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121.
The Israel network of Healthy Cities has been operating since 1990, and the first evaluation of its performance was carried out in 2004. The objectives were to evaluate the level of implementation of the 'Healthy Cities' principles and strategies in each network city and to assess the contribution of the network to its member cities. Coordinators of 18 active healthy cities participated in the study by completing a questionnaire with the aid of key informants in the municipality. The survey covered six dimensions of Healthy Cities' principles and strategies, and each was analyzed as a sum of scores of separate components and measures, converted to a 0-10 scale. Cities were found to differ in their performances. The dimension of intersectoral collaboration received the highest mean score (8.0 +/- 1.6), while the environmental protection dimension received the lowest one (4.5 +/- 2.2). Time investment by the coordinator of > 20 h a week is significantly associated with a higher score on the management dimension (7.8 versus 4.4 where the coordinator invests 20 h a week or less, P < 0.001). Previous work experience in either public health or community work was associated with higher scores of the community participation and intersectoral partnership dimensions (6.9 versus 5.2 and 8.5 versus 6.8, respectively, P < 0.05). Political support was associated with the city equity policy dimension (8.1 versus 4.8 in cities with high versus low political support, P < 0.01). Coordinator's participation in the network's activities is associated with better scores on all the dimensions except for environmental protection. It appears that political commitment and support is a significant enabling condition, which, together with the capacity building of the coordinator, may lead to better implementation of Healthy Cities' policy. Environmental issues should be incorporated into training sessions to enhance the environmental protection dimension.  相似文献   
122.
城乡交界地区育龄妇女生殖道感染现状及综合防治探讨   总被引:12,自引:7,他引:5  
目的 调查城乡交界地区育龄妇女生殖道感染状况以及相关因素,在人口流动性大的地区,探索降低育龄妇女生殖道感染有效可行的综合防治策略。方法 在陕西省关中平原地区的城乡交界处采用多阶段随机抽样的方法,抽取340名非经期已婚育龄妇女进行问卷调查,同时进行妇科检查及相应的实验室检查。结果 各类生殖道感染总患病率为76.8%。常见的生殖道感染性疾病为慢性宫颈炎、阴道炎、附件炎,患病率分别为51.2%、27.4%、15.0%。其相关的危险因素有:文化程度初中以下、无经济来源、未使用避孕套、性病知识得分低、经期使用不洁物品及经期有过性生活、配偶对本人生病就医持消极态度、既往患过滴虫性阴道炎。结论 在人口流动性大的城乡交界处,应因地制宜,积极调动各方面力量进行生殖道感染的防治。动员政府管理部门提供政策支持;利用计生部门提供完善的服务网络和做社会工作的经验;同时医疗卫生部门可加大其宣传力度,加强技术人员培训,坚持开展普查普治工作;以家庭为干预单位,提高妇女的自我保健意识,积极动员男性参与。在多方面共同努力下,建立一套综合防治模式,降低生殖道感染患病率,促进生殖健康。  相似文献   
123.
Abstract

Recent research has examined how gay and bisexual men experience and navigate the variations in sexual minority stigma that exist across geographic contexts, with implications for their health. We extend this literature on stigma, mobility, and health by considering the unique and understudied setting of the small city. Drawing on semi-structured interviews (n = 29) conducted in two small US cities (New Haven and Hartford), we find that these small cities serve as both destinations and points of departure for gay and bisexual men in the context of stigma. New Haven and Hartford attracted gay and bisexual men from surrounding suburbs where sexual minority stigma was more prevalent and where there were fewer spaces and opportunities for gay life. Conversely, participants noted that these small cities did not contain the same identity affirming communities as urban gay enclaves, thus motivating movement from small cities to larger ones. Our data suggest these forms of mobility may mitigate stigma, but may also produce sexual health risks, thus drawing attention to small cities as uniquely important sites for HIV prevention. Furthermore, our analysis contributes to an understanding of how place, stigma and mobility can intersect to generate spatially distinct experiences of stigmatised identities and related health consequences.  相似文献   
124.
目的:比较东中西部城市税收、社会医疗保险、商业健康保险和居民现金卫生支出4种卫生筹资渠道的累进性。方法:利用2011年8个社区卫生综合改革典型城市居民健康询问调查数据,采用比例法描述东中西部城市4种卫生筹资渠道的分布,并计算其集中指数和kakwani指数。结果:东中西部城市不同经济水平家庭的社会医疗保险、商业健康保险和居民现金卫生支出构成差异均无统计学意义(χ2社会医疗保险=3.697, P=0.883;χ2商业健康保险=11.349, P=0.183;χ2现金卫生支出=4.146, P=0.844),而直接税构成差异具有统计学意义(χ2=17.439, P=0.026),东部城市家庭直接税的公平性好于中部城市。总体上,呈现累进性的筹资渠道是直接税、职工医疗保险、商业健康保险;呈现累退性的是间接税、居民医疗保险,而现金卫生支出在东部城市呈现累退性,在中部和西部城市呈现累进性。结论:发挥税收在筹资公平性的作用;完善社会医疗保险制度;提高卫生服务的可及性。  相似文献   
125.
The authors conducted a time-series analysis to estimate the acute effects of high temperature in 6 cities in Korea and to compare thresholds of temperature on daily mortality among the cities. They examined the association between total mortality and the daily mean temperature and heat index during the summers in Korea from 1994 to 2003. The threshold temperature was estimated to be between 27.0°C and 29.7°C for 4 cities. For a daily mean temperature increase of 1°C above the thresholds in Seoul, Daegu, Incheon, and Gwangju, estimated percentage increases in daily mortality were 16.3 (95% confidence interval [CI] = 14.2-18.4), 9.10 (CI = 5.12-13.2), 7.01 (CI = 4.42-9.66), and 6.73 (CI = 2.47-11.2), respectively. These city-specific threshold temperatures and the magnitude of the effects of hot temperature indicate that any analysis of the impact of climate change should take into account regional differences.  相似文献   
126.
Objectives To determine the levels of resistance to first‐line tuberculosis drugs in three cities in three geopolitical zones in Nigeria. Methods A total of 527 smear‐positive sputum samples from Abuja, Ibadan and Nnewi were cultured on BACTEC‐ MGIT 960. Drug susceptibility tests (DST) for streptomycin, isoniazid, rifampicin and ethambutol were performed on 428 culture‐positive samples on BACTEC‐MGIT960. Results Eight per cent of the specimens cultured were multi‐drug‐resistant Mycobacterium tuberculosis (MDR‐TB) with varying levels of resistance to individual and multiple first–line drugs. MDR was strongly associated with previous treatment: 5% of new and 19% of previously treated patients had MDR‐TB (OR 4.1 (95% CI 1.9–8.8), P = 0.001) and with young adult age: 63% of patients with and 38% without MDR‐TB were 25–34 years old (P = 0.01). HIV status was documented in 71%. There was no association between MDR‐TB and HIV coinfection (P = 0.9) and gender (P > 0.2 for both). Conclusions  MDR‐TB is an emerging problem in Nigeria. Developing good quality drug susceptibility test facilities, routine monitoring of drug susceptibility and improved health systems for the delivery of and adherence to first‐ and second‐line treatment are imperative to solve this problem.  相似文献   
127.
"海洋文化城市"与长三角沿海城市发展   总被引:4,自引:0,他引:4  
“海洋文化城市”是一种崭新的城市文明形态,既不同于一般的海滨城市,又与恶性损耗海洋文化资源、刺激经济增长的“海洋经济型城市”有着本质区别。目前,长三角沿海城市的形象定位。与“海洋文化城市”存在着严重的错位。廓清“海洋文化城市”的理论内涵,不仅可以丰富长三角沿海城市发展思路,还能够为沿海城市发展提供科学的实践路径。  相似文献   
128.
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