Relationship between occupational aluminium exposure and histone lysine modification through methylation

BackgroundAluminium is an environmental neurotoxin to which human beings are extensively exposed. However, the molecular mechanism of aluminium toxicity remains unclear.MethodsThe changes in cognitive function of aluminum exposed workers under long-term occupational exposure were evaluated, and the relationship between cognitive changes, plasma memory related BDNF and EGR1 protein expression, and variations of epigenetic markers H3K4me3, H3K9me2, H3K27me3 expression levels in blood was explored.ResultsMMSE, DSFT, DST scores in cognitive function and the levels of plasma BDNF and EGR1 protein expression decreased with the increase of blood aluminum level. H3K4me3, H3K9me2, H3K27me3 expression levels in peripheral blood lymphocytes of aluminum exposed workers were statistically different (all P<0.05). H3K4me3, H3K9me2 and H3K27me3 expression levels in lymphocytes were correlated with blood aluminum level. BDNF, EGR1 protein level and H3K4me3, H3K9me2, H3K27me3 expression levels have different degrees of correlation. There was a linear regression relationship between plasma BDNF, H3K4me3 and H3K9me2. H3K9me2 had a greater effect on BDNF than H3K4me3. There is a linear regression relationship between EGR1, H3K4me3 and H3K27me3, and the influence of H3K4me3 on EGR1 is greater than that of H3K27me3 on EGR1.ConclusionAlummnum may regulate the expression of BDNF and EGR1 by regulating H3K4me3, H3K27me3 and H3K9me2, and affect the cognitive function of workers by affecting the expression of BDNF and EGR1.     

政府补偿与监管机制改革对公立医疗机构公共卫生及公益性服务的影响分析

目的 分析上海市闵行区政府补偿与监管机制改革对公立医疗卫生机构的公共卫生和公益性服务状况的影响。方法 收集2008—2012年闵行区12家社区卫生服务中心的公共卫生服务和公益性服务,以及3家综合性医院的公益性服务的指标数据,并将部分指标与上海市同期的平均水平进行比较分析。结果 改革后,闵行区社区卫生服务中心公共卫生服务能力显著提升,服务质量保持在较高水平,服务效率也有所改进,公共卫生服务数量明显优于上海市平均水平。结论 闵行区政府补偿与监管机制改革对公立医疗卫生机构的公共卫生和公益性服务的提供有积极的影响,但未来需要关注对公益性服务的激励和补偿,尤其是补偿机制和标准更为明确和细化。     

A hidden deadly venomous insect: First eco-epidemiological assessment and risk mapping of lonomism in Argentina

BackgroundEnvenomation by the South American Lonomia saturniid caterpillars, named lonomism, constitutes an emerging and somewhat neglected public health issue in Argentina and neighboring countries. Considering that there is an intricate relationship between environment and human health in such cases, this study aimed to analyze the eco-epidemiological profile of 40 accidents and 33 occurrences of Lonomia spp. in Misiones (Argentina) between January 2014 and May 2020.Methodology/Principal findingsWe described the eco-epidemiological variables and characterized the abiotic scenario of such cases. Additionally, we obtained a density map that shows the punctual intensity of Lonomia records throughout Misiones. Most of the accidents occurred in the Department of Guaraní and involved male victims younger than 20 years old. The accidental/occasional occurrence of Lonomia spp. (considering both adult and caterpillar stages together) was significantly higher in the rural area, whereas only adult specimens were found in urban areas. We determined that the presence of this insect in Misiones is positively related to higher temperatures and solar radiation, and larger precipitation and evapotranspiration throughout the year.Conclusion/SignificanceThis study represents an initial step towards the global understanding of lonomism as a public health problem in Argentina. It provides a map of the risk level for this envenomation in Misiones, which could help authorities address public health policy efforts to implement sustainable strategies for prevention and response to this threat in Northeastern Argentina and neighboring regions.     

Metasynthesis of Youth Suicidal Behaviours: Perspectives of Youth,Parents, and Health Care Professionals

BackgroundYouth suicide is a major public health issue throughout the world. Numerous theoretical models have been proposed to improve our understanding of suicidal behaviours, but medical science has struggled to integrate all the complex aspects of this question. The aim of this review is to synthesise the views of suicidal adolescents and young adults, their parents, and their healthcare professionals on the topics of suicidal behaviour and management of those who have attempted suicide, in order to propose new pathways of care, closer to the issues and expectations of each group.ConclusionThe violence of the message of a suicidal act and the fears associated with death lead to incomprehension and interfere with the capacity for empathy of both family members and professionals. The issue in treatment is to be able to witness this violence so that the patient feels understood and heard, and thus to limit recurrences.     

二级及以上医疗机构公共卫生职能承担现况调查

目的 了解我国二级及以上医疗机构公共卫生职能的承担情况。方法 对4个省进行实地调研,对180家二级及以上医院进行问卷调查。结果 上报医疗机构对15项公共卫生职能的承担数为0.78,发文组与设置组承担数更高。各项公共卫生工作在医疗机构的开展情况不尽相同。院内公共卫生职能管理分散。结论 建议在二级及以上医院内部单独设置公共卫生科（处）,统筹全院公卫工作,并对各级各类医疗机构的公卫职责进行重新划分。     

我国二级及以上医疗机构开展公共卫生工作现况分析

目的 对二级以上医疗机构疾病预防控制等公共卫生工作现况进行评估。方法 对全国10个省163家医院进行二级以上医疗机构公共卫生工作开展基本情况调查和人员基本情况调查的问卷调查;对全国34个省、自治区、直辖市和新疆生产建设兵团进行函调以及对浙江、河南、辽宁和甘肃4个省进行实地调研。结果（1）医疗机构应承担的公共卫生职能与落实情况相差甚远。（2）医疗机构从事公共卫生工作积极性不高。（3）医疗机构在公共卫生工作中接受多个部门管理,但在工作中缺乏协调。结论（1）弥合临床医疗服务体系与公共卫生体系的割裂状态。（2）增强医疗机构从事公共卫生工作积极性。（3）加强督察考核,促进公共卫生工作的落实。     

政府补偿与监管机制改革对医疗服务的影响分析

目的 分析政府补偿与监管机制改革前后闵行区公立医疗卫生机构的医疗卫生服务状况的变化,探索研究政府补偿与监管机制改革对医疗卫生机构运行绩效的影响。方法 进行机构调查和二手资料分析。结果 改革后,闵行区公立医疗机构医疗服务数量不断增加,服务质量保持在较高水平,服务效率有所改进,医疗费用得到控制;综合性医院和社区卫生服务中心的服务质量和费用控制均优于上海市平均水平。结论 政府补偿与监管机制改革在一定程度上提高了闵行区公立医疗卫生机构医疗服务的绩效。     

Overcoming barriers to the broader implementation of life cycle thinking in business and public administration

Preamble. It is the Purpose of this Corner to serve as an information and communication channel as well as a discussion forum between science and policy in general, as well as between research and management, in business and public administration with regard to goods and services (products). It is the aim of this Corner to improve awareness of, and to help more effectively implement, life cycle thinking in all stages of decision making in business and public administration. This Corner ‘EU Life Cycle Policy and Support’ appears regularly. Contributions are invited and uninvited articles, as well as discussion comments from the LCA community. They outline practical experiences, information on new regulations, directives and other policy instruments, as well as important theoretical considerations. This first edition of the Corner provides, for discussion, a broad commentary on our underlying thoughts and ideas. This builds on ideas presented in e.g. the business context in the Life Cycle Management special edition (Int J LCA Special Issue 1, 2007), as well as recent policy developments in the European Union. This editorial is illustrated with example references related to each issue that were recently published in the journal (see [1–11]). Dr. David W. Pennington is responsible for the Environmental Assessment of Waste and the Sustainable Management of Natural Resources (ENSURE) in the European Commission’s Joint Research Centre (JRC), based at the Institute for Environment and Sustainability in Ispra, Italy. ENSURE complements conventional methods for waste and resource management with the development of recommended approaches, indicators, reference data, and case studies that facilitate life cycle thinking in European business and public administrations. The ENSURE team, consisting of about 15 staffs, provides independent support through computer simulations, modelling, expert workshops, and state-of-the-art laboratories. The responsibilities include the implementation of the European Platform on LCA, which is developing the Reference European Life Cycle Data System (ELCD) and associated Technical Guidance Documents. The team has successfully conducted a series of international workshops and carried out pilot studies with Member States in relation to Life Cycle Thinking and Waste Management. Activities now include the development of European Life-Cycle Guidelines for Waste Management, and the broader development of Life Cycle-based Sustainability Indicators.     

Is the Current Fine Particulate Standard Protective of Public Health?

The new annual PM_2.5 standard will be the most difficult particulate matter (PM) standard to satisfy. At issue is whether the extant health evidence supports the rationale for this standard being the controlling standard. Indeed the key issue is whether this standard will result in the most cost-effective way to protect public health. This paper examines the health literature and concludes that the evidence for the annual PM_2.5 standard is weak. The bulk of the health evidence is related to daily exposures to PM₁₀ and larger particle sizes, and there is no rational way to decide upon the correct level for this standard. It is unclear whether the most restrictive PM_2.5 standard will be protective of public health. Clearly research is needed to determine the correct PM metric, averaging time, and level for a standard. To date such research has been limited.     

Effect of User Charges on Secondary Level Surgical Care Utilization and Out-of-Pocket Expenditures in Haryana State,India

BackgroundGeneration of resources for providing health care services is an important issue in developing countries. User charges in the form of Surgical Package Program (SPP) were introduced in all district hospitals of Haryana to address this problem. We evaluate the effect of this SPP program on surgical care utilization and out-of-pocket (OOP) expenditures.MethodsData on 25437 surgeries, from July 2006 to June 2013 in 3 districts of Haryana state, was analyzed using interrupted time series analysis to assess the impact of SPP on utilization of services. Adjustment was made for presence of any autocorrelation and seasonality effects. A cross sectional survey was undertaken among 180 patients in District hospital, Panchkula during June 2013 to assess the extent of out of pocket (OOP) expenditure incurred, financial risk protection and methods to cope with OOP expenditure. Catastrophic health expenditure, estimated as any expenditure in excess of 10% of the household consumption expenditure, was used to assess the extent of financial risk protection.ResultsUser charges had a negative effect on the number of surgeries in public sector district hospitals in all the 3 districts. The mean out-of-pocket expenditure incurred by the patients was Rs.4564 (USD 74.6). The prevalence of catastrophic expenditure was 5.6%. A higher proportion among the poorest 20% population coped through borrowing money (47.2%), while majority (86.1%) of those belonging to richest quintile paid from their monthly income or savings, or had insurance.ConclusionThere is a need to increase the public financing for curative services and it should be based on the needs of population. Any form of user charge in public sector hospitals should be removed.     

华东某省三级公立医院员工薪酬现状调查

目的 分析华东某省三级公立医院薪酬结构和薪酬水平并提出合理化建议,为公立医院薪酬制度改革和补偿机制改革提供决策依据。方法 以某省58家三级公立医院为研究对象,运用描述性分析、t检验和方差分析等方法,对薪酬结构和薪酬水平进行统计分析。结果 财政补助收入仅占总收入的4%;薪酬支出占总支出的26.6%,无地域差异;医务员工年人均收入9.47万元,存在地域差异;医务员工薪酬水平是非私营单位在岗职工的1.76倍。结论 政府应加大对公立医院的财政补助力度,放宽对医疗行业薪酬总量管控,提升医务员工薪酬水平和社会薪酬地位;公立医院迫切需要建立一套科学、合理的薪酬分配体系。     

Protocols,Toolboxes and Resource papers

In the August 2009 issue of Autophagy, I indicated that we were launching a new category of article, Protocols. At that time, I noted that we would ultimately be placing these articles on a new site online. Well, that time has finally arrived (see www.landesbioscience.com/journals/autophagy/protocols/ for links to these papers). Therefore, it seems appropriate for me to briefly distinguish among three types of community-oriented papers, Protocol, Toolbox and Resource.     

公立医院薪酬分配体系现状调查与分析

目的 了解公立医院薪酬体系的现状与存在的主要问题,为构建以战略为导向的薪酬体系提供依据。方法 采用问卷调查法获得公立医院薪酬管理的基本数据,运用统计描述法对问卷进行分析。结果 现行公立医院的薪酬体系未与医院战略有效结合,与外部环境相脱节,现行薪酬体系缺乏公平性与科学性,不同岗位层级薪酬差距不大,无法形成具有竞争力的薪酬体系。结论 现行薪酬体系同医院的战略相脱节,未能有效体现医院战略。     

CoordConv-Unet: Investigating CoordConv for Organ Segmentation

ObjectivesConvolutional neural networks (CNNs) have established state-of-the-art performance in computer vision tasks such as object detection and segmentation. One of the major remaining challenges concerns their ability to capture consistent spatial and anatomically plausible attributes in medical image segmentation. To address this issue, many works advocate to integrate prior information at the level of the loss function. However, prior-based losses often suffer from local solutions and training instability. The CoordConv layers are extensions of convolutional neural network wherein convolution is conditioned on spatial coordinates. The objective of this paper is to investigate CoordConv as a proficient substitute to convolutional layers for medical image segmentation tasks when trained under prior-based losses.MethodsThis work introduces CoordConv-Unet which is a novel structure that can be used to accommodate training under anatomical prior losses. The proposed architecture demonstrates a dual role relative to prior constrained CNN learning: it either demonstrates a regularizing role that stabilizes learning while maintaining system performance, or improves system performance by allowing the learning to be more stable and to evade local minima.ResultsTo validate the performance of the proposed model, experiments are conducted on two well-known public datasets from the Decathlon challenge: a mono-modal MRI dataset dedicated to segmentation of the left atrium, and a CT image dataset whose objective is to segment the spleen, an organ characterized with varying size and mild convexity issues.ConclusionResults show that, despite the inadequacy of CoordConv when trained with the regular dice baseline loss, the proposed CoordConv-Unet structure can improve significantly model performance when trained under anatomically constrained prior losses.     

县级公立医院薪酬水平感知及满意度影响因素分析

目的 探讨县级公立医院薪酬水平感知和满意度的影响因素。方法 采用调查问卷对县级公立医院员工进行现场调查,利用SPSS 19.0软件对数据进行Logistic回归分析。结果 Logistic回归分析发现,员工薪酬水平感知受到个体的工作年限、岗位类别、职称、是否在编、每周工作时间和医院的级别6个因素的影响。薪酬水平满意度受到个体的工作年限、科室类别、每周工作时间和医院级别4个因素的影响。结论 县级公立医院员工薪酬水平感知和满意度偏低。完善员工的职称晋升机制,完善薪酬设计,建立向临床一线超负荷工作者倾斜、体现岗位价值的薪酬政策,实现同工同酬是提高员工薪酬水平感知和满意度的可行选择。     

综合性三级医院公益性评价的灰关联聚类分析

摘要 目的 对不同地区的7家综合性三级医院进行公益性水平的初步评价与分析。方法 运用灰关联聚类分析。 结果 7家三级医院的公益性水平总体偏低,仅各有一家医院经灰关联聚类分析归类为好与中,其余5家医院均归类为欠佳,不同地区三级医院公益性水平有一定差别。结论 灰关联聚类分析证明公立三级综合性医院公益性水平亟待加强,应从公益性的影响因素入手提高与改善公立三级医院的公益性水平。     

An Update on the Louisiana and Texas Rigs-to-Reefs Programs in the Gulf of Mexico

Abstract

The Louisiana and Texas Rigs-to-Reefs programs enjoy widespread public, industry, and government support and have become models for similar programs around the world. Louisiana’s Rigs-to-Reefs program is the largest in the world, and since its inception in 1986 about 363 oil and gas platforms have been donated, or on average about 12 structures per year. Texas’s Rigs-to-Reefs program started in 1990, and since this time about 154 structures have been donated, or about six structures per year. A summary update of the Louisiana and Texas reef programs is provided, along with recent changes in legislative activity. Donation trends and statistics are reviewed. The Rigs-to-Reefs programs are unlikely to see donation activity above historic levels, and both programs should start planning for a future where the income generated from future projects diminishes.     

Public and healthcare providers awareness of Coronavirus (COVID-19) in Qassim Region,Saudi Arabia

BackgroundThe rapid and extensive spread of the COVID-19 pandemic has become a major cause of concern for both general public and healthcare profession.ObjectiveThe aim of this study is to analyze and evaluate the awareness of both the general public and healthcare providers in Qassim region in Saudi Arabia.MethodA cross-sectional study was conducted randomly in different shopping malls in Qassim region from 10th of February to 10th of March 2020. All participants have answered the designed questionnaire. The structured questionnaire recorded demographics and awareness of both public participants as well as health care providers.ResultA total of 130 participants have answered the designed questionnaire, out of which 67participants were males (58.5%) and 54 were females (41.5%). Overall, 129 (99%) out of the 130 participants are aware of COVID-19, and 116 (90%) have recognize it as a respiratory disease and 100% of the participants have recognized it as a contagious disease. Around 94% of the participants were able to recognize the correct incubation period of the virus. Participants of the age group 20–40 showed higher awareness level than other age groups (P value = 0.005). In addition, government employees showed higher awareness level than other profession groups (P = 0.039). Results showed significant positive correlation between the recognition of high-risk groups, reliable source of information, infection symptoms, disease prevention and available treatments.ConclusionGeneral public and health care professionals from Qassim Region showed adequate awareness of COVID-19. However, there is a strong need to implement periodic educational interventions and training programs on infection control practices for COVID-19 across all healthcare professions.     

Newspaper Portrayals,Local Policies,and Dog-Supportive Public Space: Who's Wagging Whom?

ABSTRACT

Dog-walking promotes physical activity and positive social interactions, and thus dog-walking has implications for people's physical and mental health. As a result, experts in public health have endorsed designing and managing public space to support dog-walking. Nevertheless, the presence of dogs in public space is subject to negotiation and can be controversial. Generally, municipal governments or local councils exercise political jurisdiction over both dogs and public space. As a case study, we systematically collected and analyzed a local newspaper's portrayals of issues relating to dog-walking in public space. Our purpose was to understand how public and policy agendas were being represented by local media, during a period of time when local policies on dog ownership and dog-supportive public space were being reviewed and revised. The analysis involved three phases: 1) thematic content analysis; 2) issue framing analysis; and 3) policy analysis. Thematically, we found that social conflict predominated. In terms of issue framing, local policy and individual dog owner behavior were both problematized. Over time, the policy agenda evolved to emphasize the design and management of public space, especially park land. Policy-makers presented this emphasis on public space as a proactive strategy to reduce social conflict and to promote compliance with existing rules on dog ownership. When it comes to promoting dog-walking to benefit animal welfare and human health, our findings underscore the importance of paying close attention to local policies and media coverage. In fact, we found that endogenous conflict and public controversies can actually represent significant opportunities to bring about positive changes in the lives of humans and nonhuman animals.     

公立医院外部绩效评价的执行路径研究

目的 探索公立医院外部绩效评价在公立医院的有效执行路径。方法 访谈公立医院管理人员,调研不同执行情况的北京市属公立医院进行案例分析;构建公立医院外部绩效评价政策执行的分析框架;对公立医院外部绩效评价政策资料和研究文献进行分析。结果 构建公立医院外部绩效评价政策在公立医院的四种执行模式,归纳外部绩效评价执行的院科两级影响因素。结论 政府主管部门、公立医院、部门科室三层级的绩效评价融合是推进公立医院外部绩效评价政策在公立医院内有效执行的路径选择。