Globalization and perinatal medicine – How do we respond?

Globalization is both inevitable and usually desirable and contains advantageous and disadvantageous issues. It is a source of both hope and of apprehension and is an accelerating process in flow of information, technology, goods and services, and production means. Globalization has a complex influence on perinatal health. The bonds that link perinatologists together transcend geographic, political, religious, and lingual differences, resulting in a globalization that optimizes perinatal care. In this review, we will discuss some of the global problems facing modern perinatologists.

?Close to 1.5 billion people in the world, live in extreme poverty, a situation which is particularly stark in the developing world, where 80% of them live. Poor people have little or no access to qualified health services and education, and do not participate in the decisions critical to their day-to-day lives. Poverty cannot be defined solely in terms of lack of income. A person, a family, even a nation is not deemed poor only because of low economic resources. Little or no access to health services, lack of access to safe water and adequate nutrition, illiteracy or low educational level, and a distorted perception of rights and needs are also essential components of poverty. Expression of poverty in perinatal health care in developing countries are high maternal death and morbidity rates, huge perinatal and childhood losses, and high birth rates. There are good reasons to define it as a global tragedy in our time.

?Although the mankind has come quite far because the development of civilization and more advances in the health care were made during the past 100 years than in all previous human history, some inhabitants of our planet are not able to experience it. According to some data, every 3 s a newborn dies, and every minute a pregnant woman dies in the globalized world. All together over 10 million deaths every year, which indicates that health security is not strong enough. It is essential for improvement of these discouraging data to be aware that global health security is only as strong as its weakest link. The situation in perinatal health affected by the global crisis could be solved if the world community can agree on and enact comprehensive reforms in both economic and social areas, and on the national and international level.     

中国现阶段企事业人力资源配置的现状及对策

从人力资源角度出发，本文对现代社会中的企事业的一个选人用人制度做了一些思考。主要是我国在现在乃至未来的一段时间究竟该施行何种人力资源配置，目前世界上最普遍最流行的就是能力、学历、资力这三大考量因素，可是不同的国家不同的公司会有不同的主次排比，那么什么样的组合才是适合、有利于我国企事业单位的呢？通过一系列国内外情况的比较分析加之对上海地区的具体调研、统计、分析得出笔者个人的结论：我们已进入唯能力时代，能力至上是必然趋势（除个别特例），学历和资力是能力的两个舆论缺一不可，但针对企业和事业单位的性质不同，具体在学历和资力间会有轻重之别，一般而言企业单位更应强调学历，事业单位更应强调资力。集中论述了中国现阶段企事业单位人力资源配置的现状及对策，基本分为三个层次进行：（1）我国人力资源配置现状调查及美日比较；（2）这种配置现存的可能的发展变化；（3）应解决问题的对策。     

局麻下经皮肾碎石术对高危肾结石患者的疗效与安全性探讨

目的：探讨B超引导局麻下经皮肾取石对高危。肾结石患者的疗效与安全性。方法：依据术前美国麻醉医师协会（ASA）评分,将91例行局麻下经皮肾镜取石术肾结石患者分为高危组（ASAUI或Ⅳ）23例和低危组（ASAI或11）68例,所有患者均运用微通道（F18）PCNL钬激光碎石术。记录并比较两组年龄、体质指数、合并疾病数量、结石平均体积、手术时间、术中出血量、结石清除率、平均术后住院时间及手术并发症。结果：高危组与低危组的平均年龄[（56．0士12．3）、（52．0±11．6）岁]、体质指数[（29．2土4．5）、（28．5±4．8）]、结石总体积[（3．12±1．13）、（3．27土1．45）cm^3]、术中平均估计失血量[（126±20）、（112±23）m1]、手术时间[（57±25）、（62±28）min]及主要并发症发生率（12．7％、13．5％）之间差异均无统计学意义（P〉0．05）。高危组与低危组在平均合并疾病数量[（4．7±1．8）、（1．4±0．7）]、平均术后住院天数[（8．5土3．7）、（6．2±2．3）d]、结石清除率（72．5％、91．3％）之间差异有统计学意义（P〈O．05）。结论：局麻下经皮肾取石对高危肾结石患者同样安全可行。     

和谐管理理论应用于医疗风险管理的启示

阐述了医疗风险管理的特点和目前我国医疗风险管理的现状，提出运用和谐管理理论的思想与风险管理相结合、利用双规则的互动耦合机制丰富医疗风险管理的思想，并论述了和谐管理理论对医疗风险管理的指导意义，为医疗风险管理的深入研究奠定了基础。     

The health implications of civic association in Russia

Can civic and political participation influence health outcomes, and if so, does the general aversion to joining community activities have some connection to poor health outcomes in Russia? Using data from surveys of 18,000+ urban Russians conducted from 2003 to 2005 and controlling for a wide range of variables, we find that individuals who join collective civic and political activities report better health than non-joiners and that living in a participatory community may enhance one’s health, regardless of one’s own participation.     

抓住电子病历应用共享核心推进数字化医院建设

国家卫生部对电子病历应用水平验收主要是对医院、区域电子病历共享进行验收,意在促进区域协同医疗和全民健康管理.长安医院紧紧抓住全国电子病历试点医院这一契机,努力建设数字化医院,获得国家卫生部“电子病历系统应用水平”考核全国第一,医院建设获得全面推进.     

尊重患者知情同意权 构建和谐医患关系

因侵害患者知情同意权引发的医疗纠纷越来越多,已影响到和谐医患关系的构建。医疗机构及其医务人员应当充分认识患者知情同意权的本质,尊重患者知情同意权;增强责任心,防止过失侵害患者知情同意权;提高医疗水平,避免对患者知情同意权的侵害;严格规范告知义务履行的程序和方式,防止医患之间因侵害知情同意权而发生纠纷,保护医患双方的合法权益,构建和谐的医患关系。     

论医学院校图书馆在学习型社会构建中的作用

学习型社会是一个终身学习、全民学习的社会。在医学院校构建学习型社会必须集医科师生个人与医学院校团体的力量,有效整合其机构的文化信息资源,充分发挥其效益。在阐述学习型社会的内涵与构建意义基础上,分析医学院校图书馆倡导自主学习的理念,拥有构建学习型社会需要丰富的学习资源,先进的信息传播技术应用及文献信息资源协同保障系统平台搭建,良好的学习环境、浓厚的学习氛围等优势,提出医学院校图书馆在构建学习型社会中有树立服务师生及员工的服务理念,开放常规服务,开展深层次信息服务等作用。     

The role of the physical environment in adolescent mental health

The existing literature suggests an association between the physical environment and mental health but also complex relationships between the social and the physical environment as well as between objective and subjective measures of the environment. In this study, we attempted to explore the role of the residential neighbourhood's physical environment in adolescent mental health, taking this complexity into account. Using data on 3683 ten- to 15-year-olds from England and Wales who participated in Understanding Society, we investigated the role of neighbourhood greenspace and air pollution in adolescent mental health (measured with the Strengths and Difficulties Questionnaire) while controlling for measures of neighbourhood and family socio-economic disadvantage as well as subjective perceptions of social cohesion, crime, safety, and noise in the neighbourhood. In linear regression models, greenspace and air pollution could not predict mental health. However, fear of being a victim of crime was a consistent predictor of mental health and behaviour, indicating the essential role of young people's subjective experience of their neighbourhoods for their mental health and well-being.     

The Enigma of Japanese Ageing-in-Place Practice in the Information Age: Does Digital Gadget Help the (Good) Practice for Inter-Generation Care?

Against the background of Japanese demographic transition towards a very aged one: 22% (and 10%) of the population are aged 65 or above (and 75 or above) in mid-2008, the socio-familial reluctance for ageing-in-institutions, and the limited (already the inadequacy of) institutional care, ageing-in-place is both the socio-familial desirable and the policy solution. This paper examines the coping strategies of Japanese society, in the shortage of caring services, with socio-techno innovations derived from information and communication technologies (ICT), towards ageing-in-place. Mobile phone and e-communications promise for borderless, flexible and ubiquitous contacts: real time, round-the-clock, anytime and anywhere, making the geo-spatial conditions irrelevant and for all age groups, but are these offerings for the beneficiaries of an ageing society? Mobile communicative gadgets become social necessity for most Japanese and they are used for intensive social networking; for instance, the mobile phone's role in friendship-building among younger generations—but what about the senior adults for the place anchorage for active ageing? This paper examines and discusses the socio-familial-spatial (social networking, location and place) relevance of mobile communication, emphasizing the use of ICT and mobile communication by/with/for ageing population, for realizing the benefits of ageing-in-place. It especially considers elderly and their families, in the need for socially and geo-spatially fixed anchors (the essence of ageing-in-place), despite (or perhaps because of) the ‘mobility’ through ICT. Our key observations: the trend towards the intensification of ICT use, though affecting differential inter-personal relationship, evidently enables the practice for ageing-in-place in the information age.