汉赋两题

释汉赋兴盛的原因“一代有一代之文学”。文学史上的两汉时期,是赋的兴盛时期。刘勰就西汉主要赋家论述辞赋兴盛的总势时这样说:汉初词人,顺流而作,陆贾扣其端,贾谊振其绪,枚、马同其风,王扬骋其势,皋、朔已下,品物毕图。繁积于宣时,校阅于成世,进御之赋千有余篇。大抵说来,西汉初叶,辞赋即呈现出勃     

Primary care networks: choose your physicians wisely

As hospitals and health care systems maneuver for a position in the integrated health care delivery system, no initiative is more important than building an effective and competitive primary care network. Yet this critical initiative is fraught with potential pitfalls. In their haste to develop primary care networks, hospitals and health care systems may fail to thoroughly evaluate network participants and in turn create large, inclusive, and inefficient primary care networks that don't come close to breaking even, much less repay practice acquisition costs. In an effort to become more efficient, practitioners often find themselves in the unenviable position of "de-selecting" peers retrospectively. The author presents criteria for evaluating and selecting network physicians.     

Setting health priorities: a review of concepts and approaches

The setting of health priorities is primarily concerned with the equitable distribution of resources and is now more than ever an important part of strategic planning within the National Health Service (NHS). The basic information which can be used to assist in such decision-making and the process by which different agencies become involved are important aspects of priority-setting; this article is based on a major review of the research literature on these aspects and provides a discussion and an analysis of experience within health and other fields. From this material a number of possible approaches to priority-setting are identified and discussed. The article concludes that, before it can be decided how priorities should be set in the future, outstanding questions about how far rational approaches are feasible, about who is to be involved and what role they should play, and about how far such decisions are to be taken nationally or locally will need further consideration.     

新的产业革命

微电子工业方面的非凡进展触发了一场"第二次产业革命".在这场革命中,新技术将使原来由人力操作的工种自动化.这种自动化看来会提高生产率,但将威胁大量的就业机会.当国家科学院的一个委员会声称,"现代的电子工业已经宣告了一场第二次的产业革命……它对社会的影响甚至比原来的产业革命更大",这时候就该引起我们迫切重视了.因为科学院的各个委员会向来是不夸大事实的.并不是唯独科学院指出了电子工业技术的最新进展是势不可挡的社会变革的先驱.在过     

The validity of indices for rural health manpower needs assessment

Population-to-practitioner ratios have long been the primary index in the designation of health manpower shortage areas. This paper documents that application of the widely used population-to-dentist index results in understatement of the need for dental health manpower in rural areas. Through the analysis of utilization data collected from a statewide health screening program in Colorado, the practice of sole reliance on the population-to-dentist indices as an indicator of need was tested. Another measure, the area-(square miles) to-dentist ratio was formulated, examined, and found to be a more useful referent of the need for additional health manpower in rural areas. Utilization of dental services in sparsely settled rural counties of Colorado was unrelated to population-to-dentist ratios. A strong, statistically significant association of utilization with land area-to-dentist ratios was found. The findings of this analysis suggest a need for reevaluation of needs assessment methodologies used in the designation of health manpower shortage areas. Indices more sensitive to consumer circumstance than to the number of health care providers available must be considered.