This paper primarily concerns the effective coordination of the procedures and methods employed in open pit mining operations under the background of river management.The central objective of this study is to identify...This paper primarily concerns the effective coordination of the procedures and methods employed in open pit mining operations under the background of river management.The central objective of this study is to identify a viable approach for ensuring rational and efficient development of open pit mineral resources while simultaneously protecting and restoring the ecological environment of the river.This approach should facilitate the realization of a harmonious symbiosis between mining and river management.The intricate mutual influence relationship between river management and open pit mining is first analyzed in depth,which provides a solid foundation for the subsequent coordination strategy development.In light of the aforementioned considerations,a set of coordination procedures for open pit mining based on river management conditions is proposed.These procedures emphasize the integration of river protection into the overall layout of mining at the planning stage.The implementation of scientific mining schemes,accompanied by rigorous control of the scope and depth of mining operations,has proven to be an effective means of reducing the impact of mining activities on river environments.This approach has also facilitated the achievement of a balance and coordination between mining and river management.展开更多
BACKGROUND There is limited literature on managing the airway of patients with linear immunoglobulin A(IgA)bullous dermatosis,a rare mucocutaneous disorder that leads to the development of friable bullae.Careful clini...BACKGROUND There is limited literature on managing the airway of patients with linear immunoglobulin A(IgA)bullous dermatosis,a rare mucocutaneous disorder that leads to the development of friable bullae.Careful clinical decision making is necessary when there is a risk of bleeding into the airway,and a multidisciplinary team approach may lead to decreased patient morbidity during these high-risk scenarios,especially when confronted with an unusual cause for bleeding.CASE SUMMARY A 45-year-old African American female presented to our ambulatory surgical center for right corneal transplantation due to corneal perforation after blunt trauma in the setting of cicatricial conjunctivitis and diffuse corneal neovascularization from linear IgA bullous dermatosis.The diagnosis of IgA dermatosis was recent,and the patient had been lost to follow-up.The severity of the disease and extent of airway involvement was unknown at the time of the surgery.Significant airway bleeding was noticed upon intubation and the otorhinolaryngology team had to be called to the operating room.The patient required transfer to the intensive care unit where a multidisciplinary team was involved in her case.The patient was extubated on postoperative day 4.CONCLUSION A multidisciplinary approach to treating this disease is the best course of action before a surgical procedure.In our case,key communication between the surgery,anesthesia,and dermatology teams led to the quick and safe treatment of our patient’s disease.Ambulatory surgery should not be considered for these cases unless they are in full remission and there is no mucous membrane involvement.展开更多
Objective To introduce the accession procedure and evaluation of PIC/S,and help relevant departments in China to understand the requirements of PIC/S in detail,and to promote the process of China’s entry into PIC/S.M...Objective To introduce the accession procedure and evaluation of PIC/S,and help relevant departments in China to understand the requirements of PIC/S in detail,and to promote the process of China’s entry into PIC/S.Methods The procedures and steps of joining PIC/S,the evaluation process of PIC/S,and the experience of several countries in joining PIC/S were introduced and analyzed,which could help the relevant personnel in China understand the specific contents.Results and Conclusion According to the requirements of PIC/S,it is necessary to establish a unified GMP quality management system.展开更多
Engineers often need to look for the right pieces of information by sifting through long engineering documents, It is a very tiring and time-consuming job. To address this issue, researchers are increasingly devoting ...Engineers often need to look for the right pieces of information by sifting through long engineering documents, It is a very tiring and time-consuming job. To address this issue, researchers are increasingly devoting their attention to new ways to help information users, including engineers, to access and retrieve document content. The research reported in this paper explores how to use the key technologies of document decomposition （study of document structure）, document mark-up （with EXtensible Mark- up Language （XML）, HyperText Mark-up Language （HTML）, and Scalable Vector Graphics （SVG））, and a facetted classification mechanism. Document content extraction is implemented via computer programming （with Java）. An Engineering Document Content Management System （EDCMS） developed in this research demonstrates that as information providers we can make document content in a more accessible manner for information users including engineers.The main features of the EDCMS system are： 1） EDCMS is a system that enables users, especially engineers, to access and retrieve information at content rather than document level. In other words, it provides the right pieces of information that answer specific questions so that engineers don＇t need to waste time sifting through the whole document to obtain the required piece of information. 2） Users can use the EDCMS via both the data and metadata of a document to access engineering document content. 3） Users can use the EDCMS to access and retrieve content objects, i.e. text, images and graphics （including engineering drawings） via multiple views and at different granularities based on decomposition schemes. Experiments with the EDCMS have been conducted on semi-structured documents, a textbook of CADCAM, and a set of project posters in the Engineering Design domain. Experimental results show that the system provides information users with a powerful solution to access document content.展开更多
With the application of the principle of PDCA, and dr awing on the experience of the process methods of the ISO9000 and the system met hods of management, the author analyses the basic requirement to fulfill quality m...With the application of the principle of PDCA, and dr awing on the experience of the process methods of the ISO9000 and the system met hods of management, the author analyses the basic requirement to fulfill quality management system in enterprises. Then the author inquires into the procedure t o establish the efficiency quality management system. Finally four stages (plan, do, check, action) and eight steps (decision, plan, analyze, design, do, check, improve, fulfill) are put forward to fulfill quality management system.展开更多
Pain is a common experience for inpatients,and intensive care unit(ICU)patients undergo more pain than other departmental patients,with an incidence of 50%at rest and up to 80%during common care procedures.At present,...Pain is a common experience for inpatients,and intensive care unit(ICU)patients undergo more pain than other departmental patients,with an incidence of 50%at rest and up to 80%during common care procedures.At present,the management of persistent pain in ICU patients has attracted considerable attention,and there are many related clinical studies and guidelines.However,the management of transient pain caused by certain ICU procedures has not received sufficient attention.We reviewed the different management strategies for procedural pain in the ICU and reached a conclusion.Pain management is a process of continuous quality improvement that requires multidisciplinary team cooperation,painrelated training of all relevant personnel,effective relief of all kinds of pain,and improvement of patients'quality of life.In clinical work,which involves complex and diverse patients,we should pay attention to the following points for procedural pain:(1)Consider not only the patient's persistent pain but also his or her procedural pain;(2)Conduct multimodal pain management;(3)Provide combined sedation on the basis of pain management;and(4)Perform individualized pain management.Until now,the pain management of procedural pain in the ICU has not attracted extensive attention.Therefore,we expect additional studies to solve the existing problems of procedural pain management in the ICU.展开更多
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 ...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.展开更多
Objective: To evaluate the quality of pain management in cardiac ICU patients by using a questionnaire. Methodology: All post cardiac surgery patients between 18 and 75 years old were included in this survey. Chronic ...Objective: To evaluate the quality of pain management in cardiac ICU patients by using a questionnaire. Methodology: All post cardiac surgery patients between 18 and 75 years old were included in this survey. Chronic pain patients, paediatric patients, emergency surgeries were excluded. A predesigned proforma was prepared according to American Pain Society recommendations and distributed among Cardiac ICU patients after 24 hours of extubation. This proforma was explained to the patients and collected later. The questionnaire was related to pain severity, aggravating and relieving factors, side effects of analgesics, affective experience and satisfaction with pain management. Results: Total 308 patients participated in one year period. 243 (78.9%) were male and 65 (21.1%) were female. Multimodal analgesia was used in most of the patients. Severity of pain was described as mild 70% and moderate 28.6%. Most of the patients complained of sharp pain 100 (37.5%), mainly at the site of incision 129 (41.9%). The main aggravating factor associated with increased pain was deep breathing 118 (39.8%) while pain was minimized by taking pain medications 40.6%. A significant association was found between preoperative counseling about pain options and satisfaction. 96.8% reported satisfaction with pain management. Conclusion: Although overall pain control was reported as adequate and patients were highly satisfied, there were areas which need further improvement. These include strategies to provide preoperative information about postoperative pain management and better training of medical staff to assess and manage pain. Additionally, the concerns and fears of patients about pain treatment need to be addressed.展开更多
Information technology have changed information media by networking and internet using technology in health as same as another part improve efficiency and effectiveness. Currently, the medical document is reality-base...Information technology have changed information media by networking and internet using technology in health as same as another part improve efficiency and effectiveness. Currently, the medical document is reality-based medicine, so that is the most important, richest and the most realistic source of medical and health information. Health information management systems that require systems to the storage, retrieval, storage and elimination of health records (by law), and adjust to the rules of professional. These processes are difficult and time consuming for human. In the meantime semantic HIM seem best solution.展开更多
Objective The purpose of the present study is to provide scientific evidence for the implementation of standardized management of the loaner instruments by examining the process of receiving through issuing steps and ...Objective The purpose of the present study is to provide scientific evidence for the implementation of standardized management of the loaner instruments by examining the process of receiving through issuing steps and analyzing challenges encountered by the CSSD of our hospital. Methods The loaner instruments were collected and categorized into the control group( 2 639 pieces during the period of January 2013 to December 2014) and the observation group( 2 418 pieces during the period of January 2015 to December 2016). The possible causes of the challenges were carefully investigated and analyzed. Results After the implementation of standardized management procedures,the efficiency and qualified care of the loaner instruments was significantly improved by measuring qualified rate. The difference in the qualified rate between control and observation groups was statistically significant( P < 0. 01). Conclusion The implementation of the standardized management procedures is important for central sterilization supply departments in guarantee of safe supplies of the loaner instruments,reducing operation risks,and ultimately ensuring patient safety.展开更多
In this paper, we conduct research on the higher vocational student status management under the perspective of procedural justice. The main task of higher vocational education is to develop production, construction, m...In this paper, we conduct research on the higher vocational student status management under the perspective of procedural justice. The main task of higher vocational education is to develop production, construction, management and service of fi rst-line high-skilled applied talents. Higher vocational colleges must according to the talent market demand to set up the professional, training target, teaching content, to the talent market for applied talents’ with high skill specific requirements embodied in the culture type, specification, and the teaching content. One’s status as a student, it is to point to upon passing the entrance examination, offi cial admission the admission formalities in basic accordance with the relevant provisions, report to qualified students after registration. Management refers to the school in accordance with relevant state policies, laws and regulations for students from entrance to graduation during the management of the implementation of the training process. Our research proposes the new perspective on the issues that will be necessary.展开更多
Normal aging is a process that involves loss of functional reserve of most organ systems of the human body, most significantly: cardiovascular, pulmonary, renal and nervous systems. Advancements in both surgery and an...Normal aging is a process that involves loss of functional reserve of most organ systems of the human body, most significantly: cardiovascular, pulmonary, renal and nervous systems. Advancements in both surgery and anesthesia have made it possible to operate more safely on the elderly population and those older patients with multiple severe co-morbidities that were not routinely possible in the recent past. Regional anesthesiologist have proven to be instrumental in this regard as regional anesthetic/analgesic techniques may now permit surgeons to operate on the elderly who were not ideal surgical candidates or unable to tolerate general anesthesia. In addition, regional techniques provide alternatives that may optimize acute pain control and reduce the incidence of devastating side effects during the perioperative period such as: myocardial infarction, pulmonary embolism, pneumonia, and also increases the opportunity to allow for early ambulation and shorter hospital stays. These anesthetic options now provide the elderly patient with better medical care alternatives, but also can show a significant financial impact on health care system resources. Further understanding on aging molecular biology, physiology and pathophysiology, together with technical improvements of regional anesthetic techniques will continue to make it safer and more efficacious to operate on the elderly population with evidence of reduced morbidity and mortality. Although there is only anecdotal evidence that regional anesthesia(RA) improves survival, there is little doubt that RA plays an important role in perioperative optimization of pain control and decreases pain management complications as well as a reduction in healthcare costs. Beyond traditional operating rooms, elderly patients may increasingly benefit from RA and acute pain management in Emergency Rooms, medical clinics and even within a patient's home. Therefore, the focus of this review is directed toward geriatric patients and beneficial effects of RA on outcomes in the elderly.展开更多
文摘This paper primarily concerns the effective coordination of the procedures and methods employed in open pit mining operations under the background of river management.The central objective of this study is to identify a viable approach for ensuring rational and efficient development of open pit mineral resources while simultaneously protecting and restoring the ecological environment of the river.This approach should facilitate the realization of a harmonious symbiosis between mining and river management.The intricate mutual influence relationship between river management and open pit mining is first analyzed in depth,which provides a solid foundation for the subsequent coordination strategy development.In light of the aforementioned considerations,a set of coordination procedures for open pit mining based on river management conditions is proposed.These procedures emphasize the integration of river protection into the overall layout of mining at the planning stage.The implementation of scientific mining schemes,accompanied by rigorous control of the scope and depth of mining operations,has proven to be an effective means of reducing the impact of mining activities on river environments.This approach has also facilitated the achievement of a balance and coordination between mining and river management.
文摘BACKGROUND There is limited literature on managing the airway of patients with linear immunoglobulin A(IgA)bullous dermatosis,a rare mucocutaneous disorder that leads to the development of friable bullae.Careful clinical decision making is necessary when there is a risk of bleeding into the airway,and a multidisciplinary team approach may lead to decreased patient morbidity during these high-risk scenarios,especially when confronted with an unusual cause for bleeding.CASE SUMMARY A 45-year-old African American female presented to our ambulatory surgical center for right corneal transplantation due to corneal perforation after blunt trauma in the setting of cicatricial conjunctivitis and diffuse corneal neovascularization from linear IgA bullous dermatosis.The diagnosis of IgA dermatosis was recent,and the patient had been lost to follow-up.The severity of the disease and extent of airway involvement was unknown at the time of the surgery.Significant airway bleeding was noticed upon intubation and the otorhinolaryngology team had to be called to the operating room.The patient required transfer to the intensive care unit where a multidisciplinary team was involved in her case.The patient was extubated on postoperative day 4.CONCLUSION A multidisciplinary approach to treating this disease is the best course of action before a surgical procedure.In our case,key communication between the surgery,anesthesia,and dermatology teams led to the quick and safe treatment of our patient’s disease.Ambulatory surgery should not be considered for these cases unless they are in full remission and there is no mucous membrane involvement.
文摘Objective To introduce the accession procedure and evaluation of PIC/S,and help relevant departments in China to understand the requirements of PIC/S in detail,and to promote the process of China’s entry into PIC/S.Methods The procedures and steps of joining PIC/S,the evaluation process of PIC/S,and the experience of several countries in joining PIC/S were introduced and analyzed,which could help the relevant personnel in China understand the specific contents.Results and Conclusion According to the requirements of PIC/S,it is necessary to establish a unified GMP quality management system.
基金This work was supported by the UK Engineering and Physical Sciences Research Council(EPSRC)(No.GR/R67507/01).
文摘Engineers often need to look for the right pieces of information by sifting through long engineering documents, It is a very tiring and time-consuming job. To address this issue, researchers are increasingly devoting their attention to new ways to help information users, including engineers, to access and retrieve document content. The research reported in this paper explores how to use the key technologies of document decomposition （study of document structure）, document mark-up （with EXtensible Mark- up Language （XML）, HyperText Mark-up Language （HTML）, and Scalable Vector Graphics （SVG））, and a facetted classification mechanism. Document content extraction is implemented via computer programming （with Java）. An Engineering Document Content Management System （EDCMS） developed in this research demonstrates that as information providers we can make document content in a more accessible manner for information users including engineers.The main features of the EDCMS system are： 1） EDCMS is a system that enables users, especially engineers, to access and retrieve information at content rather than document level. In other words, it provides the right pieces of information that answer specific questions so that engineers don＇t need to waste time sifting through the whole document to obtain the required piece of information. 2） Users can use the EDCMS via both the data and metadata of a document to access engineering document content. 3） Users can use the EDCMS to access and retrieve content objects, i.e. text, images and graphics （including engineering drawings） via multiple views and at different granularities based on decomposition schemes. Experiments with the EDCMS have been conducted on semi-structured documents, a textbook of CADCAM, and a set of project posters in the Engineering Design domain. Experimental results show that the system provides information users with a powerful solution to access document content.
文摘With the application of the principle of PDCA, and dr awing on the experience of the process methods of the ISO9000 and the system met hods of management, the author analyses the basic requirement to fulfill quality management system in enterprises. Then the author inquires into the procedure t o establish the efficiency quality management system. Finally four stages (plan, do, check, action) and eight steps (decision, plan, analyze, design, do, check, improve, fulfill) are put forward to fulfill quality management system.
文摘Pain is a common experience for inpatients,and intensive care unit(ICU)patients undergo more pain than other departmental patients,with an incidence of 50%at rest and up to 80%during common care procedures.At present,the management of persistent pain in ICU patients has attracted considerable attention,and there are many related clinical studies and guidelines.However,the management of transient pain caused by certain ICU procedures has not received sufficient attention.We reviewed the different management strategies for procedural pain in the ICU and reached a conclusion.Pain management is a process of continuous quality improvement that requires multidisciplinary team cooperation,painrelated training of all relevant personnel,effective relief of all kinds of pain,and improvement of patients'quality of life.In clinical work,which involves complex and diverse patients,we should pay attention to the following points for procedural pain:(1)Consider not only the patient's persistent pain but also his or her procedural pain;(2)Conduct multimodal pain management;(3)Provide combined sedation on the basis of pain management;and(4)Perform individualized pain management.Until now,the pain management of procedural pain in the ICU has not attracted extensive attention.Therefore,we expect additional studies to solve the existing problems of procedural pain management in the ICU.
文摘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.
文摘Objective: To evaluate the quality of pain management in cardiac ICU patients by using a questionnaire. Methodology: All post cardiac surgery patients between 18 and 75 years old were included in this survey. Chronic pain patients, paediatric patients, emergency surgeries were excluded. A predesigned proforma was prepared according to American Pain Society recommendations and distributed among Cardiac ICU patients after 24 hours of extubation. This proforma was explained to the patients and collected later. The questionnaire was related to pain severity, aggravating and relieving factors, side effects of analgesics, affective experience and satisfaction with pain management. Results: Total 308 patients participated in one year period. 243 (78.9%) were male and 65 (21.1%) were female. Multimodal analgesia was used in most of the patients. Severity of pain was described as mild 70% and moderate 28.6%. Most of the patients complained of sharp pain 100 (37.5%), mainly at the site of incision 129 (41.9%). The main aggravating factor associated with increased pain was deep breathing 118 (39.8%) while pain was minimized by taking pain medications 40.6%. A significant association was found between preoperative counseling about pain options and satisfaction. 96.8% reported satisfaction with pain management. Conclusion: Although overall pain control was reported as adequate and patients were highly satisfied, there were areas which need further improvement. These include strategies to provide preoperative information about postoperative pain management and better training of medical staff to assess and manage pain. Additionally, the concerns and fears of patients about pain treatment need to be addressed.
文摘Information technology have changed information media by networking and internet using technology in health as same as another part improve efficiency and effectiveness. Currently, the medical document is reality-based medicine, so that is the most important, richest and the most realistic source of medical and health information. Health information management systems that require systems to the storage, retrieval, storage and elimination of health records (by law), and adjust to the rules of professional. These processes are difficult and time consuming for human. In the meantime semantic HIM seem best solution.
基金Special Fund of Academic Competence Improvement Project in Nursing of Integrated Traditional Chinese and Western M edicine(TG20180002g)
文摘Objective The purpose of the present study is to provide scientific evidence for the implementation of standardized management of the loaner instruments by examining the process of receiving through issuing steps and analyzing challenges encountered by the CSSD of our hospital. Methods The loaner instruments were collected and categorized into the control group( 2 639 pieces during the period of January 2013 to December 2014) and the observation group( 2 418 pieces during the period of January 2015 to December 2016). The possible causes of the challenges were carefully investigated and analyzed. Results After the implementation of standardized management procedures,the efficiency and qualified care of the loaner instruments was significantly improved by measuring qualified rate. The difference in the qualified rate between control and observation groups was statistically significant( P < 0. 01). Conclusion The implementation of the standardized management procedures is important for central sterilization supply departments in guarantee of safe supplies of the loaner instruments,reducing operation risks,and ultimately ensuring patient safety.
文摘In this paper, we conduct research on the higher vocational student status management under the perspective of procedural justice. The main task of higher vocational education is to develop production, construction, management and service of fi rst-line high-skilled applied talents. Higher vocational colleges must according to the talent market demand to set up the professional, training target, teaching content, to the talent market for applied talents’ with high skill specific requirements embodied in the culture type, specification, and the teaching content. One’s status as a student, it is to point to upon passing the entrance examination, offi cial admission the admission formalities in basic accordance with the relevant provisions, report to qualified students after registration. Management refers to the school in accordance with relevant state policies, laws and regulations for students from entrance to graduation during the management of the implementation of the training process. Our research proposes the new perspective on the issues that will be necessary.
文摘Normal aging is a process that involves loss of functional reserve of most organ systems of the human body, most significantly: cardiovascular, pulmonary, renal and nervous systems. Advancements in both surgery and anesthesia have made it possible to operate more safely on the elderly population and those older patients with multiple severe co-morbidities that were not routinely possible in the recent past. Regional anesthesiologist have proven to be instrumental in this regard as regional anesthetic/analgesic techniques may now permit surgeons to operate on the elderly who were not ideal surgical candidates or unable to tolerate general anesthesia. In addition, regional techniques provide alternatives that may optimize acute pain control and reduce the incidence of devastating side effects during the perioperative period such as: myocardial infarction, pulmonary embolism, pneumonia, and also increases the opportunity to allow for early ambulation and shorter hospital stays. These anesthetic options now provide the elderly patient with better medical care alternatives, but also can show a significant financial impact on health care system resources. Further understanding on aging molecular biology, physiology and pathophysiology, together with technical improvements of regional anesthetic techniques will continue to make it safer and more efficacious to operate on the elderly population with evidence of reduced morbidity and mortality. Although there is only anecdotal evidence that regional anesthesia(RA) improves survival, there is little doubt that RA plays an important role in perioperative optimization of pain control and decreases pain management complications as well as a reduction in healthcare costs. Beyond traditional operating rooms, elderly patients may increasingly benefit from RA and acute pain management in Emergency Rooms, medical clinics and even within a patient's home. Therefore, the focus of this review is directed toward geriatric patients and beneficial effects of RA on outcomes in the elderly.
