AIDS prevention: what are we talking about?

A psychiatrist from Calcutta objects to the colonial culture which still dominates India. Specifically the call for prevention of AIDS and the spread of HIV made by developed countries, yet socioeconomic conditions in India hinder any prevention efforts. India faces other more common and preventable fatal diseases. The basic needs (food, shelter, health, and education) of most people cannot even be met. Thus an AIDS prevention program is an expensive luxury and probably would not reach those whose needs are already not met. 65% of AIDS cases are in Africa especially central Africa and almost 90% of AIDS cases in developing countries are in the most productive age group (20-49 years). The HIV/AIDS epidemic is indeed dealing countries an economic blow. For example, in 1988, AIDS related medical costs in the US stood at US$8.5 billion; lost wages US$55.6 billion; and research, education, and blood screening US$2.3 billion. Developing countries cannot absorb such an economic impact. The AIDS epidemic can strain a developing country's health system such as Zaire. For example, the cost of providing proper care for only 10 AIDS patients is higher than the entire budget of the largest hospital. Yet this hospital's physicians diagnose as many as 15 new cases daily. Economic loss/year due to AIDS deaths in Zaire will equal 8% of the gross national product by 1995. The poor often do not have access to health services. illiteracy (88%) in Brazil impedes AIDS prevention messages from reaching remote rural populations. Brazil already faces a high infant mortality rate and 33% of the population has malaria. Health and social problems in developing countries are so common that AIDS is just 1 more disease. Another obstacle to AIDS prevention in developing countries is that the poor cannot afford to buy condoms. The root cause of AIDS in developing countries is poverty.     

Socioeconomic determinants of health in Australia: policy responses and intervention options

Tackling socioeconomic health inequalities represents one of Australia's most challenging public health issues. Research has demonstrated that the role of physicians and other health professionals, as advocates for change in the delivery of health services, public health policy and other community-wide initiatives, is extremely important in reducing mortality and improving health outcomes. Multilevel actions to reduce health inequalities should include changes to macrolevel social and economic policies; improving living and working conditions; strengthening communities for health; improving behavioural risk factors; empowering individuals and strengthening their social networks; and improving responses from the healthcare system and associated treatment services. Australia has yet to develop a coordinated and integrated approach to addressing health disparities; however, previously successful public health interventions addressing other health issues are good starting points.     

Medical students, medical schools and international health

Over the past decade, student participation in international health has moved beyond individual elective terms in developing countries to collective responses led by student international health organisations. There are now at least 10 such organisations, with more than 500 medical students participating at a local or national level each year. Student international health organisations can deliver short- and long-term benefits to developing countries, while equipping students with skills such as leadership, teamwork and cultural sensitivity. Activities include delivery of medical equipment, fundraising, educating university communities, and acting as advocates for social justice. We believe Australian medical schools must formally incorporate international health into their curricula, drawing upon the experiences of schools in Europe and North America.     

浅析健康投资对经济发展的作用

健康投资状况是衡量一个国家或地区社会经济文化发展程度、卫生事业发展规模和水平的一个尺度。投入一定量卫生费用所取得的健康成果,是健康投资的经济效益。世界卫生组织曾提出“投资卫生领域,促进经济发展”的新战略。其宗旨是投资健康、扩大内需和发展卫生事业可以促进国家宏观经济的发展。从几个方面简单阐述了健康投资对我国经济发展的作用。     

Working with funding agencies in the delivery of healthcare in the Asia Pacific region

Australia is one of the healthiest countries in the world, although we have a long way to go before the health of Indigenous Australians matches that of the population as a whole. In 1999-2000, the Commonwealth Government spent 8.5% of GDP on healthcare, ranking our health spending among the highest in the world. By contrast, many people living in our region are burdened by emerging epidemics, such as HIV/AIDS, diseases associated with economic and industrial development, and problems of communicable disease and nutritional deficiencies. For decades, many Australians have been working towards improving health in these developing countries by providing their knowledge and expertise. While the financial resources for healthcare are largely the responsibility of individual national governments, the international system plays an important role in assisting developing countries to improve their health standards. From our own experiences of working with AusAID and the World Health Organization on two projects to eradicate iodine-deficiency disorders in China and Tibet, we illustrate how health professionals can work with international aid agencies to deliver healthcare and make a difference to the lives of people in developing countries.     

埃及应对经济全球化的战略与措施

经济全球化进程推动了埃及的经济改革 ,主要表现在私有化和经济自由化均取得了较大的发展。埃及政府应对全球化挑战 ,既有成功的经验 ,又有痛心的教训。埃及政府要求基本上改变原先的经济体制 ,在进行根本的改革时 ,强调维护本国的主权和利益 ,顾及社会和平 ,其积极参与经济全球化的立场和态度 ,对于广大的第三世界国家而言具有重要的借鉴意义     

经济全球化背景下医学生的道德构建

毋庸置疑,地球村将是人类社会发展的一个必然趋势,在这一趋势中起决定作用的当然是经济的全球化。经济全球化影响到世界各国、各民族方方面面的发展,其中包括民族道德。所以,在经济全球化的进程中,我们不得不重视意识领城的反作用。尤其是现在的中国,在经历了30年改革开放之后,于一片繁荣之中,我们发现了许多问题。对于这些问题,我们都做了很多有益的探索与研究,如经济全球化与市场经济的发展,与国际政治的关系,与对外开放的关系等等。但是,在经济全球化与民族道德的关系上的探讨,无论是广度还是深度方面,都还不够。     

中国与埃及经贸关系简析

对外贸易格局反映着各国一定时期的外交理念和社会经济发展水平。上世纪70年代以来,埃及对外贸易格局以偏重与欧美发达国家的传统贸易关系为主,同时又兼顾与发展中国家之间的贸易往来。目前,在埃及对外经济交往中,埃中经贸关系呈现出强劲的发展势头,两国在经贸数量、种类、规模上都有较大的发展。深化合作、优势互补、互利双赢是解决埃及对华贸易逆差问题的主要途径,也是进一步巩固双边关系、推动经贸关系向更高水平发展的切实选择。     

试论经济因素对民国时期中医救亡斗争的影响

近代民族虚无主义思潮的影响,使许多国人对中医学持否定态度。中医药自身的经济价值、社会各界对中医的经济支持,对于民国时期中医救亡斗争的胜利发挥了重要作用。同时,民国时期的中医教育、临床和行政,无不受到经济条件的制约。分析经济因素对中医存续和发展的影响,具有一定的现实意义。中医与国计民生息息相关,既要把中医药产业视为民族经济的重要组成部分,又要把中医药事业当作国家投资的一个重要方面。重视并妥善处理中医药与社会经济的关系,才能促进中国卫生事业的快速发展。     

Uppsala Clinical Research Center—development of a platform to promote national and international clinical science

Abstract

Uppsala Clinical Research Center (UCR) is a non-profit organization that provides service for clinical research aiming for development and improvement of health care in Sweden and worldwide. UCR was started in 2001 with the ambition to shift the focus of clinical research from new medications or devices launched by the industry to problem-based research on issues identified in clinical reality, for example through the national quality registries. In order to accomplish these goals, UCR has established services in: 1) clinical trials of new and old methods in health care; 2) quality development of the health care system supported by internet-based national quality registries; 3) biostatistics, epidemiology, and data management; 4) biobanking of biological materials (Uppsala Biobank); 5) high-throughput biochemical analyses (UCR laboratory); and 6) academic leadership by the members of the UCR research faculty. The UCR clinical trials group provides services for investigator-driven projects in all areas of health care, for global mega-trials on new pharmaceutical treatments and devices, for biobanking including biomarker and genetics analyses, and for clinical events adjudication in national as well as global mega-trials. During the last few years, UCR has been a pioneer in establishing the registry-based randomized clinical trial (R-RCT), which today is an international model on how to perform cost-effective pragmatic randomized trials in the real-world environment. In 2002, UCR started the first national competence center for national quality registries, which pioneered the development of the current internet-based technologies for registering, reporting, and supporting continuous systematic improvement of health care. UCR is currently harboring around 20 national quality registries in all areas of health care. Today, UCR is the leading European center for registry-based quality development and evaluation of new medical treatments in cardiovascular care and has started to support other European countries in implementing the UCR registry platform in order to improve quality of care in the European Union.     

Maternity rights, work, and health in France and Italy

This article focuses on the principles and the implementation of maternity rights (MR) in France and Italy. Results show that MR are well established in both countries, where about 80% of women employed during pregnancy were back to work 1 year after childbirth. Nevertheless, social inequalities were found. Less-educated women and those who had manual jobs or worked in small firms in the private sector or off-the-books were less likely to take an extended leave and to return to work. Despite differences in child care provisions, quality and accessibility of child care were common concerns for both French and Italian mothers. Employment was not related to any health problem in Italy 1 year after birth; in France, unemployed new mothers had high rates of psychological distress. Financial worries and marital problems were associated with several health problems in both countries. In conclusion, combining work and motherhood is possible in these 2 countries without too many costs for women, at least for the more privileged among them. However, this relative ease could vanish if social and economic conditions changed for the worse.     

From maternity to parental leave policies: women's health, employment, and child and family well-being

Pregnancy and maternity are increasingly viewed as social as well as individual risks that require health protection, employment protection and security, and protection against temporary loss of income. Begun more than a century ago in Germany, paid and job-protected maternity leaves from work were established in most countries initially out of concern for maternal and child physical health. Beginning in the 1960s, these policies have expanded to cover paternity and parental leaves following childbirth and adoption as well. Moreover, they have increasingly emerged as central to the emotional and psychological well-being of children as well as to the employment and economic security of their mothers and fathers. They are modest social policies, but are clearly an essential part of any country's child and family policy. No industrialized country today can be without such provision, and the United States is a distinct laggard in these developments.     

Preventive health reform: what does it mean for public health?

A revitalised public health strategy offers the most sustainable way to address current health inequalities and prevent chronic non-communicable diseases. Success in these goals requires a whole-of-government approach and long-term investments. A sizeable proportion of this investment must be outside the health sector, in the social, economic and environmental fabric of our society. The benefits of the federal government's proposed prevention agenda will only be realised if there is greater clarity about what constitutes preventive health activity, who is responsible for carrying out the preventive agenda, how it is integrated and funded within the health care system, and how prevention outcomes will be measured and evaluated.     

Losing the battle of the bulge: causes and consequences of increasing obesity.

Increasing proportions of Australians are overweight or obese, a problem shared by all developed and, increasingly, developing nations. Now as many people in the world are overweight as underweight. Increasing obesity is a serious public health as well as economic problem. Its associated greater risks of high blood pressure, heart disease, osteoarthritis, type 2 diabetes, some cancers and other health problems consume considerable proportions of healthcare budgets. Health inequalities often reflect social inequalities, but with overweight there is also a male-female difference in the relationship between overweight and socioeconomic status. Health promotion campaigns are underestimating the social determinants of health, and "risk fatigue" is affecting attitudes to complying with healthy lifestyle standards. Proposals to reverse the obesity trend, such as taxing or restricting the advertising of unhealthy foods, raise contentious issues of choice and regulation.     

恩格斯的社会医学思想及其对新医改的启示

恩格斯是社会医学的真正创始人.在《英国工人阶级状况》一书中,恩格斯描述了英国工人的工作场所和工作条件,认为其恶劣的工作环境和社会生活条件导致了早期英国工人的疾病、残疾、死亡、健康无保障等问题.恩格斯呼吁社会应建立各种改善工人健康和预防疾病的制度,采取各种社会卫生措施保障工人最起码的生活条件和健康平等.恩格斯的社会医学思想对于当今世界各国医改的推进与实施,具有深刻的启示和现实的指导意义.我国的新医改应在恩格斯社会医学思想指导下并借鉴外国成功的医改模式,建立适合中国国情、政情、民情的,从家有健康的新模式.     

The importance of Leadership towards universal health coverage in Low Income Countries

Universal health coverage—defined as access to the full range of the most appropriate health care and technology for all people at the lowest possible price or with social health protection—was the goal of the 1978 Alma-Ata Conference on Primary Health Care in Kazakhstan. Many low-income (developing) countries are currently unable to reach this goal despite having articulated the same in their health-related documents. In this paper we argue that, over 30 years on, inadequate political and technical leadership has prevented the realization of universal health coverage in low-income countries.     

Australian mental health reform: time for real outcomes

After 12 years of national mental health reform, major service gaps and poor experiences of care are common. The mental health community reports little progress in implementing its key priorities, such as expanded early-intervention programs, comanagement of people with mental health problems and related alcohol or substance misuse, and widening of the spectrum of acute care settings. We propose new national targets for reducing the social and economic costs of poor mental health; these include increased access to effective care, reduced suicide rates and improved rates of return to full social and economic participation. We detail specific service reforms designed to maximise the chance of achieving these targets, and prioritise youth health and integrated primary care programs. New independent and national reporting systems on the progress of mental health reform are urgently required.     

Is the Turkish Health Care System Ready to Be a Part of the European Union?

Lately, Turkey is struggling to recover from the economic effects of the economic crisis so that the government officials are trying to impose budget cuts in health and education sectors. After the United States, the country's national defense expenditures are the highest among the NATO countries. Therefore, Turkey allocates only 3–4% of the gross domestic product for health care expenses. Overall, the health status in Turkey is the lowest among the European Union countries; infant mortality rate is about 45 per 1000 live births, which is the highest on the European continent, and per capita health care expenditure is $120. Although 75% of the people are covered by some type of public insurance, 25% of the Turkish people do not have any insurance coverage. The national system is funded by taxes (43%), out of pocket payments (32%), and social and private insurance premiums (25%). This study examines whether Turkey is ready to be a part of the European Union in terms of the health sector of its economy and health status of its people.     

社会资本参与全民健康信息化建设的PEST-SWOT分析

目的：探索社会资本参与全民健康信息化建设的开展情况并提出发展策略,以期为卫生健康部门及社会资本开展全民健康信息化建设提供参考。方法：采用PEST-SWOT分析法,从政治、经济、社会和技术角度对社会资本参与全民健康信息化建设的优势、劣势、机会和威胁进行分析。结果：PEST-SWOT分析显示,社会资本参与全民健康信息化建设具有政策引导支持、市场规模巨大、社会资本充裕、信息技术先进等优势,但存在准入退出界限模糊、收益模式不够明确、融资渠道不畅、公众参与度不够及现有技术不能满足需求等劣势。国家加大支持力度、居民生活水平显著提高、智能终端和良好网络环境不断普及、人口老龄化程度加深、国内外有可借鉴经验为其发展提供了机会,同时面临着政策不稳定、医保相关政策不完善、居民信任度低、信息安全和隐私保护、标准化问题等威胁。结论：卫生健康部门与社会资本应充分利用各自的优势和外部机遇,从政治、经济、社会和技术等方面采取相应措施,化解内部劣势和抵御外部威胁,促进社会资本参与全民健康信息化建设。     

青年教师如何上好留学生微生物学实验课的探索

经济全球化和综合国力的提高,使我国同其它国家间的文化交流日益普遍,大量的国外学生进入我国高校。作为高校教学主力军的青年教师,如何上好留学生教学课,是教师面临的一个崭新的研究课题。本文就青年教师在医学微生物学实验教学过程中,如何针对留学生的特点、选择合适教材、作好教学准备、保证教学实施和课后辅导与反馈进行思考,并就青年教师如何上好实验课进行初步探索。