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Pediatric and Congenital Cardiology, Cardiac Surgery and Intensive Care

為了解決Service oriented的問題，作者 這樣論述：

Eduardo M. da Cruz is the Associate Medical Director of the Heart Institute, Head of the Pediatric Cardiac Critical Care Program and Director of the Cardiac Intensive Care Section and Inpatient Services at Children’s Hospital Colorado, University of Colorado Denver, School of Medicine. He has had an

international life career in Portugal, Costa Rica, France, United Kingdom, Switzerland and the United States of America. He trained in Medicine and then in Pediatrics at the Universidad de Costa Rica and the Hospital Nacional de Niños in San José, Costa Rica, and then pursued a fellowship in pediat

ric cardiology and intensive care in Paris, France (Hôpital Necker-Enfants Malades, Université René Descartes-Paris V- La Sorbonne). After completing his training, Eduardo stayed in Europe as an attending physician until 2007, when he joined the cardiovascular team at Children’s Hospital Colorado in

Denver, USA, where he currently holds the title of Tenured Professor of Pediatrics, Pediatric Cardiology & Intensive Care. He has close to 30 years of experience in the medical and perioperative management of neonates, children and young adults with complex congenital or acquired heart disease, inc

luding heart transplant, mechanical assistance and quality improvement, safety, clinical effectiveness, stewardship, and crew resource management. He is actively involved in clinical and translational research and teaching in the fields of pediatric cardiology and cardiac intensive care, has deliver

ed close to 300 international lectures, and is a reviewer for 28 peer-reviewed journals, and the Editor or Co-Editor of eight CICU textbooks, including the reference entitled Pediatric and Congenital Cardiology, Cardiac Surgery and Intensive Care (Springer-Verlag UK), a major textbook and e-book/e-r

eference with 6 volumes and close to 4000 pages (Editor-in-Chief) and the first Textbook dedicated to the Intensive Care of Adults with Congenital Heart Disease (Editor-in-Chief). He has published 80 book chapters and more than 100 manuscripts in peer-reviewed journals. He is the Emeritus Founder of

the Working Group on Pediatric Cardiac Intensive Care of the Association for the European Pediatric and Congenital Cardiology (AEPC), Past-Chair and founder of the Section on Pediatric and Congenital Cardiac Intensive Care & Mechanical Circulatory Support of the European Society of Pediatric and Ne

onatal Intensive Care (ESPNIC), a former Board Member of the Congenital Domain of the European Association for Cardio-Thoracic Surgery (EACTS), member of the Society of Pediatric Research (SPR), the European Society of cardiology (ESC) and of multiple other international Societies. Eduardo da Cruz i

s also an Expert Reviewer for the European Commission Horizon 2020 Project, and the President and Chair of the Board of Surgeons of Hope Foundation, a United Nations-affiliated Non-Governmental Organization based in New York, USA. In 2019, he was the recipient of the American College of Cardiology D

istinguished Service Award.Dr. Dunbar Ivy began his medical career at Tulane University School of Medicine following his premedical studies at Davidson College. While at Tulane, he became excited about a career in Pediatric Cardiology under the mentorship of Dr Arthur Pickoff. He then obtained train

ing in General Pediatrics at the University of Colorado School of Medicine in Denver, Colorado. Early mentors in Pediatric Cardiology included Drs. Michael Schaffer and Henry Sondheimer. Interest in altitude related illness and pulmonary hypertension in congenital heart disease were fostered by Dr R

obert Wolfe on the clinical side and Drs Steve Abman and John Kinsella in the fetal sheep laboratory while a fellow in Pediatric Cardiology at the University of Colorado. Following fellowship, he became a research instructor under the guidance of Dr Mark Boucek, who encouraged him to pursue a career

as a clinician scientist. During his time as a Bugher fellow, he obtained early grants from the March of Dimes and American Heart Association regarding the role of endothelin in the perinatal pulmonary circulation. This work transitioned into a National Institutes of Health K-08 award to continue t

o study molecular derangements in the endothelin pathway in models of pulmonary hypertension. In 2003 Dr Ivy took the position of Chief of Pediatric Cardiology and Selby’s Chair of Pediatric Cardiology. His research focus became more clinical and translational. As Director of the Pediatric Pulmonary

Hypertension Program, he began early clinical studies of medical therapy in children, including the use of intravenous epoprostenol, subcutaneous treprostinil, and oral bosentan. He began to work with Dr Robin Shandas regarding measurement of right ventricular afterload in children with pulmonary h

ypertension in an NIH sponsored Specialized Centers of Clinically Oriented Research grant headed by Dr Kurt Stenmark. Further work on ventricular vascular coupling has continued with NIH funding. Dr Ivy was the inaugural Chairman of the first Pediatric Pulmonary Hypertension taskforce at the World S

ymposium of Pulmonary Hypertension in Nice, France in 2013. Dr. Ivy is a member of multiple societies, and has published over 250 peer reviewed manuscripts.Dr. James Jaggers was born and raised in Western Nebraska. He completed medical school at the University of Nebraska Medical Center in Omaha Neb

raska. He then completed General Surgery at the Oregon Health Sciences University in Portland Oregon and Thoracic Surgery training at the University of Colorado Health Sciences Center in Denver, where he also completed a Pediatric Cardiac Surgery Fellowship at The Childrens Hospital In Denver. From

there, his first Faculty position was as assistant professor of Surgery at Duke University Medical Center where he rose to the rank of Associate Professor with tenure and Chief of Pediatric Cardiac Surgery and Director of the Duke Pediatric Heart Institute. During his time as chief of Pediatric Card

iac Surgery at Duke, Dr. Jaggers directed the pediatric cardiovascular surgery laboratory and mentored many research fellows. He was principal and co-principal investigator on two basic Science NIH grants and one Pediatric Heart Network NHLBI sponsored multicenter study. In 2010, Dr. Jaggers moved t

o the University of Colorado and Children’s Hospital Colorado where he is now the Barton Elliman Chair of Congenital Cardiac Surgery and Professor of Surgery. Dr. Jaggers’s Clinical focus is in all areas of Congenital Cardiac Surgery including complex neonatal repairs, single ventricle surgery, hear

t transplantation and surgery for connective tissue disorders. He has special interest in quality, safety and effective care for children. He is also the program director for the University of Colorado’s Congenital cardiac surgery training program. His research interests include Stem cell delivery t

o improve heart function in children with complex congenital heart disease, and laboratory research in investigation into the protein signaling of aortic stenosis and uncompensated cardiac hypertrophy and myocardial dysfunction. Dr. Jaggers is a member of multiple Societies, and has published over 1

40 peer reviewed manuscripts, published 30 book chapters and is a reputed national and international educator and lecturer.

Harnessing Complexity for Better Outcomes in Public and Non-Profit Services

為了解決Service oriented的問題，作者French, Max,Hesselgreaves, Hannah,Wilson, Rob 這樣論述：

ePDF and ePUB available Open Access under CC-BY-NC-ND licence. How can public services and social interventions create and sustain good outcomes for the populations they serve? Building on research in public health, social epidemiology and the social determinants of health, this book presents com

plexity theory as an alternative basis for an outcome-oriented public management praxis. It takes a critical approach towards New Public Management and provides new conceptual inroads for reappraising public management in theory and practice. It advances two practical approaches: Human Learning Syst

ems (a model for public service reform) and Learning Partnerships (a model for research and academic engagement in complex settings). With up-to-date and extensive discussions on public service reform, this book provides practical and action-oriented guidance for a radical change of course in manage

ment and governance.

運用醫病共享決策於血糖控制不佳之 第二型糖尿病人的成效探討

為了解決Service oriented的問題，作者毛佩玲 這樣論述：

研究背景：血糖控制不佳會增加大小血管併發症的發生及死亡風險，而糖尿病人自我健康照護行為是影響血糖好壞的關鍵因素，藉由醫病共享決策以病人為中心之照護方式，由醫護人員和病人共同參與治療決策達成共識，可激發病人成為健康參與者的能力，實現治療目標。研究目的：運用以自我效能理論為基礎之醫病共享決策實施模式，探討血糖控制不佳之第二型糖尿病人的自我效能、健康促進行為及疾病控制改變之成效。研究方法：本研究為類實驗之前驅研究，採兩組前後測之研究設計，研究對象為某區教學醫院門診有參與糖尿病共同照護方案且血糖控制不佳之第二型糖尿病人為樣本，進行隨機分派至實驗組或對照組，病人無法得知分配組別，共收案60人，每組各3

0人。研究期間為2021年4月14日至2021年9月14日，實驗組接受醫病共享決策照護模式含選擇性會談、可能性會談及決定性會談，實驗組於介入後一週及一個月各進行電訪追蹤行為遵從度。對照組則接受常規衛教。研究工具為人口學資本資料、糖尿病健康識能中文評估量表、糖尿病控制自我效能及健康促進行為量表、醫病共享決策推廣計畫成效評估調查問卷、決策後悔量表。利用SPSS22.0套裝軟體進行統計分析，包括以描述性統計方法進行人口學特性分析，推論性統計以獨立樣本t檢定（Independent Sample t- test）及卡方檢定（Chi-Square Test）檢視兩組之人口學基本資料的差異，以配對t檢定（

paired t-test）及廣義估計方程式（generalized estimating equations, GEE）分析兩組介入前後數值差異及兩組組內、組間差異。研究結果：針對血糖控制不佳之第二型糖尿病人，經由醫病共享決策衛教介入發現：實驗組相對於對照組之結果，在健康識能平均增加0.9±0.29分（p