我国生猪生产效率及补贴政策评价

文章采用数据包络分析方法（DEA）分别对我国生猪生产效率进行了区域差异和规模比较。研究表明,生猪生产效率呈现出明显的地区差异,与西部地区比较,东部更有效率,但呈现规模不经济的状况;规模养殖比散养有较高的经济效率,但散养生猪仍具有较灵活的成本优势。根据研究结论,认为中国实施区域差别化的生猪补贴扶持政策有一定的合理性,但应有侧重,东部应侧重效率导向,中西部地区应以规模导向为主;同时在发展规模化养殖过程中也应注意差异化,对不同规模养殖户实行差别的补贴政策;生猪补贴政策还应充分考虑生产和消费布局等。     

Building multivariable prognostic and diagnostic models: transformation of the predictors by using fractional polynomials

To be useful to clinicians, prognostic and diagnostic indices must be derived from accurate models developed by using appropriate data sets. We show that fractional polynomials, which extend ordinary polynomials by including non-positive and fractional powers, may be used as the basis of such models. We describe how to fit fractional polynomials in several continuous covariates simultaneously, and we propose ways of ensuring that the resulting models are parsimonious and consistent with basic medical knowledge. The methods are applied to two breast cancer data sets, one from a prognostic factors study in patients with positive lymph nodes and the other from a study to diagnose malignant or benign tumours by using colour Doppler blood flow mapping. We investigate the problems of biased parameter estimates in the final model and overfitting using cross-validation calibration to estimate shrinkage factors. We adopt bootstrap resampling to assess model stability. We compare our new approach with conventional modelling methods which apply stepwise variables selection to categorized covariates. We conclude that fractional polynomial methodology can be very successful in generating simple and appropriate models.     

Probiotics and human lactational mastitis: A scoping review

ProblemLactational mastitis is a common condition amongst breastfeeding women. It is associated with decreased breastfeeding rates and often treated with antibiotics.BackgroundThe anti-inflammatory effects of probiotics have been identified as a potential treatment or prevention strategy for lactational mastitis leading to increased commercial and public interest. Despite the marketing of probiotics to women, evidence is still emerging as to its efficacy.Aim/MethodsThis scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) to identify and examine the evidence around probiotic consumption and lactational mastitis. The review addressed the question; what is the evidence regarding probiotic consumption and human lactational mastitis? Studies were critically appraised using the Joanna Briggs Institute checklist for randomised control trials (RCTs).FindingsFive RCTs met the inclusion criteria; three concerned probiotic consumption for the treatment of mastitis, two for the prevention of mastitis. All reported a lower incidence of mastitis in the probiotic groups.DiscussionAlthough potentially promising results were reported across all studies there were significant methodological limitations concerning; appropriately described baseline characteristics, study hypotheses, lack of power calculations, definitional issues, and potential conflicts of interest.ConclusionProbiotics may have utility for the treatment or prevention of lactational mastitis. However only a few studies with significant limitations have been published to date. Well designed and conducted studies are needed before evidence-based recommendations can be made for use of probiotics in the treatment or prevention of lactational mastitis.     

钢轨砂带磨削中的力特性分析

本文对钢轨砂带磨机中出现的“重磨”、“轻磨”、抱带、断带等问题进行了分析研究,并提出了解决上述问题的可行性方法。     

改良鼻饲法减轻老年危重症患者肠内营养并发症的研究

目的探讨改良鼻饲法对老年危重症患者胃肠内营养并发症的影响。方法采用传统鼻饲法（对照组）与改良鼻饲法（试验组）进行老年危重症患者胃肠内营养支持,对并发症比较。试验组采用能全力营养素接输血管持续滴注方法鼻饲,对照组采用传统方法鼻饲（营养液同试验组）,比较两组鼻饲后胃肠道并发症（呕吐和返流、误吸、腹胀、腹泻、消化道出血、便秘）发生率。结果鼻饲后胃肠道并发症发生率试验组明显低于对照组（P〈0．05）。结论能全力营养素液持续滴注鼻饲法可安全用于老年危重症患者,且对维持胃肠道结构和功能、减少并发症、促进营养状态和改善预后有显著临床意义,能明显提高护理工作效率。     

Taking Charge of Self: Breast Health Practices of Older Rural Women

ABSTRACT

The purpose of this grounded theory study was to explore breast health practices of older Vermont women residing in rural communities. Although the three components of breast health-mammography, clinical breast exam, and self-breast exam-are recommended for women 40 years and over, minimal research has empirically analyzed the breast health practices of healthy women to ascertain if, in fact, these procedures are followed, and if so, what the motivation is for doing so. Twelve women, 50–64 years, participated in face-to-face, audiotaped interviews. Data analysis, including line-by-line and constant comparative approaches, occurred concurrently with data collection. Taking Charge of Self, the generated theory, describes participants' engagement in a process of learning how to take charge of their lives. The analysis indicates that health care providers have a powerful role in the lives of women in this age group. With an increasing emphasis on health promotion and disease prevention, health care providers are positioned to cultivate and support women's development of the personal or internal motivation for health and well-being.     

“It Makes My Skin Crawl”: Women’s experience of breastfeeding aversion response (BAR)

ProblemSome women who intend to breastfeed experience a breastfeeding aversion response (BAR) while breastfeeding.BackgroundLittle is known about the experience of those who have feelings of aversion while breastfeeding.AimThis study aimed to investigate the experiences of women who have an aversion response to breastfeeding while their infant is latched at the breast. This is the first study that aims to understand this breastfeeding aversion response (BAR) as described by women who experience this phenomenon.MethodsInterpretative phenomenological analysis (IPA) was used to conduct and analyse ten semi-structured in-depth interviews with women who self-identified as experiencing BAR.FindingsFour overarching themes were identified: (1) Involuntary, strong sensations of aversion in response to the act of breastfeeding, (2) Internal conflict and effects on maternal identity, (3) The connection between BAR and relationships with others, and (4) Reflections on coping with BAR and building resilience.DiscussionSome women who intend to breastfeed can experience BAR, and this negative sensation conflicts with their desire to breastfeed. BAR can impact on maternal wellbeing. Those who experience BAR may benefit from person-centred support that directly addresses the challenges associated with BAR to achieve their personal breastfeeding goals.ConclusionThe experience of BAR is unexpected and difficult for mothers. If support is not available, BAR can have detrimental effects on maternal identity, mother–child bonds, and intimate family relationships.     

Emergence of social support networks among breast cancer survivors through a community-based physical activity program in Colombia

Physical activity (PA), social networks, and social support have been associated with decreased mortality and improved quality of life among breast cancer survivors (BCS). This study used social network analysis to understand the social co-benefits of a community-based PA program for BCS in Colombia. Two types of social support networks emerged from the program: friendship (the number of edges increased by 90 %) and PA support (35 % of participants practiced PA together after the program). Using egocentric and socio-centric analysis we show the presence of homophily for friendship and PA support relations and the BCS’s roles in their networks.     

Internet-based Cognitive Behavioral Therapy for DSM-IV Sexual Dysfunctions in Breast Cancer Survivors: Predictors of Treatment Response

Abstract

Objectives: We evaluated factors predictive of the effect of internet-based cognitive behavioral therapy (CBT) in breast cancer survivors with a sexual dysfunction. Methods: Fifty-five women completed questionnaires assessing sexual functioning and distress at baseline and post-CBT. Results: Higher therapy compliance and better partner baseline sexual functioning predicted better post-CBT sexual functioning. Higher therapy compliance and higher partner relationship satisfaction predicted lower sexual distress. Therapy compliance, in turn, was predicted by active partner involvement in therapy and a stronger therapeutic relationship. Conclusions: To increase the effect of internet-based CBT, we recommend partner involvement in therapy and establishing a strong therapeutic relationship.