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A Hope More Powerful Than the Sea: One Refugee’s Incredible Story of Love, Loss, and Survival

為了解決inflatable ring的問題，作者Fleming, Melissa 這樣論述：

The stunning story of a young woman, an international crisis, and the triumph of the human spirit.Adrift in a frigid sea, no land in sight--just debris from the ship's wreckage and floating corpses all around--nineteen-year-old Doaa Al Zamel floats with a small inflatable water ring around her wa

ist and clutches two children, barely toddlers, to her body. The children had been thrust into Doaa's arms by their drowning relatives, all refugees who boarded a dangerously overcrowded ship bound for Sweden and a new life. For days, Doaa floats, prays, and sings to the babies in her arms. She must

stay alive for these children. She must not lose hope.Doaa Al Zamel was once an average Syrian girl growing up in a crowded house in a bustling city near the Jordanian border. But in 2011, her life was upended. Inspired by the events of the Arab Spring, Syrians began to stand up against their own o

ppressive regime. When the army was sent to take control of Doaa's hometown, strict curfews, power outages, water shortages, air raids, and violence disrupted everyday life. After Doaa's father's barbershop was destroyed and rumors of women being abducted spread through the community, her family dec

ided to leave Syria for Egypt, where they hoped to stay in peace until they could return home. Only months after their arrival, the Egyptian government was overthrown and the environment turned hostile for refugees.In the midst of this chaos, Doaa falls in love with a young opposition fighter who pr

oposes marriage and convinces her to flee to the promise of safety and a better future in Europe. Terrified and unable to swim, Doaa and her young fiance hand their life savings to smugglers and board a dilapidated fishing vessel with five hundred other refugees, including a hundred children. After

four horrifying days at sea, another ship, filled with angry men shouting insults, rams into Doaa's boat, sinking it and leaving the passengers to drown.That is where Doaa's struggle for survival really begins.A Hope More Powerful Than the Sea is an emotionally charged, eye-opening true story that r

epresents the millions of unheard voices of refugees who risk everything in a desperate search for the promise of a safe future. Melissa Fleming sheds light on the most pressing humanitarian crisis of our time and paints a vivid, unforgettable portrait of the triumph of the human spirit.

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以多層次迴歸模型探討病患因素及醫療因素對髖部骨折患者再住院及再手術之影響

為了解決inflatable ring的問題，作者林宇宏 這樣論述：

背景:減少非計畫性再住院率及再手術率對於提升醫療品質是常見的指標之一，對於病患的預後情況，除了考量病患本身因素之外，其中醫療因素的干預亦是影響之一，如醫師的執診量影響、醫院有關出院計畫之流程、醫院權屬的差別、甚至是醫療機構所在地位於鄉村或是都市的差異，都可能干預病患在術後的療效。目的:本研究主要針對老年髖部骨折病患評估病患因素及醫療因素對於非計畫性再住院率及再手術率之影響。方法:採用回溯性世代研究法，資料取自衛福部資料科學中心之全民健保資料庫全檔，研究對象為2001年至2014年60歲以上首次髖部骨折之病患，並以入院日期作為指標日。性別、年齡、共病症指數、都市化程度、醫師密度、手術部位及手術

方式為病患因素；髖部骨折醫院手術量及權屬別為醫療因素。以內科併發症率為再住院率指標，外科併發症為再手術率指標，並以90天再住院率、再手術率、及365天再手術率以多層次迴歸模型進行分析，模型中以病患因素為層級一、醫療因素為層級二，透過兩階層的模型分析，探討病患因素與醫療因素對結果的影響，每位研究對象追蹤最多一年。結果:此次研究對象共有207,652人，90天內發生再住院共有19,569(9.42%)人，90天內發生再手術共有13,109人(6.31%)，365天內發生再手術共有20,924人(10.08%)， 90天內發生死亡共有12,139人(5.85% )，365天內發生死亡共有31,506

人(15.17% )，結果顯示在病患因素中，女性在再住院、再手術及死亡發生率比男性低，年齡大於80歲以上者90及365天再住院及死亡率比60-79歲高，但在再手術率上呈現較低發生率，CCI指數愈高再住院、再手術及死亡率均較高，內固定術死亡率、再手術及再住院率比半髖關節置換術低，股骨頸骨折在再住院及死亡率上較低，但在再手術中呈現較高發生率，醫師密度在365天死亡率中呈現高醫師密度其365天死亡率較低。手術量愈高之醫院，再住院率及再手術率皆會顯著降低。，中手術量之醫院相較於低手術量之醫院，90天內發生再手術率減少18%(OR=0.82, p