WHO's Service Availability and Readiness Assessment of primary health care services of commune health centers in a rural district of Northern Vietnam

The objective of this study was to assess the availability and readiness of the primary health care (PHC) services of commune health centers (CHCs) in Quoc Oai, a rural district of Northern Vietnam based on the World Health Organization's Service Availability and Readiness Assessment (SARA) tool. The study was done in 2 steps. First, the heads of the 21 CHCs of Quoc Oai district were interviewed using SARA, a quantitative survey, and the responses were then validated by direct observations of each facility. The results showed that although the average number of health staffs in each CHC met the national standards (at least 5 staffs per CHC), its allocation within each CHC was not properly met because some CHCs had only 2 health staffs. Several health equipment and facilities were not fully available in many CHCs, and although the majority of the PHC services were available at the CHCs, their readiness remained limited. Several significant correlates between the availability of health care workers and the availability of the facilities and the PHC services were observed, suggesting that they depend upon and affect one another in the health system. Using the SARA‐based inventory, the study helps health managers and policy makers to prioritize efforts and allocate resources more appropriately. To be effective, attention should be given to how to make facilities, services, and human resources for health ready for PHC activities—more investment and support from the system (from higher to lower level) and the government.     

基于WHO/HAI标准化法的陕西省零售药店儿童基本药物可获得性及价格研究

目的:为我国儿童基本药物目录的出台及改善儿童药物使用现状提供参考。方法:采用世界卫生组织和国际健康行动组织共同制定的WHO/HAI标准化法,于2012年对陕西省6个城市的60家零售药店的28种儿童基本药物进行调研,将零售药店药品零售价格与国际参考价进行对比研究。结果:儿童基本药物在陕西省零售药店的可获得性低;原研药零售价格远高于国际参考价,而最低价格仿制药零售价格较为合理;治疗急性病的儿童基本药物的可负担性较好。结论:应尽快出台儿童基本药物目录;加大研发适宜儿童使用的剂型、规格及包装;对原研药合理定价;鼓励零售药店采购和销售基本药物。     

Alcohol Availability and Injury: The Role of Local Outlet Densities

BACKGROUND: We analyzed the relationship between alcohol availability and injury that occurred during the 6 months before survey administration. METHOD: The data examined were from a general population survey administered to 13,440 California respondents as part of a community-based project to reduce alcohol-involved injury and death. Two separate analyses were performed. The first considered individual local outlet densities (which included both on-premise establishments such as bars and restaurants and off-premise establishments such as liquor and grocery stores) as they affect individual phone survey respondents' self-reported injuries. To address potential spatially autocorrelated errors and geographically lagged effects, a second analysis considered aggregate outlet densities within geographic areas as they affect the proportion of survey respondents who reported injury. No spatial autocorrelation or significant lagged effects were found, which supported our individual-level analyses. RESULTS: Our analyses indicated an association between both on-premise and off-premise individual-level outlet densities and self-reported injuries. CONCLUSION: Alcohol availability seems to be related to self-reported injury. The mechanisms behind this relationship, however, are not clear, and further study is indicated.     

基于大数据的医疗系统虚拟化研究与设计

针对医院信息系统现状,提出医疗系统虚拟化拟解决的问题,包括高可用性、管理、故障或容灾以及成本问题。从服务器和存储虚拟化两方面阐述如何采用VMware设计基于大数据的医疗系统虚拟化方案并介绍其虚拟集群应用。     

The Medical Consumption of Opioids in Colombia, 1997–2007

ABSTRACT

The World Health Organization classifies opioid analgesics as essential medicines in the treatment of severe pain and recommends their increased availability. The combination of availability, training of professionals, and a legal framework granting access to these medicines has led to a sharp increase in the consumption of morphine and other opioids in developed countries. However, in Colombia, consumption of opioid analgesics appears to fail to meet patient needs. To analyze the current trends in medical consumption of opioids in Colombia, the numbers of defined daily doses of opioid analgesics for total inhabitants and the population that died of cancer between 1997 and 2007 were calculated and compared. The import of raw materials and medicines varied greatly every year. However, from 2003, a trend toward the increased consumption of morphine, hydromorphone, and methadone was observed. Availability was inconsistent and opioid consumption showed an increase when calculated for total inhabitants and for cancer deaths. The unreliable availability of opioid analgesics may be responsible for their limited consumption. Chronic underuse and a trend toward increased consumption have been confirmed. Monitoring of consumption to promote rational use is recommended.     

我国基本药物生产流通使用中存在问题和成因分析

描述我国药品生产、流通和使用等各个环节中存在的问题，从政策层面上揭示了基本药物可获得性低的原因，提出政府应系统考虑基本药物目录范围、基本药物生产、供应、使用和价格等各个方面，形成国家基本药物政策，从制度上确保公众对基本药物的可获得性。     

Experience with Lippes loop and copper-T intrauterine devices in rural Bangladesh

Experience with IUD use among rural Bangladeshi women within two programmatic efforts demonstrates that the Copper-T IUD suited the needs of younger, lower-parity women better than Lippes Loop. The differential performance by the device was especially marked within the program that offered a broad selection of contraceptive methods and occurred mainly because of lower rates of expulsion and lower rates of discontinuation for bleeding and pain among the Copper-T users. Nevertheless, the easy availability of a wide choice of methods during the second program successfully encouraged dissatisfied IUD discontinuers to try other methods of contraception.     

Estimation of hydroxymethylfurfural availability in breakfast cereals. Studies in Caco-2 cells.

The transport and availability of hydroxymethylfurfural (HMF), an intermediary product of the Maillard reaction, was investigated in the Caco-2 cell line after in vitro gastrointestinal digestion. The study was carried out at two levels; (a) an HMF-spiked culture medium, and (b) digested commercial breakfast cereals (BC). In both assays, the higher the amount of HMF offered to the cells, the higher the absolute value of transported HMF. However, HMF availability and transport are not directly proportional to the initial HMF content since HMF is partly retained in the non-soluble fraction after digestion. In addition, HMF is degraded to some extent during the gastrointestinal digestion of both HMF-spiked cell medium and BC. Average HMF availability from three commercial breakfast cereals was 9.1% (4.98-12.99%). Variations in HMF availability may be related to the particular composition of each BC, where fibre could play an important role. On the other hand, possible metabolization into the cell should also be considered.