Out of the boxes,out of the silos: The need of interdisciplinary collaboration to reduce poor-quality medical products in the supply chain

In this paper, we argue that understanding and addressing the problem of poor-quality medical products requires a more interdisciplinary approach than has been evident to date. While prospective studies based on rigorous standardized methodologies are the gold standard for measuring the prevalence of poor-quality medical products and understanding their distribution nationally and internationally, they should be complemented by social science research to unpack the complex set of social, economic, and governance factors that underlie these patterns. In the following sections, we discuss specific examples of prospective quality surveys and of social science studies, highlighting the value of cross-sector partnerships in driving high-quality, policy-relevant research in this area.     

Constructing queer mother‐knowledge and negotiating medical authority in online lesbian pregnancy journals

Medical interactions around reproduction are increasingly extending beyond the physician's office and onto the Internet, where negotiation with medical authority occurs in complex and dynamic ways. Recently, scholars have noted the Internet's potential for creating spaces where women can dialogue with and reconstruct medical authority, yet this growing body of work is overwhelming heteronormative. This paper thus interrogates how lesbian women use the Internet to challenge, deploy, and rework medical authority around reproduction while navigating the transition to parenthood. I draw from 17 online journals authored by lesbian couples during the conception, pregnancy, and birth of their first child, each spanning between 18 months and 2 years, in order to understand how the transition process unfolds over time. I argue that lesbian couples engage with medical authority when seeking affirmation and normalisation yet discard and publicly reject the heteronormative assumptions that accompany reproductive medicine. Further, they chart a new process that I term ‘constructing queer mother‐knowledge’, in which they critique and balance knowledges from institutionalised medicine, their own bodies, and their queer communities. With this new concept, I complicate understandings of lesbian mothers‐to‐be and their interactions with medical authority as they build subversive families.     

中药栀子本草考证

栀子临床应用广泛,且历史悠久,为更好地利用栀子资源,通过梳理历代文献与现代研究,对栀子名称、品种、产地、炮制、功效等方面进行考证,发现栀子命名主要以形态、色泽为依据,一定程度上反映了栀子的特征,并且存在与水栀子混用"黄栀"之名的情况。古代文献中记载的栀子产地最早为南阳,但产量不高,受人口迁移以及生产力发展的影响,栀子的产地主要转移到南方,且以南方产者为佳。在历代本草文献中记载入药用的栀子为山栀子,水栀子不堪入药,但在《伤寒论》等古代方书中有"肥栀子""大栀子"入药用的记载,通过后世对相应方剂的记载,确定二者应为水栀子,为水栀子的临床应用提供了有力依据。之所以与本草文献记载有所差异,应与《雷公炮炙论》和《伤寒论》的年代不同,栀子的产量及采收能力有所差距,且本草书重规范,择优入药,方书注重实用等特点有关,并且根据现代实验研究表明山栀子与水栀子化学成分组成、含量相似,具有相同的利胆作用。此外,系统整理了历代本草与方书中栀子的炮制方法和功效,并进行了分析,为栀子属资源的进一步研究与利用提供了参考和借鉴。     

藏药“蒂达”的名称与品种考证

采用文献考证与实地调查相结合的方法,对常用藏药材"蒂达"的名称、品种分类及其基原进行了考证和整理.结果表明,"蒂达"的名称、品种和基原极为复杂混乱,是导致其缺乏和难以制定药材质量控制标准的关键制约因素.类似状况在民族药中普遍存在,反映出了对民族药进行品种整理的必要性和迫切性.由于古代文献对于药物基原的形态描述往往较为简单,多数情况下仅根据文献考证难以准确确定其基原,在进行民族药品种整理时,还应"尊古不泥古",注重古今药材品种、基原的历史变迁和现实资源、临床使用状况的调查,并积极借鉴现代化学、生物活性评价等的研究成果,既继承民族医药的特色与优势,又推动其现代化发展.     

When the standards aren't standard: Evidence-based medicine in the Russian context

This paper examines the uses of evidence-based medicine (EBM) in post-Soviet Russia through the use of semi-structured interviews. It asks what it means to talk about practicing evidence-based medicine in a setting where the context of practice presents considerable barriers to the implementation of EBM principles. Drawing on interviews with Russian physicians, medical students and users of the healthcare system, the paper argues that in post-Soviet Russia EBM serves as a strategic discourse for segments of the medical profession. With the collapse of the U.S.S.R. the healthcare system has been going through a period of crisis, and Russian physicians are finding that they have to redefine their professional identity with respect to the domestic and the international context and have to seek new sources for legitimating their professional position. The western origins of EBM endow this rhetoric with considerable power in the Russian context and render it a very useful tool in the project of redefinition.     

经典名方中海风藤的本草考证

通过查阅古代本草、医籍,结合近现代文献资料,笔者对海风藤药材名称、基原、产地及采收加工进行考证,以期为含海风藤药材的经典名方开发提供依据。经考证表明,海风藤入药最早以“南藤”为正名收载于唐代《本草拾遗》,并有“丁公藤”“石南藤”等异名;而“海风藤”一名应出现于明代;宋代之前海风藤药材来源可能为胡椒科胡椒属植物石南藤Piper wallichii的藤茎,宋代后使用品种则多为胡椒属风藤P. kadsura、山蒟P. hancei等植物,历版《中华人民共和国药典》收载海风藤药材基原仅风藤P. kadsura一种,结合基原考证、市场调查及野生资源分布情况,建议经典名方所用海风藤基原除风藤P. kadsura外,可增加山蒟P. hancei;由于气候变化及胡椒属植物喜热的习性特点,历代海风藤药材所著录的产地呈现由秦岭一带逐渐向南迁移至南方盛产胡椒属植物的地区,明代以来则推崇福建省泉州地区;采收期为农历七月至八月,采取地上部分,除去须根、细茎及叶,晒干;历代关于海风藤药材的炮制记载较少,多为生品入药,故建议经典名方所用海风藤药材未注明特殊炮制要求的采用生品即可。     

中药降香的本草考证

降香为我国传统中药材,历代本草对其记载较为混杂,至今基原仍存在较大争议。从名称、基原、产地、品质评价、采收加工及炮制方面进行考证可知,降香本名降真香,历代本草中多以降真香为正名记载,自明代《本草纲目》将降香作为降真香的简称,后至清末、民国时期逐渐以降香作为药材正名。从古至今降香基原历经变革,古代（1840年前）国产降香基原考证为黄檀属藤黄檀Dalbergia hancei Benth.、斜叶黄檀D. pinnata （Lour.） Prain、两粤黄檀D. benthamii Prain、滇黔黄檀D. yunnanensis Franch.等能够产生香材的藤本植物,进口降香基原则考证为黄檀属印度黄檀D. sissoo DC.、小花黄檀D. parviflora Roxb.等具有心材的木本植物;由于降真香（山油柑）Acronychia pedunculata （L.） Miq.植物名与药材名相同,1840—1948年部分著作误将山油柑作降香记载;《中华人民共和国药典》1977年版首次收录降香,规定其基原为降香檀D. odorifera T. Chen。据记载,古代国产和进口降香均无明确道地产区;1949年至今,唯一道地产区为海南省。历代本草记载,进口降香以颜色红且香气甜而不辣,或颜色紫而油润者入药为佳;中华人民共和国成立后,以降香檀心材替代进口降香入药,其品质以颜色紫红、质地坚硬油润者为佳。历代本草记载降香炮制方法包括将其刮下碾成细末和烧存性;近现代以加工成细粉或镑片为主。考证结果为今后成方制剂开发及临床应用提供重要参考。     

Being in charge: Older women and their younger female kin

Our cross-cultural study of the relationship between older women and their younger female kin examines women's hierarchies based on age and focuses on the exercise of authority by women, when such authority is traditional and accepted. Data were collected for two world-wide samples each consisting of 30 societies, varying in complexity, subsistence base, geographic location, and in customs related to women's lives. Three hypotheses were tested. The findings, which are statistically significant, suggest that the relationships between older women and their younger female kin are patterned and predictable, determined by the role of women in subsistence activities, by rules for post-marital residence, and by descent.When domination can only be exercised... directly, between one person and another, it can not take place overtly and must be disguised under the veil of enchanted relationships, the official model of which is presented by the relations between kinsmen.The gentle, invisible form of violence, which is never recognized as such... can not fail to be seen as the most economical mode of domination...The system is such that the dominant agents have a vested interest in virtue. (Bourdieu 1991191, 192, 194)     

武陵地区民间146种“七”药考证与分析

为统一对民族民间“七”药的认识,解决“七”药命名中同物异名或同名异物的难题,经过多年对武陵地区“七”药的实地考察和核对有关标本,文献,考证出了该地区１４６种“七”药的名实,分析了“七”药的生态环境,基原,性味,功效及化学成分。并对“七”药的科学命名和应用开发提出了建议。     

基于分级角色的访问控制

结合RBAC模型,提出了一种基于分级角色的访问控制模型,将系统用户依据职能的不同分为不同的角色,同一类角色又划分不同的等级。定义了基本概念和等级-角色矩阵,进行了形式化的描述,并应用在实际系统中。每一个实际用户通过不同等级的角色,对应于不同访问权限的资源,并可动态地进行角色转换和等级变迁,从而使访问控制机制更为灵活。