社区卫生服务与疾病预防控制

社区卫生服务是以社区为基础，以社区人群的卫生服务需求为导向．综合、经济、方便、可及的基层卫生服务。近年来，社区卫生服务在纳入社会发展规划、健全服务网络、完善服务功能等方面取得了一定的进展，对于落实预防保健任务、方便群众就医和减轻疾病负担起到了积极作用。同时，我国的疾病预防控制体系适应疾病谱的转变和人口老龄化的趋势，除传统的传染病防治外，又将慢性非传染性疾病、地方病、职业病等的预防和控制纳入工作重点，卫生防病水平的提高为居民健康状况的改善起到了重要作用。     

卫生理化检验在疾病预防控制中作用的探讨

卫生理化检验是卫生检验中不可缺少的组成部分 ,它是以卫生工作为主体 ,检验与人体健康相关产品的物理、化学指标。随着我国加入世贸组织和卫生体制改革不断深入 ,卫生检验面临着前所未有的挑战 ,尤其是理化检验的竞争非常剧烈 ,新技术、新方法的及时引进和应用成了我们能生存的唯一基础。因此 ,提高我们的检测能力已成为我们卫生理化检验者的当务之急 ,现探讨如下 ,与大家共勉。当前面临的形势1　加入WT0以后我们面临的国际形势　我国加入WTO以后 ,经济和技术面临全球化 ,保护本国经济和增加本国产品的竞争力是国家非常重视的问题 ,为此…     

疾病预防控制工作在城乡社区卫生服务中的作用探讨

城乡社区卫生服务是社区建设的重要组成部分,疾病预防控制工作是社区卫生服务的一项重要组成部分。近年来,党和政府高度重视城乡社区疾病预防控制工作。卫生部陈竺部长在2007年全国疾病预防控制中心主任年会上强调指出,疾病预防控制工作是中国卫生工作的第一关口,我国当前的卫生工作必须“关口前移”、“重心下沉”,预防为主。     

积极青少年发展视角下的心理健康预防与促进

长期以来,人们倾向于从“病理”和“缺陷”的视角看待个体的心理健康,由此带来心理健康预防与促进的“不充分性”.该文基于积极发展的视角,从人的全面发展的角度对儿童青少年心理健康的预防与促进做了系统分析,介绍了国内外积极发展视角下的儿童青少年心理健康预防与促进模式,强调了心理健康预防与促进需关注的重点问题,并对该领域的未来发展进行了展望.     

浅议吉安市疾病预防控制工作

提高疾病预防控制能力建设是疾病预防控制体系建设的核心内容，也是做好疾病预防控制工作的基础。本文通过对吉安市疾病预防控制工作现状分析，结合工作实践，提出了提高吉安市疾病预防控制能力建设的一些看法。     

浅述如何运用卫生管理学原理制订疾病预防控制工作计划

计划是对未来行动方案的一种统筹设计.[1]科学地制定疾病预防控制工作计划是每个疾病预防控制中心业务管理的基础,开展工作的起点,也是控制和衡量疾病预防控制工作结果的依据.运用卫生管理学原理制定疾病预防控制工作计划,通过科学的计划工作程序,把疾病预防控制中心各部门及其人员有效地组织到实现计划目标上来,是疾病预防控制工作的关键.     

美国临床预防服务专家组对疾病预防的建议

妊娠期超声检查：目前并不建议在孕晚期对胎儿进行常规超声检查。·先兆子痫的筛查：建议对所有妊娠妇女在第一次孕期保健检查时通过测量血压筛检先兆子痫，并在以后的妊娠过程中定期随访。·Ｄ（Ｒｈ）不相容性妊娠筛查：建议在所有妊娠妇女第一次孕期检查时进行Ｄ（以前...     

美国临床预防服务专家组对疾病预防的建议

卵巢癌的筛查：目前尚不赞成对无症状女性通过超声、血清肿瘤标记物测量或盆腔检查来筛查卵巢癌。·胰腺癌的筛查：目前尚不赞成对无症状人群通过腹部触诊、超声波检查或血清学标记物测量常规筛查胰腺癌。·口腔癌的筛查：通过初级保健医师的常规检查以发现口腔癌的作用目...     

青岛市四方区开展社区疾病预防控制工作的体会

当前,以社区为依托、以家庭卫生服务为单位、以社区人群健康为中心、以社区卫生保健服务为工作目标的集预防、保健、医疗、健康教育、康复、计划生育“六位一体”的社区卫生服务正在全国各地如火如荼地开展起来。合理开展以健康教育、传染病防治、慢性病防治及突发性公共卫生事     

开展疾病监测工作,提高疾病预防水平

本文通过部队试点工作的实践，就如何开展疾病监测工作进行了初步的探讨：一是从宣传教育、技术培训、建立网络、坚持正确的导向及加快信息传递等方面探讨了抓什么，如何抓的问题；二是简要阐述了在部队开展疾病监测工作的好处；三是就实践过程中发现存在的问题提出了改进意见。     

Guidelines for Adolescent Preventive Services: A Role for the School Nurse

ABSTRACT: Morbidity and mortality for today's adolescent are linked most often to complex behavioral and psychosocial risk factors than in the past. The American Medical Association has developed Guidelines for Adolescent Preventive Services (GAPS) to assist the primary health practitioner in deterring adolescents from participating in health-debilitating behaviors and to promote health-enhancing behaviors. Studies have affirmed usefulness of the GAPS protocol in the private practitioner's office and in the school-based clinic. This paper explores the possibility of using the traditional school nurse to deliver the GAPS in collaboration with school and community professionals. Issues explored include identifying students for he screening, administering the survey, triage of students, interdisciplinary and interagency collaboration, confidentiality, barriers, and time constraints. (J Sch Health. 1996;66(8):281–285)     

Adolescent Preventive Services: Rates and Disparities in Preventive Health Topics Covered during Routine Medical Care in a California Sample

PurposeThe objective was to examine rates and disparities in preventive health topics covered during routine medical care for adolescents, using a California sample.MethodsUtilizing 2003 California Health Interview Survey data, the sample included 2192 adolescents attending a physical exam within the past 6 months. Adolescents reported whether nine health topics: tobacco, alcohol, drugs, seatbelts, helmets, violence, exercise, nutrition, and sexually transmitted diseases (STDs) were discussed during their most recent physical exam. Outcomes were rates of health topics discussed and disparities in rates based on age, gender, race/ethnicity, income level, and insurance status.ResultsRates ranged from 15% (violence) to 76% (nutrition, exercise). Compared to older teens, younger teens reported discussing safety more, but substances, nutrition, and STDs less. Compared to males, females reported discussing tobacco and helmets less, but exercise and STDs more. Compared to white youths, Hispanic youths reported more discussion of most topics, black youths reported more discussion of nutrition and less of violence, and Asian youths reported more discussion of seatbelts and helmets. Lower income and uninsured groups reported more discussion of health topics compared to higher income and insured groups.ConclusionsRates of coverage of health topics are below recommended levels. Contrary to expectations, minority, uninsured, and lower income groups reported higher rates of discussing health topics. Strategies to increase the coverage of preventive health topics during routine medical care should address these findings.     

未婚青少年性行为及避孕服务的可获得性

采用定量定性相结合的研究方法,于2001年9月在长春市区进行以社区为基础的调查研究。研究对象为15～24岁的青少年和未婚青年,共1253名,其中男632名,女621名。本文对研究对象的避孕药具使用及服务可获得性进行描述性分析。结果显示:15.9％的青少年有过婚前性行为,在这些人中,48.2％的青少年在首次性行为中使用了避孕方法,其中29.9％的人使用避孕套。药店是他们获得避孕方法的主要渠道,36.8％的青少年在药店获得避孕方法,22.4％从朋友那里获得避孕方法。青少年认为在寻求避孕方法过程中,服务提供者的不友好态度、咨询和服务缺乏保密性是他们遇到的主要障碍。研究建议政府应重视青少年的生殖保健服务需求,以使青少年容易获得相关的生殖健康服务,更好地保护他们避免非意愿妊娠和免受STDs和AIDS感染。     

The AMA Residency Training in Adolescent Preventive Services Project: report of the working group. The American Medical Association.

PURPOSE: To improve resident education in provision of adolescent preventive health care. The American Medical Association (AMA) Residency Training in Adolescent Preventive Services Project Working Group convened to identify specific goals and objectives (G&Os) for pediatric and family medicine resident education in adolescent clinical preventive services and recommend strategies to achieve these G&Os. METHODS: Iterative review process involving members of the working group, nine experienced teaching faculty and 16 resident physicians from family medicine and pediatric training programs, and an advisory board. RESULTS: We achieved consensus on appropriate G&Os for pediatric and family medicine residency education in adolescent clinical preventive services. Faculty and residents expressed concerns about achieving G&Os because of challenges to implementing effective training and evaluation strategies. Suggestions for achieving G&Os included development of an adolescent clinical preventive services curriculum and evaluation program that could be adapted for use in a variety of training program structures. Faculty and residents anticipated the success of a training curriculum would be influenced by: (a) availability of adequate numbers of skilled teaching faculty; (b) availability of time and support for faculty development and teaching efforts; and (c) exposure of residents to adequate numbers of adolescent patients in settings where there are clear expectations for delivery of comprehensive preventive services. CONCLUSIONS: The AMA Residency Training in Adolescent Preventive Services Project Working Group presents G&Os for organizing training experiences in adolescent clinical preventive services in family medicine and pediatric residency training programs and recommends strategies to achieve these G&Os.     

居民对社区预防服务的认知及其影响因素分析

居民对社区预防服务的认知会直接影响到社区预防服务的需求和利用。上海市大力推进社区预防服务后，提高了居民对社区预防服务和预防知识的知晓程度。但是，居民对常见传染性疾病的知晓程度偏低；不同地区居民对预防服务的认识差异较大，城郊结合地区居民对常见健康知识的了解偏低，而服务的利用是了解现有服务项目的主要途径。     

社区基本预防服务的成本测算

预防服务是一类准公共产品或具有正外部性的消费品，政府提供补助或直接予以提供就是必然的解决途径。通过分析社区基本预防服务的成本及其构成，可以为政府预防经费的预算和预防服务的战略规划提供实证参考依据，也为社区医院挖潜节支，提高资源利用效率提供决策参考。结果表明，预防经费投入与目前开展服务实际需要之间尚有一定差距，需要增加政府投入，按基本预防服务优先次序合理配置资源、规范社区 预防服务、改善工作效率是提高有限资源利用效率的有效途径。     

Parent and Adolescent Attitudes Towards Preventive Care and Confidentiality

Purpose

Little is known about whether parents and adolescents agree in their attitudes towards preventive care, private time, and confidentiality for adolescent care.