BACKGROUND & AIMS: :Adolescents who are changing residence, as well as their social and economic circumstances may experience lifestyle changes that have an effect on body composition outcomes such as undernutrition, overweight or obesity. This paper uses data from Birth to Twenty, a birth cohort of South African urban children, to determine the relationship between residential mobility and body mass index (BMI) amongst Black adolescents aged 15 (n=1613), and to examine the role of changes in household socioeconomic status (SES). The prevalence of overweight and obesity in the sample was 25% in females and 8% in males. Amongst the females, a strong positive association between residential mobility and BMI was observed for those who also experienced an increase in household SES between birth and 15 years (β=0.42, SE=0.13), while no effect was identified for males. The study shows the potential for environmental change and increased resources to influence the risk for obesity. It also highlights the value in considering the range of social environmental factors and changes across the early life course that might play a part in evolving nutritional patterns in urban transitioning environments.

背景与目标： ：正在改变居住地的青少年，以及他们的社会和经济状况，可能会经历生活方式的改变，这些改变会影响身体组成的结果，例如营养不良，超重或肥胖。本文使用南非城市儿童的出生队列出生至二十岁的数据来确定15岁黑人青少年（n = 1613）的居住流动性与体重指数（BMI）之间的关系，并研究变化的作用家庭社会经济地位（SES）。样本中超重和肥胖的患病率在女性中为25％，在男性中为8％。在女性中，对于那些出生至15岁之间家庭SES也有所增加的人，其居住活动性与BMI之间存在很强的正相关性（β= 0.42，SE = 0.13），而对男性没有影响。研究显示环境变化和增加资源影响肥胖风险的潜力。它还强调了考虑社会环境因素的范围和整个生命过程中的变化的价值，这些因素可能在城市过渡环境中不断演变的营养模式中发挥作用。

BACKGROUND & AIMS: :Epilepsy affects a larger number of individuals than previously thought-up to 2% of the population-and its effects reach further. Yet epilepsy, with its associated lingering stigma and fear, has remained in the background in terms of services and research. Traditional quantitative research often falls short when trying to describe the impact of epilepsy on the lives of individuals and their families. In the present study, focus groups were held throughout South Carolina to discuss individuals' experiences with accessing epilepsy-related services and health care, and what life with epilepsy is like. Following qualitative data analysis, findings included two themes. One theme focuses on the ongoing search for services and help. The second theme concerns the experiences of living life with epilepsy. Also highlighted are recommendations for potential improvements in public awareness and professional training, and helpful interventions.

背景与目标： ：癫痫病影响的人数比以前认为的要多，达到2％的人口，其影响进一步扩大。然而，癫痫病及其相关的污名和恐惧缠绵不绝，在服务和研究方面仍处于背景之中。当试图描述癫痫病对个人及其家庭生活的影响时，传统的定量研究往往不足。在本研究中，在整个南卡罗来纳州举行了焦点小组会议，讨论了个人在获得癫痫相关服务和医疗保健方面的经历以及癫痫患者的生活。在对数据进行定性分析之后，发现包括两个主题。一个主题侧重于对服务和帮助的持续搜索。第二个主题涉及癫痫患者的生活经历。还着重介绍了有关可能提高公众意识和专业培训的建议以及有益的干预措施。

BACKGROUND & AIMS: One hundred and twelve forearms in 56 preserved cadavers were dissected to assess the incidence of Martin-Gruber connections in a population in South Africa. The connections were found in 13 cadavers (23%) and one was bilateral. There were no significant racial or sexual differences in the incidence. The course of Martin-Gruber connections and their anatomical relationship with the ulnar artery are illustrated.

背景与目标： 解剖了56个保存完好的尸体中的11个前臂，以评估南非人口中Martin-Gruber连接的发生率。在13具尸体（占23％）中发现了这种联系，其中一种是双边的。发病率没有明显的种族或性别差异。阐明了Martin-Gruber连接的过程以及它们与尺动脉的解剖关系。

BACKGROUND & AIMS: BACKGROUND:Tuberculosis is curable, but community surveys documenting epidemiological impact of the WHO-recommended DOTS strategy on tuberculosis prevalence have not been published. We used active community surveillance to compare the impact of DOTS with earlier programmes. METHODS:We conducted tuberculosis disease surveys using random cluster sampling of a rural population in South India approximately every 2.5 years from 1968 to 1986, using radiography as a screening tool for sputum examination. In 1999, DOTS was implemented in the area. Prevalence surveys using radiography and symptom screening were conducted at the start of DOTS implementation and after 2.5 years. RESULTS:From 1968 to 1999, culture-positive and smear-positive tuberculosis declined by 2.3 and 2.5% per annum compared with 11.9 and 5.6% after DOTS implementation. The 2.5 year period of DOTS implementation accounted for one-fourth of the decline in prevalence of culture-positive tuberculosis over 33 years. Multivariate analysis showed that prevalence of culture-positive tuberculosis decreased substantially (10.0% per annum, 95% CI: 2.8-16.6%) owing to DOTS after only slight declines related to temporal trends (2.1% annual decline, 95% CI: 1.1-3.2%) and short-course chemotherapy (1.5% annual decline, 95% CI: -9.7% to 11.5%). Under DOTS, the proportion of total cases identified through clinical care increased from 81 to 92%. CONCLUSIONS:Following DOTS implementation, prevalence of culture-positive tuberculosis decreased rapidly following a gradual decline for the previous 30 years. In the absence of a large HIV epidemic and with relatively low levels of rifampicin resistance, DOTS was associated with rapid reduction of tuberculosis prevalence.

背景与目标： 背景：结核病是可以治愈的，但尚未发表证明WHO推荐的DOTS策略对结核病患病率的流行病学影响的社区调查。我们使用了主动社区监视，将DOTS与早期计划的影响进行了比较。
方法：我们采用射线照相作为痰液检查的筛查工具，从1968年至1986年大约每2.5年对印度南部农村人口进行随机整群抽样调查，进行了结核病调查。 1999年，在该地区实施了DOTS。在DOTS实施之初和2.5年后，进行了放射照相和症状筛查的患病率调查。
结果：从1968年到1999年，培养阳性和涂片阳性的结核病每年下降2.3％和2.5％，而DOTS实施后分别下降11.9％和5.6％。实施DOTS的2.5年时间占了33年来培养阳性结核病患病率下降的四分之一。多因素分析表明，仅因与时间趋势相关的轻微下降（每年下降2.1％，95％CI：1.1-），DOTS导致培养阳性结核病的患病率大幅下降（每年10.0％，95％CI：2.8-16.6％）。 3.2％）和短程化疗（每年下降1.5％，95％CI：-9.7％至11.5％）。在DOTS中，通过临床护理发现的病例总数从81％增加到92％。
结论：在实施DOTS之后，在过去30年中，培养阳性结核病的患病率迅速下降。在没有艾滋病毒大流行且对利福平耐药性相对较低的情况下，DOTS与结核病患病率的快速降低有关。

BACKGROUND & AIMS: OBJECTIVE:To describe the ritual and ethnobotanical treatments about migraine performed by shamans from several native cultures. METHODS:Anthropological field study conducted with Tzeltal Maya (Mexico), Kamayurá (Brazil), and Uru-Chipaya (Bolivia) American Indians. RESULTS:Migraine is called yaxti-wanjol chawaj by Tzeltal shamans. They wash the head of the patient with an herbal solution to treat headache. The boiled leaves of a shrub called payté wamal (Tagetes nelsonii) are used to relieve migraine. Migraine is called monkey's disease by Kamayurá natives. The disease is originated by the revenge of the killed monkey's spirit, striking to Kamayurá hunter on his head. It is treated with an herbal infusion applied in the eyes of the patient. Migraine is called eskeclamix by Chipaya people, and is treated by drinking the cañahua plant (Chenopodium palludicale) boiled with water. The patient's head may also be washed with shaman's fermented urine. CONCLUSIONS:Cultural equivalents of migraine exist in the healing system of isolated American cultures.

背景与目标： 目的：描述来自几种本土文化的萨满祭司对偏头痛的礼仪和民族植物学治疗。
方法：对Tzeltal Maya（墨西哥），Kamayurá（巴西）和Uru-Chipaya（玻利维亚）的美洲印第安人进行了人类学现场研究。
结果：偏头痛被特泽塔尔萨满（Tzeltal Shamans）称为yaxti-wanjol chawaj。他们用草药溶液冲洗患者的头部，以治疗头痛。称为paytéwamal（Tagetes nelsonii）的灌木的煮沸的叶子用于缓解偏头痛。偏头痛被卡马尤拉人称为猴子病。该病源于被杀死的猴子的精神报复，袭击了卡马尤拉（Kamayurá）猎人的头部。通过在患者眼睛中使用草药输液进行治疗。奇帕亚人称偏头痛为eskeclamix，通过喝水煮沸的卡纳瓦植物（Chenopodium palludicale）来治疗。病人的头部也可以用萨满发酵的尿液清洗。
结论：偏头痛的文化等同物存在于孤立的美国文化的康复系统中。

BACKGROUND & AIMS: BACKGROUND:Malnutrition remains one of the most common causes of morbidity and mortality among children throughout the world. This study aimed to assess prevalence of malnutrition and associated factors among children aged 6-59 months in Damot Gale, South Ethiopia. METHODS:A community based cross sectional study was conducted on 398 children aged 6-59 months in the Damot Gale district. A two-stage cluster sample design was used to select kebele and households. Anthropometric measurements and structured questionnaires were used to collect data. Bivariate and multivariate logistic regression was done by using SPSS version 20. RESULTS:The results of this study indicated that 27.6% of children were under-weight and 9% were wasted. Being male (AOR: 1.90; 95% CI: (1.10-3.32), children with shorter birth interval (AOR:2.89;95% CI: (1.23-6.80), children who had sickness some times for past 2 weeks (AOR:0.42; 95% CI:(0.10-0.93) and children whose mothers attended ANC (AOR:0.29; 95% CI: (0.16-0.52) were associated with underweight. Children whose mother's main occupation was non-farm (AOR: 7.06;95% CI: (1.31-38.21), presence of diarrhea (AOR:39.5, 95% CI: (13.68-114.30), and children whose mothers attended ANC (AOR:0.18,95% CI: (0 .18 (0.07-0.45) were associated with wasting. CONCLUSION:The prevalence of malnutrition in the study area was high. Health extension workers and stakeholders should give due concern on promotion of proper nutrition in the community.

背景与目标： 背景：营养不良仍然是全世界儿童发病和死亡的最常见原因之一。这项研究旨在评估南埃塞俄比亚达莫特盖勒（Damot Gale）6至59个月大儿童的营养不良患病率及其相关因素。
方法：在Damot Gale地区对398名6-59个月的儿童进行了基于社区的横断面研究。使用两阶段集群样本设计来选择kebele和家庭。人体测量和结构化问卷用于收集数据。使用SPSS版本20进行双变量和多变量logistic回归。
结果：这项研究的结果表明，有27.6％的儿童体重不足，有9％的儿童体重不足。男性（AOR：1.90; 95％CI：（1.10-3.32），生育间隔较短的儿童（AOR：2.89; 95％CI：（1.23-6.80），过去两周内有一段时间患病的孩子（AOR： 0.42； 95％CI：（0.10-0.93）和母亲参加ANC的孩子（AOR：0.29； 95％CI：（0.16-0.52））与体重过轻有关。母亲主要从事非农业工作的孩子（AOR：7.06； 95％CI：（1.31-38.21），腹泻（AOR：39.5、95％CI：（13.68-114.30）和母亲参加ANC的孩子（AOR：0.18,95％CI：（0 .18（0.07- 0.45）与浪费相关。
结论：研究区营养不良发生率很高。卫生保健工作者和利益相关者应在促进社区适当营养方面给予应有的关注。

BACKGROUND & AIMS: BACKGROUND & OBJECTIVES:The relevance of the gut microbiota to human health is increasingly appreciated. The objective of this study was to compare the gut microbiota of a group of adult tribals with that of healthy adult villagers in Tamil Nadu, India. METHODS:Faeces were collected from 10 healthy tribal adults (TAs) in the Jawadhi hills and from 10 healthy villagers [rural adults (RAs)] in Vellore district, Tamil Nadu. DNA was extracted, and 456 bp segments comprising hypervariable regions 3 and 4 of the 16S rRNA gene were amplified, barcoded and 454 sequenced. RESULTS:Totally 227,710 good-quality reads were analyzed. TAs consumed a millets-based diet, ate pork every day, and did not consume milk or milk products. RAs consumed a rice-based diet with meat intake once a week. In both groups, Firmicutes was the most abundant phylum, followed by Proteobacteria, Bacteroidetes and Actinobacteria. The median Firmicutes-to-Bacteroidetes ratio was 34.0 in TA and 92.9 in RA groups. Actinobacteria were significantly low in TA, possibly due to non-consumption of milk. Clostridium constituted the most abundant genus in both groups, but was significantly more abundant in TAs than RAs, while Streptococcus was significantly more abundant in RA (P<0.05). Analyses of genetic distance revealed that the microbiota were distinctly different between TA and RA, and principal component analysis using 550 distinct taxonomically identifiable sequences revealed a clear separation of microbiota composition in the two groups. Phylogenetic analysis of major microbiota indicated clustering of microbial groups at different major branch points for TAs and RAs. INTERPRETATION & CONCLUSIONS:Phylum Firmicutes and genus Clostridium constituted the bulk of the faecal microbiota, while significant differences in composition between the groups were probably due to differences in diet and lifestyle.

背景与目标： 背景与目的：肠道菌群与人类健康的关系日益受到人们的重视。这项研究的目的是比较印度泰米尔纳德邦的一群成年部落的肠道菌群与健康成年村民的肠道菌群。
方法：从贾瓦迪山的10个健康的部落成年人（TA）和泰米尔纳德邦Vellore区的10个健康的村民[农村成年人（RA）]收集粪便。提取DNA，扩增包含16S rRNA基因的高变区3和4的456 bp片段，进行条形码编码和454测序。
结果：总共分析了227,710次高质量阅读。 TAs消费以粟为基础的饮食，每天吃猪肉，不消费牛奶或奶制品。类风湿性关节炎每周食用一次以米为基础的饮食，并摄入肉类。在这两组中，Firmicutes是最丰富的门，其次是Proteobacteria，Bacteroidetes和Actinobacteria。 TA组中硬菌与拟杆菌的中位数比为34.0，RA组中值为92.9。放线菌的TA含量很低，可能是由于不食用牛奶造成的。梭菌是两组中最丰富的属，但是TA中的RA比RA中的丰富得多，而链球菌在RA中的含量明显更高（P <0.05）。遗传距离分析显示，TA和RA之间的菌群明显不同，使用550种不同的分类学上可识别的序列进行的主成分分析表明，两组中菌群的组成明显分离。主要微生物群的系统发育分析表明，在TAs和RAs的不同主要分支点上，微生物群聚集。
解释与结论：Phylum Firmicutes和梭状芽胞杆菌属构成了粪便微生物群的主体，而各组之间组成的显着差异可能是由于饮食和生活方式的差异所致。

BACKGROUND & AIMS: OBJECTIVE:This study examined the associations between respiratory symptoms and patterns of pulmonary dysfunction of 115 male roofing cement workers compared with 134 unexposed subjects. METHODS:A cross-sectional study was conducted. Environmental samplings and spirometry measurements were also collected. RESULTS:The exposed workers had higher respiratory dust exposure levels (0.65 mg/m3) compared with the unexposed groups (0.32 mg/m3). The exposed group had significantly higher prevalence than the unexposed group for shortness of breath (OR=2.19). The exposed group also had higher but insignificant prevalence of chronic cough (OR=1.34), chest tightness (OR=1.64), and wheezing (OR=1.89). The ventilatory respiratory function values (FEV1 and FVC) were slightly lower for the exposed group. CONCLUSION:An association between higher cement dust levels and a decline in ventilatory function among roofing fiber cement workers suggests that the respiratory health of roofing cement workers should be protected through policies or work standards.

背景与目标： 目的：本研究调查了115名男性屋面水泥工人与134名未暴露受试者的呼吸系统症状与肺功能障碍类型之间的关系。
方法：进行横断面研究。还收集了环境采样和肺活量测定法。
结果：暴露工人的呼吸粉尘暴露水平（0.65 mg / m3）高于未暴露组（0.32 mg / m3）。暴露组的呼吸困难患病率明显高于未暴露组（OR = 2.19）。暴露组的慢性咳嗽（OR = 1.34），胸闷（OR = 1.64）和喘息（OR = 1.89）的患病率也较高，但微不足道。暴露组的通气呼吸功能值（FEV1和FVC）略低。
结论：屋面纤维水泥工人中较高的水泥粉尘含量与通风功能下降之间存在关联，这表明应通过政策或工作标准保护屋面水泥工人的呼吸健康。

BACKGROUND & AIMS: :Aquatic birds are a reservoir of all known influenza A viruses. Avian influenza viruses have played a major role in the creation of pandemic influenza viruses in humans. In this study, we genetically characterized genes of nine isolates from waterfowl in Eulsukdo, a congregating place for migratory birds on the flyway of migration from Siberia, which is located in the southern part of South Korea. Phylogenic analysis showed that HA and NA genes of isolates belonged to Eurasian lineage, and lineage analysis showed that NS, PB1, PA, NP, and M genes of isolates clustered with Eurasian lineage, and PB2 genes of isolates belonged to North American or Eurasian lineage. Results suggest that the interregional transmission of genes of avian influenza viruses may occur in the migratory birds.

背景与目标： ：水禽是所有已知的A型流感病毒的储存库。禽流感病毒在人类大流行性流感病毒的产生中发挥了重要作用。在这项研究中，我们通过遗传学鉴定了Eulsukdo水禽的9个分离株的基因，Eulsukdo是位于韩国南部从西伯利亚迁徙的迁徙飞鸟的聚集地。系统发育分析表明，分离株的HA和NA基因属于欧亚谱系，谱系分析表明，分离株的NS，PB1，PA，NP和M基因与欧亚谱系聚在一起，而分离株的PB2基因属于北美或欧亚谱系。 。结果表明，禽流感病毒基因的区域间传播可能发生在候鸟中。

BACKGROUND & AIMS: :A study was made on the hydration and serum electrolyte changes in 55 black underground gold miners who presented with heat disorders, and control data were obtained on 52 surface and 50 underground workers without symptoms. Cases were admitted for assessment and treatment, and a questionnaire was administered on symptoms, work, fluid intake, alcohol intake, recent health, and past history of heat disorders. Twenty-eight men had experienced heat disorders in the past. Blood specimens on days 0, 1, 2, and 7 for serum sodium, potassium, magnesium, calcium, inorganic phosphate, and serum total protein were obtained from 55 cases, of which 22 also had estimations of hemoglobin and hematocrit. Initial serum electrolyte levels, because of hemoconcentration, were found to be a poor indicator of underlying changes. Changes in serum total protein were used to correct electrolyte levels for dehydration, which showed deficits in serum total sodium and potassium. This method of correction, when compared with one using hemoglobin and hematocrit, showed similar but smaller changes in serum electrolytes. The cases were divided into subgroups of "cramps" and "collapse"; no significant differences were seen in ambient conditions, age, or electrolyte changes. The cramps group, however, had drunk significantly more water. The findings overall were those of dehydration and salt depletion.

背景与目标： ：对55名患有热病的黑人地下金矿工人的水分和血清电解质变化进行了研究，并获得了52名地面工人和50名无症状地下工人的控制数据。入组病例进行评估和治疗，并就症状，工作，液体摄入，酒精摄入，近期健康和过去的热病史进行问卷调查。过去有28名男性经历过热障碍。从55例患者中获取了第0、1、2和7天的血清钠，钾，镁，钙，无机磷酸盐和血清总蛋白的血样，其中22例也有血红蛋白和血细胞比容的估计值。由于血液中的浓度，最初的血清电解质水平被认为是潜在变化的不良指标。血清总蛋白的变化用于纠正脱水的电解质水平，这表明血清总钠和钾缺乏。与使用血红蛋白和血细胞比容的校正方法相比，这种校正方法显示出相似但较小的血清电解质变化。这些病例分为“抽筋”和“崩溃”两个子组。在环境条件，年龄或电解质变化方面未见明显差异。但是，抽筋组的人喝了更多的水。总的来说，结果是脱水和盐耗不足。

BACKGROUND & AIMS: :We compared serotype distributions of Streptococcus pneumoniae isolates from patients aged <5 and o5 years with invasive pneumococcal disease in New South Wales, Australia, and antibiotic susceptibilities of isolates from the <5 years age group only, before (2002–2004) and after(2005–2009) introduction of the 7-valent pneumococcal conjugate vaccine (PCV7). Overall, there were significant decreases in the mean annual number of referred isolates (770 vs. 515) and the proportion belonging to PCV7 serotypes (74% vs. 38%), but non-PCV7 serotypes, particularly 19A, increased (5% vs. 18%). All changes were more marked in the <5 years age group.Susceptibility testing of isolates from the <5 years age group showed variation in resistance between serotypes, but significant overall increases in penicillin non-susceptibility (23% vs. 31%),ceftriaxone resistance (2% vs. 12%) and multidrug resistance (4% vs. 7%) rates ; erythromycin resistance fell (32% vs. 25%). Continued surveillance is needed to monitor changes following the introduction of 13-valent PCV in 2012.

背景与目标： ：我们比较了澳大利亚新南威尔士州<5和o5岁患有侵袭性肺炎球菌病的肺炎链球菌分离株的血清型分布和仅<5岁年龄组分离株的抗生素敏感性（2002-2004年之前和之后） （2005-2009）引入了7价肺炎球菌结合疫苗（PCV7）。总体而言，转介的分离株的年均数量显着减少（770比515）和属于PCV7血清型的比例（74％比38％），但非PCV7血清型，特别是19A血清型增加（5％vs。 18％）。 <5岁年龄组的所有变化均更为明显。<5岁年龄组的分离株的药敏试验显示血清型之间的耐药性存在差异，但青霉素的非药敏性总体显着增加（23％vs. 31％），头孢曲松耐药率（2％vs. 12％）和多药耐药性（4％vs. 7％）比率；红霉素耐药性下降（32％对25％）。在2012年推出13价PCV之后，需要持续进行监测以监测变化。

BACKGROUND & AIMS: :Ticks from mainland Australia (Victoria, New South Wales and Queensland) and Tasmania, identified morphologically as either Ixodes holocyclus or Ixodes cornuatus, were compared genetically using 24 enzyme loci. The results showed that ticks from three localities in Victoria were genetically similar to I. cornuatus in Tasmania, but both groups had fixed genetic differences at >45% of loci compared with other ticks on the mainland. In addition, there were fixed genetic differences at 0-60% of loci among I. holocyclus from different localities on the mainland. Ixodes holocyclus samples could be divided into four distinct clusters (with fixed genetic differences >15%), three of which were represented by one or two specimens. Nonetheless, these electrophoretic data suggest that I. holocyclus represents a species complex. The results also showed that the morphological criteria used to identify specimens were not always accurate because several specimens had been mis-identified morphologically. Despite limitations with the morphological identification, this study has demonstrated that I. cornuatus can be distinguished from the I. holocyclus species complex using six enzyme loci, providing the foundation for a re-examination of morphological characteristics. The present study has shown that I. cornuatus and the I. holocyclus complexes have a greater distribution than previously reported, with both occurring in sympatry at Cape Patterson, on the southern coastline of Victoria.

背景与目标： ：使用24种酶基因座对来自澳大利亚大陆（维多利亚州，新南威尔士州和昆士兰州）和塔斯马尼亚州的Ti虫进行了形态学比较，这些Ti虫在形态学上被鉴定为全环凤仙或角须凤仙。结果表明，维多利亚州三个地方的tick在遗传上与塔斯马尼亚州的角I相似，但与大陆上的其他s相比，两组的固定遗传差异均在基因座的> 45％。另外，来自大陆不同地区的全环金枪鱼之间在0-60％的基因座上存在固定的遗传差异。整轮虫超氧化物歧化酶样品可分为四个不同的簇（固定的遗传差异> 15％），其中三个由一个或两个标本代表。尽管如此，这些电泳数据表明全环线虫代表一种物种复合体。结果还表明，用于鉴定标本的形态学标准并不总是准确的，因为几个标本在形态上被误认了。尽管在形态学鉴定上有局限性，但这项研究表明，可以使用六个酶基因座将角corn与全轮虫物种区分开，为形态特征的重新研究奠定了基础。本研究表明，角鬣狗和全环线虫的分布比以前报道的要大，它们都发生在维多利亚州南部海岸线的海角帕特森的交界处。

BACKGROUND & AIMS: :During the August 23-25, 2000, convention conducted by WHO in Kathmandu, Nepal, it was decided that national mechanisms to plan and manage health sector reforms be established and strengthened. The participants of this convention were health ministers from the 10 countries that make up the WHO South East Asian Region (SEAR). It was noted in the meeting that the countries in the region need a universal prescription for health sector reforms, which comprises the components of health care financing, health care provision, human resources for health, and governance in health. Although most of the SEAR countries have initiated reforms in health care financing and decentralization of health systems, many are facing the challenge of expanding provision of health insurance. In view of this, WHO was called to help countries develop models for collective health care financing based on risk-pooling, or collective health financing. In terms of preventing HIV/AIDS, it was recommended that interventions that have been effective in preventing HIV infection in different countries must be applied widely. Moreover, the Indian delegation's suggestion that estimates on HIV/AIDS cases by WHO and UNAIDS should be reviewed and updated regularly.

背景与目标： ：在2000年8月23日至25日，世卫组织在尼泊尔加德满都举行的公约中，决定建立并加强计划和管理卫生部门改革的国家机制。该公约的参加者是来自世界卫生组织东南亚地区（SEAR）的10个国家的卫生部长。会议上注意到，该区域各国需要卫生部门改革的普遍处方，其中包括卫生保健筹资，卫生保健提供，卫生人力资源和卫生治理的组成部分。尽管大多数SEAR国家已经在医疗保健筹资和卫生系统权力下放方面进行了改革，但许多国家都面临着扩大医疗保险提供范围的挑战。有鉴于此，呼吁世卫组织帮助各国建立基于风险分担或集体卫生筹资的集体卫生筹资模式。在预防艾滋病毒/艾滋病方面，建议必须广泛应用在不同国家有效预防艾滋病毒感染的干预措施。此外，印度代表团的建议是，应定期审查和更新世卫组织和艾滋病规划署对艾滋病毒/艾滋病病例的估计数。

BACKGROUND & AIMS: :One of the worst HIV/AIDS epidemics in the world is occurring in South Africa, where heterosexual exposure is the main mode of HIV transmission. Young people 15-24 years of age, particularly women, account for a large share of new infections. Accordingly, there is an urgent need for behavior-change interventions to reduce the incidence of HIV among adolescents in South Africa. However, there are few such interventions with proven efficacy for South African adolescents, especially young adolescents. A recent cluster-randomized controlled trial of the 'Let Us Protect Our Future!' HIV/STD risk-reduction intervention for Grade 6 South African adolescents (mean age = 12.4 years) found significant decreases in self-reported sexual risk behaviors compared with a control intervention. This article describes the intervention, the use of the social cognitive theory and the reasoned action approach to develop the intervention, how formative research informed its development and the acceptability of the intervention. Challenges in designing and implementing HIV/STD risk-reduction interventions for young adolescents in sub-Saharan Africa are discussed.

背景与目标： ：南非是世界上最严重的HIV / AIDS流行病之一，异性接触是HIV传播的主要方式。 15-24岁的年轻人，尤其是女性，在新感染中占很大比例。因此，迫切需要改变行为的干预措施，以减少南非青少年中艾滋病毒的发生率。但是，很少有这类干预措施对南非青少年特别是年轻青少年具有有效的疗效。最近一项“让我们保护我们的未来！”的集群随机对照试验。与对照干预相比，南非6级（平均年龄= 12.4岁）青少年的HIV / STD降低风险干预措施发现自我报告的性风险行为显着降低。本文介绍了干预措施，社会认知理论的使用以及采取合理的行动方法来开发干预措施，形成性研究如何告知其发展以及干预措施的可接受性。讨论了为撒哈拉以南非洲地区的青少年设计和实施降低艾滋病毒/性病风险的干预措施所面临的挑战。

BACKGROUND & AIMS: :South Africa has long recognized partnerships between the public and private sectors as a policy objective in health, but experience is still limited and poorly documented. The objectives of this article are to understand the factors that increase the likelihood of success of public-private interactions in South Africa, and identify and discuss opportunities for them to be scaled up. There is a strong legislative framework and a number of guidelines and tools that have been developed by the Treasury for managing partnerships. The review of literature confirmed the need for the state to have effective regulations in order to oversee quality and standards and to provide stewardship and oversight. The public sector requires sufficient capacity not only to manage relationships with the private sector but also to enable innovation and experimentation. Evaluation is an integral part of all interactions not only to learn from successes but also to identify any perverse incentives that may lead to unintended consequences. Four case studies show that the private for-profit sector is already engaged in a number of projects that are closely aligned to current health system reform priorities. Factors that increase the likelihood of interactions being successful include: increasing the government's capacity to manage public-private relationships; choosing public-private interactions that are strategically important to national goals; building a knowledge base on what works, where and why; moving from pilots to large scale initiatives; harnessing the contracting expertise in private providers; and encouraging innovation and learning.

背景与目标： 南非：长期以来，公立和私营部门之间的伙伴关系已被公认为卫生领域的政策目标，但经验仍然有限，文献记载也很少。本文的目的是了解增加南非公私互动成功的可能性的因素，并确定和讨论扩大其规模的机会。财政部已经建立了强有力的立法框架以及许多准则和工具来管理伙伴关系。对文献的审查证实，国家有必要制定有效的法规，以监督质量和标准，并提供管理和监督。公共部门不仅需要足够的能力来管理与私营部门的关系，而且还需要进行创新和试验。评估是所有互动中不可或缺的一部分，不仅可以从成功中学习，而且可以识别可能导致意想不到的后果的任何不正当动机。四个案例研究表明，私营营利部门已经参与了许多与当前卫生系统改革优先事项紧密相关的项目。增加互动成功的可能性的因素包括：提高政府管理公私关系的能力；选择对国家目标具有战略意义的公私互动；建立关于什么有效，在哪里以及为什么起作用的知识库；从试点转向大规模计划；利用私人提供商的订约专业知识；并鼓励创新和学习。