试论金州区新型农村合作医疗管理模式

建立和完善新型农村合作医疗制度是新时期农村卫生工作的重要内容。金州区在新型农村合作医疗管理中,探索出一条自己的模式。这种模式既有可资借鉴的地方,如管理与监督分离、多方参与、服务方便快捷等;也存在着不少问题,如群众对农村合作医疗仍存在认识上的误区、用药品种太少、报销比例太低;经办人员的编制等。建议政府制定政策要有持续性和稳定性,广泛宣传,提高参合农民健康意识;增加基本药物目录的范围,适当情况下,可采取二次救助;确定合适编制,建立一支稳定、高效的新型农村合作医疗管理队伍。     

新型农村合作医疗定点医疗机构门诊用药分析

通过对新型农村合作医疗定点医疗机构门诊处方药品费用、药品种类、抗生素和激素的使用情况、给药方式等的分析,发现定点医疗机构存在不合理用药的问题,这将直接影响新型农村合作医疗的健康持续发展。对此,提出要加强健康教育和健康促进行动;加强医务人员专业知识和技能的培训;加强合理用药制度建设;加强定点医疗机构用药行为的监管。     

特需医疗服务供方意向调查分析

剖析目前特需医疗服务供方所存在的主要问题,初步探讨在我国发展特需医疗服务适宜的承担主体。采用个别访谈和问卷调查的方法对来自不同性质的医院的医护人员和医院管理人员进行了意向调查。结果显示,医院发展特需医疗服务并不是解决医务人员收入问题的有效手段;公立医院发展特需医疗服务势必会对其普通医疗服务带来负面影响。建议在确保大部分公立医院只提供普通医疗服务的基础上,由私立医院和一部分公立医院作为特需医疗服务的承担机构。     

以人为本，推进我国临终关怀事业的发展

加快我国临终关怀事业的发展进程,就要集中经济与卫生资源,提供政策和支撑条件;制定临终关怀机构的规范化建设标准和制度,强化培训和管理;加强对临终关怀伦理的研究,将关怀生命、维护尊严、尊重临终者权利、满足临终者意愿和全人关怀的伦理原则落实在临终关怀的实践中。     

The role of production abilities in the perception of consonant category in infants

The influence of motor knowledge on speech perception is well established, but the functional role of the motor system is still poorly understood. The present study explores the hypothesis that speech production abilities may help infants discover phonetic categories in the speech stream, in spite of coarticulation effects. To this aim, we examined the influence of babbling abilities on consonant categorization in 6‐ and 9‐month‐old infants. Using an intersensory matching procedure, we investigated the infants’ capacity to associate auditory information about a consonant in various vowel contexts with visual information about the same consonant, and to map auditory and visual information onto a common phoneme representation. Moreover, a parental questionnaire evaluated the infants’ consonantal repertoire. In a first experiment using /b/–/d/ consonants, we found that infants who displayed babbling abilities and produced the /b/ and/or the /d/ consonants in repetitive sequences were able to correctly perform intersensory matching, while non‐babblers were not. In a second experiment using the /v/–/z/ pair, which is as visually contrasted as the /b/–/d/ pair but which is usually not produced at the tested ages, no significant matching was observed, for any group of infants, babbling or not. These results demonstrate, for the first time, that the emergence of babbling could play a role in the extraction of vowel‐independent representations for consonant place of articulation. They have important implications for speech perception theories, as they highlight the role of sensorimotor interactions in the development of phoneme representations during the first year of life.     

The influence of rule availability and item similarity on metacognitive monitoring during categorisation

In four experiments, we examined the sources of metacognitive judgments during the categorisation of new items after the learning of old items was completed. In the rule condition, the categorisation rule was explicitly given to the participants during learning, while in the no-rule condition participants relied on feedback to infer category membership. In the transfer phase, two types of novel items were used: good and bad transfer items. Transfer items also differed in the level of similarity to their training pairs. In the rule condition, all types of transfer items were classified with high accuracy and confidence. In the no-rule condition, a dissociation between accuracy and confidence was revealed. Good transfer items were classified more accurately than bad transfer items, whereas similar items were classified with higher confidence than dissimilar items. The obtained results suggest the utilisation of two potential cues for metacognitive judgments: declarative knowledge if the correct rule is explicitly available, and item similarity if it is difficult to infer the correct rule from feedback.     

Impacts of Flooding on the Quality of Life in Rural Regions of Southern Slovakia

Human activity has significantly influenced energy flows in the landscape. Physical and geographical features of an area in the context of natural processes highlight their influence on the human lives in the affected regions of Slovakia. The paper aimed on the influence of the extraordinary flooding impact in June 2013 on the quality of life in Slovak rural regions. We have investigated the impact of the resulting damage on human activities in the rural municipality of Ch?aba. The case study of southern Slovakia can provide a more realistic view at regularly flooded areas in Slovak geographical conditions. The target of our research was to map and monitor the situation during the floods and shortly after them and to draw proposals leading to a more operative approach in the context of comprehensive flood protection in Slovakia. The added value of the research is a creation of such graphical supporting documents, which could be served as a basis for creating the plan of flood prevention management in rural territories, as a part of negative impacts of floods reduction on human activities.     

血-前列腺屏障的假说及其对前列腺炎研究的意义

在慢性前列腺炎的研究工作中,血-前列腺屏障的研究是个被忽视的领域。在Pubmed等医学类数据库中找不到一篇关于血-前列腺屏障的研究综述。甚至找不到一个关于它的令人满意的定义。我们的研究目的,就是尝试从不同研究领域的文献中寻找有关“血-前列腺屏障”的理论和实验的依据,提出一个建立在非相关文献间的隐含联系中的假说。我们相信,血-前列腺屏障是客观存在的,而且在前列腺炎的发病机制中扮演着关键性的角色。     

知情同意与保护性医疗制度的思考

为了提高医务人员尊重患者知情同意权的法律意识和建立人文医疗的服务理念,促进医学伦理和医事法律建设的进程,对医疗活动中如何理解和落实知情同意与保护性医疗制度等问题进行了比较分析。目前,在如何调节知情同意与保护性医疗的矛盾方面缺乏明确的法律依据,因此,尊重患者的合法权益不仅体现医德和对生命的尊重,同时对于人文医疗与医患和谐有着积极的促进作用。