我国现行医疗卫生政策的相关问题分析

医疗卫生是构建和谐社会的重要因素之一,也是关乎百姓切身利益的重大问题之一,近年来,医疗体制的不断改革,医疗卫生的相关政策的不断出台,已经大大地改善了我国广大人民群众的“看病难,看病贵”等问题,增加了医保的覆盖人群,减轻了城市低收入人群及农村的医疗负担,但是,我们仍面临着巨大的挑战,新的问题也不断涌现,医疗卫生政策不适应现在的医疗需求发展、经济发展不均衡、不同层次群众的医疗需求有差异等,都是医疗卫生改革中面临的问题,医疗改革的不断推进势在必行。我国的医疗保障制度覆盖率已经达到95％,但是,现行的医疗保障制度的还不能从根本上解决人民群众的“就医难,治病贵”的问题,其他医疗保险不能与现行的医疗保障制度相适应,从而,影响了我国整体的医疗水平的提高。     

Reflections on the Surgeon General's Report on Mental Health,Culture, Race,and Ethnicity

The main goal of this paper is to evaluate the Supplement to the Surgeon General's Report on Mental Health, with an eye toward informing future efforts to prevent and treat mental illness among racial and ethnic minorities. I first briefly discuss the historical background of the Supplement. I then present its strengths, which include the authority and visibility of the Office of the Surgeon General, the organization of the report by racial/ethnic group, the examination of the social and historical context of each of the racial/ethnic groups, and the emphasis on science. Last, I identify three major tensions within the Supplement, focusing on groups versus cultural processes, situating culture within individuals or social worlds, and examining differences between minority groups and whites versus examining conceptually informed processes. The Supplement makes a significant contribution to advancing our understanding of the mental health of racial and ethnic minority groups. The actions that follow (or don't follow), however, will determine the import of this document.     

The Unknown Role of Mental Health in Global Development

In this paper, the author contrasts the substantial impact of mental health problems on global disability with the limited attention and resources these problems receive. The author discusses possible reasons for the disparity: Compared to physical disorders, mental health problems are considered less important, perhaps due to lower priority of disorders that primarily cause dysfunction rather than mortality, and skepticism that mental disorders are treatable in low-resource countries. He argues that achieving improved global health and development requires addressing problems causing disability, particularly mental health problems among populations in which the common mental disorders are frequent due to deprivation, war, and disasters. The author contends that services addressing the common mental disorders could be made widely and relatively cheaply accessible if provided by non-professional workers at the community level.     

Mental health in primary care for adolescent parents

Mental health care is important for everyone, especially teenagers. However, seeking mental health services may be challenging for teenagers, particularly when they are also parents. Offering mental health care in a safe, attractive and easily accessible manner, such as primary care, increases the chances that teenage parents will receive help. Comprehensive care models need to be established to address the many needs that at-risk young mothers and their children face. There are a number of programmes available to teenage mothers that either address healthcare and psychosocial needs or focus primarily on improvements in parenting skills; yet an integrated model that delivers medical, psychiatric and psychosocial care and facilitates positive parenting skills seems to be missing. Through a university–community partnership we have recently developed a model curriculum – the Mom Power (MP) group programme – at the University of Michigan which aims to close this gap in service delivery. We elaborate on core elements and key features of this 10-week group intervention programme for high-risk teenage mothers and their children, and present preliminary outcomes data. Analyses on the first 24 MP group graduates suggest that despite ongoing life trauma during the intervention period, teenage mothers show improvements in depression and post-traumatic stress disorder symptoms post intervention, and also self-rate as less guilty and shameful regarding their parenting skills after programme completion. Although preliminary, due to design and statistical limitations, these results show promise regarding feasibility and effectiveness of this integrated approach for teenage mothers with young children delivered through primary care.     

老年患者术后急性精神障碍临床观察与护理体会

目的：观察老年术后急性精神障碍发生的相关原因并总结护理要点。方法：回顾分析老年术后发生急性精神障碍的相关因素包括手术与麻醉时间、术前合并症和术后并发症等。结果：术后急性精神障碍与多种因素相关。与全身麻醉以及术后不良的环境因素密切相关,其他原因包括年龄、术前合并症以及术后并发症的发生等。术后必要的药物治疗以及术后的心理护理是护理工作的关键,患者信赖的医护人员以及亲友的安慰交流有防治效果。结论：老年病人术后精神障碍的发生对围手术期病人的治疗康复具有一定的负面影响,应当引起医护人员的重视并采取有效防治对策。     

老年患者术后急性精神障碍临床观察与护理体会

目的:观察老年术后急性精神障碍发生的相关原因并总结护理要点。方法:回顾分析老年术后发生急性精神障碍的相关因素包括手术与麻醉时间、术前合并症和术后并发症等。结果:术后急性精神障碍与多种因素相关。与全身麻醉以及术后不良的环境因素密切相关,其他原因包括年龄、术前合并症以及术后并发症的发生等。术后必要的药物治疗以及术后的心理护理是护理工作的关键,患者信赖的医护人员以及亲友的安慰交流有防治效果。结论:老年病人术后精神障碍的发生对围手术期病人的治疗康复具有一定的负面影响,应当引起医护人员的重视并采取有效防治对策。     

爱心饲养对大熊猫心理健康及配种受孕率的影响

大熊猫在人工饲养条件下,单调、狭小的生存空间和伸手即来的食物使大熊猫的生活也变得单调而枯燥,不少饲养大熊猫的单位都存在较严重的种群健康下降问题.     

神木“全民免费医疗”的可推广性探讨

神木模式是我国＂全民免费医疗＂的一次创造性探索,虽然它不是真正意义上的全民免费医疗制度,但对比目前新医改推广的＂全民医保＂制度而言,它在解决群众＂看病难、看病贵＂的问题上起到更积极的作用,对全国也起着一定的借鉴意义。     

陆军青年军人心理素质与人格、心理健康的相关研究

目的：探讨陆军青年军人心理素质与人格、心理健康的关系。方法：整群抽取陆军青年官兵881名,采用军人心理素质量袁、艾森克人格问卷（EPQ）、症状自评量表（SCL-90）进行测评,进行方差分析和相关分析。结果：（1）陆军青年军人心理素质各因子分及总分与EPQ人格问卷中的E分呈显著正相关（p〈0．01）;与N分、P分呈显著负相关（p〈0．01）。高、中、低心理素质水平军人E、P、N得分比较有显著差异（p〈0．05）,表现为在E量表得分上高心理素质组〉中等心理素质组〉低心理素质组;而在P、N量表得分上则反之。（2）陆军青年军人心理素质各因子分及总分均与SCL-90各因子分和总均分呈显著负相关（p〈0．01）。高、中、低心理素质水平军人SCL-90各因子得分比较有显著差异（p〈0．05）,表现为低心理素质组〉中等心理素质组〉高心理素质组。结论：陆军青年军人心理素质与心理健康密切相关,心理素质越高,其心理健康水平也越高。     

Exploring core competencies for mental health and addictions work within a Family Health Team setting

Approximately 200 Family Health Teams (FHTs) have been implemented in Ontario to improve access to primary healthcare, including mental health and addiction. The objectives of this project were to examine, through a focus group and qualitative methodology with three FHTs, the profile of patients'' mental health and addiction-related needs and to identify the implications for the development of core competencies in these innovative organisations. A spectrum of needs and service trajectories was identified, as well as the importance of a wide range of clinical skills and knowledge. The results indicate that ‘core’ competencies for mental health work in the context of an FHT go well beyond those required for an embedded mental health ‘programme’ or specialised mental health counsellors, but rather they relate to the core and discipline-specific competencies of members of the entire team. In addition to specific knowledge and skills, competencies include common attitudes and values relating to teamwork, good communication and collaboration. Challenges were noted with regard to working with some community service providers, especially addiction services. Implications for core competencies at the individual and organisational level were identified.     

蜜源花粉的保健、美容与药膳

对花粉的利用历史,营养成分、药理作用等进行了论述,并收集了部分花粉美容、保健药膳等部分配方.     

The Mental Health of Ethnic Minority Groups: Challenges Posed by the Supplement to the Surgeon General's Report on Mental Health

In contrast to the conclusions reached by the Supplement to the Surgeon General's report on mental health, there is evidence that the various ethnic minority groups may exhibit significant differences in the prevalence of mental disorder. These differences cannot be fully explained by disparities or inequities in mental health services. African Americans appear to have relatively low prevalence rates despite a history of prejudice, discrimination, and the resulting stress. Ethnic differences are also revealed by findings that acculturation is negatively related to mental health for Mexican Americans and positively related to mental health for Asian Americans. Implications of these findings are discussed.     

Turkish Migrant Women Encountering Health Care in Stockholm: A Qualitative Study of Somatization and Illness Meaning

This paper presents the results from a qualitative study conducted withthe aim of exploring structures of illness meaning among somatizingTurkish-born migrant women (age 31–48) living in a poor and lowstatus suburb of Stockholm in contact with local health care services.Two to three interviews regarding experiences and understanding ofillness were conducted as well as one year, validating follow-upinterviews. Interviews were analysed with a grounded theory approach.Results are presented as the participants' agenda of understanding.Distress was communicated by concrete expressions about the body,emotions, social and life situation. Pain was prominent and oftenlateralised to one side of the body. The use of traditional expressionsof distress ranged from open use to avoidance. Attribution wascharacterised by verbalising links of coherence between health andaspects of life. Psychiatric attribution was rarely accepted or valuedas a tool for recovery, or as helpful in linking bodily symptoms toemotional distress. Three main sources for healing were used: medicalcare in Sweden and in Turkey and traditional treatment. Own capacity toinfluence recovery was mostly regarded as low. Relations to family andthe clinician were regarded as important to recovery. The encounter withlocal health care had brought the participants in contact with apsychological agenda of understanding their illness and new ways ofdealing with illness and healing. Some expressed a feeling of beingmisunderstood whereas some related positive experiences ofre-evaluation. They were all actively trying, but experiencing varyingdegrees of difficulty, to grasp the meaning of the caregiver. Theresults of the study point to the mutual need of exploring meaning inthe clinical encounter to help patients make sense out of differentperspectives of illness and healing. The need for enhanced knowledgeabout this process in a migration context will be discussed.     

Paradigms and Politics: Shaping Health Care Access for Sickle Cell Patients Through the Discursive Regimes of Biomedicine

The emergence of two different sickle cell disease and disease/treatment paradigms in two clinics, Children's Hospital West (CHW) and Children's Hospital East (CHE), demonstrates how physicians can influence institutional regimes of truth to improve patient access. Physicians at both clinics, far from simply acquiescing to dominant biomedical paradigms, recognize that their paradigms are in part rhetorical strategies designed to subvert problematic staff biases and perceptions, and to encourage a particular "self-efficacy" ethic in the patients. This paper positions physicians as struggling within the discursive regimes of biomedicine to create an institutional space where the disease and the sickle cell patient matter, and where patients comply with the performative rules of that space. This paper explores how physicians, patients, and institutions collaborate in the construction of sickle cell disease in such a way that biomedicine becomes a plural, as opposed to a singular and oppressive, discursive regime.     

儿童保健对早产儿生长和智力发育的影响及相关性研究

为了探究正常的儿童保健对早产儿生长和智力发育的影响,并明确早产儿的生长和智力发育分别与儿童保健的影响,本研究选取40例早产儿,随机分为对照组和观察组,每组20例。对照组进行常规育儿管理,观察组采用儿童保健管理。统计分析两组早产儿在0.5岁、1岁、1.5岁和2岁的生长(头围,体重和身高)和智力(智力和心理活动)发育情况及相关性。研究发现,儿童保健可明显促进早产儿的生长和智力发育,且正规儿童保健与早产儿的生长和智力发育呈正相关关系,均具有显著性差异。本研究结果说明,儿童保健可明显促进早产儿的生长和智力发育,具有重要的临床应用价值。     

医保体制下过度医疗的成因与控制策略分析

随着新一轮医改的不断深入,我国初步建立了一套适合我国国情的基本医疗卫生体系及医疗保障制度。伴随着医疗卫生事业的蓬勃发展,医疗费用也随之出现了快速增长,过度医疗是导致医疗费用快速上涨的重要原因之一。本文从需方、供方、医疗体制三方分析了其产生的原因,并探讨了国外开展的医疗费用控制对医疗市场参与主体的影响。最后,针对医疗市场自身必须适应国情、适合社会发展阶段的特点,为我国实现新医改目标提供了一些建设性的意见。     

膳食纤维及其生理保健作用的研究进展

膳食纤维被称为“第七营养素”,是过去30年来的研究热点。本文参考近5-6年来的最新研究成果,综述了膳食纤维的定义、成分及测定方法,膳食纤维的理化特性、生理保健作用、适宜推荐量及其应用现状和发展前景,对人们全面认识膳食纤维与人体健康的关系有较大的参考价值。     

A Plant Health Care Program for Brambles in the Pacific Northwest

Pratylenchus and Xiphinema species have been associated with decline and mortality of brambles (Rubus species) in the Pacific Northwest of the United States. These nematodes cause direct feeding damage and (or) transmit viruses that result in poor fruit quality and plant decline. A nematode management program has been developed by the author to minimize chemical use and nematode-induced damage while optimizing fruit production. Nematode management is an integral part of a total plant health care program in which foliar and soil pests, plant stresses, and fertility are managed.