分级护理服务内容实施现况调查研究

目的 调查临床实践中分级护理服务内容的执行状况,探讨分级护理制度服务内容存在的实质性问题。方法 采用分层抽样的方法,抽取广州某三级甲等医院8个普通成人病区的患者和护士作为调查对象,采用观察法记录患者得到的分级护理服务及护士对分级护理内容的执行情况。结果 8个病区一、二级护理患者构成比具有显著性差异（P=0.000);各病区一、二级护理患者日班所得分级护理时间平均为12.32分钟、4.81分钟,分别占总护理时间的50%和39%。各病区间执行分级护理时间无显著性差异（P=0.344）,各班次间执行分级护理时间有显著性差异（P=0.000）,其中责任班护士执行分级护理时间显著高于其他班次。临床实践中,护士对分级护理内容的执行项目：一、二、三级护理分别为21项、15项、11项。结论 原分级护理制度服务内容标准已不能完全适应临床护理实践,需要顺应新的医学模式和临床护理的发展,对其进行补充和完善。     

人类活动对广西合浦海草床服务功能价值的影响

近年来,中国海草生态系统受到严重破坏。本文以广西合浦海草床生态系统为例,采用1980—2005年当地统计资料,综合运用生态经济学的基本理论,以海草床的食物生产、调节大气、生态系统营养循环、净化水质、维持生物多样性和科学研究功能作为指标体系,对人类活动造成合浦海草床生态系统的价值损失进行了初步估算。结果表明,从1980—2005年,合浦海草床由于人类活动造成的价值损失为34657.95万元,损失率为71.97%。直接利用价值增加了4452.88万元,而间接利用价值损失为39110.83万元,损失率高达81.82%。说明人类对合浦海草床的开发利用强度增大趋势明显。     

医学检验服务支撑平台在区域医联体中的作用

自2013年以来,北京地区构建了多个区域医联体。在中日友好医院医联体运行的半年多时间里,针对遇到的问题,医联体内各医疗机构采取了许多相应的措施。针对医学检验信息互通,结果互认,样本转运等方面的问题,中日友好医院联合医联体内各成员单位引入医学检验服务支撑平台,探索一种“互助式”的新型医学检验服务模式,力求达到“六统一”的要求,实现医联体的优势互补、资源优化配置作用。     

Ecological mechanisms underpinning climate adaptation services

Ecosystem services are typically valued for their immediate material or cultural benefits to human wellbeing, supported by regulating and supporting services. Under climate change, with more frequent stresses and novel shocks, 'climate adaptation services', are defined as the benefits to people from increased social ability to respond to change, provided by the capability of ecosystems to moderate and adapt to climate change and variability. They broaden the ecosystem services framework to assist decision makers in planning for an uncertain future with new choices and options. We present a generic framework for operationalising the adaptation services concept. Four steps guide the identification of intrinsic ecological mechanisms that facilitate the maintenance and emergence of ecosystem services during periods of change, and so materialise as adaptation services. We applied this framework for four contrasted Australian ecosystems. Comparative analyses enabled by the operational framework suggest that adaptation services that emerge during trajectories of ecological change are supported by common mechanisms: vegetation structural diversity, the role of keystone species or functional groups, response diversity and landscape connectivity, which underpin the persistence of function and the reassembly of ecological communities under severe climate change and variability. Such understanding should guide ecosystem management towards adaptation planning.     

Defining criteria and indicators for a sustainability label of local public services

The assessment of sustainability of public services is an important issue, especially at local level, taken into account the central role of local governments as a major public employer and provider of a diversity of services. Local governments are close to citizens and are moving faster than other public sector levels with regard to the integration of sustainability principles in their operations and strategies. A sustainability label to communicate public service performance enables to disclose information directly to service users. However, there is a dearth of research about labels addressing specific sustainability criteria for local services. The main aim of this research was the development of a conceptual framework to define a sustainability label, as a tool to assess and communicate sustainability of local public services. The approach was developed taking into account criteria of the European Union Ecolabel and indicators of the Global Reporting Initiative guidelines. The ecolabel is a relatively well-known voluntary instrument in Europe and has the potential for application in public service activities and operations, but only assess the environmental component of sustainability. The Global Reporting Initiative, in particular the Sector Supplement for Public Agencies, was then used to integrate the other sustainability components. Thirty-six (36) criteria and respective indicators were adapted for the proposed sustainability label conceptual framework. A Portuguese local public service was used as an exploratory case study to test the proposed conceptual model into practice. The overall results demonstrate that few criteria were accomplished in this local public service, stressing that new practices and public policies need to be adopted to invert the current trend, especially through the application of assessment systems. This exploratory case study research has shown how useful can be a sustainability label to support local governments in evaluating and communicating the sustainability performance of their public services. This case could drive and support other government levels, including central and regional public administration, in adopting and exploring public service labels and their associated performance approaches.     

池州森林生态系统服务价值评估与分析

池州市是国家首个生态经济示范区,《中国21世纪议程》试点地之一,生态安徽建设试点市.基于LY/T1721-2008《森林生态系统生态服务价值评估规范》,采用实证研究、调查研究、文献研究等方法,估算了池州市森林生态系统生态服务价值.结果表明:2009年,池州市森林生态系统生态服务价值为443.30亿元,林果等实物产品价值...     

我国公立医院与社区卫生服务中心合作模式的比较与分析

通过文献评阅、专家访谈和现场调研等方法,对我国公立医院和社区卫生服务中心目前的合作模式进行了归纳,并对每种模式的成效、优缺点进行了分析。

     

人工鱼礁构建对海洋生态系统服务价值的影响——以深圳杨梅坑人工鱼礁区为例

基于深圳杨梅坑人工鱼礁区2008年的研究和统计数据,采用生态系统服务价值方法,系统分析了杨梅坑人工鱼礁建设对海洋生态系统的影响.结果表明:与深圳附近海域相比,杨梅坑人工鱼礁构建后旅游娱乐服务价值所占比例由87%降至42%,食品供给服务价值所占比例由7%升至27%,原材料供给、气候调节、空气质量调节、水质净化调节、有害生物和疾病的生物调节与控制、知识扩展服务价值所占比例少许提高;2008年,深圳杨梅坑人工鱼礁区单位面积服务价值为1714.7万元.km-2,远高于深圳市近海海洋生态系统的平均值和全球近海生态系统的平均值.人工鱼礁生态系统影响并改变了区域海洋生态系统服务价值结构,提高了区域生态系统服务价值,对于合理开发与利用海洋资源、修复受损的海洋生态环境和渔业资源有着重要意义.利用生态系统服务价值方法对人工鱼礁构建区进行评价,可以更好地反映人工鱼礁构建效益,能有效促进我国人工鱼礁建设的发展、提高海洋生态系统管理水平.     

上海地区医院图书馆的现状与发展探讨

目的：为了解上海医院图书馆的现状,为医院图书馆的标准化,规范花建设提供依据。方法：采用中国图书馆学会医院图书馆委员会统一编制的＂中国图书馆情况调查表＂,对上海医院图书馆进行问卷调查。结果：对医院图书馆人员的学历职称构成,年度经费、设备、馆舍面积、学科馆员设置、馆藏、数字资源的建设等方面的数据,按三级、二级医院分别进行统计分析,归纳总结。结论：通过本次调查,了解到上海地区45家三、二级医院在人员结构、经费、设备、数字资源的利用等方面差距较大,有待与各方面共同探索,改进工作,缩小差距。