张家港市新型农村合作医疗门诊统筹运行研究

实行门诊统筹是增强新型农村合作医疗制度吸引力的重要政策导向。文章通过对张家港市2007～2009年新型农村合作医疗制度门诊统筹运行情况的分析,提出进一步推进门诊统筹制度持续稳定运行的建议,同时也为其他地区遇类似情况时提供一定的参考。     

热矿泥疗法对2型糖尿病治疗作用的临床研究

目的探讨热矿泥治疗糖尿病的有效性和安全性。方法64例糖尿病患者随机分为治疗组和对照组,每组各32例。治疗组在原来饮食及运动治疗的基础上予以热矿泥疗法,1次/d,每次15min,15次为一个疗程。对照组仅予以原来饮食及运动治疗。结果治疗后,两组患者的血糖及糖化血红蛋白均有改善,差异有显著性意义（P〈0.05）。治疗后治疗组患者的体重指数降低,与对照组比较,差异有显著性意义（P〈0.05）。治疗过程中,无明显的副反应发生,仅仅在治疗组出现5例皮肤局部红斑,经过调低泥温后,均能坚持完成治疗。结论热矿泥疗法是治疗糖尿病的一种有效的、安全的、简单的物理治疗方法。     

Applying national survey results for strategic planning and program improvement: The National Diabetes Education Program

Since the 1970s, the federal government has spearheaded major national education programs to reduce the burden of chronic diseases in the United States. These prevention and disease management programs communicate critical information to the public, those affected by the disease, and health care providers. The National Diabetes Education Program (NDEP), the leading federal program on diabetes sponsored by the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC), uses primary and secondary quantitative data and qualitative audience research to guide program planning and evaluation. Since 2006, the NDEP has filled the gaps in existing quantitative data sources by conducting its own population-based survey, the NDEP National Diabetes Survey (NNDS). The NNDS is conducted every 2–3 years and tracks changes in knowledge, attitudes and practice indicators in key target audiences. This article describes how the NDEP has used the NNDS as a key component of its evaluation framework and how it applies the survey results for strategic planning and program improvement. The NDEP's use of the NNDS illustrates how a program evaluation framework that includes periodic population-based surveys can serve as an evaluation model for similar national health education programs.     

Active transportation to support diabetes prevention: Expanding school health promotion programming in an Indigenous community

BackgroundSchool-based physical activity (PA) interventions, including school active transportation (AT), provide opportunities to increase daily PA levels, improves fitness, and reduces risk of diseases, such as type 2 diabetes. Based on a community-identified need, the Kahnawake Schools Diabetes Prevention Project, within an Indigenous community, undertook school travel planning to contribute to PA programming for two elementary schools.MethodsUsing community-based participatory research, the Active & Safe Routes to School’s School Travel Planning (STP) process was undertaken in two schools with an STP-Committee comprised of community stakeholders and researchers. STP activities were adapted for local context including: school profile form, family survey, in-class travel survey, pedestrian-traffic observations, walkability checklist, and student mapping.ResultsSTP data were jointly collected, analyzed and interpreted by researchers and community. Traffic-pedestrian observations, walkability and parent surveys identified key pedestrian-traffic locations, helped develop safe/direct routes, and traffic calming strategies. In-class travel and mapping surveys identified a need and student desire to increase school AT. The STP-Committee translated findings into STP-action plans for two schools, which were implemented in 2014–2015 school year.ConclusionsCombining CBPR with STP merges community and researcher expertise. This project offered evidence-informed practice for active living promotions. Experience and findings could benefit Indigenous and non-Indigenous communities.     

基于药学人员视角对南京市三级医院门诊药学服务的研究

对南京地区的三级医院进行随机抽样．通过现场问卷调查以了解药学人员对门诊药学服务的认知及其工作现状。调查获知,门诊药学人员对药学服务理念已有一定认识,但受各种因素的影响,目前门诊药学工作仍以保障、供应药物为主。鉴于此,政府部门、医疗机构以及医、药、患各方应给予大力支持与配合,尤其是药学人员,需要不断提高自身素质,以便更好地为不同群体提供药学专业服务。     

留学生内科临床实践中的双语教学

医学留学生教育规模在我国呈现出不断扩大的趋势,提高教学质量成为摆在我们面前的重要课题.立足于内科临床教学,以优化教学模式为出发点,多种教学方法的灵活运用,实行双语教学,对临床实践的相关课程大胆地探索和尝试,具有一定的现实意义.     

Should Persons with Diabetes Be Licensed to Drive Trucks?—Risk Management

How should a regulatory agency interpret a risk analysis that concludes there is a small increase in risk? The agency must decide on behalf of society whether the increased risk is large enough to justify banning the risky activity or taking some other step to lessen the risks. In a companion paper (Songer et al.), we conclude that licensing insulin using persons to drive commercial motor vehicles in interstate commerce would result in 42 additional crashes each year. Here we address risk management issues by interpreting the number of additional crashes and the relative risks of the prospective handicapped drivers. Are the number of additional crashes (42) significant? Is the increase in the annual crash risk (from 0.00785 to 0.032 for non-insulin dependent and 0.048 for insulin dependent persons) significant? Are the relative risks significant for all insulin using drivers (4.7)? For drivers with a history of severe hypoglycemic reactions (19.8)? How should society tradeoff risk increases for increases in opportunity for these handicapped persons? We review other social decisions concerning highway safety: Accepting the increasing risks of letting 16 year olds drive, allowing extremely light cars, allowing some unsafe highways, and allowing extremely unsafe driving conditions at some times of day. We conclude that the additional risks from insulin using persons are well within the current accepted range of risks. Currently, 70% of states permit insulin using persons to drive trucks within their state. Nonetheless, the social cost, due to fatalities, injuries, and property damage from allowing a person with a history of severe hypoglycemic reactions to drive is more than $19,700 per year.     

312经络锻炼法对中老年糖尿病患者疗效追踪观察及相关机理研究

目的探讨312经络锻炼法对糖尿病患者的近、中、远期疗效及相关机理。方法1996年6月至2005年9月对北京炎黄经络研究中心学习班糖尿病患者347例,进行教、学、练、督导312经络锻炼法(以下简称"312"),定期随访临床疗效。并对其中29～39期班糖尿病志愿者及资料完整者86例进行较严格地科研观察。自身对照分组,312前为对照组,312后为试验组。于312前、及后1、6个月～1年、≥2年,定期分别追踪其症状、血压、血糖、用药、疗效等指标变化、分析、总结。结果①血糖资料、数据完整的86例糖尿病学员患者,其空腹血糖、餐后血糖于312后1个月、6～12个月、≥2～5年与312前比较,各均有显著性差异,P<0.01(表3、图1)。②临床效果、症状、其他指标,用药等亦相应地有所好转。312后1个月、6～12个月、≥2年的显效率逐渐缓慢递增,各分别为21%、23%、24%;总有效率各为93%、91%、93%;无效率各分别为7%、9%、7%。(表5、图2)。结论312防治糖尿病的特点:自治、全治、根治。长期坚持312,对糖尿病及其合并症、伴随疾病均具有显著效果。     

Prevalence of the metabolic syndrome and its relationship with diabetes mellitus by aging

Abstract

Introduction.?It is important to make a prompt diagnosis of metabolic syndrome (MetS) in order to prevent the development of cardio-/cerebro- vascular diseases and diabetes mellitus (DM). The authors estimated the risk of development of DM by the presence/absence of MetS and age groups.

Methods.?A cross-sectional study of subjects undergoing intensive health examination was conducted (3149 men aged 30–69 years). Diagnosis of MetS was based on the criteria of the National Cholesterol Education Program Expert Panel (NCEP).

Results.?The prevalence of DM occurring in association with MetS increased with age; it was 11.9% in subjects with MetS in their 30s, it was 19.8% in subjects with MetS in their 60s. The prevalence of DM among subjects who had one or two components of MetS also increased with age. There was a significant progressive increase of the odds ratio in subjects in their 30s, 40s, 50s and 60s who were judged as having MetS; significant increase of the odds ratio was seen in subjects in their 60s, even in those who were not judged as having MetS.

Conclusions.?Subjects with MetS show a high prevalence of DM, and the prevalence increased with age in the subjects.     

生物公民的塑造:以北京的糖尿病人为例

文章介绍了"生物公民"的理论及发展趋势,讨论了本概念对阐释北京的糖尿病人的情况的作用。生物医学的糖尿病疗法主要取决于教育病人使用一套复杂的自我监督和自我管理方法,而文章描述了这样一套全球一致的疗法如何被地方化并认同及其社会组织的基础。生物公民理论描写的认同和社会组织进程在糖尿病人的领域显然也存在,但是教育并组织糖尿病人的主要驱动力来自药物公司和病人自己,而国家扮演的角色并不重要。因此文章建议用一个相关的概念——生物社会性,作为出发点去了解诸如糖尿病的生物差异在地方性的场合如何被赋予意义,如何成为社会实践。