'Designing Better Health Care in the South': A Case Study of Unsuccessful Transformational Change in Public Sector Health Service Reform

This article presents a case study of a project known as 'Designing Better Health Care in the South' that attempted to transform four separately incorporated health services in southern Adelaide into a single regional health service. The project's efforts are examined using Kotter's (1996) model of the preconditions for transformational change in organisations and the areas in which it met or failed to meet these preconditions are analysed, using results from an evaluation that was commenced during the course of the attempted reform. The article provides valuable insights into an attempted major change by four public sector health organisations and the facilitators and barriers to such change. It also examines the way in which forces beyond the control of individual public sector agencies can significantly impact on attempts to implement organisational change in response to an identified need. This case study offers a rare glimpse into the micro detail of health care reform processes that are so widespread in contemporary health services but which are rarely systematically evaluated.     

奥运安全与流动人口犯罪--流动人口犯罪的发展趋势与防控策略

本文预断,受奥运筹办工作的影响,流动人口犯罪的数量将会增长,犯罪的类型也将增多.对流动人口犯罪,我们应冷静对待,理性地分析原因、探讨合理对策;应采取切实有效措施保护流动人口的正当权益;应把犯罪机会的减少、控制作为流动人口犯罪防控的重点.     

人肺癌中TNF-α基因多态性分布的意义及其对细胞凋亡的影响

目的:观察TNF-α基因启动子区-308位核苷酸多态性基因型在肺癌和对照人群中的分布,以及这种多态性对该基因表达和细胞凋亡的影响。方法:PER-RFLP分析112例肺癌和99例正常人的TNF-α基因启动子区-308位核苷酸多态性,TNF-α-308*G等位基因记做TNF-α1,TNF-α-308*A等位基因记做TNF- α2。免疫组织化学方法检测肺癌组织中TNF-α的表达,比较不同基因型肺癌病例的标本之间TNF-α基因表达的差异性。TUNEL法检测肺癌组织中细胞凋亡,并对比分析TNF-α-308位核苷酸多态性及其对肺癌组织中TNF -α表达和不同类型细胞凋亡的影响。结果:肺癌组与对照组的基因型分布为TNF-α1/1(52．7％、46．5％)。 TNF-α1/2(35．7％、48．5％),TNF-α2／2(11．6％、5．1％);等位基因频率为TNF-α1(70．5％、70．7％),TNF- α2(29．5％、29．3％),组间没有显著性差异,P>0．05。两种基因型个体在TNF-α基因表达上,TNF-α2/2基因型个体高于TNF-α1／1基因型的个体,两者差异显著,P<0．01。TNF-α表达的高低与癌细胞凋亡有比较明确的关系,TNF-α表达高的病例,肺癌细胞凋亡也多,与表达低的病例之间有明显差异,P<0．01。TNF-α表达的高低与间质细胞凋亡之间没有明确的关系。间质细胞平均凋亡指数在高、低分化的肺癌中分别为3．4±0．4和 3．1±0．5,组间没有显著性差异,P>0．015;癌细胞的平均凋亡指数在高、低分化的肺癌中分别为2．4±0．3和 1．7±0．4,两组间有显著性差异,P<0．05,,结论:TNF-α-308位核苷酸的多态性基因型在肺癌和正常人中的分布之间没有明显差别,这种多态性可能不是肺癌易感的遗传因素。但这种多态性与该基因的表达有关。TNF-α高表达肺癌细胞凋亡较多,间质细胞凋亡与TNF-α表达的高低变化之间没有明确的关系。在高分化的肺癌中, TNF-α表达较高,癌细胞凋亡也多,TNF-α-308位核苷酸的多态性可能与了肺癌的分化有关。     

Recent Developments to British Multicultural Theory,Policy and Practice: The Case of British Muslims

Since the early 1970s, there have been highly sophisticated arguments and conceptual discussions put forward in relation to how Western liberal democracies might wish to manage their diverse ethnic minority populations. It is apparent, however, that in the current climate, the important principles of unity and diversity are insufficient to challenge differing forms of ethnic, racial, and religious inequality. This paper argues that because of its underlying assumptions and modus operandi in the post-September 11 climate, British multiculturalism has been ineffective, even supporting some commentators' suggestions of a return to assimilationism. There is a new era in post-September 11 political hegemony, economic determinism and structural and cultural racisms, with European government rhetoric and public policy almost exclusively aimed at Muslims—whether as existing citizens or as part of a process of limiting immigration (which has tended to be from mainly Eastern European, North African, and Middle Eastern sending regions and nations). The example of New Labour and how it has attempted to deal with multiculturalism in Britain is a case in point. The discussion explores the changing concept of multiculturalism with special reference to British Muslims and debates that emerge in relation to identity, nation and civil society. It is argued that the experience and treatment of British Muslims is important to explore and appreciate in the current climate as it provides a test case for the future of (a) British multiculturalism and (b) British Muslims in society per se.     

小微企业和谐劳动关系构建的财政扶持政策研究

小微企业存在着大量的体面劳动赤字,要构建和谐劳动关系面临着许多现实困境。除了促进劳动法在小微企业的有效实施外,还应该通过财政扶持政策促进小微企业和谐劳动关系的构建。这些具体的财政扶持政策包括就业岗位、工会会费、劳动安全卫生、企业培训、社会保险费的财政补贴政策以及劳动关系规范化管理的财政激励政策。     

非传统安全理论:概念、流派与特征

安全理论可分为传统安全理论、半传统安全理论和非传统安全理论。非传统安全理论的主要特征是其安全的指涉对象、主导价值方面与传统安全理论分道扬镳,反对现实主义的国家安全观和军事/政治安全观。同时,非传统安全理论在核心概念与理论逻辑等方面又各不相同,组成了一个多元化、松散性的理论聚合体。但其开放的边界、活跃的思想也正是其力量的源泉,这为今后的非传统安全研究提供了丰富的养料。     

Re-conceptualizing State Responsibility: Human Security Protection, Confl icts and Governance

Different from the perspective of traditional national security, human security is an essential component of non-traditional security. Human security is influenced by multi-dimensional factors. Human security will be threatened if one or more of these dimensional factors get twisted. Such threats, once accumulated to a certain level, may trigger a confl ict. While some factors may have a low correlation with confl ict, some other factors may have a multiplying effect in triggering the confl ict. Further, confl ict may be triggered by a single factor or multiple factors. Poor governance may lead to escalation of confl icts. Deep understanding of triggering effects and their correlation with confl icts is essential to addressing the root causes and the management of conflicts effectively. Concepts of human security, state responsibility of protection and neo-interventionism have been developed in succession. Though the people-centered security framework draws global attention, it should be recognized that there is no international consensus on an optimal type of governance. However, according to the Charter of the United Nations, the primary responsibilities of human security protection should be rested on the government of a state. The principle of sovereignty remains the fundamental principle of international relations, which should be the guiding principle for addressing human security issues.     

核安全峰会与核安全全球治理

美国奥巴马政府上台以来,为应对核恐怖主义对美国国家安全造成的严峻威胁,提升国际社会应对核安全威胁的能力,重塑美国在核领域的领导地位,积极推动由各国首脑参加的核安全峰会。经过四届核安全峰会,国际社会在促进凝聚核安全共识、设定合作重点并推动核安全全球治理的建章立制等方面取得了诸多成果,但也面临着在后峰会时代保持国际合作势头、明确和完善核安全全球治理范畴以及进一步完善均衡的核安全全球治理机制等挑战。为确保核安全全球治理在后峰会时代的可持续发展,国际社会应在治理范畴方面分清主次,在治理模式方面坚持全球合作治理与国家治理相结合,发挥国际原子能机构的核心作用。拥有大量核材料与先进核安全技术的大国在全球治理中负有特殊责任,理应发挥表率作用。