• 【卢旺达西部可避免失明的快速评估: 冲突后环境中的失明。】 复制标题 收藏 收藏
    DOI:10.1371/journal.pmed.0040217 复制DOI
    作者列表:Mathenge W,Nkurikiye J,Limburg H,Kuper H
    BACKGROUND & AIMS: BACKGROUND:The World Health Organization estimates that there were 37 million blind people in 2002 and that the prevalence of blindness was 9% among adults in Africa aged 50 years or older. Recent surveys indicate that this figure may be overestimated, while a survey from southern Sudan suggested that postconflict areas are particularly vulnerable to blindness. The aim of this study was to conduct a Rapid Assessment for Avoidable Blindness to estimate the magnitude and causes of visual impairment in people aged > or = 50 y in the postconflict area of the Western Province of Rwanda, which includes one-quarter of the population of Rwanda. METHODS AND FINDINGS:Clusters of 50 people aged > or = 50 y were selected through probability proportionate to size sampling. Households within clusters were selected through compact segment sampling. Visual acuity (VA) was measured with a tumbling "E" chart, and those with VA below 6/18 in either eye were examined by an ophthalmologist. The teams examined 2,206 people (response rate 98.0%). The unadjusted prevalence of bilateral blindness was 1.8% (95% confidence interval [CI] 1.2%-2.4%), 1.3% (0.8%-1.7%) for severe visual impairment, and 5.3% (4.2%-6.4%) for visual impairment. Most bilateral blindness (65%) was due to cataract. Overall, the vast majority of cases of blindness (80.0%), severe visual impairment (67.9%), and visual impairment (87.2%) were avoidable (i.e.. due to cataract, refractive error, aphakia, trachoma, or corneal scar). The cataract surgical coverage was moderate; 47% of people with bilateral cataract blindness (VA < 3/60) had undergone surgery. Of the 29 eyes that had undergone cataract surgery, nine (31%) had a best-corrected poor outcome (i.e., VA < 6/60). Extrapolating these estimates to Rwanda's Western Province, among the people aged 50 years or above 2,565 are expected to be blind, 1,824 to have severe visual impairment, and 8,055 to have visual impairment. CONCLUSIONS:The prevalence of blindness and visual impairment in this postconflict area in the Western Province of Rwanda was far lower than expected. Most of the cases of blindness and visual impairment remain avoidable, however, suggesting that the implementation of an effective eye care service could reduce the prevalence further.
    背景与目标:
  • 【印度西部奥里萨邦三级医院的眼孢子虫病: 病例系列。】 复制标题 收藏 收藏
    DOI:10.4103/0301-4738.33045 复制DOI
    作者列表:Chowdhury RK,Behera S,Bhuyan D,Das G
    BACKGROUND & AIMS: :The authors present a case series of 54 subjects of Rhinosporidium. They were reported in two years at a tertiary care hospital of Western Orissa. The clinically diagnosed cases by ophthalmologists were confirmed by histopathological samples following surgery. In our series, we noted Rhinosporidium seeberi organisms as the main causative agent. Males were affected three times more than females. Children less than 10 years of age comprised more than 50% of our series. In 91% of cases, the conjunctiva was the site of this infection. Total excision of fungal mass was carried out in all cases and two cases had recurrence between 9 and 12 months following intervention. Although this is an endemic area for such infestation, unilateral manifestation observed in all cases is interesting to note. Low recurrence rate in limited follow-up period could be due to early detection and standard management.
    背景与目标: : 作者介绍了54例鼻孢子虫的病例系列。他们在两年内被报告在西部奥里萨邦的一家三级护理医院。眼科医生的临床诊断病例在手术后通过组织病理学样本证实。在我们的系列中,我们注意到鼻孢子虫是主要的病原体。男性受到的影响是女性的三倍。10岁以下的儿童占我们系列的50% 以上。在91% 情况下,结膜是这种感染的部位。所有病例均进行了真菌肿块的完全切除,其中2例在干预后9至12个月之间复发。尽管这是这种侵扰的流行地区,但在所有情况下观察到的单方面表现都值得注意。在有限的随访期内复发率低可能是由于早期发现和标准管理。
  • 【2012国际抗性传播感染联盟欧洲合作临床小组报告了欧洲淋球菌感染的诊断和管理。】 复制标题 收藏 收藏
    DOI:10.1177/0956462413476269 复制DOI
    作者列表:Brooks B,Patel R,European Collaborative Clinical Group (ECCG).
    BACKGROUND & AIMS: :The European Collaborative Clinical Group (ECCG) was inaugurated at the 26th International Union against Sexually Transmitted Infections (IUSTI) Congress in Riga, Latvia 2011. The ECCG is a network of over 100 sexually transmitted infection specialists who have come together to conduct questionnaire-based research across the European region. It is expected that this work will focus and direct guideline development. A central core group of the ECCG has also been established who are responsible for identifying suitable survey questions that will be carried out but only after approval by the full ECCG Board. The ECCG aims to conduct a maximum of two projects per year which will be presented at the annual regional congresses and published as appropriate.
    背景与目标: : 欧洲合作临床小组 (ECCG) 于2011年在拉脱维亚里加举行的第26届国际抗性传播感染联盟 (IUSTI) 大会上成立。ECCG是由100多名性传播感染专家组成的网络,他们聚集在一起在欧洲地区进行基于问卷的研究。预计这项工作将集中并指导指南的制定。还成立了ECCG的一个中央核心小组,负责确定将进行的合适的调查问题,但必须在ECCG整个董事会批准后才能进行。ECCG的目标是每年最多进行两个项目,这些项目将在年度区域大会上介绍并酌情发布。
  • 【帮助利益相关者选择和应用评估工具来减轻土壤威胁: 来自欧洲各地的研究人员的经验。】 复制标题 收藏 收藏
    DOI:10.1016/j.jenvman.2019.110005 复制DOI
    作者列表:Okpara UT,Fleskens L,Stringer LC,Hessel R,Bachmann F,Daliakopoulos I,Berglund K,Blanco Velazquez FJ,Ferro ND,Keizer J,Kohnova S,Lemann T,Quinn C,Schwilch G,Siebielec G,Skaalsveen K,Tibbett M,Zoumides C
    BACKGROUND & AIMS: :Soil improvement measures need to be ecologically credible, socially acceptable and economically affordable if they are to enter widespread use. However, in real world decision contexts not all measures can sufficiently meet these criteria. As such, developing, selecting and using appropriate tools to support more systematic appraisal of soil improvement measures in different decision-making contexts represents an important challenge. Tools differ in their aims, ranging from those focused on appraising issues of cost-effectiveness, wider ecosystem services impacts and adoption barriers/opportunities, to those seeking to foster participatory engagement and social learning. Despite the growing complexity of the decision-support tool landscape, comprehensive guidance for selecting tools that are best suited to appraise soil improvement measures, as well as those well-adapted to enable participatory deployment, has generally been lacking. We address this gap using the experience and survey data from an EU-funded project (RECARE: Preventing and REmediating degradation of soils in Europe through land CARE). RECARE applied different socio-cultural, biophysical and monetary appraisal tools to assess the costs, benefits and adoption of soil improvement measures across Europe. We focused on these appraisal tools and evaluated their performance against three broad attributes that gauge their differences and suitability for widespread deployment to aid stakeholder decision making in soil management. Data were collected using an online questionnaire administered to RECARE researchers. Although some tools worked better than others across case studies, the information collated was used to provide guiding strategies for choosing appropriate tools, considering resources and data availability, characterisation of uncertainty, and the purpose for which a specific soil improvement measure is being developed or promoted. This paper provides insights to others working in practical soil improvement contexts as to why getting the tools right matters. It demonstrates how use of the right tools can add value to decision-making in ameliorating soil threats, supporting the sustainable management of the services that our soil ecosystems provide.
    背景与目标: : 土壤改良措施要想进入广泛使用,就必须在生态上可信,社会上可接受,经济上可承受。但是,在现实世界的决策环境中,并非所有措施都能充分满足这些标准。因此,开发,选择和使用适当的工具来支持在不同决策环境中对土壤改良措施进行更系统的评估是一项重要挑战。工具的目标各不相同,从侧重于评估成本效益、更广泛的生态系统服务影响和采用障碍/机会等问题的工具,到寻求促进参与性参与和社会学习的工具。尽管决策支持工具的格局越来越复杂,但普遍缺乏选择最适合评估土壤改良措施的工具以及那些适合参与性部署的工具的综合指导。我们利用欧盟资助的项目 (RECARE: 通过土地护理预防和补救欧洲土壤退化) 的经验和调查数据来解决这一差距。Recand应用了不同的社会文化,生物物理和货币评估工具来评估整个欧洲土壤改良措施的成本,收益和采用情况。我们专注于这些评估工具,并根据三个广泛的属性评估其性能,这些属性可衡量它们的差异以及是否适合广泛部署以帮助利益相关者在土壤管理中做出决策。数据是使用在线问卷收集的,以调查研究人员。尽管一些工具在案例研究中比其他工具工作得更好,但整理的信息被用来提供选择适当工具的指导策略,考虑资源和数据可用性、不确定性的特征以及制定或推广特定土壤改良措施的目的。本文为在实际土壤改良环境中工作的其他人提供了有关为什么正确使用工具的见解。它展示了使用正确的工具如何为改善土壤威胁的决策增加价值,从而支持我们土壤生态系统提供的服务的可持续管理。
  • 【Western印迹与ELISA检测暴露于镉和三丁基锡的蓝贻贝中诱导的应激蛋白。】 复制标题 收藏 收藏
    DOI:10.1080/13547500110050792 复制DOI
    作者列表:Pempkowiak M Radłowska J Bełdowski G Kupryszewski J Wysocki R Głos Nicka J
    BACKGROUND & AIMS: :Stress proteins of the Hsp70 family induced in the blue mussel Mytilus edulis exposed in the laboratory to increased concentrations of cadmium (Cd) or tributhyltin (TBT) were analysed using Western blotting and/or ELISA tests. Statistical evaluation of results indicated that increased concentrations of Hsp70 were detected by means of the ELISA tests as compared with control organisms in extracts from the gills of mussels exposed to both Cd or TBT (p = 0.022). Results of analysis by means of Western blotting showed no differences in the levels of Hsp70 in the extracts (p = 0.151). It was concluded that the ELISA test allowed a more sensitive detection of Hsp70 than did Western blotting.
    背景与目标: : 使用Western印迹和/或ELISA测试分析了在实验室中暴露于镉 (Cd) 或三丁锡 (TBT) 浓度增加的蓝贻贝中诱导的Hsp70家族的应激蛋白。结果的统计评估表明,与暴露于Cd或TBT的贻贝的鳃提取物中的对照生物相比,通过ELISA测试检测到Hsp70的浓度增加 (p = 0.022)。通过蛋白质印迹的分析结果显示提取物中Hsp70的水平没有差异 (p = 0.151)。结论是,与蛋白质印迹法相比,ELISA测试可以更灵敏地检测Hsp70。
  • 【北美和欧洲具有潜在危险因素的儿童的侵袭性肺炎球菌疾病负担。】 复制标题 收藏 收藏
    DOI:10.1111/ijcp.12234 复制DOI
    作者列表:Rose MA,Christopoulou D,Myint TT,de Schutter I
    BACKGROUND & AIMS: BACKGROUND:Characterisation of risk groups who may benefit from pneumococcal vaccination is essential for the generation of recommendations and policy. METHODS:We reviewed the literature to provide information on the incidence and risk of invasive pneumococcal disease (IPD) in at-risk children in Europe and North America. The PubMed database was searched using predefined search terms and inclusion/exclusion criteria for papers reporting European or North American data on the incidence or risk of IPD in children with underlying medical conditions. RESULTS:Eighteen references were identified, 11 from North America and 7 from Europe, with heterogeneous study methods, periods and populations. The highest incidence was seen in US children positive for human immunodeficiency virus infection, peaking at 4167 per 100,000 patient-years in 2000. Studies investigating changes in incidence over time reported decreases in the incidence of IPD between the late 1990s and early 2000s. The highest risk of IPD was observed in children with haematological cancers or immunosuppression. Overall, data on IPD in at-risk children were limited, lacking incidence data for a wide range of predisposing conditions. There was, however, a clear decrease in the incidence of IPD in at-risk children after the introduction of 7-valent pneumococcal conjugate vaccine into immunisation programmes, as previously demonstrated in the general population. CONCLUSION:Despite the heterogeneity of the studies identified, the available data show a substantial incidence of IPD in at-risk children, particularly those who are immunocompromised. Further research is needed to determine the true risk of IPD in at-risk children, particularly in the post-PCV period, and to understand the benefits of vaccination and optimal vaccination schedules.
    背景与目标:
  • 【坚持西方饮食模式和膀胱癌风险: 膀胱癌流行病学和营养决定因素国际研究的13项队列研究的汇总分析。】 复制标题 收藏 收藏
    DOI:10.1002/ijc.33173 复制DOI
    作者列表:
    BACKGROUND & AIMS: :Little is known about the association of diet with risk of bladder cancer. This might be due to the fact that the majority of studies have focused on single food items, rather than dietary patterns, which may better capture any influence of diet on bladder cancer risk. We aimed to investigate the association between a measure of Western dietary pattern and bladder cancer risk. Associations between adherence to a Western dietary pattern and risk of developing bladder cancer were assessed by pooling data from 13 prospective cohort studies in the "BLadder cancer Epidemiology and Nutritional Determinants" (BLEND) study and applying Cox regression analysis. Dietary data from 580 768 study participants, including 3401 incident cases, and 577 367 noncases were analyzed. A direct and significant association was observed between higher adherence to a Western dietary pattern and risk of bladder cancer (hazard ratio (HR) comparing highest with lowest tertile scores: 1.54, 95% confidence interval (CI): 1.37, 1.72; P-trend = .001). This association was observed for men (HR comparing highest with lowest tertile scores: 1.72; 95% CI: 1.51, 1.96; P-trend = .001), but not women (P-het = .001). Results were consistent with HR above 1.00 after stratification on cancer subtypes (nonmuscle-invasive and muscle-invasive bladder cancer). We found evidence that adherence to a Western dietary pattern is associated with an increased risk of bladder cancer for men but not women.
    背景与目标: : 对饮食与膀胱癌风险的关系知之甚少。这可能是因为大多数研究都集中在单一食物上,而不是饮食模式,这可能更好地捕捉饮食对膀胱癌风险的任何影响。我们的目的是调查西方饮食模式与膀胱癌风险之间的关系。通过汇总来自 “膀胱癌流行病学和营养决定因素” (BLEND) 研究中的13项前瞻性队列研究的数据并应用Cox回归分析,评估了对西方饮食习惯的依从性与患膀胱癌风险之间的关联。分析了来自580-768个研究参与者的饮食数据,包括3401个事件病例和577-367个非病例。观察到对西方饮食模式的较高依从性与膀胱癌风险之间存在直接且显着的关联 (风险比 (HR) 比较最高和最低的三元分数: 1.54,95% 置信区间 (CI): 1.37,1.72; P-趋势 = .001)。在男性中观察到这种关联 (HR比较最高和最低分数: 1.72; 95% CI: 1.51,1.96; P-趋势 = .001),而女性则没有 (P-het = .001)。在癌症亚型 (非肌层浸润性和肌肉浸润性膀胱癌) 分层后,结果与1.00以上的HR一致。我们发现有证据表明,坚持西方饮食习惯与男性 (而非女性) 患膀胱癌的风险增加有关。
  • 【欧洲食品的霉菌毒素污染: 早期发现和预防策略。】 复制标题 收藏 收藏
    DOI:10.1007/s11046-006-0057-2 复制DOI
    作者列表:Magan N
    BACKGROUND & AIMS: :This paper reviews the early detection and prevention strategies which have been employed in Europe for the control of mycotoxin contamination of food in the context of a hazard analysis critical control point (HACCP) framework. The critical control points (CCPs) in the whole food chain where mycotoxins such as trichothecenes and ochratoxins are important have been identified. Ecological studies on the effect of environmental factors which are marginal for growth and mycotoxin production have been identified for Fusarium culmorum and F. graminearum (deoxynivlenol production), and for Penicillium verrucosum and Aspergillus ochraceus (ochratoxin production) in relation to cereal production and for A. carbonarius in relation to grapes and wine production (ochratoxin formation). To minimise the entry of these mycotoxins into the food chain, effective and rapid diagnostic tools are required to monitor the CCPs effectively. To this end the potential use of molecular imprinted polymers, lateral flow devices and molecular-based techniques for the rapid detection and quantification of the mycotoxigenic moulds or their toxins have also been developed.
    背景与目标: : 本文回顾了在危害分析关键控制点 (HACCP) 框架的背景下,欧洲用于控制食品霉菌毒素污染的早期检测和预防策略。已经确定了整个食物链中的重要关键控制点 (ccp),其中霉菌毒素 (例如毛孢霉烯和och毒素) 很重要。已经确定了镰刀菌和禾本科镰刀菌 (脱氧尼诺酚生产) 对生长和霉菌毒素生产的影响的环境因素的影响的生态学研究,以及与谷物生产相关的疣状青霉和曲霉 (曲霉毒素的生产) 以及与葡萄和葡萄酒生产相关的碳酸曲霉 (曲霉毒素的形成)。为了最大限度地减少这些真菌毒素进入食物链,需要有效和快速的诊断工具来有效监测ccp。为此,还开发了分子印迹聚合物,侧向流动装置和基于分子的技术用于快速检测和定量产霉菌毒素的霉菌或其毒素的潜在用途。
  • 【欧洲青少年早餐消费与客观测量和自我报告的体育活动、久坐时间和身体健康的关联: HELENA (欧洲青少年营养健康生活方式) 研究。】 复制标题 收藏 收藏
    DOI:10.1017/S1368980013002437 复制DOI
    作者列表:
    BACKGROUND & AIMS: OBJECTIVE:To examine the association of breakfast consumption with objectively measured and self-reported physical activity, sedentary time and physical fitness. DESIGN:The HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Cross-Sectional Study. Breakfast consumption was assessed by two non-consecutive 24 h recalls and by a 'Food Choices and Preferences' questionnaire. Physical activity, sedentary time and physical fitness components (cardiorespiratory fitness, muscular fitness and speed/agility) were measured and self-reported. Socio-economic status was assessed by questionnaire. SETTING:Ten European cities. SUBJECTS:Adolescents (n 2148; aged 12·5-17·5 years). RESULTS:Breakfast consumption was not associated with measured or self-reported physical activity. However, 24 h recall breakfast consumption was related to measured sedentary time in males and females; although results were not confirmed when using other methods to assess breakfast patterns or sedentary time. Breakfast consumption was not related to muscular fitness and speed/agility in males and females. However, male breakfast consumers had higher cardiorespiratory fitness compared with occasional breakfast consumers and breakfast skippers, while no differences were observed in females. Overall, results were consistent using different methods to assess breakfast consumption or cardiorespiratory fitness (all P ≤ 0·005). In addition, both male and female breakfast skippers (assessed by 24 h recall) were less likely to have high measured cardiorespiratory fitness compared with breakfast consumers (OR = 0·33; 95% CI 0·18, 0·59 and OR = 0·56; 95%CI 0·32, 0·98, respectively). Results persisted across methods. CONCLUSIONS:Skipping breakfast does not seem to be related to physical activity, sedentary time or muscular fitness and speed/agility as physical fitness components in European adolescents; yet it is associated with both measured and self-reported cardiorespiratory fitness, which extends previous findings.
    背景与目标:
  • 【欧洲存在两种马泰利亚的分子证据。】 复制标题 收藏 收藏
    DOI:10.1111/j.1550-7408.2001.tb00178.x 复制DOI
    作者列表:Le Roux F,Lorenzo G,Peyret P,Audemard C,Figueras A,Vivarès C,Gouy M,Berthe F
    BACKGROUND & AIMS: :Marteilia refringens is one of the most significant pathogens of bivalve molluscs. Previous sequencing of the small subunit ribosomal RNA gene of M. refringens isolates derived from the infected mussels (Mytilus edulis and Mytilus galloprovinciallis) and the oyster (Ostrea edulis) in Europe did not reveal genetic polymorphisms despite indications from epizootiological data that distinct types may exist. We investigated the existence of polymorphisms in the internal transcribed spacer region of the ribosomal RNA genes. The sequences of this region proved to be clearly dimorphic among Marteilia from five sampling sites. The distribution of the two genetic types, named "O" and "M", appeared to be linked to the host species, oysters and mussels, respectively. We therefore support the recognition of two species of Marteilia in Europe and propose that the "O" type corresponds to M. refringens and the "M" type to M. maurini.
    背景与目标: : Marteilia refringens是双壳软体动物最重要的病原体之一。先前对欧洲受感染的贻贝 (Mytilus edulis和Mytilus galloprovinciallis) 和牡蛎 (Ostrea edulis) 衍生的M. refringens分离株的小亚基核糖体RNA基因的测序并未揭示遗传多态性,尽管从流行病学数据表明可能存在不同的类型。我们研究了核糖体RNA基因内部转录间隔区中多态性的存在。该区域的序列在五个采样点的Marteilia中被证明是明显的二态性。两种遗传类型 “O” 和 “M” 的分布似乎分别与寄主物种牡蛎和贻贝有关。因此,我们支持在欧洲识别两种Marteilia,并建议 “O” 型对应于M. refringens,而 “M” 型对应于M. maurini。
  • 【药物利用能否有助于促进药物的更合理使用?尼泊尔西部的经验。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Shankar PR,Mishra P,Subish P,Upadhyay DK
    BACKGROUND & AIMS: :Drug utilization research describes the extent, nature and determinants of drug use in populations and aims to facilitate the more rational use of medicines. The departments of Pharmacology and Clinical Pharmacy at the Manipal College of Medical Sciences, Pokhara, Nepal are committed to promoting the more rational use of medicines. The departments run a Drug Information Center and a Pharmacovigilance Center in the teaching hospital. Over the last eight years, the departments have conducted drug utilization studies in the teaching hospital and the community. A few of these were of the intervention type and drug use was studied before and after the intervention. Members of the departments are on the hospital Drug and Therapeutics Committee. Educational initiatives to improve prescribing have been carried out in a few instances. Restricting the number of brands in the hospital pharmacy and creation of a hospital drug list has been carried out. The impact of these initiatives has been studied only in a few cases. Generic prescribing was found to be low. The educational initiatives to improve prescribing had only limited success. The hospital is in the process of framing antimicrobial use guidelines for various departments. A hospital formulary is under preparation. The influence of drug utilization studies on the prescribing patterns has been low to moderate. The department of Clinical Pharmacy runs a Medication Counseling Center in the hospital and teaches appropriate use of medicines to patients. The studies and initiatives to promote the more rational use of medicines should be continued and strengthened.
    背景与目标: : 药物利用研究描述了人群中药物使用的程度,性质和决定因素,旨在促进更合理地使用药物。尼泊尔博克拉的Manipal医学院的药理学和临床药学系致力于促进药物的更合理使用。这些部门在教学医院设有药物信息中心和药物警戒中心。在过去的八年中,各部门在教学医院和社区进行了药物利用研究。其中一些属于干预类型,干预前后对药物使用进行了研究。这些部门的成员是医院药物和治疗委员会的成员。在一些情况下,已经开展了改善处方的教育举措。限制医院药房的品牌数量并创建医院药品清单。仅在少数情况下研究了这些举措的影响。通用处方被发现很低。改善处方的教育举措仅取得了有限的成功。医院正在为各个部门制定抗菌药物使用指南。医院处方集正在准备中。药物利用研究对处方模式的影响是低到中等的。临床药学系在医院经营药物咨询中心,并向患者教授药物的适当使用。应继续并加强促进更合理使用药物的研究和举措。
  • 12 Urban health challenges in Europe. 复制标题 收藏 收藏

    【欧洲的城市健康挑战。】 复制标题 收藏 收藏
    DOI:10.1007/s11524-012-9761-z 复制DOI
    作者列表:Lawrence RJ
    BACKGROUND & AIMS: :This article synthesizes diverse official reports, statistics, and scientific papers that present demographic, economic, environmental, and social trends impacting on the health and quality of life of citizens living in European cities. A literature review led to the identification of some key challenges including an aging society, migration flows, inequalities in health, global change, and risk behaviors that should be addressed in order to promote urban health. Other challenges, such as food production and consumption, are also relevant, but not included. Cities that have participated in one or more of the phases of the WHO European Healthy Cities Network have implemented a number of policies, programs, and measures to deal with the challenges discussed in this article. Some contributions are presented to illustrate how health and quality of life in urban areas can be promoted by local authorities.
    背景与目标: : 本文综合了各种官方报告,统计数据和科学论文,这些报告介绍了影响欧洲城市居民健康和生活质量的人口,经济,环境和社会趋势。文献综述导致确定了一些关键挑战,包括老龄化社会,移民流动,健康不平等,全球变化以及为促进城市健康而应解决的风险行为。粮食生产和消费等其他挑战也是相关的,但不包括在内。参加了WHO欧洲健康城市网络一个或多个阶段的城市已经实施了许多政策,计划和措施,以应对本文中讨论的挑战。提出了一些贡献,以说明地方当局如何促进城市地区的健康和生活质量。
  • 【后共产主义中欧缺血性心脏病死亡率急剧下降: 从总体上恢复。】 复制标题 收藏 收藏
    DOI:10.21101/cejph.a3658 复制DOI
    作者列表:Ginter E,Simko V
    BACKGROUND & AIMS: :After 1970 the preexisting gap in population health between democratic Europe and communist countries became even more prominent. While in the democratic Europe there was a progressive rise in life expectancy associated with the decline in ischaemic heart disease (IHD), the trend on the other side of the iron curtain was exactly reverse. After the fall of communism in 1989 population health in the post-communist central Europe (CE) rapidly signalled a favourable recovery. This biphasic trend in post-communist countries is very remarkable. Most remarkably the decline in IHD mortality started soon after the demise of totality, even before the modernization of health care (new more effective medications and diagnostic technology), public campaign against smoking and improved supply of protective nutrients got chance to attain an important role. The decades-long psychosocial depression of communism was rapidly replaced with a promise of a better future. It is generally accepted that psychosocial factors are powerfool tools in the pathogenesis of IHD.
    背景与目标: : 在1970之后,民主欧洲和共产主义国家之间在人口健康方面存在的差距变得更加突出。虽然在民主的欧洲,与缺血性心脏病 (IHD) 下降相关的预期寿命逐渐增加,但铁幕另一端的趋势恰恰相反。共产主义垮台后,后共产主义中欧 (CE) 的1989年人口健康迅速预示着良好的复苏。后共产主义国家的这种双相趋势非常显著。最明显的是,IHD死亡率的下降在总体消亡后不久就开始了,甚至在医疗保健现代化 (新的更有效的药物和诊断技术) 之前,公众反对吸烟和改善保护性营养素的供应就有机会发挥重要作用。长达数十年的共产主义心理社会萧条迅速被对美好未来的承诺所取代。人们普遍认为,社会心理因素是IHD发病机理中的重要工具。
  • 【逐步介绍成功的抗菌管理计划。沙特阿拉伯西部一家三级护理大学医院的经验。】 复制标题 收藏 收藏
    DOI:10.15537/smj.2016.12.15739 复制DOI
    作者列表:Alawi MM,Darwesh BM
    BACKGROUND & AIMS: OBJECTIVES:To analyze and evaluate the safety and cost-effectiveness of a gradually-implemented antimicrobial stewardship programs (ASP) in a tertiary care center. METHODS:Prospective data were collected from an ASP that was gradually introduced between April 2012 and December 2013 in 6 hospital departments, over successive periods of 3 months each. A multidisciplinary team supervised antibiotic use and regulated pharmacy dispensations of a list of restricted antimicrobials (RAs). Indicators were prospectively monitored and included hospital mortality as the safety indicator; incidence of multi-drug resistance (MDR) infections as the effectiveness indicator, RA cost savings as the cost-effectiveness indicator and RA consumption indicated the process implementation. RESULTS:Between 2012 and 2014, dispensations of RAs decreased by 67% and prescriptions by 75%; no increase in mortality rate was observed. Microbiologically, there was a decreasing trend of incidence across all monitored infections, but this was only significant for Acinetobacter baumannii (p=0.007). Cost analysis showed a decrease in expenditure for RAs, with an average monthly saving of up to 326,020USD. CONCLUSIONS:Stepwise implementation of ASPs is a safe and cost-effective strategy for improving antibiotic prescribing practice and to reduce multi-drug resistance.
    背景与目标:
  • 【在中国西部爆发了耐碳青霉烯的鲍曼不动杆菌产生OXA-23碳青霉烯酶。】 复制标题 收藏 收藏
    DOI:10.1016/j.ijantimicag.2007.08.019 复制DOI
    作者列表:Zong Z,Lü X,Valenzuela JK,Partridge SR,Iredell J
    BACKGROUND & AIMS: :Twenty-two non-repetitive carbapenem-resistant Acinetobacter baumannii isolates were obtained from Intensive Care Unit patients. All of the isolates carried bla(OXA-23), bla(OXA-66), a novel cephalosporinase-encoding gene (bla(ADC-25)) and a class 1 integron with an aacC1-orfP-orfQ-aadA1a cassette array and had identical enterobacterial repetitive intergenic consensus (ERIC) profiles. ISAba1 was found upstream of bla(OXA-23), but was not associated with bla(OXA-66) or bla(ADC-25).
    背景与目标: : 从重症监护病房患者中获得了22株非重复的耐碳青霉烯类鲍曼不动杆菌分离株。所有分离株均携带bla(OXA-23),bla(OXA-66),新型头孢菌素酶编码基因 (bla(ADC-25)) 和具有aacC1-orfP-orfQ-aadA1a盒阵列的1类整合子,并具有相同的肠细菌重复基因间共识 (ERIC) 谱。ISAba1位于bla(OXA-23) 的上游,但与bla(OXA-66) 或bla(ADC-25) 无关。

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