健康教育的进展

健康教育是以医院为基地,以患者及其家属为对象,通过护理人员有计划、有目的的教育过程,达到使患者了解和增进健康知识,改变他们的健康行为,使其行为向有利于健康的方向发展。下面就健康教育的进展综述如下。1 将健康教育学纳入护理教学体系 为了满足21世纪护理发展的需要,根据现阶段许多护士对健康教育的认识及开展情况的调查,把健康教育纳入护理教学是非常必要的。国际护理学会在1973年批准修改的《国际护士     

卫生服务对改善健康状况的贡献研究

目的　分析卫生服务等因素对健康状况改善的影响。方法　采用Auster等的生产函数模型 ,将年龄调整死亡率作为健康产出 ,将卫生服务、生活方式、生存环境及经济、教育等因素作为投入 ,用两阶段最小二乘法分析各种因素的作用及作用的大小。结果　卫生服务对年龄调整死亡率的贡献大约是 0 37左右。它的影响大于教育而小于经济。结论　提示卫生服务是改善健康状况的重要影响因素 ,国家应充分重视这一系统的作用 ,从而加大对卫生尤其是公共卫生的投入 ,以更好地保护人民群众的健康。     

The role of universities in personal health improvement

There is rapidly growing evidence that much chronic disease incidence is related to individuals' patterns of living and their life-styles. Considerable evidence also suggests that the key to preventing or moderating the occurrence of chronic disease lies in moderating or adapting unhealthy life-styles and health habits.Universities have not been in the forefront of this important new area and have been surpassed by the general public and by others in the nonacademic community. There is still an important leadership role for universities to play, however, and indeed, there are some presently unfilled roles that only universities can fill.To exert the influence and leadership that they should in this field, universities will have to reexamine their present priorities and procedures, and chart new directions where necessary. Most likely, universities will have to develop entirely new “laboratories” in parallel with the university teaching hospitals, so that health promotion research can be carried out in an adequate setting. Programs of education and training in health sciences will have to be redesigned, not only to ensure that students understand the origins and development of chronic diseases, but also to ensure that they are confronted with their own susceptibility to such conditions and the steps they need to take to reduce their own personal risk. Universities need to review their allocation of financial and personnel resources for medical resident education to ensure distribution of specialist graduates that is more directly in line with the future projected needs of our country for physicians of all kinds. Finally, universities must begin to appreciate that they are also major employers to personnel and that they have an obligation and an unparalleled opportunity to develop new and innovative approaches to health promotion at the worksite.To exert the needed influence and leadership, universities will also have to come to grips with certain major obstacles in the typical university organizational form and the typical faculty reward system.With regard to university structure, it has been pointed out that research and demonstration projects in chronic disease prevention and life-style change must be multidisciplinary, involving a wide variety of faculty resources and skills; the issues and problems involved are simply too diverse and detailed to be handled by any one discipline. Universities, however, organized as they are into single-discipline departments, have had a great deal of difficulty in mounting major long-term interdisciplinary research projects and demonstrations in an effective fashion. Short-term projects and projects involving two or, at the most, three different disciplines are occasionally carried out, but major long-term projects that require a serious commitment from many departments have a serious problem.With regard to the typical university reward structure: in the past, universities have put great emphasis on individual contributions, work in which one person is clearly responsible for the results, if any occur; they have not been quick to reward team efforts in which a number of persons are equally (and sometimes indistinguishably) responsible for the results. In the same fashion, universities have not been quick to reward faculty who involve themselves in organization—or team—building, or who take on the thankless administrative tasks of managing organizations or keeping interdisciplinary teams or networks functioning effectively. Since much of the, task ahead for universities, in the area of chronic disease prevention and life-style laboratories, will involve the organizing and managing of new life-style laboratories, which will-involve the development and maintenance of broad interdisciplinary networks and teams, universities will have to change the basis on which they reward their faculty for their efforts.It is said that this country is entering a new era of disease control and improved health of its people. Universities have an important role to play in that new era but in order to play that role a good bit of thought and a considerable will to change must come about.     

Rethinking difference: a feminist reframing of gender/race/class for the improvement of women's health research.

In exploring the history of the social construction of gender/race/class in Western scientific discourse and examining the legacy of these persisting constructions in modern research on women's health, the authors join in a growing debate about sexism/racism/classism in women's health research--a debate being forwarded most forcefully by feminist epidemiologists. A major purpose of this article is to aid in the development of a new research paradigm for examining the relationship between gender, race, and class, one that considers the interdisciplinary theorizing of Third World feminists and European/American feminists of color. Following the examination of both historical and epistemological issues surrounding interlocking forms of oppression based on gender/race/class, the authors propose a feminist research agenda that not only is responsive to different women's health needs, but can potentially contribute to a process for understanding and answering the health needs of all persons.     

Regulation, innovation, and improvement of health care. The pharmaceutical sector

The paper comments on present and future scenarios for the pharmaceutical sector in Spain, framed a highly regulated system. So far the drug industry has evolved under the short term public financial constraints for additional health care spending and the long term efforts to innovate. This has not proved to offer a stable setting for the relationship between the industry and Health Authorities. The author offers from the economic analysis and a subjective appraisal from his experience some recommendations for regulatory changes in order to better align the incentives of the parts for improving the health system as a whole. The basic point is that 'consumption levels' (quantities) and not (unit costs) are the main challenge to tackle today in our Public Health Care system, and for this the decentralisation of financial responsibility is not in itself 'the' problem but it may well be a part of the solution.     

The improvement of the animal health risk analysis system in France

After several decades of gradual improvement in its system for managing health risks, France was confronted in 1996 with the bovine spongiform encephalopathy crisis. This triggered a collective questioning, which highlighted the need to reform a system that had shown its limitations. Risk analysis, established as a key principle by the Agreement on the Application of Sanitary and Phytosanitary Measures (SPS Agreement) of the World Trade Organization (WTO), was cast as the necessary basis of the reform, objectives of which were to better identify priority risks in order to ensure the protection of human and animal health, and to improve the quality of measures implemented by the public authorities. The Act of 1 July 1998 founded several independent risk assessment agencies, including the French Agency for Food Safety (AFSSA), with the specific mandate of food safety at every stage of the food chain. Other organisational reforms enhanced the new system, notably the separation between the functions of risk management and economic support for food industries, initially at central level, then in 2002 at the level of field services in the 100 French départements. Lastly, new procedures were introduced. These were designed, in accordance with the principles of risk assessment, to better identify and to individualise the different decision-making sequences. The decision-making process was extended to include submission to the agency in charge of evaluating health risks and examination by the agency of the resulting draft decision.     

The city government's role in community health improvement

Amid increasing pressures to address complex issues not traditionally assigned to localities, Healthy Cities is seen as a powerful model for community improvement and quality-of-life enhancements for individuals and organizations willing to think beyond the traditional local government management models and responsibilities. As a model for community-oriented government, it offers opportunities for fostering a return to "barnraising" concepts, civic responsibility, participation, tailoring solutions to local circumstances, and the transition of local government to governance models.