The genetic polymorphism of Plasmodium vivax genes in endemic regions of Thailand

Objective:To investigate the genetic polymorphism of Plasmodium vivax(P.vivax) PvCSP and PvMSP1 genes from field isolates at four endemic regions(North,East,West and South) of Thailand.Methods:The 152 P.vivax injected cases from dried blood spots were DMA extracted and confirmed by species-specific primer sets using multiplex PCR method.PvMSPI fragments F2 and F3:PvCSP were gcnotvped using RFLP-PCR method.Resuits:Totally amplified DNA which was multiple genotypes for PvMSP1 F2 and PvMSP1 F3 were 12.50%and 8.55%.respectively while PvCSP was 3.95%.The overall frequency of multiple genotypes was 25%.There were 12 allele tvpes of PvMSP1 F2 using AluI enzyme digestion and 8 size variations were found in P\MSP1 F3.The isolates from western region was highly genetic diverse when compare among all isolates.The predominant variant type of PvCSP gene was \ K2I0 type.Conclusions:The niulliple genotypes are common found in Thailand and it might hide the real genotype.PvCSP does not have extensive genetic diversity in this study.However.PvMSPI marker due to multiple genotypes is difficult In be analyzed.The multiple genotypes findings might stem from population migration and vector species findings.

Bibliometric analysis of research on the effects of human immunodeficiency virus in orthopaedic and trauma surgery

BACKGROUND There is little research investigating how human immunodeficiency virus(HIV)affects outcomes in orthopaedic surgery.With advances in treatment,HIV has become a chronic health problem and the chance of orthopaedic surgeons encountering it in clinical practice is increasing.AIM To ascertain the quantity and quality of peer-reviewed publications in orthopaedic journals about HIV.METHODS A search of the Web of Science database was carried out,identifying any articles relating to HIV published in orthopaedic journals.These were assessed for geographic origin and level of evidence.RESULTS Of 48.7%of orthopaedic journals listed on the Web of Science database had published articles relating to HIV.There were 168 articles about HIV in orthopaedic journals with only 40.5%(n=68)published in the time frame we analysed(January 2007 to September 2017).Very few articles came from lowincome countries and any articles published from that setting were collaborations.All of the articles were low level of evidence.CONCLUSION There is a need for more high level orthopaedic and trauma research investigating the effects of HIV,particularly research from low-income countries,where higher level research will help to guide improvements in their treatment of its musculoskeletal manifestations and complications.

Proteomics analysis of antimalarial targets of Garcinia mangostana Linn.

Objective:To investigate possible protein targets for antimalarial activity of Garcina mangostana Linn.(G.mangostana)(pericarp)in 3D7 Plasmodium falciparum clone using 2-dimensional electrophoresis and liquid chromatography mass-spectrometry(LC/MS/MS).Methods:3D7 Plasmodium falciparum was exposed to the crude ethanolic extract of G.mangostana Linn.(pericarp)at the concentrations of 12μg/mL(1C_(50)level:concentration that inhibits parasite growth by 50%)and 30μg/mL(1C_(90)level:concentration that inhibits parasite growth by 90%)for 12 h.Parasite proteins were separated by 2-dimensional electrophoresis and identified by LC/MS/MS.Results:At the IC_(50)concentration,about 82%of the expressed parasite proteins were matched with the control(non-exposed),while at the IC_(90)concentration,only 15%matched proteins were found.The selected protein spots from parasite exposed to the plant extract at the concentration of 12μg/mL were identified as eneymes that play role in glycolysis pathway,i.e.,phosphoglyeerate mutase putative,L-lactate dehydrogenase/glyceraldehyde-3-phosphate dehydrogenase,and fruetose-bisphosphate aldolase/phosphoglyeerate kinase.The proteosome was found in parasite exposed to 30μg/mL of the extract.Conclusions:Results suggest that proteins involved in the glycolysis pathway may be the targets for antimalarial activity of G.mangostana Linn.(pericarp).

Effectiveness of intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine: An in silico pharmacological model

Objective:To explore the efficacy of intermittent preventive treatment in pregnancy(IPTp)with sulfadoxine and pyrimethamine(SP)against sensitive parasites.Methods:A pharmacological model was used to investigate the effectiveness of the previous recommended at least two-dose regimen,currently recommended three-dose regimen and 4,6,8-weekly regimens with specific focus on the impact of various nonadherence patterns in multiple transmission settings.Results:The effectiveness of the recommended three-dose regimen is high in all the transmission intensities,i.e.>99%,98%and 92%in low,moderate and high transmission intensities respectively.The simulated 4 and 6 weekly IPTp-SP regimens were able to prevent new infections with sensitive parasites in almost all women(>99%)regardless of transmission intensity.However,8 weekly interval dose schedules were found to have 71%and 86%protective efficacies in high and moderate transmission areas,respectively.It highlights that patients are particularly vulnerable to acquiring new infections if IPTp-SP doses are missed.Conclusions:The pharmacological model predicts that full adherence to the currently recommended three-dose regimen should provide almost complete protection from malaria infection in moderate and high transmission regions.However,it also highlights that patients are particularly vulnerable to acquiring new infections if IPTp doses are spaced too widely or if doses are missed.Adherence to the recommended IPTp-SP schedules is recommended.

Increasing Detection and Confirmation of Tuberculosis in Children in Southern Ethiopia: Pooled Samples Tested Using Microscopy and Xpert

Background: Childhood tuberculosis accounts for about 10% of estimated TB cases in the world. Despite advances in diagnostics, childhood TB remains a challenge. We evaluated pooling method and testing with GeneXpert MTB/RIF in southern Ethiopia. Methods: This is a cross-sectional study in presumptive TB children st, 2nd and pooled samples. Results: Of 340 presumptive TB cases enrolled, 96 and 244 children submitted gastric aspirate and sputum samples respectively. Of 1020 samples collected (282 gastric aspirate and 738 sputum samples), 38 (3.7%) were positive by Xpert (10 (3.5%) from gastric aspirate and 28 (3.8%) from sputum sample). Similarly, 8 (1.2%) of sputum samples were positive by ZN but none from gastric aspirate. Of 244 children who submitted sputum samples, 3 (1.2%) were bacteriologically positive compared to 12 (4.9%) by Xpert. Of 96 children who submitted gastric aspirate samples, none were positive by ZN while 5 (5.2%) were positive by Xpert. Of bacteriologically confirmed TB cases 0.9% was by ZN and 4.7% by Xpert, an increase of 3.8%. Pooled testing increased positivity by 0.3% for ZN and 1.5% by Xpert compared to the 1st sample. Conclusions: Xpert MTB/RIF testing increases yield compared to ZN testing for gastric aspirate samples. The same-day approach and pooling samples improves efficient use of cartridge, reduce the number of visits for seeking diagnosis and save resources.

Debunking the myths perpetuating low implementation of isoniazid preventive therapy amongst human immunodeficiency virus-infected persons

Isoniazid preventive therapy(IPT) is the administration of isoniazid(INH) to people with latent tuberculosis(TB) infection(LTBI) to prevent progression to active TB disease. Despite being life-saving for human immunodeficiency virus(HIV)-infected persons who do not have active TB, IPT is poorly implemented globally due to misconceptions shared by healthcare providers and policy makers. However, amongst HIV-infected patients especially those living in resource-limited settings with a high burden of TB, available evidence speaks for IPT: Among HIV-infected persons, active TB- the major contraindication to IPT, can be excluded with symptom screening; chest X-ray and tuberculin skin testing are unreliable and often lead to logistic delays resulting in increased numbers of people with LTBI progressing to active TB; the use of IPT has not been found to increase the risk of the development of INH mono-resistance; IPT is cost-effective and cheaper than the cost of treating cases of active TB that would develop without IPT; ART and IPT have an additive effect on the prevention of TB, and both are safe and beneficial even in children. In order to sustain the recorded gains from ART scale-up and to further reduce TB-related morbidity and mortality, more efforts are needed to scale-up IPT implementation globally.

A Cross-Sectional Study of the Causes, Effects and Management Strategies for Stress and Burnout among Nurses in the Fako Division, Cameroon

Introduction: Stress and burnout are a reality which nurses encounter and try to cope with especially in the Emergency Department (ED) so that they can provide optimal patient care. Nurses who work in ED are front line providers of immediate medical care needed to stabilize patients. With the known critical shortage of health workforce in Cameroon, nurses are overloaded with work and often experience stress and burnout. Aim: This study aimed at determining the causes, effects and management strategies of stress and burnout among nurses working in the ED in hospitals in the Fako Division, Cameroon. Methods: This study was a descriptive cross-sectional study. The sample consisted of seventy nurses from five different hospitals. A purposive sampling technique was used and data was analyzed using SPSS version 16.0. Data was collected using a structured questionnaire developed from the International Stress Management Scale. Results: The highest reported cause of stress in this study was heavy workload (12.88%) and the least was no experience in handling the challenges of the department. The leading reported effect of stress was the development of musculoskeletal disorders such as joint and back pain (16.48%) and the least effect was contemplating quitting the profession (5.99%). The major management strategy used was humour (8.27%), while the least was crying out stress to feel relieved (2.18%). Conclusion: The major cause of stress and burnout among nurses in our study setting was heavy workload, which mostly results in joint and back pain. Moreover, humour was the prime management strategy for stress and burnout among nurses in the emergency department in the study setting. Thus more nurses should be employed and the working conditions of nurses improved to reduce the workload in the study hospitals.

Evaluation of Efficacy of Insecticides and Long-Lasting Insecticidal Nets for Control of Culex quinquefasciatus Say Populations from Northern Nigeria

Information on Culex mosquitoes (vectors of filarial worm and viral encephalitis) from northern Nigeria is scanty, hindering evidence-based control. Here, two Culex populations (Kano and Kaduna) were characterized. Culex quinquefasciatus and Culex pipiens were found breeding in sympatry, with some hybrid individuals identified. Larval bioassays revealed high temephos resistance (LC50s = 1.34 mg/mL and 3.01 mg/mL for Kano and Kaduna, respectively). Larvae were more sensitive to α-cypermethrin (LC50s = 0.026 mg/mL and 0.067 mg/mL for Kano and Kaduna). WHO adult tube bioassays revealed high pyrethroid and DDT resistance, with mortalities of 44.01% ± 6.79%, 35.83% ± 12.58%, 29.69% ± 9.97% and 52.47% ± 4.34% for permethrin, deltamethrin, α-cypermethrin and DDT, respectively. Highest resistance was observed with bendiocarb (mortality = 13.58% ± 3.98%). High resistance was obtained with fenitrothion and malathion (mortalities = 21% ± 4.76% and 56.47% ± 8.67%, respectively), while a full susceptibility was observed with pirimiphos-methyl. Pre-exposure to piperonylbutoxide (PBO) significantly recovered α-cypermethrin susceptibility (mortality = 82% ± 5.16%, χ2 = 50.99, p < 0.0001), compared with the conventional bioassay (mortality = 32 ± 7.30). Mortalities of <20% were obtained in cone bioassays with Yorkool, DuraNet and PermaNet3.0 (side panels) nets, suggesting a loss of efficacy of conventional long-lasting insecticidal nets. However, mortalities of 99% and 86% were obtained in Kano and Kaduna populations using the roof of PermaNet3.0 (containing PBO and deltamethrin). Despite the high frequency of the 1014F VGSC knockdown resistance mutation allele (0.90), no correlation was observed between the 1014F kdr genotype and resistance phenotype. Sequencing of fragments of the acetylcholinesterase-1 gene detected no G119S mutation, in malathion-alive and malathion-dead females. These suggest a preeminent role of metabolic resistance in these Culex populations.

Enablers and Barriers to Respectful Maternity Care in Low and Middle-Income Countries: A Literature Review of Qualitative Research

Background: Low and Middle-Income Countries (LMIC) account for 94% of maternal deaths annually. Interventions to reduce these deaths include;access to Emergency Obstetric Care (EmOC) and Skilled Birth Attendant (SBA) at childbirth. However, evidence indicates increasing access to EmOC, and SBA only does not translate into positive maternal and newborn outcome due to disrespectful care faced by women during labour. World Health Organization (WHO) guidelines emphasize on positive birth experience through Respectful Maternity Care (RMC). Therefore, this review aims to explore enablers and barriers to respectful maternity care in low and middle-income countries. Methods: We conducted an exhaustive literature search for studies that reported on enablers and barriers to respectful maternity care. Qualitative studies done in low and middle-income countries, published in English Language from the year 2000 to June 2020 were included in this study. Articles were screened by two researchers for eligibility and critical appraisal skills programme checklist was used to appraise the quality. The themes and quotes from the studies were extracted and synthesized using thematic synthesis. Results: The search strategy generated 14,190 articles and 54 studies met the inclusion criteria. Two main themes: interpersonal relationship and support, and privacy and confidential care were reported as both enablers and barriers to respectful maternity care. Strategies to promote RMC were: health education to pregnant women on care expected during labour, good communication between maternity staff and women, capacity building of staff on RMC and staff motivation. Conclusion: Respectful maternity care plays a big role in promoting health-seeking behaviours among pregnant women. However, women experience barriers ranging from provider behaviour, work environment and health system challenges. Ensuring a dignified and respectful working environment could contribute to an increase in health seeking-behaviours and consequently reduction of maternal mortality.

Knowledge of Healthcare Workers Regarding Dengue and Chikungunya in Some Health Facilities of the City of Yaoundé(Cameroon) and Its Neighbourhood

Background: Good knowledge of diseases’ epidemiology, diagnostic methods and treatment schemes are critical for early detection and effective management of dengue and chikungunya outbreaks. Here, we assessed knowledge and practices regarding dengue and chikungunya among health care workers of some health facilities of Yaoundé and its surroundings. Methods: A descriptive cross-sectional study was conducted from January to August 2020 in 35 health facilities of Yaoundé and its surroundings. Structured pre-tested questionnaire including 11 questions was used to assess healthcare workers’ (i) knowledge on dengue and chikungunya (pathogen, mode of transmission, signs and symptoms) and, (ii) management practices (diagnosis, prevention and treatment measures). Face to face interviews were conducted with healthcare workers including medical doctors, nurses, medical assistants and laboratory assistants. Findings: A total of 232 healthcare workers were interviewed. Despite that 40.95% (n = 95) of respondents had heard about dengue and chikungunya, only 4.74% (n = 11) of them were aware of the fact that both diseases are caused by virus. Also, 9 out of 232 (3.88%) knew that these diseases were transmitted by the bite of an Aedes mosquito. About 15.52% (n = 36) were able to give at least 1 clinical symptom related to dengue and chikungunya. The main diagnostic method they knew was Polymerase Chain Reaction (3.02%;n = 7). For prevention, many participants indicated vector control by using insecticide treated bednets or destroying potential breeding sites (14.23%;n = 33). Only few participants 3.88% (n = 9) knew how to manage dengue or chikungunya cases. To improve the management of both diseases, a significant proportion of healthcare workers (37.93%;n = 88) reported being in need of additional training. Conclusion: The poor knowledge regarding dengue and chikungunya among healthcare workers in Yaoundé and its neighbourhood raises the need to intensify sensitization campaigns and training activities towards this personnel.

<i>Anopheles leesoni</i>Evans 1931, a Member of the <i>Anopheles funestus</i>Group, Is a Potential Malaria Vector in Cameroon

Background: Understanding the biology of Anopheles malaria vector species is essential to planning effective and sustainable malaria control strategies in endemic countries. This study reported the implication of Anopheles leesoni in malaria transmission in Cameroon, Central Africa. Methods: Mosquitoes were collected in three localities from May 2015 to March 2018 using electric aspirators and Centers for Disease Control light traps (CDC-LT). Anopheles funestus sensu lato (s.l.) mosquitoes were identified as species using polymerase chain reaction assay (PCR). Furthermore, Plasmodium falciparum infection status was determined using the enzyme-linked immunosorbent assay (ELISA) method. Results: A total of 12,744 Anopheles mosquitoes were collected by electric aspirator (N = 4844) and CDC-LT (N = 7900). Anopheles funestus s.l. (86.95%) was the major species and the main malaria vector in rural savannah and rural forest sites followed by A. gambiae s.l. (13.05%) whereas in urban areas, A. gambiae s.l. was by far the most abundant representing 91.45% of Anopheles mosquitoes collected. Two members of the A. funestus group were identified among 1389 analysed by PCR: 1307 A. funestus sensu stricto (s.s.) (94.10%) and 82 A. leesoni (5.9%). Plasmodium falciparum infection rate was 21.04% in A. funestus s.s. For the first time, A. leesoni was found positive for P. falciparum (infection rate: 10.98%) in Cameroon. Conclusion: A very high P. falciparum infection rate was observed in this study in A. funestus s.s., highlighting its high implication in malaria transmission in Cameroon. Furthermore, the detection of P. falciparum infection in A. leesoni calls for more attention towards this neglected vector species.

Efficacy of the Microbial Larvicide VectoMax^®G against <i>Anopheles gambiae</i>s.l. and <i>Culex</i>spp. Larvae under Laboratory and Open Field Trial Experiments in the City of Yaoundé, Cameroon

Background: With the rapid expansion of insecticide resistance limiting the effectiveness of insecticide-based vector control interventions, integrated control strategies associating larviciding could be appropriate to improve current control efforts. The present experimental study assesses laboratory and field efficacy of the larvicide VectoMax®G on Anopheline and Culicine larval stages in Yaoundé. Methods: The effect of the larvicide VectoMax®G, a combination of Bacillus thuringiensis var. israelensis (Bti) and Bacillus sphaericus (Bs), on larval development was assessed during both laboratory and open field trial experiments. Laboratory experiments permitted the evaluation of five different concentrations with four replicates/experiments. Laboratory experiments were conducted with Anopheles coluzzii “Ngousso” and Culex quinquefasciatus laboratory strains. Open field trials were conducted using sixteen plastic containers with a diameter of 0.31 m buried in an array of four rows with 4 containers each. Distance between rows and between containers in a row was 1 meter. This experiment permitted to test the effect of the microbial larvicide VectoMax®G under operational application conditions on field mosquito populations. Results: The time to induce 100% mortality after exposure to serial concentrations of the larvicide varied according to the dose from 4 - 12 hours for An. coluzzii and 6 - 9 hours for Cx. quinquefasciatus in laboratory experiments. Measurements of the residual activity indicated that all VectoMax®G concentrations were still active after 35 days and killed 86% - 100% of larvae. Lethal dose of VectoMax®G killing 50% of larvae was estimated at 5.24 × 10-8 mg/m2 for An. coluzzii and 1.25 × 10-8 mg/m2 for Cx. quinquefasciatus. The lethal concentration inducing 95% mortality was estimated at 3.13 × 10-7 mg/m2 for An. coluzzii and 2.5 × 10-8 mg/m2 for Cx. quinquefasciatus. Open field trials tests indicated that sub-lethal concentrations of VectoMax®G successfully killed 100% An. gambiae s.l. larvae within 24 hours, while with Culex spp. larvae, 100% mortality was recorded after 48 hours post-treatment. Natural recolonization of water containers by larvae was recorded between 3 and 6 days respectively after the treatment with sublethal doses. Late instar larvae were recorded 5 and 6 days after treatment. When the jars were treated with reference dosage or supra doses of VectoMax®G, recolonization of water containers was observed six days after treatments. No pupae of both species were found 6 and 7 days post-treatment. Conclusions: The study indicated high efficacy of the microbial larvicide VectoMax®G against Anopheline and Culex larvae. Microbial larvicides such as VectoMax®G could be appropriate for controlling mosquito population particularly in areas experiencing high insecticide resistance or outdoor biting mosquitoes.

扩大脆弱人群健康保险覆盖率的策略:描述性系统评价

目的描述扩大脆弱人群健康保险覆盖率的策略及作者对实施这些策略的评价。方法由主题专家和检索人员讨论并试验后确定检索词,共检索28个电子数据库、12个卫生机构网站、3个灰色文献数据库和搜索引擎Google。纳入所有描述或评价已经实施的扩大脆弱人群健康保险覆盖率策略的文献。用预先设计的数据提取表收集文献内容和有关研究质量的信息,分析和描述提取信息。结果共纳入86篇文献,大多研究来自美国,主要研究人群是儿童。61篇描述策略,25篇评价策略。据卫生筹资机制理论分析,扩大健康保险的策略分为六类,即改变健康保险的入保资格、提高对健康保险的认知度、合理设置保险金水平、改进入保程序、改善卫生服务提供、改善保险的管理和组织。评价策略的研究大部分为回顾性纵向数据分析,仅有两篇为随机对照试验。评价研究的结论是所实施的策略对扩大保险覆盖有正面效应。结论美国等发达国家已实施大量策略用于扩大健康保险覆盖率,发展中国家实施的策略和相关研究均较少,发达国家实施的策略对发展中国家有一定的借鉴意义。纳入文献中有25篇评价策略效果的研究,可做进一步的系统评价,以考察策略对扩大健康保险覆盖率的效果。

新型农村合作医疗对灾难性卫生支出的影响研究

研究对2006年和2008年山东和宁夏两省(自治区)样本地区新农合补偿前后住院费用造成灾难性卫生支出发生率和灾难性卫生支出平均差距进行了分析。结果发现,新农合补偿在降低灾难性卫生支出发生率和灾难性卫生支出平均差距上起到了越来越明显的作用,但是从目前的整体补偿水平看,这种作用还是比较小的。

实行院长负责制的背景、内容及对人员表现的影响

研究院长负责制的实施北景、内容及对人员表现的影响。选择社会经济水平不同的B县(较富裕)和C县(较贫困)两个县进行调查,以召开专题小组讨论(focus group discussion)和知情者访谈(key informant interview)的定性调查方法为主,结合医院收支、诊疗等方面的定量数据进行分析。结果提示院长负责制受到院长、卫技人员的普遍拥护,调动院长与职工的工作积极性。实行院长负责制期间,两个县医院的医疗活动、经济创收、满意度与人员培训方面均有所改善。分析“放权”政策的局限性以及改善人员表现应采取的措施。讨论实行并完善院长负责制要正确处理扩大自主权和强化束约力的辩证关系和正确认识与理解新形势下的院长负责制等问题。

山东、宁夏农村居民住院卫生服务利用研究

文章对山东、宁夏农村居民2006和2008两年住院卫生服务利用的情况进行了分析。经多元logistic回归发现年龄、文化、职业、不同时间(2006和2008年)和地区(山东和宁夏)是影响农村居民住院服务利用的主要因素。通过住院费用的分析得出虽然新农合报销比例在逐年增加,但由于医疗费用的不断上涨,新农合并没有减轻农村居民住院的经济负担。

有机磷抗性致倦库蚊种群中酯酶基因扩增的定量分析

致倦库蚊Culexqinquefasciatus是丝虫病的主要传染媒介。通过生物测定、单个蚊虫酯酶α2和 β2基因拷贝数分析和酯酶 β基因序列比较 ,分析了抗性水平、抗性相关基因在种群中的分布及其基因拷贝数等的抗性分子特征。应用快速PCR仪(real timequantitativePCRs)直接检测库蚊中酯酶基因和mRNA拷贝数。结果显示 :上海致倦库蚊对对硫磷的抗性LC50 为8 12 ,酯酶活性升高是上海致倦库蚊种群对有机磷杀虫药剂产生抗性的主要机理。编码致倦库蚊酯酶 β的氨基酸序列同编码尖音库蚊酯酶B1的氨基酸序列相比同源性为 98% ;同致倦库蚊酯酶B2氨基酸序列相比同源性为 10 0 % ,同环蹶库蚊酯酶B3氨基酸序列相比同源性为 90 % ,上海致倦库蚊中酯酶α和 β基因均扩增。有机磷抗性的上海和PellRR蚊虫种群中单个蚊虫酯酶α2和β2定量基因拷贝数均不同 ,其同一蚊虫个体的酯酶α2比酯酶 β2基因的拷贝数高 ,但没有明显的规律性 ,酯酶结构基因的扩增是上海致倦库蚊种群对有机磷杀虫药剂抗性的主要机理 ,估计在野外种群的杂合个体中存在多种调控机制。

城市综合医疗机构对疑似肺结核病例诊断分析

目的探讨综合性医疗机构对肺结构病诊断延误的影响,为提高病人发现率提供参考。方法采用前瞻性队列研究与定性方法相结合,对在重庆市2个区选定的综合医疗机构就诊的结核疑似病人进行为期3个月的随访调查,并对医务人员和相关政策决策者进行个人深入访谈,以了解病人的就诊经历,分析卫生服务供方因素对结核病诊断的影响。结果49.2%的病人选择区级医院作为他们初次就诊单位;61.0%的病人被建议接受X光检查,19.1%的病人被建议进行痰检,仅4.9%的病人被建议转至结防所。定性研究支持定量的发现,医务人员对结核病控制策略了解甚少。结论综合医疗机构在结防控制工作中没有发挥应有的作用,结核控制策略在综合医疗单位中宣传不够,并缺乏与结防体系间的有效交流和合作。

新型农村合作医疗受益公平性研究

利用收入五分组法对调查的农村居民进行分组,利用集中指数、集中曲线等方法,从不同收入人群新农合覆盖率、卫生服务利用和新农合补偿三方面分析2006年和2008年新农合受益公平性的变化。结果显示:新农合使低收入人群潜在的卫生服务需要得到释放,新农合受益公平性得到改善。

10个卫生院卫生服务情况的8种方法综合评价结果

多指标综合评价方法极其常用.为了综合评价卫生管理"放权"政策对人员表现的影响,本文以10个卫生服务指标、多种(8种)综合评价法,对福建省小康的B县与较贫困的C县,共10个卫生院(B县的DX、HF、LM、SZ与JS卫生院;C县的XQ、GT、LF、WH与QX卫生院)的卫生服务状况,进行综合评价,结果如下.