An integrated information system for all-hazards health preparedness and response: New York State Health Emergency Response Data System.

Effective and timely exchange of information among healthcare, state and local public health, and other health emergency response partners is essential to all-hazards emergency preparedness and response. Since fall of 2001, NY State Department of Health has partnered with the healthcare and public health community in New York to implement a statewide Health Emergency Response Data System to meet this need. During this time, it has been used in a wide range of preparedness and response applications including regional and local exercises, surveillance, health facility asset tracking, and response to actual health events. The architecture, design, and implementation model used in the system readily support all-hazards preparedness and response at state, regional, and local levels. It has become one of the most important assets to health emergency response in New York State.     

The implementation of the Medical Regulation Office and Mobile Emergency Attendance System and its impact on the gravity profile of non-traumatic afflictions treated in a University Hospital: a research study

Background

The public health system of Brazil is structured by a network of increasing complexity, but the low resolution of emergency care at pre-hospital units and the lack of organization of patient flow overloaded the hospitals, mainly the ones of higher complexity. The knowledge of this phenomenon induced Ribeirão Preto to implement the Medical Regulation Office and the Mobile Emergency Attendance System. The objective of this study was to analyze the impact of these services on the gravity profile of non-traumatic afflictions in a University Hospital.

Methods

The study conducted a retrospective analysis of the medical records of 906 patients older than 13 years of age who entered the Emergency Care Unit of the Hospital of the University of São Paulo School of Medicine at Ribeirão Preto. All presented acute non-traumatic afflictions and were admitted to the Internal Medicine, Surgery or Neurology Departments during two study periods: May 1996 (prior to) and May 2001 (after the implementation of the Medical Regulation Office and Mobile Emergency Attendance System). Demographics and mortality risk levels calculated by Acute Physiology and Chronic Health Evaluation II (APACHE II) were determined.

Results

From 1996 to 2001, the mean age increased from 49 ± 0.9 to 52 ± 0.9 (P = 0.021), as did the percentage of co-morbidities, from 66.6 to 77.0 (P = 0.0001), the number of in-hospital complications from 260 to 284 (P = 0.0001), the mean calculated APACHE II mortality risk increased from 12.0 ± 0.5 to 14.8 ± 0.6 (P = 0.0008) and mortality rate from 6.1 to 12.2 (P = 0.002). The differences were more significant for patients admitted to the Internal Medicine Department.

Conclusion

The implementation of the Medical Regulation and Mobile Emergency Attendance System contributed to directing patients with higher gravity scores to the Emergency Care Unit, demonstrating the potential of these services for hierarchical structuring of pre-hospital networks and referrals.

     

HEE-GER: a systematic review of German economic evaluations of health care published 1990–2004

Background  

Studies published in non-English languages are systematically missing in systematic reviews of growth and quality of economic evaluations of health care. The aims of this study were: to characterize German evaluations, published in English or German-language, in terms of various key parameters; to investigate methods to derive quality-of-life weights in cost-utility studies; and to examine changes in study characteristics over the years.     

An integrated model of care to counter high incidence of HIV and sexually transmitted diseases in men who have sex with men – initial analysis of service utilizers in Zurich

Background  

As other countries, Switzerland experiences a high or even rising incidence of HIV and sexually transmitted infections (STI) among men who have sex with men (MSM). An outpatient clinic for gay men (" Checkpoint ") was opened in 2006 in Zurich (Switzerland) in order to provide sexual health services. The clinic provides counselling, testing, medical treatment and follow-up at one location under an "open-door-policy" and with a high level of personal continuity. We describe first experiences with the new service and report the characteristics of the population that utilized it.     

密蒙花黄酮类化合物的分离和鉴定

从密蒙花(Buddleia officinalis Maxim)的花蕾中分离得到8个黄酮类化合物,其小3个甙元:刺槐素(acacetin,1),芹菜素(apigenin,2),木犀草素(luteolin,3);5个甙:密蒙花新甙(neobudofficide,4),蒙花甙(linarin=acaciin,5),木犀草素7-O-芸香糖甙(6),木犀草素-7-O-葡萄糖甙(7),秋英甙(cosmosiin,8)。化合物4为新化合物,用化学和波谱法确定其结构为5.7-二羟基-4'-甲氧基黄酮-7-O-α-L-吡喃鼠李糖基-(1→2)-[α-L-吡喃鼠李糖基-(1→6)]-β-D-吡喃葡萄糖甙,除化合物1和5以外,其它化合物均为首次从密蒙花中得到。