公平视角下护理人员绩效工资分配的改善策略

描述了医疗机构护理人员绩效工资分配办法的现状,在提出基本工资发放存在显性不公平的基础上,进一步揭露了绩效工资分配中的隐性不公平问题,即基本工资较高一方侵占了工资较低一方的部分绩效工资。同时,提出绩效工资分配中隐性不公平程度与护理人员的工资差距和低工资护理人员的数量密切相关。针对传统分配办法的隐性不公平现象,提出了改善绩效工资分配不公平的策略并对改进的效果进行了验证。最后,指出了新型绩效工资分配办法的主要功能主要在于改进公平,而不是提高效率,并应用利益相关者分析方法,对新型分配制度的可行性进行了分析和讨论。     

Direct seeding of Brazilian savanna trees: effects of plant cover and fertilization on seedling establishment and growth

Direct seeding is a promising technique for ecological restoration, but it has been poorly studied in neotropical savannas. Different types of plant cover (no cover, crops, or green manure) and fertilization (unfertilized, synthetic fertilizer, or poultry litter) were used to verify if survival and growth of different tree species after direct seeding could be enhanced by the use of any combination of these techniques. Seedling emergence, establishment, and growth were followed for 2 years for six savanna tree species sown in an agricultural field in Central Brazil. Germination was high (52%, on average) for Anacardium occidentale, Aspidosperma macrocarpon, Hymenaea stigonocarpa, Dipteryx alata, Eugenia dysenterica, and Magonia pubescens. Six additional species were planted, but less than 5% of these seeds germinated. Crops (60% shade) did not affect seedling survival and biomass compared with the control treatment, supporting the use of this strategy during the initial phase of restoration to involve farmers in the process. In contrast, the excessive shading (95%) from the green manure treatment decreased the survival of two species and the growth in biomass and diameter of five species, especially when combined with fertilization. Seedling growth was very slow throughout the experiment, requiring extended weed management. This study supports the use of direct seeding of the studied species for savanna restoration, but methods could be improved to include a larger number of species.     

Phylogenetic effects, the loss of complex characters, and the evolution of development in calyptraeid gastropods

Abstract Despite considerable theoretical and empirical work on the population genetic effects of mode of development in benthic marine invertebrates, it is unclear what factors generate and maintain interspecific variation in mode of development and few studies have examined such variation in a phylogenetic context. Here I combine data on mode of development with a molecular phylogeny of 72 calyptraeid species to test the following hypotheses about the evolution of mode of development: (1) Is the loss of feeding larvae irreversible? (2) Is there a phylogenetic effect on the evolution of mode of development? (3) Do embryos of direct‐developing species lose the structures necessary for larval feeding and swimming and, if so, is the degree of embryonic modification correlated with the genetic distance between species? The results of these analyses suggest that mode of development evolves rapidly and with little phylogenetic inertia. There are three cases of the possible regain of feeding larvae, in all cases from direct development with nurse eggs. It appears that species with planktotrophic, lecithotrophic, or direct development with nurse eggs all have equal evolutionary potential and retain the possibility of subsequent evolution of a different mode of development. However, species with direct development from large yolky eggs appear to be subject to phylogenetic constraints and may not be able to subsequently evolve a different mode of development. Finally, species that have more recently evolved direct development have less highly modified embryos than older direct‐developing species. Since species with nurse eggs generally have fewer embryonic modifications than those from large yolky eggs, this embryological difference may be the underlying cause of the difference in evolutionary potential.     

血液灌流救治危重型毒蛇咬伤的临床护理

目的探讨血液灌流(HP)救治重型毒蛇咬伤的临床治疗和护理方法.方法采用德国生产的型号为Adsorda300C的血液灌流器、CVVH导管为重症毒蛇咬伤病人行HP救治,护士配合医生,认真做好HP术前、术中、术后的观察与护理工作.结果5例患者行HP时间为4h,均为一次性炭肾治疗成功,痊愈出院.结论HP能及时有效的清除血中毒物,治疗效果确切,疗效快.在行HP技术时,护士应充分做好准备,掌握娴熟的专科操作技术,密切观察病情变化,保持各种管道通畅,保护好穿刺部位,及时处理各种并发症,才能保证HP的顺利进行.     

Activity of salivary glands in secreting honey‐elaborating enzymes in two subspecies of honeybee (Apis mellifera L)

The activity of invertase, glucose oxidase and amylase in the cephalic (post‐cerebral) and thoracic salivary glands is determined in Egyptian and Carniolan honeybees (Apis mellifera L). For this purpose, three ages of worker bees are selected for enzyme assays. The results show that the three target enzymes are detected in the two glands during the three worker ages, except invertase, which cannot be detected in the cephalic gland of newly emerged bees of both subspecies. In both glands, the secretion of invertase is highest, followed by amylase and then glucose oxidase. In Carniolan bees, invertase secretion of the cephalic and thoracic glands increases gradually with age. In Egyptian bees, invertase increases with age only in the cephalic gland, whereas, in the thoracic gland, the highest secretion activity is detected in 10–15‐day‐old bees. The highest amounts of glucose oxidase and amylase in the cephalic gland are detected in newly emerged individuals of both Egyptian and Carniolan bees. In the thoracic gland, however, the highest activity of both enzymes is recorded only in newly emerged Egyptian bees. The results are discussed in the light of bee management and biological aspects of the two subspecies.     

Comparison of patient and staff temple dose during fluoroscopically guided coronary angiography,implantable cardiac devices,and electrophysiology procedures

There is a paucity of literature comparing patient and staff dose during coronary angiography (CA), implantable cardiac devices, permanent pacemakers (PPM) and electrophysiology (EP) procedures and little noting dose to staff other than cardiologists. This study sought to compare patient and occupational dose during a range of fluoroscopically guided cardiac procedures. Radiation dose levels for the patients (n = 1651), cardiologists (n = 24), scrub (n = 32) and scout nurses (n = 35) were measured in a prospective single-centre study between February 2017 and August 2019. A comparison of dose during CA, device implantation, PPM insertion and EP studies was performed. Three angiographic units were used, with dosimeters worn on the temple of staff. Results indicated that occupational dose during PPM was significantly higher than other procedures. The cardiologist had the highest mean dose during biventricular implantable cardioverter-defibrillators; levels were approximately five times that of ‘normal’ pacemaker insertions. Transcatheter aortic valve implantations (TAVI) were associated with relatively high mean doses for both staff and patients and had a statistically significant higher (>2 times) mean patient dose area product than all other categories. TAVI workups were also related to higher mean cardiologist and scrub nurse dose. It was observed that the mean scrub nurse dose can exceed that of the cardiologist. The highest mean dose for Scout nurses were recorded during EP studies. Given the significantly higher temple dose associated with PPM insertion, cardiologists should consider utilizing ceiling mounted lead shields, lead glasses and/or skull caps where possible. Efforts should also be made to minimize the use of DSA during TAVI and TAVI workups to reduce cardiologist, nurse and patient dose.     

Moderating Night Radiative Cooling Reduces Frost Damage to Metrosideros polymorpha Seedlings Used for Forest Restoration in Hawaii

Winter frosts caused by radiative cooling were hypothesized to limit successful reintroduction of Hawaiian plants other than Acacia koa to alien‐dominated grasslands above 1700 m elevation. We determined, in the laboratory, the temperature at which irreversible tissue damage occurred to Metrosideros polymorpha leaves. We also conducted a field study of this species to determine if (1) leaf damage was correlated with sub‐zero leaf temperatures, (2) radiative cooling could be moderated by canopies of A. koa, and (3) low soil temperatures contributed to seedling damage. The last was evaluated by thermally buffering seedlings with water‐filled bladders placed at their base to keep roots warm, or by installing a radiation shield to reduce early morning transpiration when water uptake from cold soils would be least. Leaf temperatures were monitored between midnight and 7:00 a.m. using fine‐wire thermocouples, and leaf damage was recorded monthly. In the laboratory, supercooling protected leaves from mild sub‐zero temperatures; irreversible tissue damage occurred at about ?8°C. In the field, leaf damage was strongly correlated with degree‐hours below freezing. Unprotected seedlings suffered the greatest leaf damage. Those sheltered under A. koa trees rarely experienced temperatures below ?3°C, and damage was minimal. Shaded and thermally buffered seedlings suffered less damage than unprotected plants, probably due to elevated leaf temperatures rather than improved water relations. Using A. koa or artificial devices to reduce radiative cooling during winter nights should enhance establishment of M. polymorpha in high‐elevation rangeland.