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: :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由公共卫生学院和北卡罗来纳大学教堂山分校的Kenan-Flagler商学院联合提供的基于团队的培训计划。这个为期9个月的计划教公共卫生经理如何更好地管理人员，信息和财务。参与者将学习如何与社区合作伙伴一起团队合作，以及如何作为社会企业家进行思考和行为。为了实践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。本文介绍了该计划并解释了过程评估的结果，该评估研究了如何最好地构建和部署基于团队的方法，以创建更有效，更具企业家精神的公共卫生经理。研究结果表明，招聘和保留能力很强，课程要素与学习者的需求相关，并且学习者对课程感到满意并重视。确定了计划模型的几个特定好处，以及支持业务计划成功和技能在工作中的应用的几个要素。根据这些发现，确定了开发类似计划的四个成功因素。

BACKGROUND & AIMS: BACKGROUND:Telephone surveys have been used widely in public health research internationally and are being increasingly used in Ireland and the U.K. METHODS:This study compared three telephone surveys conducted on the island of Ireland from 2000 to 2004, examining study methodology, outcome measures and the per unit cost of each completed survey. We critically examined these population-based surveys which all explored health related attitudes and behaviours. RESULTS:Over the period from 2000 to 2005 the percentage of calls which succeeded in contacting an eligible member of the public fell, from 52.9% to 31.8%. There was a drop in response rates to the surveys (once contact was established) from 58.6% to 17.7%. Costs per completed interview rose from 4.48 euro to 15.65 euro. Respondents were prepared to spend 10-15 minutes being surveyed, but longer surveys yielded poorer completion rates. Respondents were willing to discuss issues of a sensitive nature. Interviews after 9 pm were less successful, with complaints about the lateness of the call. Randomisation from electronic residential telephone directory databases excluded all ex-directory numbers and thus was not as representative of the general population as number generation by the hundred-bank method. However the directory database was more efficient in excluding business and fax numbers. CONCLUSION:Researchers should take cognisance of under-representativeness of land-line telephone surveys, of the increasing difficulties in contacting the public and of mounting personnel costs. We conclude that telephone surveying now requires additional strategies such as a multimode approach, or incentivisation, to be a useful, cost-effective means of acquiring data on public health matters in Ireland and the U.K.

背景与目标：

BACKGROUND & AIMS: AIMS:To assess the relationship between ambulance attendances, emergency department (ED) presentations and hospital admissions for acute alcohol intoxication and the timing of public holidays, sporting and social events. DESIGN:Time-series analysis was used to explore trends in intoxication in the context of major events. SETTING:Population of Melbourne, Victoria, Australia between 2000 and 2009. PARTICIPANTS:All patients attended by ambulance, presenting to hospital EDs, or admitted to hospital who were classified as acutely alcohol intoxicated. MEASUREMENT:Analysis of daily numbers of presentations for acute alcohol intoxication associated with major events were undertaken, including lead and lag effects. Analyses controlled for day of week and month of year to address temporal and seasonal variations. FINDINGS:Alcohol intoxication presentations were significantly elevated the day before all public holidays, with intoxication cases on the day of public holidays only higher on New Year's Day (ambulance 6.57, 95% confidence intervals (CI): 3.4-9.74; ED 3.34, 95% CI: 1.28-5.4) and ANZAC Day (ambulance 3.71, 95% CI: 0.68-6.75). The Australian Football League (AFL) Grand Final (ED 2.37, 95% CI: 0.55-4.19), Commonwealth Games (ED 2.45, 95% CI: 0.6-4.3) and Melbourne Cup Day (ambulance 6.14, 95% CI: 2.42-9.85) represented the sporting events with significant elevations in acute intoxication requiring medical attention. The last working day before Christmas was the only social event where a significant increase in acute intoxication occurred (ambulance 8.98, 95% CI: 6.8-11.15). CONCLUSIONS:Acute alcohol intoxication cases requiring ambulance, emergency department and hospital in-patient treatment increase substantially on the day preceding public holidays and other major social events.

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: This paper reports on a public authority's decision to "make" or "buy" mental health services. Data come from key informant interviews with California county contract or program managers. The questionnaire measures the extent of contracting and the importance of factors that are hypothesized to affect the relative costs of contracting. The percent of contracting by programs ranges from zero to 100, averaging 41%. Sixty-two percent of rural programs perceive little or no competition for public mental health contracts, and contract significantly less than urban programs. The extent of contracting is related to economic and public organizational factors.

背景与目标： 本文报告了公共机构 “制造” 或 “购买” 精神卫生服务的决定。数据来自对加利福尼亚县合同或计划经理的关键线人采访。问卷测量了合同的程度以及假设会影响合同相对成本的因素的重要性。按项目签订合同的百分比从零到100，平均41%。60 2% 的农村计划对公共精神卫生合同的竞争很少或没有竞争，并且合同明显少于城市计划。缔约的程度与经济和公共组织因素有关。

BACKGROUND & AIMS: -2

背景与目标： -2

BACKGROUND & AIMS: :Widespread interest in global health issues is a common characteristic of students and faculty in schools of public health and schools of medicine. Building on strong university-based and community-based programs in global health, the University of Washington has created a unique Department of Global Health that is housed jointly in its School of Public Health and Community Medicine and its School of Medicine. The creation of this department has generated significant enthusiasm throughout the university and the Seattle community as a new paradigm for addressing global health education, research, and service. Placing the new Department of Global Health in two university schools and finding the appropriate niche for the department among the university's many global health initiatives presented challenges, as well as opportunities. This article describes the goals of the department, the process by which it was created, and what it expects to accomplish.

背景与目标： : 对全球卫生问题的广泛关注是公共卫生学院和医学院的学生和教职员工的共同特征。华盛顿大学以强大的基于大学和社区的全球卫生计划为基础，创建了一个独特的全球卫生部门，该部门位于其公共卫生和社区医学学院及其医学院中。这个部门的创建在整个大学和西雅图社区产生了极大的热情，成为解决全球健康教育，研究和服务的新范式。将新的全球卫生部门安置在两所大学学校中，并在大学的许多全球卫生计划中找到适合该部门的利基市场，带来了挑战和机遇。本文介绍了该部门的目标，创建该部门的过程以及预期实现的目标。

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: :In a prospective cohort study of Finnish public sector employees, the authors examined the association between workplace social capital and depression. Data were obtained from 33,577 employees, who had no recent history of antidepressant treatment and who reported no history of physician-diagnosed depression at baseline in 2000-2002. Their risk of depression was measured with two indicators: recorded purchases of antidepressants until December 31, 2005, and self-reports of new-onset depression diagnosed by a physician in the follow-up survey in 2004-2005. Multilevel logistic regression analysis was used to explore whether self-reported and aggregate-level workplace social capital predicted indicators of depression at follow-up. The odds for antidepressant treatment and physician-diagnosed depression were 20-50% higher for employees with low self-reported social capital than for those reporting high social capital. These associations were not accounted for by sex, age, marital status, socioeconomic position, place of work, smoking, alcohol use, physical activity, and body mass index. The association between social capital and self-reported depression attenuated but remained significant after further adjustment for baseline psychological distress (a proxy for undiagnosed mental health problems). Aggregate-level social capital was not associated with subsequent depression.

背景与目标： : 在一项对芬兰公共部门雇员的前瞻性队列研究中，作者研究了工作场所社会资本与抑郁症之间的关联。数据来自33,577名员工，他们最近没有抗抑郁药治疗史，并且在2000-2002年的基线时没有医生诊断的抑郁症病史。通过两个指标来衡量他们的抑郁症风险: 记录到2005年12月31日之前的抗抑郁药购买量，以及2004-2005年医生在随访调查中诊断出的新发抑郁症的自我报告。使用多水平logistic回归分析来探讨自我报告和综合水平的工作场所社会资本是否可以预测随访时的抑郁指标。自我报告社会资本低的员工的抗抑郁治疗和医生诊断的抑郁症的几率比报告社会资本高的员工高20-50%。这些关联没有按性别，年龄，婚姻状况，社会经济地位，工作地点，吸烟，饮酒，体育锻炼和体重指数来解释。社会资本与自我报告的抑郁症之间的关联减弱，但在进一步调整基线心理困扰 (未诊断的精神卫生问题的代表) 后仍然显着。总水平的社会资本与随后的萧条无关。