医用高值耗材对医疗费用产生影响的分析和思考

文章对近三年医用高值耗材使用数量、金额、单价及其增长率进行调查,发现临床高值耗材使用量增幅大,进而分析了医用高值耗材对医疗费用产生的影响,提出政府物价部门定价要科学,卫生行政部门准入要监管,医院内部采购、使用、收费要规范,以促进医用高值耗材的合理使用,控制医疗费用快速增长,降低患者负担和医疗服务成本.     

Demographic transition in sub-Saharan Africa: How big will the economic dividend be?

In mid-demographic-transition, many Asian countries enjoyed a large demographic ‘dividend’: extra economic growth owing to falling dependant/workforce ratios, or slower natural increase, or both. We estimate the dividend, 1985–2025, in sub-Saharan Africa and its populous countries. Dependency and natural increase peaked around 1985, 20 years after Asia. The UN projects an acceleration of the subsequent slow falls but disregards slowish declines in young-age mortality and thus, we argue, overestimates future fertility decline. Even if one accepts their projection, arithmetical and econometric evidence suggests an annual, if not total, dividend well below Asia's. The dividend arises more from falling dependency than reduced natural increase, and could be increased by accelerating the fertility decline (e.g., by reducing young-age mortality) or by employing a larger workforce productively. Any dividend from transition apart, low saving in much of Africa (unlike Asia) means that, given likely natural increase, current consumption per person is unsustainable because it depletes capital per person.     

Protocol for student replication of published research

Subpart D of the Common Rule establishes 4 categories of research that may be conducted on children. One category, 45 CFR 46.406, permits research posing a minor increase over minimal risk and no prospect of direct benefit but expected to yield vital knowledge about the subjects' disorder or condition. To include other children in research posing a minor increase over minimal risk and no prospect of direct benefit requires federal review and approval of the Secretary of Health and Human Services under 45 CFR 46.407. It is widely held that children generally should not be exposed to more than minimal risk in research without the prospect of direct benefit. To justify deviating from this norm, as 406 allows, two claims must be true: (1) When there is vital knowledge to be gained from studying children, it is permissible to expose some children to a minor increase over minimal risk with no prospect of direct benefit; (2) It is permissible for locally reviewed and approved research to expose only children with the disorder or condition under investigation to greater risk with no prospect of direct benefit. The justification for (1) appears to be grounded in the magnitude of benefit to society combined with the need to study children. This article demonstrates that, even if the necessity and magnitude of benefit to society justify exposing children to increased risk, the decision to categorically restrict participation in such research to children with the disorder or condition under investigation (unless the study is federally reviewed and approved) is not justified. Subpart D should be revised.     

西藏的人口与土地资源的承载能力

中国西藏自治区虽然“地大” ,但并非人们想象的那样“物博”。随着人口的不断增加 ,特别是农牧区人口的快速增加 ,西藏的一些自然资源也面临过渡开采和利用问题 ,这一问题在西藏草原畜牧业的发展上表现得尤为突出 ,使得西藏这一最古老的产业面临严峻的挑战。与此同时 ,作者还从多个视角提出了应对这一挑战的诸多建议     

人口增长能拉动消费吗?——模型及广东的实证分析

考虑到人口在社会总消费中的特殊作用,在凯恩斯和新古典理论框架下的各主要经典消费函数理论模型中,引入人口年龄结构变量,对广东城乡居民的消费函数进行实证检验,并对广东居民的总消费进行预测.研究发现,尽管居民的消费倾向较高,但居民消费率在国民经济发展中所占比重偏低,人口增长对消费拉动效应不显著.     

基于多维度感知风险的中国公众无偿献血意愿及影响因素分析

基于多维度感知风险,调查中国公众的献血意愿现状,探讨其影响因素,为无偿献血者招募与保留工作提供科学依据。本文从公众对献血行为、心理、情境、制度、偏见、服务、宣传七个维度的感知风险入手,在问卷调查与因素分析的基础上,基于实证分析,解释各种因素之间的相互关系,揭示不同特征中国公众献血意愿的差异,进而有针对性地制定无偿献血招募及保留措施,促进我国无偿献血事业可持续发展。     

三十烷基磷酸酯钾对玉米的早熟增产作用

玉米苗期喷施三十烷基磷酸酯钾(TPK),可显著地促进茎叶和根系的生长;增强抗逆性,并加速了生育进程。用0.01mg·L-1质量浓度的TPK喷施玉米茎叶,可早熟2-3d,增产11.25％,而质量浓度为0.001mg·L-1、0.1mg·L-1处理的效果不如0.01mg·L-1的明显。     

Quantitative Microbial Risk Assessment of Cryptosporidiosis and Giardiasis from Very Small Private Water Supplies

This article reports a quantitative microbial risk assessment of the risk of Giardia and Cryptosporidium in very small private water supplies. Both pathogens have been implicated in causing outbreaks of waterborne disease associated with such supplies, though the risk of endemic disease is not known. For exposure assessments, we used existing data to derive regression equations describing the relationships between the concentration of these pathogens and Escherichia coli in private water supplies. Pathogen concentrations were then estimated using national surveillance data of E. coli in private water supplies in England and France. The estimated risk of infection was very high with the median annual risk being of the order of 25–28% for Cryptosporidium and 0.4% to 0.7% for Giardia, though, in the poorer quality supplies the risk could be much higher. These risks are substantially greater than for public water supplies and well above the risk considered tolerable. The observation that observed infection rates are generally much lower may indicate increased immunity in people regularly consuming water from private supplies. However, this increased immunity is presumed to derive from increased disease risk in young children, the group most at risk from severe disease.     

国际油价不确定性与中国经济增长——基于GARCH-in-Mean SVAR模型的实证研究

通过建立双变量的GARCH-in-Mean SVAR模型,将代表国际油价不确定性的变量——油价变动率的条件标准差,引入结构向量自回归模型(SVAR),来检验国际油价不确定性对中国经济增长的影响。研究表明,国际油价的不确定性尚未对中国经济增长造成显著的负面影响。此外,油价不确定性延长了油价变动对中国经济产生的负面影响,相应缩短了其正面影响,而且,中国经济增长对油价正负冲击的响应具有不对称性。     

关于人口增长、环境退化、贫困与政策取向的深层次思考

通过对人口增长与环境退化和贫困之间的关系分析,得出人口增长是环境恶化和资源过快耗竭的关键原因.而恶化的环境和资源的稀缺又导致贫困.在此基础上,提出了解决这个问题的政策取向--除了关键依靠科技进步和控制人口增长外,还应加强城镇化建设和停止误导性的开发.