21世纪我国农村卫生人力的配置和利用

２１世纪我国农村卫生人力的配置和利用梁照升（河南省周口地区卫校４６６０００）农村卫生人力是实施初级卫生保健三大支持体系（机构、人力、制度）的重要因素之一。如何配置我国卫生人力资源，加速卫生人才培养，充分利用卫生人力，是２１世纪中国卫生亟待解决的课题，...     

初级卫生保健在我国农村社会经济与卫生工作中的地位与作用

我国开展农村卫生工作几十年来 ,是初级卫生保健真正使农村卫生工作走上规范化和科学化发展之路。没有哪一项卫生工作能象初级卫生保健工作一样受到各级政府和相关部门的如此重视并摆上位置。实践证明 ,初级卫生保健是我国农村卫生工作的龙头和核心 ,抓初保也就抓住了农村卫生工作的关键。初级卫生保健工作的开展 ,有利于农村社会主义精神文明建设 ,加快农民奔小康的步伐 ;有利于缩小农村地区间卫生差异 ,加快实现共同富裕 ;有利于农村科学文明风尚的普及 ,加快农村卫生生活方式的形成。1　初级卫生保健在我国农村社会经济中的地位1.1　实施…     

1990年重点选题

我国农村卫生事业发展的回顾与反思我国农村卫生发展战略中国初级卫生保健工作与农村卫生政策研究我国初级卫生保健策略与卫生资源分配状况剖析基层卫生体制改革与初级卫生保健策略领导层开发与初级卫生保健的实施初级卫生保健工作中的思想政治工作研究农村预防保健队伍思想建设的有关论述有关实施PHC规划,改善卫生面貌的论著我国农村2000年人人享有卫生保健规划目标及达标对策初级卫生保健工作管理程序     

第五次全国农村卫生经济学术讨论会召开

第五次全国农村卫生经济学术讨论会9月1日～6日在北戴河召开。本次会议的主题是“PHC经费的筹集与使用”。这是学术界第一次专题研讨初级卫生保健有关的经费问题。有21篇论文参加了大会交流。会议期间代表们就初级卫生保健费用与发展我国农村卫生事业的关系,初级卫生保健费用的内涵、项目构成,筹集初级卫生保健经费的渠道及方式,初级卫生保健经费的分配原则,初级卫生保     

《中国初级卫生保健》杂志投稿指南

《中国初级卫生保健》杂志是由国家卫生部主管、中国初级卫生保健基金会、黑龙江省农村卫生协会主办的综合指导类期刊。主要栏目有:初级卫生保健理论和政策研究、医疗保障制度、农村卫生、社区卫生服务、爱国卫生、乡镇卫生院管理、卫生服务网络建设、妇幼保健、疾病预防与控制、慢性     

《中国初级卫生保健》杂志投稿指南

《中国初级卫生保健》杂志是由国家卫生部主管、中国初级卫生保健基金会、黑龙江省农村卫生协会主办的综合指导类杂志。主要栏目有：初级卫生保健理论和政策研究、医疗保障制度、农村卫生、社区卫生服务、爱国卫生、乡镇卫生院管理、卫生服务网络建设、妇幼保健、疾病预防与控制、     

社区环境与村医疗点业务收入关系的研究

世界卫生组织(WHO)在1998年第51届世界卫生大会上提出:21世纪人人享有初级卫生保健的目的,在于继续实现1978年阿拉木图会议发起的人人享有卫生保健的理想。并确定了21世纪人人享有卫生保健的总目标和具体目标。我国农村初级卫生保健工作的进一步落实要依靠三级卫生服务网,其中作为网底的村级卫生组织是初级卫生保健的主体,是切实保障全体农村居民享受基本卫生服务、实现2000年全球卫生目标和我国2010年第二个初级卫生保健十年规划目标的关键。     

初级卫生保健的内涵及其在我国的发展回顾

由世界卫生组织及其成员国于1978年《阿拉木图宣言》提出的“初级卫生保健”,是指最基本的、人人都能得到的、体现社会平等权利的、人民群众和政府都能负担得起的卫生保健服务。初级卫生保健所反映的核心价值观是社会公平,所信奉的理论是“健康乃人类的基本权利”,所追求的目标是“人人享有健康”,所采用的技术是适宜技术。中国初级卫生保健实践始于建国之初,20世纪50年代初确定的“面向工农兵、预防为主、团结中西医、卫生工作与群众运动相结合”四大方针,已包含了初级卫生保健的基本思想和内容。建国后的前30年取得的成就为国际上形成初级卫生保健策略奠定了实证基础,随后20年是我国初级卫生保健发展阶段,政府承诺实现2000年人人享有卫生保健的目标,但取得的健康效果有限。21世纪以来,政府仍然把初级卫生保健作为农村卫生的中心任务,但是可持续性问题还没有解决。     

对21世纪初期我国农村初级卫生保健的战略思考

党的十五届三中全会通过的《中共中央关于农业和农村工作若干重大问题的决定》已经把“发展农村卫生,使农民享有初级卫生保健”确定为到2010年建设有中国特色社会主义新农村的目标之一。“使农民享有初级卫生保健”再次成为我国党和政府对我国21世纪初期继续开展初级卫生保健,实现“人人享有卫生保健”的政治承诺和责任。世界卫生组织在第五十一届世界卫生大会上也重新制定了《21世纪人人享有卫生保健》文件,指出“人人享有卫生保健”是一个理想,是一个导致人民健康逐步改善的过程,而不是一个单纯的时限目标,它是一项正在发展的计划进程的一…     

21世纪中国农村社区卫生保健模式构想

２１世纪中国农村卫生工作怎样发展？如何保障９亿农民的基本卫生服务？针对这些问题，结合当前农村卫生工作实际，本文提出了２１世纪中国农村社区卫生保健模式构想。作者认为２１世纪中国农村卫生保健模式应是以初级卫生保健为主要内容。以健康保障制度为支撑条件，以通科医生负责制为形式的综合卫生服务模式。并通过论证认为该模式具有一定的优越性和可行性，将会给２１世纪中国在村卫生工作揭开崭新的一页。     

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.     

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.     

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.     

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.     

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.