补齐医疗废物和危险废物收集处理短板的思考和建议

为推动落实中共中央政治局会议提出的“加快补齐医疗废物、危险废物收集处理设施方面短板”有关指示精神,推进危险废物环境管理领域治理体系和治理能力现代化,结合全国医疗废物、危险废物环境管理情况以及新型冠状病毒肺炎疫情防控期间医疗废物应急处置情况,通过数据分析和政策文件系统梳理,识别出医疗废物、危险废物收集处置短板,并提出相应的对策建议.结果表明,目前仍存在医疗废物收集处置和管理有待加强、医疗废物应急处置能力薄弱、危险废物利用处置能力不匹配不均衡、集中处置区域合作和跨省（区、市）协同有待探索、处置产业有待升级发展等问题.建议编制实施全国医疗废物和危险废物收集处理设施建设规划,提升医疗废物环境管理和应急响应能力,提升医疗废物、危险废物调查评估和监管信息化能力,统筹建立健全多层次的危险废物处置设施体系,推动利用处置技术优化升级,通过加强顶层设计,聚焦重点领域,推进医疗废物危险废物补短板工作.      

沙区沙化土地封禁保护补偿标准的估算——最小数据方法在甘肃省民勤县的运用

论文以甘肃省民勤县沙化土地封禁保护实践工作为研究背景,运用最小数据方法,估算了激励沙区农户将沙化耕地自愿转化为封禁土地的生态补偿（封禁补偿）标准。以水资源服务表征土地管理方式转变之后的生态系统服务产出,由调查获得的农户机会成本推导出了水资源服务供给曲线,并计算出了封禁补偿标准与土地转化比例、水资源服务供给量之间的定量关系。研究结果表明：1）实施封禁补偿,可激励农户改变沙化耕地利用方式,减少农业用水需求量,增加生态用水供给量,对民勤和石羊河流域生态保护意义重大;2）民勤县规划封禁保护区总面积为1.55万hm²,期望水资源服务产出为1.02亿m³,需要按照19 770元·hm^-2的标准补偿才能激励农户实现这一政策目标;3）以新一轮退耕还林补偿标准3 600元·hm^-2为参照线,只能促使3.51%的沙化耕地转化为封禁土地,在设计封禁补偿机制时,需要提高封禁补偿标准。     

关于完善《中华人民共和国基本医疗卫生与健康促进法（草案三次审议稿）》的思考与建议:基于劳动力健康视角

基于劳动力健康视角,研究近期公开征求意见的《中华人民共和国基本医疗卫生与健康促进法(草案三次审议稿)》,为进一步完善提供技术支撑。依据循证决策的原理,针对法律草案的相关内容,梳理研究涉及劳动力人群和职业健康的国内外法律和实践。研究结果表明:保障劳动力健康的有关表述,在法律草案的总则、基本医疗卫生服务、医疗卫生机构、医疗卫生人员、健康促进5章仍需要强化,为此提出了14条具体建议和修改意见。     

Development of urban planning guidelines for improving emergency response capacities in seismic areas of Iran

This paper presents the results of research carried out to improve emergency response activities in earthquake-prone areas of Iran. The research concentrated on emergency response operations, emergency medical care, emergency transportation, and evacuation—the most important issues after an earthquake with regard to saving the lives of victims. For each topic, some guidelines and criteria are presented for enhancing emergency response activities, based on evaluations of experience of strong earthquakes that have occurred over the past two decades in Iran, notably Manjil (1990), Bam (2003), Firouz Abad-Kojour (2004), Zarand (2005) and Broujerd (2006). These guidelines and criteria are applicable to other national contexts, especially countries with similar seismic and social conditions as Iran. The results of this study should be incorporated into comprehensive plans to ensure sustainable development or reconstruction of cities as well as to augment the efficiency of emergency response after an earthquake.     

肺炎疫情期间医护人员心理危机干预效果分析

为提升医护人员心理健康水平,该文对肺炎疫情期间医护人员实施心理危机干预并分析其效果,以参与2020年1月25日-2月25日湖北省武汉市新冠肺炎疫情期间救治工作的300名医护人员作为研究对象,平均划分为实验组和对照组,其中针对实验组实施统一的心理危机干预训练,此期间对照组未参与训练但日常生活与实验组统一,选取四种量表分别对干预前后的两组实施测评。测评结果表明,干预后实验组的SCL-90各因子得分、SDS得分及SAS得分较干预前均下降明显,且下降幅度超过对照组;实验组干预后的GQOLI总得分与各维度得分均较干预前显著升高,且升高幅度高于对照组。综上,心理危机干预可显著提升医护人员的心理健康水平,缓解其心理紧张等症状,能够在一定程度上降低肺炎疫情期间医护人员的心理危机感。     

突发性灾难重大事件后公众对心理服务的认知和需求

为分析突发性灾难重大事件发生后公众对心理服务的认知和需求现状,采用随机抽样的方法在全国范围内抽取458名群众作为被试,使用“突发性灾难重大事件后公众心理服务认知和需求”调查问卷进行调查。结果显示:①不同性别人群、不同年龄阶段人群对“突发性灾难重大事件后心理服务”的认知存在显著差异(X^2=9.82,p<0.05;X^2=33.99,p<0.05)。②不同年龄阶段的人群对民众开展心理服务的必要性态度存在显著差异(X^2=15.84,p<0.05)。不同文化程度人群、不同性别人群对突发性灾难重大事件后心理服务活动的参与意愿存在显著差异(X^2=7.20,p<0.05;X^2=6.78,p<0.05)。③不同文化程度人群对心理服务知识和技能需求存在显著差异(X^2=28.65,p<0.05),在接受心理服务场所的选择上也存在显著差异(X^2=16.44,p<0.05)。不同年龄阶段人群对接受心理服务场所的选择上存在显著差异(X^2=21.52,p<0.05)。分析结果显示:在遭受突发性灾难重大事件时,公众对心理服务的了解程度一般,但参与意愿和需求强烈,因此,国家和社会应加快社会心理服务体系的建设,促进公众的心理健康。     

Effects of Dram Shop,Responsible Beverage Service Training,and State Alcohol Control Laws on Underage Drinking Driver Fatal Crash Ratios

Objectives: In this study, we aimed to determine whether three minimum legal drinking age 21 (MLDA-21) laws—dram shop liability, responsible beverage service (RBS) training, and state control of alcohol sales—have had an impact on underage drinking and driving fatal crashes using annual state-level data, and compared states with strong laws to those with weak laws to examine their effect on beer consumption and fatal crash ratios.

Methods: Using the Fatality Analysis Reporting System, we calculated the ratio of drinking to nondrinking drivers under age 21 involved in fatal crashes as our key outcome measure. We used structural equation modeling to evaluate the three MLDA-21 laws. We controlled for covariates known to impact fatal crashes including: 17 additional MLDA-21 laws; administrative license revocation; blood alcohol concentration limits of.08 and.10 for driving; seat belt laws; sobriety checkpoint frequency; unemployment rates; and vehicle miles traveled. Outcome variables, in addition to the fatal crash ratios of drinking to nondrinking drivers under age 21 included state per capita beer consumption.

Results: Dram shop liability laws were associated with a 2.4% total effect decrease (direct effects: β =.019, p =.018). Similarly, RBS training laws were associated with a 3.6% total effect decrease (direct effect: β =.048, p =.001) in the ratio of drinking to nondrinking drivers under age 21 involved in fatal crashes. There was a significant relationship between dram shop liability law strength and per capita beer consumption, F (4, 1528) = 24.32, p <.001, partial η² =.016, showing states with strong dram shop liability laws (Mean (M) = 1.276) averaging significantly lower per capita beer consumption than states with weak laws (M = 1.340).

Conclusions: Dram shop liability laws and RBS laws were both associated with significantly reduced per capita beer consumption and fatal crash ratios. In practical terms, this means that dram shop liability laws are currently associated with saving an estimated 64 lives in the 45 jurisdictions that currently have the law. If the remaining 6 states adopted the dram shop law, an additional 9 lives could potentially be saved annually. Similarly, RBS training laws are associated with saving an estimated 83 lives in the 37 jurisdictions that currently have the laws. If the remaining 14 states adopted these RBS training laws, we estimate that an additional 28 lives could potentially be saved.     

Are ecosystem service hotspots located in protected areas? Results from a study in Southern Italy

Ecosystems are essential in providing multiple services to society. However, understanding ecosystem services (ESS) in terms of spatial distribution and trade-offs still remains a challenge for landscape planners and natural resource managers. In this paper, we analyzed the supply of a set of ESS – carbon storage, soil erosion protection, biodiversity, and recreation – within the landscape surrounding the city of Bari in Southern Italy. Through an analysis of this landscape, which includes natural protected areas, such as Natura 2000 Network sites, national and regional parks and nature reserves, and in view of the recent Fitness Check of the Nature Directives, we aimed to provide answers to the following questions: (i) Where are the areas of high and low supply of individual ecosystem services located?; (ii) Where do ecosystem service trade-offs (i.e., ‘hotspots’ and ‘coldspots’) occur?; and (iii) To what extent are ecosystem service hotspots and coldspots located within or outside of natural protected areas? Results show that most of the landscape in the study area supplied at least one of the selected ESS and that ESS hotspots were mostly located within forested and/or natural areas. Hotspots occupied 8.0% of the total landscape, with 23.7% located in natural protected areas. Coldspots were scarce and equal to 2.4%; they constituted only 0.1% of natural protected areas. Almost all of the landscape (89.6%) consists of intermediate areas (i.e., between hotspots and coldspots); 76.2% of natural protected areas consists of intermediate areas. This latter finding is relevant because the high intermediate classes are potentially high-performing areas, which lie mainly on the borders of protected spaces; they can positively influence ecological processes and thus enhance a wide-ranging provision of ESS. Our results highlight the importance of analyzing landscapes to facilitate the selection of priority areas where management efforts would yield maximum benefits.     

医用输液生产中药品安全隐患分析及对策

针对医用输液生产中易受到异物污染、存在安全隐患的现状,分析安全隐患产生的主要环节及成因。当前生产中普遍采用的人工灯检方法,由于劳动强度大、工人易疲劳,并不能从源头上完全杜绝含有异物微粒的输液进入临床。为此,提出利用机器视觉技术对输液中异物微粒进行在线自动检测的解决方案。首先建立输液中异物粒子的运动轨迹数学模型;然后提取输液视觉图像序列中每个可能目标的有效特征,通过特征匹配和轨迹关联进行甄别检测;最后对视觉系统进行标定,确定检测到的异物微粒的粒径大小及微粒数量。实验表明,该技术对输液中微小异物检出确率达95%以上,能从源头上有效避免医用输液生产中异物污染。     

构建促进循环经济型服务业发展的保障体系

循环经济是促进可持续发展的重要手段,服务业近年来在我国发展迅速,由此造成的环境问题也日见突出,用循环经济的理念对服务业进行引导显得很有意义。发展循环型经济、建立循环型社会是实施可持续发展战略的重要途径和实现形式。本文剖析了我国在发展循环经济型服务业方面诸多应改进和进行创新的内容,利用循环经济的理论从行政、法律、经济、社会等方面探讨了循环经济型服务业建设实施的保障体系,为服务业按循环经济的规律运行作了有益的探索。