Strengthening implementation success using large-scale consensus decision-making - A new approach to creating medical practice guidelines

A study involving over 2000 stoma care nurses in the development of best practice guidelines for the assessment of peristomal body profiles, patient engagement and patient follow-up was conducted in 2018. The study was designed to develop guidelines for stoma care treatment and product selection and to decrease the evidence to implementation gap. The project built on research evidence from a literature review of 77 articles. The results of the literature review were then used to inform a series of Delphi surveys sent out to stoma care nurses through Association and industry list-serves in 11 languages. The Delphi surveys were followed by a face2face professionally facilitated discussions among nurse-research experts. The project concluded with a facilitated consensus dialogue among 960 stoma care nurses from 25 countries, resulting in an implementation plan to ensure the guidelines become a normal part of routine patient care. The study resulted in a set of medical practice guidelines for stoma care nurses, designed to improve patient outcomes and patient quality of life, that were accepted and adopted into routine medical practice across 25 countries. This article describes the study and how the process used, coined the ‘Modified Delphi Process’ by the process designer, led to faster implementation than is generally experienced in the medical community.     

影响轮毂轴承失效的几大因素的研究

轮毂轴承失效模式主要有轴承烧蚀、滚子磨损、保持架变形等形式，如不即时发现会导致转向节断裂，引起车祸，后果不堪设想。影响轮毂轴承失效的主要因素有：轴承游隙值设定游隙及如何调整，以下以客车、卡车底盘轮毂轴承的预紧方法合理游隙值。     

新疆口岸实施“大通关”制度的现状、问题及对策

以阿拉山口岸为代表的新疆口岸自2002年实施＂大通关＂制度以来,采取了一系列改革措施,大大缩短了报检和通关时间,大幅度节约了企业支出,提高了监管水平,改善了投资环境,通关建设走在了全国前列。但也存在着一些不现实的困难和问题。应继续加强对＂大通关＂工作的领导,抓紧电子口岸建设,积极推进和完善＂大通关＂机制,从而更有力地提高口岸工作效率。     

Get It Now: Five Years Later

Abstract

Five years ago, Tennessee Technological University Library implemented the use of Get It Now from the Copyright Clearance Center to provide their users with instant access to journal articles. Funding for this initiative came from the cancellation of expensive ejournal packages. Examining implementation, usage, costs, and pros and cons is helpful for other libraries considering this method of document delivery.     

西部大开发以来我国西部地区经济格局变动研究

用人均GDP的标准差、变异系数、基尼系数、σ系数及经济增长率的标准差分别测算了1999年至2007年西部地区12省内部经济发展的总体差异,发现西部大开发政策实施以来,西部地区内部差距逐渐拉大,这不但表现在西部12省(市、区)的总体差异,而且表现在地理位置相近的西南地区各省份之间、西北地区各省份之间,以及收入水平相当的高收入省份之间、低收入省份之间.借用马尔可夫链方法考察单个省份的经济发展行为变化,发现西部地区已经形成了两个分别向高水平和低水平演进的趋同集团.且稳定性很高.     

信用衍生品的法律规制:国际改革趋向及启示

信用衍生品对于提高金融机构的风险管理水平和整个金融体系的安全和效率都具有重要作用。但是,由于缺乏有效的法律规制,信用衍生品逐渐由风险管理工具转变为投机工具。危机后,全球范围内的场外金融衍生品规制框架重构渐次展开。对于信用衍生品法律规制的主要内容,可以归纳为集中清算、信用风险管理和信息透明化三个方面。这些国际改革实践,对我国信用衍生品市场及其法制的构建和发展具有重要的借鉴意义。