Health Damage of Air Pollution: An Estimate of a Dose–Response Relationship for the Netherlands

This paper estimates the dose-response relationship between air pollution and the number of work loss days for the Netherlands. The study is based on illness data (work loss days) for the Dutch labour population and average year concentrations of air pollution in 29 districts. The dose-response relationship has been estimated by means of two different techniques: the ordinary least squares method (OLS) and the one-way fixed-effects method (OWFEM), which we consider to be more adequate. In general health effects are much smaller when OWFEM is applied than if OLS is used. With OWFEM a significant relationship is found between sulphate aerosol (SO₄), ammonia (NH₃) and the number of work loss days (WLDs). Particulates (TSP), O₃ and SO₂ have no significant effect on the number of WLDs. These results differ from those obtained in studies in the United States, which indicate that particulates (TSP) and other small particles, ozone (O₃) and to a lesser extent SO₄ and SO₂ significantly influence the number of WLDs.     

浅析农村妇女在婚姻家庭中土地财产权益及法律保护

土地是农民生存和发展的根基,土地问题是解决当前"三农"即农村、农业、农民问题的核心.土地制度的建立完善和实施直接关系到国家农业产业的发展和农村社会、经济秩序的稳定.农村妇女由于传统习惯和文化素质的影响对土地的依赖性更强,所以对农村妇女土地权益的保护更为重要.《婚姻法》修正后对夫妻财产制度作了许多新的规定,特别是第39条第2款,"夫或妻在家庭土地承包经营中享有的权益等,依法应当予以保护"的规定,是婚姻法对夫妻财产制度的一个新的突破.目前,农村妇女土地权益受侵害的现象比较严重和突出,在一定程度上扰乱了农村的经济秩序和社会秩序,因此,关注农村妇女权益保护,对解决农村妇女土地承包权问题是非常必要的.     

2017年北京社区卫生服务中心处方集中点评结果

目的汇总分析北京市16个区县近100家社区卫生服务中心处方抽样点评的结果,比较各区之间的差异,细化点评结果,促进全市合理用药。方法抽取2017年6月第2周,全门诊不包括草药处方,共计50189张处方,进行精细化集中点评。结果2017年北京16个区县社区卫生服务中心平均处方金额为160.07元,注射剂使用率为5.56%,全部基本药物占比为68.29%,处方的不合理率为8.8%。结论对于北京市社区卫生服务中心门诊处方集中点评最应改进的为统一点评标准,其次还应完善处方管理,强化药剂师自身的业务学习.     

A review and validation of overall survival extrapolation in health technology assessments of cancer immunotherapy by the National Institute for Health and Care Excellence: how did the initial best estimate compare to trial data subsequently made available?

Background: Validation of overall survival (OS) extrapolations of immune-checkpoint inhibitors (ICIs) during the National Institute for Health and Care Excellence (NICE) Single Technology Assessment (STA) process is limited due to data still maturing at the time of submission. Inaccurate extrapolation may lead to inappropriate decision-making. The availability of more mature trial data facilitates a retrospective analysis of the plausibility and validity of initial extrapolations. This study compares these extrapolations to subsequently available longer-term data.

Methods: A systematic search of completed NICE appraisals of ICIs from March 2000 to December 2017 was performed. A targeted search was also undertaken to procure published OS data from the pivotal clinical trials for each identified STA made available post-submission to NICE. Initial Kaplan-Meier curves and associated extrapolations from NICE documentation were extracted to compare the accuracy of OS projections versus the most mature data.

Results: The review identified 11 STAs, of which 10 provided OS data upon submission to NICE. The extrapolations undertaken considered parametric or piecewise survival models. Additional data cut-offs provided a mean of 18 months of OS beyond the end of the original data. Initial extrapolations typically under-estimated OS from the most mature data cut-off by 0.4–2.7%, depending on the choice of assessment method and use of the manufacturer- or ERG-preferred extrapolation.

Conclusion: Long-term extrapolation of OS is required for NICE STAs based on initial immature OS data. The results of this study demonstrate that the initial OS extrapolations employed by manufacturers and ERGs generally predicted OS reasonably well when compared to more mature data (when available), although on average they appeared to underestimate OS. This review and validation shows that, while the choice of OS extrapolation is uncertain, the methods adopted are generally aligned with later-published follow-up data and appear appropriate for informing HTA decisions.     

Definitions and progress of ecosystem health and ecological security

1. Introduction Development of human industrial civilization and predatory exploitation of natural resources have in- duced tremendous changes of ecological environment. In recent years, territorial and global environmental problems have increased, such as greenhouse effect, depletion of ozone, global warming, water scarcity, water pollution, acid rain, decrease of biodiversity, soil erosion desertification etc. These changes seriously intimidate the health and security of ecosystems, and dist…     

基于风景健康的海南省自贸区人居环境 空间研究

海南经过30年的经济特区建设已正式迈入自贸区建设的新时代，所面临的地区发展与生态维育矛盾逐步加剧。为保育海南优良的生态品质，提升海南人居环境空间质量，基于“健康、生态、人居”三元耦合与互动多赢的发展关系，提出与之适宜的风景园林健康理论；结合前人经验，以人居环境空间规划为切入点，解析人居环境空间研究内容。运用ArcGIS 10.2.2空间分析和Fragstats 4.2景观格局分析，解析海南省域三生空间敏感性、资源利用效率可持续性，以及资源服务范围与开发建设空间适宜性，结合人居环境空间发展特征，提出从全岛国土空间、资源统筹和空间营造3个方面进行规划引导，并提出以下观点：1)人类活动对资源环境和空间利用的合理性是有效保障海南人居环境空间的前提基础；2)遵循风景园林健康理论指导的全域国土空间规划、资源统筹规划和空间营造规划是提升海南人居环境空间的根本路径；3)“健康、生态、人居”三元耦合和互动多赢的关系均衡与协调是提升海南人居环境空间的终极目标。     

台湾全民健康保险财务危机论析

台湾全民健康保险自1995年实施至今已经取得了显著的成效,民众的健康有了基本的保障.但是,台湾健保也面临着严重的财务问题,至今已经爆发了三次财务危机.本文从台湾健保的管理制度、财务收入制度和财务支出制度等方面对其财务危机进行了分析,并总结出它为完善我国大陆健康保险制度提供的借鉴意义.     

浅谈少数民族地区的刑法适用

我国是一个统一的多民族国家,根据各民族政治、经济、文化各方面的特点,以及少数民族同胞的居住特点和不同的风俗习惯,结合我国少数民族地区刑法适用应遵循的思想原则,提出我国少数民族地区变通适用刑法应当考虑的几个问题.     

美国公共预算改革的途径:管理、政治和法律

公共预算是通过分配有限资源来实现人类各种不同目的的公共行政活动,目前是公共行政的核心所在。为解决如何分配资源的问题,美国公共预算领域产生并发展了多种预算研究途径,戴维.H.罗森布鲁姆将它们归纳为管理途径、政治途径与法律途径。本文试图从该视角入手,以此对美国公共预算改革进行历史的回顾,探析公共预算改革的发展趋势,从而阐明在实践中运用各种预算理论解决不同预算问题的可行性和必要性。     

Law without justice: The dilemmas of formalization and fairness in the legalistic organization

There is growing evidence of a litigation mentality rampant in organizations, which has created a legalistic mindset in many managers. Increasingly, managerial decisions are becoming dominated by a concern for what is legally defensible at the expense of broader social considerations such as justice and fairness. The papers in this special issue explore how this legalistic mindset has created new organizational and social dilemmas, and situations of law whithout justice.