北京市朝阳区"生活方式疾病综合防治示范社区项目"实施研究

北京市朝阳区于2002年12月在两个示范社区开展实施了为期3年的北京市政府制定的“生活方式疾病综合防治示范社区项目”。该项目采用了国际通用的方法，在社区诊断的基础上，针对社区的主要健康问题实施全人群（即一般人群、高危人群和患病人群）的干预策略；重点通过改善高危人群的不良生活方式和行为习惯，有效控制、逐渐降低因此引起的高血压、糖尿病、肥胖、心血管病等对健康的危害。     

“健康管理”的理念和实践

论述了健康管理的定义,提出当今健康管理的主题是慢性生活方式疾病的预防与控制,通过健康管理阻断慢性生活方式疾病的自然进程,实施“饮食、身体活动与健康的全球战略”,预防控制代谢紊乱,促进健康饮食和身体活动并促成能量平衡的生活方式是关键。同时提出了当前在健康管理实践中的问题和解决办法。     

社区健康管理的实践初探

近年来,随着中国改革开放与经济的快速发展,人们对健康维护服务的需求逐日增加,医疗卫生服务体系已经由将优质资源集中在疾病甚至是终末期的治疗,转向疾病早期的预防以及健康生活方式的促进,而社区卫生服务是我国医疗卫生体系的网底,扮演着重要角色,社区健康管理因此应运而生。本文将就社区健康管理的初步实践进行阐述,以探讨更为有效的居民健康维护方式。     

强化政府责任 促进预防事业健康发展

如何促进新形势下预防事业的健康发展,本文认为关键在强化各级政府的责任,落实预防事业相关下策。当前掺着重强化政府对预防事业的责任,主要包括：真正把预防工作纳入政府的重要议事日程;切实执行预防事业相关卫生经济政策;继续实行对预防机构的税、费优惠政策;努力保证预防事业经费合理增长;保留并增加预防事业专项资金;多渠道筹集预防资金;科学规范预防机构有偿服务行为;进一步加强预防事业法制建设。     

社区健康干预的实践与思考

社区健康干预是指以社区为单位,多部门协作,有组织有计划地开展一系列活动,以创造有利于健康的环境,改变人们的行为和生活方式,降低健康危险因子水平,预防疾病,促进健康,提高生活质量.     

为中国健康管理事业的健康发展鼓劲

近年来，随着人民生活的不断改善，人们对健康服务的需求显著提高。面临着慢性非传染性疾病对健康和生命的威胁，健康管理作为一项崭新的健康服务手段的重要性越来越得到广泛认同。在不长的时间内，我国各种类型的医疗服务机构纷纷推出各种健康管理服务。如何利用市场经济的杠杆来规范健康管理市场就成了当前的一项重要任务。     

健康与健康管理

随着社会经济的高速发展,人们在享受丰富多彩的物质和文化生活,以及日趋发达的医学服务的同时,对健康的意识和需求也在不断提升。因此21世纪的医学所追求的不仅仅是提高治疗水平,而是让人类生活得更健康。“预防疾病产生,促进身体健康,提高生命质量”是本世纪的健康主题。     

淞南镇创建艾滋病健康促进社区的实践与体会

上海市宝山区淞南镇根据《宝山区预防控制艾滋病中长期规划（2002～2015）实施意见》的要求，两年来，为创建艾滋病健康促进社区，探索综合防治工作模式作了有益的尝试和实践。     

做好社区健康服务促进儿童保健事业发展

积极开展的社区卫生服务通过8年的运作和实践，全区儿童健康水平逐年提高。政府的重视和参与、卫生主管部门对社区卫生服务的管理是做好儿童保健工作的关键。区、街道、社区紧密协作，责、权、利明确是开展社区卫生服务工作的保证。     

我的健康我知道——发展需求催生健康管理事业

我的健康管理的起步 如同其他学科和行业一样，健康管理在中国兴起也是由于市场的需要，健康资源是中国近期经济起飞的主要动力之一。     

突发公共卫生事件儿童健康传播实践与探讨

在突发公共卫生事件中,儿童作为弱势群体,面临更多的权利缺失风险,而合理的健康传播有助于保护儿童权利。本文以新型冠状病毒肺炎疫情为例,以儿童权利为框架,基于传播学经典的"5W"理论,梳理2020年1月22日至4月28日中国卫生和教育行政主管部门政务媒体、部分儿童相关机构自媒体、社会主流媒体关于疫期儿童的相关信息发现,中国儿童健康传播主体多元,传播内容凸现对儿童权利相关(49%)的重视,传播渠道彰显全媒体特点,但将儿童作为传播对象的重视度不够(3%),传播效果经历了从负向到正向的转变。据此提出了社交媒体时代突发公共卫生事件儿童健康传播"知情、有益、参与"原则和"风险评估前置"策略,呼吁儿童健康传播机构重视保护儿童权利,并提升儿童健康素养和媒介素养。     

灾区卫生救援实践与思考

"5·12"汶川特大地震,牵动着全国人民的心.为了帮助灾区人民做好灾后防病工作,全国各地卫生防疫工作人员纷纷响应号召开赴前线.现将对在灾区现场近三周的工作实践情况进行讨论,为今后的救灾防病工作提供参考.     

Petroleum scarcity and public health: considerations for local health departments

Recognition of petroleum as a finite global resource has spurred increasing interest in the intersection between petroleum scarcity and public health. Local health departments represent a critical yet highly vulnerable component of the public health infrastructure. These frontline agencies currently face daunting resource constraints and rely heavily on petroleum for vital population-based health services. Against this backdrop, petroleum scarcity may necessitate reconfiguring local public health service approaches. We describe the anticipated impacts of petroleum scarcity on local health departments, recommend the use of the 10 Essential Public Health Services as a framework for examining attendant operational challenges and potential responses to them, and describe approaches that local health departments and their stakeholders could consider as part of timely planning efforts.     

关于我国公共卫生策略的思考

20 0 3年 2月初 ,一场突如其来的严重急性呼吸综合征 (SARS)先由广东、后在北京爆发流行 ,在全国大部分省市肆虐、蔓延 ,成为由传染病所致的突发公共卫生事件引发的一场国难。人民的生命安全受到严重威胁 ,正常的生产、生活及社会活动秩序被打乱 ,我国的国民经济受到严重损失。虽然在我国政府强有力的领导下 ,疫情已经基本得到控制 ,但这场灾难对中国乃至世界的影响将深刻而长远。1988年 1月 ,上海发生了世界历史上罕见的甲型肝炎的爆发流行 ,流行高峰期每天发病人数超过 10 0 0 0人 ,最高日发病达到 190 13人。至当年 5月 13日 ,共有 310…     

Evaluative designs in public health: methodological considerations

Evaluation of public health interventions poses numerous methodological challenges. Randomization of individuals is not always feasible and interventions are usually composed of multiple factors. To face these challenges, certain elements, such as the selection of the most appropriate design and the use of a statistical analysis that includes potential confounders, are essential. The objective of this article was to describe the most frequently used designs in the evaluation of public health interventions (policies, programs or campaigns). The characteristics, strengths and weaknesses of each of these evaluative designs are described. Additionally, a brief explanation of the most commonly used statistical analysis in each of these designs is provided.     

Important considerations in the development of public health advisories for arsenic and arsenic-containing compounds in drinking water

Drinking water contamination by arsenic remains a major public health problem. Acute and chronic arsenic exposure via drinking water has been reported in many countries of the world; especially in Argentina, Bangladesh, India, Mexico, Thailand, and Taiwan, where a large proportion of drinking water (ground water) is contaminated with a high concentration of arsenic. Research has also pointed out significantly higher standardized mortality ratios and cumulative mortality rates for cancers of the bladder, kidney, skin, liver, and colon in many areas of arsenic pollution. General health effects that are associated with arsenic exposure include cardiovascular and peripheral vascular disease, developmental anomalies, neurologic and neurobehavioral disorders, diabetes, hearing loss, portal fibrosis of the liver, lung fibrosis, hematologic disorders (anemia, leukopenia, and eosinophilia), and carcinoma. Although, the clinical manifestations of arsenic poisoning appear similar, the toxicity of arsenic compounds depends largely u[on the chemical species and the form of arsenic involved. On the basis of its high degree of toxicity to humans, and the non-threshold dose-response assumption, a zero level exposure is recommended for arsenic, even though this level is practically non-attainable. In this review, we provide and discuss important information on the physical and chemical properties, production and use, fate and transport, toxicokinetics, systemic and carcinogenic health effects, regulatory and health guidelines, analytical methods, and treatment technologies that are applied to arsenic pollution. Such information is critical in assisting the federal, state and local officials who are responsible for protecting public health in dealing with the problem of drinking water contamination by arsenic and arsenic-containing compounds.     

The promising application of health technology assessment in public health: a review of background information and considerations for future development

Introduction

Health technology assessment (HTA) is a multidisciplinary approach to the evaluation of health-care technologies, which aims to support the decision-making process by driving medical, technical and economic knowledge. It is characterised by the contextual examination of epidemiological, clinical, economic, social, ethical and organisational implications.

Main part

Even if it was born in fields other than medicine, HTA has progressively spread as an innovative tool to assess health-care technologies such as drugs, medical devices and surgical procedures. Through a scientific literature review the purpose of applying HTA to public health was explained and discussed. Tackling interventions to control health determinants has great potential for reducing the burden of disease and for promoting health in the general population. Anyway health expenditure for public health is low: this could threaten interventions and damage the role of public health itself. HTA could represent a guide to best invest in this field and to gain in efficacy and effectiveness in line with current strategies to implement health services in all sectors.

Conclusion

HTA could represent a good tool to address all topics and problems pertaining to choices in public health and could allow decision-makers to best invest scarce available resources.     

Hazardous materials emergency incidents: public health considerations and implications

Objective : Hazardous materials (HAZMAT) incidents, including the deliberate release of toxic chemicals, can cause a significant drain on resources as well as heightened anxiety in the community. Recent high‐profile incidents, including the 2018 illegal waste storage fire in Victoria, Australia, have highlighted the complexity but also the value of multidisciplinary approaches to HAZMAT events. This brief report examines issues from a public health perspective and reflects on the experience of such events in South Australia. Methods : The type, location and time of HAZMAT incidents for the period 2001 to 2018 (inclusive) in South Australia were compiled and classified from a database of the state Technical Advice Coordinator. Results : The profile of HAZMAT events was diverse, including fires, spills, unknown chemicals, sabotage and suicides. Incidents frequently occurred around transportation corridors and storage facilities. Public health agency involvement was most evident for known or suspected biological agents (toxins) and chemical toxicants with persistent exposures. Conclusion and implications for public health : Public health agencies are likely to have a greater future role in HAZMAT management as the complexity of incidents increases (e.g. mass casualty events and events involving vulnerable subpopulations). There is a need for a national HAZMAT surveillance database to coordinate agency responses on a national level. A unified approach to risk communication for vulnerable communities is also critical.