Defacement: Public Secrecy and the Labor of the Negative

Defacement: Public Secrecy and the Labor of the Negative. Michael Taussig. Stanford: Stanford University Press, 1999. 311 pp.     

Trichloroethylene in the Environment: Public Health Concerns

The Agency for Toxic Substances and Disease Registry (ATSDR) prepares toxi-cological profiles for hazardous substances found at waste sites and elsewhere in the environment. In 1997 the agency updated its toxicological profile for trichloroethylene and included new and expanded information on the health effects associated with exposures to trichloroethylene. Several endpoints of concern are described in the profile. However, in this paper only results from studies reporting developmental and carcinogenic effects from trichloroethylene exposures in human and experimental animal studies are summarized and evaluated. Based on its assessment of the available studies and limitations in the reported findings, ATSDR has determined there is limited but suggestive evidence that developmental effects may be a concern for some persons exposed to TCE in drinking water. Moreover, developmental effects may be the most sensitive of all non-cancer health effects associated with trichloroethylene exposures. Significant questions remain about the likely mode(s) of action for TCE-induced carcinogenesis in humans and the basis for differences in pharmacokinetics handling of TCE across animal strains and sex. However, on the basis of animal data and the suggestive, yet inconclusive, human data available, ATSDR has determined that cancer should be an effect of concern for people exposed to TCE in the environment. ATSDR agrees that the available literature supports the premise that TCE is “reasonably anticipated to be a human carcinogen” as defined by the U.S. National Toxicology Program.     

Public health: the control of meningococcal disease in Quebec

A first outbreak of serogroup C meningococcal disease occurred in the province of Quebec in 1990-1992 and lead to a mass immunization campaign using polysaccharide vaccines. In 2001, a second outbreak was identified and a mass vaccination campaign was carried out, using the newly licensed conjugate vaccine. Clinical, epidemiological, economic and social studies were instrumental in the decision making for implementing these control programs.     

Leptospirosis: Public health perspectives

Leptospirosis, caused by a spirochete of genus Leptospira, is considered the most widespread zoonosis in the world. It has a global distribution with a higher incidence in the tropics and subtropics, ranging from 10 to 100 human cases per 100,000 individuals. Leptospirosis is considered an “emerging” zoonosis due to increased contact between animals and humans and the resulting human encroachment into wildlife habitat. Climate change and its associated environmental shifts can affect the degree of transmission of leptospirosis. Surveillance for leptospirosis is important for early detection of cases because early treatment is crucial to decrease morbidity and mortality. In June 2012, the Council of State and Territorial Epidemiologists approved reinstatement of leptospirosis as a Nationally Notifiable Condition. Reinstatement of national surveillance will facilitate the assessment of the incidence, geographic distribution, trends, and risk factors associated with human cases and the identification of outbreaks and potential new animal reservoirs.     

公立医院公益性反思与政府责任分析

在我国公立医院改革对举办主体、服务的性质、机构的性质和机构的逐利动机等方面存在误解或混淆,公立医院公益性体现在服务的内容、对象和区域上。实现和维护公立医院公益性需要明确公立医院公益性的根本原因和具体体现,政府要从微观保障、中观管理和宏观监督三个层面综合发挥作用。