Improving the healthcare service quality in Chinese Public Class-A Hospitals: from frontline healthcare professional's perspectives

In a highly competitive market, healthcare service improvement is important to satisfy people’s increasing need for care and to maintain the sustainability of hospitals' competitive advantages. Although Public Class-A hospitals are the top hospitals in China, existing problems exert negative influences on service quality. This research aims to contribute to the improvement of Chinese Public Class-A hospitals by investigating the perspectives of healthcare professionals regarding service improvement. Using a qualitative approach, 16 professionals working for several Public Class-A hospitals were interviewed and expressed their views on the existing service quality, the factors influencing this service and made suggestions about how to improve it. The results of content analysis revealed that professionals view Chinese Public Class-A hospitals as having good medical ability, advanced equipment and reliable curative effect. The price of treatment is considered high but acceptable. According to professionals, the main problems were poor service attitude, lack of emotional support, communication problems, long waiting times, environmental problems, and administrative problems. The identified barriers to high-quality service delivery include professional pressure and burnout, patient factors, remuneration and promotion perspectives. Overall, more people-centered services were suggested, meaning that healthcare professionals should improve their service consciousness and humane care, while the whole society should give humane care to healthcare professionals as well. Other suggestions involved enhancing the hierarchical medical system, strengthening doctor-patient communication, optimizing the treatment processes, improving hospital environment and publicity, and dispensing health education. In short, addressing these themes can contribute to improve the service of Chinese Public Class-A hospitals.Num mercado altamente competitivo, a melhoria da qualidade dos serviços de saúde é importante para satisfazer as crescentes necessidades de cuidados da população e para a sustentabilidade das vantagens competitivas dos hospitais. Os hospitais públicos de Classe-A ocupam os lugares cimeiros na China, e os problemas neles existentes influenciam negativamente a qualidade do serviço que prestam. Este estudo tem por objetivo contribuir para a melhoria destes hospitais investigando as perspetivas dos profissionais sobre a melhoria do serviço. Com base numa abordagem qualitativa, 16 profissionais que trabalham em diversos hospitais públicos de Classe-A foram entrevistados e expressaram os seus pontos de vista sobre o nível de qualidade de serviço existente, os fatores que afetam este serviço e as sugestões para o melhorar. Os resultados da análise de conteúdo revelam que os profissionais vêm os hospitais chineses de Classe-A como tendo elevada capacidade médica, equipamento avançado e uma reposta curativa eficaz. O preço dos serviços é considerado relativamente elevado, mas aceitável. Segundo os profissionais, os principais problemas existentes nestes hospitais referem-se à existência de fraca atitude de serviço, falta de suporte emocional, problemas de comunicação, longas listas de espera, problemas ambientais e problemas administrativos. As barreiras à prestação de cuidados de maior qualidade identificadas pelos profissionais reportam-se à pressão e ao burnout dos profissionais, a fatores relacionados com os doentes, à remuneração e às perspetivas de promoção. Em geral, os profissionais sugerem um serviço mais centrado nas pessoas, ou seja, os profissionais deverão acentuar a prestação de cuidados mais conscienciosos e humanos, enquanto a sociedade deverá cuidar de forma também mais humana dos profissionais de saúde. Outras sugestões focam-se na melhoria do sistema hierárquico de saúde, no fortalecimento da comunicação ente o médico e o doente, na optimização dos processos terapêuticos, na melhoria do ambiente hospitalar e na prática de educação em saúde. Em suma, lidar com estes temas pode contribuir para a melhoria do serviço prestado pelos hospitais chineses de Classe-A

Engineering yeast for improved recombinant protein production

Recombinant proteins are broadly used from basic research to therapeutic development and include industrial enzymes and pharmaceutical proteins. The increasing demand for improved production and enhanced quality of recombinant proteins requires robust biotech-based strategies to overcome the limitations of protein extraction from natural sources. A variety of cell factories are therefore established for the large-scale production of recombinant proteins of interest. In comparison to other expression systems, the budding yeast Saccharomyces cerevisiae is an attractive production platform due to its high tolerance to harsh fermentation conditions, and importantly its capability to perform eukaryotic post-translational modifications and to secrete the biologically active product to the extracellular medium. Thus, many strategies have been applied to engineer this organism for increasing its recombinant protein secretory capacity and productivity.The major aim of this thesis work was to study and develop efficient yeast platforms for the production of different heterologous proteins for medical or industrial use through diverse engineering strategies. The first part of this work explored in depth a line of previously evolved yeast strains with improved protein secretory capacity. The universal applicability of the evolved strains was evaluated to produce different antibody fragments, but it was concluded that this secretion platform was not suitable for all types of pharmaceutical proteins tested. Furthermore, by re-introducing all 42 protein-sequence-altering mutations identified in the evolved strains into the parental strain using the CRISPR/Cas9 technology, 14 targets were shown to be beneficial for protein production and 11 out of these 14 beneficial targets were newly identified to be related to recombinant protein production. The second part of this work focused on investigating novel targets related to the cellular stress response and the protein secretory process to rationally optimize S. cerevisiae. Furthermore, screening for suppressors of amyloid-β cytotoxicity in a yeast Alzheimer’s disease model revealed a number of gene targets that reduced oxidative stress and improved production of recombinant proteins. Additionally, a proteome-constrained genome-scale protein secretory model of S. cerevisiae (pcSecYeast) was constructed to simulate the secretion of various recombinant proteins and predict system-level engineering targets for increasing protein production. In summary, the work presented in this thesis provides different efficient strategies to develop yeast platforms for the high-level production of valuable industrial or pharmaceutical proteins, and also provides general guidelines for designing other cell platforms for efficient protein production. Integrated application of various engineering approaches will make meaningful advancements in the field of recombinant protein production in the future

Analysis of Family-Health-Related Topics on Wikipedia

New concepts, terms, and topics always emerge; and meanings of existing terms and topics keep changing all the time. These phenomena occur more frequently on social media than on conventional media because social media allows a huge number of users to generate information online. Retrieving relevant results in different time periods of a fast-changing topic becomes one of the most difficult challenges in the information retrieval field. Among numerous topics discussed on social media, health-related topics are a major category which attracts increasing attention from the general public. This study investigated and explored the evolution patterns of family-health-related topics on Wikipedia. Three family-health-related topics (Child Maltreatment, Family Planning, and Women’s Health) were selected from the World Health Organization Website and their associated entries were retrieved on Wikipedia. Historical numeric and text data of the entries from 2010 to 2017 were collected from a Wikipedia data dump and the Wikipedia Web pages. Four periods were defined: 2010 to 2011, 2012 to 2013, 2014 to 2015, and 2016 to 2017. Coding, subject analysis, descriptive statistical analysis, inferential statistical analysis, SOM approach, and n-gram approach were employed to explore the internal characteristics and external popularity evolutions of the topics. The findings illustrate that the external popularities of the family-health-related topics declined from 2010 to 2017, although their content on Wikipedia kept increasing. The emerged entries had three features: specialization, summarization, and internationalization. The subjects derived from the entries became increasingly diverse during the investigated periods. Meanwhile, the developing trajectories of the subjects varied from one to another. According to the developing trajectories, the subjects were grouped into three categories: growing subject, diminishing subject, and fluctuating subject. The popularities of the topics among the Wikipedia viewers were consistent, while among the editors were not. For each topic, its popularity trend among the editors and the viewers was inconsistent. Child Maltreatment was the most popular among the three topics, Women’s Health was the second most popular, while Family Planning was the least popular among the three. The implications of this study include: (1) helping health professionals and general users get a more comprehensive understanding of the investigated topics; (2) contributing to the developments of health ontologies and consumer health vocabularies; (3) assisting Website designers in organizing online health information and helping them identify popular family-health-related topics; (4) providing a new approach for query recommendation in information retrieval systems; (5) supporting temporal information retrieval by presenting the temporal changes of family-health-related topics; and (6) providing a new combination of data collection and analysis methods for researchers

Blow-up analysis for a doubly nonlinear parabolic system with multi-coupled nonlinearities

This paper deals with the global existence and the global nonexistence of a doubly nonlinear parabolic system coupled via both nonlinear reaction terms and nonlinear boundary flux. The authors first establish a weak comparison principle, then by constructing various upper and lower solutions, some appropriate conditions for global existence and global nonexistence of solutions are determined respectively

Reconfigurable Antennas for UWB Cognitive Radio Communication Applications

In this chapter, reconfigurable antennas are reviewed for ultra-wideband (UWB) cognitive radio communication applications. The defected microstrip structure (DMS) has been reviewed and integrated into the UWB antennas to form the desired filtering antennas which can filter out unexpected narrowband signal interferences. Then, switches are incorporated into the filtering UWB antennas to construct the cognitive radio UWB (CR-UWB) antenna to make the antenna switch between the UWB antenna and band-notched UWB antenna. In these CR-UWB antennas, the DMSs are to give the desired notches while the switches are used for realizing the switchable characteristics. Several reconfigurable antennas and CR-UWB antennas are created and investigated. The results show that the designed CR-UWB antenna can switch between different modes, making it amazing for UWB, band-notched UWB, and multiband communication system applications