Doctor's Orders Research Articles

A neuro-heuristic approach for recognition of lung diseases from X-ray images

Background and objectiveThe X-ray screening is one of the most popular methodologies in detection of respiratory system diseases. Chest organs are screened on the film or digital file which go to the doctor for evaluation. However, the analysis of x-ray images requires much experience and time. Clinical decision support is very important for medical examinations. The use of Computational Intelligence can simulate the evaluation and decision processes of a medical expert. We propose a method to provide a decision support for the doctor in order to help to consult each case faster and more precisely. MethodsWe use image descriptors based on the spatial distribution of Hue, Saturation and Brightness values in x-ray images, and a neural network co-working with heuristic algorithms (Moth-Flame, Ant Lion) to detect degenerated lung tissues in x-ray image. The neural network evaluates the image and if the possibility of a respiratory disease is detected, the heuristic method identifies the degenerated tissues in the x-ray image in detail based on the use of the proposed fitness function. ResultsThe average accuracy is 79.06% in pre-detection stage, similarly the sensitivity and the specificity averaged for three pre-classified diseases are 84.22% and 66.7%, respectively. The misclassification errors are 3.23% for false positives and 3.76% for false negatives. ConclusionsThe proposed neuro-heuristic approach addresses small changes in the structure of lung tissues, which appear in pneumonia, sarcoidosis or cancer and some consequences that may appear after the treatment. The results show high potential of the newly proposed method. Additionally, the method is flexible and has low computational burden.

Three Billboards Outside Ebbing, Missouri (2017) dir. by Martin McDonagh

Three Billboards Outside Ebbing, Missouri (2017) dir. by Martin McDonagh Caroline Fernelius In Missouri, there exists no town by the name of Ebbing, a fact belied by the gritty, at times unflinching realism of Three Billboards Outside Ebbing, Missouri (dir. Martin McDonagh, 2017). Amidst dreams of cowboys and Indians, McDonagh has conjured an anti-mythos of a land and a people brutalized, repeatedly, not by the glossy and nostalgia-commanding hardships of yesteryears but by twenty-first-century scourges: police brutality, racism, and uneven national patterns of industrialization that inevitably leave places like Ebbing behind. Viewers get the sense from the film's opening sequence that Ebbing—at once self-contained (not a single Starbucks dots Main Street) and devastatingly reflective of these global truths—reverberates with the unmistakable anxiety of a place deeply unsure of itself. Minutes after the film commences with a series of shots of decrepit, dirty road-side billboards, the local advertising agency boy, Red (Caleb Landry Jones), snarkily concedes that not many frequent those parts anymore, at least not "since the freeway got put in." Although viewers never see this aforementioned freeway, it looms off-screen as an emblem of the irrevocable instability of a town caught between what was and what is, between community and individual, between the promised order of Western civilization and the threat of chaos that underlies all manmade entities, including notions of justice. Three Billboards Outside Ebbing, Missouri follows mother Mildred Hayes' (Frances McDormand) increasingly controversial and at times violent efforts to track down her daughter Angela's (Kathryn Newton) rapist and murderer after the local police department fails to turn up any leads in a span of seven months. In so doing, the film portrays Ebbing and its inhabitants as perhaps senselessly wedded to the idea of control in an uncontrollable world; in the age of sniffer dogs and big data, Angela's remains provide [End Page 225] nothing of use to law enforcement. Without any eyewitnesses, Chief Willoughby (Woody Harrelson) remains frustratedly in the dark as an anguished Mildred sponsors billboards in protest, drills a hole in the thumb of the town dentist, sets fire to the police station, and (potentially) commits murder just after the film's end. Intriguingly, Mildred's version of asserting order, albeit usually in vain, assumes essential incompetence at the institutional level and relies upon extralegal brute force. The mother's iteration of justice might read as primitive, but Ebbing is presented as a disorderly place in which one lacks options—it is a land between the twin coasts of progress and reason that attracts ghosts rather than financiers, a space where bandits and plunderers might do their damage and escape unscathed into the dusty horizon. Chief Willoughby, a superficially plausible option to represent the faith in the collective that Mildred sorely lacks, sides unmistakably with her on at least one front. Dying of pancreatic cancer, Willoughby leaves the hospital against doctor's orders, and less than halfway through the film, he commits suicide so as to establish some degree of bodily autonomy in the face of a rapid and inevitable physical decline. When the holy trinity of institutions—the church, the state, and marriage—proves incapable of delivering more palatable versions of redemption, the film suggests that justice must instead be seized forcefully. During a dinner-date scene, Mildred encounters her ex-husband out with his (much younger) girlfriend, a down-on-her-luck former zookeeper who chummily insists on the adage, "anger begets greater anger." Maybe so, but Ebbing hosts a cast of characters with little else but anger at their immediate disposal. While looking on in disgust, then, viewers might refrain from blaming such characters for their behavior. As Mildred burns down the police station, slow-moving imagery and the words of a now-dead Willoughby ("Hate never solved nothing. But calm did. And thought did") contrast uneasily with an awesome display of uninhibited wrath, of a primal need to act rather than be acted upon, to assert something, anything in a place where one's assertions fall dumb in the face of cosmic, uncontrollable forces. In the end, Ebbing presents as a place just out of reach of the...

ЭКОНОМИКА ЗДОРОВЬЯ В ЗДРАВООХРАНЕНИИ

Health, Economics and health organization have the largest number of publications at all levels of government. However, direct measurement and dosed funding for each remains out of reach for the majority of the population. For them also remains unclear: what are the fundamental laws you need to follow to fulfill the doctor's orders. The movement towards monopoly narrows the health care market. Collective economic, social and urban projects do not reduce the pharmacy chain. The budget remains in surplus if mortality is not reduced. Medical statistics do not have the properties of a microscope. Therefore, for the population health is a social self-movement. Each industry has its own technology and economic costs, forming departmental lists of services and works at the expense of the state budget. The article on the Federal laws and regulations shows the relevance of updating health care to build a list of services and improve the methodology of budget planning on the basis of four health sectors R, N, Q and Z. It is established that the ratio of financing of the proposed industries (in multiplicities) is not : 10 : 100 : 1000 does not lead to the planned effects and possible efficiency evaluation. Conclusions and proposals of the article are necessary for the Concept of improving the efficiency of budget expenditures (adopted in January 2019).

Sindrom iritabilnog kolona – trauma lekara i pacijenta

Introduction: Irritable bowel syndrome represents chronic, functional bowel disorder, without organic substrate, which manifests with abdominal pain, bloating and diarrhea and/or constipation. Diagnosing irritable bowel syndrome includes anamnesis, physical examination and depending on indications, endo-scopic exam as well. Therapy includes medications and psychotherapy, during exacerbations. Case report: Female patient 26 year old, pays a visit to outpatient clinic, due to frequent stools in last couple of weeks. She has 2-4 stools a day, without mucilage or blood in the stool. She feels bloated and experiences abdominal discomfort , which subsides after emptying stool contents. She denies other symptoms and has been perfectly healthy up till now. After the examination we came up with working diagnosis-IBS and the patient was presented with the treatment plan. She disagrees with it and asks for specialist referral. From the first referral, to hospitalization, to making final diagnosis, a year has passed and the final diagnosis has been the same as the diagnosis made by the family medicine specialist. Conclusion: In order for primary care doctors to be health system gate keepers , it takes sufficient time for them to spend with a patient (reduce the number of patients seen daily), greater work autonomy and adequate health legislations, which is possible through systemic changes, as a result of a dialogue of all relevant participants in the health care system.

Association between time-appropriate vaccinations in early childhood and individual and community-level factors in Japan

Objective Recently, in Japan, the compulsory vaccinations administered during early childhood have been becoming increasingly varied. As a result, the vaccination schedule has become complicated. In this study, we aimed to identify the association of time-appropriate vaccination during early childhood (dependent variable) with individual-level factors including socioeconomic status and having a family doctor. We also studied the association of time-appropriate vaccination with community-level factors including the number of pediatricians in a community.Methods Multilevel logistic regression models were used for analysis. Time-appropriate BCG, DPT, and measles vaccinations were the dependent variables. Individual-level data were obtained through a survey of parents of 18-month-old children as part of the final evaluation of "Healthy Parents and Children 21"; community-level data were obtained through a survey of municipalities as part of the aforementioned final evaluation as well as through a national survey. There were 23,583 parents in 430 municipalities who were eligible for analysis.Results Time-appropriate vaccination of infants was carried out by 88.3% of parents. The results of the multilevel logistic regression showed that time-appropriate vaccination was significantly lower for those who did not have a family doctor (adjusted odds ratio [AOR], 0.45; 95% confidence interval [CI], 0.36-0.55), the fourth or later birth order (0.23; 0.19-0.28), mothers aged less than 19 years at childbirth (0.17; 0.13-0.24), full-time working mothers (0.52; 0.47-0.58), and those under very difficult economic conditions (0.66; 0.57-0.77). Among community-level factors, only use of vaccination data by a municipality had a significantly negative association with the dependent variable.Conclusion Not having a family doctor, the mother's young age, late birth order, poor economic status, and full-time working mothers were risk factors associated with delayed vaccinations. It is necessary to improve environments that promote infants having a family doctor as well as to promote special approaches toward families at risk for delayed vaccinations.

Is Unionization Just What the Doctor Ordered? Collective Bargaining for Doctors, Nurses, and Lawyers

Is Unionization Just What the Doctor Ordered? Collective Bargaining for Doctors, Nurses, and Lawyers

Power of Judgment: The Significance of Kant's Philosophy for the Medical System Today

The ways of thinking in the manufacturing sciences are increasingly determining the rationality within medicine as a practical or action-based science. This "technological paradigm" infiltrates the field of medicine with the promise of increasing efficiency while simultaneously improving quality at various points in the system. Simple linear causal relationships generally need to be taken into account when manufacturing products. Even complex manufacturing processes can be broken down into the smallest units and, therefore, also be automated. The situation in complex systems such as the human body, however, is completely different. In order for doctors to be able to carry out their actions within this complex system, medicine as a science provides the physician with rules on the means that should be used to decide which remedy should be used, when and how. This judgment of which remedy should be used, when and how, what is known as the indication, is a central medical moment. This requires a power of judgment sharpened by experience. The indication, in turn, essentially determines the course of a disease and thus the quality of the treatment or the quality of result so often referred to these days.

Study on the accuracy of oxygen concentration of modified oxygen treatment with Venturi and humidity system

To verify the accuracy of oxygen concentration (FiO2) of modified oxygen treatment with Venturi and humidity system. Patients just after ventilator weaning and before the removal of tracheal intubation/tracheotomy tube, who admitted to the intensive care unit (ICU) of Henan Provincial People's Hospital from May 1st to December 15th in 2017, were enrolled. All patients were given a modified oxygen treatment with Venturi and humidity system, and the oxygen flow rate (Flow) of the Venturi device and the oretical value of FiO2 were adjusted according to the patient's condition. Patients were divided into five groups based on doctor's orders: Flow 3 L/min FiO2 0.24, Flow 3 L/min FiO2 0.26, Flow 6 L/min FiO2 0.28, Flow 6 L/min FiO2 0.30, Flow 9 L/min FiO2 0.35. The value of FiO2 at the inhalation end of patients of each group was measured by TSI airflow analyzer, and the consistency between the measured value of FiO2 at the inhalation end and the FiO2 marked value of Venturi was compared and analyzed. When the FiO2 theoretical value of Venturi were adjusted to 0.24, 0.26, 0.28, 0.30, and 0.35, the measured values of FiO2 at the inhalation end of patients were 0.38±0.05, 0.38±0.05, 0.40±0.04, 0.41±0.04, and 0.77±0.11, respectively, which were all significantly higher than the theoretical value of FiO2 (all P < 0.01). The difference between the measured value of FiO2 at the inhalation side and the FiO2 value of the Venturi annotated and the difference rate were both "V"-shaped, both of which decreased with the increase in theoretical value of FiO2 to a Flow of 9 L/min and a theoretical value of FiO2 0.35, the accuracy was the worst, with the FiO2 difference of 0.42±0.11, and the FiO2 difference rate of (121.6±36.5)%. There is a difference between the measured value and the theoretical value of FiO2 at the inhalation end of the modified Venturi oxygen therapy humidification system, which needs to be paid attention to during clinical oxygen therapy.

A data-driven framework of typical treatment process extraction and evaluation

BackgroundA clinical pathway (CP) defines a standardized care process for a well-defined patient group that aims to improve patient outcomes and promote patient safety. However, the construction of a new pathway from scratch is a time-consuming task for medical staff because it involves many factors, including objects, multidisciplinary collaboration, sequential design, and outcome measurements. Recently, the rapid development of hospital information systems has allowed the storage of large volumes of electronic medical records (EMRs), and this information constitutes an abundant data resource for building CPs using data-mining methods. MethodsWe provide an automatic method for extracting typical treatment processes from EMRs that consists of four key steps. First, a novel similarity method is proposed to measure the similarity of two treatment records. Then, we perform an affinity propagation (AP) clustering algorithm to cluster doctor order set sequences (DOSSs). Next, a framework is proposed to extract a high-level description of each treatment cluster. Finally, we evaluate the extracted typical treatment processes by matching the treatment cluster with external information, such as the treatment efficacy, length of stay, and treatment cost. ResultsBy experiments on EMRs of 8287 cerebral infarction patients, it is concluded that our proposed method can effectively extract typical treatment processes from treatment records, and also has great potential to improve treatment outcome by personalizing the treatment process for patients with different conditions. ConclusionThe extracted typical treatment processes are intuitive and can provide managerial guidance for CP redesign and optimization. In addition, our work can assist clinicians in clearly understanding their routine treatment processes and recommend optimal treatment pathways for patients.

Quality of Life among Adolescents with Type I Diabetes Mellitus at AL-Najaf Center for Diabetes and Endocrine

Aims of the study: To assess the quality of life among adolescent with type I diabetes mellitus and to identify the relationship of adolescents quality of life and their demographic data.Methodology: A cross-sectional descriptive design is carried out in AL-Sadder Medical City/ AL-Najaf Center for Diabetes and Endocrine, from September 20th, 2016 until July 5th, 2017. A Non-Probable (Purposive Sample) of (150) Diabetes Mellitus Adolescents is selected: they visited Al-Sadder Medical City at Al-Najaf Center for Diabetes and Endocrine. The data were collected through the use of well-designed questionnaire, consisting of three parts: the first part is the socio demographic data form, socio- economic status scale of the family and Anthropometric Measurement of Weight and of Height. The second part is the clinical data for adolescents that consists of (8) items. The third part is the quality of life domains that consists of (51) items. The reliability of the questionnaire was determined through a pilot study and the validity was determined through a panel of (17) experts. The data were described statistical, and analyzed through the use of descriptive statistical and inferential statistical methods.Results: the highest percent 58.0% of the adolescents was male gender; 74.7% of the adolescents have normal weight; whether the type of treatment was injection in 98.7% of adolescents; the measurement of the HbA1c was &gt; 6.5 in 80.7 of the adolescents; mean of score for QOL was 2.22 (moderate) because the lowest scores were reported by adolescents (social and communication) domain.Conclusion: the study concluded that quality of life as moderate. Specific domains that lead to the deterioration of quality of life, including social and communication, were identified. Almost adolescents have elevated HbA1c that occur as a result of not following doctor order concerning monitoring eating regimen levels and refused frequency blood glucose monitoring. Male and late adolescent age/ were majority adolescents with T1DM.Recommendation: Instruction and educational sessions must take place thoroughly for the adolescents with Type I Diabetes Mellitus to improve their quality of life. Carbohydrate intake must be monitored, by carbohydrate calculating or the estimation based on experience. This is a key strategy for achieving glycemic control. Caregivers and school teachers should be knowledgeable about how to administer insulin based on, doctor orders in case the adolescent is incapable of personal achieve.

Status report of analgesic prescriptions by general practitioners in elderly people aged 75 and over, upon admission in geriatric medicine.

The main objective of this study is to describe the current therapeutic strategy for pain in elderly patients, by general practitioners. In this prospective study, 149 patients aged 75 years and over, hospitalized in geriatric medicine at the University Hospital of Caen, were recruited between June and September 2015. All analgesic data was recorded from the patients' prescriptions and medical files. 66% of the patients had at least one analgesic. More than 96% of patients who took analgesics were treated with a step 1 analgesic (mainly paracetamol), and approximately 30% received a step 2 analgesic (69% tramadol). Only 8% received step 3 analgesics. The proportion of patients treated with an antiepileptic was higher in cases of neuropathic pain. Adjuvant drugs were prescribed 17.3% on doctor's orders. Pain was mainly of a mechanical nature, due to osteoarthritis. The results of the study exhibit a well-balanced therapeutic management of pain by general practitioners for ambulatory elderly patients in agreement with the guidelines.

‘Just What the Doctor Ordered’: Promoting Wellbeing with Medical Students

The tertiary student experience is not the same for all. Some students navigate the challenges of student life and flourish amidst stresses, whilst others experience considerable distress and disengage (Stallman, 2010; Larcombe et al., 2015). Much research has sought to identify what factors contribute to students’ thriving at university and what constitutes a successful student. Medical students have long been thought of as ‘successful’ students with high academic attainments and abilities, however recent research suggests medical students experience higher rates of mental health distress and suicidal ideation compared to the broader student population (Rotenstein et al., 2016). In recognition of the challenges faced by medical students, in 2017 the Melbourne Medical School (MMS) developed a new proactive approach to student wellbeing through adopting a ‘Health Promoting University’ strategic model (Okanagan Charter, 2015). The overarching strategic model entails a stage-based process of program endorsement, implementation and evaluation; of which the MMS is currently half way through (Stage 4). The framework has facilitated the development of proactive individual interventions and group based programs, all designed in close consultation with medical students, and seeking to broaden the scope of what constitutes a successful medical student. This innovative approach to medical student health and wellbeing demonstrates a school-wide, prevention-based approach to promoting student wellbeing. The authors detail the design, beginning stages of delivery, and future plans and aspirations for this evidence-based model of student wellbeing.

Informed Consent: No Longer Just What the Doctor Ordered? Revisited

Several years ago, I authored what I intended as a comprehensive paper on the less “conventional” aspects of informed consent, largely focusing on matters more personal to the “disclosing” physician. Since that time, other authors have commented on some of these matters. As the law of informed consent has continued to develop and courts have recently considered informed consent issues unrelated to the typical required disclosure, I have concluded that it is time to revisit the unconventional and other selected topics of informed consent.

Design and implementation of an advanced telemedicine model for the rural people of Bangladesh.

Telemedicine based healthcare service faces different difficulties especially in the remote people of Bangladesh. The objective of this study was to implement an advanced telemedicine model in order to provide the healthcare services for the rural people of Bangladesh. We developed the telemedicine model using an ardunio based low cost portable telemedicine tool kit by interfacing android application. Then we collected ECG, blood pressure, temperature, concentration of glucose in blood, SPO2, body position, airflow, height and weight through our developed model. Moreover, we designed a server for storing the recorded signal from the patients in order to treat them by health care professionals. Finally, this model is successfully tested with the patients of Marie Stopes Bangladesh Hospital Dhaka. We have removed noise from the recorded signal successfully through our developed hardware and software based techniques. Real time data were visualized to the expert doctor in order to prescribe them through our model. These results support that rural patient vital information can be collected in an automated way through the advanced model. Both rural and urban doctors can share and exchange patient information more effectively for the treatment of patient. The results of this research indicated that our developed telemedicine system can be used effectively in order to deliver healthcare services for the rural people of Bangladesh.

Cultures of Confinement: Health, Illness, and Madness in The Cabinet of Dr. Caligari and The Magic Mountain

Cultures of Confinement:Health, Illness, and Madness in The Cabinet of Dr. Caligari and The Magic Mountain Robert Heynen (bio) In an article on war neuroses in Weimar Germany, Jason Crouthamel recounts the story of a disabled veteran's unusual challenge to medical and political authority in the aftermath of World War I: At a 1921 Berlin city assembly meeting, witnesses testified that a psychologically-disabled war victim under the pseudonym "Dr. Franzke-Rudolph" used false papers to disguise himself as a medical doctor in order to infiltrate his pension and health-care office. Once established in the administration area of the welfare office, this individual began to "incite rebellion" and, according to the police, attempted to set up a "communist headquarters" for the revolution led by welfare recipients. Local papers reported that in his clash with police just before he was led off to an asylum, the would-be doctor declared that the health-care administrators, insurance court clerks and doctors were all "mentally ill" and he called for a new system led by war victims themselves.1 Dr. Franzke-Rudolph's direct action was an astute and nuanced piece of political theater that pointed to a number of issues facing German veterans, most notably around access to social supports. His utopian plan for setting up a "communist headquarters" highlighted the extent to which questions of social welfare, health, and illness had become politicized, with anti-psychiatry ideas influencing the broader left-wing revolutionary movements of the post-World War I period.2 And, his subsequent confinement [End Page 683] in an asylum reflected a tactic used frequently by authorities seeking to suppress those movements. The modernist and avant-garde movements of the Weimar period were shaped in turn by these complex debates around psychiatric or medical confinement, radical politics, and war. Modernists had long appropriated experiences of madness and illness, with madness in particular both celebrated as offering a primitivist access to an untrammelled aesthetic and psychic freedom, while simultaneously signifying the destabilizing and fragmenting experience of modern life.3 For many, however, the experience of war and postwar revolution highlighted the inadequacy of these often vague and apolitical perspectives. In some cases, artists and writers themselves experienced medicalized confinement directly, some as patients (the expressionist playwright Ernst Toller, for example, who was also later imprisoned for his leading role in the Bavarian Soviet Republic), others as orderlies (the expressionist painter and printmaker Conrad Felixmüller). In part because of these direct experiences, but more broadly due to the experience of the brutality of war, in movements like Dada madness and illness were increasingly politicized. As with Franzke-Rudolph, practices of confinement themselves came to be seen as part of larger oppressive capitalist and militarist social structures.4 We need to be careful about making too much of this shift, however. Even after the war a romantic notion of madness remained influential, perhaps most notably in Hans Prinzhorn's 1922 book Artistry of the Mentally Ill. Prinzhorn was a psychiatrist and art historian who worked in an asylum and collected the artworks produced by inmates. These he compared favorably with expressionism, although he insisted that inmates' art was spontaneous and unconscious, calling their work Bildnerei (image-making) in contrast to the consciously-produced Kunst (art) of artists. Artists flocked to him and his collection, but while he worked in an asylum, he had little to say about war, politics, or the institutional basis of psychiatric and medical confinement.5 What might a more politicized attention to the institutional politics of confinement, one closer to Franzke-Rudolph than Prinzhorn, bring to an understanding of the modernist fascination with madness and illness? To engage with this question, I will examine two of the most famous Weimar-era evocations of confinement, the asylum of Robert Wiene's 1920 film The Cabinet of Dr. Caligari and the tuberculosis sanatorium in the Swiss Alps of Thomas Mann's 1924 novel The Magic Mountain. Both struggle with the complex intersections of madness, illness, and creativity, each foregrounding the material as well as the metaphorical or allegorical dimensions of confinement. Both film and novel respond to the rise of psychiatric medicine and psychoanalysis, and the...

Informed Consent: No Longer Just What the Doctor Ordered? Revisited

Several years ago, I authored what I intended as a comprehensive paper on the less “conventional” aspects of informed consent, largely focusing on matters more personal to the “disclosing” physician. Since that time, other authors have commented on some of these matters. As the law of informed consent has continued to develop and courts have recently considered informed consent issues unrelated to the typical required disclosure, I have concluded that it is time to revisit the unconventional and other selected topics of informed consent.

Education of physiology in nursing school: common issues and measures with pharmacology

Anatomy, physiology or pharmacology is the important subject in nursing education. Nursing education is established in a law since 1951. Although the law is revised many times according to social situation, the subjects like physiology have been positioned as a basic specialized subject in the law now. Physiology is educated at 1st grade in most nursing school. However, there are some problems in educating physiology. First, academic ability in nursing students tend to decline recently. For example, there are some students who cannot solve simple arithmetic. They cannot calculate how much volume (mL) they have to aspirate injection solution to the syringe, when a doctor orders an injection medicine. Thus, there are increasing number of students who are not good at calculation. Second, they do not learn the technical term exactly. There are many names of pharmaceutical drug they must learn in pharmacology, some of which have similar names of pharmaceutical drug. If students do not learn them exactly, there is the possibility of causing a medical accident. Third, students learn something or an events from restricted one side. Therefore, they cannot answer the question they are asked from a different point of view. Furthermore, student cannot relate the knowledge they have learned with other knowledge. It seems that it must be important to have students understand how to utilize the knowledge in physiology or pharmacology in nursing practice at an early stage.

Treatment Compliance of Arthritis Patients and its Influencing Factors

Objective: To investigate the therapeutic compliance of arthritis patients and its influencing factors, and to propose the measures to improvethe therapeutic effect of arthritis patients. Methods A total of 144 patients with arthritis were investigated by self-designed questionnaire.The survey included general information, living habits, prevalence and self - feeling of the patients. The data were analyzed by SPSS17.0 statistical software. Results: Patient compliance was related to the sex of the patients, the number of half-hour exercise per week, thetype of illness, the condition of medical insurance, the understanding of the side effects and the feelings. And patients with less number ofexercise hour per week less, did not participate in health insurance, have no enough understanding of the side effects show poor compliance.Conclusion: In order to reduce or delay the occurrence of arthritis, we should educate patients on health education, strengthen their selfcontrol,obey their doctor's orders, have the knowledge of the disease and their drugs, understand the side effects of drugs, and activelyparticipate in physical exercise, and call on the government to increase the implementation of medical insurance policy.

Just What the Doctor Ordered? Physician Mobility After the Adoption of Electronic Health Records

Although significant research has examined the effect of enterprise information systems on the behavior and careers of employees, the majority of this work has been devoted to the study of blue and grey collar workers, with little attention paid to the transformative effect IT may have on high status professionals. In this paper, we begin to bridge this gap by examining how highly skilled professionals react to the increasing presence of technology within their organizations. Specifically, we investigate how the implementation of electronic health record systems (EHRs) affects physician mobility and the decision to continue practicing at their current hospital. Results from a census of physicians in the state of Florida suggest that when these enterprise systems create complementarities for the physician, their tenure at the focal organization increases significantly. However, when technologies are disruptive to the physician’s routines, there is a pronounced exodus from the organization. Interestingly, d...

A Weekend Camping is Just What the Doctor Ordered

A Weekend Camping is Just What the Doctor Ordered