COMMUNITY PARTNERSHIPS: THE UNI PROGRAM

In September 1992, the W. K. Kellogg Foundation undertook its UNI Program initiative, as part of its Latin American programmes, with the funding of 15 projects, in eight countries, and supporting strategies. The aim of the UNI Program in health professions education is to achieve synchronous development of educational models that are based on local health care systems where there is an important community participation in their management. An overriding problem inhibiting reform in health professions education towards a community orientation is the absence of academic community-based, problem-focused health care systems integrating the functions of health care, research, and teaching which would balance the tertiary-oriented models. The process of community participation is also unclear. All institutions propose major changes in the areas of curriculum, use of new learning opportunities at the community level, and interdisciplinary work. All will involve, as a minimum requirement, medical and nursing education, although 12 projects will also involve dentistry education, and 10 will involve other health professions — pharmacists, social workers, nutritionists, etc. This paper provides an overview of the programme, information on the progress of the 15 projects, and the perspectives to extend the programme to other countries in the Latin America region.     

IMPLEMENTING A COMMUNITY INITIATIVE FOR THE PREVENTION OF INJURY ON FARMS IN NEW ZEALAND

ABSTRACT: Among New Zealand occupational injuries, farm-related injuries are second only to forestry in importance. A three-year Farm Safety Study, funded by the Accident Rehabilitation and Compensation Insurance Corporation, researched the epidemiology of farm injury in New Zealand, the safety behaviour and attitudes of people living on farms and the international literature on farm safety strategies. The Farm Safety Study made funds and regional injury information available to a local farm women's network in Southland to initiate work on farm safety through a series of workshops. Evaluation indicated effective coverage of farm types and localities. Outcomes included increased safety awareness, suggestions for a range of individual, community and institutional strategies and proposals for a local fieldworker. Over half the women responding to an evaluation questionnaire reported taking specific action to make their own farm safer. This project indicates that linking integrated, locally based research with action by community groups can be an effective mechanism to advance change.     

新型糖肽类抗生素——达巴万星

随着广谱抗菌药物及免疫抑制剂的使用，人口老龄化社会现象，抗菌药物耐药问题日益严重。和抗菌药物耐药相比，研制一种新型的抗菌药物的速度远远落后于前者。耐药的革兰阳性（G+）球菌是导致临床抗感染治疗失败的主要原因之一。达巴万星(dalbavancin)为Vicuron Pharmaceuticals公司开发的一种新型半合成糖肽类抗生素，为替考拉宁类似物A40926的衍生物，其化学结构式见图1。目前已完成了Ⅲ期临床试验，它对各类临床常见G+菌具有高度抗菌活性。达巴万星具有和替考拉宁相似的分子结构，但羧基肽基团末端的酰胺基修饰提高了达巴万星对葡萄球菌属，特别是凝固酶阴性葡萄球菌的抗菌活性；而亲脂支链和二聚体的形成提高了达巴万星的组织穿透性和与细菌细胞膜的亲和力。和替考拉宁等糖肽类抗生素一样，达巴万星通过与细菌细胞壁肽聚糖上D 丙氨酰 丙氨酸末端特异性结合，抑制细菌细胞壁肽聚糖的延伸和交联，阻止细胞壁合成而发挥杀菌作用。     

A JOINT PROBLEM DRINKING CLINIC: THE KING'S COLLEGE AND MAUDSLEY HOSPITALS INITIATIVE

We describe the establishment of a joint alcohol misuse clinic,staffed by both a psychiatrist and a physician, in a LondonTeaching Hospital providing general as well as specialist medicalservices. The demographic and medicopsychiatric problems ofthe first 100 referrals (60% attendance rate) are described.The clinic provides an assessment and re-education role formost patients referred with alcohol misuse problems: the needfor specialist alcohol treatment facilities, especially forin-patients, remains essential. In addition, the clinic providesa valuable training and research resource.     

Road Trauma — A Rural Public Health Problem

ABSTRACT: In economic terms road trauma is Australia's major public health problem. It discriminates against the young, the elderly and the rural community. In order to be resolved, the issue must be firmly placed on the health care agenda and more research needs to be carried out in relation to rural road trauma. There are many reasons why rural health professionals should be involved with traffic safety. These include the recognition of road trauma as a health care issue in public debate and health professional training and education; emergency trauma management and continuity of care; research, social advocacy and preventive strategies. Networking and inter-professional cooperation are also seen as vital to the promotion of a safer Australia. The issue has environmental implications and is part of the promotion of healthy communities. The understanding of the implementation problems relating to road safety initiatives is the great traffic safety issue of the decade and health care professionals can help to stimulate debate about these matters.