我国公立医院财政补偿机制与方法研究

财政补偿机制改革关系到公立医院改革目标的实现。在深入理解医院公益性内涵的基础上,针对财政补偿对医院公益性的影响,结合当前补偿思路存在的问题,以解决“看病难、看病贵”问题为目标,提出了基于时序比较的财政补偿机制,给出了相应的财政补偿方法。     

湖北省县级公立医院改革试点医院人力资源配置分析

??????? 目的 了解县级公立医院改革试点医院人力资源配置现状,为合理配置县级公立医院人力资源提供依据。方法 采用现场问卷调查的方法对湖北省12家县级公立医院的960名医护人员进行调查,并对结果进行描述性统计和Spearman秩相关分析 。结果 (1)县级公立医院人力资源数量低于全国平均水平; (2)县级公立医院规模扩张,但是人力资源补给不足;(3)医务人员素质偏低。结论 宏观调控县级公立医院人力资源、促进县级医院的人才引进和培养、增强人力资源质量建设,以提高县级公立医院医疗服务水平。     

Réflexions sur la place des médecins spécialistes en médecine nucléaire dans le dispositif d’annonce en cancérologie

Nuclear medicine physicians are very involved in French's oncology announcement procedure. However, their role needs to be analysed and evaluated. Before diagnosis’ announcement, information provided by nuclear medicine physicians are never neutral for patients. Information must not increase patient's anxiety or false patient's sense of reassurance. In this context, it seems necessary to engage in ethical reflexions about nuclear medicine physicians communication challenges.     

Effect of genotype and graft type on the hydraulic characteristics and water relations of grafted melon

Abstract

From the measurements of the profiles of hydraulic conductance and water potential from soil through to the leaf system in fully established melon plants, the limits to water flow set by coupling of hydraulic conductance (k) with water relation parameters was evaluated in the laboratory using high pressure flow device (HPFM) and evaporative flux method (EF). The rootstock Arava was grafted onto self, and onto two genotypes (AR57 and AR82) using side and V graft types, and there was an ungrafted control. Hydraulic transport efficiency was estimated from measurements of evaporative flux (transpiration rate) and leaf water potential (ψL) measured between pre-dawn and sunset during the growth cycle. Measured parameters to characterize the hydraulic efficiency (architecture) of the vascular system of melon were normalized to areas of leaves and stem cross section; this enabled the examination of their physiological and ecological functions. The effects of rootstock genotype were more marked on graft union and scion water relations. Differences in the magnitudes of water relation parameters of hydraulic conductance, water potential (lwp) and evaporative water loss (EF) were detected. AR/RS82 side grafted exhibited high EF and Kh despite its lower leaf water potential compared to AR/RS57 V grafted. Self grafting (Arava/Arava grafts) in melon seems to improve water relations and xylem water transport efficiency. Parameters describing the hydraulic efficiency (architecture) of vascular system of melon plants were described in relation to plant attributes. The expression of hydraulic conductance of the root and shoot system relative to plant attributes did not eliminate differences in the magnitudes of conductance elements in tomato and melon. Differences obtained among the different melon grafts in whole plant leaf and stem area specific hydraulic conductance (Kl) indicate the carbon efficiency and hence the cost of resource allocation to areas of root surface and leaves. The role of plant water relations in root-shoot communications and whole plant regulation of water flux are inferred from this study.     

Societal views and animal welfare science: understanding why the modified cage may fail and other stories

The innovations developed by scientists working on animal welfare are often not adopted in practice. In this paper, we argue that one important reason for this failure is that the solutions proposed do not adequately address the societal concerns that motivated the original research. Some solutions also fail because they do not adequately address perceived constraints within the industry. Using examples from our own recent work, we show how research methods from the social sciences can address both of these limitations. For example, those who persist in tail-docking cattle (despite an abundance of evidence showing that the practice has no benefits) often justify their position by citing concern for cow cleanliness. This result informs the nature of new extension efforts directed at farmers that continue to tail dock, suggesting that these efforts will be more effective if they focus on providing producers with methods (of proven efficacy) for keeping cows clean. Work on pain mitigation for dehorning shows that some participants reluctant to provide pain relief believe that the pain from this procedure is short lasting and has little impact on the calf. This result informs the direction of new biological research efforts to understand both the magnitude and duration of any suffering that result from this type of procedure. These, and other examples, illustrate how social science methodologies can document the shared and divergent values of different stakeholders (to ensure that proposed solutions align with mainstream values), beliefs regarding the available evidence (to help target new scientific research that meets the perceived gaps), and barriers in implementing changes (to ease adoption of ideas by addressing these barriers).     

A method for in situ monitoring of the isotope composition of tree xylem water using laser spectroscopy

Field studies analyzing the stable isotope composition of xylem water are providing important information on ecosystem water relations. However, the capacity of stable isotopes to characterize the functioning of plants in their environment has not been fully explored because of methodological constraints on the extent and resolution at which samples could be collected and analysed. Here, we introduce an in situ method offering the potential to continuously monitor the stable isotope composition of tree xylem water via its vapour phase using a commercial laser‐based isotope analyser and compact microporous probes installed into the xylem. Our technique enables efficient high‐frequency measurement with intervals of only a few minutes per sample while eliminating the need for costly and cumbersome destructive collection of plant material and laboratory‐based processing. We present field observations of xylem water hydrogen and oxygen isotope compositions obtained over several days including a labelled irrigation event and compare them against results from concurrent destructive sampling with cryogenic distillation and mass spectrometric analysis. The data demonstrate that temporal changes as well as spatial patterns of integration in xylem water isotope composition can be resolved through direct measurement. The new technique can therefore present a valuable tool to study the hydraulic architecture and water utilization of trees.     

Support for Kurdish language rights in Turkey: the roles of ethnic group,group identifications,contact, and intergroup perceptions

The question of Kurdish language rights has been a central issue in the Turkish–Kurdish conflict. The current study examined endorsement of Kurdish language rights in relation to intergroup factors (i.e. group identifications, cross-group friendships, perceived discrimination, and perceived out-group beliefs about state unity) among self-identified Turkish and Kurdish participants. The results indicate that Turks were much less in favour of these rights than the Kurds. In addition, for the Turks, higher national and ethnic identification were associated with lower support for Kurdish language rights, while cross-group friendship, perceived discrimination of Kurds and the belief that Kurds endorse national unity were associated with more support for rights. For the Kurdish participants, stronger national identification seems to undermine the mobilizing meaning that Kurdish group identification has for language rights support. Furthermore, friendship with Turks can undermine the support for rights because it strengthens national identification and reduces ethnic identification.     

Competition and facilitation between Australian and Spanish legumes in seven Australian soils

This paper evaluates the relative performance and competitive ability of seven legumes from the Iberian Peninsula, Spain (one already invasive in Australia), grown singly or pairwise with seven legumes from south‐western Australia in their own soils. Indices of growth used were root, shoot and total mass and shoot dimensions. Water content, xylem water potential during drying and nodule production were also measured. The index of competition used was the intensity of competition coefficient (ICC), which is suitable for additive designs. The Australian species usually grew larger than the Spanish species, in their presence or absence, although the results were sensitive to the index of growth or resource capture used. The Australian legumes usually possessed greater total water content than the co‐occurring Spanish legumes. At least five Australian species were less reduced or not affected at all by inter‐regional competition compared with growth in isolation. Two Australian legumes performed relatively poorly in the presence of at least four Spanish legumes. The ICC identified many instances of growth promotion (facilitation) of the Australian species, which we attribute to extra nitrogen obtained through enhanced nodulation of both cohabiting species. Five of the seven Spanish species were outcompeted by the Australian species, whereas the growth of two was sometimes facilitated. Although the Spanish legumes had greater competitive ability in the more fertile Australian soils, they remained competitively inferior to the Australian legumes in their first season of growth and none is likely to displace the native legumes at this stage of growth. Longer‐term field studies are needed to fully evaluate the potential invasiveness of perennial legumes.     

Public perceptions of a white‐tailed sea eagle (Haliaeetus albicilla L.) restoration program

The historic persecution and decline of European raptor populations precipitated the use of reintroduction as a species restoration tool in the late twentieth century. One of the key requirements of the World Conservation Union reintroduction guidelines concerns the need for social feasibility studies to explore the attitudes of local human populations toward restoration and reintroduction proposals. Ahead of any formal proposals to reintroduce white‐tailed sea eagles to Cumbria, United Kingdom, we conducted a baseline public attitudinal survey (n = 300). We identified broad public support for this reintroduction, which transcended differences in the demographic, geographic, and employment profiles of the study cohort. There was public recognition that white‐tailed sea eagles could deliver a broad range of socioeconomic and environmental benefits with few detrimental impacts. Although the value of attitudinal surveys of this nature has been questioned, we would argue that they provide a useful baseline “snapshot” ahead of a more structured and focused reintroduction consultation. These results reinforce the emergence of public interest in the restoration of European raptors in the late twentieth and early twenty‐first century.