加强医院药学管理 创新医院药学服务

随着科学技术的进步,医院药学发展的总趋势是进行医院药事管理,药学技术工作和药学服务要向临床靠拢。这就要求医院药学部门应掌握国内外药学发展动态,根据实际情况不断引进、吸收和应用现代药学新知识、新技术和新方法,创新医院药学管理。文章对此进行了分析,并就创新医院药学管理提出了建议。     

Dependency, social factors, and the smoking cessation process: the doctors helping smokers study

We analyzed data obtained from a representative sample of the smoking patients (n = 1,338) of 66 family physicians to determine predictors of attempts to stop smoking, desire to quit smoking, and successful smoking cessation. Compared to subjects who made no attempt to quit smoking, subjects who tried to quit smoking tended to be younger, had tried to quit smoking in the year prior to the study, waited longer before smoking their first cigarette of the day, had more desire to quit smoking, and had more social support for quitting. Education and cigarettes smoked per day were not independently related to the subject making a quit attempt. Desire to quit smoking was associated with an attempt to quit in the year prior to the study and social support for smoking cessation (support of spouse, second most important social contact, and physician). Desire to quit smoking was not independently related to age, education, or dependency on cigarettes (measured by the number of cigarettes smoked per day and the length of time a subject waited before smoking the first cigarette of the day). Compared to subjects who tried to quit and failed, subjects who succeeded were older, smoked fewer cigarettes per day, and waited longer to smoke their first cigarette of the day. Spouse support, support of the second most important social contact, and advice of a doctor to quit smoking were not independently related to whether or not a cessation attempt would be successful. These data suggest that successful smoking cessation requires two components: social support to make an attempt to quit and the ability to overcome dependency on cigarettes to make the attempt successful.     

充分发挥绍兴市社区卫生服务机构功能的几点构想

据调查,绍兴地区各个大中型医院＂看病难、看病贵＂问题较为突出,而且许多高层次专科医生在诊疗一些常见小病,既浪费医疗资源,也不利于高层专科人才的提高。这与目前社区卫生服务机构不完善,社区卫生服务队伍不健全,人员素质不高,双向转诊制度不落实,绝大部分患者涌向大中型医院有关。如要从根本上来解决这一问题,就必须大力发展社区卫生服务,培养以全科医师为骨干的社区卫生服务队伍,提高社区卫生服务能力,同时做好政府优惠政策的宣传工作及适宜技术的推广工作,完善双向转诊制度等措施,让社区来承担预防、保健、健康教育、计划生育、医疗和康复等六位一体的职能。逐步做到＂大病进医院,小病在社区＂,这样对于方便群众就医,减轻费用负担,建立和谐的医患关系,具有重要意义。     

推进国防卫生动员准备

坚持战时卫勤保障需求为中心,在当前国防动员力量建设的基础上,健全法律法规体系,扎实做好国防卫生动员准备,提高卫生动员保障能力。坚持军地一体为框架,构建卫生动员联动格局,必须加强统筹力度;坚持建用一致目标,做好卫生动员无缝链接,优化机构运行环境,促进卫生动员工作落到实处。坚持以实战需求为牵引,构建卫勤保障信息化平台,扎实抓好实战化研训,做到平时准备与战时保障的无缝链接。     

Coordinating Canada's research response to global health challenges: the Global Health Research Initiative

The Global Health Research Initiative (GHRI) involving the Canadian International Development Agency, the Canadian Institutes of Health Research, Health Canada and the International Development Research Centre seeks to coordinate Canada's research response to global health challenges. In light of numerous calls to action both nationally and internationally, an orientation to applied health policy and systems research, and to public health research and its application is required to redress global inequalities in wealth and health and to tackle well-documented constraints to achieving the United Nations Millennium Development Goals. Over the last four years, the GHRI has funded close to 70 research program development and pilot projects. However, longer-term investment is needed. The proposed dollars 100 million Teasdale-Corti Global Health Research Partnership Program is such a response, and is intended to support teams of researchers and research users to develop, test and implement innovative approaches to strengthening institutional capacity, especially in low- and middle-income countries; to generating knowledge and its effective application to improve the health of populations, especially those most vulnerable; and to strengthen health systems in those countries. While Canada stands poised to act, concerted leadership and resources are still required to support "research that matters" for health and development in low- and middle-income countries.     

A 4-year study of Pseudomonas aeruginosa susceptibility to antibiotics (1998-2001) in northern Lebanon

Four hundred and sixty-four Pseudomonas aeruginosa strains were isolated in northern Lebanon at the Islami Hospital Microbiology department, in Tripoli. The purpose of this study was to evaluate the susceptibility of these strains to antibiotics, to compare this susceptibility according to the nature of the sample and the year of sampling. The results show that urinary samples were the most frequent (39.3%), followed by wound samples (21.2%), and ear samples (16.5%). The average rate of susceptible strains was 39.8% to ticarcillin, 56.9% to piperacillin, 58.2% to piperacillin + tazobactam, 74.1% to imipenem, 63.3% to ceftazidime, 60.4% to cefepime, 62.1% to aztreonam, 60.3% to netilmicin, 57.5% to gentamicin, 62.2% to tobramycin, 69% to amikacin, 100% to colistin, 45.4% to pefloxacin and ofloxacin, 57.7% to ciprofloxacin and 1.3% to rifampicin. The study showed that the strains isolated from pulmonary secretions were the most resistant to antibiotics.     

市场经济体制下的医院经营之道

医院面对其置身医疗市场的现实,应慎重决策,认真管理;以病人需求为导向,注意经营效益;抓大不放小,实行低成本扩张战略;采取开展高新和适应技术,改善环境,加强成本核算,提高服务质量,拓宽医疗市场途径,争取医疗市场份额;抓好急危重症抢救、介入治疗、微创手术、器官移植四在技术,提高技术水平和医疗质量。同时,医院还要重视抓好机构改革、干部管理、人才管理,处理好发展与稳定的关系。     

Possible broad impacts of long work hours

The paper summarizes research linking long work hours to a wide range of risks to workers, families, employers, and the community. The risks are theorized to stem from less time to recover from work, longer exposure to workplace hazards, and less time to attend to non-work responsibilities. Risks to workers include sleep deprivation, poor recovery from work, decrements in neuro-cognitive and physiological functioning, illnesses, adverse reproductive outcomes, and injuries. Risks to families include delayed marriages and child bearing, and obesity in children. Risks to employers include reduced productivity and increases in workers errors. Mistakes by fatigued workers have broad reaching impacts to the community: medical errors, automobile crashes with other drivers on the road, and industrial disasters that damage the environment.     

Precision Food Parenting: A Proposed Conceptual Model and Research Agenda

Precision medicine, nutrition and behavioral interventions are attempting to move beyond the specification of therapies applied to groups, since some people benefit, some do not and some are harmed by the same therapy. Instead, precision therapies are attempting to employ diverse sets of data to individualize or tailor interventions to optimize the benefits for the receiving individuals. The benefits to be achieved are mostly in the distant future, but the research needs to start now. While precision pediatric nutrition will combine diverse demographic, behavioral and biological variables to specify the optimal foods a child should eat to optimize health, precision food parenting will combine diverse parent and child psychosocial and related variables to identify the optimal parenting practices to help a specific child accept and consume the precision nutrition specified foods. This paper presents a conceptual overview and hypothetical model of factors we believe are needed to operationalize precision food parenting and a proposed research agenda to better understand the many specified relationships, how they change over the age of the child, and how to operationalize them to encourage food parenting practices most likely to be effective at promoting healthy child food choices.     

Cultivating a worldly repose: the contribution of Sally Gadow's work to interpretive inquiry

This paper discusses the contribution that the work of Sally Gadow makes to understandings of interpretive inquiry and it's potential to inform and influence nursing practice, research, and education. The discussion draws on several of Gadow's published works that make explicit her understandings of what it means to be interpretive, to be open to multiple truths, to hear multiple voices, to have a history, to be experienced, and to recognize agency in language. Situating this discussion of Gadow's contribution in opposition to a metaphysics of genius is intended to move our understanding of particular work past the subjectivity that produced it, past the subjectivized responses to the work, past the reporting on myself – my thoughts, my perspectives, my experiences – to explore, to see the worthwhileness or even the possibilities of exploring the work itself and the worlds it evokes. This paper is a deliberate attempt to disrupt the call to the author to save us from the task of interpreting the questions that the work itself places us under. Gadow's work itself points us away from a valorization of the voice of the author of the work, a single voice, and towards a cultivation of a worldly repose where each interpretive account points us to some longstanding whole to which the work belongs and from which it gains its sense and significance.     

2007～2008年江苏省淡色库蚊和家蝇的抗性研究

目的了解江苏省蚊蝇对常用杀虫剂的抗药性情况,指导蚊蝇防治的科学用药。方法蚊虫抗药性检测采用幼虫浸渍法,家蝇采用点滴法。结果南京市家蝇对敌敌畏、溴氰菊酯、高效氯氰菊酯和残杀威的抗药性均相对较高,而淮安市均为最低;4种杀虫剂中,残杀威抗性均为最高,其次为敌敌畏,溴氰菊酯抗性均为最低。淡色库蚊对高效氯氰菊酯、溴氰菊酯和仲丁威的抗性在淮安市均为最高,对双硫磷抗性在苏州市为最高;4种杀虫剂中,仲丁威抗性均为最高,溴氰菊酯除在淮安高于双硫磷外,抗性均为最低。结论在蚊蝇防治时应避免使用抗性较高的残杀威、仲丁威和敌敌畏,优先考虑使用溴氰菊酯等拟除虫菊酯类杀虫剂。     

社区产后访视健康教育对母乳喂养的影响

目的:通过社区产后访视健康教育知识宣传让产妇和家属了解和接受母乳喂养知识和技能,提高母乳喂养率.方法:社区产后访视人员在产妇及新生儿出院后3天、28天各进行上门访视一次,先了解产妇及新生儿健康状况、母乳喂养知识了解程度和喂养技能掌握情况,再根据当前存在的问题给予纠正.对可能发生的问题给予预防措施指导.利用健康教育宣传母乳喂养知识,使产妇及家属了解和接受母乳喂养知识.结果:社区产后访视健康教育宣传指导使产妇及家属接受和正确实施母乳喂养,从而提高了母乳喂养率.结论:社区产后访视利用健康教育宣传和指导母乳喂养知识和技能对提高母乳喂养率有很大的促进作用.     

Studies of resistance to chloroquine, quinine, amodiaquine and mefloquine among Philippine strains of Plasmodium falciparum

One hundred cases of slide-confirmed Plasmodium falciparum malaria admitted to the San Lazaro Hospital, Manila, Philippines were screened for in vitro resistance to chloroquine, quinine, amodiaquine and mefloquine using the microtechnique. 59 of the 100 primary parasite isolates produced schizonts, whereas the remaining 41 isolates did not. 51 of the 59 isolates tested were resistant in vitro to chloroquine and eight were sensitive. In contrast, three of the primary isolates were resistant to quinine, three showed resistance to amodiaquine and four were mefloquine-resistant. 43 of the strains judged chloroquine-resistant in vitro were fully in vitro sensitive to amodiaquine, quinine and mefloquine. One chloroquine-resistant isolate was also resistant to quinine alone. Three isolates that were resistant to chloroquine were also resistant to amodiaquine. An additional three were cross-resistant to chloroquine and mefloquine. A single isolate was found to be resistant to chloroquine, quinine and mefloquine and another was cross-resistant to chloroquine, quinine and amodiaquine. All strains demonstrating in vitro resistance to amodiaquine, quinine or mefloquine also showed in vitro resistance to chloroquine. The parasites in 22 patients showed in vivo resistance to chloroquine therapy. 86% were of the R1 type, 9% were R2 and 5% R3. All 22 patients demonstrating in vivo resistance to chloroquine showed in vitro resistance.     

Principles for planning the teaching of health promotion in an MPH course

The Ottawa Charter on Health Promotion defined the term Health Promotion as "the process of enabling people to increase control over, and to improve, their health". It also specifies that "to reach a state of complete physical mental and social well-being, an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment". Three main strategies for promoting health were stated: advocacy, enabling, and mediating. A great emphasis was put on policy. The Jakarta Declaration at the 4th International Conference on Health Promotion in 1997 reconfirmed the Ottawa Charter and added to it that "Health Promotion is carried out by and with people, not on or to people". The learning objectives of health promotion should refer to the values and strategies of 'Health 21', to the strategies and areas of action in health promotion as specified in the Ottawa Charter, and it should be relevant to the needs of the society that the participants are going to serve. The main goal of a training program in health promotion should be to develop competence in health promotion. "Competence" refers to the combination of three domains: attitudes, knowledge, and skills. Each school of public health or planners of an MPH course should decide upon the right mix of these three domains, according to their institute's mission and goals.     

Food Involvement,Food Choices,and Bioactive Compounds Consumption Correlation during COVID-19 Pandemic: How Food Engagement Influences Consumers’ Food Habits

The containment measures due to the COVID-19 pandemic affected food-related activities, influencing dietary behavior, food habits, and dietary choices. This study aimed to compare the relationship between food involvement and dietary choices before and during the pandemic, investigating the role played by food in dietary habits. Responses given by 2773 Italian consumers to an online survey were studied through the Food Involvement Scale (FIS) and correlated to eating habits. FIS scores were then used to explain the importance given to food in circumstances related to well-being, health, and protection against COVID-19 and used to study the relationship between FIS and bioactive compound knowledge, use, and efficacy against COVID-19. The consumers more involved in food issues recognized the importance of food in circumstances related to well-being, health, and protection against COVID-19 and improved their diet during the pandemic. Moreover, consumers who gave more importance to food also revealed higher attention to the use of healthy substances, such as bioactive compounds, considering them effective against COVID-19. These results showed that food experiencing and involvement could be important elements to promote healthy dietary habits that are essential to maintain physical and mental health during emergency periods such as the COVID-19 pandemic.     

Weight Management,Weight Perceptions,and Health-Compromising Behaviours Among Adolescent Girls in the COMPASS Study

Evidence suggests associations between weight management intentions, weight perceptions, and health-compromising behaviours among adolescent girls. Drawing on cross-sectional data for 21,456 girls, we employed multinomial logistic regression to examine whether smoking, binge drinking, and breakfast-skipping were associated with weight management intentions and weight perceptions. According to self-reported heights and weights, 61.4% of girls were in the healthy weight category. However, most reported trying to manage their weight, with 58% trying to lose, 4.5% trying to gain, and 18% trying to maintain their weight. Smokers were more likely than non-smokers to report intentions to lose, gain, or maintain weight versus to do nothing. However, smokers were less likely than non-smokers to perceive themselves as underweight or overweight versus about the right weight. Binge drinkers were more likely than other girls to report an intention to gain and less likely to be trying to maintain their weight versus doing nothing, and breakfast-skippers were more likely to report trying to lose or gain weight but less likely to report trying to maintain weight versus doing nothing. Binge drinkers and breakfast-skippers were more likely than non-binge drinkers and non-breakfast-skippers, respectively, to perceive themselves as underweight, overweight or very overweight versus about the right weight. In sum, the majority of girls reported trying to manage their weight, and those engaging in other health-compromising behaviours were more likely to do so, though the exact nature of the associations differed by behaviour. Recognition of shared underlying risk factors for this clustering of behaviours may inform comprehensive health promotion efforts.     

Teenagers’ Explanations of Bullying

The aim of the present study was to explore how teenagers explain why bullying takes place at school, and whether there were any differences in explaining bullying due to gender and prior bullying experiences. One hundred and seventy-six Swedish students in Grade 9 responded to a questionnaire. Mixed methods (qualitative and quantitative methods) were used to analyze data. The grounded theory analysis generated five main categories and 26 sub categories regarding accounts of bullying causes. Results indicated that youth tended to explain bullying in terms of individualistic reasons (bully attributing and victim attributing) than in terms of peer group, school setting, or human nature/society reasons. Girls were more likely to attribute bullying causes to the bully and much less to the victim, compared to boys. Moreover, youth classified as bullies were more likely to attribute the reason for bullying to the victim and much less to the bully, compared to victims, bystanders, and victims/bullies.     

Radiological threat assessment and the Federal Response Plan--a gap analysis

The ability of the federal government to effectively and efficiently respond to nuclear or radiological terrorist attacks has been the subject of intense discussion and analysis for many years. Because of recent terrorist activities and intelligence information, there is strong sentiment that it is not a question of if, but when, a radiological or nuclear terrorist attack will occur. As a result, there is considerable concern that the federal government may not be adequately prepared to respond to an attack involving a radiological dispersal device or improvised nuclear device. In response to these concerns, federal departments and agencies have initiated actions to develop a better understanding of the magnitude of the radiological/nuclear terrorist threat, assess the ability of the federal government to support state and local responses to such attacks, and improve the Nation's ability to prepare for, respond to, and recover from these types of attacks. In an era of limited fiscal growth and competing priorities, the federal government will have to enhance its collaboration with state and local governments, the private sector, and academia to ensure that the Nation is capable of responding to a terrorist attack involving radioactive or nuclear material.     

Strengthening capacity in developing countries for evidence-based public health: the data for decision-making project

Public health officials and the communities they serve need to: identify priority health problems; formulate effective health policies; respond to public health emergencies; select, implement, and evaluate cost-effective interventions to prevent and control disease and injury; and allocate human and financial resources. Despite agreement that rational, data-based decisions will lead to improved health outcomes, many public health decisions appear to be made intuitively or politically. During 1991-1996, the US Centers for Disease Control and Prevention implemented the US Agency for International Development funded Data for Decision-Making (DDM) Project. DDM goals were to: (a) strengthen the capacity of decision makers to identify data needs for solving problems and to interpret and use data appropriately for public health decisions; (b) enhance the capacity of technical advisors to provide valid, essential, and timely data to decision makers clearly and effectively; and (c) strengthen health information systems (HISs) to facilitate the collection, analysis, reporting, presentation, and use of data at local, district, regional, and national levels. Assessments were conducted to identify important health problems, problem-driven implementation plans with data-based solutions as objectives were developed, interdisciplinary, in-service training programs for mid-level policy makers, program managers, and technical advisors in applied epidemiology, management and leadership, communications, economic evaluation, and HISs were designed and implemented, national staff were trained in the refinement of HISs to improve access to essential data from multiple sources, and the effectiveness of the strategy was evaluated. This strategy was tested in Bolivia, Cameroon, Mexico, and the Philippines, where decentralization of health services led to a need to strengthen the capacity of policy makers and health officers at sub-national levels to use information more effectively. Results showed that the DDM strategy improved evidence-based public health. Subsequently, DDM concepts and practices have been institutionalized in participating countries and at CDC.