Letters and Visits System Optimization and Implementation

The letters and visits system plays a vital role in government work, serving as a crucial tool for supervising law enforcement and administrative conduct, ensuring public officials’ integrity, and promoting governance by law. As Chinese citizens’ political awareness grows, the volume of letters and visits has increased steadily. This paper reviews the current state of letters and visits information construction, identifies challenges and problems in system integration, presents integration ideas for existing systems, and proposes an innovative approach to letters and visits system integration. This research aims to provide valuable insights and guidance for other units undertaking similar system integration efforts.

A NEW DAY FOR CHINA-VIETNAM RELATIONS Chinese President Xi Jinping’s fruitful visit to Vietnam

Chinese President Xi Jinping made a state visit to Vietnam from December 12 to 13,2023.During the two-day visit,China and Vietnam issued a joint statement on continuing to deepen and elevate their comprehensive strategic cooperative partnership and building a community with a shared future that carries strategic significance.The two sides also signed more than 30 agreements on bilateral cooperation.These developments injected strong momentum into China-Vietnam relations and elevated bilateral ties to a new height.

Residents Achieve a High Patient Satisfaction in Pre-Anesthetic Patient Assessment. An Observational Study

A physician’s empathetic attitude is regarded as an important influencing factor towards patient satisfaction. However, physicians’ self-assessed empathy declines during medical school and through residency, which may limit patient satisfaction in the doctor-patient contact. In conse-quence, we hypothesized that residents might fail in generating high levels of patient satisfaction. We conducted an observational study in the setting of a pre-anesthetic assessment center, Univer-sity Hospital Leipzig, Germany. Patient satisfaction was measured using the overall ZUF-8 score (8 - 32 points;increasing with patient satisfaction). Data were collected by questionnaires (ZUF-8 items, additional satisfaction items, and items of organizational and logistical processes). Key items for patient satisfaction as primary endpoints were defined. Statistical evaluation was performed in dependency of the anesthesiologists’ level of training (residents vs. consultants) by using the Mann-Whitney-U test or the chi square test, as required. Statistical significance was accepted for p < 0.05. In total, 2565 patients were assessed for eligibility. 986 patients met the criteria of inclusion. 978 questionnaires were submitted with 517 questionnaires being excluded because of missing values. Finally, 461 questionnaires could be analysed. Both residents and consultants achieved a high level of patient satisfaction. The ZUF-8-scores were comparable between the groups (p = 0.91), whilst the quality of consultation was rated slightly better by patients being assessed by residents (p = 0.047). The results in additional satisfaction items were comparable between the groups. We found a trend in residents assessing to be rated more friendly. Residents are able to generate a high level of patient satisfaction which is comparable to that of consultants with scores ranging between “good” and “very good”. Small albeit significant differences in favor of residents underline the quality of their performance in pre-anesthetic patient assessment.

The Definition of Non-Urgent Visits to the Emergency Department and Validation of Criteria for Referrals

Background: The centers of disease control and prevention define a non-urgent Emergency Department (NU-ED) visit as a medical condition requiring treatment within more than 24 hours. These visits constitute one of the main reasons for emergency department (ED) overcrowding, which greatly affects healthcare workers’ wellbeing, health costs, patients’ satisfaction and treatment outcomes. Currently, there is no solid definition of non-urgent emergency visits, which is the first step towards dealing and potentially solving this issue. Having that, the aim of the current study is to define and validate the criteria for NU-ED visits in Israel. Methods: This qualitative study included twelve senior physicians and nurses working in Emergency Department and/or Health Maintenance Organizations (HMOs) across Israel. The study was performed using in-depth, semi-structured, open-ended interviews. Qualitative data analysis was performed by conventional content analysis. Results: The urgency of medical visits was defined based on these two questions: 1) Does the medical condition require an immediate treatment? 2) Is the emergency department the only place that can provide the required treatment at a certain timepoint? We found that non-urgent visits mostly occur during the nights and weekends, when medical treatments are not available in the HMOs. Visitors for non-urgent cases mostly complained about minor injuries or chronic conditions, fever, abdominal or chest pain. Most visits occurred based on referral from the family physician or the nurse from the call center. Participants reported a lack of awareness and knowledge about the roles of the EDs and the available options in the HMOs, which seem unable to provide patients with appropriate treatments. The usage of triage scales seems to ensure that patients are being treated based on the clinical urgency of their condition. Medical cases that score above 3 can be defined as non-urgent visits. Therefore, implementation of these scales in the community and their use in decision making of referrals to emergency department might greatly reduce non-urgent visits. Conclusions: Participants defined urgent ED visits as medical situations that need to be treated immediately, while there are no available treatment options in the HMOs. Participants identified many reasons behind NU referrals to the ED, mainly, low awareness about the role of ED, low availability of certain tests in the HMOs, and inability to provide adequate treatment in the community.

Open visitation in the NICU:nurses’perspectives on barriers and facilitators

Objective:This study aimed to investigate the nurses’perspectives on open family visitation and its barriers and facilitators in neonatal intensive care units(NICUs).Methods:This is a descriptive,cross-sectional study.A total of 113 nurses employed in 3 main NICUs of Tabriz participated in the study through the census sampling method.Nurses’perspectives on open visitation and its facilitators and barriers were assessed and analyzed using the Beliefs and Attitudes toward Visitation in NICU Questionnaire(BAVNIQ)and descriptive and analytical statistics,respectively.Results:Approximately 74%of the nurses who participating in the study had a moderate perspective on open visitation.From the nurses’viewpoint,“Parents’low awareness of sensitivity and hygienic principles of the NICU”was the first(90.3%)barrier,and the 2 factors,namely,“physical structure of the ward/lack of sufficient space”and“far distance between family’s residence and the hospital/having another child,”were the second(86.8%)barrier with an equal percentage.Among the facilitating factors,“Supporting employed parents during the neonate’s hospitalization”and“providing facilities for family accommodation in the hospital”were the first(82.3%)and the second(79.6%)facilitators,respectively,for open visitation.Conclusions:The majority of NICU nurses had a moderate perspective on the family open visitation.This reluctance seems to be originated mainly from the factors inhibiting open visitation,making its implementation challenging for nurses.The perspective of the frontline staff in caring for vulnerable infants on facilitators and barriers to open visitation may help policymakers,managers,and relevant officials in decision-making and implementing new visiting policies in the NICUs.

CIIS President Talks with Think Tank Experts during Europe Visit

From February 21 to 25,CIIS President Xu Bu visited the United Kingdom,Belgium,and Switzerland and had extensive and in-depth communication with experts and scholars from more than ten think tanks in the three countries.

Revisiting The Maritime Silk Road In Penglai

Penglai,Yantai City,is located at the northern tip of the Shandong Peninsula,330 kilometers north of Langya Port in Qingdao.In 133 BC,Emperor Wudi(156-87 BC)of the Han Dynasty visited the region during an inspection tour of the eastern part of his empire.He gazed out into the sea in the direction of the mythical Mount Penglai,home of immortals.

ANOTHER FRUITFUL VISIT

Cambodian Prime Minister Hun Sen’s visit to China in early February showcased the special“ironclad”friendship between China and Cambodia Cambodian Prime Minister Hun Sen made an official visit to China from February 9 to 11.The visit was significant in that it took place at the beginning of the year marking the 65th anniversary of the establishment of China-Cambodia diplomatic relations and the“Year of China-Cambodia Friendship.”

机构投资者调研与公司审计意见购买行为:刺激效应还是抑制效应?

公司管理层实施审计意见购买行为及其监管治理是审计学界与监管部门长期关注的重要问题。机构投资者调研作为投资者发掘公司内部信息并缓解信息不对称的一种非正式制度安排,会抑制还是刺激公司实施审计意见购买行为?本文基于我国上市公司的机构投资者调研数据,通过实证研究发现:机构投资者调研会刺激公司实施审计意见购买行为,参与调研机构数量越多、调研频数越高,被调研公司的审计意见购买动机越强,审计意见激进度也越高。进一步分析发现,在机构投资者调研的刺激效应下,公司主要通过选聘“中小”事务所实施审计意见购买,其目的是掩盖公司盈余管理及经营风险的“不利信号”。在缓解内生问题、排除替代性解释、考虑审计轮换制度影响等一系列稳健测试之后,上述结论依然成立。因此,建议会计师事务所应重视由机构投资者调研衍生的客户公司审计风险,市场监管部门应加强公司审计师选聘行为监管,提高机构投资者调研的外部治理效应。

北京协和医院麻醉科进修医师科研规范化培训模式探索

目的 评估北京协和医院麻醉科进修医师科研培训效果,探索麻醉科进修医师科研培训模式。方法 选取2019年1月至2022年12月在北京协和医院麻醉科进行规范化培训的151名进修医师为研究对象,首先通过问卷调查了解其科研背景和科研需求,根据问卷调查的结果,制订全面的培训模式,包括科研经验分享、科研课题参与、学习资源共享、科研脱产训练和专人指导等。共培训6个月,进修结束前通过问卷收集进修医师的反馈。结果 共发放151份调查问卷,回收139份有效问卷。临床科研、教学研究和转化医学是进修医师最感兴趣的科研方向。科研基础知识匮乏、缺乏单独的科研时间和缺乏开展科研工作的经验是进修医师在科研工作中遇到的最大困难。而技术支持、专人指导及给予科研时间是进修医生最期待得到的帮助。通过6个月的培训,88.5%的进修医师认为进修课程对其科研水平有提高作用。同时进修医师也希望今后多开展临床科研设计、基础科研和科研论文撰写方面的培训。结论 科研培训已成为麻醉科进修医师培训的一部分。针对每位进修医师的特点,因材施教,从而实现其进修学习需求,提高继续教育的培养质量。

域外罪犯会见的发展趋向及本土化思考

近年来,域外诸多国家和地区以及国际社会充分认识到罪犯会见在罪犯矫正及预防再犯等方面的重要功能,积极开展罪犯会见领域的基础理论和实证研究,实务部门也积极探索开发会见相关项目与实践,立法部门不断健全完善罪犯会见法律体系,取得了显著成效。域外已有的研究、实践探索及立法完善对健全我国本土化会见体系具有重要意义。我国应重视并加强对会见性质厘清、会见功能界定及会见原则诠释等的基础理论研究,在开展重新犯罪调查过程中持续深入开展加强罪犯会见以预防再犯及代际犯罪的实证调查,推动在基层监狱积极开发着力提升罪犯会见效能的会见项目,同时通过修改完善《监狱法》《罪犯会见通信规定》等不断健全罪犯会见的规范性体系。

移动信息化访视平台在乳腺癌改良根治术患者中的应用效果

目的探讨移动信息化访视平台在乳腺癌改良根治术患者中的应用效果。方法选取2023年2月至9月于东南大学附属中大医院手术室初次接受择期乳腺癌改良根治术的180例患者,采用随机数字表法将其分为两组,每组90例,对照组脱落6例,最终纳入对照组84例和观察组90例。对照组采用常规口头宣教和发放宣传册的方式进行访视,观察组采用移动信息化访视平台进行访视。比较两组术前访视时间、患者满意度、术前准备完善情况、访视前及麻醉等待期焦虑自评量表(SAS)和抑郁自评量表(SDS)评分。结果观察组术前访视时间短于对照组,患者满意度高于对照组,术前准备完善率高于对照组(P<0.05)。访视前,两组SAS和SDS评分比较,差异无统计学意义(P>0.05);麻醉等待期,两组SAS和SDS评分均低于访视前,且观察组低于对照组(P<0.05)。结论移动信息化访视平台可显著缩短乳腺癌改良根治术患者术前访视时间,提高访视效率和术前准备完善率,缓解患者术前抑郁、焦虑程度,提高患者满意度,使围手术期访视工作更规范、便捷和高效,为手术和患者安全提供保障。

分时段预约胸外科门诊迟到患者特征的回顾性分析

目的分析在分时段预约中四川大学华西医院胸外科门诊患者迟到的特征。方法从四川大学华西医院HIS中提取2019年胸外科患者人口信息及预约就诊信息,共获得有效数据9378例。以正常患者为对照组,采用SPSS 24.0软件对迟到患者进行分析。结果年龄、性别、来源地、就诊类型、就诊时间、预约方式、专家级别、就诊时段是患者迟到的影响因素,差异均有统计学意义(P<0.05)。患者在周一迟到率最高,达到34.6%。每天上午时段的>08:30—09:00迟到率最高,达到78.1%;下午时段的>13:00—13:30迟到率最高,达到65.7%。结论在预约就诊时段内迟到的患者具有一定的特征,需根据相关特征提出解决方案,以提高患者在预约时间段内就诊的依从性。

医疗机构伦理委员会实地访查实践与思考

实地访查是伦理委员会对临床研究实施情况的监督检查方式之一。作者从实地访查的具体实施要点和流程、有因访查和无因访查等访查类型、实地访查开展过程中各方人员的具体职责和访查内容、访查发现问题的讨论及反馈等方面,分享了伦理委员会通过实地访查及时发现研究过程中存在的问题,形成切实可行改进措施,达到保护研究参与者的目的。伦理委员会通过开展实地访查,可以协助临床专业科室及研究团队在临床研究项目准备或实施过程中遵守伦理原则,对医疗机构开展的临床研究进行实时质量控制,及时反馈项目存在的问题并落实整改。伦理委员会通过实地访查,了解临床研究开展的真实情况和实施过程中遇到的具体问题,及时解决,切实保护研究参与者的安全和权益。

论新时代信访工作法治化模式

党的十八大以来,信访工作法治化改革持续推进,其制度成果集中体现于《信访工作条例》。新时代的信访工作法治化,要求每个环节严格依法,做到预防法治化、受理法治化、办理法治化、监督追责法治化、维护秩序法治化。它建立于“在法治轨道上全面建设社会主义现代化国家”“全面推进国家各方面工作法治化”的理论基础之上,显现出鲜明的时代特征,形成了制度化规范化的“信访渠道汇集问题、依法分流处理、兜底解决剩余问题”的信访工作法治化模式。这种模式具有高度的实践回应性,信访渠道聚集问题有其社会心理基础,分流处理问题契合体制运行规律,剩余问题兜底解决有赖综合施策。这种模式不仅回应合法诉求,而且能有效回应政策性、情感性等各种诉求,体现了信访工作的群众工作属性,在法治化的同时保持了社会主义底色。

情景模拟教学法在麻醉学专业本科生麻醉前访视带教中的应用

目的研究情景模拟教学法在麻醉学专业本科生麻醉前访视带教中的应用效果。方法选取2016、2017和2018级温州医科大学麻醉学专业本科生128名,随机分成两组:常规教学组66名,情景模拟教学组62名。学生课程结束后由两位带教老师对学生就麻醉前访视内容(体格检查、问诊内容、问诊技巧)进行评分。同时发放调查问卷调查学生对教学方式的满意度。结果情境模拟教学组学生在体格检查、问诊内容、问诊技巧三方面得分明显高于常规教学组,差异均有统计学意义(t分别=5.41、13.55、5.57,P均<0.05)。情境模拟教学组学生对教学方法的满意度明显高于常规教学组,差异有统计学意义(t=6.80,P<0.05)。结论情景模拟教学法能够显著提高学生的学习成绩,使学生能更高效率地掌握麻醉前访视的内容,提高学生的临床技能。

互联网+“手术e候厅”对腹腔镜全子宫切除术患者术前访视知晓度及焦虑水平的影响

目的:探讨互联网+“手术e候厅”对全子宫切除术患者术前访视知晓度及焦虑水平的影响。方法:选取2022年1月-2023年10月本院行腹腔镜全子宫切除术患者102例,随机数字表法分为对照组和观察组各51例,分别予以常规围术期护理模式干预或互联网+“手术e候厅”护理模式干预。比较两组术前访视知晓度、不同时间点焦虑程度(包括家属)、心理及血压变化情况、护理满意度。结果:观察组术前访视知晓度及护理满意度(92.2%)均优于对照组(76.5%),手术室等候时的心率(76.48±9.23)、血压(114.39±6.54 mmHg/76.07±7.13 mmHg)均低于对照组(83.51±8.19、123.58±8.42 mmHg/84.54±6.49 mmHg),手术室等候时、术后1 d 7项广泛性焦虑障碍量表(GAD-7)评分(7.19±2.58分、3.15±1.02分)均低于对照组(9.35±3.26分、4.21±1.07分),其家属手术等候时GAD-7评分(6.28±2.26分)也低于对照组(8.39±2.11分)(均P<0.05)。结论:应用互联网+“手术e候厅”干预可提高全子宫切除术患者术前访视知晓度,缓解焦虑情绪,利于保持心率、血压平稳,护理满意度提高。

基于虚拟仿真的术前访视系统在提高帕金森手术病人心理护理效果中的应用研究

目的:构建基于虚拟仿真(virtual reality,VR)技术的帕金森手术病人术前访视系统,并对其访视效果进行评价。方法:选取2021年7月—2022年3月医院收治的42例帕金森手术病人为对照组,2022年4月—12月收治的48例帕金森手术病人为试验组。对照组采用视频模式的术前访视;试验组则基于VR技术制作术前访视系统软件,并采用VR智能设备(3D眼镜)对病人进行术前访视,比较两组的焦虑状态[状态焦虑量表(STAI-S)]、心理护理效果。结果:试验组和对照组病人访视后的STAI-S评分均较访视前降低,且试验组STAI-S评分低于对照组(P<0.05);两组围术期心理护理效果比较差异无统计学意义(P>0.05)。结论:VR术前访视系统的应用可为帕金森手术病人提供专业化、标准化、同质化的护理服务,通过佩戴VR智能设备,使病人获得沉浸式、互动式亲身体验,具有视频访视模式无法比拟的优势,可更有效缓解病人的焦虑状态、提高心理护理效果。

MDT教学在进修医师脊柱肿瘤培训中的应用研究

目的:探讨多学科协作(multi-disciplinary team, MDT)教学在脊柱肿瘤教学中的效果。方法:选择2020年9月至2022年9月在北京大学第三医院骨科进修的脊柱外科专业的32名进修医师为研究对象,采用试验对照方法,在脊柱原发性肿瘤教学时采取MDT教学,在脊柱转移瘤教学时采取传统查房方法教学。通过客观的考核、课堂体验调查,对比两种不同教学方法的教学效果。结果:考核结果表明,在判断肿瘤良恶性、制定手术方案以及术后是否需要放化疗或靶向治疗这3个问题上,两种教学方法下医师得分分别为(9.0±1.1)分、(9.2±0.7)分、(9.1±0.8)分以及(7.4±1.4)分、(7.2±1.1)分、(6.8±0.9)分,其差异具有统计学意义(P<0.05)。调查结果表明,65.6%的医师认为MDT教学使其对脊柱肿瘤更感兴趣,71.9%的医师认为MDT教学提高了其自主学习能力,75.0%的医师认为MDT教学提高了其学习效率,87.5%的医师认为MDT教学增长了其脊柱肿瘤的相关知识。结论:采用MDT教学可以激发进修医师的学习兴趣,提高自主学习能力及学习效率,更好地掌握脊柱肿瘤相关知识。

结合图卷积神经网络和集成方法的推荐系统恶意攻击检测

推荐系统已被广泛应用于电子商务、社交媒体、信息分享等大多数互联网平台中,有效解决了信息过载问题。然而,这些平台面向所有互联网用户开放,导致不法用户利用系统设计缺陷通过恶意干扰、蓄意攻击等行为非法操纵评分数据,进而影响推荐结果,严重危害推荐服务的安全性。现有的检测方法大多都是基于从评级数据中提取的人工构建特征进行的托攻击检测,难以适应更复杂的共同访问注入攻击,并且人工构建特征费时且区分能力不足,同时攻击行为规模远远小于正常行为,给传统检测方法带来了不平衡数据问题。因此,文中提出堆叠多层图卷积神经网络端到端学习用户和项目之间的多阶交互行为信息得到用户嵌入和项目嵌入,将其作为攻击检测特征,以卷积神经网络作为基分类器实现深度行为特征提取,结合集成方法检测攻击。在真实数据集上的实验结果表明,与流行的推荐系统恶意攻击检测方法相比,所提方法对共同访问注入攻击行为有较好的检测效果并在一定程度上克服了不平衡数据的难题。