Rebuilding and strengthening health systems and providing basic health services in fragile states

The international community has compelling humanitarian, political, security and economic reasons to engage in rebuilding and strengthening health systems in fragile states. Improvements in health services and systems help to strengthen civil society and to restore legitimacy to governments. Effective engagement with fragile states to inform the design of health programmes and selection of interventions depends on donor coordination and an understanding of health system challenges. Planning requires consideration of allocation (services to be delivered), production (organisation of services), distribution (beneficiaries of services) and financing. The criteria for selecting interventions are: their impact on major health problems; effectiveness; the possibility of scale-up; equity; and sustainability. There are various options for financing and models of engagement, but support should always combine short-term relief with longer-term development. Stakeholders should aim not only to save lives and protect health but also to bolster nations' ability to deliver good-quality services in the long run.     

Occupational Health Care in Small and Medium-Sized Enterprises—How Many Doctors Do We Need and How Do We Ensure Good Care?

The translation of the framework directive 89/391/EEC (Council Directive 89/391/EEC) into national law aims at supplying occupational protection and health care to all employees of large, small, and medium-sized enterprises (SMEs) likewise, depending on assessed exposure. Prior incomplete protection of the German workforce with bias against the SMEs requires an assessment of quantitative and qualitative adequacy of present occupational health care practice and also of future needs.

Therefore, the Federal Institute for Occupational Safety and Health of Germany initiated a study to evaluate the present state of occupational health care in 4 regions with different geographic and economic structure. Based on these data the future demand for adequately trained occupational physicians will be estimated by employing a statistical method that allows for including a large number of modifying variables (economic development, demographic change, etc.).

Expected result of the applied technique are the estimated minimal and maximal number of occupational physicians that have to be trained to meet future demand. In the same study models of best practice will be identified and evaluated for general application. The project started in October 1997 and will be finished by January 2000.     

The Relationship Between Psychosocial Work Factors,Work Stress and Computer-Related Musculoskeletal Discomforts Among Computer Users in Malaysia

We analyzed occupational exposure to potentially infectious body fluids among health care workers (HCWs). Nurses were the most common exposed category of HCWs. In 73.6% cases needle sticks had been the reason of exposure. Recapping a needle was the cause of exposure in 6.9% accidents. Among 189 registered HCWs, 66 (34.9%) performed invasive procedures without any personal protective equipment. Prophylaxis with antiretroviral drugs was necessary in 43 (22.8%) cases.

As many as 60.3% of exposure incidents to potentially infectious material result from non-compliance with the relevant recommendations. Continuous education and training is critically needed to prevent occupational exposure to blood-borne infections among health care workers.     

Pre- and post-hatch trophic egg production in the subsocial burrower bug, Canthophorus niveimarginatus (Heteroptera: Cydnidae)

In recent years, three terrestrial bugs, Adomerus triguttulus and Sehirus cinctus (Cydnidae) and the closely related Parastrachia japonensis (Parastrachiidae), have been the focus of several fascinating studies because of the remarkable, extensive parental care they were found to display. This care includes egg and nymph guarding, production of trophic eggs, unfertilized, low cost eggs that are used as food by newly hatched nymphs, and progressive provisioning of the host seed. In this study, we have investigated yet a third related Asian cydnid, Canthophorus niveimarginatus, with regard to the possible occurrence of some or all of these complex traits in order to assess how widespread these maternal investment patterns are in this group of insects and to better understand the implications of their manifestations from an evolutionary context. Manipulative experiments were carried out in the lab to determine whether females provision nests. Observational and egg removal studies were carried out to determine whether trophic eggs are produced, and, if they are, their possible impact on nymphal success. The findings revealed that C. niveimarginatus does, in fact, progressively provision young, and this species also displays all of the other behaviors associated with extended parental care in subsocial insects. Moreover, unlike the other two related species, which place trophic eggs on the surface of the original egg mass, C. niveimarginatus produces both pre- and post-hatch trophic eggs. Nymphs deprived of access to post-hatch trophic eggs had significantly lower body weight and survival rate than those that fed on them. To our knowledge, this is the first time the production of both pre- and post-hatch trophic eggs has been demonstrated in insects outside the Hymenoptera. In this paper, we qualitatively and quantitatively demonstrate the provisioning behavior and patterns of trophic egg production in C. niveimarginatus. When and how trophic eggs are produced and delivered to young should have important correlations with the ecological and life history constraints under which a species has evolved. Thus, we also discuss the possible ecological and life history factors that favor the evolution of post-hatch trophic eggs.     

长江流域下游水体中药品和个人护理品赋存、分布、溯源及风险评估研究进展

药品和个人护理品（PPCPs）作为一类新污染物,种类繁多,且广泛存在于自然水体中。长江流域下游地区由于人口稠密,产业发达,PPCPs对于水体的污染问题尤为突出。简述了2010—2021年长江流域下游水体中PPCPs的赋存状况、时空分布及溯源分析情况,并对PPCPs的生态环境风险评估研究进展进行总结,揭示了近10年来长江流域下游水体中PPCPs的污染状况及变化态势,提出了未来PPCPs监测、溯源和风险评估的发展趋势,以期为水环境中PPCPs污染物的预警和管控提供参考依据。     

疫情背景下长江中游地区典型饮用水源中PPCPs分布特征与风险评估

对新冠疫情（COVID-19）背景下长江中游武汉段的18个集中式饮用水源地共26个采样点进行水体样品采集.采用超高效液相色谱三重四极杆串联质谱（UPLC-MS/MS）对样品中的药品与个人护理品（PPCPs）的31种物质进行检测,分析了PPCPs的污染特征和生态与健康风险.结果表明,在26个采样点中,共检出23种PPCPs,其中有5种物质在所有点位均有检出,ΣPPCPs浓度范围介于102.44~745.78 ng·L^-1,平均值为206.87 ng·L^-1.检出污染物浓度最高的物质为水杨酸和强力霉素,浓度范围介于28.24~534.24 ng·L^-1和28.72~416.60 ng·L^-1.从空间分布来看,汉江抗生素类PPCPs浓度整体高于长江,而其他种类PPCPs,则表现为长江较高于汉江.生态风险评价结果表明,汉江的生态风险高于长江,藻类风险水平高于无脊椎动物和鱼类,其中水杨酸、强力霉素、林可霉素和金霉素对藻类风险水平较高.健康风险评价结果表明,饮水途径对成人及儿童产生的风险范围分别介于1.14×10^-4~1.36×10^-1和1.04×10^-4~8.21×10^-1,风险水平总体较低,但儿童健康风险高于成人,需要引起重视.通过与近年来长江和汉江流域PPCPs的检出情况对比,疫情背景下长江武汉段PPCPs的污染水平属于中等水平,汉江武汉段的PPCPs污染水平较高.     

某市再生水灌区水土环境中PPCPs污染特征分析

为初步了解再生水灌区土壤环境中药物与个人护理品（PPCPs）的污染特征,识别灌区地下水中PPCPs的主要来源,对某市东南郊Y灌区内的淸灌区、再生水灌区以及湿地三种类型的场地进行了精细剖面钻探工作,采集不同深度土壤、灌区地表水及成井地下水样品,分别对其进行了常规指标和15种PPCPs浓度的测试.结果表明,不同场地土壤中PPCPs含量分布存在差异,土壤剖面中PPCPs含量总体表现为再生水灌区 > 清灌区 > 湿地.土壤中PPCPs总浓度平均值为15.6μg/kg,主要以卡马西平CBZ、苯扎贝特BF、吉非罗齐GF、氯霉素CP、吲哚美辛IM为主.灌区地表水中PPCPs总含量明显高于地下水,总浓度平均值分别为272.5ng/L和63.5ng/L,且地表水中,PPCPs含量呈现沿程递减现象.利用Multi-cell基本原理并结合推流的概念刻画PPCPs从地表穿透土壤包气带进入地下水的垂向输移过程,计算结果显示除卡马西平CBZ、甲芬那酸MA和萘啶酸NA外,其余9种PPCPs计算值和地下水中的实测值吻合良好,初步证实再生水是灌区地下水中PPCPs的主要来源.     

胰十二指肠切除术患者的心理干预等个性化护理效果分析

目的:对胰十二指肠切除术抑郁症患者住院期间实施包括心理干预在内的个性化护理并评价其效果.方法:将我院2009年3月至2012年3月收治胰十二指肠切除术患者56例后随机分成对照组和干预组各28例,对照组接受常规护理,干预组住院期间接受心理干预在内的个性化护理.在入院当天、术前天和出院前1天对两组患者进行抑郁自评量表(SDS)并比较两组患者的SDS和分值,统计两组患者住院时间和并发症.结果:干预组患者SDS分值的降低幅度较对照组明显;差异有统计学意义(P<0.05)前者住院时间、并发症要少于后者,且满意率高.结论:心理干预等个性化护理能有效改善患者围手术期的抑郁情绪,减少并发症,有助于早期康复.表2,参10.     

Young convict cichlids use visual information to update olfactory homing cues

In this study, we tested the tendency of young cichlids to orient towards their parents using chemical cues. Convict cichlids have biparental defence of their free-swimming young. If young become separated from their family they must rejoin their family within minutes to have any chance of survival. Here, we used a dichotomous Y-maze to test if displaced convict cichlid young can use chemical cues to orient to their family. First, we showed that young preferentially orient toward water taken from their home tank versus blank water taken from a tank that contained no fish. Second, we showed that young prefer home tank water to water from a tank containing another family of convict cichlids. In a third experiment, we placed young convict cichlids in a small aquarium inserted within a larger aquarium. The large aquarium contained either their parents or no fish. The small insert aquarium contained blank water from a tank that had never contained fish. After 20 min in the insert tank, young convict cichlids were placed in the Y-maze and given a choice between either their home tank water or water from the insert tank. Convict cichlids that did not see their parents during the 20-min conditioning period oriented strongly toward chemical cues of their home tank water. Young that saw their parents during the 20-min conditioning period oriented strongly toward the chemical cues of the insert tank. These data indicate that young convict cichlids use visual cues to learn and reset the smell of “home” in less than 20 min.