我国农村医疗卫生存在的问题及财政对策构想

该文从政府缺位角度分析当前我国农村医疗卫生事业领域存在的问题，并就政府缺位原因进行解析，提出解决我国农村医疗卫生事业领域政府缺位问题的对策构想：供需兼顾，稳步推进我国医疗卫生体制改革；多方筹资，促进医疗卫生体制均衡发展；加大农村医疗卫生事业的财政支出力度；构建符合我国国情、促进农村医疗卫生事业发展的公共财政保障机制。     

我国农村医疗卫生存在的问题分析及财政对策构想

从政府缺位入手分析当前我国农村医疗卫生事业领域存在的问题，并就政府缺位原因进行解析，提出解决我国农村医疗卫生事业领域政府缺位问题的对策构想：供需兼顾，稳步推进我国医疗卫生体制改革；多方筹资，促进医疗卫生体制均衡发展；加大农村医疗卫生事业的财政支持力度；构建符合我国国情、促进农村医疗卫生事业发展的公共财政保障机制。     

政界视域中医疗卫生领域政府主导的内涵界定评析

政府文件多次提及政府主导概念并从不同角度界定医疗卫生领域政府主导内涵。通过对政府四大文件中政府主导内涵界定的评析以全面展示政府主导概念由浅入深的认识过程,并以此全面、深入地揭示医疗卫生领域政府主导的内容、本质和历史演变。     

对我国医疗卫生体制改革的思考

我国的医疗卫生体制改革一直是人们关注的焦点，其改革的取向也存在着很大的争议。从总体上划分，医疗所涉及的领域主要有两个：一个是医疗保障体制，另一个是医疗机构。医疗卫生改革的讨论也就存在于这两个领域。在医疗保障体制建设中，应强化政府主导，市场发挥补充作用，而在医疗机构建设中，应强化市场化导向，政府发挥补充作用。     

北京和睦家医院和诊所再度通过国际联合委员会认证

据了解，中国医疗卫生发展论坛从2003年开始，至今已召开了8届。中国医疗卫生产业发展论坛的建立是促进了业界的政府、医疗、企业、专家、学者之间的沟通与交流，     

中国亟需发展医疗卫生领域第四产业

众所周知，人类医疗卫生事业是各国政府和社会团体对民众实行一定福利政策的社会公益事业，它是在注重社会效益的前提下追求经济效益的一种特殊商品化产业。以前，医疗卫生事业通常是由医院、药品和医疗器械这三大支柱所组成。如今，另一支柱产业，在国际上被称之为医疗卫生领域第四大     

医疗卫生领域服务型政府建设的四个阶段

服务型政府的建设是实现医疗卫生体制改革成功的关键。医疗卫生领域服务型政府的建设必然经历"分、交、管、系"四个阶段。     

反商业贿赂：多棱镜下的“治贿运动”

去年年底、今年年初，特别是两会过后，医疗卫生领域的反商业贿赂可谓波涛汹涌，声势浩大。而在六、七月份开始的“自查自纠”更是变成了一场“整风运动”。对这近一年的专项治理，政府官员、专家学者、法律人士，还有回扣的主角一医药代表都通过自己的视角表达了对治贿行动的理解。     

公共卫生产品与政府卫生投入补偿机制

从公共卫生产品的性质和特点出发，指出市场经济环境下医疗卫生领域存在的主要问题，分析管理者对公共卫生和基本医疗领域施加干预的必要性，提出健全政府卫生投入补偿机制的主要途径，以公共产品的视角阐述了政府在公共卫生和基本医疗领域应担负的责任和所起的作用。     

“报告”里的“卫生”路

自新医改启动至今已有4年．这4年中，医疗卫生领域中取得了什么成绩，又发生了哪些变化，我们试图追溯一场新医改的嬗变。通过摘录2009-2013年政府工作报告中医疗卫生相关内容，从报告中关于医疗卫生的点点滴滴描述，管窥新医改的渐进过程。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.