某社区2019年第二类疫苗接种疑似预防接种异常反应监测结果

目的了解某社区第二类疫苗接种及疑似预防接种异常反应(AEFI)情况。方法通过查询疫苗出入库系统和中国免疫规划信息管理系统,对2019年该社区第二类疫苗使用及AEFI报告情况进行分析。结果2019年,该社区接种门诊共接种第二类疫苗21种7449剂,接种数最多的是13价肺炎疫苗(784剂)。接种数居前6位的依次为13价肺炎疫苗、ACYW135群流脑多糖疫苗、轮状病毒疫苗、百白破-IPV-HIB五联疫苗、手足口EV71疫苗、九价人乳头瘤疫苗。累计报告AEFI病例94例,发生率为1.26%;一般反应占96.81%,异常反应占3.19%。报告AEFI疫苗共12种,报告发生率居前6位的分别为13价肺炎疫苗、百白破-IPV-HIB五联疫苗、百白破-IPV-HIB四联疫苗、手足口EV71疫苗、九价HPV疫苗、AC结合流脑疫苗。结论第二类疫苗品种接种量均有所增加,AEFI报告发生率有所波动,需加强监测。     

区域性卫生规划及卫生资源配置标准的比较分析

目的：比较分析各地区域性卫生规划和卫生资源配置标准，为制定下阶段的区域卫生规划和资源配置标准提供科学依据。方法：采用文献定性和定量的分析方法，比较不同地区区域性卫生规划文献发表的数量、文献的主题和卫生资源配置标准等。结果：东部地区所发表的论文数量多于西部地区，但各地区发表文献的主题无显著差异；每千人口床位数、每千人口执业医师数、每千人口的执业护士数、每百万人口的CT和MRI数东部地区均高于西部地区；四川省各项指标低于西部地区。结论：区域性卫生规划和卫生资源的配置是改善和提高区域内的卫生综合服务能力以及卫生资源利用效率的重要措施，各地区的资源配置应与社会经济的发展相一致，要充分体现公平和效率、合理和实用的原则。     

The metamorphosis of health planning in the Netherlands and the USA

The United States and the Netherlands are the focus for this comparative analysis of the evolutionary interaction between health planning and the political system, seen in the context of change in social and economic ideologies. While health planning in the USA started in 1946, it was the comprehensive health planning program in 1966 that created the form to be followed by Health Systems Agency effort in 1974: local, voluntary planning, coordinated by state agencies, supported by federal funding. Health planning in the Netherlands has moved through four distinct periods: a hospital construction period, starting during the post-war recovery; a hospital regionalization period, from 1971 through the late 1970s; a transition period from the late 1970s to 1982, during which several planning approaches were considered; and, the current comprehensive health and social services planning period. Today, federal support for health planning in the US has been eliminated as part of the current de-regulatory, competitive health care strategy. Health planning in the US is now an institutional activity, with less focus on community needs. Advocated changes in the Dutch planning approach incorporate ideas similar to past approaches in the US; but, a failed approach in one nation may work in another, if the underlying cultural and organizational characteristics are sufficiently different.     

区域性卫生规划文献分析与评价

目的：对1990年至2002年6月期间在各种刊物上发表的区域性卫生规划的论文进行分析。方法：采用文献分析法，对论文发表的刊物、时间、作者所在地和单位、论文的主题和类别进行分析。结果：论文发表的刊物主要是卫生管理类、卫生经济、卫生政策、卫生资源等国家级刊物；发表的年份主要集中在1998年以后的几年中；作者所在的地区以北京、上海和山东最多；作者的单位以卫生行政单位和大专院校居多；论文的主题是以卫生资源配置居多；论文的类别以描述性的分析最多，理论研究其次。结论：应加强对区域性卫生规划实施评价和卫生资源配置方法的研究，不断总结经验，进一步推动区域性卫生规划的开展。     

Chemical neuromodulation of frontal-executive functions in humans and other animals

Neuromodulation of frontal-executive function is reviewed in the context of experiments on rats, monkeys and human subjects. The different functions of the chemically identified systems of the reticular core are analysed from the perspective of their possible different interactions with the prefrontal cortex. The role of dopamine in spatial working memory is reviewed, taking account of its deleterious as well as facilitatory effects. Baseline-dependent effects of dopaminergic manipulation are described in rats on an attentional task, including evidence of enhanced function following infusions of D1 receptor agonists into the prefrontal cortex. The precise nature of the cognitive task under study is shown to be a powerful determinant of the effects of mesofrontal dopamine depletion in monkeys. Parallels are identified in human subjects receiving drugs such as the indirect catecholamine agonists L-dopa, methylphenidate and the dopamine D2 receptor blocker sulpiride. The effects of these drugs on different types of cognitive function sensitive to frontal lobe dysfunction are contrasted with those of a manipulation of 5-HT function, dietary tryptophan depletion. Hypotheses are advanced that accord the ascending systems a greater deal of specificity in modulating prefrontal cortical function than has hitherto been entertained, and clinical and theoretical implications of this hypothesis are discussed.     

The impact of school exclusion zone planning guidance on the number and type of food outlets in an English local authority: A longitudinal analysis

The use of planning policy to manage and create a healthy food environment has become a popular policy tool for local governments in England. To date there has been no evaluation of their short-term impact on the built environment. We assess if planning guidance restricting new fast food outlets within 400 m of a secondary school, influences the food environment in the local authority of Newcastle Upon Tyne, UK. We have administrative data on all food outlets in Newcastle 3 years pre-intervention 2012–2015, the intervention year 2016, and three years’ post-intervention 2016–2019. We employ a difference-in-difference approach comparing postcodes within the school fast food outlet exclusion zone to those outside the fast-food exclusion zones. In the short term (3 years), planning guidance to limit the number of new fast-food outlets in a school exclusion zone did not have a statistically significant impact on the food environment when compared with a control zone.     

流动人口的计划生育管理分析

对1998年在上海闵行区开展的“以现居住地为主”的计划生育综合干预项目中外来育龄妇女的计划生育管理状况进行分析,综合运用定量与定性研究方法以了解她们的计划生育管理状况及对计生管理的态度和要求,评价计生管理干预对改善本市外来育龄妇女的计生管理状况及提高她们对计划生育管理的认知的效果。结果显示：通过管理干预,外来育龄妇女携带原籍计划生育证明的比例和持有计划生育信息卡的比例以及暂住证上加盖计划生育合格章的比例均明显增加,妇女对计划生育服务的满意度也明显增加。认为“以现居住地为主”的流动人口计划生育管理有助于计划生育管理,应进一步加强流入地与流出地的联络、协调与积极配合,加强流动人口的计生双向管理。     

开展社区卫生服务 促进基层医院发展

论述了开展社区卫生服务的必要性,提出开展社区卫生服务是基层医院和乡镇卫生院摆脱困境,取得新的发展的一条重要途径。在此基础上指出,开展社区卫生服务需要政府的高度重视和有关部门的大力支持;需要合理的区域规划,防止卫生资源的浪费;需要花大气力培养全科医生,提高业务素质;需要提高认识,转变观念,增强服务功能;需要加强管理,拓展服务范围,规范服务方式。     

Distinct prefrontal activations in processing sequence at the sentence and script level: an fMRI study

Neuropsychological studies have shown that the prefrontal cortex is important in planning and monitoring everyday behaviour. In this study, using functional magnetic resonance imaging (fMRI), we investigated whether specific prefrontal regions are involved in processing a sequence of actions. Subjects were required to perform two different tasks: Script-event order and Sentence-word order. Script sequence and word sequence processing were found to activate partially overlapping areas which are known to be implicated in language processing. In addition, the Script-task activated a large area in the dorsolateral prefrontal cortex (Brodmann area 6 and 8, BA 6 and 8), in both the left and right hemispheres, as well as the left supplementary motor area and left angular gyrus (BA 39). Our results suggest that these prefrontal areas may be more specifically involved in the process of analysing sequential links in the action domain.