and modeled after existing methods, was utilized to clarify and codify the evidence that forms the basis for the recommendations. The level of evidence that supports each recommendation is listed after each recommendation using the letters A, B, C, or E.

Standards of Medical Care in Diabetes

Attachment--and loss.

www.mobilehealthmap.org 617‐442‐3200 New research shows that mobile health clinics improve health outcomes for hard to reach populations in cost‐effective and culturally competent ways . A Harvard Medical School study determined that for every dollar invested in a mobile health clinic, the US healthcare system saves $30 on average. Mobile health clinics, which offer a range of services from preventive screenings to asthma treatment, leverage their mobility to treat people in the convenience of their own communities. For example, a mobile health clinic in Baltimore, MD, has documented savings of $3,500 per child seen due to reduced asthma‐related hospitalizations. The estimated 2,000 mobile health clinics across the country are providing similarly cost‐effective access to healthcare for a wide range of populations. Many successful mobile health clinics cite their ability to foster trusting relationships. Qualitative research in such mobile health clinics has found that patients value the informal, familiar environment in a convenient location, with staff who “are easy to talk to,” and that the staff’s “marriage of professional and personal discourses” provides patients the space to disclose information themselves. A communications academic argued that mobile health clinics’ unique use of space is important in facilitating these relationships. Mobile health clinics park in the heart of the community in familiar spaces, like shopping centers or bus stations, which lend themselves to the local community atmosphere.

Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care

Self-Management of Depression: Cultivating social support: the role of peer support in self-management

A Vietnam war veteran with posttraumatic stress disorder, status-post-myocardial infarction, in therapy with an Asian therapist.

Authors' Response to Letter to the Editor.

Undetected leakage of fluid hydrocarbons from pipelines or underground storage tanks into the subsurface environment are environmental and public health hazards. It is evident that there is a need for efficient, effective and accurate technology to detect these leaks rapidly and non-destructively, so as to make the process safe, to make quantitative risk assessment, and to provide effective preventive measures. There are unsurmountable limitations in many existing leak detection techniques. Moreover, early detection of leakage would allow rapid remediation at source to significantly reduce the remediation costs, and more importantly the environmental impact. The results of an experimental investigation for the technical feasibility and practicality of a technique for detection and location of fluid hydrocarbon leaks in underground pipelines and storage tanks based on the principles of time-domain reflectometry (TDR) are presented in this paper. The measurement sensitivity of the technique was evaluated for 3 different types of cables, 2 cable configurations (parallel-wires or coaxial), 2 leaking fluids (tap water or petrol), a single leak or double leaks, and 2 backfill materials (fine sand or gravel) by a series of field-scale model tests. The testing parameters were varied systematically. The experimental results indicate that TDR is a technically feasible technique for the detection of fluid hydrocarbon leaks from pipelines and underground storage tanks when the setup configuration is appropriate. 

Feasibility of a TDR-based Technique for Fluid Hydrocarbon Leak Detection

Purpose The objectives of this study were to examine the psychometric properties of the Uncertainty Stress Scale (USS) and to compare the usefulness of two versions of the scale (USS-4 and USS-10) among a large community-based sample of Chinese adults. Participants and Methods The Uncertainty Stress Scale was validated in 904 community residents (mean age: 32.71 ± 10.99; male: 41.7%) through an online survey conducted in February 2020. Psychometric properties of reliability (Cronbach’s alpha), construct validity (confirmatory factor analysis), and criterion validity (correlation and ROC curve analyses) were evaluated using established benchmarks. To validate the USS, we used the Chinese version of the Perceived Stress Scale (CPSS). In addition, sensitivity, specificity, and suitable cutoff values of the two versions of USS were determined. Results Both versions of the USS had high internal consistency (USS-10: 0.941; USS-4: 0.851). Confirmatory factor analyses supported a one-factor structure for both measures. Both USS-4 and USS-10 scores were significantly positively correlated with CPSS scores, indicating acceptable criterion validity. Conclusion The findings of the current study confirmed that the psychometric properties of two Chinese versions of USS are acceptable. Furthermore, the 4-item USS was as effective as the 10-item USS for the measurement of uncertainty stress in our community-based sample of Chinese adults suggesting that the USS-4 is a time-efficient alternative to the USS-10 which can be used when the circumstances require a time-efficient instrument (eg, in epidemiological studies with a large test battery).

https://www.dovepress.com/getfile.php?fileID=84249

Albert Yeung

Papers

Self-Management of Depression: Cultivating social support: the role of peer support in self-management

A Vietnam war veteran with posttraumatic stress disorder, status-post-myocardial infarction, in therapy with an Asian therapist.

Authors' Response to Letter to the Editor.

Feasibility of a TDR-based Technique for Fluid Hydrocarbon Leak Detection

Validation of the 4-Item and 10-Item Uncertainty Stress Scale in a Community-Based Sample of Chinese Adults