珠海市医疗卫生机构工作人员控烟知识、态度、行为现状调查

目的 了解珠海市医疗卫生机构工作人员吸烟现状及主要影响因素,为卫生系统全面控烟提供决策依据.方法 采用分层整群抽样方法,在珠海市各级医疗卫生机构中随机抽取13个监测点,对1 900名在职工作人员进行问卷调查.结果 男女合计现总吸烟率9.86%,其中男性现吸烟率28.48%,女性现吸烟率0.55%,男性现吸烟率明显高于女性(χ2=264.97,P<0.01).不同年龄、学历、工作岗位的工作人员吸烟率差异具有统计学意义(χ2=23.80,P<0.001;χ2=13.61,P=0.001;χ2=52.67,P<0.001).烟草危害知识知晓率为64.34%,仅有6.55%的医疗卫生机构工作人员知道烟中的尼古丁不是引起大多数癌症的化学物质,10.07%的医生从未给病人戒烟建议.结论 珠海市医疗卫生机构工作人员现吸烟率虽不高,但医务人员控烟干预服务能力不足,相关知识知晓率偏低.     

基于ITIL的高职院校数字图书馆运维服务托管

分析了高职院校数字图书馆运维服务托管现状,探讨了目前高职院校数字图书馆运维服务托管的几种模式,并提出了基于ITIL的运维服务托管对策。     

山东省医疗机构中药制剂技术审评常见问题及分析

目的 对我省医疗机构中药制剂技术审评中发现的问题进行汇总分析，探讨在既要鼓励中医药发展，又要保障公众用药安全的新形势下，对“医疗机构应用传统工艺配制中药制剂实施备案管理”工作提供参考。方法 对我省2015～2018年申报的中药制剂的审评情况进行了调研，汇总分析医疗机构制剂申报资料中存在的主要问题。结果 医疗机构制剂的申报需要在制剂名称、功能主治、说明书、工艺及质量标准研究、临床研究资料等方面进行完善。结论 建议相关医疗机构加强前期的立题科学性和必要性审查，做好相关研究工作，充分考虑医院和患者的实际需求，以促进医疗机构中药制剂的健康发展，繁荣中医药事业。     

Growing up in foster families or institutions: Attachment representation and psychological adjustment of young adults

ABSTRACT

Background: Attachment Theory has become one of the leading theories in human development. Nonetheless, empirical studies focusing on how attachment unfolds during adolescence are still scarce particularly in Spain, due to the lack of adequate measures. Objective: This study aims to validate the Important People Interview (IPI) in a shorter questionnaire version (Important People- Questionnaire; IP-Q); to analyse the changes in different affiliative bonds to multiple figures -family, peers, romantic partners – over the course of adolescence; and to identify boys’ and girls’ hierarchical ordering of their specific attachment bonds. Method: 1025 Spanish adolescents, aged 12–17 years old completed the IP-Q. Results: The results showed that the IP-Q has convergent and divergent validity. Moreover, this measure indicated that peers overtake some family members in proximity-seeking and support-seeking, but not in the overall hierarchical ordering of the attachment bond during adolescence. Conclusions: The bond with the romantic partner increases in terms of scoring on the affiliative subscales as adolescence progresses. There are significant gender differences among the hierarchy patterns of attachment for boys and girls. Developmental changes in adolescent attachment are discussed.     

Small business activity does not measure entrepreneurship

Entrepreneurship policy mainly aims to promote innovative Schumpeterian entrepreneurship. However, the rate of entrepreneurship is commonly proxied using quantity-based metrics, such as small business activity, the self-employment rate, or the number of startups. We argue that those metrics give rise to misleading inferences regarding high-impact Schumpeterian entrepreneurship. To unambiguously identify high-impact entrepreneurs we focus on self-made billionaires (in US dollars) who appear on Forbes Magazine’s list and who became wealthy by founding new firms. We identify 996 such billionaire entrepreneurs in 50 countries in 1996–2010, a systematic cross-country study of billionaire entrepreneurs. The rate of billionaire entrepreneurs correlates negatively with self-employment, small business ownership, and firm startup rates. Countries with higher income, higher trust, lower taxes, more venture capital investment, and lower regulatory burdens have higher billionaire entrepreneurship rates but less self-employment. Despite its limitations, the number of billionaire entrepreneurs appears to be a plausible cross-country measure of Schumpeterian entrepreneurship.Given the prominence of entrepreneurship, it may come as a surprise that there is no consensus on how it should be defined in empirical research. Sometimes entrepreneurship is used to refer to anyone operating a private business, regardless of size and activity. Driven by greater data availability, most empirical studies rely on definitions such as the self-employment rate, the number of startups, and small business activity (1). In other contexts, entrepreneurship refers to the subset of firms that are innovative and growth-driven (2, 3). This Schumpeterian definition of the entrepreneur as an innovator and as a driver of growth dominates in theoretical entrepreneurship research and in entrepreneurship policy (4, 5). Thus, when academics and business leaders were asked to define entrepreneurship, the most common choices were the creation and growth of new ventures and innovation. By contrast, the creation of a mom-and-pop business was not viewed as entrepreneurship (6).Leaving aside the semantic discussion of what exactly constitutes entrepreneurship, there is an important empirical issue of how well commonly used operationalizations capture the rate of Schumpeterian entrepreneurship. An implicit assumption appears to be that countries and industries with a large number of small firms and startups also tend to be those where most innovative high-growth firms emerge.However, an overwhelming majority of the self-employed are not entrepreneurial in the Schumpeterian sense, as they never bring a new innovation to the market and do not plan to grow their business. In the United States, the industries with the largest concentrations of self-employed men are construction, landscaping services, auto repair, restaurants, truck transportation, and farming. For women, the corresponding industries include private households (cooks and maids), child day care services, restaurants, and beauty salons. The majority of small businesses in the United States have no employees other than the owner. Nor do most small businesses eventually grow large. Most small businesses are best described as permanently small rather than nascent entrepreneurial firms.Shane (7) argues that necessity-driven and opportunity entrepreneurs should be treated separately, documenting a negative cross-country correlation between having many high- and low-expectation startups. Baumol (3) distinguishes between “innovative” and “replicative” entrepreneurs, where the former are the type of entrepreneurs studied by Schumpeter (2). Hurst and Pugsley (8) forcefully argue against using self-employment as synonymous with entrepreneurship. They estimate that only 10–20% of small businesses report any innovative activity at all and point out that when new startups were asked about growth ambitions, 75% of respondents stated that “I want a size I can manage myself or with a few key employees” (ref. 8, p. 96). Different types of business owners also differ in terms of personality traits (9).Both types of businesses are important for a well-functioning economy, but their workings are entirely different. Innovative and replicative businesses operate in different ways, but are not easily distinguishable in statistics, which means that special approaches must be designed for empirical analysis.One way through which scholars have attempted to distinguish the different classes of firms is by restricting attention to “high-impact entrepreneurs” (10, 11), which is to say those that grow rapidly. The difficulty of estimating the rate of high-impact entrepreneurship in a standardized way across countries has thus far prevented cross-country comparisons.We propose a measure of high-impact Schumpeterian entrepreneurship across countries using information from the Forbes Magazine worldwide list of billionaires during 2 decades. Our measure of high-impact entrepreneurship is based on the accumulation of wealth for founders of new business ventures. We compare this measure to quantity-based empirical proxies for entrepreneurship such as self-employment, small business ownership, and number of startups. Henceforth in the paper for the sake of brevity, “entrepreneurship” refers to billionaire entrepreneurship, the focus of this paper.For each billionaire, the source of wealth was investigated, allowing us to identify 996 self-made billionaires who became rich by founding new firms. Using these individuals to construct a per capita rate of high-impact entrepreneurship, we show that this measure is robustly and negatively correlated with self-employment rates, small business ownership rates, and the rate of startup activity.     

两种音乐干预模式在老年痴呆前期病人中的应用

[目的]研究儿歌习唱式和中医五调式两种音乐治疗模式在养老机构老年痴呆前期病人中的应用效果。[方法]采用简易精神状态检查量表（MMSE）和西方失语成套测验法（WAB汉译版）评估并比较干预前后痴呆前期老人的认知功能和语言能力。[结果]儿歌习唱组在干预后MMSE评分和WAB失语商积分均显著高于干预前;且与对照组比较差异有统计学意义（P〈0.05）。中医五调组在干预后MMSE评分和WAB失语商积分与干预前比较差异无统计学意义（P〉0.05）。[结论]儿歌习唱式音乐治疗模式更适合应用于养老机构,是一种有效、经济、安全防治痴呆的非药物治疗手段和护理方法。     

揆度求奇恒 黄溪无止境——黄山名士陈无咎医学思想撷析

简述民国时期黄山名士陈无咎的传奇经历,分析其医学思想。治学宗从《内经》,实践崇尚揆度;弘扬丹溪学说,创办中医院校;主张取长补短,融汇中西医学,旨在发展中医。     

论专门机构在反性骚扰中的作用——以美国和我国台湾的经验为例

建立专门的机构执行反性骚扰的立法是很多国家和地区的经验.从美国的平等就业机会委员会和我国台湾地区的就业歧视评议会和性骚扰防治委员会的发展,我们可以看到专门机构对于性骚扰纠纷的解决具有重要的意义.性骚扰纠纷的私密性、复杂性、当事人双方地位的不平等性都要求有专门的机构有针对性地解决这类纠纷.我国大陆地区在将来制定反性骚扰法律时应当建立专门的机构来实施反性骚扰的法律.     

加强医疗机构安全保障工作的法律视角分析

文章对医疗机构安全保障工作的法律属性、责任形式进行了分析,提出医疗机构作为提供医疗服务的特定场所,必须健全管理制度,完善硬件设施,配备必要人员,加强安全保障教育,避免因违反安全保障义务导致的侵权行为发生.     

复杂适应系统理论视角下国家基本药物制度的实施分析

近年来,愈来愈多的学者将复杂适应系统(CAS)理论应用于理解卫生系统和卫生服务提供过程.以CAS理论为框架,通过对3个西部贫困区县医疗机构案例进行分析,为理解现阶段基层医疗机构实施国家基本药物制度所面临的挑战提供新的思路.