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：

BACKGROUND & AIMS: Despite numerous legal interventions, minors continue to purchase and consume alcohol. Prior research had suggested that the decision to request identification to prove legal age was susceptible to various judgement and decision heuristics. This research examined whether the physical attractiveness of the potential consumer and the presence or absence of others were significant predictors of alcohol accessibility. Bartenders (n = 130) rated a target individual who was either high or low in attractiveness. Results indicated that attractiveness was a significant predictor of "proofing likelihood". High levels of attractiveness were associated with a decrease in the likelihood of being asked to provide proof of legal age for the purchase of alcohol. Individuals presented alone were seen as significantly older than when grouped with others. Implications of these findings for the restriction of alcohol availability among minors are considered.

背景与目标： 尽管有许多法律干预，未成年人仍继续购买和消费酒精。先前的研究表明，要求证明合法年龄的决定容易受到各种判断和决策启发式的影响。这项研究检查了潜在消费者的身体吸引力以及其他人的存在与否是否是酒精可及性的重要预测因素。调酒师 (n = 130) 对吸引力高或低的目标个体进行了评分。结果表明，吸引力是 “打样可能性” 的重要预测指标。高吸引力与被要求提供购买酒精的法定年龄证明的可能性降低有关。单独出现的人被认为比与他人分组时要大得多。考虑了这些发现对限制未成年人饮酒的影响。

BACKGROUND & AIMS: -2

背景与目标： -2

BACKGROUND & AIMS: :The recognition that human papillomavirus (HPV) infection is the central, necessary cause of cervical cancer paved the way to new fronts of prevention via improved screening methods and HPV vaccination. Much has been learned in all fronts, from the molecular basis of our understanding of how HPV causes disease to the health economics of preventive strategies at the individual and population levels. Progress in other areas of cancer control has yet to show the same multi- and trans-disciplinary gains seen in research on HPV-associated malignancies, which is one of the unequivocal success stories in disease prevention. Yet, as an embarrassment of riches, much more research is needed to fill the gaps in knowledge that remain before we are able to reap the benefits from the knowledge translation from all fronts. Public health research on setting-specific implementation of HPV-based preventive strategies and more concerted advocacy to counter barriers facing the adoption of these strategies are likely to yield major dividends in reducing the burden of HPV-associated diseases. This article forms part of a special supplement entitled "Comprehensive Control of HPV Infections and Related Diseases" Vaccine Volume 30, Supplement 5, 2012.

背景与目标： : 认识到人乳头瘤病毒 (HPV) 感染是宫颈癌的主要必要原因，通过改进筛查方法和HPV疫苗接种，为预防的新领域铺平了道路。从我们对HPV如何引起疾病的理解的分子基础到个人和人群水平的预防策略的健康经济学，在各个方面都学到了很多东西。癌症控制的其他领域的进展尚未显示出与HPV相关的恶性肿瘤研究中相同的多学科和跨学科收益，这是疾病预防中明确的成功案例之一。然而，作为财富的尴尬，需要更多的研究来填补知识的空白，这些空白在我们能够从各个方面获得知识翻译的好处之前仍然存在。针对特定环境实施基于HPV的预防策略的公共卫生研究以及采取这些策略所面临的障碍的更协调一致的倡导，可能会在减轻HPV相关疾病的负担方面产生重大好处。本文是2012年《HPV感染及相关疾病的综合控制》疫苗第30卷第5期补充的部分内容。

BACKGROUND & AIMS: :Discussions of drug policy tend not to consider whether the stated goals of policies are an accurate statement of what they are meant to do and also may not consider the fact that what benefits some people may harm others. We explore these issues and present an agenda for research in this area that, while not eliminating these difficulties, both illuminates them and can help guide actors toward more effective action.

背景与目标： : 关于毒品政策的讨论往往不会考虑政策的既定目标是否是对其意图的准确陈述，也可能不会考虑这样一个事实，即某些人的利益可能会损害其他人。我们探讨了这些问题，并提出了该领域的研究议程，尽管没有消除这些困难，但两者都阐明了这些困难，并可以帮助指导行为者采取更有效的行动。

BACKGROUND & AIMS: BACKGROUND:Road traffic injuries contribute substantially to the disease burden in India. This paper describes the road safety issues discussed by members of the Indian Parliament, and highlights the gaps that need to be addressed to make road safety visible as a public health problem to policy-makers in India. METHODS:All questions asked to and information provided by the Ministry of Road Transport and Highways, and questions relating to accident asked to the Ministry of Health and Family Welfare of the Government of India were reviewed for the two Houses of the Indian Parliament for the years 2002 to 2004. RESULTS:Of the 1529 questions asked to the Ministry of Road Transport and Highways, only 140 (9.1%) were related to road safety, whereas 1076 (70.5%), 181 (11.8%), 51 (3.3%) and 81 (5.3%) were related to other aspects of the national highways, state roads, vehicles and other issues, respectively. Data on the magnitude of road crashes dealt only with the number of crashes and fatalities and not with the age, sex and type of road users affected by road traffic injuries. The parliamentarians were informed that human error was the main cause of road crashes in India; however, the robustness of this information is questionable. Strategies to prevent road crashes focused mainly on training of drivers with little attention to other factors that cause road crashes. The discussion on legislations also focused on drivers, ignoring other road users. Ten of the 4741 questions (0.2%) asked to Ministry of Health and Family Welfare were related to accident, the majority of which were about the setting up of trauma care services. CONCLUSION:An appropriate policy and intervention response by policy-makers is not possible with data that are presented in a manner that do not highlight the true nature of the problem, and are neither comprehensive nor robust. Majority of the proposed road safety interventions by the Ministry of Road Transport and Highways are based on the traditional view of human error as a major cause of road crashes highlighting the lack of a scientific public health approach towards prevention of road crashes. It would be useful to build the technical capacity of the Ministry of Road Transport and Highways in road safety to use the available data more effectively, and to facilitate generation of further relevant data about the magnitude, underlying causes and impact of road traffic injuries, for policy-makers to better understand the critical issues for planning effective road safety policies and interventions to reduce the high burden of mortality and morbidity due to road crashes in India.

背景与目标：

BACKGROUND & AIMS: STUDY QUESTION:What was the impact on access to assisted reproductive technology (ART) treatment by different socioeconomic status (SES) groups after the introduction of a policy that increased patient out-of-pocket costs? SUMMARY ANSWER:After the introduction of a policy that increased out-of-pocket costs in Australia, all SES groups experienced a similar percentage reduction in fresh ART cycles per 1000 women of reproductive age. Higher SES groups experienced a progressively greater reduction in absolute numbers of fresh ART cycles due to existing higher levels of utilization. WHAT IS KNOWN ALREADY:Australia has supportive public funding arrangements for ARTs. Policies that substantially increase out-of-pocket costs for ART treatment create financial barriers to access and an overall reduction in utilization. Data from the USA suggests that disparities exist in access to ART treatment based on ethnicity, education level and income. STUDY DESIGN, SIZE, DURATION:Time series analysis of utilization of ART, intrauterine insemination (IUI) and clomiphene citrate by women from varying SES groups before and after the introduction of a change in the level of public funding for ART. PARTICIPANTS/MATERIALS, SETTING, METHODS:Women undertaking fertility treatment in Australia between 2007 and 2010. MAIN RESULTS AND THE ROLE OF CHANCE:Women from higher SES quintiles use more ART treatment than those in lower SES quintiles, which likely reflects a greater ability to pay for treatment and a greater need for ART treatment as indicated by the trend to later childbearing. In 2009, 10.13 and 5.17 fresh ART cycles per 1000 women of reproductive age were performed in women in the highest and lowest SES quintiles respectively. In the 12 months after the introduction of a policy that increased out-of-pocket costs from ∼$1500 Australian dollars (€1000) to ∼$2500 (€1670) for a fresh IVF cycle, there was a 21-25% reduction in fresh ART cycles across all SES quintiles. The absolute reduction in fresh ART cycles in the highest SES quintile was double that in the lowest SES quintile. LIMITATIONS, REASONS FOR CAUTION:In this study, SES was based on the average relative socioeconomic advantage and disadvantage of small geographic areas, and therefore may not reflect the SES of an individual. Additionally, the policy impact was limited to the 12 months following its introduction, and may not reflect longer term trends in ART treatment. WIDER IMPLICATIONS OF THE FINDINGS:While financial barriers are an important obstacle to equitable access to ARTs, socioeconomic differences in utilization are likely to persist in countries with supportive public funding, due in part to differences in childbearing patterns and treatment seeking behaviour. Policy makers should be informed of the impact that changes in the level of cost subsidization have on access to ART treatment by different socioeconomic groups. STUDY FUNDING/COMPETING INTEREST(S):G.M.C. receives grant support to her institution from the Australian Government, Australian Research Council (ARC) Linkage Grant No LP1002165; ARC Linkage Grant Partner Organisations are IVFAustralia, Melbourne IVF and Queensland Fertility Group. V.P.H. is employed as an Economics Research Associate on the same grant. P.J.I. is Medical Director of the IVF Clinic, IVFAustralia and has a financial interest in the parent group, Virtus. TRIAL REGISTRATION NUMBER:N/A.

背景与目标：

BACKGROUND & AIMS: :Recognizing that robust information on health systems in other countries can provide valuable lessons for the English National Health Service, the Department of Health commissioned an academic team to provide an 'On-call Facility for International Healthcare Comparisons' in 2005. This paper describes the work of this novel approach to informing policy and reviews the experience of the first two years. It illustrates the well-documented challenges of comparative analysis of health systems. One important issue is understanding the health system context so as to interpret phenomena and draw appropriate policy conclusions. Other challenges include the potential tension between academic interest and rigour, and the need for timely analysis to inform the Department of Health's rapidly changing policy agenda. The diversity and nature of topics covered, as well as the rapid turn-around time have meant that the Facility has had to balance rigour and timeliness carefully to ensure the value and relevance of reports. A strong research base linked with an international network of country experts promotes the provision of high quality analyses at relatively low costs. However, such an arrangement can only be sustained if it provides scope for additional primary research. A formal evaluation of the influence on health care policy-making in England is not yet available. Such knowledge will be of crucial importance for the development of similar resources elsewhere.

背景与目标： : 认识到其他国家卫生系统的可靠信息可以为英国国家卫生服务局提供宝贵的经验教训，卫生部委托一个学术团队为国际医疗保健比较提供 “随叫随到的设施” 2005年。本文介绍了这种新颖的政策通报方法的工作，并回顾了前两年的经验。它说明了卫生系统比较分析的有据可查的挑战。一个重要的问题是了解卫生系统的背景，以便解释现象并得出适当的政策结论。其他挑战包括学术兴趣和严谨之间的潜在紧张关系，以及需要及时分析以告知卫生部迅速变化的政策议程。所涵盖主题的多样性和性质以及快速的周转时间意味着该设施必须仔细平衡严谨性和及时性，以确保报告的价值和相关性。与国际国家专家网络相联系的强大研究基础促进以相对较低的成本提供高质量的分析。然而，这种安排只有在为额外的初级研究提供空间的情况下才能持续下去。尚未对英格兰对医疗保健政策制定的影响进行正式评估。这些知识对于在其他地方开发类似资源至关重要。

BACKGROUND & AIMS: :Tungiasis (sand flea disease) is an ectoparasitic skin disease caused by the female sand flea/jigger flea (Tunga penetrans). As poverty is the major driving force of the disease, it can be called as a poverty-associated plague. It is one of the emerging neglected diseases in Latin America, Caribbean, sub-Saharan Africa, and India. The aim of the present scrutiny was to assess the public health impact of tungiasis, associated risk factors, and emerging opportunities to prevent and control tungiasis. Searches of PubMed, Google Scholar, and online search engines (Google, AOL, and Yahoo) using keywords "parasitic skin disease," "tungiasis," "sand flea," " tungiasis-associated risk factors," "tungiasis prevention and control," and their synonyms were used as a source of references. Searches were made without time limitations. Of 167 potential articles identified by these criteria, 51 appropriate were selected for review. Tungiasis is widespread in the resource-constrained settings of low-income economies. In the tropics, it is highly prevalent among the impoverished populations, but the associated risk factors are often poorly identified and remain uncontrolled. Though it is a self-limiting disease with considerable morbidity, the parasite may cause subsequent secondary morbidity through life-threatening complications and infections like cellulitis, tetanus, and death. However, the direct and indirect sociocultural, economic, and health impact of tungiasis is often undervalued and misunderstood. A systematic assessment on disease burden is still dearth and deficient. Over the decades, tungiasis has been largely neglected by the scientific community, policy makers, and healthcare stakeholders. In the endemic regions, even tungiasis is not listed for the disease control priorities in the regional, national, and international agenda. The majority of the epidermal parasitic skin diseases particularly tungiasis needs a sustainable global scientific research and control policy. This urges intensive efforts to develop a road map that delivers a clear vision towards zero new infection by designing low-cost prevention and control strategies. Besides, there is an urgency to develop culturally appropriate communication techniques and workable collaboration on a global scale by bringing all the stakeholders of endemic countries.

背景与目标： : Tungiasis (沙蚤病) 是由雌性沙蚤/跳蚤 (Tunga penetrans) 引起的一种外部寄生虫性皮肤病。由于贫困是该疾病的主要驱动力，因此可以将其称为与贫困相关的瘟疫。它是拉丁美洲，加勒比海地区，撒哈拉以南非洲和印度新兴的被忽视的疾病之一。本次审查的目的是评估外膜病对公共卫生的影响，相关的危险因素以及预防和控制外膜病的新兴机会。搜索PubMed，Google Scholar和在线搜索引擎 (Google，AOL和Yahoo)，使用关键字 “寄生性皮肤病”，“tungiasis”，“沙蚤”，“tungiasis相关危险因素”，“tungiasis预防和控制，” 和它们的同义词被用作参考文献的来源。搜索没有时间限制。在这些标准确定的167篇潜在文章中，选择了51篇合适的文章进行审查。在低收入经济体资源受限的环境中，突尼斯病很普遍。在热带地区，它在贫困人口中非常普遍，但相关的风险因素往往无法识别，并且仍然不受控制。尽管它是一种具有相当高发病率的自限性疾病，但该寄生虫可能会通过威胁生命的并发症和感染 (如蜂窝织炎，破伤风和死亡) 引起继发疾病。但是，tungiasis对社会文化，经济和健康的直接和间接影响常常被低估和误解。对疾病负担的系统评估仍然缺乏和不足。几十年来，tungiasis在很大程度上被科学界，政策制定者和医疗保健利益相关者所忽视。在流行地区，甚至在区域，国家和国际议程中也没有将tungiasis列为疾病控制重点。大多数表皮寄生性皮肤病，尤其是tungiasis，需要可持续的全球科学研究和控制政策。这敦促加紧努力，制定路线图，通过设计低成本的预防和控制策略，实现零新感染的清晰愿景。此外，迫切需要通过吸引流行国家的所有利益攸关方，在全球范围内发展文化上适当的交流技术和可行的合作。

BACKGROUND & AIMS: OBJECTIVES:We evaluated the trend of end-of-life healthcare utilization and life-sustaining interventions for older adults with dementia 3 to 4 years after the change in hospice policy. DESIGN:Population-based retrospective cohort study. SETTING AND PARTICIPANTS:We used the National Health Insurance Research database of enrolled patients ≥65 years of age diagnosed with dementia who died in 2010-2013 (n = 2062). METHODS:Aggressive treatments, including healthcare utilization and life-sustaining interventions, were recorded within 6 months of death. Aggressive healthcare utilization included ≥1 emergency department visits, ≥1 hospitalizations, >14 days of hospitalization, intensive care unit admission, and death in an acute care hospital. Life-sustaining interventions were enteral tube, artificial nutrition, blood transfusion, hemodialysis, invasive ventilation, and cardiopulmonary resuscitation. RESULTS:Compared with 2010‒2012, 2013 rates significantly decreased for all measures (P < .001). Composite scores of healthcare utilization and life-sustaining treatments in 2013 were significantly lower than for 2010‒2012, after controlling for confounding variables (both P < .001). CONCLUSIONS AND IMPLICATIONS:Older patients with dementia had a trend of reduced healthcare utilization and fewer life-sustaining treatments near the end of life from 2010 to 2013 after a policy change.

背景与目标：

BACKGROUND & AIMS: AIM:This paper is a report of an exploration of the concept of service user involvement in mental health nursing using a discourse analysis approach. BACKGROUND:Service user involvement has come to be expected in mental health nursing policy and practice. This concept, however, is often applied somewhat ambiguously and some writers call for a clearer understanding of what service users actually want. METHOD:A Foucauldian discourse analysis was conducted in 2005, examining literature and health policies published by the United Kingdom government and service users. The discursive perspectives of both were explored and conceptual themes were generated from the data. FINDINGS:Concepts occurring within government discourse include language relating to service users, the notion of service user involvement and power. Concepts from the service user discourse include power, change and control, theory, policy and practice, and experiential expertise. Differences in perspectives were found within these themes which distinguished government from service user discourses. Greater flexibility in ideas and perspectives was demonstrated by service users, with a seemingly greater range of theoretical underpinnings. CONCLUSION:Greater awareness is needed of the significance of language, of how subtle inferences may be drawn from the rhetorical language of policies, of how these might affect the involvement of service users, and of the implications for the role of mental health nurses. Nurses need to be aware of these tensions and conflicts in managing their practice and in creating a mental health nursing philosophy of 'involvement'. If true 'involvement' is to ensue, nurses may also need to consider the transfer of power to service users.

背景与目标：

BACKGROUND & AIMS: :Sheila Leatherman has broad experience in health management, public policy, and academic research. She has held positions in federal and state healthcare agencies and served as CEO of a large HMO and as an executive of one of the largest managed care companies in the United States. Ms. Leatherman's time is currently devoted to healthcare research, both in the United States and the United Kingdom. In the United States, she is founder and chair of the Center for Health Care Policy Evaluation, an independent private-sector research institute, and adjunct professor in the Department of Health Policy and Management, School of Public Health at the University of North Carolina. In the United Kingdom, she is a senior adviser to The Nuffield Trust, which commissioned her to evaluate the National Health Service strategy for quality of care management (1997-1998 and 2002-2003), and in which she is involved in an ongoing policy and research program in quality evaluation. She is a Senior Associate at the Judge Institute of Management Studies and Distinguished Associate at Darwin College, both at Cambridge University. Her areas of research are quality of care, health policy, and managed care, and she has written more than 25 articles, which have been published in such prestigious journals as the Journal of the American Medical Association, Health Affairs, Medical Care, and the International Journal of Quality.

背景与目标： : Sheila Leatherman在健康管理，公共政策和学术研究方面拥有丰富的经验。她曾在联邦和州医疗机构任职，并担任大型HMO的首席执行官，以及美国最大的管理式医疗公司之一的高管。Leatherman女士的时间目前致力于美国和英国的医疗保健研究。在美国，她是独立的私营部门研究机构卫生保健政策评估中心的创始人和主席，也是北卡罗来纳大学公共卫生学院卫生政策与管理系的兼职教授。在英国，她是Nuffield Trust的高级顾问，该信托委托她评估《国家医疗服务质量管理战略》 (1997-1998和2002-2003)，并参与了正在进行的政策和质量评估研究计划。她是剑桥大学法官管理研究所的高级助理和达尔文学院的杰出助理。她的研究领域是护理质量，卫生政策和管理式护理，她撰写了25篇以上的文章，这些文章发表在《美国医学协会杂志》，《健康事务》，《医疗保健》等著名期刊上。和国际质量杂志。

BACKGROUND & AIMS: :Antisocial behavior persists as a preeminent public policy issue in the United States. A more critical assessment of both the policies and the programs designed to address this problem is necessary, and new risk factors for antisocial behavior need to be investigated. Sufficient evidence exists to hypothesize that exposure to neurotoxins may be a risk factor for antisocial behavior. Neurotoxins such as lead have been demonstrated to affect the cognitive development of children, and impaired cognition is accepted as a risk factor for antisocial behavior. Little consideration has been given, however, to the possible link between neurotoxins and human behavior. This paper presents a biologically and socially plausible justification for this association, reviews the supporting evidence, and emphasizes the need for additional investigation of the phenomenon. Elucidation of this risk factor may lead to new strategies for preventing or mitigating antisocial behaviors among youth and adults.

背景与目标： : 反社会行为在美国一直是一个突出的公共政策问题。有必要对旨在解决此问题的政策和计划进行更严格的评估，并且需要调查反社会行为的新风险因素。有足够的证据可以假设暴露于神经毒素可能是反社会行为的危险因素。神经毒素 (例如铅) 已被证明会影响儿童的认知发展，并且认知受损被认为是反社会行为的危险因素。然而，人们很少考虑神经毒素与人类行为之间的可能联系。本文为这种关联提供了生物学和社会上合理的理由，审查了支持证据，并强调了对该现象进行进一步调查的必要性。阐明这一危险因素可能会导致预防或减轻青年和成年人反社会行为的新策略。

BACKGROUND & AIMS: :Health policies are specified in documents that contain values, objectives, strategies, and interventions to be implemented. The objective of our study was to analyse health policy documents of six European cities and one county council published around 2010 to determine (i) how cities conceptualize health inequalities, and (ii) what strategies are proposed to reduce them. We performed a qualitative document analysis. We selected Health or Health Inequalities policy documents and analysed the following aspects: general characteristics of the document, inclusion and definition of health inequalities, promotion of good governance and participation, number of objectives, and evaluation. We also described specific objectives. Rotterdam, London, and Stockholm use a conceptual framework. Two of them define health inequalities as a social gradient. Intersectoral action, participation, and evaluation are included in most documents. Interventions focus mainly on the socioeconomic context.

背景与目标： : 在包含要实施的价值观，目标，策略和干预措施的文件中指定了健康政策。我们研究的目的是分析2010年左右发布的六个欧洲城市和一个县议会的卫生政策文件，以确定 (i) 城市如何概念化健康不平等现象，以及 (ii) 提出了哪些减少不平等现象的策略。我们进行了定性文件分析。我们选择了健康或健康不平等政策文件，并分析了以下几个方面: 文件的一般特征，健康不平等的纳入和定义，促进善治和参与，目标数量和评估。我们还描述了具体目标。鹿特丹、伦敦和斯德哥尔摩使用概念框架。其中两个将健康不平等定义为社会梯度。大多数文件都包含部门间行动、参与和评估。干预主要集中在社会经济背景上。

BACKGROUND & AIMS: :The development of "targeted biologics" as cancer therapy has made the field ripe for investment from the private sector and is changing the face of cancer medicine, while also raising important policy concerns about price, profit, and continued innovation. In this interview Barbara Culliton talks with Thomas Roberts, who sees this world from a unique perspective. Roberts, an oncologist, has practiced at the Massachusetts General Hospital and is currently thinking about innovation as a hedge fund manager.

背景与目标： : 作为癌症治疗的 “靶向生物制剂” 的发展使该领域已经成熟，可以从私营部门投资，并正在改变癌症医学的面貌，同时也引起了对价格，利润和持续创新的重要政策关注。在这次采访中，芭芭拉·库利顿 (Barbara Culliton) 与托马斯·罗伯茨 (Thomas Roberts) 进行了交谈，后者从独特的角度看待这个世界。罗伯茨是一名肿瘤学家，曾在马萨诸塞州总医院执业，目前正在考虑作为对冲基金经理进行创新。