Liabilities for damages incurred by delayed medical treatment in patients with low cure rate / 中华医院管理杂志

It is difficult for the patients with low cure rate to achieve the requirements of the"but for rule"or "preponderance of evidence standard" in the traditional causal argument. In dealing with such cases ,judicial practice has tried to broaden the concept of damage ,and adopt the theories of"loss of chance" ,"expectation infringement theory"or"comparative possibility theory" ,with the purpose to make up for the applicable dilemma of traditional causality. However ,the expansion of the concept of the damage will objectively cause some problems like abuse of rights ,concrete right becoming nothing and even subjective imputation.In the current legal system ,we can analogical apply the rule of joint dangerous act ,and correct the causal relationship to resolve such incidents. It will be more fair and just .

La prevención y mitigación de los riesgos de los pasivos ambientales mineros (PAM) en Colombia: una propuesta metodológica

La minería colombiana ha adquirido una gran importancia en la economía del país. No obstante su relevancia, las repercusiones ambientales y sociales no son insignificantes; por el contrario, los alcances del deterioro que genera han exigido la adopción de políticas públicas que los contrarresten. El país está a la zaga en América Latina en política ambiental, particularmente en lo referente a la gestión de los llamados pasivos ambientales mineros y al cierre de minas abandonadas, inactivas, paralizadas o huérfanas, que requieren medidas de mitigación o remediación; además del manejo del riesgo de sus efectos negativos actuales y futuros. Para una adecuada gestión de estos pasivos es conveniente el diseño y aplicación de una matriz de riesgo que incorpore las buenas prácticas mineras, para así mitigar y prevenir mayores daños en el entorno socio-ambiental.

The Colombian mining has acquired an important role in the economy of the country. Despite its relevancy, environmental and social impacts are not insignificant, on the contrary the scope of this deterioration has demanded the adoption of public policies to counteract it. The country is lagging behind in Latin America in environmental policy particularly as regards manage of so called mining environmental liabilities and abandoned, inactive, paralyzed or orphaned mine closure requiring measures to mitigate them or remedy them, in addition to the management of risks of effects both current and future. For a suitable management of these liabilities, it is convenient the design and application of a risk matrix incorporating good mining practices in order to mitigate and prevent further damage to socio-environmental surroundings.

Mineração colombiana tornou-se cada vez mais importante na economia do país. Apesar de sua relevância, impactos ambientais e sociais não são insignificantes; pelo contrário, o alcance da deterioração que gera exigiram a adoção de políticas públicas que neutralizam. O país está ficando para trás na América Latina na política ambiental, particularmente em relação à gestão de passivos ambientais de mineração e fechamento de minas abandonadas, inativos ou órfão paralisadas, exigindo mitigação ou remediação conhecido; além da gestão de riscos de efeitos negativos atuais e futuras. Para uma gestão adequada desses passivos é conveniente para a concepção e implementação de uma matriz de risco para incorporar as boas práticas de mineração, a fim de mitigar e evitar mais danos ao ambiente sócio-ambientais.

Analysis on the Liabilities of Urban Public Hospitals in Jiangxi / 中国卫生经济

Objective:To understand the liability situation of urban public hospitals in Jiangxi.Methods:Qualitative and quantitative analysis,descriptive analysis and comparative analysis were used to analyze the causes and changes of urban public hospitals' debt increase.Results:To meet the increasing demand for health diagnosis and services,debt infrastructure and the purchase of equipment coupled with inadequate financial investment were performed in public hospitals,which resulted in the sustainably increasing of liabilities level in urban public hospitals.Conclusion:Governments at all levels should increase the capital expenditure of hospital construction and equipment investment,strictly control the public hospital debt behavior,the implementation of the reform of public hospitals canceled drug addition,establishing the characteristics of the medical industry personnel salary system and other measures to resolve the synchronous speed of public hospital debt and prompt public hospital debt risk control in the reasonable scope.

25 años del Centro Nacional de Seguridad Nuclear / 25 years of the National Centre of Nuclear Safety

El artículo resume las actividades desarrolladas por el Centro Nacional de Seguridad Nuclear en sus veinticinco años de trabajo, como Autoridad Reguladora de la República de Cuba en materia de seguridad nuclear, radiológica, así como la contabilidad y control de los materiales nucleares. Se presentan las principales acciones y resultados relacionados con el establecimiento del control regulador en el país, dirigidos a elevar el nivel de seguridad en el uso de las fuentes de radiaciones ionizantes

The article summarizes the activities developed during the last 25 years by the National Centre of Nuclear Safety, as the Regulatory Authority of the Republic of Cuba for the nuclear and radiation safety and for the accountability and control of nuclear materials. It also deals with the main actions and results towards the establishment of the national regulatory control, aimed to guarantee the safe use of ionizing radiation sources in the country

Analysis of assets and liabilities of secondary public hospitals in Wuhan city / 中华医院管理杂志

Objective To analyze the assets and liabilities of secondary public hospitals of Wuhan city in Hubei province ,in order to provide references to control the debt scale of such hospitals .Methods Twenty‐one public secondary public hospitals of Wuhan city were analyzed using official statistics on their asset and liabilities from 2012-2014 .Results Such a timeframe witnessed a year‐on‐year growth of both total assets and liabilities of these hospitals ,yet the growth rate of total assets(35.15% ) falls behind that of total liabilities (53.62% )significantly ;significantly slower growth rate of non‐current assets since 2013 ;higher current liabilities than long‐term liabilities on yearly basis ;year‐on‐year grow th of liquidity rate and quick ratio in general ;significant rise of debt‐to‐assets ratio .Conclusions The overall debt scale of such hospitals keeps growing ,a trend deserving actions and correction .

THINKING ABOUT THE INDEBTEDNESS OF THE LARGE PUBLIC HOSPITAL / 现代医院

Public hospital is a public medical institutions , but at the present, the government's financial abil-ity is limited, which input for the hospital is symbolic .In fact, in order to survive and develop , the hospital debts be-come the main means of financing of public hospital .The liabilities of hospital mainly include two aspects : one is the current liabilities, such as the credit payment which is formed by the drug ; the other is the long term liabilities, such as the borrowing from financial institutions , which is used to construct the fixed asset of the hospital .Now, the man-agement of the debts has become an important means for the development of hospital , although, the hospital can solve the problem of the shortage of the funds to expand the scale of development and the power of competing , but inevita-bly, which will accompany by some risks , at the same time of indebtedness .So, hospital should carry on the scientif-ic decision, and make the early warning and management about the necessary financial risk .

Comparative Study on Legal Liabilities System for Drug Safety between Home and Abroad / 中国药师

Objective:To analyze the legal liabilities system for drug safety in China through learning from the experience of drug safety laws in foreign countries. Methods:The legal liabilities system for drug safety at home and abroad ( America, Canada, Singa-pore, Australia, Japan and Korea) were compared to find out the defects exiting in Chinese legal system. Results: There were differ-ences in the legal liabilities system for drug safety among the various countries. The legal liabilities systems for drug safety from the a-bove foreign countries were sound. In our country, the pharmacist law was not established yet, therefore, the legal liabilities system for drug safety should be improved to enhance drug safety monitoring level. Conclusion:It is very important to improve the legal liabilities system for drug safety in our country to enhance drug safety monitoring level.

Responsabilidad legal de los residentes de Anestesiología y Reanimación / Legal liabilities of anesthesiology and resuscitation residents

Introducción: las obligaciones y la responsabilidad legal de los residentes en general y los de nuestra especialidad en particular, constituyen un tema muy complejo y ambiguo, pues como médicos deben asumir tareas específicas y como personal en formación su participación es muy limitada. Este hecho está dado, porque los errores médicos que ocurren en Anestesiología cuestan vidas y constituyen una de las principales causas de demandas en el mundo las cuales se han incrementado progresivamente en los últimos años. Objetivos: hacer una puesta al día sobre la responsabilidad legal de los Residentes de Anestesiología y Reanimación. Desarrollo: son obligaciones de los médicos residentes nacionales o extranjeros que cursen una especialidad, además de las que señalan las leyes respectivas de cada país, participar en el estudio y tratamiento de los pacientes que se les encomienden, siempre sujetos a las indicaciones y supervisión de los especialistas o profesores adscritos a la unidad médica receptora de residentes. Se debe tener en cuenta que las leyes son las mismas para todos los médicos con especialidad o sin ella, durante la residencia médica. Existen al menos tres situaciones que dan lugar a responsabilidad del residente: Falta de vigilancia en la asistencia o por la dirección del tutor y extralimitación por parte del Hospital, del Sistema de Salud o por parte del residente. Conclusiones: las obligaciones del residente, así como su responsabilidad legal, es un problema de todos y hay que prevenir para no tener que lamentar.

Introduction: the legal obligations and liabilities to be complied with by all residents, particularly by residents from our specialty, constitute a very complex and ambiguous subject, for as physicians they should carry out specific tasks, while as in-training personnel their participation is very limited. This is due to the fact that in anesthesiology medical errors cost lives, and they are one of the main reasons for legal complaints worldwide, which have gradually increased in recent years. Objective: update the legal liabilities of anesthesiology and resuscitation residents. Results: it is the obligation of national and foreign physicians serving a residency, besides those contained in their country's legislation, to participate in the study and treatment of the patients assigned to them under the guidance and supervision of specialists or professors from the health institution sponsoring the residency. It must be borne in mind that during the residency period the legislation is the same for both specialist and nonspecialist physicians. There are at least three situations which give rise to residents' liability: inattention while caring for patients, deficient guidance by the tutor and overstepping of authority by the hospital, the health system or the resident. Conclusions: the obligations and legal liabilities of residents are everyone's responsibility. Precautions should be taken so that regrettable events do not occur.

Avaliação da exposição ao Pb e Cd em crianças de 0 a 17 anos por consumo de alimentos vegetais cultivados em solos contaminados no município de Santo Amaro (BA) / Evaluation of Pb and Cd exposure in children 0 to 17 years of age by consumption of vegetable food cultivated in soils contaminated in Santo Amaro (BA)

O objetivo do presente trabalho foi estimar as doses de exposição aos contaminantes chumbo (Pb) e cádmio (Cd) em crianças de 0 a 17 anos de idade via consumo de alimentos vegetais cultivados em quintais contaminados, localizados no entorno de uma metalúrgica desativada, no município de Santo Amaro, Estado da Bahia. Para a estimativa das doses foi utilizada a metodologia de avaliação de riscos sobre a saúde humana, especificamente a etapa de análise da exposição, determinando as concentrações dos metais e variáveis sociodemográficas das crianças. As doses de exposição estimadas para ambos os contaminantes superaram os valores recomendados pela Organização Mundial da Saúde (OMS), atingindo valores máximos de exposição de 166,9 μg.kg−1 dia−1 e 2,95 μg.kg−1 dia−1 para o Pb e o Cd, respectivamente, por consumo de frutas. Os resultados comprovam que o consumo de alimentos vegetais cultivados em quintais pela população residente próxima à antiga fábrica é uma importante rota de exposição atual aos metais, representando um risco para a saúde da população.

This paper aims to estimate the exposure of children between 0 to 17 years old to lead (Pb) and cadmium (Cd) via ingestion of vegetables cultivated in contaminated backyards located in the surroundings of a deactivated lead metallurgy in Santo Amaro, Bahia, Brazil. For the estimation of the exposure doses, the risk assessment on human health methodology, exposure analysis, was used, determining the concentrations of metals and socio-demographic variables of children. The estimated doses for both contaminants exceeded the values recommended by the World Health Organization (WHO). Maximum obtained values were 166.9 μg.kg−1 day−1 and 2.95 μg.kg−1 day−1 for Cd and Pb, respectively, due to fruits consumption. The results show that the consumption of vegetables cultivated in the backyards by the population living near the deactivated metallurgical plant plays an important role in the exposition of the population to metals.

Mechanisms for guarding against and dissolving risks of the medical profession / 中华医院管理杂志

The special nature of medical care determines the high riskiness of the medical profession that is lacking in other professions. In view of the high-techness and high riskiness of the medical profession, it is only proper to start thinking about setting up corresponding mechanisms for guarding against and dissolving the risks so as to safeguard the legitimate rights of the doctors. Guarding against and dissolving risks of the medical profession fall into a systematic framework of regulations and legal arrangements that are composed of mechanisms for dispersing risks of the medical profession, mechanisms for sharing medical liabilities and systems of medical care and social security.

Defining and analyzing the appropriate scope of liabilities ratio for state-owned hospitals / 中华医院管理杂志

In recent years, the issue of liabilities in state-owned medical institutions in China has come to the attention of departments at different levels and has become one of the top concerns of various government departments and hospital administrators. Defining the appropriate scope of liabilities ratio for hospitals has become an urgent task in ensuring their unconventional and sustainable development from a high starting point and at a fast pace. On the basis of relevant financial theories and in light of the current situation of the domestic medical market and characteristics of state-owned hospitals, the paper makes a case study of the liabilities ratio of hospitals in a certain region so as to explore the appropriate scope of liabilities ratio and the scale of liabilities for hospitals.