模糊综合评价法在医疗服务系统中的应用

针对我国目前部分医院存在医疗质量差、医患关系紧张、医疗风险大等问题,急需要研究科学管理与质量评估办法.论文运用系统方法,对于医疗服务系统中的技术质量(服务自然属性)和功能质量(服务社会属性)两部分给出基于SWOT的模糊综合评价法的一般步骤;解决评价影响因素的模糊性或不确定性、定性指标难以定量化等问题;最后运用一般的医疗服务质量评价指标体系进行说明.旨在通过科学的质量评估来正确认识我国医疗服务系统存在的主要问题,对政府制定卫生政策,更好实现优化管理、组织运营具有积极意义.     

国家精准扶贫评估理论体系及其实践应用

十八大以来我国实施精准扶贫、精准脱贫方略,实行"最严格的考核评估"制度,以确保扶贫工作务实、脱贫过程扎实、脱贫结果真实。精准扶贫评估是提升国家精准扶贫工作成效的重要手段,对于决战决胜脱贫攻坚、推进国家治理体系和治理能力现代化具有重要意义。文章基于国家精准扶贫成效第三方评估工作实际,探讨了乡村贫困化分异规律及其科学认知,梳理总结了国家精准扶贫评估理论、技术体系,深入分析了评估理论与技术在历年评估调查中的应用及其贡献。研究表明:(1)乡村贫困化的"孤岛效应""边际递减效应",以及政府"扶"与农户"贫"之间的供需结构,是实施精准扶贫成效评估的科学意义所在,客观要求深入开展考核评估,以评促改,有效提升精准扶贫工作绩效;(2)乡村贫困化的理论认知与实践需求是确立评估目标、制定评估方案的重要依据,对于细化扶贫成效评估指标、探明指标内涵、制定评估工作方案具有直接的指导作用;(3)国家精准扶贫成效第三方评估技术体系是一个包括评估关键技术、评估支撑技术、成套设备支持系统和评估大数据平台的完整系统,持续支撑了2016—2020年国家精准扶贫成效评估,较好地发挥了"质检仪""指挥棒"和"推进器"的作用,为全...     

安全文化史学的创建研究

为建立安全文化史学(SCH)学科体系,完善安全文化学(SC)与安全史学(SH)学科理论体系,立足于学科建设,论证创立安全文化史学的可能性与必要性;基于安全文化学与安全史学的定义提出安全文化史学的定义,分析安全文化史学的内涵及其学科基础、研究对象、研究内容、研究方法和研究步骤5个学科基本问题。研究结果表明,从方法论角度看,安全文化史学是安全史学与安全文化学的一种研究新策略,其研究可有效弥补传统二者研究所存在的弊病和缺陷。     

流域生态系统健康评价研究

以流域为单元,评价生态系统健康状况,将为流域的规划、管理和保护以及流域综合治理提供决策依据。总结了国内外关于流域生态系统健康评价的方法,对流域生态系统健康评价体系的理论基础、基本框架、指标选择、指标的评价函数、权重分配、体系建构步骤等关键性问题进行了研究。以“自然条件限制因子-流域生态健康指示因子-人类活动影响因子”评价体系为基础,选择了水质、植被、水土保持、生物多样性、湿地、土地利用、人口、点源污染、面源污染、水资源开发利用率、河流自然化、人均GDP、土壤、水文和生物第一性潜在生产率等20项指标,构建每个评价指标的评价函数,利用层次分析法对滦河山区流域和北四河平原流域进行生态系统健康评价。综合评价结果表明,滦河山区流域和北四河平原流域生态系统健康得分为76和46,年降雨量、点源污染、面源污染、水资源开发利用率是我国北方半湿润/半干旱地带小流域生态系统健康状况的主要控制因子。     

Estimation of the measurement uncertainty and practical suggestion for the description of the metrological traceability in clinical laboratories

Clinicians request a large part of measurements of biological quantities that clinical laboratories perform for diagnostic, prognostic or diseases monitoring purposes. Thus, laboratories need to provide patient’s results as reliable as possible. Metrological concepts like measurement uncertainty and metrological traceability allow to know the accuracy of these results and guarantee their comparability over time and space. Such is the importance of these two parameters that the estimation of measurement uncertainty and the knowledge of metrological traceability is required for clinical laboratories accredited by ISO 15189:2012. Despite there are many publications or guidelines to estimate the measurement uncertainty in clinical laboratories, it is not entirely clear what information and which formulae they should use to calculate it. On the other hand, unfortunately, there are a small number of clinical laboratories that know and describe the metrological traceability of their results, even though they are aware of the lack of comparability that currently exists for patient’s results. Thus, to try to facilitate the task of clinical laboratories, this review aims to provide a proposal to estimate the measurement uncertainty. Also, different suggestions are shown to describe the metrological traceability. Measurement uncertainty estimation is partially based on the ISO/TS 20914:2019 guideline, and the metrological traceability described using the ISO 17511:2020. Different biological quantities routinely measured in clinical laboratories are used to exemplify the proposal and suggestions.     

典型农牧交错区农业生态系统健康测度及其持续利用对策

生态系统健康作为全球管理的新目标,作为分析生态系统的新方法而受到青睐,是现代生态学的研究热点之一。本文根据生态系统健康的内涵和农牧交错带农业生态系统的特点,从活力、组织结构和恢复力3个方面选取18个指标,构建了农牧交错带农业生态系统健康的评价指标体系。在此基础上建立综合评价模型,应用于赤峰12个旗（区、县）,得到如下结果：农业生态系统健康状况处在“健康”标准是红山区和巴林右旗;处在“临界健康”标准是克什克腾旗、元宝山区、敖汉旗、松山区;处在“不健康”标准是宁城县、林西县、巴林左旗、喀喇沁旗、阿鲁克尔沁旗、翁牛特旗。评价结果基本上反映了当地农业生态系统的健康状况,说明建立的评价指标体系与模型是可行的。最后提出了农牧交错带农业生态系统持续利用的对策。     

Utility of icteric index in clinical laboratories: more than a preanalytical indicator

IntroductionTotal bilirubin tests are highly demanded in clinical laboratories. Since icteric index (I-index) has zero cost, we aimed to evaluate its clinical utility and cost-effectiveness to determine if total bilirubin is necessary to be tested. We took into account if haemolysis could interfere to icteric index determination.Material and methodsRetrospectively we reviewed I-index results in two cohorts (43,372 and 8507 non-haemolysed and haemolysed samples, respectively). All determinations were done using Alinity c chemistry analysers (Abbott Diagnostics). Receiver operating characteristic (ROC) curve was used to determine the optimal index cut-off to discriminate between normal and abnormal bilirubin concentration (20.5 µmol/L).ResultsThe ROC curve analysis suggested 21.4 µmol/L as the optimal I-index cut-off but differences in sensitivity and specificity were detected between patient derivation. For rejecting purpose, 15.4 µmol/L and 17.1 µmol/L I-index thresholds were selected based on patient derivation (inpatients and emergency room; and primary care and outpatients, respectively) with 97% sensitivity and 0.25% false negative results. Sensitivity was much lower in haemolysed samples. We selected 34.2 µmol/L I-index as threshold to detect hyperbilirubinemia with 99.7% specificity and 0.26% false positive results, independent of haemolysis. With the icteric index cut-offs proposed, we would save 66% of total bilirubin requested and analyse total bilirubin in around 2% of samples without total bilirubin requested.ConclusionsThis study supports the use of I-index to avoid bilirubin determination and to identify patients with hyperbilirubinemia. This work considers that the economic and test savings could help to increase the efficiency in clinical laboratories.     

美国科技项目监督体系——以科技计划管理专业机构NIH为例

研究美国以专业机构管理项目为基础的科技项目监督机制,在此基础上,围绕现阶段我国科技计划管理改革对科技监督提出的要求,提出建立我国内外结合、分层分级的科技监督体系的建议。     

Evaluation of preanalytical and postanalytical phases in clinical biochemistry laboratory according to IFCC laboratory errors and patient safety specifications

IntroductionThe aim of the study was to determine the current state of laboratory’s extra-analytical phase performance by calculating preanalytical and postanalytical phase quality indicators (QIs) and sigma values and to compare obtained data according to desired quality specifications and sigma values reported by The International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Working Group – Laboratory errors and Patient Safety.Materials and methodsPreanalytical and postanalytical phase data were obtained through laboratory information system. Rejected samples in preanalytical phase were grouped according to reasons for rejection and frequencies were calculated both monthly and for 2019. Sigma values were calculated according to “short term sigma” table.ResultsThe number of rejected samples in laboratory was 643 out of 191,831 in 2019. Total preanalytical phase rejection frequency was 0.22%. According to the reasons for rejection, QIs and sigma values were: “Samples with excessive transportation time”: 0.0036 and 5.47; “Samples collected in wrong container” 0.02 and 5.11. In December, QIs and sigma values were: “Samples with excessive transportation time”: 0.01 and 5.34; “Samples collected in wrong container”: 0.03 and 4.98. The postanalytical QIs and sigma values were: “Reports delivered outside the specified time”: 0.34 and 4.21; “Turn around time of potassium”: 56 minute and 3.84, respectively. There were no errors in “Critical values of inpatients and outpatients notified after a consensually agreed time”.ConclusionsExtra-analytical phase was evaluated by comparing it with the latest quality specifications and sigma values which will contribute to improving the quality of laboratory medicine.     

国家创新体系中的国家问题：一种技术创新企业主体变为国家主体的时代诠释

从技术技校企业单一主体中凸现出国家创新体系国家主体，这是一种时代发展的必然。文章从技术创新企业主体的问题入手，阐明了国家创新体系中国家问题的实质，能否保证技术创新，创新体系高效率地运转，表现在国家整体层次上就是是否遵循了一系列共同的规律。     

创建国家创新系统

深化改革,健全市场经济体制,建立国家导控市场、市场引导企业,企业主体化、营销优化、国家投入最大化、系统化、配套化和财政金融及贸易政策支持的国家创新系统.     

基于可持续性的国家科技基础设施评价系统研究

本文提出了科技基础设施评估的指导思想和工作原则,认为该评估应是一个系统的评估。从可持续性的角度构建了国家科技基础设施评价三维(自身发展维、协同维和综合效能维)模型,分析了不同类型科技基础设施的评估导向,提出了评估的管理机制。     

军工安全文化概念框架研究

军工安全文化对保障军工企业安全生产具有重要作用.应用综合归纳的方法,通过对安全文化、军工文化等相关概念进行梳理,提出军工安全文化的基本概念,并从六个方面分析了军工安全文化的内涵.研究得出:军工安全文化是军工文化的组成部分,以保障国家利益与人民生命财产安全为目标,是军工企业的安全价值观与安全行为规范的集合,通过军工企业组织体系对军工企业生产系统施加影响,具有很强的稳定性.最后从四个方面分析了对军工安全文化的概念框架进行研究的重要意义.     

Developing a National Innovation System on the Basis of National Conditions

While building a na- tional innovation sys- tem with Chinesecharacteristics, China should not blindly follow developed countries or simply negate its successful prac- tice over the past five decades in scientific and technological (S&T) development and its hard-earned S&T infrastructure and systems, much less forget the basic fact that China is currently in the primary stage of socialism and will remain in this stage for a long time to come, urges CAS Pres ident LU Yongxiang, who is also v…     

构建国家工程研究中心国有资本营运与监管体系

为促进科技成果转化,加速形成民族高科技产业,重构国家创新系统,“八五”期间国家计委会同有关部门实施了国家工程研究中心计划。在深化科技体制改革的今天,转换经营机制,建立现代企业制度是国家工程研究中心发展的必然选择。在规范运作过程中,如何实现国家工程研究中心国有资本保全和增值是其中的关键性问题之一。本文在充分分析了原有国有资产管理体制的缺陷后,构建了高校国家工程研究中心国有资本营运与监管体系。     

能力导向（CBA）视角下的大学教学评价体系

能力导向评价（CBA）源于工作领域对于大学毕业生的能力预期,这种能力是专业知识、技能和态度的有机融合,因此,能力导向的教学评价方式能够对大学生综合能力的提升提供有力的支持。近年来,国外出现了基于能力导向的教学评价方式的理论研究,其中,目标体系及其有效性的判断标准是相关研究的关注焦点,同时,该系统运作的策略和流程对于指导我国大学的教学评价具有一定的现实意义。     

新形势下国家竞争情报体系建设的原则

本文通过对国家竞争情报体系的内容和含义的分析和主要发达国家的竞争情报体系建设概况的介绍，讨论了建设我国竞争情报体系的意义和原则。     

英国国家健康研究院的管理创新分析和思考

通过对英国国家健康研究院的深入剖析,总结提炼在管理和机制建设方面的特色和创新点,为我国科技计划管理改革提供指导和借鉴。