关注健康,没有借口——高寿糖尿病明星Louis Zorich的健康态度

<正>"不管存在多少借口,预防和控制糖尿病比出现并发症后再去补救要容易得多。"2008年11月的一次常规体检后,84岁高龄的美国著名演员Louis Zorich得知自己患上了糖尿病。     

Mental health,employment, and welfare tenure

This article determines the prevalence of mental health diagnosis and impairment among 632 participants in Temporary Assistance for Needy Families (TANF) and describes the relationship between these problems and welfare tenure and employment. A random sample of female TANF participants was surveyed in two California counties consecutively for 3 years, starting in 1999. TANF participants who have mental health problems are more likely than those who have none to leave welfare as a result of sanction and less likely to work at all. They also work fewer weeks in a year and fewer hours per week. In the course of 36 months, their earned income is substantially lower than that of those who do not have mental health problems. © 2005 Wiley Periodicals, Inc. J Comm Psychol 33: 587–609, 2005.     

Bridging the gap between primary care and the cancer system: The UPCON Network of CancerCare Manitoba

PROBLEM BEING ADDRESSED     

Dementia and the Over-75 Check: the role of the primary care nurse

Primary care nurses are very likely to provide a substantial part of the routine care for patients with dementia. In order to examine the knowledge and attitudes of the primary care nurses who undertake the Over-75 Check, towards assessing and managing patients with symptoms of dementia, and to assess their level of support for a clinical practice guideline, a postal questionnaire survey was undertaken of primary care nurses responsible for the Over-75 Check in 209 general practices in Gloucester, Avon and Somerset. The questionnaire ascertained some demographic information about the nurses, their training and the practice routine for the Over-75 Check. It also included a case vignette describing a typical presentation of dementia at an Over-75 Check. A 65% response rate was achieved. Only one-fifth of respondents ever used formal validated cognitive tests as part of the Over-75 Check. In response to the vignette, nearly 10% took no action at all and a further 25% simply referred the patient on. Amongst the remainder there was considerable variation regarding the tasks considered to be within their remit. The respondents strongly supported the introduction of guidelines. Given the variation in professional responsibilities between practices, it is proposed that a clinical practice guideline covering diagnosis, assessment and management of dementia should address the practice as a whole rather than be targeted to specific professionals. The guideline should prompt professionals carrying out an Over-75 Check to recognize symptoms of dementia and raise awareness of the range of tasks which need to be undertaken in confirming diagnosis, assessing needs and managing patients. Results from this study suggest that improved training and increased autonomy for primary care nurses would improve access to services for these patients and their carers.     

Postnatal concerns of mothers: an update

The purpose of this study was to determine the major concerns of primiparae and multiparae 1 month post-delivery and the resources used in meeting identified concerns. A mail-back questionnaire developed by Gruis (1977) was used. The sample was composed of 19 primiparae and 22 multiparae from Vancouver BC, Canada. The most frequently identified concerns of primiparae (N greater than 6) were baby feeding, fatigue, breast soreness, baby behaviour, return of the figure, limiting visitors, regulating demands, growth and development, interpreting behaviour, physical care of the baby, and labour and delivery. The most frequently identified major concerns of multiparae (N greater than 6) were fatigue, regulating demands, emotional tension, jealousy of other children, and the labour and delivery experience. The vast majority of major concerns were dealt with effectively. The women used a variety of resources, and their partners were particularly helpful. However, for 14 (64%) of the multiparae in this study, the hospital stay did not provide preparation for the first weeks at home with their new baby. It is suggested that community caregivers should see their postnatal clients as soon as possible after discharge from hospital. Teaching sessions can occur in the home, and in accordance with individual concerns.     

AMALGAMATION OF HEALTH SERVICES IN SOUTH‐WEST VICTORIA: REINVENTION OR SURVIVAL?

ABSTRACT: In Australia 'the hospital' has long been considered the cornerstone of small, rural health services. However, this premise has been altered significantly by the introduction of casemix loading and diagnostic-related groups that promote a rationalised output-based model of management. In the light of these changes, many rural health services have struggled to reinvent themselves by establishing a range of service models such as Multi-purpose Service (MPS) and Health Streams, while maintaining traditional models (i.e. bush nursing centres, nursing homes and aged-care facilities). These changes are about survival. This paper analyses one such case in south-west Victoria, the Macarthur and District Community Outreach Service, and compares the outcomes with other similar Victorian rural health research projects. Particular attention is paid to the nature of the health services, the management of change and the proposed health outcomes for the local rural communities. In conclusion, it is argued that this study adds to the body of knowledge surrounding the construction of models of community health and development programming, These models impact upon future rural and remote area initiatives throughout Australia.     

Prevalence and location of teeth marks observed on painted surfaces in an evaluation of the HUD lead hazard control grant program

Data from an evaluation of the HUD Lead Hazard Control Grant Program were used to evaluate the prevalence and location of teeth marks on painted surfaces in residential housing. The results of these analyses will be useful in the development of more effective pediatric lead poisoning prevention programs. These programs have historically placed considerable emphasis on surfaces accessible to children for mouthing activities. This study analyzes the largest set of data ever assembled on the prevalence of teeth marks in housing. Data from 308,851 observations in 3,454 housing units were analyzed to determine the prevalence of teeth mark observations per surface, dwelling unit, and building component, and by housing age, inspector, and grantee. An average of 4.0 teeth marks per 10,000 surfaces with paint-lead greater than or equal to 1.0 mg/cm2 were observed. For surfaces with less than 1.0 mg/cm2 lead the rate was 1.5 teeth marks/10,000 surfaces. The number of teeth marks per 10,000 surfaces increased with age of housing for surfaces with 1.0 mg/cm2 or higher lead but not for surfaces with less than 1.0 mg/cm2 lead. Teeth mark observation rates were 36 times higher for windowsills than for other components and ranged up to 11 per 10,000 surfaces and 9 dwellings per 100 dwelling units for 2 grantees with the highest rates. Blood lead levels in children exhibiting moderate to high mouthing behavior were higher than in children without such behavior, especially in housing where teeth marks were observed. Special priority should be given to windowsills when making decisions on lead hazard control for "accessible," "chewable," or "mouthable" surfaces.     

Benchmarking HIPAA compliance

One of the nation's largest academic medical centers is benchmarking its operations using internally developed software to improve privacy/confidentiality of protected health information (PHI) and to enhance data security to comply with HIPAA regulations. It is also coordinating the development of a web-based interactive product that can help hospitals, physician practices, and managed care organizations measure their compliance with HIPAA regulations.