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Non-Invasive Ventilation and Weaning: Principles and Practice, Second Edition

為了解決Well ventilated的問題，作者 這樣論述：

Now in full-colour, this eagerly-anticipated second edition continues to be the most comprehensive resource available on non-invasive ventilation (NIV), both in the hospital and at home. Reflecting a global perspective with expert contributors from more than 15 countries, the book: - provides clinic

al examples of NIV in practice with insightful vignettes- covers home- and intensive care-based ventilation- details NIV use in acute and chronic respiratory failure, plus paediatric and other specialty applications. Disease-specific sections provide best practice in the science, diagnostics and man

agement of conditions such as COPD, cardiac failure, neuromuscular disease and obesity, while features such as 'Common Clinical Questions & Answers', abundant tables and illustrations, chapter summaries and new clinical vignettes showcase the realities of NIV in practice. This is essential reading f

or pulmonologists, critical care physicians and intensive care medicine specialists.　　　　　　　　　 Mark Elliott MD FRCP (UK) is a Consultant Respiratory Physician, Department of Respiratory Medicine, St James’s University Hospital, Leeds, UK. He has been responsible for developing the home sleep and as

sisted ventilation service, for acute in hospital NIV and weaning of patients with prolonged ventilator dependence. His research interests are in acute and chronic noninvasive ventilation and sleep related abnormalities of breathing.Stefano Nava MD is Professor of Medicine and Chief of the Respirato

ry and Critical Care Unit, presso S. Orsola Malpghi Hospital in Bologna, Italy; it is one of Italy’s largest hospitals. Dr. Nava has served both the ATS in its Critical Care Assembly as well as the European Respiratory Society in several capacities. He also sits on a joint task force between the ATS

and ERS on noninvasive ventilation which aims to keep literature on the subject up to date. Dr. Nava has written more than 100 papers on the noninvasive ventilation. Born in Crema, Italy, Dr. Nava earned his degree in medicine at Pavia University, where he subsequently specialized in pulmonary dise

ase, intensive care medicine, and anesthesiology. Between 1985 and 1988, he took a research fellowship in pulmonary medicine at Royal Victoria Hospital and the Meakins-Christie Laboratories, at McGill University in Canada. It was there, under the tutelage of the venerable professors Joseph Milic-Emi

li, Francois Bellemare, and the late Peter T. Macklem, that Dr. Nava studied respiratory mechanics and physiology--mainly in invasively ventilated patients.Bernd Schönhofer MD, PhD, is Director, Department of Respiratory and Critical Care Medicine, Klinikum Region Hannover, Oststadt - Heidehaus, Han

nover, Germany

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Mental Health, Health-related Quality of Life and Behaviors among Outpatients during the COVID-19 Pandemic: A Multiple Hospitals and Health Centers Study in Vietnam

為了解決Well ventilated的問題，作者NGUYEN HOANG MINH 這樣論述：

BackgroundGlobally, the coronavirus disease (COVID-19) pandemic has been placing unprecedented challenges and burdens on various aspects of life, such as economics, culture, politics, education, and healthcare. The uncertainty of COVID-19 increases concerns and fear in the communities, especially i

n those with symptoms like COVID-19 (S-LikeCV19). Additionally, many countries have implemented preventive measures (e.g., lockdown, home confinement, social distancing), leading to considerable changes in peoples’ lives, such as working and learning from home, unemployment, lack of physical connect

ion, and food insecurity. Besides, it is reported that people with underlying health conditions (UHC) and infected with COVID-19 have a higher risk of serious symptoms and complications. Therefore, COVID-19-related factors (e.g., fear, lockdown, S-LikeCV19) and UHC may influence peoples’ psychologic

al health and health behaviors, further lowering their health-related quality of life (HRQoL). Furthermore, people who need health services encountered many challenges during the pandemic, such as difficulties in accessibility, examination and treatment delays, and concerns about COVID-19 infection.

From a public health perspective, it is crucial to understand the impacts of COVID-19-related factors and explore protective factors that can improve lifestyles, psychological health, and HRQoL in outpatients. In addition, due to unavailable specific treatments, non-pharmaceutical interventions (e.g

., adherence to preventive measures, health knowledge improvement, healthy lifestyles) are highly recommended to mitigate the consequences of the COVID-19 pandemic.Therefore, this study was conducted on outpatients during the initial stage of the COVID-19 pandemic for the following purposes:(1) To e

xplore the impacts of UHC, S-LikeCV19, and lockdown on anxiety and depressive symptoms; and examine the modification effects of health behaviors (e.g., eating behaviors, physical activity, smoking, drinking) and preventive behaviors.(2) To explore impacts of UHC, S-LikeCV19, lockdown, and fear of CO

VID-19 (F-CV19) on HRQoL; and examine the modification effects of health literacy, eHealth literacy (eHEALS), digital healthy diet literacy (DDL).(3) To explore impacts of UHC, S-LikeCV19, lockdown, and fear of COVID-19 (F-CV19) on changes in eating behaviors and physical activity; and examine the m

odification effects of eHEALS, DDL.MethodsA cross-sectional study was conducted from 14th February to 31st May 2020 in 18 hospitals and health centers in Vietnam. Data were obtained from 8291 outpatients, including socio-demographic characteristics, UHC, S-LikeCV19, F-CV19, health-related behaviors

(smoking, drinking, eating behaviors, and physical activity), preventive behaviors, eHEALS, DDL, depression (measured by 9-item Patient Health Questionnaire), anxiety (measured by 7-item Generalized Anxiety Disorders), and HRQoL (measured by 36-item Short Form Survey). In addition, multiple linear a

nd logistic regression; and interaction models were performed to explore potential associations.ResultsThe prevalence of anxiety and depression was 12.5% and 22.3%, respectively. Patients with UHC had 3.44 times higher anxiety likelihood and 2.71 times higher depression likelihood, while patients wi

th S-LikeCV19 had 3.31 times higher anxiety likelihood and 3.15 times higher depression likelihood than their counterparts. Similarly, patients under lockdown were 2.39 and 2.89 times more likely to have anxiety and depression than those without lockdown, respectively. Interaction models indicated h

igh compliance with preventive behaviors, unchanged/more physical activity, and unchanged/healthier eating behaviors significantly attenuated the associations of UHC, S-LikeCV19, and lockdown with anxiety and depressive symptoms. In addition, unchanged/more alcohol drinking significantly attenuated

the association between UHC and anxiety. Furthermore, the association between S-LikeCV19 and depression was attenuated by higher health literacy scores in outpatients during the pandemic.This study showed that only fear of COVID-19 was negatively associated with HRQoL (B, -0.79; 95% CI, -0.88 to -0.

70; p < 0.001). Interaction models suggested that the inverse association between F-CV19 and HRQoL was mitigated by higher eHEALS scores or higher DDL scores.Patients with UHC, or with S-LikeCV19, or under lockdown had 54%, 52%, and 62% lower likelihoods of unchanged/healthier eating behaviors, and

21%, 58%, and 22% lower likelihoods of unchanged/more physical activity. Interaction models indicated that the association between lockdown and eating behaviors was significantly attenuated by higher DDL scores. Meanwhile, the association between lockdown and physical activity was significantly miti

gated by higher eHEALS scores. There was no statistically significant interaction of UHC and S-LikeCV19 with DDL and eHEALS on changes in health behavior outcomes.Conclusions:During the pandemic, patients under lockdown period, or with UHC, or S-LikeCV19 were more likely to have anxiety and depressi

ve symptoms; and less likely to have unchanged/healthier eating behaviors and unchanged/more physical activity. In addition, patients with higher F-CV19 were more likely to have poorer HRQoL.High adherence to preventive behaviors, physical activity, and healthy eating behaviors could mitigate the ne

gative impacts of UHC, S-LikeCV19, and lockdown on anxiety and depression. In addition, higher health literacy could mitigate the impact of S-LikeCV19 on depression during the pandemic. Besides, alcohol drinking was found to lower the impact of UHC on anxiety.Moreover, better eHEALS and DDL could mi

tigate the adverse impacts of F-CV19 on HRQoL. Higher eHEALS could help to alleviate the impact of lockdown on physical activity, while higher DDL could mitigate the impact of lockdown on eating behaviors.Our findings provide timely and reliable evidence for appropriate strategies to enhance healthy

lifestyles, preventive behaviors, eHEALS, and DDL, thereby preventing outpatients from psychological disorders and improving their HRQoL during the pandemic.

A Beginner’s Guide to Poultry Farming in Your Backyard: Raising Chickens for Eggs and Food

為了解決Well ventilated的問題，作者Singh, Dueep Jyot 這樣論述：

A Beginner's Guide to Poultry Farming in Your Backyard Raising Chickens for Eggs and Food Table of Contents Introduction It Is Just Chicken Feed Sustainable Poultry Feed Crop bound Chickens Best Natural Food for Chickens Hatching Chickens How to Make an Incubator Fresh Water Supply Nesting boxes Fre

e Ranging Birds Dust baths and Shed Floor Covering Bumble Foot Building Your Own Chicken Coop Egg Production Raising Broilers for the Market Well Ventilated Coops Protecting chickens from Predators Conclusion The Truth about Growth Promoting Feed Author Bio Introduction Ever since man found out that

it was extremely easy to have domesticated sources of food, reared right in his yard, millenniums ago, is it a wonder that poultry especially chicken farming is one of the best methods to get easy access to a good source of food for your family? There is absolutely no country in the world, except p

erhaps the Arctic regions, - where man has not reared ducks, chickens and other poultry for table purposes down the centuries. Apart from these being an easy source of eggs to eat for breakfast, lunch and dinner every day, you also knew that you would have a tough old rooster for dinner, when a larg

e number of family members popped in unexpectedly, demanding sustenance. We are going to be concentrating on chicken farming, for domestic purposes in this book. You have this dream of raising chickens in your backyard. You are interested in a continuous supply of eggs, and the occasional chicken fo

r your pot of a Sunday. Layers are those chickens, which are normally raised for egg production. The chickens which are going to go straight into the pot are called broilers. Since ancient times, human beings have been raising poultry for domestic purposes and also for marketing purposes. Poultry fa

rming has been a part of rural life in the east down the centuries. All the kitchen waste was fed to the hens. These hens came under the 21st century poultry farming term - free ranging. That meant they were allowed to scratch about in the backyard, getting their fill of insects, worms, green vegeta

bles, organic matter, and was it a wonder that they laid delicious, nutritious, and proteinaceous eggs? Every intelligent householder kept three or four hens depending on the size of his family, and he bought a cock from the market, when he needed chickens. Once a clutch of chickens was hatched, Coc

ky Locky went into the cook pot. One of the common mistakes made by new poultry farmers is buying a large number of birds, because they are not very clear about whether they want these words for home consumption or they want to trade in the eggs and poultry meat. Around 50 years ago, one of my fathe

r's colleagues was facing this problem. He had this huge garden and backyard. He had heard about dad rearing poultry in that garden successfully. So he also wanted to experiment in this exciting new activity which would keep his family well supplied with eggs, and fresh meat. So the next time dad we

nt visiting to his base on a tour, he asked dad the best way to raise birds without too much of a hassle. You are going to get these easy tips in the book.

探討橫膈膜及呼吸對肩膀運動學和周邊肌肉活性的影響

為了解決Well ventilated的問題，作者賴星霓 這樣論述：

研究背景: 現今臨床上，橫膈式呼吸訓練已被廣泛應用在不同族群，但目前研究僅證明橫膈膜之功能和下背痛的發生較為相關，和其他部位的疼痛之關係則較無著墨，過去研究指出橫膈膜的呼吸功能下降時，呼吸輔助肌會提高活性來達到相同換氣量，而呼吸輔助肌在解剖上直接/間接的連接到肩帶，過度活化可能影響肩胛周邊肌群活性和肩胛骨運動學。另一個橫膈膜可以影響肩帶的途徑為姿勢穩定功能，身為核心穩定肌群的一部分，橫膈膜能影響腹內壓的穩定，若橫膈膜功能下降造成核心不穩定，是否會透過動力鍊對肩關節穩定度及其運動學造成影響仍有待研究。研究目的: 此研究的目的包括(1)探討在三種呼吸情境下舉手，肩胛骨運動學和肩胛周邊肌群活化之差

異，(2) 探討挑戰橫膈膜功能後，對健康成年人在舉手時的肩胛骨運動學、肩胛周邊肌群活化之影響。研究設計: 本研究為橫斷式研究研究對象: 本研究將招募30位健康成年人研究方法: 本實驗將會先進行橫膈膜超音和核心穩定度測試的測量，接著進入主要測試，本研究會設計三種呼吸情境，包含安靜呼吸、吸飽氣後憋氣以及吐氣到底後憋氣，在不同的呼吸情境下做啞鈴負重舉手，收取肩胛骨運動學和肩胛周邊肌群肌電圖數據。主要測試結束後會休息30分鐘，接著讓受試者進行吸氣阻力任務來挑戰橫膈膜功能，結束後在安靜呼吸下再做一次主要測試，最後進行橫膈膜超音波和核心穩定測試的測量。統計分析: 使用SPSS 22.0進行統計分析，將以重

複量數二因子變異數分析去比較不同呼吸情境以及橫膈膜挑戰過後肩胛骨運動學和肌肉活性的差異，α值設在0.005。結果: 和平靜呼吸相比，吸飽氣後憋氣在舉手任務中呈現顯著較高的肩胛骨上轉 (1.2-1.7度)和內轉(1.3度)，胸鎖乳突肌(1.0-1.2%)之肌肉活性也顯著提高；吐氣到底後憋氣在舉手任務則呈現肩胛骨內轉(1.1-5度)顯著下降，伴隨前鉅肌(3.0-5.8%)和下斜方肌(4.5%)之肌肉活性顯著提高以及胸鎖乳突肌之 (0.4-0.8%)肌肉活性顯著下降。除此之外，在吸氣阻力任務後的舉手任務呈現肩胛骨上轉(0.8-2.38度)顯著增加，相關肌肉活性和平靜呼吸時相比則無顯著差異。結論: 在

不同呼吸情境間，肩胛骨運動學和相關肌肉活性的差異可能源於肋腔直徑和胸椎動作的變化，若想在舉手任務時維持較理想的肩胛骨運動學，採用吸飽氣後憋氣可能會是一個較有效率的策略。除此之外，即使在吸氣阻力任務後觀察到肩胛骨上轉提升，高強度的呼吸訓練對肩胛骨運動學的效益仍需更多研究探討。