Quality of health care for ethnic/racial minority populations

This article reviews the composition and characteristics of the health professions, the demographics of the national population, and factors that influence access to health care and satisfaction with care for ethnic/racial minority populations in the United States. In addition, an overview of publicly funded US health insurance programs for the poor is provided along with a discussion of the impact that managed care is having on the American health care system. Finally, the paper summarizes conference discussions regarding the problems, strategies, and approaches that the UK and the US have experienced with respect to providing quality health care for ethnic/racial minority populations.     

我国居民自我药疗健康风险的行为干预策略探讨

目的:为减少我国居民自我药疗的健康风险提供行为干预策略。方法:分析我国居民自我药疗的健康风险与行为模式。结果与结论:必须通过加大健康教育力度,提高居民用药能力,规范非处方药品的包装和说明书管理,推广实施《优良药店工作规范》,广泛开展消费者用药咨询服务,提高药师素质,加强药品不良反应监测与报告等方法,方可对居民的自我药疗行为进行干预。     

Comparison of Alcohol Dependence in Subjects from Clinical, Community, and Family Studies

This study contrasts the prevalence of alcohol-related symptoms, ages of onset of alcoholism milestones, and lifetime prevalence of other psychiatric disorders in three samples of alcohol-dependent individuals: alcoholics sampled from a variety of clinical settings (not necessarily alcoholism treatment facilities), relatives of alcoholic probands who participated in a Family Study of alcoholism, and alcoholics identified in the St. Louis Epidemiologic Catchment Area survey. Alcohol dependence (with or without abuse) was assessed using DSM-III diagnostic criteria for all samples. Clinical alcoholics had significantly more lifetime alcohol symptoms than Family Study and Community alcoholics and a significant excess of many alcohol symptoms. Onset information indicated that the three groups were similar in terms of appearance of milestones of alcohol dependence. For females aged 45 or younger, lifetime prevalence of major depression was high in both Clinical and Family Study alcoholics compared with Community alcoholics; male alcoholics from the Community Study had an excess of drug dependence. Findings suggest that, although alcoholics identified in clinical settings may have more severe alcohol dependence, certain types of psychiatric comorbidity are present to a greater degree in other samples of untreated alcoholics.     

Strategies intended to address vaccine hesitancy: Review of published reviews

When faced with vaccine hesitancy, public health authorities are looking for effective strategies to address this issue. In this paper, the findings of 15 published literature reviews or meta-analysis that have examined the effectiveness of different interventions to reduce vaccine hesitancy and/or to enhance vaccine acceptance are presented and discussed. From the literature, there is no strong evidence to recommend any specific intervention to address vaccine hesitancy/refusal. The reviewed studies included interventions with diverse content and approaches that were implemented in different settings and targeted various populations. Few interventions were directly targeted to vaccine hesitant individuals. Given the paucity of information on effective strategies to address vaccine hesitancy, when interventions are implemented, planning a rigorous evaluation of their impact on vaccine hesitancy/vaccine acceptance will be essential.     

中国农村地区AIDS临床发病特点及应对策略

目的　提高对农村地区艾滋病 (AIDS)临床发病特点的认识。方法　对农村地区 10多个村庄的有偿供血员中近 10 0 0名艾滋病病毒 (HIV)感染者 /AIDS患者的临床特点进行实地调查分析。结果　 (1)临床特点呈现高发病率、高丙型肝炎 (丙肝 )病毒 (HCV)感染率和高母婴传播率 ,低乙型肝炎 (乙肝 )病毒 (HBV)感染率 (三高一低 ) ;临床表现为发热、腹泻、口腔霉菌感染 (口腔溃疡 )、皮疹四大主症。 (2 )同一时间对 5 0 0例患者进行免疫功能调查显示 :CD+ 4 >5 0 0 / μl 90例 (18% ) ,CD+ 4 2 0 0～ 5 0 0 / μl 2 89例 (5 7 8% ) ,CD+ 4 <2 0 0 / μl 12 1例 (2 4 2 % )。 结论　中国农村地区HIV/AIDS目前正处于发病高峰时期 ,发病速度为 2 4 2 % ;三高一低 ,四大主症是农村地区AIDS患者的主要临床特点 ;尽快为农村地区的AIDS患者提供医疗支持是当前最为紧迫的任务 ;积极、稳妥、持续、科学的医疗支持策略将是农村地区AIDS临床工作顺利开展的可靠保障。     

Activation of Stratification Strategies and Results of the interventions on frail patients of Healthcare Services (ASSEHS) DG Sanco Project No. 2013 12 04

To face the challenge of active and healthy ageing (AHA), European Health Systems and services should move towards proactive, anticipatory and integrated care. Health care systems thus need to personalize services, put patients at the centre of care and provide services using the adequate resources. Population health risk management is emphasized through the use of tools to stratify people with chronic diseases according to their risk. Effective screening of frailty is vital for optimizing the care of frail populations at risk. The Activation of Stratification Strategies and Results of the interventions on frail patients of Healthcare Services (ASSEHS) EU project (N° 2013 12 04) is an international effort whose aim is to bring together stratification-related professionals from Health Services, Academia and Research in the EU in order to (i) study current existing health risk stratification strategies and tools, (ii) spread their use and application on frail elderly patients, (iii) minimize deterioration of conditions and/or (iv) prevent emergency or hospital admissions. The analysis of Risk Stratification in different Health Systems will generate conclusions and risk stratification solutions, which will be transferable to a variety of regions in the future. ASSEHS is in line with Area 4 of the B3 Action Plan of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA).     

Quality assurance in drug demand reduction in European countries: an overview

Background: The EMCDDA, through its network of National Focal Points, collects information on the quality assurance systems for drugs-related interventions across European countries. European National Drug Strategies include recommendations for systems and approaches for the assurance of the quality of interventions.

Methods: We searched National Drug Strategies for elements related to quality assurance in drug demand reduction and summarised information through questionnaires administered to the EMCDDA Network of National Focal Points.

Results: In total, 15 National Drug Strategies and 60 questionnaires were analysed. Almost all the strategies include quality-related topics. Frequently, the Ministry of Health leads quality assurance although sometimes jointly with the Ministries of Education, Labour, Family and Social Welfare. Accreditation systems are common, but implemented in different ways. Training and education are widely provided, for the vast majority of countries, consisting of short-term training to keep professionals updated. Guidelines and Standards are gathering momentum as the major tools for the implementation of evidence-based recommendations and are usually available across countries.

Conclusions: Although the evidence base for interventions in drug demand reduction is becoming available and accepted, attention needs to be given to implementation issues. The European countries are rapidly moving towards paying greater attention to the quality of interventions.     

Adopting,manipulating, transforming: Tactics used by gender practitioners in South African NGOs to translate international gender policies into local practice

This paper looks at what is lost and gained through the process of translating international policy from a global to a local space. It does this by sharing results from a multisite ethnographic study of gender practices in foreign-funded South African health organisations. This study identifies a number of tactics used by practitioners to deal with the funding constraints and unique knowledge systems that characterise local spaces, including: using policy to appeal to donors; merging gender with better resourced programmes; and redirecting funding allocations. These tactics point to how practitioners are adopting, manipulating and transforming international policies in order to suit their everyday working realities.