新型农村合作医疗筹资问题研究

农村合作医疗的发展历史表明，合作医疗经费是影响和制约其发展的决定性因素。新型农村合作医疗试点地区的经验也同样表明其首要的难题是筹资问题。文章从新型农村合作医疗筹资政策、筹资主体、筹资标准等方面分析影响筹资的原因，进而提出相应的政策建议。     

宁波市新型农村合作医疗制度运行状况分析

文章通过对宁波市新型农村合作医疗制度运行状况分析认为,本地区新型农村医疗合作制度运行整体平稳,其筹资结构、筹资水平和补偿模式体现了沿海经济发达地区新农合工作的特点。针对农民对新型农村合作医疗制度知晓率不高、基金结余率偏高等问题,提出加强组织引导和基金管理,进一步提高基金运行效率等建议。     

新型农村合作医疗筹资问题研究

农村合作医疗的发展历史表明合作医疗经费是影响和制约其发展的决定性因素。新型农村合作医疗试点地区的经验也同样表明其首要的难题是筹资问题。从新型农村合作医疗筹资政策、筹资主体、筹资标准等方面分析影响筹资的原因．进而提出相应的政策建议．     

新型农村合作医疗筹资与农民参与意愿研究——以安徽省的调查资料为例

新型农村合作医疗制度是顺应广大农民对医疗的迫切需要，以解决农民基本医疗保障问题而开展的工作，近期将覆盖全国80％以上的县。在新型农村合作医疗制度试点和实施过程中，筹资问题是新型农村合作医疗能否持续开展的决定因素，而农民对新型农村合作医疗试点工作的态度和参与意愿则对筹资起到决定作用。本文以安徽省首批几个试点县的调查资料为依据，分析影响农民参与新型农村合作医疗的意愿，进而分析影响合作医疗筹资的主要因素，并提出相应的建议。     

提高新型农村合作医疗农民个人筹资绩效的研究进展

农民个人筹资困难是新型农村合作医疗运行中普遍存在的问题.不少试点地区和研究学者就如何提高农民个人筹资绩效进行了一些实践与探索,如滚动式、协议委托式、集约化方式、依托农民经合组织、市场营销方式、缴费年限累积制、非货币型等多种筹资.现将近年来新型农村合作医疗农民个人筹资方式研究做一综合分析.     

浙江省不同经济地区新型农村合作医疗筹资与补偿方案的比较研究

在农村合作医疗制度的设计中，确定与当地社会经济发展水平相适应的，科学合理的筹资水平和补偿程度一直是重点和难点问题，也是整个合作医疗制度稳定、安全运行以及可持续发展的关键。文章通过对浙江省27个试点县关于合作医疗筹资与补偿方案的设计、运行状况的调查与比较分析，提出不同经济发展地区新型农村合作医疗筹资与补偿的适宜方案及建议，为政府决策提供参考依据。     

贫困山区新型农村合作医疗长效筹资机制新探

贫困山区新型农村合作医疗长效筹资是新型农村合作医疗制度在贫困山区稳定、持续运作的关键。该文针对贫困山区新型农村合作医疗筹资存在的问题及其原因进行了探析,以促进新型农村合作医疗制度在贫困山区的可持续发展。建立贫困山区新型农村合作医疗长效筹资模式关系到我国的国际形象和在世界经济社会发展中的地位,同时对广大发展中国家解决贫困地区农村居民的医疗出资问题具有重要的理论意义与实践价值。     

新型农村合作医疗筹资机制研究--基于农村居民意愿调查

在新型农村合作医疗制度的建设中,筹资机制直接影响其可持续运行。文章全面分析调查地区新型农村合作医疗筹资情况和农村居民筹资意愿及其影响因素,并在此基础上提出完善筹资机制的对策。     

新型农村合作医疗实际运行中的问题探讨

为促进新型农村合作医疗持续健康发展，通过考察试点县(县级市)新型农村合作医疗实际运行过程，分别从新型农村合作医疗筹资、管理和支付的角度对其存在的问题进行探讨。在筹资过程中，要正视其筹资主体已经发生了重大改变．对新型农村合作医疗是否一定要强调农民自愿参加的制度提出了疑义。在管理和支付过程中，提出要注意协调、控制利益相关各方的行为，改进基金支付和精确测算支付比例等问题。     

吉林省新型农村合作医疗试点方案(摘录)

基金筹集。新型农村合作医疗制度实行个人缴费、集体扶持和政府资助相结合的筹资机制。农民以家庭为单位参加新型农村合作医疗，每人筹资标准不低于30元。其中，个人筹资标准不低于每人每年10元。经济条件好的地区可相应提高个人缴费标准。持有证件的农村五保户、特困户参加当地的新型合作医疗，个人筹资部分由民政部门从农村贫困家庭医疗救助基金中支付。在乡重点优抚对象需要交纳的资金可以从医疗保障资金中支付。有条件的乡(镇)村集体经济组织应对本地新型农村合作医疗制度给予适当扶持，集体经济组织类型、出资标准由县级人民政府确定，但不得向农民摊派。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.