Objective: Government targets to reduce waiting times are putting enormous pressures on outpatient services. The implementation of an electronic care records service (CRS) at our hospital in 2008 has led to widespread...Objective: Government targets to reduce waiting times are putting enormous pressures on outpatient services. The implementation of an electronic care records service (CRS) at our hospital in 2008 has led to widespread press coverage of ensuing chaos in clinical administration. We wanted to know how this new electronic system impacted on our working patterns in outpatient clinics and – more specifically – on the time actually spent with the patients. Material & methods: This study was performed 4 and 12 months after implementation of CRS to assess its impact on the time distribution in clinic. Senior doctors were monitored with a stop clock during consultations. Timings for pre- and post-consultation administration, and the actual consultation with the patient were recorded. A total of 170 consultations were evaluated in this way. Results: The key findings were that the total time needed to spend on a urological outpatient of 16 minutes remains unchanged from the pre-CRS era, but a majority (57%) of this time is spent in administration on the computer without the patient involved. Conclusion: No more than 15 patients should be seen in a 4 hour outpatient clinic per doctor. This recommendation drawn up by BAUS before CRS remains still valid. Patient administration related to the consultation that has previously been done by administrative aides is now to be done by the doctors on the computer in the same consultation session. Intended to streamline patient pathways, this does reduce the quality interaction-time between doctor and patients significantly.展开更多
With new requirements proposed for technical standards work under the new circumstances,the article combining with the practice of Wuhan Iron and Steel Company Limited(WISCO)points out that enterprises must improve th...With new requirements proposed for technical standards work under the new circumstances,the article combining with the practice of Wuhan Iron and Steel Company Limited(WISCO)points out that enterprises must improve the work pattern of standards development and revision,and strengthen the standards implementation management and product quality supervision,so that technical standards can serve as a bridge between technologies and industrialization,support the industrial upgrading and structural optimization,create conditions for promoting trade and unify the market and provides means for global competition,helping enterprises to better cope with the increasing market competition.展开更多
China is witnessing a very complicated economic development environment.Migrant workers'working patterns will directly affect their income level and the realization of many economic and social development goals.Th...China is witnessing a very complicated economic development environment.Migrant workers'working patterns will directly affect their income level and the realization of many economic and social development goals.This paper collects relevant data from three places:Shanghai,Lanzhou and Chengdu for empirical research whose results show that determinants of migrant worker's willing working time in urban areas mainly include the“income-consumption difference”,“urban-rural consumption difference”and their“urban income and expenditure uncertainty”.These factors directly affect their effective working time in the city,and determine their choice of choosing corresponding work patterns.From the significant differences of these factors,we can see that migrant workers in China is still struggling to solve their material needs under the pressure of livelihood,and less attention is paid to their spiritual needs and the pursuit of quality of life.展开更多
The identification of contamination sources within the food chain with polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzo-furans (PCDFs), (“dioxins”), and PCBs is difficult and complex. PCDD/PCDF ...The identification of contamination sources within the food chain with polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzo-furans (PCDFs), (“dioxins”), and PCBs is difficult and complex. PCDD/PCDF can be formed as unintentional compounds in a number of chemical processes as well as in almost every combustion process. PCBs were intentionally produced chemicals that were manufactured for decades before the ban in marketing and use in many countries around 1985. The pattern of occurrence can change from the original source in particular via feedingstuffs to food of animal origin as result of bioaccumulation. A number of examples illustrate the challenging detective work and key scientific aspects for identification of the sources, for support of the risk management and for performance of monitoring programs. The contamination of milk and milk products in European countries with dioxins was caused by compound feeds containing citrus pulp pellets from Brazil which had high dioxin levels as a result of the use of heavily contaminated lime used for neutralization. The Belgian dioxin crisis was caused by a feed additive heavily contaminated with PCBs which were discharged into a recycled fat used in the production of animal feed. Guar gum from India was contaminated with sodium pentachlorophenate and dioxins. Clay was found to be possibly highly contaminated with dioxins possibly formed by geothermal processes over time;use of such clay as feed additive or for human intake led to elevated dioxin levels in food and humans. Bioanalytical screening in combination with comprehensive physicochemical investigations led to the detection of brominated flame retardants and brominated dioxins in a feed additive. Buffalo milk was contaminated in Italy presumably caused by illegal deposition of waste. High PCB levels in fuel oil for drying of breadcrumb used as a feed ingredient caused a major dioxin crisis with pork meat in Ireland. Fatty acids for technical purposes originating from a biodiesel company were used for production of feed fat which contaminated parts of the food chain in Germany. In addition to effects on human and animal health these incidents also have serious economic consequences which could be mitigated by more frequent control on food and feed. Addressing both these issues, the European Community has developed a strategy to reduce the presence of dioxins and PCBs in the environment and in feed and food comprising the establishment of maximum and action levels.展开更多
文摘Objective: Government targets to reduce waiting times are putting enormous pressures on outpatient services. The implementation of an electronic care records service (CRS) at our hospital in 2008 has led to widespread press coverage of ensuing chaos in clinical administration. We wanted to know how this new electronic system impacted on our working patterns in outpatient clinics and – more specifically – on the time actually spent with the patients. Material & methods: This study was performed 4 and 12 months after implementation of CRS to assess its impact on the time distribution in clinic. Senior doctors were monitored with a stop clock during consultations. Timings for pre- and post-consultation administration, and the actual consultation with the patient were recorded. A total of 170 consultations were evaluated in this way. Results: The key findings were that the total time needed to spend on a urological outpatient of 16 minutes remains unchanged from the pre-CRS era, but a majority (57%) of this time is spent in administration on the computer without the patient involved. Conclusion: No more than 15 patients should be seen in a 4 hour outpatient clinic per doctor. This recommendation drawn up by BAUS before CRS remains still valid. Patient administration related to the consultation that has previously been done by administrative aides is now to be done by the doctors on the computer in the same consultation session. Intended to streamline patient pathways, this does reduce the quality interaction-time between doctor and patients significantly.
文摘With new requirements proposed for technical standards work under the new circumstances,the article combining with the practice of Wuhan Iron and Steel Company Limited(WISCO)points out that enterprises must improve the work pattern of standards development and revision,and strengthen the standards implementation management and product quality supervision,so that technical standards can serve as a bridge between technologies and industrialization,support the industrial upgrading and structural optimization,create conditions for promoting trade and unify the market and provides means for global competition,helping enterprises to better cope with the increasing market competition.
基金The National Social Science Fund of China:Study on the Impact of Migrant Workers'Migrant Birds Work Mode and Employment Security in the Process of Urbanization(15XJL011)。
文摘China is witnessing a very complicated economic development environment.Migrant workers'working patterns will directly affect their income level and the realization of many economic and social development goals.This paper collects relevant data from three places:Shanghai,Lanzhou and Chengdu for empirical research whose results show that determinants of migrant worker's willing working time in urban areas mainly include the“income-consumption difference”,“urban-rural consumption difference”and their“urban income and expenditure uncertainty”.These factors directly affect their effective working time in the city,and determine their choice of choosing corresponding work patterns.From the significant differences of these factors,we can see that migrant workers in China is still struggling to solve their material needs under the pressure of livelihood,and less attention is paid to their spiritual needs and the pursuit of quality of life.
文摘The identification of contamination sources within the food chain with polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzo-furans (PCDFs), (“dioxins”), and PCBs is difficult and complex. PCDD/PCDF can be formed as unintentional compounds in a number of chemical processes as well as in almost every combustion process. PCBs were intentionally produced chemicals that were manufactured for decades before the ban in marketing and use in many countries around 1985. The pattern of occurrence can change from the original source in particular via feedingstuffs to food of animal origin as result of bioaccumulation. A number of examples illustrate the challenging detective work and key scientific aspects for identification of the sources, for support of the risk management and for performance of monitoring programs. The contamination of milk and milk products in European countries with dioxins was caused by compound feeds containing citrus pulp pellets from Brazil which had high dioxin levels as a result of the use of heavily contaminated lime used for neutralization. The Belgian dioxin crisis was caused by a feed additive heavily contaminated with PCBs which were discharged into a recycled fat used in the production of animal feed. Guar gum from India was contaminated with sodium pentachlorophenate and dioxins. Clay was found to be possibly highly contaminated with dioxins possibly formed by geothermal processes over time;use of such clay as feed additive or for human intake led to elevated dioxin levels in food and humans. Bioanalytical screening in combination with comprehensive physicochemical investigations led to the detection of brominated flame retardants and brominated dioxins in a feed additive. Buffalo milk was contaminated in Italy presumably caused by illegal deposition of waste. High PCB levels in fuel oil for drying of breadcrumb used as a feed ingredient caused a major dioxin crisis with pork meat in Ireland. Fatty acids for technical purposes originating from a biodiesel company were used for production of feed fat which contaminated parts of the food chain in Germany. In addition to effects on human and animal health these incidents also have serious economic consequences which could be mitigated by more frequent control on food and feed. Addressing both these issues, the European Community has developed a strategy to reduce the presence of dioxins and PCBs in the environment and in feed and food comprising the establishment of maximum and action levels.
