BACKGROUND & AIMS: :It is well reported in the epilepsy literature that use of antiepileptic drugs (AEDs) leads to bone loss. Validated instruments were administered to assess knowledge, health behavior, quality of life, and stigma, to determine their effects on self-efficacy for osteoprotective and self-management behaviors. This adult epilepsy population had a mean age of 45, with 20 years of AED exposure. Fifty subjects were Caucasian and 44 were non-Caucasian. By one-way ANOVA, there were significant differences in self-efficacy based on ethnicity, medical assistance, status, and seizure frequency. Differences in knowledge based on ethnicity, education, and income were also noted. Regression analysis revealed that the factors that most predict self-efficacy for calcium, exercise, and self-management do not parallel each other. Age and ethnicity were predictive of self-efficacy for epilepsy self-management only. Medical management factors varied among the models. Overall quality of life was a positive predictor for both calcium and exercise self-efficacy.

背景与目标： ：在癫痫文献中有充分的报道指出，使用抗癫痫药（AED）会导致骨质流失。使用经过验证的工具来评估知识，健康行为，生活质量和污名，以确定它们对自我保护的自我保护作用以及对骨保护和自我管理行为的影响。该成人癫痫患者的平均年龄为45岁，暴露于AED的时间为20年。五十名受试者是高加索人，四十四名是非高加索人。通过单因素方差分析，根据种族，医疗救助，身份和癫痫发作频率，自我效能有显着差异。还指出了基于种族，教育和收入的知识差异。回归分析显示，大多数预测钙，运动和自我管理的自我效能的因素并不相互平行。年龄和种族仅能预测癫痫自我管理的自我效能。医疗管理因素因模型而异。总体生活质量是钙和运动自我效能的积极预测指标。

BACKGROUND & AIMS: :Health care workers' perceptions of patient suffering have not been well studied. Patients and health care workers were invited to answer a single, open-ended question. To develop a survey tool that could be validated and used for future research, what health care workers thought causes or caused the most suffering for patients was compared with what patients actually identified as the cause of their worst suffering. Health care workers underestimated loss and significantly underestimated physical nonpainful symptoms as causes of maximal suffering. Communication, emotional, and systems issues were often overestimated by health care workers. Health care workers may not accurately perceive what causes the worst suffering for patients. More studies are needed.

背景与目标： ：医护人员对患者痛苦的看法尚未得到很好的研究。邀请患者和医护人员回答一个开放性问题。为了开发一种可以被验证并用于未来研究的调查工具，将医护人员认为造成或造成患者最大痛苦的原因与实际确定为造成其最严重痛苦的原因进行了比较。医护人员低估了损失，严重低估了身体无痛的症状，这是造成最大痛苦的原因。医护人员常常高估了沟通，情感和系统问题。医护人员可能无法准确地了解是什么导致患者遭受最严重的痛苦。需要更多的研究。

BACKGROUND & AIMS: Inflammatory cell infiltration of the lung is a predominant histopathological change that occurs during radiation pneumonitis. Emigration of inflammatory cells from the circulation requires the interaction between cell adhesion molecules on the vascular endothelium and molecules on the surface of leukocytes. We studied the immunohistochemical pattern of expression of cell adhesion molecules in lungs from mice treated with thoracic irradiation. After X-irradiation, the endothelial leukocyte adhesion molecule 1 (ELAM-1; E-selectin) was primarily expressed in the pulmonary endothelium of larger vessels and minimally in the microvascular endothelium. Conversely, the intercellular adhesion molecule 1 (ICAM-1; CD54) was expressed in the pulmonary capillary endothelium and minimally in the endothelium of larger vessels. Radiation-mediated E-selectin expression was first observed at 6 h, whereas ICAM-1 expression initially increased at 24 h after irradiation. ICAM-1 and E-selectin expression persisted for several days. P-selectin is constitutively expressed in Weibel-Palade bodies in the endothelium, which moved to the vascular lumen within 30 min after irradiation. P-selectin was not detected in the pulmonary endothelium at 6 h after irradiation. The radiation dose required for increased cell adhesion molecule expression within the pulmonary vascular endothelium was 2 Gy, and expression increased in a dose-dependent manner. These data demonstrate that ICAM-1 and E-selectin expression is increased in the pulmonary endothelium following thoracic irradiation. The pattern of expression of E-selectin, P-selectin, and ICAM-1 is distinct from one another.

背景与目标： 肺炎性细胞浸润是放射性肺炎期间发生的主要组织病理学变化。炎性细胞从循环系统的迁移需要血管内皮细胞粘附分子与白细胞表面分子之间的相互作用。我们研究了用胸腔照射治疗的小鼠肺中细胞粘附分子表达的免疫组织化学模式。 X射线照射后，内皮白细胞粘附分子1（ELAM-1; E-选择素）主要在较大血管的肺内皮中表达，而在微血管内皮中则最低表达。相反，细胞间粘附分子1（ICAM-1; CD54）在肺毛细血管内皮中表达，而在较大血管的内皮中表达最少。辐射介导的E-选择素表达首先在6 h观察到，而ICAM-1表达最初在辐射后24 h增加。 ICAM-1和E-选择素表达持续数天。 P-选择蛋白在内皮的Weibel-Palade体中组成性表达，在照射后30分钟内移至血管腔。照射后6 h在肺内皮中未检测到P-选择素。肺血管内皮细胞中细胞粘附分子表达增加所需的辐射剂量为2 Gy，并且表达以剂量依赖性方式增加。这些数据表明，胸腔照射后，肺内皮中的ICAM-1和E-选择蛋白表达增加。 E-选择素，P-选择素和ICAM-1的表达模式彼此不同。

BACKGROUND & AIMS: OBJECTIVE:This study reviewed whether participants who were given a continence education package, which included a Continence Educational Brochure (CEB), and who indicated that they were bothered by incontinence symptoms changed health-seeking behaviors about their incontinence problem because of being given the brochure. METHOD:This study used a descriptive and exploratory design. Participants were given the CEB and asked to read the information. They were also asked to complete a continence questionnaire and mail this back to the research team. Participants who indicated that they were bothered by a continence problem and consented to being interviewed were telephoned 2 to 3 months later. They were asked questions to determine their actions and progress in relation to managing their continence problem and whether the CEB had influenced their behavior. SETTING AND SUBJECT:A total of 631 participants (352 females, 55.8%; 279 males, 44.2%) from 4 rural and regional settings in Victoria, Australia, participated. Of this sample, 111 participants (78 females, 70.3%; 33 males, 29.7%) who reported that they were bothered by a continence problem were interviewed 3 months after being given the CEB. RESULTS:Two thirds of the total sample of participants (n=111) sought help for their continence problem. Approximately 70.3% (n=78) continued to have a continence problem. Of this group, 84.6% were still bothered by the continence problem and 65.4% had taken action to treat their incontinence. Forty-nine participants (44.1%) indicated that they had discussed the issue of bladder or bowel problems with someone directly because of this study or the information contained in the brochure. More than 94% of participants who remembered the CEB indicated that they believed the brochure would be helpful if given to other people. CONCLUSIONS:These findings suggest that the CEB prompted individuals to discuss their continence problem and in fewer cases to seek professional help. Given these findings, distribution of a continence education package is advocated as a continence health promotion strategy.

背景与目标： 目的：本研究回顾了参加者的节制教育包，其中包括节制教育手册（CEB），并指出他们因节制失禁症状而受到困扰，从而改变了他们对失禁问题的健康寻求行为，因为他们获得了手册。
方法：本研究采用描述性和探索性设计。参加者获得了CEB的邀请，并要求阅读信息。还要求他们填写节制问卷并将其邮寄回研究团队。 2至3个月后打电话给表示自己受到节制问题困扰并同意接受采访的参与者。他们被问到问题，以确定他们在处理自控问题方面的行动和进展，以及CEB是否影响了他们的行为。
地点和主题：来自澳大利亚维多利亚州4个农村和地区性地区的631名参与者（352名女性，占55.8％； 279名男性，占44.2％）参加了该项目。在该样本中，有111名参与者表示接受节制问题后感到困扰，他们被告知接受CEB后接受了采访（78名女性，占70.3％； 33名男性，占29.7％）。
结果：参与者（n = 111）的总样本的三分之二寻求帮助，以解决他们的节制问题。大约70.3％（n = 78）仍然存在尿失禁问题。在这一组中，仍有84.6％的人患有尿失禁问题，还有65.4％的人已经采取了行动来治疗他们的尿失禁。 49名参与者（44.1％）表示，由于该研究或小册子中包含的信息，他们直接与某人讨论了膀胱或肠道问题。记得CEB的参与者中，超过94％的参与者表示，他们认为该手册对其他人有帮助。
结论：这些发现表明，CEB促使个人讨论他们的节制问题，并在较少的情况下寻求专业帮助。鉴于这些发现，提倡分发节制教育一揽子计划作为节制健康促进策略。

BACKGROUND & AIMS: :Priority setting of health interventions is often ad-hoc and resources are not used to an optimal extent. Underlying problem is that multiple criteria play a role and decisions are complex. Interventions may be chosen to maximize general population health, to reduce health inequalities of disadvantaged or vulnerable groups, ad/or to respond to life-threatening situations, all with respect to practical and budgetary constraints. This is the type of problem that policy makers are typically bad at solving rationally, unaided. They tend to use heuristic or intuitive approaches to simplify complexity, and in the process, important information is ignored. Next, policy makers may select interventions for only political motives. This indicates the need for rational and transparent approaches to priority setting. Over the past decades, a number of approaches have been developed, including evidence-based medicine, burden of disease analyses, cost-effectiveness analyses, and equity analyses. However, these approaches concentrate on single criteria only, whereas in reality, policy makers need to make choices taking into account multiple criteria simultaneously. Moreover, they do not cover all criteria that are relevant to policy makers. Therefore, the development of a multi-criteria approach to priority setting is necessary, and this has indeed recently been identified as one of the most important issues in health system research. In other scientific disciplines, multi-criteria decision analysis is well developed, has gained widespread acceptance and is routinely used. This paper presents the main principles of multi-criteria decision analysis. There are only a very few applications to guide resource allocation decisions in health. We call for a shift away from present priority setting tools in health--that tend to focus on single criteria--towards transparent and systematic approaches that take into account all relevant criteria simultaneously.

背景与目标： ：卫生干预措施的优先级设置通常是临时的，资源没有得到最佳利用。潜在的问题是，多个标准起着作用，并且决策很复杂。可以选择干预措施，以最大程度地提高总体人口健康，减少弱势或弱势群体的健康不平等，广告/或应对威胁生命的情况，所有这些都涉及实际和预算方面的限制。这是决策者通常无助于理性解决的典型问题。他们倾向于使用启发式或直观的方法来简化复杂性，并且在此过程中，重要的信息将被忽略。接下来，政策制定者可能只出于政治动机选择干预措施。这表明需要采取合理和透明的方法来确定优先事项。在过去的几十年中，已经开发出许多方法，包括循证医学，疾病负担分析，成本效益分析和公平性分析。但是，这些方法仅集中于单个标准，而实际上，决策者需要在选择时同时考虑多个标准。此外，它们并未涵盖与决策者相关的所有标准。因此，有必要开发一种确定优先级的多标准方法，并且最近确实将其确定为卫生系统研究中最重要的问题之一。在其他科学学科中，多准则决策分析已经得到了很好的发展，已经得到了广泛的认可并被常规使用。本文介绍了多准则决策分析的主要原理。只有很少的应用程序可以指导健康状况中的资源分配决策。我们呼吁从目前卫生领域的优先重点设定工具（倾向于只关注单一标准）转变为同时考虑所有相关标准的透明，系统的方法。

BACKGROUND & AIMS: :In the last few decades, the importance of selenium in human health has been the subject of numerous studies. It is believed that the physiological effects of selenium occur mainly through the function of selenoproteins, which incorporate selenium in the form of one or more selenocysteine residues. Recent advances in understanding the complex regulation of selenoprotein synthesis and functional characterization of several members of the selenoprotein family have contributed to an improved comprehension of the role(s) of selenium in human health and the great diversity of physiological pathways influenced by this trace element.

背景与目标： ：在过去的几十年中，硒在人类健康中的重要性一直是众多研究的主题。据信硒的生理作用主要通过硒蛋白的功能而发生，硒蛋白以一种或多种硒代半胱氨酸残基的形式掺入硒。在了解硒蛋白合成的复杂调控和硒蛋白家族几个成员的功能表征方面的最新进展有助于人们更好地理解硒在人类健康中的作用以及受该微量元素影响的多种生理途径。

BACKGROUND & AIMS: :The health issues of young adulthood have received relatively little attention compared with those of adolescence, although the critical issues in young adulthood parallel those of adolescence. Young adults often fare worse than adolescents on health indicators, with many measures of negative outcomes--including rates of injury, homicide, and substance use--peaking during the young adult years. The contextual factors shaping health status and access to care in young adulthood differ significantly from the context of adolescence. This article synthesizes national data to present a health profile of young adults, reviewing social indicators that describe the context of young adulthood and presenting measures of health status. We examine mortality, morbidity, risky behaviors, and health care access and utilization, identifying the most significant gender and racial/ethnic disparities. The article also identifies limitations of existing data and offers suggestions for future research and health monitoring in this area. We conclude with a discussion of current efforts to address the health and well-being of young adults and argue for creating a national health agenda for young adults that includes research, programs and policies to address health issues during this period of the lifespan.

背景与目标： ：与青春期相比，青年期的健康问题受到的关注相对较少，尽管青年期的关键问题与青春期的问题平行。在健康指标上，年轻人通常比青少年情况更糟，在年轻人成年时期，有很多负面结果的衡量指标，包括伤害率，杀人率和药物使用率。决定健康状况和成年后获得医疗服务的情境因素与青春期有很大不同。本文综合了国家数据，以介绍年轻人的健康状况，回顾了描述年轻人成年背景的社会指标，并提出了健康状况的衡量指标。我们检查了死亡率，发病率，危险行为以及医疗保健的获取和利用，确定了最重要的性别和种族/族裔差异。本文还指出了现有数据的局限性，并为该领域的未来研究和健康监测提供了建议。最后，我们讨论了当前为解决年轻人的健康和福祉所做的努力，并争辩了制定一项针对年轻人的国家健康议程，其中包括研究，计划和政策，以解决这一生命周期内的健康问题。

BACKGROUND & AIMS: OBJECTIVE:To investigate the effects of local labor market conditions and the availability of employer-sponsored health insurance on exits from the Medicaid program. DATA SOURCE:Data for this project come from a unique administrative database containing a 2 percent sample of all cases on California's Medicaid program in 1987 and a 2 percent sample of all new cases starting each year between 1987 and 1995. STUDY DESIGN:The results are estimated using a discrete duration model where the monthly exit probability is a function of demographic characteristics, local labor market variables, the probability of having employer-sponsored insurance, and fixed year and county effects. PRINCIPAL FINDINGS:Improvements in labor market opportunities (i.e., employment growth, wage growth, and increases in the availability of employer-sponsored health insurance) promote exits off the Medicaid program. A 2.5 percentage point increase in the availability of employer-sponsored insurance leads to a 6 percent increase in the probability that a completed spell lasts no more than 2 years. It would take a 2 percentage point decrease in unemployment rates or a 10 percent increase in average quarterly earnings to yield an equivalent increase in the likelihood of exiting Medicaid within 2 years. These effects are robust to the inclusion of county-level fixed effects and time effects. CONCLUSIONS:Medicaid expenditures and caseloads are sensitive to local economic fluctuations and secular trends in the availability of health insurance. Continued decreases in employer-based health insurance coverage will greatly increase the demand for public insurance coverage and the financial pressures on state governments.

背景与目标： 目的：调查当地劳动力市场状况以及雇主赞助的医疗保险对医疗补助计划退出的影响。
数据来源：该项目的数据来自一个独特的管理数据库，该数据库包含1987年加利福尼亚州医疗补助计划所有病例的2％样本，以及从1987年至1995年每年开始的所有新病例的2％样本。
研究设计：使用离散持续时间模型估算结果，其中每月退出概率是人口统计学特征，当地劳动力市场变量，拥有雇主赞助的保险的概率以及固定的年度和县级影响的函数。
主要发现：劳动力市场机会的增加（即就业增长，工资增长以及雇主赞助的健康保险的增加）促使人们退出了医疗补助计划。雇主赞助的保险的可用性增加2.5个百分点，则完整的持续时间不超过2年的概率将增加6％。失业率降低2个百分点或平均季度收入提高10％，才能在2年内退出医疗补助计划。这些效应对于将县级固定效应和时间效应包括在内是有力的。
结论：医疗补助支出和病案量对当地经济波动和健康保险可及性的长期趋势很敏感。基于雇主的健康保险覆盖率的持续下降将大大增加对公共保险覆盖率的需求以及州政府的财务压力。

BACKGROUND & AIMS: :A major problem in the search for new cancer drug targets is that the drugs are often toxic to normal tissues and require high doses to kill tumor cells. Therefore cellular targets which appear to involve low dose responses to cancer therapy are especially interesting since they could selectively target normal tissues which are not targeted by the treatment and thus may be responsible for unpleasant side effects or may be amenable to exploitation in order to improve the therapeutic ratio. One such target, which is the subject of this review, is radiation-induced bystander effects [RIBE], which result in the observation of radiation like responses in cells which have not been irradiated. RIBE is a novel phenomenon which indicates that at low doses, cell signaling is more important than direct DNA damage. Historically, DNA has always been considered to be the target for radiation therapy. The growing realization that signaling is important opens up several important therapeutic strategies which will be discussed in this review. RIBE appears to be the result of a generalized stress response in tissues or cells which is expressed at the level of the tissue, organ or organism rather than at the level of the individual cell. The signals may be produced by all exposed cells, but the response may require a quorum of cells in order to be expressed. The major response involving low LET (x- or gamma-ray) radiation exposure discussed in the existing literature is a death response. This has many characteristics of apoptosis but may be detected in cell lines without p53 expression, although the death response is suppressed in many tumor cell lines. While a death response in unirradiated normal cells around a tumor might appear to be adverse, it can in fact be protective and remove damaged cells from the population. If harnessed correctly, it could lead to the development of new drugs aimed not at tissue destruction but at enabling homeostatic mechanisms to control tumor expansion. In this scenario, the level of harmful or beneficial response will be related to the background damage, carried by the cell population, and the genetic programme determining response to damage. This focus may be important when attempting to predict the consequences of mixed therapies involving radiation and other cytotoxic agents. In this review, our current knowledge of the mechanisms underlying the induction of bystander effects by ionizing radiation is reviewed, and the question of how bystander effects may be harnessed to produce a new generation of anti-cancer drugs aimed at stabilization of tissue homeostasis rather than tissue destruction is considered.

背景与目标： ：寻找新的癌症药物靶标的主要问题是该药物通常对正常组织有毒性，需要高剂量才能杀死肿瘤细胞。因此，细胞靶标似乎涉及对癌症治疗的低剂量反应，因此特别令人感兴趣，因为它们可以选择性地靶向未被治疗靶标的正常组织，因此可能引起令人不快的副作用，或者可能适于利用以改善治疗效果。治疗比率。辐射诱导的旁观者效应[RIBE]是本综述的主题之一，该效应导致在未辐射的细胞中观察到辐射样反应。 RIBE是一种新现象，表明在低剂量时，细胞信号传导比直接DNA损伤更为重要。从历史上看，DNA一直被认为是放射治疗的目标。人们日益认识到信号转导很重要，这开启了几种重要的治疗策略，本文将对此进行讨论。 RIBE似乎是组织或细胞中普遍的应激反应的结果，这种应激反应是在组织，器官或生物体的水平而不是单个细胞的水平表达的。信号可能由所有暴露的细胞产生，但响应可能需要一定数量的细胞才能表达。现有文献中讨论的涉及低LET（X射线或γ射线）辐射暴露的主要反应是死亡反应。这具有许多细胞凋亡特征，但尽管在许多肿瘤细胞系中死亡反应受到抑制，但在没有p53表达的细胞系中可能检测到。虽然在肿瘤周围未照射的正常细胞中的死亡反应似乎是不利的，但实际上可以起到保护作用，并从群体中清除受损的细胞。如果利用得当，它可能会导致开发新药物，其目的不是破坏组织，而是使稳态机制能够控制肿瘤的扩展。在这种情况下，有害或有益反应的水平将与细胞群体所携带的背景损伤以及决定对损伤的反应的遗传程序有关。当试图预测涉及放射线和其他细胞毒剂的混合疗法的后果时，这一重点可能很重要。在这篇综述中，我们对电离辐射诱发旁观者效应的潜在机制的现有知识进行了综述，并探讨了如何利用旁观者效应来生产旨在稳定组织稳态而不是稳定组织的新一代抗癌药物的问题。考虑组织破坏。

BACKGROUND & AIMS: INTRODUCTION:Since 2003, Iraq has struggled to build a single national health system administered by the Iraqi Ministry of Health, but politics, lack of leadership, and a cultural bias against treating soldiers in civilian hospitals have hindered access to care for members of Iraq's armed forces who are wounded in combat. METHODS:U.S. surgeons are providing trauma care for Iraqi soldiers in American field hospitals, with more than 80% of hospital bed days occupied by Iraqis. At the same time, Iraqi hospitals have been treating the many civilian casualties of violence, and the Ministry of Health has greatly improved its emergency response and management capabilities over the past year. RESULTS:Ministry of Health hospitals have adequate surgical capabilities and bed capacity to care for both civilian and security forces casualties. Faltering attempts to develop a national health policy that provides comprehensive care for Iraqi Security Forces will jeopardize Iraq's ability to assume responsibilities for the country's national defense, and could delay the withdrawal of Coalition military forces from Iraq. CONCLUSIONS:It is imperative that leadership of the new government of Iraq and the international surgical community strongly endorse the implementation of a single health care system for all Iraqis.

背景与目标： 简介：自2003年以来，伊拉克一直在努力建立由伊拉克卫生部管理的单一国家卫生系统，但是政治，缺乏领导力以及在民用医院中对待士兵的文化偏见阻碍了伊拉克武装部队获得医疗服务在战斗中受伤的部队。
方法：美国外科医生正在美国野战医院为伊拉克士兵提供创伤护理，其中80％以上的病床天都由伊拉克人占用。同时，伊拉克医院一直在治疗许多平民的暴力伤亡，而卫生部在过去一年中大大提高了其应急响应和管理能力。
结果：卫生部的医院具有足够的手术能力和床位能力，可以照顾平民和安全部队的伤亡。制定一项旨在为伊拉克安全部队提供全面护理的国家卫生政策的步履蹒跚的尝试将危及伊拉克承担起负责该国国防的责任的能力，并可能延迟联军从伊拉克撤军。
结论：伊拉克新政府和国际外科界的领导层必须坚决支持为所有伊拉克人实施单一的卫生保健系统。

BACKGROUND & AIMS: BACKGROUND:Surveys of the population are commonly used to obtain information on health status. Increasingly, researchers are linking self-reported health status information to primary care consultation data. However, it is not known how participating in a health-related survey affects consultation behaviour. The objective of this study was to assess whether completion of a health-related questionnaire changes primary care consultation behaviour. METHODS:Participants were 3402 adults aged 50 and over from the general population in North Staffordshire, UK, who completed a health-related postal survey received in April 2003. The survey was predominantly about occurrence and severity of knee pain in the last year. Primary care attendance for the three months following response was compared to three control periods: i) the three months prior to the survey, ii) the same time period in the previous year and iii) the same time period in the following year. Comparisons were made on consultations for any problem, consultations for musculoskeletal disorders and consultations for knee problems. RESULTS:The percentage of subjects consulting for any condition was marginally higher for the three months directly after receipt of the questionnaire but the difference was only statistically significant in comparison to the three months before the survey (64% v. 62%, p = 0.05). There was little difference in consultation prevalence for musculoskeletal problems immediately after the survey compared to the three control periods. There was an increase of 37% in knee disorder consultations for the three months after the survey compared to the three months directly before the survey (p = 0.02). However, consultation prevalence for knee problems was identical for the three months after the survey to the same time periods in the years prior to and following the survey (both p = 0.94). CONCLUSION:The results from this study suggests that questionnaires related to physical health do not affect the standard consulting behaviour of patients, even for the symptom under investigation. This should reassure researchers who wish to link self-reported health status and medical care utilisation and clinicians whose patients are involved in such research.

背景与目标： 背景：人口调查通常用于获取有关健康状况的信息。研究人员越来越多地将自我报告的健康状况信息与初级保健咨询数据联系起来。但是，尚不清楚参与健康相关调查如何影响咨询行为。这项研究的目的是评估完成与健康有关的问卷是否会改变初级保健咨询的行为。
方法：参与者是来自英国北部斯塔福德郡（North Staffordshire）的3402名年龄在50岁以上的成年人，他们于2003年4月完成了一项与健康相关的邮政调查。该调查主要是关于去年膝盖疼痛的发生和严重程度。将响应后三个月的基层医疗出勤率与三个对照期进行比较：i）调查前三个月，ii）上一年的相同时期，iii）下一年的相同时期。对任何问题的咨询，肌肉骨骼疾病的咨询和膝盖问题的咨询进行了比较。
结果：在收到问卷后的三个月中，针对任何情况进行咨询的受试者的百分比略高，但与调查前的三个月相比，差异仅在统计上具有统计学意义（64％对62％，p = 0.05 ）。与三个对照期相比，调查后立即就骨骼肌肉问题进行咨询的患病率差异不大。与调查前三个月相比，调查后三个月的膝关节疾病咨询增加了37％（p = 0.02）。但是，膝关节问题的咨询患病率在调查后的三个月内与调查前后几年中的相同时间段相同（均为p = 0.94）。
结论：这项研究的结果表明，与身体健康相关的问卷不会影响患者的标准咨询行为，即使对于所调查的症状也是如此。这应该使希望将自我报告的健康状况和医疗利用联系起来的研究人员以及患者参与此类研究的临床医生得到保证。

BACKGROUND & AIMS: :The causes of racial and ethnic inequalities in health and the most appropriate categories to use to address health inequality have been the subject of heated debate in recent years. At the same time, genetic explanations for racial disparities have figured prominently in the scientific and popular press since the announcement of the sequencing of the human genome. To understand how such explanations assumed prominence, this essay analyzes the circulation of ideas about race and genetics and the rhetorical strategies used by authors of key texts to shape the debate. The authority of genetic accounts for racial and ethnic difference in disease, the author argues, is rooted in a broad cultural faith in the promise of genetics to solve problems of human disease and the inner truth of human beings that is intertwined with historical meanings attached to race. Such accounts are problematic for a variety of reasons. Importantly, they produce, reify, and naturalize notions of racial difference, provide a scientific rationale for racially targeted medical care, and distract attention from research that probes the complex ways in which political, economic, social, and biological factors, especially those of inequality and racism, cause health disparities.

背景与目标： 近年来，种族和族裔健康不平等的原因以及用于解决健康不平等的最适当类别一直是人们争论的焦点。与此同时，自从人类基因组测序宣布以来，有关种族差异的遗传解释在科学和大众媒体中占据了突出的位置。为了理解这种解释是如何引起人们注意的，本文分析了有关种族和遗传学的思想的传播以及关键文本作者用来形成辩论的修辞策略。作者认为，遗传权能解释疾病的种族和族裔差异，这源于一种广泛的文化信仰，即人们信奉遗传学来解决人类疾病和人类内在真理的诺言，与人类历史的内在涵义交织在一起。种族。由于多种原因，这样的帐户是有问题的。重要的是，它们产生，证实和归纳了种族差异的概念，为针对种族的医疗保健提供了科学依据，并分散了对研究政治，经济，社会和生物学因素（尤其是不平等因素）的复杂方式的研究的注意力和种族主义，造成健康差异。

BACKGROUND & AIMS: :The Management Academy for Public Health is a team-based training program jointly offered by the School of Public Health and the Kenan-Flagler Business School at the University of North Carolina at Chapel Hill. This 9-month program teaches public health managers how to better manage people, information, and finances. Participants learn how to work in teams with community partners, and how to think and behave as social entrepreneurs. To practice and blend their new skills, teams develop a business plan that addresses a local public health issue. This article describes the program and explains the findings of the process evaluation, which has examined how best to structure and deploy a team-based method to create more effective, more entrepreneurial public health managers. Findings indicate that recruitment and retention are strong, program elements are relevant to learners' needs, and learners are satisfied with and value the program. Several specific benefits of the program model are identified, as well as several elements that support business plan success and skills' application on the job. On the basis of these findings, four success factors critical for developing similar programs are identified.

背景与目标： ：公共卫生管理学院是一项基于团队的培训计划，由北卡罗来纳大学教堂山分校的公共卫生学院和Kenan-Flagler商学院联合提供。这个为期9个月的课程向公共卫生经理讲授如何更好地管理人员，信息和财务。参与者学习如何与社区合作伙伴一起工作，以及如何思考和表现为社会企业家。为了练习和融合他们的新技能，团队制定了解决当地公共卫生问题的商业计划。本文介绍了该程序，并说明了过程评估的结果，该过程评估了如何最好地构建和部署基于团队的方法来创建更有效，更具创业精神的公共卫生经理。调查结果表明，招聘和留住人才的能力很强，计划要素与学习者的需求相关，学习者对计划感到满意和重视。确定了计划模型的几个特定优点，以及支持业务计划成功和技能在工作中应用的几个要素。根据这些发现，确定了开发类似程序的四个成功因素。