台湾地区妇幼保健服务管理特色与启示

为进一步加强妇幼保健服务体系建设,促进妇幼卫生事业的改革与发展,提升妇幼健康服务水平,介绍台湾地区妇幼卫生保健相关政策、管理模式及服务理念,为我国内地妇幼保健机构建设、发展规划、妇幼保健管理及开展特色服务提供学习和借鉴的经验和启示。     

杭州市下城区流动儿童保健体检覆盖率研究

目的:了解杭州市下城区5岁以下流动儿童看护人对儿童保健服务的需求、知识、态度及未定期进行儿童保健体检的原因;有针对性地开展对策研究,促进流动人口妇幼保健适宜技术的开展。方法:对300名居住在下城区的5岁以下流动儿童的看护人进行问卷调查。结果:流动儿童看护人的经济收入及文化程度较低;看护人对于儿童保健体检的认识不足,有14.0%的看护人不知道需要健康体检,仅有51.9%的看护人表示知道相关政策及流程;看护人对儿童保健服务有一定需求,80.5%的看护人表示会定期带孩子进行体格检查;32.9%的看护人认为健康体检应该免费,42.7%可以接受10元以下的健康体检费用。结论:流动儿童看护人对于儿童保健体检的认识不足,经济收入较低是制约流动儿童保健体检覆盖率提高的主要原因;政府层面出台的妇幼保健服务政策、政府部门间紧密协作及加强宣传是提高流动儿童保健体检覆盖率的有效手段。     

苏州市中医养生保健服务机构现状调查与分析

中医养生保健是中医药事业的重要组成部分,积极发展中医养生保健服务是提高人民群众健康素质和健康水平的重要途径,开展中医养生保健服务机构调研工作,对规范中医养生保健服务机构执业行为,完善中医养生保健工作的保障措施,促进中医养生保健事业的发展有着深远意义。     

以社区为基础的妇幼保健网络建设与妇女儿童健康

对云南省２０个项目县项目开展前后县、乡、村三级妇幼保健网络建设及妇幼保健服务的改善与当地妇女儿童健康的关系进行分析。本文认为，动员各级政府加强对社区妇幼保健工作的重视是促进妇幼保健工作的有力保障。县、乡、村三级妇幼保健机构的建设、人员的充实、基本服务设备的配备和服务人员（主要指乡村医生）基本报酬的落实是开展妇幼卫生服务的基础。加强妇幼卫生人员培训，改进培训方法，推广适宜技术，增强服务技能，提高服务质量，是提高妇幼健康水平的关键。抓住重点妇幼卫生问题，围绕降低孕产妇死亡率和５岁以下儿童死亡率，促进妇幼健康，开展相关的妇幼保健服务是促进妇幼健康水平提高的保证     

潍坊市2002-2012年孕产妇健康状况分析及对策研究

目的掌握潍坊市妇女健康状况,发现存在的问题,探索其原因,不断采取干预措施,为政府决策提供妇幼保健服务客观依据和对策,提高潍坊市孕产妇健康水平。方法查阅潍坊市卫生局有关孕产妇健康状况报表等相关统计材料,收集数据,并对其进行统计分析。结果孕产妇保健服务利用情况（孕产妇早检率、产前检查率、产后访视率、孕产妇系统管理率）逐年提高;孕产妇死亡率逐年下降,但城乡差异明显。结论①明确妇幼保健服务的目标和任务;②为政府决策提供妇幼保健服务的相关对策,争取增加经费投入,促进妇幼卫生事业的发展;③广泛宣传、全面开展健康教育,提高群众认识;④加强妇幼保健机构自身建设,提高服务能力。     

健康中国背景下区级妇幼保健机构保健服务供给分析

目的研究剖析我国某中部地区省会城市区级妇幼保健机构的资源配置和服务供给状况,并提出可行性建议以保障妇幼保健服务供给,满足健康中国背景下妇女儿童不断增长的妇幼保健服务需求。方法基于Donabedian的结构、过程和结果维度,选用定量指标分析保健服务供给,结合供给理论进行原因分析。结果区级妇幼保健机构人员学历水平较高,妇幼保健服务供给优于全国平均水平,妇幼健康指标也优于全国水平。但妇女保健服务供给优于儿童保健服务供给,同时各区保健服务供给存在较大差异,影响了妇幼保健服务公平性,部分区免费孕前优生健康检查目标人群覆盖率和两癌筛查率低于全国水平。二孩政策下的孕产妇死亡和出生缺陷风险提高对妇幼保健服务供给提出了挑战。结论妇幼保健机构人力资源短缺和信息系统制约了妇幼保健服务供给,机构建设和居民妇幼保健需求的不断增加有效促进了妇幼保健服务供给。     

浅谈母婴保健专项技术服务的影响因素及对策

《母婴保健法》自 1995年实施以来 ,我县母婴保健工作逐步步入了法制化管理的轨道 ,妇幼保健事业得到了长足发展 ,对依法保障妇女儿童的健康发展起到了重大作用。但是 ,在实施《母婴保健法》和从事母婴保健专项技术服务的过程中 ,还存在着不少问题 ,使我县妇幼保健事业的发展速度相对滞后于发达地区。本文分析影响此项工作开展的困扰因素 ,并提出发展对策。1　影响开展母婴保健专项技术服务的困扰因素1 1　没有形成贯彻实施《母婴保健法》的社会舆论氛围《母婴保健法》作为我国妇幼保健事业历史上的第一部法律 ,其重要意义不言而喻。但在一…     

加强领导 夯实基础 促进基层妇幼保健事业全面发展

目的:通过2005～2009年兰州市安宁区妇幼保健工作开展情况,了解基层妇幼保健工作进展,促进基层妇幼保健事业全面发展。方法:将2005～2009年兰州市安宁区妇幼保健基本情况、业务开展以及新拓展项目进行对比分析。结果:2005～2009年兰州市安宁区婚前保健、孕产妇系统化保健、儿童系统化保健各项主要指标均呈上升趋势,孕产妇、婴儿及5岁以下儿童死亡率呈逐年下降趋势。结论:随着国家对基层妇幼保健工作扶持力度的增加和重视程度的提高,基层妇幼保健机构立足基础保健,拓宽服务项目,顺应时代发展,不断促进基层妇幼保健事业全面发展。     

睢宁县实施“提高妇幼卫生综合服务能力”合作项目的基本做法

睢宁县在实施“提高妇幼卫生综合服务能力”合作项目中 ,转变各级政府对妇幼保健工作的认识 ,改善基层妇幼卫生服务条件 ,提高妇幼保健人员的能力 ,建立健全三级保健网络 ,增强广大妇女、儿童的保健意识和健康水平 ,推动了妇幼保健事业健康发展。     

启东市妇幼保健工作回顾与思考

妇幼保健工作是一项社会公益性事业,担负着降低孕产妇和婴儿死亡率、提高出生人口素质、保障妇女健康和母婴安全的重要任务.妇幼保健机构足妇幼保健服务的主要载体,其发展对妇幼卫生事业的健康发展起着举足轻重的作用[1].     

Die sogenannte Vinylchlorid-Krankheit—eine berufsbedingte Systemsklerose?

Zusammenfassung Es wurden 13 Arbeiter untersucht, die zwischen 1 3/4 und 18 Jahren in einem PVC-herstellenden Betrieb beschäftigt waren. 8 von ihnen wiesen sklerodermieartige Hautveränderungen (Abb. 2) auf, die histologisch charakterisiert sind durch Verbreiterung und Homogenisierung der kollagenen Faserbündel (Abb. 3 u. 4) sowie Fragmentation und Rarefizierung der elastischen Fasern (Abb. 5). Bei 7 Patienten bestanden trommelschlegelartige Auftreibungen einzelner Fingerendphalangen (Abb. 1). 11 Patienten zeigten Durchblutungsstörungen der Extremitäten (4 von diesen ein Raynaud-Syndrom) und 6 Patienten Acroosteolysen einzelner Fingerendphalangen (Abb. 6, Tabellen 1–3).Darüber hinaus bestand bei allen Patienten eine Thrombocytopenie, bei 12 Patienten eine Splenomegalie, bei 11 Patienten eine Einschränkung der Leberfunktion (erhöhte BSP-Retention). An der Leber ließ sich histologisch bei den 5 laparoskopierten Patienten eine deutliche Fibrosierung der Portalfelder nachweisen. Bei 4 Patienten bestanden Oesophagusvaricen (Tabellen 4 u. 5). 8 Patienten zeigten eine Partialinsuffizienz mit Hinweisen für vorwiegend restriktive Veränderungen.Die hier beschriebenen Veränderungen gehen weit über das bisher bekannte Acroosteolysesyndrom hinaus. Es wird der dringende Verdacht geäußert, daß langfristige Vinylchlorid-Exposition dieses komplexe Krankheitsbild verursacht. Daher wird für diese systemische Krankheit die Bezeichnung Vinylchlorid-Krankheit vorgeschlagen.Wir danken Frau E. Voigtländer für die Herstellung der klinischen und histologischen Abbildungen.     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

Empathic processes: perception by medical students of patients'' anxiety and depression

Perceptions by medical students of patients' affective states were investigated, and the effect of the students' own emotions on such perceptions. One hundred and one fourth-year medical students rated the levels of anxiety and depression of three women patients presented on videotape, rated their own levels of anxiety and depression and completed a questionnaire on aspects of the rating process. Students had widely different and often inappropriate perceptions of patients' levels of anxiety and depression. Students who consistently overrated anxiety or depression in patients, compared to those who consistently underrated, were themselves significantly more anxious or depressed. These data suggest a need in medical education for systematic teaching of empathic skills and for recognition of potential bias in clinical decision-making arising from the clinician's own emotional state.     

The reported incidence of work-related ill-health in Scotland (2002-2003)

BACKGROUND: Although incidence data for work-related ill-health in the UK are available, more detailed information for smaller geographical areas has hitherto been unpublished. AIMS: To estimate the incidence of work-related ill-health reported by clinical specialists in Scotland, 2002-2003. METHODS: THOR (The Health and Occupation Reporting network) is a UK wide reporting scheme for work-related ill-health. In 2002-2003, 241 out of 2162 physicians in THOR were based in Scotland. We have summarized the reported cases and calculated incidence rates for categories of ill-health by age, gender and industry. The UK Labour Force Survey (2002) was used to provide denominator data, with comparisons made between rates for Scotland and the rest of the UK. RESULTS: In 2002-2003, 4043 estimated cases were reported from Scotland. Mental ill-health was most frequently reported (41%); followed by musculoskeletal disorders (31%), skin disorders (16%), respiratory disease (10%), hearing disorders (2%) and infection (1%). The reported average annual incidence rate per 100,000 employees for all work-related ill-health in Scotland was 86.0. The highest reported rate for mental ill-health was found for employees in public administration and defence (76.7 per 100,000), and health and social work (72.3 per 100,000). The construction industry had the highest reported rate of musculoskeletal disorders (41.6 per 100,000), while hairdressers appeared at most risk of developing occupational contact dermatitis (rate=86.4 per 100,000). CONCLUSIONS: Despite its limitations, THOR has indicated types of work-related ill-health and related industries for targeted disease prevention in Scotland.     

Function of the protein RPE65 in the visual cycle

A protein called RPE65 performs a key role in the trans-cis isomerization of retinol in the retinal pigment epithelium of the eye. The palmitoylation of RPE65 serves to switch off the visual cycle in darkness and to switch it on in the light.     

Acute symptoms following work with pesticides

BACKGROUND: Serious accidental poisoning by pesticides is rare in the UK, but more minor pesticide-related illness may be under-reported. Anecdotally, use of sheep dip has been linked with flu-like symptoms. AIM: To explore the frequency, nature and determinants of acute symptoms following work with pesticides. METHODS: A postal survey of men in three rural areas of England and Wales provided data on occupational use of five categories of pesticide, occurrence of 12 specified symptoms within 48 h of using pesticides and tendency to somatize. Risk factors for pesticide-related symptoms were assessed by modified Cox regression. RESULTS: Of 10 765 responders (response rate = 31%), 4108 had at some time used pesticides occupationally, including 935 (23%) who reported symptoms following such work on at least one occasion. In two areas, acute symptoms were most frequent following use of sheep dip (29 and 32% of users), but in the third area the rate was significantly lower (13% of users). The relative frequency of symptoms was similar for all five categories of pesticide, and flu-like symptoms did not cluster unusually among users of sheep dip. Risk of pesticide-related symptoms increased with somatizing tendency (prevalence ratio for highest versus lowest category 2.4, 95% confidence interval 2.0-3.0) and was higher in men who had used pesticides most often or handled concentrate. CONCLUSION: Acute symptoms are common following work with pesticides, but in many cases the illness may arise through psychological rather than toxic mechanisms.     

The Life Events Inventory: re-scaling based on an occupational sample.

The objective of this study was to compare the validity of the original weightings used by the Life Events Inventory (LEI) with those obtained from a contemporary occupational sample. Fifty male and 62 female manufacturing employees (age range 16-55 years) assigned scores to each item on a slightly modified version of the LEI scale. The current sample consistently assigned higher weights to events/items than did the original sample, but there was high agreement in terms of item ranking. Some distinct age and gender differences in scoring were apparent, and are discussed further. It was concluded that when separate weightings are employed for age and gender groups, the LEI remains a useful tool for quantifying background levels of stress in both workplace stress audits and epidemiological studies where statistical control for non-occupational sources of stress is required.     

Maxillofacial injuries related to work accidents: a new concept of a hospital-based full electronic occupational trauma surveillance system

The objective of this study was to investigate the occurrence of occupational maxillofacial injuries using a newly installed relational database. Twenty-six injuries were identified out of 28,624 patients admitted to the emergency unit during a 12 month period. Falls from height or being struck by moving objects were common causes of these injuries. Two-thirds of those identified were construction workers. This paper demonstrates the power of modern databases to identify specific occurrences that may provide the basis for prevention in the future.     

Rôles physiologiques des endocannabinoïdes dans le contrôle de l’homéostasie énergétique

Endocannabinoids are endogenous lipids which modulate the release of neurotransmitters and activate different signaling pathways, through the binding to cannabinoïd receptors, CB1 and CB2. Endocannabinoids are involved in the control of a variety of behavioural and neuroendocrine functions, including feeding behaviour. In the central nervous system, they essentially modulate the expression of orexigen or anorexigen neuropeptides thus resulting in the stimulation of food intake. Their peripheral targets are mainly the liver and the white adipose tissue where they stimulate lipogenesis, through the modulation of several enzymes and proteins expressions. Cannabinoïd receptor agonists are nowadays prescribed to improve appetite of people suffering from cancer or AIDS. In the same way, CB1 antagonist, such as Rimonabant, could provide efficient treatment of obesity.