Analysis of factors influencing the outpatient workload at Chinese health centres

<p>Abstract</p> <p>Background</p> <p>Although the community health service system is now established in China, the utilisation of the community health service institutions is low due to the lack of a gate-keeping role of the primary health service providers and referrals among the three-tiered health service institutions. In addition to this, patients who can afford to pay, often seek best services in big hospitals to guarantee the quality of care. Thus, the need of guiding the patients to the community health services and increasing the utilisation of the community health service institutions is becoming an urgent problem, which hinders the future development of community health services. This study focuses on the question of how to increase the utilisation of Chinese community health centres (HCs).</p> <p>Methods</p> <p>A cross-sectional Base-line Survey of Chinese City Community Health Service System Building using the multi-staged cluster sampling was conducted to collect data from all HCs in 28 key contact cities. Relevant indicators of totally 1790 HCs were analysed. The statistical methods included ANONVA and logistic regression.</p> <p>Results and Conclusions</p> <p>The analysis suggested several key factors for increasing the outpatient workload (OW) at the HCs: establishing an adequate referral system among the different levels of the health system; enhancing the qualification of health personnel and increasing the compensation by the health insurance for services provided at HCs. Other key factors with a positive effect on the OW included: the government ownership of the HCs, the scale of the institutions, the medical equipment used, the mix of health services provided, and the women in childbearing age in the residence.</p

Foresight in a research institution: a critical review of two exercises

Foresight is a powerful tool for imagining possible futures, for raising public awareness, for helping decision-making and addressing questions related to the relationship between science and society. In this article we make a critical analysis of two foresight exercises organized by a research institution. A precise description of the exercises conducted on the futures of the cocoa commodity chain and the hevea commodity chain helps to understand the possible processes of a foresight exercise, what foresight can achieve and what kinds of difficulties can occur. From these experiences, proposals are made to facilitate the development of strategic intelligence in a research institution and improve the linkages between foresight, evaluation and programme formulation. The role of foresight in transforming knowledge and in pushing a closed system into a political arena is also shown. Copyright © 2003 John Wiley & Sons, Ltd.

NGC 3628: ejection activity associated with quasars

SIGLEAvailable from: http://www.mpa-garching.mpg.de / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekDEGerman

LMC N113 and N159W ALMA para-H_2_CO datacubes

We mapped the kinetic temperature structure of two massive star-forming regions, N113 and N159W, in the Large Magellanic Cloud (LMC). We have used ∼1.6" (∼0.4pc) resolution measurements of the para-H2CO JKaKc=303-202, 322-221, and 321-220 transitions near 218.5GHz to constrain RADEX non local thermodynamic equilibrium models of the physical conditions. The gas kinetic temperatures derived from the para-H2CO line ratios 322-221/303-202 and 321-220/303-202 range from 28 to 105K in N113 and 29 to 68K in N159W. Distributions of the dense gas traced by para-H2CO agree with those of the 1.3mm dust and Spitzer 8.0um emission, but they do not significantly correlate with the H emission. The high kinetic temperatures (Tkin≳50K) of the dense gas traced by para-H2CO appear to be correlated with the embedded infrared sources inside the clouds and/or young stellar objects in the N113 and N159W regions. The lower temperatures (Tkin<50K) were measured at the outskirts of the H2CO-bearing distributions of both N113 and N159W. It seems that the kinetic temperatures of the dense gas traced by para-H2CO are weakly affected by the external sources of the Hα emission. The non thermal velocity dispersions of para-H2CO are well correlated with the gas kinetic temperatures in the N113 region, implying that the higher kinetic temperature traced by para-H2CO is related to turbulence on a ∼0.4pc scale. The dense gas heating appears to be dominated by internal star formation activity, radiation, and/or turbulence. It seems that the mechanism heating the dense gas of the star-forming regions in the LMC is consistent with that in Galactic massive star-forming regions located in the Galactic plane

"Opening up" and "closing down" power, participation, and pluralism in the social appraisal of technology

Discursive deference in the governance of science and technology is rebalancing from expert analysis toward participatory deliberation. Linear, scientistic conceptions of innovation are giving ground to more plural, socially situated understandings. Yet, growing recognition of social agency in technology choice is countered by persistently deterministic notions of technological progress. This article addresses this increasingly stark disjuncture. Distinguishing between appraisal and commitment in technology choice, it highlights contrasting implications of normative, instrumental, and substantive imperatives in appraisal. Focusing on the role of power, it identifies key commonalities transcending the analysis/participation dichotomy. Each is equally susceptible to instrumental framing for variously weak and strong forms of justification. To address the disjuncture, it is concluded that greater appreciation is requiredin both analytic and participatory appraisalto facilitating the opening up (rather than the closing down) of governance commitments on science and technology

DUNES survey observational results

VizieR online Data Catalogue associated with article published in journal Astronomy &amp; Astrophysics with title 'DUst around NEarby Stars. The survey observational results.' (bibcode: 2013A&amp;A...555A..11E