Conectar
To systematically evaluate the effects of a fast-track recovery programme on perioperative wound infections and postoperative complications in patients undergoing biliary tone surgery, we conducted a comprehensive search of PubMed, Web of Science, Cochrane Library, Embase, China Biomedical Literature Database, Wanfang and China National Knowledge Infrastructure databases from inception to 29 September 2023 for randomised controlled trials (RCTs) focusing on the application of a fast-track recovery programme in patients undergoing biliary stone surgery. Two researchers independently screened and evaluated the studies based on predefined inclusion and exclusion criteria, and data were subsequently extracted from the included studies. Stata software (version 17.0) was employed for data analysis. Overall, 19 RCTs involving 2363 patients were included, with 1178 patients allocated to the fast-track recovery programme group and 1185 to the conventional care group. The results revealed a significantly lower occurrence of wound infection (3.74% vs. 9.45%, OR = 0.36, 95% CI: 0.25–0.51, p < 0.001) and postoperative complications (11.38% vs. 27.34%, OR = 0.31, 95% CI: 0.25–0.39, p < 0.001) in the fast-track recovery programme group compared to the conventional care group. The available evidence supports the assertion that implementing a fast-track recovery programme in the perioperative period of patients undergoing biliary stone surgery effectively reduces the incidence of wound infections and postoperative complications while facilitating postoperative recovery.
This study aimed to analyse the effects of servant leadership on nurses' emotional failure and compliance with standard precautions and to explore the moderating effect of individual resilience.
A cross-sectional survey.
This descriptive cross-sectional study was conducted from October 9 to November 1, 2022. The convenience sampling method was used to collect questionnaire data from 924 clinical nurses in a third-class general hospital in Chongqing, China.
The emotional exhaustion and compliance with standard precautions were at the general level. Servant leadership mediated by emotional exhaustion had a significant positive predictive effect on compliance with standard precautions. Personal resilience played a negative moderating role in the relationship between servant leadership and emotional exhaustion. For nurses with low resilience, servant leadership had a greater impact on emotional exhaustion.
The current compliance with standard precautions for clinical nurses is not high due to emotional exhaustion. The level of servant leadership can alleviate nurses' emotional exhaustion and improve compliance with standard precautions. Especially for nurses with low personal resilience, the care and support of department leaders are needed.
We found that the compliance with standard precautions is not high, and the link between emotional exhaustion, servant leadership and compliance with standard precautions provides a basis for further patient care.
There was no patient or public involvement.
Nurses are the key population for hospital infection prevention and control, and their level of compliance with standard precautions is of great significance for hospital infection prevention and control. However, in practice, nurses' compliance with standard precautions is generally low. Most of the previous studies on nurses' compliance with standard precautions were conducted from the perspective of individual nurses, based on the staff's ‘knowledge, belief, and action’ to study the current status of compliance with standard precautions and the factors affecting adherence, with less attention paid to the influence of psychological, environmental, and organizational factors. Therefore, the study focuses on the impact of servant leadership and emotional exhaustion on standard precautionary adherence, which is of great significance for good care management at the organizational level. It also explored how the impact of servant leadership on emotional exhaustion varies across levels of resilience, which is important for accurately identifying different types of nursing staff and targeting assistance.
by Huanhuan Wang, Xiaoli Fan, Qilan Zhao, Pengfei Cui
Agrifood systems account for 31% of global greenhouse gas emissions. Substantial emissions reduction in agrifood systems is critical to achieving the temperature goal set by the Paris Agreement. A key challenge in reducing GHG emissions in the agrifood value chain is the imbalanced allocation of benefits and costs associated with emissions reduction among agrifood value chain participants. However, only a few studies have examined agrifood emissions reduction from a value chain perspective, especially using dynamic methods to investigate participants’ long-term emissions reduction strategies. This paper helps fill this gap in the existing literature by examining the impact of collaborations among agrifood value chain participants on correcting those misallocations and reducing emissions in agrifood systems. We develop a dynamic differential game model to examine participants’ long-term emissions reduction strategies in a three-stage agrifood value chain. We use the Hamilton-Jacobi-Bellman equation to derive the Nash equilibrium emissions reduction strategies under non-cooperative, cost-sharing, and cooperative mechanisms. We then conduct numerical analysis and sensitivity analysis to validate our model. Our results show that collaboration among value chain participants leads to higher emissions reduction efforts and profits for the entire value chain. Specifically, based on our numerical results, the cooperative mechanism results in the greatest emissions reduction effort by the three participants, which leads to a total that is nearly three times higher than that of the non-cooperative mechanism and close to two times higher than the cost-sharing mechanism. The cooperative mechanism also recorded the highest profits for the entire value chain, surpassing the non-cooperative and cost-sharing mechanisms by around 37% and 16%, respectively. Our results provide valuable insights for policymakers and agrifood industry stakeholders to develop strategies and policies encouraging emissions reduction collaborations in the agrifood value chain and reduce emissions in the agrifood systems.
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