Una combinación de alto riesgo: obesidad,marcas de alimentación,menores y retos en YouTube

ObjectiveTo identify high-risk content in food advertising that combines obesogenic features with a highly emotionally engaging format.MethodComparison of 304 videos (47 hours and 41 minutes) from 13 food brand channels (traditional advertising) and from 15 child YouTuber channels (endorsement and influence) posted in 2019. Exploratory content analysis of variables describing the communication style of the “challenges” format.ResultsChallenges are the most common type of content (53.3%; n = 162), with a greater prevalence on child YouTuber channels (59%; n = 131) than on brand channels (41%; n = 31).ConclusionsContent created by consumers is not covered by current audiovisual communication legislation. Increased control of these practices is urgently needed, in terms of legislation, self-regulation and codes of ethics. Creativity, enjoyment or mere entertainment is not a sufficient argument for the persuasive promotion of behaviors that endanger the physical health of children.     

DASH饮食模式治疗高血压的研究进展与挑战

高血压是心血管疾病中导致全球疾病负担及死亡的主要原因，但全球的高血压控制率均较低。终止高血压（DASH）饮食常作为国际高血压联盟及多国高血压防治指南推荐的一线非药物控制血压措施，但因推广性较差、患者依从性低难以有效发挥其作用。改良DASH饮食契合不同的饮食文化和疾病特殊需求，有利于提升饮食外推性、治疗效果及患者依从性。但DASH饮食的改良方法繁多，目前的研究显示其对高血压相关危险因素的防治效果并不统一。本文从改良DASH饮食起源与发展、改良DASH饮食的效果、改良DASH饮食目前的挑战及展望进行阐述，以期为改良DASH饮食降压效果提供依据，为未来改良DASH饮食研究方向提供参考。     

Challenges in conducting post-authorisation safety studies (PASS): A vaccine manufacturer's view

Post-authorisation safety studies (PASS) of vaccines assess or quantify the risk of adverse events following immunisation that were not identified or could not be estimated pre-licensure. The aim of this perspective paper is to describe the authors’ experience in the design and conduct of twelve PASS that contributed to the evaluation of the benefit-risk of vaccines in real-world settings. We describe challenges and learnings from selected PASS of rotavirus, malaria, influenza, human papillomavirus and measles-mumps-rubella-varicella vaccines that assessed or identified potential or theoretical risks, which may lead to changes to risk management plans and/or to label updates. Study settings include the use of large healthcare databases and de novo data collection. PASS methodology is influenced by the background incidence of the outcome of interest, vaccine uptake, availability and quality of data sources, identification of the at-risk population and of suitable comparators, availability of validated case definitions, and the frequent need for case ascertainment in large databases. Challenges include the requirement for valid exposure and outcome data, identification of, and access to, adequate data sources, and mitigating limitations including bias and confounding. Assessing feasibility is becoming a key step to confirm that study objectives can be met in a timely manner. PASS provide critical information for regulators, public health agencies, vaccine manufacturers and ultimately, individuals. Collaborative approaches and synergistic efforts between vaccine manufacturers and key stakeholders, such as regulatory and public health agencies, are needed to facilitate access to data, and to drive optimal study design and implementation, with the aim of generating robust evidence.     

Vulnerable prisoners: Dementia and the impact on prisoners,staff and the correctional setting

The aim of this paper is to increase awareness and highlight the need for prisoner’s early identification of dementia and recommend support strategies within the Australian correctional setting. The number of older people is increasing within the correctional setting, causing a corresponding increase in the number of prisoners with dementia. These older prisoners are at greater risk of developing cognitive impairment and dementia which increases their vulnerability in the correctional environment including their interactions with both correctional services staff and other prisoners. Correctional settings have not been designed for older prisoners or those with dementia, which poses problems for physical and psychological health. People who have encounters with the criminal justice system are generally in poorer physical and mental health than the general population. Identifying dementia in the early stages provides opportunities to initiate strategies and supports to slow the progression. However being incarcerated increases the likelihood of not being identified with dementia until the later stages of the disease process, which significantly reduces opportunities for early intervention.     

我国家庭医生签约服务政策演变及趋势分析*

随着医药卫生体制改革的不断深入,家庭医生签约服务制度不断完善,我国已经建立了家庭医生制度和相应配套措施。自2006年起,家庭医生制度的发展可以分为三个阶段,政府根据基层卫生服务状况及相应的社会环境制订和调整了一系列政策法规。本文回顾了家庭医生制度演变,对各阶段的政策内容及特点进行了梳理。在此基础上分析了在政策指导下家庭医生签约服务面临的挑战,提出完善家庭医生制度的相应建议,为实现签约服务相应目标提供参考依据。     

社会办医的新时期：机遇、挑战与对策

国家对社会资本举办医疗机构的重视不断增强,社会办医的发展具备政策、经济和社会等方面的条件,社会办医发展不断加速.但加快发展社会办医仍然存在目标和定位不清、社会资本引入动力不足、可持续性发展困难、政府和市场角色混淆和监管不力等问题.本文在分析了社会办医发展现状的基础上明确了加快发展社会办医的机遇与挑战,并提出了应对挑战的对策建议,即拓宽社会办医的服务内容与人群、创造良好的资本进入环境、促进社会办医可持续性发展、明确政府和市场在社会办医中的职能和加强对社会办医的监管.