我国农作物秸秆综合利用产业促进政策研究

［目的］深入地分析了我国秸秆综合利用产业现行促进政策，阐述了存在的主要问题，并提出针对性解决方法，以期为促进秸秆综合利用政策体系建设提供政策建议。［方法］按照法律法规、目标引导和考核、财税补贴、技术研发和推广、信息统计等进行分类，综合评述各类现行政策的特点、使用范围和有效性，并采用相关者利益分析等方法分析存在问题，提出政策建议。［结果］随着我国秸秆露天焚烧问题日益突出，国家加大了对秸秆综合利用重视的程度，出台一系列关于秸秆综合利用等方面的法律、法规和激励政策等，初步构建了秸秆综合利用政策体系，呈现出聚焦关键环节、关键技术和重点地区的趋势。但是，还存在着政策的有效性有限，未形成合力； 农民参与度低； 使用环节缺乏激励政策等问题。［结论］建议出台区域生态补偿制度，落实耕地地力保护补贴政策，鼓励终端产品使用和消费等政策。     

Healthcare resource utilization by patients with treatment-refractory myasthenia gravis in England

Aims: To examine healthcare resource utilization associated with refractory myasthenia gravis (MG) in England.

Materials and methods: This was a retrospective cohort study of linked data from the Clinical Practice Research Datalink and the Hospital Episode Statistics database collected between 1997 and 2016. Included patients were ≥18?years of age at the index MG diagnosis. Patients with refractory MG were identified using an algorithm based on treatments received. Healthcare resource utilization since the index date was compared between refractory and non-refractory cohorts.

Results: The study included 1149 patients with MG, of whom 66 (5.7%) were refractory. Sex and age at diagnosis did not significantly differ between the refractory and non-refractory cohorts. Rates of healthcare resource utilization per person-year were significantly higher (p?p?Limitations: The algorithm for identifying refractory patients did not include clinical criteria. Also, treatments administered in hospitals or by specialists were not available in the databases.

Conclusions: Patients in England with refractory MG more often visit healthcare providers, are hospitalized and visit an emergency room than patients with non-refractory MG.     

基于SWOT-AHP的工业仓储用岛开发利用策略研究——以舟山群岛新区为例

本文采用SWOT分析法对舟山工业仓储用岛开发利用的优势、劣势、机遇和挑战进行定性分析,再通过AHP法进行定量分析,构建SWOT-AHP模型。通过计算舟山工业仓储用岛开发利用策略四边形,确定舟山工业仓储用岛开发利用应选择开拓型战略,即发挥自身优势、抓住外部机遇。     

Resource utilization and charges of patients with and without diagnosed venous thromboembolism during primary hospitalization and after elective inpatient surgery: a retrospective study

Aims: To assess incremental charges of patients experiencing venous thromboembolisms (VTE) across various types of elective inpatient surgical procedures with administration of general anesthesia in the US.

Methods: The authors performed a retrospective study utilizing data from a nationwide hospital operational records database from July 2014 through June 2015 to compare a group of inpatients experiencing a VTE event post-operatively to a propensity score matched group of inpatients who did not experience a VTE. Patients included in the analysis had a hospital admission for an elective inpatient surgical procedure with the use of general anesthesia. Procedures of the heart, brain, lungs, and obstetrical procedures were excluded, as these procedures often require a scheduled ICU stay post-operatively. Outcomes examined included VTE events during hospitalization, length of stay, unscheduled ICU transfers, number of days spent in the ICU if transferred, 3- and 30-day re-admissions, and total hospital charges incurred.

Results: The study included 17,727 patients undergoing elective inpatient surgical procedures. Of these, 36 patients who experienced a VTE event were matched to 108 patients who did not. VTE events occurred in 0.2% of the study population, with most events occurring for patients undergoing total knee replacement. VTE patients had a mean total hospital charge of $60,814 vs $48,325 for non-VTE patients, resulting in a mean incremental charge of $11,979 (p?<?.05). Compared to non-VTE patients, VTE patients had longer length of stay (5.9 days vs 3.7 days, p?<?.001), experienced a higher rate of 3-day re-admissions (3 vs 0 patients) and 30-day re-admissions (7 vs 2 patients).

Conclusions: Patients undergoing elective inpatient surgical procedures with general anesthesia who had a VTE event during their primary hospitalization had a significantly longer length of stay and significantly higher total hospital charges than comparable patients without a VTE event.     

基于经济新常态的长春市水资源开发利用潜力评价

以长春市为研究对象,基于未来经济处于新常态的发展态势,构建包含水资源、社会、经济、生态环境4个子系统的评价指标体系,并确定各指标的评价等级标准;基于模糊数学理论以及层次分析法构建包括目标层、准则层、指标层的3层模糊综合评价模型,以2015年为现状水平年,应用模型对长春市水资源开发利用潜力进行综合评价。结果表明:长春市水资源开发利用程度处于中等偏上水平,各辖区水资源开发利用规模不平衡,可通过产业结构调整提高全市用水效率,为经济持续增长提供保障。     

面源污染视角下江西省耕地利用效率研究

[目的]在面源污染视角下考察耕地利用效率,可以为推动耕地可持续利用提供理论和参考依据。[方法]文章基于2000—2014年我国13个粮食主产省(区)耕地投入产出的面板数据,运用SBM方向性距离函数将耕地面源污染因素纳入到传统的效率分析框架,从省际比较的维度对江西省耕地利用效率进行了测度与分析。[结果]考虑面源污染因素对耕地利用效率测算产生了一定的影响;江西省耕地利用效率值呈现阶段性特征,耕地利用效率排名比较稳定,近年来排名有上升趋势;江西省耕地利用绩效一般,且与最佳实践者存在较大的差距。[结论]忽视面源污染因素的耕地利用效率评估是失真和不符合实际的,宜将面源污染因素纳入到耕地利用效率的测度框架,以此来更科学地量化评估耕地利用绩效;设计和完善相关政策,以有效控制耕地面源污染;加强与先进省(区)的交流与合作,学习其农业可持续耕作技术与管理经验,进一步推动江西省耕地产出与资源、环境协调发展。     

Advancing environmental productivity: Organizational mindfulness and strategies

This study investigates the importance of mindfulness‐based organization systems and policies on the organization's continuous efforts to become a greener company. The study is devised as a pooled cross‐sectional time series analysis of productivity in energy consumption, water utilization, and waste generation and recycling of U.S. companies. The data set taken from U.S. Newsweek 500 recorded 600 companies dispersed into 63 industries during the period of 2012–2014 and provided 1,498 company–industry–year observations. The study found that systems and policies (e.g., deployment of third‐party auditors for its environmental metrics report; linkage of the remuneration of company's senior executive team with the achievement of environmental performance targets; and establishment of a committee at the Board of Directors' level whose mandate includes sustainability of the company in environment‐ and resource‐related matters) connect the company's mindfulness to its effort in improving the environmental quality through the company's productivity in energy consumption, water utilization, and waste generation and recycling. The relationships are positive and significant. Also, systems and policies serve as a motivator for the firm to continue to improve upon the current achievements. The study emphasizes the importance of translating organizational and individual mindfulness into organization policies and systems in order to motivate the organization to continuously improve its productivity in energy consumption, water utilization, and waste generation and recycling leading to improvements in environmental quality.     

中国耕地资源利用的碳排放时空特征及脱钩效应研究

研究目的:揭示中国耕地资源利用的碳排放时空分异规律及其与农业经济增长之间的脱钩关系,以期为中国耕地资源低碳化利用政策的制定和推行提供参考。研究方法:IPCC碳排系数法,TAPIO脱钩分析法。研究结果:(1)中国耕地资源利用的碳排放整体上呈现增长趋势,但2010年后增速趋于下降并于2016年开始转入负增长,省际差异不断扩大的同时区域间差异趋于缩小;(2)中国耕地资源利用的碳排放强度总体上处于下降态势,省际和区域间碳排放强度的差异总体上趋于缩小;(3)中国耕地资源利用的不同碳排放源的碳排放量及增速呈现不同的时序波动特征,同时存在明显的地域差异性,其中,化肥是最主要碳排放源;(4)中国2000—2012年耕地资源利用的碳排放与农业经济增长之间呈现以"弱脱钩"为主,但2013—2017年不同省域的脱钩类型及脱钩程度趋于差异化。研究结论:中国耕地资源利用碳排放的时空分异性显著,且与农业经济增长之间不同阶段和不同省域呈现不同脱钩类型,需突出减排重点、实施差异化策略及注重绿色发展等多途径推进耕地资源低碳化利用,提高政策的精准性。     

Association between provider specialty and healthcare costs and glycemic control for patients with diabetes

Aims: To analyze the association between provider, healthcare costs, and glycemic control for patients with diabetes mellitus (DM).

Materials and methods: This cross-sectional study identified adults with type 1 or 2?DM (T1D, T2D) in the Optum database. The main independent variable was provider (endocrinologist or primary care). Regression analysis compared total medical and pharmacy costs, adjusting for health status and other patient differences, by provider.

Results: For all patients, HbA1C improvement was greater, and medical costs significantly lower with an endocrinologist rather than a primary care provider. The largest HbA1C improvement (4%) occurred for insulin-dependent patients seen by endocrinologists. Significant medical savings with endocrinologist management occurred within the Medicare Advantage population in every sub-group of patients, with 14% lower costs ($4,767) for patients with T1D, 11% lower costs ($3,160) for patients with macro- and microvascular complications, and 10% lower costs ($2,237) for insulin-dependent patients. Within the commercial insurance population, medical costs were reduced by ≥9% in every sub-group of patients, with a 20% reduction ($8,450) for patients with micro- and macrovascular complications. Overall total costs (medical and pharmacy) were 8% ($1,541) higher for patients receiving endocrinologist rather than primary care, although endocrinologist care resulted in a 9% reduction (–$3,710) in costs for Medicare Advantage patients with T1D. Total medical costs (excluding pharmacy costs) may be a more accurate indicator of costs associated with patients in various stages of DM.

Limitations: There was insufficient data to develop risk-adjustment payments for pharmacy costs based on disease severity. The cross-sectional design identifies associations and not cause–effect relationships.

Conclusion: DM management by an endocrinologist was associated with greater HbA1C improvement and significantly lower medical costs. Total costs were higher with an endocrinologist, but for patients with T1D lower costs were seen, ranging from 2–9% regardless of insurance type.