基于绩效的公立医疗机构政府补偿机制的探索

目的 剖析闵行区公立医疗机构政府补偿机制的要素与特点,为深化公立医疗机构改革提供决策参考。方法 收集和梳理政策文件,分析改革前后,政府补偿范围、补偿方式和补偿水平的变化,总结补偿机制特点。结果 改革后医疗服务和公共卫生服务经费按绩效考核结果进行补偿,基本建设和设备购置经费、政府指令性任务、学科发展、人员培养和科研教育经费的补偿标准和办法得到了明确。结论 闵行区公立医疗机构政府补偿机制以公益性为目标,以绩效考核为依据,运用了信息化工具,考虑了机构类型的差异,有利于引导医疗机构持续改进绩效,实现公益性目标。     

Quantifying post-fire regrowth of remotely sensed mediterranean vegetation with percolation-based methods

ABSTRACT

Mediterranean landscapes are characterized by high stability to fire since regeneration of pre-existing spatial relationships among distinctive vegetation patches is quite rapid. The aim of this paper is to introduce a method based on percolation theory to quantitatively estimate structural variations in remotely sensed biomass data linked to post-fire dynamics of Mediterranean vegetation. The ability of the proposed method to estimate fire-induced variations in Mediterranean vegetation patterns made it appropriate to the monitoring of post five vegetation regrowth in Mediterranean landscapes at the Landsat TM scale.     

医疗机构合理用药评价模型的构建研究

目的 针对医疗机构的合理用药水平进行评价研究。方法 根据医疗机构合理用药的具体要求,构建医疗机构合理用药评价指标体系,采用基于模糊群决策的方法和多指标评价分析法构建医疗机构合理用药评价模型。结果 构建了基于模糊群决策的医疗机构合理用药评价模型,并通过实例分析证明了评价模型的可行性。结论 建立的基于模糊群决策的医疗机构合理用药评价模型能够对医疗机构的合理用药水平进行科学评价,为提高医疗机构合理用药水平奠定基础。     

Adding ecology into phylogeography: ecological niche models and phylogeography in tandem reveals the demographic history of the subalpine warbler complex

Capsule: This study documents evidence of interglacial refugia during the Last Interglacial for birds in the Mediterranean region, and emphasizes the importance of the Last Interglacial on the geographic distribution and genetic structure of Mediterranean species.

Aims: We focused on the historical biogeography of the subalpine warbler complex: Subalpine Warbler Sylvia cantillans and Moltoni’s Warbler Sylvia subalpina; we tested if this Mediterranean bird complex shared a similar demographic fate as the present-day widespread species in the temperate zones of Europe, through the late Quaternary glacial-interglacial cycles.

Methods: An ecological niche model was developed to predict the geographic distribution of the subalpine warblers under the past (the Last Interglacial and the Last Glacial Maximum) and the present bioclimatic conditions. Additionally, Bayesian Skyline Plot analysis was used to assess effective population size changes over the history of the subalpine warbler complex.

Results: During the Last Glacial Maximum, the subalpine warblers almost reached their current distribution in the Mediterranean region; yet, unlike the widespread temperate bird species, they survived the Last Interglacial in allopatric refugia in the Mediterranean region.

Conclusion: A unique biogeographic pattern was revealed, indicating the importance of the Last Interglacial on current distributional patterns and demographic histories of common bird species in the Mediterranean region. This study suggests that Mediterranean biogeography is far more complex than previously assumed, and so deserves further study and more attention.     

Diet and diving behaviour of European Storm Petrels Hydrobates pelagicus in the Mediterranean (ssp. melitensis)

Capsule Unlike Atlantic populations, which feed on krill, Mediterranean populations feed mainly on pelagic fish Gymnammodites cicerellus.

Aims To determine the diet and dive depth of the Mediterranean subspecies of European Storm Petrels Hydrobates pelagicus melitensis.

Methods Analysis of regurgitates of adults arriving at the colony for chick feeding and by determination of dives depth using the capillary tube method.

Results The main prey is Gymnammodites cicerellus, a pelagic fish. Storm Petrels dive for their prey and can reach up to 5 m in depth. They also make short foraging trips just outside the colony where they capture Opossum Shrimps Misydacea.

Conclusions European Storm Petrels in the Mediterranean exploit pelagic fish which are taken by diving. This contrasts with the Atlantic populations which feed mainly on krill. Mediterranean birds also feed on Opossum Shrimps Mysidacea during short foraging trips made at night just outside the colony. Differences in diet between long and short foraging trips may be because adults have to forage for both themselves and their chicks.     

A palm fossil closely related to Chamaerops humilis L. from the Lower Miocene of Sardinia

Abstract

This paper deals with the anatomical and histological study of a silicified specimen of a palm consisting of a part of the trunk surrounded by roots. The sample comes from the Lower Miocene of North West Sardinia. The comparison with fossil species and exsting species leads to the conclusion that the specimen belongs to a new fossil species closely related to Chamaerops humilis L., widespread throughout the Mediterranean area. Paleo-environmental considerations confirm the presence in Sardinia, in the epoch in question, of formations of Mediterranean forest corresponding in part to forest existing in North Africa today.     

Contributo Allo Studio Fitosociologico Dei Popolamenti Algali Del Mediterraneo Orientale

Abstract

Marine phytocoenoses in the Eastern Mediterranean Setz. — In this paper a survey is given on the benthic communities observed in the Eastern Basin of the Mediterranean Sea. The investigation was carried out in 13 localities with aid of diving technique, down to 70 mt. depth. Samples at greater depths were collected with the use of a bottom-dredge. The data obtained from 56 phytoso-ciological «relevés» are shown in the 6 tables in the text. The ecological analysis has pointed out the subtropical character of the biocoenoses encoutered, due to the environmental factors. The surface Corallinaceae communities and the depth one, markedly in its precorraligenous facies, have exhibited the most conspicuous and subtropical characters. A comparative survey is carried out with the analogous formation which are found in the Western Mediterranean Basin. An attempt is made to interpret the ecological requirements of some algal species, whose distribution in the Mediterranean Sea is of particular interest. The conclusions are given as temporary assumption in view of a more detailed synthetic work to be carried out in the next years on the problems concerning the algal communities in the Mediterranean Sea.     

Floristic distinctiveness and endemic richness of woody plants highlight the biodiversity value of the herriza among all Mediterranean heathlands

Background: Heathlands are relatively abundant in the landscape of the western Mediterranean region, especially in the Strait of Gibraltar region, where it is locally known as herriza. They are associated with a mild Mediterranean climate regime and with acid, nutrient-poor soils. They harbour a high plant diversity, often viewed as a consequence of the transition between European Atlantic heathland and Mediterranean sclerophyllous shrubland floras.

Aims: To determine whether species-rich Mediterranean heathlands, including the herriza, constitute distinct heathland formations rather than transitional vegetation units between Atlantic heathlands and Mediterranean garrigue shrublands.

Methods: We quantified species richness, endemism and analysed the β-diversity of the woody component of Mediterranean heathland communities throughout its geographic range, with special emphasis on the Strait of Gibraltar region.

Results: Mediterranean heathlands, including the herriza, are not transitional communities between Atlantic heathlands and Mediterranean shrublands. Woody species richness and, particularly, endemic richness was the highest in the herriza.

Conclusions: The high biodiversity values of the herriza are a likely consequence of the ecological singularity of the Strait of Gibraltar region and its known role as a glacial refugium. Despite its treeless feature, the herriza deserves special recognition and protection from both in its European and North African extension.     

政府补偿与监管机制改革对公立医疗卫生机构科教与学科建设的影响分析

目的 分析政府补偿与监管机制改革对公立医疗卫生机构教学、科研以及学科建设的影响。方法 通过对上海市闵行区的机构调查,收集并分析2008—2012年3所公立综合性医院和12家社区卫生服务中心的医学教育、科研项目、论文发表及重点学科建设状况的相关数据。结果 闵行区公立综合性医院和社区卫生服务中心的医学教育和科研能力有所提升,重点学科建设也有所加强;但仍然存在教学能力薄弱,科研水平层次偏低,缺乏高质量的重点学科等问题。结论 政府补偿与监管机制改革在一定程度上强化了公立医疗机构的医学教育、科研能力和学科建设,但未来需进一步加大对科教和学科建设的鼓励和支持力度。     

Recent records of the Nile Soft-shelled Turtle,Tríonyx triunguis,and of the Euphrates Soft-shelled Turtle,Tríonyx euphratìcus,in the Middle East

Abstract

Thriving populations of the Spiny Oyster Spondylus spinosus Schreibers, 1793, an Indo-Pacific bivalve, are reported from off the Mediterranean coast of Israel. The taxonomy and nomenclature of this new Lessepsian migrant are briefly discussed. The polymorphism of the Mediterranean specimens is discussed. Their habitat is described, and the epibionts and predators in the Mediterranean are enumerated.     

Community‐based native seed production for restoration in Brazil – the role of science and policy

• Large‐scale restoration programmes in the tropics require large volumes of high quality, genetically diverse and locally adapted seeds from a large number of species. However, scarcity of native seeds is a critical restriction to achieve restoration targets.
• In this paper, we analyse three successful community‐based networks that supply native seeds and seedlings for Brazilian Amazon and Cerrado restoration projects. In addition, we propose directions to promote local participation, legal, technical and commercialisation issues for up‐scaling the market of native seeds for restoration with high quality and social justice.
• We argue that effective community‐based restoration arrangements should follow some principles: (i) seed production must be based on real market demand; (ii) non‐governmental and governmental organisations have a key role in supporting local organisation, legal requirements and selling processes; (iii) local ecological knowledge and labour should be valued, enabling local communities to promote large‐scale seed production; (iv) applied research can help develop appropriate techniques and solve technical issues.
• The case studies from Brazil and principles presented here can be useful for the up‐scaling restoration ecology efforts in many other parts of the world and especially in tropical countries where improving rural community income is a strategy for biodiversity conservation and restoration.

     

基于博弈论与激励相容理论的我国分级诊疗体系分析

目的 了解政府、大型综合医院、上级医疗机构与基层医疗机构在分级诊疗体系下的利益诉求,以推进分级诊疗体系的建立。方法 采用博弈论分析这些利益主体间的矛盾,利用激励相容理论提出建议。结果 政府投入不足,上级医疗机构不愿下沉医疗资源,基层医疗机构能力不足等问题阻碍了分级诊疗体系的推行。结论 发挥政府引领作用,加大政府投入;加强医疗机构的分工协作,合理配置医疗资源;提高基层医疗机构服务能力。     

Resources available to individuals and organisations involved with marine turtle research and conservation in the Mediterranean

Abstract

We review some key resources freely or cheaply available to those involved with marine turtle research and conservation in the Mediterranean. These include: Marine Turtle Newsletter, Listservs, bibliographic databases, Mediterranean specific technical manuals, IUCN Marine Turtle Specialist Group publications, internet sources and books.     

Seasonal variation of circulating plasma carotenoids in Mediterranean Great Tit males Parus major

Capsule Mediterranean Great Tits showed a marked increase in levels of circulating carotenoids during moult and autumn.

Aims To study seasonal variation in plasma carotenoid content during a whole annual cycle for Great Tits Parus major inhabiting a Mediterranean woodland.

Methods We used a sample of 71 adult male Great Tits captured in NE Spain during a whole year. Data were organized into four seasons (winter, breeding, moult and autumn). We sampled blood to extract plasma. Carotenoid plasma concentrations were analysed by High-performance liquid chromatography (HPLC).

Results Lutein and zeaxanthin content varied seasonally, with a marked increase in levels during moult and autumn. Within the moulting period, levels increased gradually as the season progressed. This pattern differed significantly from that previously described in northern European populations, where high values appear mainly in the breeding season. Carotenoid concentrations (lutein: 1.2?±?0.25, zeaxanthin: 0.07?±?0.03?µg mL^?1) were also lower than in northern Europe.

Conclusion Mediterranean Great Tits show a very different pattern of circulating carotenoids and lower levels than northern European populations. The increasing pattern of carotenoid availability found within the moulting period raises the need to control for the effect of sampling date when analysing data on carotenoid concentrations at different times of year.     

药品可及性视角下国家基本药物制度实施效果评价

目的 研究基本药物制度对我国基层医疗卫生机构药品可及性的影响。方法 选取上海、江西、四川和重庆共24家基层医疗机构进行问卷调查和小组访谈。结果 基本药物制度实施后,基层医疗卫生机构药品的配备率、招标采购、配送时间以及患者药品负担得到了明显改善,药品零差率销售补偿机制不断完善。结论 我国基层医疗卫生机构基本药物的可及性不断提高,但是在目录遴选、招标采购、药品配送、人才队伍建设和补偿机构方面仍然存在着诸多问题。     

When to use what: Methods for weighting and aggregating sustainability indicators

ContextSustainability indices (SIs) have become increasingly important to sustainability research and practice. However, while the validity of SIs is heavily dependent on how their components are weighted and aggregated, the typology and applicability of the existing weighting and aggregation methods remain poorly understood.ObjectivesTo close the knowledge gap regarding when to use which weighting and aggregation methods for constructing SIs, we review the most commonly used methods for weighting and aggregating SIs, discuss their benefits and drawbacks, and suggest a process-oriented approach for choosing appropriate weighting and aggregation methods depending on research objectives.MethodsOur review synthesis was based on peer-reviewed journal articles, books, and reports by international organizations, governmental agencies, and research institutions. After carefully examining their principles, characteristics, and applications, we selected and classified the frequently used methods for indicator weighting and aggregation.ResultsWe systematically discuss the benefits and drawbacks of nine weighting methods and three aggregation methods. We propose a four-step process for choosing the most suitable weighting and aggregation methods based on: research purposes, spatial and temporal scales, and sustainability perspectives.ConclusionsIn this research, we chose the most commonly used methods for weighting and aggregating SIs and analyzed the characteristics, strengths and weaknesses of each method. We found that choosing appropriate weighting and aggregation methods for a specific sustainability assessment project is an extremely important and challenging task. To meet this challenge, we propose a process-oriented approach for properly selecting methods according to the purpose, scale and sustainability concept. This approach can facilitate the proper selection of these methods in sustainability research and practice.     

Redefining the dose of the entomopathogenic fungus Metarhizium brunneum (Ascomycota,Hypocreales) to increase Fe bioavailability and promote plant growth in calcareous and sandy soils

Background and aims

Plants differ in their ability to use different nitrogen (N) chemical forms, these differences can be related to their ecology and drive community structure. The capacity to uptake intact organic N has been observed in plants of several ecosystems. However, soil organic N uptake by Mediterranean plants is unknown despite organic N being abundant in Mediterranean ecosystems. We compare the uptake of different N forms in two widespread coexisting Mediterranean forest trees with contrasting ecophysiological characteristics: Quercus ilex and Pinus halepensis.

Methods

To estimate root uptake rate of each N form we used equimolar solutions (1 mM N) of ¹⁵NO₃ ^?, ¹⁵NH₄ ⁺ and ¹⁵N-¹³C glycine.

Results

NH₄ ⁺ and glycine were taken up at a similar rate, but faster than NO₃ ^? in both species. Intact dual labeled glycine was found in both species, demonstrating that both species can absorb intact organic N.

Conclusions

Despite their ecological differences, both species had similar preference for N forms suggesting no fundamental niche complementarity for N uptake. The higher preference for NH₄ ⁺ and glycine over NO₃ ^? possibly reflects adaptation to the differing proportions of N forms in Mediterranean soils.

     

Toxic dinoflagellates in the Mediterranean sea

Abstract

A review of the distribution of toxic dinoflagellates and related toxic events in the Mediterranean Sea is provided. Diarrhetic shellfish poisoning (DSP) and paralytic shellfish poisoning (PSP) are the main seafood contaminations, that have been reported since 1987. In 1994 four lethal cases for PSP were reported in Morocco. DSP seems to be restricted in the Northern part of the basin, while PSP contamination presents a wider distribution. Potentially DSP species, belonging to the genus Dinophysis, are widely distributed in the Mediterranean Sea, suggesting a wider extension of this contamination. The lack of monitoring programs in the Southern Mediterranean could be responsible of DSP overlooking. The species responsible for PSP are Gymnodinium catenatum in the Alboran Sea and Alexandrium minutum in various parts of the basin. Ichtyotoxic effects, due to Gymnodinium and Gyrodinium species, have been sporadically reported in some Mediterranean areas.