我国产科人力资源配置现状及公平性分析

目的了解我国不同地区产科人力资源配置现状,通过对产科人力资源分布的公平程度进行测量,为政府和卫生行政部门提供决策依据。方法对44个抽样地市的助产机构2010年产科人力资源配置与服务数量等情况进行信函调查,应用洛伦茨曲线和基尼系数评价产科人力资源分布公平性。结果 2010年我国每万人拥有产科医务人员2.2人,每平方公里拥有产科医务人员0.05人;2010年我国产科医生、助产士及护士按人口分布的基尼系数分为0.196、0.204,按地理面积分布的基尼系数为0.499、0.518。结论我国产科医务人员数量不足,结构欠合理;产科人力资源按人口分布公平性较高,按地理面积分布公平性较差。我国应加强产科人力资源的规划建设,有效实施区域卫生规划政策。     

中国儿科人力资源配置现状及公平性分析

目的了解中国不同地区不同级别儿科人力资源配置和提供服务现状,分析儿科人力资源分布的公平程度,为政府和卫生行政部门提供参考依据。方法 2011年采用随机抽样法抽取44个抽样地市,并采用信函调查法对44个抽样地市的医疗机构2010年儿科人力资源配置与服务数量等情况进行调查,应用洛伦茨曲线和基尼系数评价儿科人力资源分布公平性。结果 2010年中国每万人口拥有儿科医务人员1.50人,每平方公里拥有儿科医务人员0.03人;不同地区儿科医务人员分布差异有统计学意义;县级及以上医疗机构儿科医务人员工作负担较重;2010年中国儿科医生、护士按人口分布的基尼系数分为0.259、0.302,按地理面积分布的基尼系数为0.570、0.588。结论中国儿科医务人员数量不足,医务人员结构欠合理;儿科人力资源地理分布公平性有待提高。中国应加强儿科人力资源的规划建设,有效实施区域卫生规划政策。     

浙江省护理人力资源配置公平性研究

目的 对浙江省护理人力资源配置公平性进行分析,为卫生行政部门加强护理人力资源的管理及合理配置提供借鉴.方法 采用洛伦兹曲线（Lorenz Curve）与基尼系数（Gini Coefficient）来评价浙江省护理人力资源配置公平性. 结果 2011年浙江省各地护理人力资源按人口、面积分布的洛伦兹曲线均分布在绝对公平线附近;按人口分布的基尼系数为0.16,按面积分布的基尼系数为0.28.结论 浙江省护理人力资源配置总体上公平,但布局欠合理,其人口公平性优于地理公平性.     

广东省疾控机构免疫规划人力资源配置现状及公平性分析

目的从人口和地理角度评价广东省疾病预防控制机构免疫规划人力资源配置公平性。方法采用基尼系数测量广东省不同区域免疫规划人力资源的公平性。结果广东省疾控机构免疫规划人员配置总量按人口分布及按面积分布的基尼系数分别为0.353和0.279。韶关市每万名儿童拥有免疫规划人员5.78人,中山市仅为0.36人,二者相差16倍。高级职称人员50.42%集中在珠三角地区,按人口分布及按面积分布的基尼系数分别为0.475和0.580。免疫规划人员高、中、初级的比例为1:1.98:8.15。结论广东省疾控机构免疫规划人员配置总量在人口、地理分布上体现出较好的公平性,但人力资源职称结构有待优化调整,且人力资源配置存在区域性差异,优质人力资源分布不公平。     

浙江省健康教育机构人力资源配置现状及公平性评价

目的 了解浙江省健康教育机构人力资源配置现状及公平性情况,为健康教育工作规划提供科学依据.方法 对2011年浙江省健康教育人员相关数据进行统计描述,用洛伦茨曲线、基尼系数及泰尔指数评价健康教育人力资源配置的公平程度.结果 全省健康教育机构专职人员学历以本科、专科为主,职称以初级、中级为主,专职人员的构成比例在省地县三级逐级降低,按各市人口分布的健康教育专职人员总量及在岗健康教育工作人员总量的基尼系数分别为0.2496和0.2092,按各市地域面积分布的专职人员总量及在岗健康教育工作人员总量的基尼系数分别为0.4124和0.3534.各市专职健康教育人员按人口及面积配置的泰尔总指数分别为0.1271和0.2993.结论 浙江省各市健康教育专职人力资源配置公平性相对较好,人口配置公平性优于地理配置公平性;需进一步加强浙江省健康教育人力资源投入,优化人员专业学历结构.     

山东省专业公共卫生机构人力资源配置公平性研究

目的 分析2015年山东省专业公共卫生机构人力资源配置公平性。方法 描述山东省专业公共卫生机构人力资源配置基本情况,采用洛伦茨曲线、基尼系数、泰尔指数,从人口、地理面积、经济发展水平三个维度分析山东省专业公共卫生机构人力资源配置公平性。结果 截止到2015年末,山东省每万人专业公共卫生机构人员6.5人,高于全国水平（6.4人）。除注册护士按地理面积分布（0.2369）外,其余人员按人口、地理面积分布的基尼系数均在0.1~0.2之间;按经济发展水平均在0.2~0.3之间,注册护士最大为0.2889。各类人员的泰尔指数与其基尼系数有相同的趋势,且区域内差异贡献率（88.1%~96.6%）高于区域间（3.4%~11.9%）。结论 山东省专业公共卫生机构人力资源按人口分布的公平性优于按地理面积和经济发展水平,注册护士配置公平性相比于其他人员稍差。区域内差异是导致山东省专业公共卫生机构人力资源配置区域内相对不公平的主要原因。     

重庆市儿科人力资源配置现状及公平性分析

目的了解重庆市儿科人力资源配置现状,分析儿科人力资源分布的公平程度,为政府部门优化资源配置提供理论依据。方法通过调查问卷收集重庆市40个区县所有提供儿科医疗服务机构的人力资源配置数据,采用洛伦兹曲线和基尼系数评价儿科人力资源分布的公平性。结果重庆市每千名儿童拥有儿科医务人员1.63人,每平方公里拥有儿科医务人员0.10人。儿科医护比为1:1.7,儿科人才资源主要集中分布在主城片区、综合性医院、三级医疗机构和公立医疗机构。儿科医师、护士按人口分布的基尼系数分别为0.427、0.418,均处于较不公平状态,按地理面积分布的基尼系数分别为0.613、0.628,均处于绝对不公平状态。结论重庆市儿科医务人员数量不足、结构不合理且配置不均衡,要加大儿科人力资源建设,并且重视按地理分布的公平性。     

淮安市疾控机构人员配置公平性分析

目的：分析淮安市八个县（区）疾病预防控制机构人员配置的公平性,为政府制定资源配置标准提供依据。方法：收集 2014年各县(区)疾控中心人力资源统计数据,结合服务人口和地理分布资料,利用基尼系数和洛伦兹曲线评价其资源配置的 公平性.结果:全市8个县（区）疾控共有298名工作人员,每万人口平均有工作人员0.65(0.35-1.03)名,每平方公里面积有工 作人员0.10(0.01-0.53)名.按服务人口和地理面积计算的基尼系数分别为0.22和0.36。结论：淮安市疾控机构人力资源配置的 人口公平性较好,且优于地理分布公平性;个别县（区）人力资源配置相对薄弱,需进一步调整。     

2013—2017年我国护理人力资源配置现状及公平性研究

目的 分析我国护理人力资源配置情况,为进一步合理配置护理人力资源提供依据。方法 采用洛伦兹曲线、基尼系数及泰尔指数对我国2013—2017年护理人力资源按人口和地理面积配置的公平性进行分析。结果 2013—2017年,我国护理人力资源按人口配置的基尼系数均在0.1以下,泰尔指数在0.0047～0.0058之间;按地理面积配置的基尼系数均在0.6以上,泰尔指数在0.05482～0.05650之间。无论按人口还是按地理面积配置,泰尔指数组内贡献率均高于组间贡献率。结论 我国护理人力资源配置存在不公平现象,护理人力资源按人口配置公平性优于按地理面积配置,影响我国护理人力资源配置不公平性的主要原因是区域内差异。     

中国护理人力资源现状及其配置研究

目的:从数量、结构和配置公平性等几个方面分析中国护理人才队伍的现状,并探讨护理人才队伍建设中存在的问题,为政府部门制定护理人才队伍建设策略提供依据。方法:运用《中国卫生统计年鉴》和《中国卫生和计划生育统计年鉴》数据,描述性分析中国2010年和2015年注册护士的数量、学历、职称、年龄等基本情况及其变化,采用基尼系数评价中国护理人力资源按人口及地理面积的配置公平性。结果:2010—2015年,中国护理人员的数量呈现较大幅度的增长,人员结构进一步优化并且总体呈现年轻化趋势。从配置公平性角度看,我国护理人力资源按人口分布基尼系数低于0. 2,公平性好;按地理面积配置基尼系数接近0.6,处于高度不公平状态。结论:中国护理人才队伍建设成效显著,但是仍存在人才梯队不合理、地区间发展不均衡等问题。建议扩大培养规模,加强护理教育,改善护理效率合理配置资源。     

Salmonellas in pigs and animal feeding stuffs in England and Wales and in Denmark

A comparison has been made between the incidence of salmonellas in pigs and feeding stuffs in England and Wales and in Denmark. In Denmark there is veterinary legislation requiring the sterilization of imported and home produced feed ingredients of animal origin. There is no such legislation in England and Wales. In Denmark 0·3% of resterilized imported meat and bone meal was contaminated with salmonellas. This compared with 23% of meat and bone meal in England and Wales and 20-27% of other ingredients of animal origin. In England and Wales salmonellas were isolated from 7% of caecal samples and 6% of lymph node samples, while in Denmark they were isolated from 3% of caecal samples and 4% of lymph node samples. In England and Wales 25 serotypes were found in both pigs and feeds and these included nearly all the most prevalent human pathogens. In Denmark four of the six serotypes in pigs had been found in resterilized feed. One notable difference between the two studies was the very wide range of serotypes found in pigs in England and Wales and the narrow range in Denmark. A second was that Salmonella typhimurium formed 15% of all Salmonella strains isolated from pigs in England and Wales, and 60% of those in Denmark.     

Lunasin is prevalent in barley and is bioavailable and bioactive in in vivo and in vitro studies

Lunasin, a unique 43-amino acid peptide found in a number of seeds, has been shown to be chemopreventive in mammalian cells and in a skin cancer mouse model. To elucidate the role of cereals in cancer prevention, we report here the prevalence, bioavailability, and bioactivity of lunasin from barley. Lunasin is present in all cultivars of barley analyzed. The liver and kidney of rats fed with lunasin-enriched barley (LEB) show the presence of lunasin in Western blot. Lunasin extracted from the kidney and liver inhibits the activities of HATs (histone acetyl transferases), yGCN5 by 20% and 18% at 100 nM, and PCAF activity by 25% and 24% at 100 nM, confirming that the peptide is intact and bioactive. Purified barley lunasin localizes in the nuclei of NIH 3T3 cells. Barley lunasin added to NIH 3T3 cells in the presence of the chemical carcinogen MCA activates the expression of tumor suppressors p21 and p15 by 45% and 47%, decreases cyclin D1 by 98%, and inhibits Rb hyperphosphorylation by 45% compared with the MCA treatment alone. We conclude that lunasin is prevalent in barley, bioavailable, and bioactive and that consumption of barley could play an important role of cancer prevention in barley-consuming populations.     

Prevalence and Trends in Overweight in Mexican-American Adults and Children

Overweight and obesity have been increasing in many countries. Our objective is to describe the trends in overweight and obesity occurring in the Mexican-American population in the United States. Data on measured height and weight for Mexican Americans come from the following surveys: the Hispanic Health and Nutrition Examination Survey (HHANES, 1982–84), the Third National Health and Nutrition Examination Survey (NHANES III, 1988–94), and NHANES 1999–2002. In 1999–2002, 73% of Mexican-American adults were overweight and 33% were obese. Obesity increased between NHANES III and NHANES 1999–2002, from 24% to 27% for men and from 35% to 38% for women. Increases were also seen for children and adolescents. The Mexican-American population in the United States, both children and adults, is showing trends in overweight and obesity over time that are similar to those seen in other segments of the U.S. population and indeed in many countries     

Lead and cadmium in soil and Isopoda woodlice in Croatia

The aim of the study was to determine lead and cadmium concentrations in Isopoda woodlice and soil and to estimate their relation in the environment and the possibility of the use of isopods as biological indicators of pollution. Samples of isopods and soil were collected at two locations in Northern Croatia and analyzed for lead and cadmium. One location was in the forest, and another in the meadow near the road. Isopods were dry- ashed and soil was extracted with nitric acid. Elements were analyzed by atomic absorption spectrometry. Results revealed that the two locations were significantly different in lead and cadmium in extracted soil and isopods. Lead concentration in extracted soil was 34.6 mg/kg dry weight in the forest and 43.3 mg/kg dry weight in the meadow near the road. Respective cadmium values were 0.147 and 0.180 mg/kg. Lead concentrations in isopods were 2.40 and 4.22 mg/kg dry weights, and cadmium 0.757 and 0.411 mg/kg dry weight, respectively. Correlation of lead or cadmium between isopods and soil irrespective of location gave significant and linear relations for both elements.     

环孢素A及其在产科和生殖领域应用的研究

环孢素A(Cyclosporin A,CsA)是一种大环内酯类免疫抑制剂,广泛应用于器官移植后排斥反应和自身免疫性疾病的防治.近年对CsA在产科和生殖领域的应用展开了一系列研究,CsA不仅能从多方面诱导母胎免疫耐受,还能促进滋养细胞增殖、抑制凋亡,增强其运动、迁移和侵袭能力,从而对妊娠起到双重调节作用,有望成为原因不明...     

Management of pregnancy and childbirth in England and Wales and in France

This paper reviews national data on obstetric and neonatal practices in England and Wales, and in France between 1970 and 1980. The data have been derived from national statistics and surveys on national samples of births in 1970, 1975 and 1980 in England and Wales, and 1972, 1976 and 1981 in France. The analysis shows that there was no major difference in pregnancy outcome, but wide variations in medical practices, and their trend over time. The main differences were: in England and Wales a higher number of antenatal visits, a higher percentage of inpatient admissions during pregnancy, a higher rate of induction, more episiotomies, a higher rate of resuscitation at birth, and admission to neonatal special care units; in France, a higher rate of caesarean sections before and during labour, some evidence of a more active management of labour, and a longer hospital post-natal stay. These differences in practice reflect differences in objectives and assessment of the effectiveness of care between the two countries: they point out the need for better monitoring and evaluation of obstetric and neonatal practices.     

Research and teaching in social and preventive medicine and in public health

Summary Both public health and social and preventive medicine are characterised by the common goal of promoting, maintaining and improving health and preventing disease, and both are concerned with a population-related, preventive and environmental perspective. But whereas public health is interdisciplinary and goes far beyond the medical focus, social and preventive medicine is medically based and forms a bridge between public health and medical practice. Research in a department of social and preventive medicine serves to support preventive and medico-social activities in medical practice as well as in public health. This is illustrated by results from research conducted at the author's department during the last twenty years. Examples are research in support of smoking cessation activities, and research used for the planning of care for the elderly. Both the research and the teaching activities of the department take into account the population focus of public health as well as the focus on individual medicine in clinical practice.

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Forschung und Lehre in Sozial-und Präventivmedizin und öffentlicher Gesundheit

Zusammenfassung Sowohl das Gebiet der öffentlichen Gesundheit als auch dasjenige der Sozial-und Präventivmedizin sind durch das Ziel der Förderung, Erhaltung und Verbesserung der Gesundheit sowie der Krankheitsvorbeugung gekennzeichnet, und beide beschäftigen sich mit einer bevölkerungsbezogenen, präventiven und umweltbezogenen Perspektive. Aber während die öffentliche Gesundheit stark interdisziplinär ist und weit über den medizinischen Fokus hinausreicht, ist die Sozial-und Präventivmedizin ein medizinisches Fach und stellt eine Brücke zwischen der öffentlichen Gesundheit und der ärztlichen Praxis dar. Die Forschung in einem Institut für Sozial-und Präventivmedizin dient der Förderung präventiver und sozialmedizinischer Tätigkeiten in der ärztlichen Praxis wie auch in der öffentlichen Gesundheit. Dies wird durch die Forschungstätigkeit des Instituts des Autors aus den letzten 20 Jahren illustriert, wobei Beispiele aus den Gebieten der Förderung der Raucherentwöhnung und der Betreuung behinderter Betagter dargestellt werden. Sowohl in den Forschungs-als auch in den Lehrtätigkeiten des Instituts finden der Bevölkerungsbezug der öffentlichen Gesundheit wie auch der individualmedizinische Ansatz der ärztlichen Praxis ihren Ausdruck.

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La recherche et l'ensignement en médecine sociale et préventive et en santé publique

Résumé La santé publique aussi bien que la médecine sociale et préventive sont caractérisées par le but commun de promouvoir, maintenir et améliorer l'état de santé et de prévenir les maladies, et elles s'orientent vers une perspective de population, de prévention et environnementale. Mais la santé publique est interdisciplinaire et va loin au-delà de la médecine, tandis que la médecine sociale et préventive est basée sur la médecine et représente le lien entre la santé publique et la pratique médicale. La recherche d'un institut de médecine sociale et préventive sert à appuyer les activités préventives et médico-sociales au cabinet médical aussi bien qu'en santé publique. Cela est illustré par des résultats de recherches conduites dans les vingt années passées à l'institut de l'auteur, et les exemples sont tirés de la recherche en appui de la promotion de la cessation de fumée et de la planification de la prise en charge des personnes âgées et handicapées. Les activités de recherche et de l'enseignement de l'institut tiennent compte de la perspective de population cacactéristique de la santé publique, aussi bien que de la dimension de médecine individuelle caractéristique de la pratique clinique.

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Paper presented at a symposium on The Public Health Perspective of Social and Preventive Medicine, in celebration of the 20th anniversary of the Department of Social and Preventive Medicine, University of Berne, 25 June 1992 in Berne.