Measuring Immunization Coverage among Preschool Children: Past, Present, and Future Opportunities

Control of vaccine-preventable diseases depends on maintaininghigh levels of immunization coverage. Immunization coverageamong preschool children remains suboptimal in some areas andsociodemographic subgroups, as well as for more recently introducedvaccines, leaving susceptible young children vulnerable to complicationsfrom vaccine-preventable diseases. This paper reviews approacheshistorically used to measure immunization coverage among preschoolchildren in the United States. The strengths and weaknessesof various approaches to measuring immunization coverage amongpreschool children are explored, with emphasis on the currentmeans to measure national immunization coverage—the NationalImmunization Survey. Methods for measuring immunization coverageamong preschool children at local and state levels are alsoevaluated. Future opportunities and challenges for measuringimmunization coverage at the local, state, and national levelsare explored. child health services • child, preschool • communicable disease control • comparative study • immunization programs • immunization schedule • vaccination     

Lifecourse Health Development: Past, Present and Future

During the latter half of the twentieth century, an explosion of research elucidated a growing number of causes of disease and contributors to health. Biopsychosocial models that accounted for the wide range of factors influencing health began to replace outmoded and overly simplified biomedical models of disease causation. More recently, models of lifecourse health development (LCHD) have synthesized research from biological, behavioral and social science disciplines, defined health development as a dynamic process that begins before conception and continues throughout the lifespan, and paved the way for the creation of novel strategies aimed at optimization of individual and population health trajectories. As rapid advances in epigenetics and biological systems research continue to inform and refine LCHD models, our healthcare delivery system has struggled to keep pace, and the gulf between knowledge and practice has widened. This paper attempts to chart the evolution of the LCHD framework, and illustrate its potential to transform how the MCH system addresses social, psychological, biological, and genetic influences on health, eliminates health disparities, reduces chronic illness, and contains healthcare costs. The LCHD approach can serve to highlight the foundational importance of MCH, moving it from the margins of national debate to the forefront of healthcare reform efforts. The paper concludes with suggestions for innovations that could accelerate the translation of health development principles into MCH practice.     

护理人员编制配备现状分析

护理人员编制是临床配备护理人员的依据,通过分析国外护理人员编制情况及我国护理人员编制配备现状,指出现护理人员编制中存在的问题和影响因素,为探索新型护理人员编制配备方案提出了一些参考。     

Genetics of Type 2 Diabetes: Past,Present, and Future

Diabetes has reached epidemic proportions worldwide. Currently, approximately 537 million adults (20–79 years) have diabetes, and the total number of people with diabetes is continuously increasing. Diabetes includes several subtypes. About 80% of all cases of diabetes are type 2 diabetes (T2D). T2D is a polygenic disease with an inheritance ranging from 30 to 70%. Genetic and environment/lifestyle factors, especially obesity and sedentary lifestyle, increase the risk of T2D. In this review, we discuss how studies on the genetics of diabetes started, how they expanded when genome-wide association studies and exome and whole-genome sequencing became available, and the current challenges in genetic studies of diabetes. T2D is heterogeneous with respect to clinical presentation, disease course, and response to treatment, and has several subgroups which differ in pathophysiology and risk of micro- and macrovascular complications. Currently, genetic studies of T2D focus on these subgroups to find the best diagnoses and treatments for these patients according to the principles of precision medicine.