Objective:Nurse-led virtual outpatient clinics are now a familiar component of healthcare delivery across many disciplines,including cancer care,or thopedics,rheumatology,and gastroenterology.However,establishing a nu...Objective:Nurse-led virtual outpatient clinics are now a familiar component of healthcare delivery across many disciplines,including cancer care,or thopedics,rheumatology,and gastroenterology.However,establishing a nurse-led vir tual clinic is challenging for nursing management,par ticularly regarding resources.We aimed to investigate nursing practices and processes and patient experiences in relation to vir tual outpatient clinics.Methods:This was a cross-sectional,descriptive study using mixed data collection methods.Patients(n=324)from 4 specialist clinics completed the Virtual Clinics Patient Satisfaction Questionnaire(VCSQ)survey.Five Nurse Specialists participated in a focus group interview.Results:Most participants(86.3%)reported being satisfied/very satisfied with the virtual clinics,particularly those that were nurse-led.Nurse specialists identified electronic health records(EHRs)and additional IT and administrative support as important for efficiency and effectiveness of the clinics.Conclusions:Nurse-led virtual clinics can be an effective and efficient way to provide care to patients.Nurse managers need to ensure supportive structures are in place,for example,dedicated administrators,IT support and infrastructure,education/training,and relevant policies/procedures.The success of nurse-led virtual services requires key infrastructure to support nursing staff and sustain this service.展开更多
Infected necrotizing pancreatitis(INP)remains a life-threatening complication of acute pancreatitis.Despite advancements such as endoscopic ultrasound(EUS)-guided drainage,lumen-apposing metal stents,and protocolized ...Infected necrotizing pancreatitis(INP)remains a life-threatening complication of acute pancreatitis.Despite advancements such as endoscopic ultrasound(EUS)-guided drainage,lumen-apposing metal stents,and protocolized step-up strate-gies,the clinical practice remains heterogeneous,with variability in endoscopic strategies,procedural timing,device selection,and adjunctive techniques contri-buting to inconsistent outcomes.This review synthesizes current evidence to contribute to a structured framework integrating multidisciplinary team decision-making,advanced imaging(three-dimensional reconstruction,contrast-enhanced computed tomography/magnetic resonance imaging),EUS assessment,and biomarker-driven risk stratification(C-reactive protein,procalcitonin)to optimize patient selection,intervention timing,and complication management.Key stan-dardization components include endoscopic assessment and procedural strate-gies,optimal timing of intervention,personalized approaches for complex pan-creatic collections,and techniques to reduce the number of endoscopic debride-ments and mitigate complications.This work aims to enhance clinical outcomes,minimize practice heterogeneity,and establish a foundation for future research and guideline development in endoscopic management of INP.展开更多
Objective To explore the risk management of the changes of sponsors and/or production sites during drug clinical trials based on the theories of quality management,risk management,and change management.Methods The met...Objective To explore the risk management of the changes of sponsors and/or production sites during drug clinical trials based on the theories of quality management,risk management,and change management.Methods The method of failure modes and effect analysis(FMEA)was used to identify risks through literature research,expert consultation,comparative research,and comprehensive analysis.Besides,risk priority number(RPN)was used to evaluate the risks.Results and Conclusion A FMEA of the changes of sponsors and/or production sites in clinical trials was constructed and RPN values of every failure mode and causes were obtained.Based on the RPN values,the core risk control points for different combination modes of sponsors and/or production sites after their changes were identified.It is recommended that China should strengthen the construction of the sponsor responsibility system.In addition,the changes of sponsors and/or production sites during the clinical trial period should be allowed in an orderly manner under the premise of ensuring the quality of clinical trials and subject protection.展开更多
This study analyzes the causes and effects of climate change in the upper Niger River basin and the implementation of local adaptation strategies based on EMS(Environmental Management Systems).It aims to strengthen ec...This study analyzes the causes and effects of climate change in the upper Niger River basin and the implementation of local adaptation strategies based on EMS(Environmental Management Systems).It aims to strengthen ecological resilience and sustainable natural resource management practices through training,awareness-raising,and community participation.The work was conducted in three rural communes in the Kissidougou prefecture,located in the Faranah administrative region.Data collection and analysis tools included questionnaires,GPS devices,digital devices,laptops,and Excel and SPSS software.The methodology employed a participatory and multidisciplinary approach combining a literature review,surveys of 163 respondents,semi-structured interviews with 16 key informants,training for 218 technical staff and local elected officials(30%of whom were women),and awareness-raising activities for 1,800 participants in local languages.Five community forests covering 443.58 hectares were integrated into management plans,concerted,under the coordination of the NGO APARFE.The results show an increase in average temperature(+0.8°C since 1960),a decrease in rainfall(-5.3 mm/month),and increased vulnerability of populations dependent on agriculture.The integration of the EMS(Environmental Management System)has led to improvements in environmental governance,community forest management,awareness of sustainable agricultural practices,and the inclusion of women(51%of participants).In short,the EMS is an effective tool for strengthening community resilience and environmental sustainability.展开更多
The purpose of this study is to investigate the effectiveness of the“expiration manager”mini program in managing the validity of ward items.The program was used to manage frequently and infrequently used consumables...The purpose of this study is to investigate the effectiveness of the“expiration manager”mini program in managing the validity of ward items.The program was used to manage frequently and infrequently used consumables by setting up an automatic reminder function.The item failure rate and the time required for nurses to conduct counts over 6 months before and after implementation were compared,as well as evaluated system availability using the System Usability scale(SUS).Results showed that after implementing the mini program,both the item failure rate and non-recognition rate significantly decreased(P<0.05),while the inspection pass rate significantly increased(P<0.05),and the monthly inventory time was reduced(P<0.05).The SUS evaluation yielded a total score of 74.38±11.73,with learnability at 80.21±20.27 and availability at 72.92±11.18,all indicating good user acceptance.In conclusion,the“expiration manager”mini program can effectively improve the efficiency of item expiration management,reduce the risk of expiration,and save inspection time,thereby demonstrating high user acceptance and promising potential for wider adoption.展开更多
Collaborative forest management (CFM) is a form of forest governance in which local communities are involved in the management and decision-making processes related to forest resources. It is believed that forests und...Collaborative forest management (CFM) is a form of forest governance in which local communities are involved in the management and decision-making processes related to forest resources. It is believed that forests under such management are better in tree diversity and conservation status and thus hold more carbon stocks. The study assessed the impact of CFM on carbon stocks, tree species diversity & tree species density in Mabira Central Forest Reserve. Data were collected from plots that were systematically laid in the different purposively selected forest areas. The study findings show that there is no difference in stem density and carbon stocks between CFM and non-CFM areas. CFM areas had lower species richness compared to non-CFM areas. CFM areas, however, exhibited more species diversity than non-CFM areas. Climax colonization may favor a few dominant species over others, hence lowering species diversity despite the number of species being many in the understory, hence at the same time increasing species richness. Likewise, disturbance in CFM area may affect natural colonization and favor the emergency of many species either naturally or through assisted regeneration by reforestation, hence increasing diversity, whereas artificial selection of preferred species through harvesting may lower species richness, as observed. Recommendations for improving collaborative forest management (CFM) areas include implementing targeted interventions to enhance carbon sequestration, such as promoting reforestation and afforestation with high-carbon-storing species and strengthening monitoring and evaluation frameworks to assess carbon stock changes over time. Additionally, efforts should focus on enhancing biodiversity conservation by implementing more stringent protection measures and reducing human disturbance while encouraging community participation in biodiversity monitoring and conservation education.展开更多
Objective To analyze the current situation of drug shortage in some western countries and their management strategies,and to put forward feasible suggestions for drug shortage management in China.Methods The methods o...Objective To analyze the current situation of drug shortage in some western countries and their management strategies,and to put forward feasible suggestions for drug shortage management in China.Methods The methods of literature research and comparative study were used to collect policy information and related data from official government websites and news websites,then,the current situation and management of drug shortage in some western countries were compared and studied to summarize their effective experience in dealing with drug shortage.Results and Conclusion The current situation and influencing factors of drug shortage in these western countries are different,but the management system established to deal with drug shortage is good,including the support of policies and regulations,the early warning of monitoring platform and the construction of organizational system.Drawing lessons from their experience,China should strengthen cooperation and consultation among stakeholders and rationally allocate powers and responsibilities.The transparency of drug shortage data disclosure should be increased.The important role of pharmacists should be played to strengthen the management.Further optimizing the drug shortage management system in China can ensure the safety of drug supply.展开更多
Decision making is one of the important activities of the managerial problems. Scientific methodology for quantitative techniques is an essential tool in the contemporary decision making protocols. In this paper an at...Decision making is one of the important activities of the managerial problems. Scientific methodology for quantitative techniques is an essential tool in the contemporary decision making protocols. In this paper an attempt is made to develop a stochastic model on manager’s performance appraisal. Managerial choice among the available options for decision making is formulated to obtain the stochastic process, to derive the model and to obtain statistical measures. Numerical illustrations are provided for understanding the managerial performance and its evaluation. This study is useful to assess the abilities of an employee by his/her employer. Development of Desktop automations to this study will open a wide spectrum of dynamic Decision Support Systems.展开更多
The centralized procurement of drugs in the medical system is a key link,which not only affects the economic effect of institutions,but also relates to the medical quality and patient safety.In the current era,central...The centralized procurement of drugs in the medical system is a key link,which not only affects the economic effect of institutions,but also relates to the medical quality and patient safety.In the current era,centralized drug procurement in hospitals can meet the needs of most patients;however,the specific steps of the work still need to be optimized.Starting from the level of hospital drug centralized procurement work,this paper discusses the policy background,analyzes the practice of drug centralized procurement in tertiary hospitals,and provides specific work management suggestions,aiming to improve work efficiency and serve as a reference for optimizing subsequent hospital drug centralized procurement work.展开更多
Objective:To examine how emotional labor demands and strategies influence work engagement and occupational identity among Portuguese volunteer firefighters.Methods:Participants completed the Emotional Work Requirement...Objective:To examine how emotional labor demands and strategies influence work engagement and occupational identity among Portuguese volunteer firefighters.Methods:Participants completed the Emotional Work Requirements Scale,Emotional Labour Scale,Utrecht Work Engagement Scale,and Social Identity Scale.Multiple linear regression analyses were conducted to assess the predictive effects of emotional labor demands and strategies on work engagement and occupational identity.Results:Emotional labor explained 11.8%of the variance in work engagement and 10.9%in occupational identity.Positive emotion expression significantly predicted higher work engagement and a stronger occupational identity,while the suppression of negative emotions predicted a weaker occupational identity.Other emotional labor dimensions were not significant.Conclusions:Findings underscore the dual role of emotional labor—as a resource when positive emotions are expressed and as a strain when negative emotions are habitually suppressed.Targeted interventions to promote authentic positive expression and effective emotional processing may enhance firefighters’well-being,strengthen crisis team performance,and benefit the communities they serve.Further research is needed to deepen the understanding of emotional labor in crisis response contexts.展开更多
Water is essential for agricultural production;however,climate change has exacerbated drought and water stress in arid and semi-arid areas such as Iran.Despite these challenges,irrigation water efficiency remains low,...Water is essential for agricultural production;however,climate change has exacerbated drought and water stress in arid and semi-arid areas such as Iran.Despite these challenges,irrigation water efficiency remains low,and current water management schemes are inadequate.Consequently,Iranian crops suffer from low water productivity,highlighting the urgent need for enhanced productivity and improved water management strategies.In this study,we investigated irrigation management conditions in the Hamidiyeh farm,Khuzestan Province,Iran and used the calibrated AquaCrop and WinSRFR(a surface irrigation simulation model)models to reflect these conditions.Subsequently,we examined different management scenarios using each model and evaluated the results from the second year.The findings demonstrated that combining simulation of the AquaCrop and WinSRFR models was highly effective and could be employed for irrigation management in the field.The AquaCrop model accurately simulated wheat yield in the first year,being 2.6 t/hm^(2),which closely aligned with the measured yield of 3.0 t/hm^(2).Additionally,using the WinSRFR model to adjust the length of existing borders from 200 to 180 m resulted in a 45.0%increase in efficiency during the second year.To enhance water use efficiency in the field,we recommended adopting borders with a length of 180 m,a width of 10 m,and a flow rate of 15 to 18 L/s.The AquaCrop and WinSRFR models accurately predicted border irrigation conditions,achieving the highest water use efficiency at a flow rate of 18 L/s.Combining these models increased farmers'average water consumption efficiency from 0.30 to 0.99 kg/m^(3)in the second year.Therefore,the results obtained from the AquaCrop and WinSRFR models are within a reasonable range and consistent with international recommendations.This adjustment is projected to improve the water use efficiency in the field by approximately 45.0%when utilizing the border irrigation method.Therefore,integrating these two models can provide comprehensive management solutions for regional farmers.展开更多
Objective:To analyze the effect of pharmacist-led rational drug use management of antibiotics during the perioperative period in gynecology.Methods:Two hundred patients who underwent gynecological surgery between Marc...Objective:To analyze the effect of pharmacist-led rational drug use management of antibiotics during the perioperative period in gynecology.Methods:Two hundred patients who underwent gynecological surgery between March 2023 and December 2023 were selected and randomly divided into two groups.In the experimental group,the pharmacist led the medication management during the perioperative use of antibiotics,while the control group received routine antibiotic management.The management effects were compared between the two groups.Results:The irrational drug use rate,the incidence of adverse drug reactions,the cost of antibiotics,and the incidence of postoperative infection were all lower in the experimental group compared to the control group(P<0.05).Conclusion:Implementing pharmacist-led medication management during the perioperative period of gynecological surgery can prevent irrational drug use,reduce adverse drug reactions,control drug costs,and lower the risk of postoperative infection.展开更多
Objective To discuss the flexible supervision and communication mode in the post-approval change(PAC)of drugs,to explore how to ensure the quality and availability of drugs during the changes,and to provide some sugge...Objective To discuss the flexible supervision and communication mode in the post-approval change(PAC)of drugs,to explore how to ensure the quality and availability of drugs during the changes,and to provide some suggestions and reference for promoting the timely marketing of drugs.Methods Based on the comparability protocol guidelines issued by the US FDA in October 2022,the regulatory status quo of PAC between China and the US was compared to explore the feasibility of implementing comparability protocols in China.Results and Conclusion According to the specific situation of post-approval of drug change supervision,some suggestions were put forward to optimize the PAC management procedure,such as establishing the communication pathways between holders and health authorities,publishing relevant guidance and strengthening training,so as to provide reference for the implementation of comparability protocols in China.展开更多
Transjugular intrahepatic portosystemic shunts(TIPSs)are generally used for the management of complications of portal hypertension in patients with decompensated cirrhosis.However,hepatic encephalopathy(HE),which impa...Transjugular intrahepatic portosystemic shunts(TIPSs)are generally used for the management of complications of portal hypertension in patients with decompensated cirrhosis.However,hepatic encephalopathy(HE),which impairs neuropsychiatric function and motor control,remains the primary adverse effect of TIPS,limiting its utility.Prompt prevention and treatment of post-TIPS HE are critical,as they are strongly associated with readmission rates and poor quality of life.This review focuses on the main pathophysiological mechanisms underlying post-TIPS HE,explores advanced biomarkers and predictive tools,and discusses current management strategies and future directions to prevent or reverse HE following TIPS.These strategies include preoperative patient assessment,individualized shunt diameter optimization,spontaneous portosystemic shunt embolization during the TIPS procedure,postoperative preventive and therapeutic measures such as nutrition management,medical therapy,fecal microbiota transplantation,and stent reduction.展开更多
Cropland is persistently affected by soil loss by water erosion in China,which causes economic loss and threatens soil health.Integrating crop switching and improved management provides a promising strategy for contro...Cropland is persistently affected by soil loss by water erosion in China,which causes economic loss and threatens soil health.Integrating crop switching and improved management provides a promising strategy for controlling soil loss by water erosion in cropland and promoting sustainable agriculture.However,optimizing crop composition with fewer inputs involves balancing agricultural resource use with environmental costs.Aiming to explore the potential of crop switching as a strategy for mitigating soil erosion in cropland,we develop a spatial optimization model that redistributes the sown areas of different crops in each prefecture-level city based on existing resource availability.Our findings gained from our simulations show that crop switching in China alone can reduce total soil erosion in cropland by an estimated 13%.Furthermore,combining crop switching with improved agricultural management practices can further reduce soil erosion in cropland by an estimated 25%.Cereals including maize,wheat,and rice demonstrate significant potential for reducing soil erosion in cropland.Shifting major maize-producing areas northward could result in a substantial decrease in soil erosion,ranging from 10% to 19% of historical soil erosion in cropland.These results offer implications for formulating regional strategy in mitigating soil erosion challenges in China while maximizing the benefits from existing agricultural resource.展开更多
BACKGROUND Thiocolchicoside(TCC),a muscle relaxant with anti-inflammatory properties,is often used alongside nonsteroidal anti-inflammatory drugs(NSAIDs)to treat musculoskeletal pain.This synergistic approach leverage...BACKGROUND Thiocolchicoside(TCC),a muscle relaxant with anti-inflammatory properties,is often used alongside nonsteroidal anti-inflammatory drugs(NSAIDs)to treat musculoskeletal pain.This synergistic approach leverages the complementary mechanisms of action,providing more effective relief for conditions such as arthritis,muscle spasms,and soft tissue injuries.AIM To evaluate the comparative efficacy of the combination therapy of TCC and NSAIDs vs NSAID monotherapy in pain management.METHODS A systematic search of PubMed and Google Scholar databases through October 2024 was performed to evaluate the effectiveness of combined TCC and NSAID therapy vs NSAIDs alone.A retrospective analysis of electronic medical records from India spanning 3 years(2020-2023)examined treatment patterns and focused on clinical outcomes including pain relief,functional improvement,and adverse effects.Key metrics for assessment included visual analog scale scores and hand-to-floor distance,with secondary outcomes assessing patient satisfaction and adverse event(AE)incidence.RESULTS A systematic literature search revealed seven studies,involving 1137 subjects,aligning with the eligibility criteria from a total of 833 hits.Combination therapy using parenteral TCC with NSAIDs significantly reduced pain intensity[standardised mean difference(SMD):-1.33,P<0.001]and enhanced functional improvement(SMD:-1.08,P<0.001)compared to NSAIDs alone.Patients on combination therapy are 6.7 times more likely to experience over 30%pain relief and 5.2 times more likely to achieve over 50%pain relief.Post surgery pain reduction and patient satisfaction were notably higher in the combination group[odds ratio(OR)=10.14,P<0.001].There were no significant differences in mild/moderate AE rates between the groups(OR=1.30,P=0.378).CONCLUSION Evidence indicates that multimodal therapy,including parenteral TCC with NSAIDs,provides quicker and effective pain relief,reduces muscle spasms,and improves hand-to-floor distance compared to using NSAIDs or TCC alone.展开更多
This study presents a methodology to enhance energy management systems(EMS)in hybrid electric vehicles(HEVs)to reduce fuel consumption and greenhouse gas emissions.A novel surrogate-assisted optimization framework is ...This study presents a methodology to enhance energy management systems(EMS)in hybrid electric vehicles(HEVs)to reduce fuel consumption and greenhouse gas emissions.A novel surrogate-assisted optimization framework is employed,incorporating key performance metrics such as fuel efficiency and emissions to develop data-driven surrogate models of the EMS.These models are optimized using various algorithms targeting parameters such as engine idle speed,thermostat temperature fraction,regeneration load factor,and battery stateof-charge thresholds.Correlation analysis highlights the significant impact of the lower state-of-charge threshold and thermostat temperature fraction on fuel efficiency and emissions.Among the optimization methods,the combination of a backpropagation neural network(BPNN)and a multi-objective genetic algorithm(MOGA)proves most effective,achieving fuel consumption reductions of 5.26%and 5.01%in charge-sustaining and charge-depletion modes,respectively.Additionally,the BPNN-based MOGA demonstrates notable improvements in emission reduction.These findings suggest that optimizing rule-based EMS parameters without altering underlying management rules can significantly enhance performance under diverse and unanticipated driving conditions.展开更多
基金supported by Nursing and Midwifery Practice Development Unit(NMPDU),Dublin South,Kildare,and Wicklow,Nurses preparedness for end of life conversations(No.P210537)。
文摘Objective:Nurse-led virtual outpatient clinics are now a familiar component of healthcare delivery across many disciplines,including cancer care,or thopedics,rheumatology,and gastroenterology.However,establishing a nurse-led vir tual clinic is challenging for nursing management,par ticularly regarding resources.We aimed to investigate nursing practices and processes and patient experiences in relation to vir tual outpatient clinics.Methods:This was a cross-sectional,descriptive study using mixed data collection methods.Patients(n=324)from 4 specialist clinics completed the Virtual Clinics Patient Satisfaction Questionnaire(VCSQ)survey.Five Nurse Specialists participated in a focus group interview.Results:Most participants(86.3%)reported being satisfied/very satisfied with the virtual clinics,particularly those that were nurse-led.Nurse specialists identified electronic health records(EHRs)and additional IT and administrative support as important for efficiency and effectiveness of the clinics.Conclusions:Nurse-led virtual clinics can be an effective and efficient way to provide care to patients.Nurse managers need to ensure supportive structures are in place,for example,dedicated administrators,IT support and infrastructure,education/training,and relevant policies/procedures.The success of nurse-led virtual services requires key infrastructure to support nursing staff and sustain this service.
基金Supported by the Education and Teaching Reform Project of the First Clinical College of Chongqing Medical University,No.CMER202305Natural Science Foundation of Xizang Autonomous Region,No.XZ2024ZR-ZY100(Z)Program for Youth Innovation in Future Medicine,Chongqing Medical University,China,No.W0138.
文摘Infected necrotizing pancreatitis(INP)remains a life-threatening complication of acute pancreatitis.Despite advancements such as endoscopic ultrasound(EUS)-guided drainage,lumen-apposing metal stents,and protocolized step-up strate-gies,the clinical practice remains heterogeneous,with variability in endoscopic strategies,procedural timing,device selection,and adjunctive techniques contri-buting to inconsistent outcomes.This review synthesizes current evidence to contribute to a structured framework integrating multidisciplinary team decision-making,advanced imaging(three-dimensional reconstruction,contrast-enhanced computed tomography/magnetic resonance imaging),EUS assessment,and biomarker-driven risk stratification(C-reactive protein,procalcitonin)to optimize patient selection,intervention timing,and complication management.Key stan-dardization components include endoscopic assessment and procedural strate-gies,optimal timing of intervention,personalized approaches for complex pan-creatic collections,and techniques to reduce the number of endoscopic debride-ments and mitigate complications.This work aims to enhance clinical outcomes,minimize practice heterogeneity,and establish a foundation for future research and guideline development in endoscopic management of INP.
文摘Objective To explore the risk management of the changes of sponsors and/or production sites during drug clinical trials based on the theories of quality management,risk management,and change management.Methods The method of failure modes and effect analysis(FMEA)was used to identify risks through literature research,expert consultation,comparative research,and comprehensive analysis.Besides,risk priority number(RPN)was used to evaluate the risks.Results and Conclusion A FMEA of the changes of sponsors and/or production sites in clinical trials was constructed and RPN values of every failure mode and causes were obtained.Based on the RPN values,the core risk control points for different combination modes of sponsors and/or production sites after their changes were identified.It is recommended that China should strengthen the construction of the sponsor responsibility system.In addition,the changes of sponsors and/or production sites during the clinical trial period should be allowed in an orderly manner under the premise of ensuring the quality of clinical trials and subject protection.
文摘This study analyzes the causes and effects of climate change in the upper Niger River basin and the implementation of local adaptation strategies based on EMS(Environmental Management Systems).It aims to strengthen ecological resilience and sustainable natural resource management practices through training,awareness-raising,and community participation.The work was conducted in three rural communes in the Kissidougou prefecture,located in the Faranah administrative region.Data collection and analysis tools included questionnaires,GPS devices,digital devices,laptops,and Excel and SPSS software.The methodology employed a participatory and multidisciplinary approach combining a literature review,surveys of 163 respondents,semi-structured interviews with 16 key informants,training for 218 technical staff and local elected officials(30%of whom were women),and awareness-raising activities for 1,800 participants in local languages.Five community forests covering 443.58 hectares were integrated into management plans,concerted,under the coordination of the NGO APARFE.The results show an increase in average temperature(+0.8°C since 1960),a decrease in rainfall(-5.3 mm/month),and increased vulnerability of populations dependent on agriculture.The integration of the EMS(Environmental Management System)has led to improvements in environmental governance,community forest management,awareness of sustainable agricultural practices,and the inclusion of women(51%of participants).In short,the EMS is an effective tool for strengthening community resilience and environmental sustainability.
基金The First Affiliated Hospital of Shaoyang University,China(Project No.:23FY1015)。
文摘The purpose of this study is to investigate the effectiveness of the“expiration manager”mini program in managing the validity of ward items.The program was used to manage frequently and infrequently used consumables by setting up an automatic reminder function.The item failure rate and the time required for nurses to conduct counts over 6 months before and after implementation were compared,as well as evaluated system availability using the System Usability scale(SUS).Results showed that after implementing the mini program,both the item failure rate and non-recognition rate significantly decreased(P<0.05),while the inspection pass rate significantly increased(P<0.05),and the monthly inventory time was reduced(P<0.05).The SUS evaluation yielded a total score of 74.38±11.73,with learnability at 80.21±20.27 and availability at 72.92±11.18,all indicating good user acceptance.In conclusion,the“expiration manager”mini program can effectively improve the efficiency of item expiration management,reduce the risk of expiration,and save inspection time,thereby demonstrating high user acceptance and promising potential for wider adoption.
文摘Collaborative forest management (CFM) is a form of forest governance in which local communities are involved in the management and decision-making processes related to forest resources. It is believed that forests under such management are better in tree diversity and conservation status and thus hold more carbon stocks. The study assessed the impact of CFM on carbon stocks, tree species diversity & tree species density in Mabira Central Forest Reserve. Data were collected from plots that were systematically laid in the different purposively selected forest areas. The study findings show that there is no difference in stem density and carbon stocks between CFM and non-CFM areas. CFM areas had lower species richness compared to non-CFM areas. CFM areas, however, exhibited more species diversity than non-CFM areas. Climax colonization may favor a few dominant species over others, hence lowering species diversity despite the number of species being many in the understory, hence at the same time increasing species richness. Likewise, disturbance in CFM area may affect natural colonization and favor the emergency of many species either naturally or through assisted regeneration by reforestation, hence increasing diversity, whereas artificial selection of preferred species through harvesting may lower species richness, as observed. Recommendations for improving collaborative forest management (CFM) areas include implementing targeted interventions to enhance carbon sequestration, such as promoting reforestation and afforestation with high-carbon-storing species and strengthening monitoring and evaluation frameworks to assess carbon stock changes over time. Additionally, efforts should focus on enhancing biodiversity conservation by implementing more stringent protection measures and reducing human disturbance while encouraging community participation in biodiversity monitoring and conservation education.
文摘Objective To analyze the current situation of drug shortage in some western countries and their management strategies,and to put forward feasible suggestions for drug shortage management in China.Methods The methods of literature research and comparative study were used to collect policy information and related data from official government websites and news websites,then,the current situation and management of drug shortage in some western countries were compared and studied to summarize their effective experience in dealing with drug shortage.Results and Conclusion The current situation and influencing factors of drug shortage in these western countries are different,but the management system established to deal with drug shortage is good,including the support of policies and regulations,the early warning of monitoring platform and the construction of organizational system.Drawing lessons from their experience,China should strengthen cooperation and consultation among stakeholders and rationally allocate powers and responsibilities.The transparency of drug shortage data disclosure should be increased.The important role of pharmacists should be played to strengthen the management.Further optimizing the drug shortage management system in China can ensure the safety of drug supply.
文摘Decision making is one of the important activities of the managerial problems. Scientific methodology for quantitative techniques is an essential tool in the contemporary decision making protocols. In this paper an attempt is made to develop a stochastic model on manager’s performance appraisal. Managerial choice among the available options for decision making is formulated to obtain the stochastic process, to derive the model and to obtain statistical measures. Numerical illustrations are provided for understanding the managerial performance and its evaluation. This study is useful to assess the abilities of an employee by his/her employer. Development of Desktop automations to this study will open a wide spectrum of dynamic Decision Support Systems.
文摘The centralized procurement of drugs in the medical system is a key link,which not only affects the economic effect of institutions,but also relates to the medical quality and patient safety.In the current era,centralized drug procurement in hospitals can meet the needs of most patients;however,the specific steps of the work still need to be optimized.Starting from the level of hospital drug centralized procurement work,this paper discusses the policy background,analyzes the practice of drug centralized procurement in tertiary hospitals,and provides specific work management suggestions,aiming to improve work efficiency and serve as a reference for optimizing subsequent hospital drug centralized procurement work.
基金funded by national funds through FCT-Fundação para a Ciência e a TecnologiaI.P.(Foundation for Science and Technology,I.P.) under project UIDB/05037/2020.
文摘Objective:To examine how emotional labor demands and strategies influence work engagement and occupational identity among Portuguese volunteer firefighters.Methods:Participants completed the Emotional Work Requirements Scale,Emotional Labour Scale,Utrecht Work Engagement Scale,and Social Identity Scale.Multiple linear regression analyses were conducted to assess the predictive effects of emotional labor demands and strategies on work engagement and occupational identity.Results:Emotional labor explained 11.8%of the variance in work engagement and 10.9%in occupational identity.Positive emotion expression significantly predicted higher work engagement and a stronger occupational identity,while the suppression of negative emotions predicted a weaker occupational identity.Other emotional labor dimensions were not significant.Conclusions:Findings underscore the dual role of emotional labor—as a resource when positive emotions are expressed and as a strain when negative emotions are habitually suppressed.Targeted interventions to promote authentic positive expression and effective emotional processing may enhance firefighters’well-being,strengthen crisis team performance,and benefit the communities they serve.Further research is needed to deepen the understanding of emotional labor in crisis response contexts.
基金The study was funded by the Soil and Water Research Institute of Iran.
文摘Water is essential for agricultural production;however,climate change has exacerbated drought and water stress in arid and semi-arid areas such as Iran.Despite these challenges,irrigation water efficiency remains low,and current water management schemes are inadequate.Consequently,Iranian crops suffer from low water productivity,highlighting the urgent need for enhanced productivity and improved water management strategies.In this study,we investigated irrigation management conditions in the Hamidiyeh farm,Khuzestan Province,Iran and used the calibrated AquaCrop and WinSRFR(a surface irrigation simulation model)models to reflect these conditions.Subsequently,we examined different management scenarios using each model and evaluated the results from the second year.The findings demonstrated that combining simulation of the AquaCrop and WinSRFR models was highly effective and could be employed for irrigation management in the field.The AquaCrop model accurately simulated wheat yield in the first year,being 2.6 t/hm^(2),which closely aligned with the measured yield of 3.0 t/hm^(2).Additionally,using the WinSRFR model to adjust the length of existing borders from 200 to 180 m resulted in a 45.0%increase in efficiency during the second year.To enhance water use efficiency in the field,we recommended adopting borders with a length of 180 m,a width of 10 m,and a flow rate of 15 to 18 L/s.The AquaCrop and WinSRFR models accurately predicted border irrigation conditions,achieving the highest water use efficiency at a flow rate of 18 L/s.Combining these models increased farmers'average water consumption efficiency from 0.30 to 0.99 kg/m^(3)in the second year.Therefore,the results obtained from the AquaCrop and WinSRFR models are within a reasonable range and consistent with international recommendations.This adjustment is projected to improve the water use efficiency in the field by approximately 45.0%when utilizing the border irrigation method.Therefore,integrating these two models can provide comprehensive management solutions for regional farmers.
文摘Objective:To analyze the effect of pharmacist-led rational drug use management of antibiotics during the perioperative period in gynecology.Methods:Two hundred patients who underwent gynecological surgery between March 2023 and December 2023 were selected and randomly divided into two groups.In the experimental group,the pharmacist led the medication management during the perioperative use of antibiotics,while the control group received routine antibiotic management.The management effects were compared between the two groups.Results:The irrational drug use rate,the incidence of adverse drug reactions,the cost of antibiotics,and the incidence of postoperative infection were all lower in the experimental group compared to the control group(P<0.05).Conclusion:Implementing pharmacist-led medication management during the perioperative period of gynecological surgery can prevent irrational drug use,reduce adverse drug reactions,control drug costs,and lower the risk of postoperative infection.
文摘Objective To discuss the flexible supervision and communication mode in the post-approval change(PAC)of drugs,to explore how to ensure the quality and availability of drugs during the changes,and to provide some suggestions and reference for promoting the timely marketing of drugs.Methods Based on the comparability protocol guidelines issued by the US FDA in October 2022,the regulatory status quo of PAC between China and the US was compared to explore the feasibility of implementing comparability protocols in China.Results and Conclusion According to the specific situation of post-approval of drug change supervision,some suggestions were put forward to optimize the PAC management procedure,such as establishing the communication pathways between holders and health authorities,publishing relevant guidance and strengthening training,so as to provide reference for the implementation of comparability protocols in China.
基金Supported by the National Natural Science Foundation of China,No.82270649.
文摘Transjugular intrahepatic portosystemic shunts(TIPSs)are generally used for the management of complications of portal hypertension in patients with decompensated cirrhosis.However,hepatic encephalopathy(HE),which impairs neuropsychiatric function and motor control,remains the primary adverse effect of TIPS,limiting its utility.Prompt prevention and treatment of post-TIPS HE are critical,as they are strongly associated with readmission rates and poor quality of life.This review focuses on the main pathophysiological mechanisms underlying post-TIPS HE,explores advanced biomarkers and predictive tools,and discusses current management strategies and future directions to prevent or reverse HE following TIPS.These strategies include preoperative patient assessment,individualized shunt diameter optimization,spontaneous portosystemic shunt embolization during the TIPS procedure,postoperative preventive and therapeutic measures such as nutrition management,medical therapy,fecal microbiota transplantation,and stent reduction.
基金financially supported by the National Natural Science Foundation of China(Grant No.42377321)。
文摘Cropland is persistently affected by soil loss by water erosion in China,which causes economic loss and threatens soil health.Integrating crop switching and improved management provides a promising strategy for controlling soil loss by water erosion in cropland and promoting sustainable agriculture.However,optimizing crop composition with fewer inputs involves balancing agricultural resource use with environmental costs.Aiming to explore the potential of crop switching as a strategy for mitigating soil erosion in cropland,we develop a spatial optimization model that redistributes the sown areas of different crops in each prefecture-level city based on existing resource availability.Our findings gained from our simulations show that crop switching in China alone can reduce total soil erosion in cropland by an estimated 13%.Furthermore,combining crop switching with improved agricultural management practices can further reduce soil erosion in cropland by an estimated 25%.Cereals including maize,wheat,and rice demonstrate significant potential for reducing soil erosion in cropland.Shifting major maize-producing areas northward could result in a substantial decrease in soil erosion,ranging from 10% to 19% of historical soil erosion in cropland.These results offer implications for formulating regional strategy in mitigating soil erosion challenges in China while maximizing the benefits from existing agricultural resource.
文摘BACKGROUND Thiocolchicoside(TCC),a muscle relaxant with anti-inflammatory properties,is often used alongside nonsteroidal anti-inflammatory drugs(NSAIDs)to treat musculoskeletal pain.This synergistic approach leverages the complementary mechanisms of action,providing more effective relief for conditions such as arthritis,muscle spasms,and soft tissue injuries.AIM To evaluate the comparative efficacy of the combination therapy of TCC and NSAIDs vs NSAID monotherapy in pain management.METHODS A systematic search of PubMed and Google Scholar databases through October 2024 was performed to evaluate the effectiveness of combined TCC and NSAID therapy vs NSAIDs alone.A retrospective analysis of electronic medical records from India spanning 3 years(2020-2023)examined treatment patterns and focused on clinical outcomes including pain relief,functional improvement,and adverse effects.Key metrics for assessment included visual analog scale scores and hand-to-floor distance,with secondary outcomes assessing patient satisfaction and adverse event(AE)incidence.RESULTS A systematic literature search revealed seven studies,involving 1137 subjects,aligning with the eligibility criteria from a total of 833 hits.Combination therapy using parenteral TCC with NSAIDs significantly reduced pain intensity[standardised mean difference(SMD):-1.33,P<0.001]and enhanced functional improvement(SMD:-1.08,P<0.001)compared to NSAIDs alone.Patients on combination therapy are 6.7 times more likely to experience over 30%pain relief and 5.2 times more likely to achieve over 50%pain relief.Post surgery pain reduction and patient satisfaction were notably higher in the combination group[odds ratio(OR)=10.14,P<0.001].There were no significant differences in mild/moderate AE rates between the groups(OR=1.30,P=0.378).CONCLUSION Evidence indicates that multimodal therapy,including parenteral TCC with NSAIDs,provides quicker and effective pain relief,reduces muscle spasms,and improves hand-to-floor distance compared to using NSAIDs or TCC alone.
文摘This study presents a methodology to enhance energy management systems(EMS)in hybrid electric vehicles(HEVs)to reduce fuel consumption and greenhouse gas emissions.A novel surrogate-assisted optimization framework is employed,incorporating key performance metrics such as fuel efficiency and emissions to develop data-driven surrogate models of the EMS.These models are optimized using various algorithms targeting parameters such as engine idle speed,thermostat temperature fraction,regeneration load factor,and battery stateof-charge thresholds.Correlation analysis highlights the significant impact of the lower state-of-charge threshold and thermostat temperature fraction on fuel efficiency and emissions.Among the optimization methods,the combination of a backpropagation neural network(BPNN)and a multi-objective genetic algorithm(MOGA)proves most effective,achieving fuel consumption reductions of 5.26%and 5.01%in charge-sustaining and charge-depletion modes,respectively.Additionally,the BPNN-based MOGA demonstrates notable improvements in emission reduction.These findings suggest that optimizing rule-based EMS parameters without altering underlying management rules can significantly enhance performance under diverse and unanticipated driving conditions.
