上海市农村社区卫生服务站药品管理调查分析

目的：了解上海市郊区社区卫生服务站（村卫生室）药品管理的现状，分析存在的问题，为制定《上海市农村社区卫生服务站基本药物目录》提供依据。方法：采用分层随机抽样的方法，进行问卷调查。结果：调查的72个社区卫生服务站（村卫生室）在药品管理中药品管理部门和药品采购部门的不统一、部分单位药品没有做到日清月结等；在药品使用过程中药物品种配备范围太大、部分村卫生室没有配备中成药等；在用药过程中，部分乡村医生对选择首选药品等存在错误认识。结论要统一药品管理部门和药品采购渠道，加强社区卫生服务站（村卫生室）药品的日常管理，制定上海市农村社区卫生服务站基本药物目录，提高乡村医生药品管理和使用药品的水平。     

农村中医药发展指标确定

根据七部委最近颁发的《中国农村初级卫生保健发展纲要（2001～2010年）》中有关农村中医药人员、服务量两个明确指标，国家中医药管理局要求到2010年，基本完成县级中医医院房屋设备的改造和建设任务; 完成乡（镇）卫生院中医科的基础设施建设，使中医药技术服务参与医疗、预防、保健的全过程; 加强对村卫生室的中医药业务管理和指导，使村卫生室具备开展中医药服务的基本设施，每个村至少有一名中医或能中会西的乡村医生。到2005年，全国乡（镇）卫生院临床中医医疗服务人员要具备中医执业助理医师及以上执业资格，其他中医药卫生技术人员…     

加强农村社区卫生服务站建设全面开展农村社区卫生工作

余姚市西北街道社区卫生服务中心(原老方桥镇社区卫生服务中心)自1996年开展农村社区卫生服务以来，特别是现阶段通过加强对原村卫生室转型后的社区卫生服务站的建设，使农村社区卫生工作取得了不少成效。2003年获得并通过了浙江省农村社区卫生服务示范点的验收。现街道共有服务人口4万余人，17个行政村。有街道卫生院即社区卫生服务中心1家，社区卫生服务站(村卫生室)13家，乡村医生34人。     

中医药助力新农合，惠民利民

我省注重发挥中医药在新型农村合作医疗中的作用，制订了一系列激励和扶持政策措施，将中医医疗机构列入新农合定点医疗机构，把中药饮片、中成药、中医适宜技术列入新农合报销范围，并提高报销比例，有效地降低了参事农民的医药费用。农村中医药服务网络不断完善：全省已建设县级中医医院120所；有1405所卫生院设置了中医科、中药房并配备中药饮片和中成药，占乡镇卫生院总数的83.23％：有32566所村卫生室配备了中药饮片，占村卫生室总数的51.25％；70％的乡村医生能够运用中西医两法治疗农村常见病、多发病。积极开展农村中医工作先进县建设，已建成全国农村中医工作先进县（市、区）12个、全省农村中医工作先进县20个。威海市通过国家中医药管理局验收被确定为全国第一个地市级农村中医工作先进市，烟台市被确定为建设单位。向全省农村大力推广中医药50项适宜技术，到2007年底，全省所有县（市、区）均开展了中医适宜技术推广工作，乡镇推广覆盖率达到97.8％，村卫生室覆盖率达到85，似，已被国家中医药管理局确定为全国惟一农村适宜技术推广示范省，多次在全国会议上介绍经验。     

疾病预防控制中心参与农村社区卫生服务工作的思考

我市疾病预防控制中心 ,在市卫生局、开化县卫生局的重视和支持下 ,会同开化县疾控中心 ,在该县底本乡开展了以疾病预防控制工作为首要内容的农村社区卫生服务改革试点 ,取得了一定的成效。1　开展农村社区卫生服务对疾病预防控制工作的现实意义1.1　村卫生室功能萎缩和服务的不适应性 ,需要建立新的服务模式 ,以适应疾病预防控制工作的要求　随着农村经济的发展 ,我市农村卫生服务机构发生了深刻的变化 ,以村卫生室为主体的村级卫生机构分化明显。服务人口集中 ,业务水平较好的卫生室已经成为实质上的个体诊所 ,而许多因乡村医生年龄过大 ,…     

宁波市沿海地区29个村卫生室服务现状调查

目的:了解村卫生室服务的基本现状。方法:采用普查的方法,对浙江省宁波市某镇29个村卫生室进行卫生服务现状调查。结果:村卫生室平均业务用房为44.21平方米;医疗设备基本符合村卫生室国家标准,乡村医生的文化程度偏低,年龄偏大,男性偏多,村卫生室均为私营性质,用药不合理,以医疗服务为主。结论:乡村医生业务水平低;难以满足农村居民基本就医需求和提供六位一体的农村社区卫生服务。应加强乡村医生队伍建设,改善村卫生室的设施设备条件,强化乡村医生的用药监管,建立卫生服务评价和考核机制,推进乡村一体化管理。     

宁夏农村村级卫生服务现状分析

目的了解宁夏农村村级卫生服务的基本现状。方法采用普查的方法，自行设计调查表。对宁夏石嘴山市惠农县辖区内26个村卫生室进行卫生服务现状调查。结果平均每村有0．92所卫生室，村卫生室房屋简陋。规模小，平均业务用房为56．55m^2；村卫生室医疗设备简陋，乡村医生文化程度偏低，10年内没有参加过培训；村卫生室办医型式个体占92．3％，医疗质量无人管理，乡村医生资格准入没有严格标准和程序。结论乡村医生的医疗技术水平低；村卫生室卫生服务功能低下，绝大多效为私人诊所。难以满足农民基本就医需求。     

四川省贫困地区村卫生室服务能力现状分析

目的：通过对四川省贫困地区村卫生室服务能力现状的分析，为村卫生室的建设提供参考；方法：采用问卷定量与社会学定性访谈相结合的方法；结果：四川省贫困地区村卫生室在人员素质和基础设施方面比较落后，服务能力较低，业务开展受到局限，管理规范有待加强；建议：政府应该加大对乡村卫生室的投入，重视乡村医生素质的培养和提高，对村级卫生室形成制度化管理，从而保证三级医疗网网底作用的充分发挥。     

强体系、抓队伍、优服务山东省筑牢乡村振兴村级卫生服务网底

村卫生室和乡村医生是农村医疗卫生服务的网底,长期以来在保障农村居民健康方面发挥了重要作用.近年来,山东省以打造乡村振兴齐鲁样板健康板块为目标,全面落实"以基层为重点"的新时期卫生与健康工作方针,开展引领提升工程,分级分类推进村卫生室标准化建设,实施三年行动推动村级卫生服务体系提档升级,多措并举优化提升乡村医生队伍结构素...     

上海市郊农村社区卫生服务站处方使用现况调查

文章对上海市郊县72个农村社区卫生服务站（村卫生室）2005年处方进行抽样调查，通过对单张处方用药品种、抗生素使用、中成药使用、激素使用、给药途径、单张处方均次费用等进行统计分析，旨在探讨如何使乡村医生合理使用基本药物，提高医疗质量。     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.