矿难与政府角色

近一段时间重大矿难频频发生,伤亡程度让世界震惊,给遇难者家庭造成的巨大心理创伤和经济损失,及其对内对外带来的政治影响,更是难以估计。透过矿难,我们不难发现其经济上的必然性,而政府作为煤炭行业安全生产的监管者,由于监管制度问题而导致的监管失灵,是矿难频发的深层次原因。在现行宏观经济环境下,必须改变政府角色,使之成为真正的监管者,才能从根本上遏制矿难的频发。     

浅谈社区卫生服务在医改中的转型

作为医疗服务保障网的社区卫生医疗而言,以"保基本、强基层、建机制"为工作重点,以达到人人享有基本医疗卫生服务为目标,突出深化医药卫生体制改革,使全体居民人人拥有基本医疗保障,人人享有基本公共卫生服务.其可及性、服务质量、服务效率尤为重要,为了努力满足人民群众多层次、多样化的医疗卫生服务需求,社区卫生服务机构在十一五后发生了诸多转变.     

发展视角下的西北农村社区服务

西北农村社区是一个生产和生活紧密结合的共同体.在西北农村自然和社会禀赋不足的情况下,如何把农村社区服务与农业生产、农民增收结合起来,如何将社区服务作为提升居民生存发展能力和促进当地农村社会持续发展的手段是西北农村社区服务必须面对的挑战.从发展理论视角出发分析了西北农村社区服务的现状、理念、政策与实务,认为西北农村社区服务应立足于"发展"定位,明确政府的主导责任,建立包括政府、民间组织、社区居民多元参与的上下和水平合作的伙伴关系.     

Health Services and Health Care Economics: The Health Psychology Marketplace.

In an effort toward cost containment, the health care system in the United States has undergone radical changes in the last decade. These changes have influenced the delivery of clinical health psychology services. This article reviews several economic and marketing factors salient to the clinical health psychology marketplace. For example, these economic changes have placed greater emphasis on the need for cost-effectiveness and accountability in the health psychology field. Implications for education and training, collaboration with other health care specialties, new practice initiatives, and public relations are reviewed. Future challenges and opportunities for clinical health psychology are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Background and prospects of the Community Health Act

Japan was defeated in World War II and almost all of the nation was demoralized by the destruction and damage to much of the nation. The medical and health care system during and before World War II needed to be reformed radically and fundamentally since almost all medical and health institutes were destroyed. On the other hand, many health personnel came back from overseas after the war. Japanese modern medicine had developed on the basis of German medicine; however, many aspects of American medicine, including public health and democracy, were rapidly introduced following the end of World War II. The American type of health center was established and many laws concerning medical and health care were enacted in 1947-1948. One of them was "The Health Center Law." The National Health Insurance Act was enacted in 1958 and the total population has been covered by health insurance plans since 1961. Many physicians quit the health centers and they have worked as clinicians under the National Health Insurance scheme, because health centers were introduced before adequate education and research existed in the field of public health. On the other hand, the health insurance scheme was in its golden age during the high economic growth period of the 1960s. Japan has succeeded in all forms of modern technology and economy for the past 30 years and is now one of the top nations in the field of medical and health care, such as the numbers of clinics and hospitals and beds, the frequency of consulting with a doctor, length of hospital stay, examinee rates in mass health examinations in the community and workplace and so on. Health conditions have changed drastically from the 1950s to the present. Therefore, health centers do not fit current health needs. For example, mortality from tuberculosis, acute infections diseases and also stomach and uterus cancers and apoplexy have decreased rapidly while mortality from chronic diseases, especially lung, breast and rectal cancers, and myocardial infarction have increased gradually. Changes of life style resulting from rapid economic growth are suspected to be important causes of the change in the prevalence of these diseases. Mass health examination was important and effective as a preventive measure against tuberculosis, especially as a means of early detection and early treatment. However, it is not now effective against chronic diseases. The screening examination has resulted in identifying many patients suspected of being ill. Every examiner must be able to distinguish pathologic findings from physiologic changes of aging. Every patient must, therefore, understand his/her individuality and evaluate the result of his/her efforts to improve life style by receiving a health examination. Accordingly, the aim of health examination has changed from early detection to health support for the examinee. During the decades when life expectancy was less than 50 years of age, it was not necessary for people to plan for retirement. Moreover, there was little burden on younger generations to provide care for the aged people because there were few old people more than 70 years of age and the birth rate was high. Nowadays, elderly people face many years of life after retirement and there are too many aged people in relation to the number of younger persons. As for medical care services, many new medical needs have emerged in recent years, including "quality of life," "palliative medicine in terminal care," "establishment of a primary care system" and "comprehensive care connecting health and medical care with welfare" etc. Improved living standards resulting from economic growth, called the "economic miracle" internationally, have helped to bring about a rapid and wide range of change in daily lifestyle, such as eating habits, working conditions and environment. The Ministry of Health and Welfare has made every effort to revise the laws in relation to health and medical care systems, in order to adjust to recent     

The evolving health care system: the role of the Health Resources and Services Administration

The toxicity of Atrazine and that of its Desethylatrazine metabolite has been defined employing two organisms already tested in our labs the Dugesia gonocephala, belonging to a scissiparous strain coming from the island of Tavolara (Sardinia) and the Thamnocephalus platyurus, crustacean anostracan produced under form of quiescent cysts from Creasel Ltd. (Deinze, Belgium). It has been defined the lethal concentrations at 50% of Atrazine and of Desethylatrazine, of which it has been studied also the report dose-effect in the comparisons of the rectilinear motility. The results highlight that in the comparisons of the T. platyurus Atrazine expounds a toxicity of around three times that of its metabolite; this is not seen with the Planarians that are equally sensitive to both the compounds. The use of these two experimental models for the evaluation of the contamination of bodies of water is shown to be particularly useful given their great sensitivity to pollutants.     

Occupational Health Research in Developing Countries: The Experience in Ecuador

We report the results of a double-blind, placebo-controlled trial in nine cystic fibrosis (CF) subjects receiving cationic liposome complexed with a complementary DNA encoding the CF transmembrane conductance regulator (CFTR), and six CF subjects receiving only liposome to the nasal epithelium. No adverse clinical effects were seen and nasal biopsies showed no histological or immuno-histological changes. A partial restoration of the deficit between CF and non-CF subjects of 20% was seen for the response to low Cl- perfusion following CFTR cDNA administration. This was maximal around day three and had reverted to pretreatment values by day seven. In some cases the response to low Cl- was within the range for non-CF subjects. Plasmid DNA and transgene-derived RNA were detected in the majority of treated subjects. Although these data are encouraging, it is likely that transfection efficiency and the duration of expression will need to be increased for therapeutic benefit.     

Insulin sensitivity and blood pressure in a biethnic sample: the Miami Community Health Study

An association between blood pressure and insulin sensitivity among normotensive African-Americans has not been demonstrated consistently in epidemiologic studies. Part of the discrepancy may be due to studying persons with profound obesity-an insulin-resistant state itself. The association between insulin-mediated glucose uptake (i.e., insulin sensitivity) and blood pressure was examined among 25 nondiabetic African-American and 28 white non-Hispanic persons aged 25-44 years who ranged from normal weight to obese, using the hyperinsulinemic euglycemic clamp technique. In bivariate analyses, insulin sensitivity was inversely related to systolic (p < 0.01) and diastolic blood pressure (p = 0.08) among African-American persons and to diastolic blood pressure among white non-Hispanic subjects (p < 0.05). Covariate adjustment for age and sex had only a marginal effect on these results. When the data were pooled and further adjusted for ethnicity, insulin sensitivity remained significantly associated with both systolic and diastolic blood pressure (p < 0.01 for each). To consider the effect of obesity, body mass index (BMI) was divided at the sample median (26.5 kg/m2) and the analyses were repeated within each stratum. Among those whose BMI was below the median value, each increment in insulin sensitivity was associated with a 2-mmHg decrease in systolic blood pressure (p = 0.02). These results suggest that ethnicity was not a strong effect modifier in this sample and indicated that insulin sensitivity was inversely related to blood pressure level in these normotensive African-American and white, non-Hispanic participants.     

低碳经济与政府作用分析

低碳经济作为一种新的经济发展模式,以全新的理念变革着经济社会发展方式.由于其追求资源节约、环境保护等外部效应与具有"经济人"特征的市场主体目标的背离,引发了市场失灵,造成低碳经济发展动力的不足.在此背景下,研究低碳经济发展与政府作用的内在关系,准确定位政府角色,提出了规划指导、宣传教育、立法保障、制度强化、政策引导和带头示范等发挥政府作用促进中国低碳经济发展的政策建议,以期为政府职能部门决策提供理论支撑.     

公共关系与政府改革阻力的化解

针对信息沟通不畅、利益格局的调整以及整个社会外部环境等一系列因素使政府改革的进行变得困难重重的现实,分析了公共关系所强调的沟通与协调不仅能为政府改革搜集到有效的信息,而且其所倡导的双向互动也能在潜移默化中转变公众的态度,从而为政府改革提供动力与支持.指出在未来政府改革过程中,有必要在组建一支政府内部专业公关团队的基础上,运用沟通、参与、关怀等策略,推动政府改革的顺利进行.