农村养老保险的现状、问题与出路——以福建省宁德市为例

家庭养老、土地养老是宁德农村养老的主要形式,社区养老在宁德当前还没有推广价值,宁德当前不仅"老农保"参保率低、养老金的保障水平也低,而且"新农保"才刚刚处于试点阶段.宁德农村养老保险存在的问题是:对农村农民养老保险认识不到位影响了农民的养老习惯;"老农保"参保率太低,保障水平过低;筹资渠道少、筹资能力弱;基金保值增值难,基金管理较为松散.宁德农村养老保险的出路在于要总结"新农保"试点经验,尽快上升为人大地方法规,实现新农村养老保险有法可依;加强财政支持,提高补贴标准,用利益诱导农民参与"新农保";加强农村基层"新农保"机构建设,实现"新农保"的社会实效;切实做好新老农保的制度衔接,实现农村保险制度的稳定性,扩大农民的参保率.     

加快我国社会养老体系建设分析

我国的养老产业和养老服务的发展还相对滞后,中国正面临快速老龄化的严峻挑战和人口结构老龄化的重大难题,如何加快建立健全养老社会服务体系,让老年人安享老年生活,是摆在我们面前亟需解决的问题.     

企业构建以协同发展为引领的创新体系探究

从协同创新体系创建的背景、意义、方法及应用等方面探究有效可行的方法路径,通过明确指导思想和基本原则,构建组织保障,优化创新战略部署、管控、验收等管理流程,搭建创新体系融通平台发挥产学研合作联盟作用,挖掘创新潜能兴起全员创新热潮,打造创新体系人才队伍等措施,最终可构建多维协同、上下联动的以协同发展为引领的创新体系,促进企业实现“高端化、智能化、绿色化”发展新突破。     

甘肃省定西市安定区农民环境教育体系构建研究——生态脆弱型贫困地区农民环境教育思考

安定区(原定西县)位于甘肃省中部,属典型的生态脆弱型贫困区.调查显示,该区农民环境教育与"水保立区"宏观战略、生态环境治理工程建设及市民环境教育失衡;同时,该区农民环境意识方面表现出浅层和深层不平衡、不同年龄段人群不平衡和环境知识与环保行为脱节现象.因此,应着力构建农民环境教育体系,促进农民环境教育协调发展:制订科学的农民环境教育计划,实现与战略的对接;坚持农村视角,保证农民环境教育内容的适切性;创新教育方式,提高农民环境教育的实效性;整合现有资源,打造立体化的农民环境教育阵地;关注农民利益需求,促使知行有效转变;强化对农民环境教育的战略认识,促进区域生态与经济社会协调发展.     

构建以企业为主体的技术创新体系加快国有企业的改革与发展

介绍了创新的基本概念和重要性。论述了企业是技术创新的主体并分析了我国及云南省构建技术创新体系的历程、现状和存在的主要问题。概述了云南冶金集团总公司构建企业技术创新体系的实践。针对我国及云南省构建以企业为主体的技术创新体系面临的困难和问题,从五个方面提出了应采取的对策和措施。     

中西部地区农民工返乡创业支持体系研究——以安徽省阜阳市为例

受2008年金融危机及我国沿海地区产业结构调整的影响,中西部地区农民工纷纷返乡创业,成为推动欠发达地区县城经济发展的重要力量.在分析农民工返乡创业支持体系影响因素的基础上,通过对中西部地区农民工创业现状的调查,结合Logistic回归模型,针对研究结论,提出了从政策环境、创业培训、金融服务、风险预警等方面促进中西部地区农民工返乡创业更好更快发展.     

城镇人居环境体系建设的规划和研究——以河北任县为例

从建设思路、规划目标、生态城镇建设3个方面,对河北省任县人居环境体系建设进行了规划和研究.强调理想的人居环境应适于人类生存且与自然相和谐,城市体系规划、城市总体规划、详细归划等环节中都应融入人居环境的先进理念.     

如何实现资源型企业可持续发展——以河北峪耳崖金矿为例

通过分析当前河北峪耳崖金矿所面临的主要问题,对资源型企业如何实现可持续发展提出了合理化建议。从充分利用矿产资源角度,认为加强地质综合研究,充分利用矿产资源是保证矿山企业可持续发展的必要途径之一,对此提出了具体的对策和措施,可为类似矿山提供参考。     

试析文化遗产型景区保护机制创新——以福建土楼为例

文化遗产型景区保护机制需要不断创新,文章在分析国内外文化遗产型景区的保护现状的基础上,以福建土楼为例,从保护理念、保护投入、保护管理、保护技术、保护监督等方面试析文化遗产型景区保护机制的创新.     

大学课程的形成性评价体系探究——以大学英语课程为例

一直以来,因为对如何评价学生学习,特别是通过实时性评价学生学习状况,及时的调整教学策略,最大限度地调动学生学习的自主性、积极性的重视不够。教学评价常被简化成一种机械的考核手段,划分等级成了评价的唯一,激发学生学习兴趣和反馈教学都变得十分苍白。因此,探索一套完整、系统、可行的形成性评价体系对教和学都意义深远。这里就以大学英语课程为例,对形成性评价体系的理论、应用及形成策略做探讨。     

福建省养老服务问题及对策初探

在分析福建省养老服务事业发展所面临的问题基础上,对发展福建省养老服务事业提出对策和建议,指出要以科学发展观为指导,发展养老服务理念:加快政府职能转变,推进养老服务体系建设:建立社会多元筹资模式,鼓励社会力童投入养老产业:提升社区服务水平,优化社区养老服务体系运行机制:建立专业化养老工作者队伍,充分发挥志愿者作用,力图为发展养老服务需求提供政策理论依据,积极有效地应对福建省人口老龄化以及社会变迁.     

Predictors of aggressive behaviors: a longitudinal study in senior day care centers

Aggressive behaviors place elderly persons and their caregivers at risk. This study examines longitudinally the predictors of aggressive behaviors based on staff and family members' ratings of 200 community-dwelling participants from senior day care centers. The main difference between physically and verbally aggressive behaviors was found to be the role of physical and mental health. Cognitive impairment and poor quality of relationship were the main predictors of physically aggressive behaviors. Verbally aggressive behaviors were predicted mainly by depressed affect, low quality of relationships, and poor physical health. These results validate and expand prior cross-sectional research on the correlates of aggression in other populations, and guide in the development of interventions.     

A case study in interdisciplinary care of the critically ill

At mitosis, the nucleus of higher eukaryotic cells disassemblies into components which subsequently reform functional nuclear envelopes in the two daughter cells. The molecular mechanisms underlying this remarkable morphological reorganization are the focus of active investigation. Recent electron microscopy techniques have provided intriguing glimpses of intermediate structures in both nuclear envelope and nuclear pore complex reassembly.     

A phenomenological study of ethical decision-making experiences among senior intensive care nurses and doctors concerning withdrawal of treatment

Substantial evidence has recently accumulated showing domestic cats to be the principal reservoirs of Bartonella henselae, the aetiological agent of human diseases including cat-scratch disease, bacillary angiomatosis, bacillary peliosis and a febrile bacteraemia syndrome. To determine the prevalence of antibodies reactive with Bartonella henselae in cats from southern Africa, indirect fluorescent antibody assays were carried out on feline sera from South Africa and Zimbabwe. Overall, 23% (39/171) of cats had antibody titres > or = 1/64, with cats from Zimbabwe (24%; 28/119) having higher seroprevalences than those from South Africa (21%; 11/52) although this difference was not statistically significant. The implications of these findings for veterinarians in southern Africa are discussed.     

Nurse managed occupational health services without on-site clinical care delivery: a case example

1. In this program management/community network model of occupational health services, the occupational health nurse is responsible for managing program development and implementation, with vendors providing the clinical services. 2. Occupational health nurses' primary areas of responsibility are occupational health, disability case management, ergonomics, and health promotion. 3. Successful management of program outcomes requires the occupational health nurse to continually assess employee/business needs, maintain communication with employees and management, and partner with the environmental, health, and safety team, other functional work groups, and vendors. 4. Effective management of contracts becomes critical to the process beginning with clear service requirements through the delivery of quality services.     

Coeliac disease in primary care: case finding study

OBJECTIVES: To provide evidence of underdiagnosis of coeliac disease and to describe the main presenting symptoms of coeliac disease in primary care. DESIGN: Case finding in a primary care setting by testing for coeliac disease by using the endomysial antibody test. SETTING: Nine surgeries in and around a market town in central England, serving a population of 70 000. PARTICIPANTS: First 1000 patients screened from October 1996 to October 1997. OUTCOME MEASURES: Determination of endomysial antibody titre of patients fulfilling the study criteria, followed by small intestine biopsy of those with positive results. RESULTS: The 30 patients (out of 1000 samples) with positive results on the endomysial antibody test all had histological confirmation on small intestine biopsy. The commonest mode of presentation (15/30) was anaemia of varying severity. Most patients (25/30) presented with non-gastrointestinal symptoms. Specificity of the endomysial antibody test was 30/30. CONCLUSIONS: Underdiagnosis and misdiagnosis of coeliac disease are common in general practice and often result in protracted and unnecessary morbidity. Serological screening in primary care will uncover a large proportion of patients with this condition and should be made widely available and publicised. Coeliac disease should be considered in patients who have anaemia or are tired all the time, especially when there is a family history of the disease.     

Academic psychiatry and managed care: a case study

An academic department of psychiatry in New York City eliminated the need for behavioral managed care intermediaries by transforming itself from a fee-for-service system to a system able to engage in full-risk capitation contracts. The first step was to require health maintenance organizations to contract directly with the department. The department formed two legal entities, a behavioral management services organization for utilization management and a behavioral integrated provider association. The authors describe these entities and review the first year of operation, presenting data on enrollees, capitation rates, and service utilization for the first three contracts. The fundamental differences in the treatment model under managed care and under a fee-for-service system are highlighted. The authors conclude that by contracting directly with insurers on a full-risk capitation basis, departments of psychiatry will be better able to face the economic threats posed by the cost constraints inherent in managed care and maintain or re-establish their autonomy as care managers as well as high-quality care providers.     

Challenges of traction in critical care: a case study

PROBLEM/CONDITIONS: Despite widespread availability of a safe and effective vaccine against tetanus, 124 cases of the disease were reported during 1995-1997. Only 13% of patients reported having received a primary series of tetanus toxoid (TT) before disease onset. Of patients with known illness outcome, the case-fatality ratio was 11%. REPORTING PERIOD COVERED: 1995-1997. DESCRIPTION OF SYSTEM: Physician-diagnosed cases of tetanus are reported by state and local health departments to CDC's National Notifiable Diseases Surveillance System. In addition, since 1965, supplemental clinical and epidemiologic information for cases has been provided to CDC's National Immunization Program. RESULTS: From 1995 through 1997, a total of 124 cases of tetanus were reported from 33 states and the District of Columbia, accounting for an average annual incidence of 0.15 cases per 1,000,000 population. Sixty percent of patients were aged 20-59 years; 35% were aged > or =60 years; and 5% were aged <20 years, including one case of neonatal tetanus. For adults aged > or =60 years, the increased risk for tetanus was nearly sevenfold that for persons aged 5-19 years and twofold that for persons aged 20-59 years. The case-fatality ratio varied from 2.3% for persons aged 20-39 years to 16% for persons aged 40-59 years and to 18% for persons aged > or =60 years. Only 13% of patients reported having received a primary series of TT before disease onset. Previous vaccination status was directly related to severity of disease, with the case-fatality ratio ranging from 6% for patients who had received one to two doses to 15% for patients who were unvaccinated. No deaths occurred among the 16 patients who previously had received three or more doses. Tetanus occurred following an acute injury in 77% of patients, but only 41% sought medical care for their injury. All patients who sought care were eligible for TT as part of wound prophylaxis, but only 39% received it. Tetanus in injecting-drug users (IDUs) with no known acute injury comprised 11% of all cases, compared with 3.6% during 1991-1994. None of the IDU-associated tetanus cases occurred among persons who were known to have been vaccinated. Sixty-nine percent of IDU-associated tetanus cases were reported from California, and 77% of these cases occurred in heroin users. INTERPRETATION: Tetanus remains a severe disease that primarily affects unvaccinated or inadequately vaccinated persons. Adults aged > or =60 years continue to be at highest risk for tetanus and for severe disease. However, the overall incidence of tetanus has decreased slightly since the late 1980s and early 1990s, from 0.20 to 0.15, a result primarily of a decreased incidence among persons aged > or =60 and <20 years. ACTIONS TAKEN: Tetanus is preventable through both routine vaccination and appropriate wound management. In addition to decennial booster doses of diphtheria and tetanus toxoids during adult life, the Advisory Committee on Immunization Practices (ACIP) recommends vaccination visits for adolescents at age 11-12 years and for adults at age 50 years to enable health-care providers to review vaccination histories and administer any needed vaccine. Every contact with the health-care system, particularly among older adults and IDUs, should be used to review and update vaccination status as needed.     

Innovation and survival: a case study in planning medical library services

In the information age, information utilities like libraries are as sensitive to the stresses of change as any other organization. This article is a case study of a small, specialized medical library as it attempted to understand, and cope with, the complex simultaneous challenges of serious budgetary constraints, technological change, and shifting user demands in the mid 1990s. To support planning decisions in a period of declining use statistics, the Medical Library at Women's College Hospital, Toronto, carried out a user survey that posed choices about priorities among services. Conclusions drawn from the survey and its related planning process may help similar organizations design an appropriate service blend for future users.