长三角邮政速递一体化发展的策略探讨

随着我国长江三角洲地区经济一体化的进一步发展,长三角邮政速递业务一体化发展的重要性日益凸显,但在邮政速递整体协调能力、邮政速递品牌文化建设水平、网络信息共享程度和优质速递服务能力四个方面存在一定的发展障碍.针对此,长三角邮政速递一体化发展的具体策略为:落实速递部门的主体地位,建设适应长三角的EMS品牌文化,加强速递信息共享能力建设以及提高邮政速递的服务水平.     

影响我国邮政特快专递业竞争力的因素分析

从市场环境的角度出发,我国的邮政特快专递从现在的垄断竞争阶段发展到完全竞争阶段是大势所趋。我国的速递公司和竞争对手各有优劣势,通过对哈尔滨地区用邮结构的调查分析,可以看到,EWS有其存在的必要性。影响其交换量的因素可概括为:商业因素、经济因素、技术因素、社会、地理因素、法律因素等。     

新标准通道经皮肾镜治疗上尿路结石的临床疗效分析

目的探讨B超引导下新标准通道经皮肾镜治疗上尿路结石的临床疗效。方法采用新标准通道与微通道经皮肾镜碎石术(PCNL)治疗肾、输尿管上段结石79例。新标准通道组43例,微通道组36例。全部使用瑞士EMS—Vario.四代气压弹道联合超声吸附碎石清石系统碎石取石,比较2种通道的疗效。结果 79例穿刺均一次成功。两小组手术时间分别为(85.2±21.5)min和(104.7±18.5)min;一次结石清除率分别为81.4%(35/43)、58.3%(21/36)。两组术后发热分别为4例和10例,经加强抗感染、补液等治疗后5d内体温恢复正常。平均出血量分别为(80±10)mL和(76±9)mL;结论在拥有熟练的微通道PCNL技术基础上开展新标准通道PCNL,后者疗效更满意;而微通道只能作为新标准通道的补充。     

Pilot testing the detection of elder abuse through emergency care technicians (DETECT) screening tool: results from the DETECT pilot project

Objective: To pilot test the feasibility of implementing an elder abuse (EA) screening tool (DETECT) designed for medics.

Methods: Testing occurred between September 17th, 2015 and October 26th, 2015. MedStar Mobile Healthcare medics completed the DETECT tool when responding to calls for community-dwelling patients 65 years of age or older.

Results: The DETECT tool was used 1,248 times by 97% of medics responding to an eligible 911 call. Medics responded affirmatively to at least one screening item on 209 of the completed screenings (16.8%). Immediately following the introduction of the DETECT tool, there was an increase of 5.4 (226% above baseline) reports per month (p = 0.0056).

Conclusions: The DETECT tool was easily incorporated into medic’s field-based practice and resulted in an increase in medic generated reports of EA to APS. Future research designed to evaluate the tool’s validity and reliability are warranted.     

Analysis and optimization of an ambulance offload delay and allocation problem

Ambulance offload delays have recently become one of the most significant operational challenges for Emergency Medical Services (EMS) providers. Offload delays occur when an ambulance arriving at a hospital Emergency Department (ED) is blocked until a bed becomes available for the patient. To formally investigate the effect of patient routing decisions on EMS offload delays, we introduce a stylized queueing network model with blocking. Following a decomposition approach, we develop an approximation scheme to find explicit solutions that can be used to find proper patient allocation policies to multiple hospitals in a region. We introduce a Markov chain representation for a single ED network and solve for its exact steady state distribution. A comprehensive numerical study is carried out to validate the approximation approaches and to gain insight into ambulance offload delays. By keeping the total offload delays at minimal levels, we observe that it is better to load larger EDs more heavily than smaller ones due to resource pooling.     

Motivation for ISO 14000 certification: development of a predictive model

Environmental issues have become critical concerns of businesses in recent years. The Singapore Environment Ministry is urging organizations to consider adopting the ISO 14000 Environmental Management Standards. The main purpose of this study was to investigate and identify a number of variables which would be able to predict the motivation of organizations in adopting the ISO 14000 Standards. Through extensive literature search eight possible predictive variables/factors (cost savings, top management concern, employee welfare, meeting environmental regulations, meeting customer expectations, concern over trade barriers, following head office environmental practices, and gaining competitive advantages) were identified. In total, 300 pre-tested survey questionnaires were mailed out to companies from the Electronic and Chemical industries in Singapore. A response rate of about 20% was obtained. The survey instrument was tested for reliability and validity. Using stepwise discriminant analysis, a predictive discriminant function was developed. Only four out of the originally identified eight variables were included in the model. Possible benefits of such a model for Singapore and other industrializing countries are highlighted.     

A three-state disease model with interval-censored data: Estimation and applications to AIDS and cancer

In presence of interval-censored data, we propose a general three-state disease model with covariates. Such data can arise, for example, in epidemiologic studies of infectious disease where both the times of infection and disease onset are not directly observed, or in cancer studies where the time of disease metastasis is known up to a specified interval. The proposed model allows the distributions of the transition times between states to depend on covariates and the time in the previous state. An estimation procedure for the underlying distributions and the model coefficients is suggested with the EM algorithm. The EMS algorithm (Smoothed EM algorithm) is also considered to obtain smooth estimates of the distributions. The proposed method is illustrated with data from an AIDS study and a study of patients with malignant melanoma.     

EMS对枇杷花药胚状体细胞有丝分裂的影响

采用不同浓度的EMS对枇杷花药胚状体进行离体诱变,并以未诱变的材料作对照,对其引起的细胞学效应进行了研究.结果表明:在EMS诱变过的材料中均观察到一定数量的染色体畸变;球胚细胞中随着EMS浓度的升高有丝分裂指数降低,而染色体畸变率升高.胚性细胞与球胚细胞中有相同的变化趋势,但各自的分裂指数和染色体畸变率并不相同.     

Implementation of a high-performance cardiopulmonary resuscitation protocol at a collegiate emergency medical services program

ABSTRACT

Out-of-hospital cardiac arrest (OHCA) is a significant public health issue. Although OHCA occurs relatively infrequently in the collegiate environment, educational institutions with on-campus emergency medical services (EMS) agencies are uniquely positioned to provide high-quality resuscitation care in an expedient fashion. Georgetown University's on-campus EMS program recently updated its medical protocols to reflect the latest literature in resuscitation science. In a high-performance CPR (HPCPR) resuscitation, minimally interrupted chest compressions are emphasized, along with a coordinated team-based approach.     

在环境管理体系中如何搭建有效实施平台

从环境管理体系的概念、工作内容和核心思想入手，结合世界环境审计发展的社会推动力，简要阐述相关方的参与和全面监督机制的建立是各类组织环境管理体系建立和有效实施的重要保证。