Does the Internal Audit Function Play a Role in Mitigating Earnings Management?

This paper aims to investigate the effect of the characteristics of the internal audit function(IAF)on earnings management(EM)for a sample of 27 Tunisian listed companies.The authors employed the Correlated Panels Corrected Standard Errors model to estimate the regression equation.The results showed that EM is negatively associated with internal audit effectiveness,frequency of audit committee meetings with Chief Audit Executives(CAEs),the partial outsourcing of internal audit,and the firm’s size.Moreover,the authors found a positive relationship between EM and the use of IAF as a training ground for management and the private sector.This study is important to academics,regulators,and policymakers in introducing new governance reforms to strengthen the IAF as an important internal governance mechanism to reduce earnings management practices in emerging countries.The results also provide useful information for investors to examine the effect of internal audit characteristics on earnings management.

Effective Development of Enterprise Emergency Management under the New Policy of Safety Production

In recent years,China has formed a more perfect emergency management system,and has achieved more significant results.The form of safety production has maintained a continuous good development trend,showing the characteristics of"two declines,one being basically flat,and one zero occurrence".In order to further strengthen the implementation of production safety responsibilities and resolutely prevent and contain extremely major accidents,the recent national production safety teleconference deployed 15 measures to pay close attention to the implementation,seriously pursue accountability,adhere to the red line,and immediately carry out in-depth and solid production safety inspections across the country.In such a high pressure situation,the ways to effectively carry out the security management of enterprises were briefly described in this paper.

Information Management in Disaster and Humanitarian Response: A Case in United Nations Office for the Coordination of Humanitarian Affairs

To guarantee a unified response to disasters, humanitarian organizations work together via the United Nations Office for the Coordination of Humanitarian Affairs (OCHA). Although the OCHA has made great strides to improve its information management and increase the availability of accurate, real-time data for disaster and humanitarian response teams, significant gaps persist. There are inefficiencies in the emergency management of data at every stage of its lifecycle: collection, processing, analysis, distribution, storage, and retrieval. Disaster risk reduction and disaster risk management are the two main tenets of the United Nations’ worldwide plan for disaster management. Information systems are crucial because of the crucial roles they play in capturing, processing, and transmitting data. The management of information is seldom discussed in published works. The goal of this study is to employ qualitative research methods to provide insight by facilitating an expanded comprehension of relevant contexts, phenomena, and individual experiences. Humanitarian workers and OCHA staffers will take part in the research. The study subjects will be chosen using a random selection procedure. Online surveys with both closed- and open-ended questions will be used to compile the data. UN OCHA offers a structure for the handling of information via which all humanitarian actors may contribute to the overall response. This research will enable the UN Office for OCHA better gather, process, analyze, disseminate, store, and retrieve data in the event of a catastrophe or humanitarian crisis.

Nurse anesthetists’perceptions and experiences of managing emergence delirium:A qualitative study

BACKGROUND This study employs a descriptive phenomenological approach to investigate the challenges anesthesia nurses face in managing emergence delirium(ED),a common and complex postoperative complication in the post-anesthesia care unit.The role of nurses in managing ED is critical,yet research on their understanding and management strategies for ED is lacking.AIM To investigate anesthetic nurses’cognition and management experiences of ED in hopes of developing a standardized management protocol.METHODS This study employed a descriptive phenomenological approach from qualitative research methodologies.Purposeful sampling was utilized to select 12 anesthetic nurses from a tertiary hospital in Shanghai as research subjects.Semi-structured interviews were conducted,and the data were organized and analyzed using Colaizzi’s seven-step analysis method,from which the final themes were extracted.RESULTS After analyzing the interview content,four main themes and eight subthemes were distilled:Inefficient cognition hinders the identification of ED(conceptual ambiguity,empirical identification),managing diversity and challenges(patientcentered safe care,low level of medical-nursing collaboration),work responsibilities and pressure coexist(heavy work responsibilities,occupational risks and stress),demand for high-quality management(expecting the construction of predictive assessment tools and prevention strategies,and pursuing standardized management processes to enhance management effectiveness).CONCLUSION Nursing managers should prioritize the needs and suggestions of nurses in order to enhance their nursing capabilities and provide guidance for standardized management processes.

Adhesive small bowel adhesions obstruction: Evolutions in diagnosis, management and prevention

Intra-abdominal adhesions following abdominal surgery represent a major unsolved problem. They are the first cause of small bowel obstruction. Diagnosis is based on clinical evaluation, water-soluble contrast followthrough and computed tomography scan. For patients presenting no signs of strangulation, peritonitis or severe intestinal impairment there is good evidence to support non-operative management. Open surgery is the preferred method for the surgical treatment of adhesive small bowel obstruction, in case of suspected strangulation or after failed conservative management, but laparoscopy is gaining widespread acceptance especially in selected group of patients. "Good" surgical technique and anti-adhesive barriers are the main current concepts of adhesion prevention. We discuss current knowledge in modern diagnosis and evolving strategies for management and prevention that are leading to stratified care for patients.

Major gastrointestinal bleeding and antithrombotics: Characteristics and management

BACKGROUND There are few reports on major gastrointestinal(GI)bleeding among patients receiving an antithrombotic.AIM To describe clinical characteristics,bleeding locations,management and inhospital mortality related to these events.METHODS Over a three-year period,we prospectively identified 1080 consecutive adult patients admitted in two tertiary care hospitals between January 1,2013 and December 31,2015 for major GI bleeding while receiving an antithrombotic.The bleeding events were medically validated.Clinical characteristics,causative lesions,management and fatalities were described.The distribution of antithrombotics prescribed was compared across the bleeding lesions identified.RESULTS Of 576 patients had symptoms of upper GI bleeding and 504 symptoms of lower GI bleeding.No cause was identified for 383(35.5%)patients.Gastro-duodenal ulcer was the first causative lesion in the upper tract(209 out of 408)and colonic diverticulum the first causative lesion in the lower tract(120 out of 289).There was a larger proportion of direct oral anticoagulant use among patients with lower GI than among those with upper GI lesion locations(P=0.03).There was an independent association between gastro-duodenal ulcer and antithrombotic use(P=0.03),taking account of confounders and proton pump inhibitor coprescription.Pair wise comparisons pointed to a difference between vitamin K antagonist,direct oral anticoagulants,and antiplatelet agents in monotherapy vs dual antiplatelet agents.CONCLUSION We showed a higher rate of bleeding lesion identification and suggested a different pattern of antithrombotic exposure between upper and lower GI lesion locations and between gastro-duodenal ulcer and other identified upper GI causes of bleeding.Management was similar across antithrombotics and in-hospital mortality was low(5.95%).

Biological Early Warning and Emergency Management Support System for Water Pollution Accident

Water pollution accidents such as chemical spill and toxicants leach have become a serious issue in the world, which brings great threats to the aquatic ecosystem and drinking water safety. To detect unknown pollutions in time and take proper emergency actions, this study developed a system which integrated an online intelligent water quality monitoring device with a high efficient water quality model. The device is based on water quality probes and biological sensors which use fish motion as indicator. The numerical model is a combination of Euler and Lagrangian approaches. Finite element method is applied to simulate the flow field in an unstructured grid, and the pollutant be- haviours are traced through particle tracking. Oracle is used to manage the basic and monitoring data, and ArcSDE as well as ArclMS technologies are applied to make the system WebGIS-based so as to improve the data receiving and dispatching efficiency. The developed system has been successfully operated in Douhe Reservoir and Taihu Lake, China, where drinking water intakes are installed. It is seen from the applications that the online intelligent water qual- ity monitoring and emergency support system can be of great support to emergency management.

Impact of failure mode and effects analysis-based emergency management on the effectiveness of craniocerebral injury treatment

BACKGROUND Craniocerebral injuries encompass brain injuries,skull fractures,cranial soft tissue injuries,and similar injuries.Recently,the incidence of craniocerebral injuries has increased dramatically due to the increased numbers of traffic accidents and aerial work injuries,threatening the physical and mental health of patients.AIM To investigate the impact of failure modes and effects analysis(FMEA)-based emergency management on craniocerebral injury treatment effectiveness.METHODS Eighty-four patients with craniocerebral injuries,treated at our hospital from November 2019 to March 2021,were selected and assigned,using the random number table method,to study(n=42)and control(n=42)groups.Patients in the control group received conventional management while those in the study group received FMEA theory-based emergency management,based on the control group.Pre-and post-interventions,details regarding the emergency situation;levels of inflammatory stress indicators[Interleukin-6(IL-6),C-reactive protein(CRP),and procalcitonin(PCT)];incidence of complications;prognoses;and satisfaction regarding patient care were evaluated for both groups.RESULTS For the study group,the assessed parameters[pre-hospital emergency response time(9.13±2.37 min),time to receive a consultation(2.39±0.44 min),time needed to report imaging findings(1.15±4.44 min),and test reporting time(32.19±6.23 min)]were shorter than those for the control group(12.78±4.06 min,3.58±0.71 min,33.49±5.51 min,50.41±11.45 min,respectively;P<0.05).Pre-intervention serum levels of IL-6(78.71±27.59 pg/mL),CRP(19.80±6.77 mg/L),and PCT(3.66±1.82 ng/mL)in the study group patients were not significantly different from those in the control group patients(81.31±32.11 pg/mL,21.29±8.02 mg/L,and 3.95±2.11 ng/mL respectively;P>0.05);post-intervention serum indicator levels were lower in both groups than pre-intervention levels.Further,serum levels of IL-6(17.35±5.33 pg/mL),CRP(2.27±0.56 mg/L),and PCT(0.22±0.07 ng/mL)were lower in the study group than in the control group(30.15±12.38 pg/mL,3.13±0.77 mg/L,0.38±0.12 ng/mL,respectively;P<0.05).The complication rate observed in the study group(9.52%)was lower than that in the control group(26.19%,P<0.05).The prognoses for the study group patients were better than those for the control patients(P<0.05).Patient care satisfaction was higher in the study group(95.24%)than in the control group(78.57%,P<0.05).CONCLUSION FMEA-based craniocerebral injury management effectively shortens the time spent on emergency care,reduces inflammatory stress and complication risk levels,and helps improve patient prognoses,while achieving high patient care satisfaction levels.

Pre-Hospital Management of Craniocerebral Trauma in South Saharan Africa: Cotonou Experience

The management of craniocerebral trauma begins at the site of the accident. This is one of the diseases for which pre-hospital care is well codified. The objective of this study is to report the experience of the Emergency Aid Medical Service (EMAS) of BENIN in the pre-hospital management of craniocerebral trauma. 146 head injuries were cared for. 116 were male. The mean age was 32 years with extremes ranging from 2 to 77 years. Etiology in 68% of patients was a public road accident. And the request for the use of the EMAS was made by highway users for 41% of the injuries. About 5.5% were severe cranio-brain injuries, more than 75% of which had died in intensive care. In 77% of the EMAS interventions, there was an intensive care physician in the team. 34 wounded had been transported in a vacuum mattress. The rigid cervical collar was used in 8 major traumas. All the wounded were transported by ambulance. The duration of hospitalization varied from a few hours in the emergency department to 90 days in the hospital ward. 9 patients died. One of them, who died in an ambulance, was a woman. The prehospital medical care of head trauma in BENIN is still progressing.

Emergency Plan for Water Supply in Consecutive Droughts and Sustainable Water Resources Management in Beijing

Beijing, the capital city of China, has suffered from acute water shortage, with only 300 m3/a of water resources available per capita. In addition, Beijing has experienced a prolonged period of consecutive droughts from 1999 to 2010. Water crisis has constrained the socio-economic development of Beijing. Meanwhile, the national "South-to-North Water Transfer"（STNWT） project, which is expected to provide some relief to the water crisis in Beijing, is still under development. In order to ensure the security of water supply in Beijing before the completion of the STNWT project, several measures have been implemented to cope with droughts, including pumping groundwater from emergency well fields,water saving, recycling of water, rain and flood water harvesting, and the diversion of water from neighboring rivers and groundwater basins. Groundwater from four emergency well fields contributes the most to the public and domestic water supplies in Beijing, supplying a total volume of 1.8×10;m;.The water crisis is supposed to be mitigated by the completion of the STNWT project. After the completion of this project, more sustainable management of water resources will be implemented,including the use of aquifers as groundwater reservoirs and conjunctive use of surface water and groundwater resources.

Contingency management strategies of the Nursing Department in centralized rescue of patients with coronavirus disease 2019

Objectives:This article aims to summarize a series of contingency management strategies of the Nursing Department in the centralized treatment of patients with coronavirus disease 2019(COVID-19).Methods:The strategies of the Nursing Department included an early warning for prevention and control,taking functions of vertically commanding and horizontally coordinating,and reasonably allocating nursing workforce,to facilitate centralized treatment work in the in-hospital fever clinic,isolation wards and ICU,and referral and admission of critical patients.Five special groups were established in charge of training and examination,management and supervision,psychological support,logistical support,and reporting and publicity,respectively.Results:It was achieved that no deaths from critical patients and no medical staff,no other patients were infected.Conclusion:Through the implementation of these strategies,safe and efficient centralized treatment was ensured timely,orderly and sustainably.

Foreign object ingestion and esophageal food impaction:An update and review on endoscopic management

Foreign body ingestion encompasses both foreign object ingestion(FOI) and esophageal food impaction(EFI) and represents a common and clinically significant scenario among patients of all ages. The immediate risk to the patient ranges from negligible to life-threatening, depending on the ingested substance,its location, patient fitness, and time to appropriate therapy. This article reviews the FOI and EFI literature and highlights important considerations and implications for pediatric and adult patients as well as their providers. Where published literature is insufficient to provide evidence-based guidance, expert opinion is included to supplement the content of this comprehensive review.

Emergency department operations and management education in emergency medicine training

BACKGROUND:This study was undertaken to examine the current level of operations and management education within US-based Emergency Medicine Residency programs.METHODS:Residency program directors at all US-based Emergency Medicine Residency programs were anonymously surveyed via a web-based instrument.Participants indicated their levels of residency education dedicated to documentation,billing/coding,core measure/quality indicator compliance,and operations management.Data were analyzed using descriptive statistics for the ordinal data/Likert scales.RESULTS:One hundred and six(106)program directors completed the study instrument of one hundred and fifty-six(156)programs(70%).Of these,82.6%indicated emergency department(ED)operations and management education within the training curriculum.Dedicated documentation training was noted in all but 1 program(99%).Program educational offerings also included billing/coding(83%),core measure/quality indicators(78%)and operations management training(71%).In all areas,the most common means of educating came through didactic sessions and direct attending feedback or 69%-94%and 72%-98%respectively.Residency leadership was most confident with resident understanding of quality documentation(80%)and less so with core measures(72%),billing/coding/RVUs(58%),and operations management tools(23%).CONCLUSIONS:While most EM residency programs integrate basic operational education related to documentation and billing/coding,a smaller number provide focused education on the dayto-day management and operations of the ED.Residency leadership perceives graduating resident understanding of operational management tools to be limited.All respondents value further resident curriculum development of ED operations and management.

The application of feedforward control in the nursing emergency management of COVID-19

Objective:To explore the application of feedforward control in the nursing emergency management of COVID-19.Methods:The feedforward control theory was applied to the emergency management of COVID-19 nursing,including grasping the latest epidemic information,preparing for the early stage,formulating nursing workflow,implementing flexible management,standardizing isolation and protection measures,unifying nursing document record format,and implementing humanistic care.Results:During the period of support to Wuhan,the nursing work in the isolated area was orderly,the nursing staff's job satisfaction was high,no nursing errors and hospital infections occurred.Conclusion:Efficient feedforward control in the nursing emergency management that could avoid work blindness to a certain extent and play a guiding role in maintaining the normal operation of treatment and nursing work and protecting the safety of patients and medical staff in the ward during the epidemic period of COVID-19.

Nursing emergency management practice of COVID-19 in a traditional Chinese medicine hospital

Nursing work is an integral part of hospital work.Under the challenge of the COVID-19 epidemic,it is particularly important to establish a timely and efficient nursing management system.The nursing department of our hospital used the theory and method of feedforward control to formulate the emergency plan for epidemic prevention and control and to conduct drills.The plan includes the establishment of the emergency management system for epidemic nursing and key prevention and control positions,rational allocation of human resources,and strengthening personnel training,so as to ensure the efficient operation of nursing epidemic prevention and control work and provide a reference for nursing management mode during the epidemic.

Status of Severe Accident Management Guidelines at Kozloduy Nuclear Power Plant

The objective of this paper is to present the current organization of the Emergency Procedures including Emergency Operating Procedures (EOP) and Severe Accident Management Guidelines (SAMG) in Kozloduy Nuclear Power Plant (KNPP) as a function of the severity of the accident conditions. Special attention is paid to SAMG. It is described when the SAMG are used and at which conditions in a transition between the EOPs and the SAMG should be made. The Critical Safety Function Restoration Guidelines and their connections with SAMGs and EOPs are also discussed. The arrangement of SAMG is described in detail, since in the KNPP exist 2 types of SAMGs for Main Control Room (MCR) and for the Accident Management Centre (AMC) and they contain the same strategies, but they are different in format. Both types are symptom oriented procedures, but those for MCR are in 2-column-format with interconnections, whereas those for the AMC are developed in a logical manner and simplified for people, who take decisions. In the paper, they are also discussed the adopted strategies in existing SAMG that should be followed to recover from a damaged core condition and to prevent or mitigate the release of fission products. In the paper, they are also described a number of technical measures for management and mitigation of severe accidents, which are implemented in KNPP before and after the Fukushima accident. Many of them are common for WWER-1000 type of reactors, but some of them are unique and plant specific. This information can be useful for operators of other WWER type reactors or even PWR reactors.

Fever Outpatient Service of General Hospital Applies “1 + 3 + 3” Emergency Management Mode to Deal with COVID-19 Pandemic

Purpose: To discuss the effect of “1 + 3 + 3” emergency management mode to deal with COVID-19 pandemic in fever outpatient service of general hospitals. Method: This paper analyzes and summarizes the problems encountered by fever outpatient service in dealing with the COVID-19 pandemic from three aspects of “One Team”, “Three-Key” Control and “Three Mosts”. Results: The application of “1 + 3 + 3” emergency management mode can effectively boost the orderliness and efficiency of fever outpatient service in dealing with COVID-19 pandemic. Conclusion: The “1 + 3 + 3” emergency management mode provides a new management mode and idea for dealing with COVID-19 pandemic, so the fever outpatient service of general hospitals can better improve the national overall anti-pandemic situation.

Emergency management of reservoirs and water treatment plants in typhoon season:a case study of Ningbo

Coastal cities represented by Ningbo are directly or indirectly affected by typhoons each year. By analyzing the past three typical typhoons landing in Ningbo from 2013 to 2016, it was found that before and after the typhoon transit, reservoir and water treatment plant would be made by the destructive impact, including the increasing water level, water volume in a short time, and the deteriorating water quality. Among those, the water quality caused by typhoons increased the water treatment process load, the amount of water purification agents increased significantly,and the emergency response put a great pressure on the inventory of water plants. Based on the statistics and analysis of the basic parameters of the reservoir and water treatment plant during the typhoon season, the emergency management of the typhoon was divided into three situations, namely, pre-typhoon, typhoon period and post-typhoon. Thus, it is effective for the relevant practitioners of the reservoir and water plant to ensure the safe water supply during typhoon season.

Study on Emergency Management of Geological and Meteorological Disasters

The damage caused by geological and meteorological disasters was pointed out in this paper through analyzing the features and causes of geological and meteorological disasters.To strengthen emergency management of geological and meteorological disasters,it is suggested to rigorously investigate potential geological hazard points,to strengthen observation and warning system,to take group prevention and group test as a supplementary to professional observation,to build up the last line of defense to geological and meteorological disasters,to set up functional cooperation mechanism,and to publicize disaster prevention and mitigation.

A Proposal for a Geospatial Database to Support Emergency Management

The basic procedure of the Italian Civil Protection Department aims at reducing disaster losses by giving prominence to a proactive strategy, focusing on prevision and prevention of hazard events rather than postdisater activities. Italian law commits municipalities to produce Emergency Plans that include risk scenarios as well as all data required for emergency management, such as structures, infrastructures and human resources. However the law in the matter of Civil Protection does not supply information about how to produce and archive necessary data for emergency planning and management. For this reason, we propose a standard methodology to create a geodatabase using GIS software, to collect all data that could be used by municipalities to create Emergency Plans. The resulting geodatabase provides a tool for hazard mitigation planning, allowing not only the identification of areas at risk, but also the structures, infrastructures and resources needed to overcome a crisis, thus improving all strategies of risk reduction and the resilience of the system [1].