Management and prevention of diabetes in primary health care in Amazonas / Ações de prevenção e controle de diabetes na atenção primária no Amazonas

Actions for the prevention and management of type 2 diabetes (T2DM PM) are priorities within primary health care, from the dispensing of specific medications to non-pharmacological actions, such as physical activity and nutrition. The aim of the study was to describe prevention and man-agement of type 2 diabetes actions and their components in primary health settings in the State of Amazonas, Brazil. An observational study based on RE-AIM framework. Preventions and manage-ments actions approach were described by 5 dimensions: (R) reach, (E) effectiveness, (A) adoption, (I) implementation, and (M) maintenance. Data was collected in Primary Health Care Units from 6 cities from Amazonas, Brazil. The questionnaires were addressed to managers regarding current T2DM PM programs and their development. This study identified 17 different types of diabetes prevention and/or management actions currently implemented. Eleven actions included both pre-vention and management actions with 53.8% focusing on physical activity and nutrition orientation. However, zero actions reported any form of evaluation measuring changes in physical activity and nutrition behavior, and actions reported collecting feedback from participants, providers, and health professionals' workers. A total of 310 health professionals participated in diabetes actions, including 4 physical educational professionals and 3 nutritionists, with 100% of the efforts coordinated by nurses. Actions were based on traditional health education practices such as lectures and did not have practical activities that help to change and maintain healthy habits. Despite this, primary care plays a fundamental role in caring for users with chronic illnesses in cities in the interior of Amazonas

Ações de prevenção e controle da diabetes do tipo 2 (T2DM) são prioridades dentro da atenção primária de saúde, desde a dispensação de medicações específicas, às ações não medicamentosas como atividade física e nutrição. O objetivo foi caracterizar ações de prevenção e manejo (PM) e seus componentes na atenção primária no Estado do Amazonas, Brasil. Estudo observacional baseado no modelo RE-AIM. Estratégias adotadas em ações de PM foram descritas pelas 5 dimensões: (R) Alcance, (E) Efetividade, (A) Adoção, (I) Implementação e (M) Manutenção. Dados foram coletados em Unidades Básicas de Saúde em 6 cidades do Amazonas, Brasil. Os questionários endereçados aos gestores visavam ações de PM e seu desenvolvimento. Este estudo identificou 17 diferentes tipos de ações. Onze ações contemplaram ambas as estratégias de PM com 53,8% focadas em atividade física e orientações nutricionais. No entanto, nenhuma ação relatou mensuração para avaliação de mudanças no nível de atividade física e no comportamento nutricional. As ações baseiam suas avaliações em coleta de feedback dos participantes, equipe executora e profissionais de saúde. Ao todo, 310 profissionais de saúde participaram de ações, incluindo 4 profissionais de educação física e 3 nutricionistas, sendo 100% dos esforços coordenados por enfermeiros. As ações de PM da T2DM são baseadas em práticas tradicionais de educação em saúde como palestras e não possuem atividades práticas que auxiliem na mudança e manutenção de comportamentos saudáveis. Apesar disso, a atenção primária exerce um papel fundamental no cuidado ao usuário portador de doença crônica em municípios do interior do Amazonas

Status of sub-health and its influencing factors in community health care workers in Hongkou District, Shanghai / 上海预防医学

Objective To determine the sub-health status and influencing factors among medical staff in community health service centers, and to provide scientific evidence for intervention measures and strategies of health promotion. Methods A questionnaire survey was conducted in 692 community medical staff from 8 community health service centers in Hongkou District, Shanghai.Sub-health condition scale was used to identify the incidence rate of sub-health.Simple job stress questionnaire was used to identify the incidence rate of occupational stress.The correlations between sub-health status and demographic and sociological factors, living habits, occupational stress and other factors were determined by multivariate logistic regression analysis. Results The incidence rate of sub-health among targeted community medical staff was 71.4%.The following factors were shown to be related to the incidence of sub-health: women (OR=2.24, 95%CI: 1.42-3.55), per capita living area ≤ 30 m2(OR=2.19, 95%CI: 1.24-3.87), daily average sleep time < 7 hours (OR=1.64, 95%CI: 1.10-2.46), habits of drinking alcohol (OR=1.58, 95%CI: 1.04-2.40), frequent overtime work (OR=1.79, 95%CI: 1.12-2.86) and occupational stress (OR=1.73, 95%CI: 1.16-2.58). Conclusion The incidence rate of sub-health among medical staff in community health service centers is high, and unhealthy living habits and occupational stress are the influencing factors.

Efficacy of community rehabilitation combined with drug therapy on patients with schizophrenia in rural communities / 四川精神卫生

ObjectiveTo study the efficacy of community rehabilitation combined with drug therapy on rehabilitation of patients with schizophrenia in rural communities， and to provide references for community rehabilitation of patients with schizophrenia in rural areas of our country. MethodA total of 81 patients in rural communities of three towns in Lanzhou new area who met the diagnostic criteria of International Classification of Diseases， tenth edition （ICD-10） were randomly divided into study group （n=39） and control group （n=42）. Both groups received general drug treatment. On this basis， the study group received community rehabilitation intervention for 6 months. Before and after intervention， Positive and Negative Syndrome Scale （PANSS）， Activity of Daily Living Scale （ADL）， Social Disability Screening Schedule （SDSS） and Schizophrenia Quality of Life Scale （SQLS） were used to assess the psychotic symptoms， social function and quality of life in two groups. ResultsAfter intervention， the PANSS total score ［（55.54±14.75） vs. （63.52±13.95）， t=-2.504， P=0.014］， negative symptom factor score ［（15.64±4.50） vs. （18.38±5.13）， t=-2.547， P=0.013］ and general psychopathological factor score ［（25.67±7.39） vs. （30.35±6.60）， t=-3.015， P=0.003］ of the study group were lower than those of the control group. The SDSS score ［（8.21±3.78） vs. （10.21±4.67）， t=-2.118， P=0.037］ and SQLS score ［（18.97±6.23） vs. （22.43±8.04）， t=2.150， P=0.035］ of the study group were lower than those of the control group. ConclusionCommunity rehabilitation combined with drug therapy may help alleviate psychotic symptoms， improve social function and improve quality of life in patients with schizophrenia in rural communities.

Perspectives on the Continuous Medication Monitoring Function of Pharmacies in the Community Health Care System: A Nationwide Survey in Japan / 日本補完代替医療学会誌

Objective: The objective of this study was to identify the perceived importance of various pharmacy functions among residents in the community health care system.Methods: We conducted an online survey of nationwide panelists enrolled by a research company to assess the perceived degree of importance of having a pharmacy that performs various functions in the community health care system (i.e., “comprehensive importance”).Results: “Comprehensive importance” was compared among 2,400 respondents disaggregated into several groups. The results revealed that “encouragement for medical consultations at medical institutions” had a strong effect on “comprehensive importance”.Conclusion: The results of this survey highlight the need for preventive medical care and a further expansion of the consultation function at pharmacies in the future.

Avaliação do serviço de coleta para exame colpocitológico pela escala SERVQUAL / Evaluación del servicio de recolección para examen colpocitológico por la escala SERVQUAL / Avaliação do serviço de coleta para exame colpocitológico pela escala SERVQUAL

ABSTRACT Objective: To analyze women's perception of the quality of the service provided for colposcopy test in the city of Belém (PA), Brazil. Method: Quantitative-descriptive study on 400 women who underwent Pap test on the public healthcare network, using the Service Quality (SERVQUAL) model. We used the Cronbach's alpha index to measure the reliability of the scale, and data were analyzed by quartiles of the gaps of the dimensions: tangibility, responsiveness, reliability, assurance, and empathy. Results: The assurance dimension, corresponding to the knowledge and courtesy of staff, featured the highest degree of importance to users; and empathy, which corresponds to the staff's concern with women's needs, featured the lower degree. The most expressive negative gaps concerned the structure of services and the attitude of healthcare professionals when collecting the material. Conclusion: All gaps featured negative relationship between what was expected and perceived, expressing dissatisfaction regarding the service.

RESUMEN Objetivo: Analizar la percepción de mujeres acerca de la calidad del servicio de colpocitología oncótica en Belém (PA). Método: Estudio cuantitativo-descriptivo con 400 mujeres que realizaron el examen de colpocitología oncótica en la red pública de salud, utilizando el modelo Service Quality (SERVQUAL). Se utilizó el Alpha de Cronbach para medir la confiabilidad de la escala, y los datos fueron analizados por los cuartiles de los gaps de las dimensiones: tangibilidad, responsividad, confiabilidad, credibilidad y empatía. Resultados: La dimensión credibilidad, correspondiente al conocimiento y a la cortesía de los funcionarios, presentó mayor grado de importancia para las usuarias; y la empatía, que corresponde a la preocupación demostrada por los funcionarios con las necesidades de las mujeres, exhibió menor grado. Los gaps negativos más expresivos se refieren a la estructura de los servicios y a la actitud de los profesionales con ocasión de la recolección del material. Conclusión: Todos los gaps presentaron relación negativa entre lo esperado y lo percibido expresando la insatisfacción con relación al servicio.

RESUMO Objetivo: Analisar a percepção de mulheres acerca da qualidade do serviço de colpocitologia oncótica em Belém (PA). Método: Estudo quantitativo-descritivo com 400 mulheres que realizaram o exame de colpocitologia oncótica na rede pública de saúde, utilizando o modelo Service Quality (SERVQUAL). Utilizou-se o Alpha de Cronbach para medir a confiabilidade da escala, e os dados foram analisados pelos quartis dos gaps das dimensões: tangibilidade, responsividade, confiabilidade, credibilidade e empatia. Resultados: A dimensão credibilidade, correspondente ao conhecimento e cortesia dos funcionários, apresentou maior grau de importância para as usuárias, e a empatia, que corresponde à preocupação demonstrada pelos funcionários com as necessidades das mulheres, exibiu menor grau. Os gaps negativos mais expressivos dizem respeito à estrutura dos serviços e a atitude dos profissionais por ocasião da coleta de material. Conclusão: Todos os gaps apresentaram relação negativa entre o esperado e o percebido expressando a insatisfação em relação ao serviço.

A field survey on provision of health care service in a community clinic of Bangladesh: a case study of Raicho community clinic

Background: Community clinics have been restarted in 2009 by government of Bangladesh through a project called “Revitalization of Community Health Care Initiatives in Bangladesh” (RCHCIB) to enhance provision of healthcare services at community level. We have conducted a survey on provision of health care service to recognize the availability and extent of health services provided in a community clinic of Bangladesh.Methods: 25 respondents who usually receive primary health care service from Raicho community clinic situated in Comilla district of Bangladesh were included in the survey.Results: The highest number of respondents was male (52%) and the majority of them were literate (96%).36% of study population were included in no income group, whereas 20% belong to rich population group. 32% people presented with fever (32%) followed by weakness (24%) in the community clinic. 32% respondents went to community clinic for him/her and that was the highest. The highest number of people were referred to private clinic (32%). 70% respondents think that women are receiving maternal service in the clinic. 88% respondents have participated in EPI vaccination program. 80% respondents use contraceptive method and majority used contraceptive pill. 68% people received sufficient medicine, whereas 32% respondents did not receive medication from the clinic. 75% respondents think that during working hours CHCP and HA are available in the clinic. 48% population mentioned corruption is the most possible responsible factor for heath service inequalities at grass-root level.Conclusions: Although standards are lacking in providing services, community clinics have opened a new era in health service of Bangladesh.

Analysis of potentially inappropriate medication among community elderly patients in dongcheng district of beijing / 中国药学杂志

OBJECTIVE: To evaluate the prevalence and risk factors of potentially inappropriate medication (PIM) among elderly inpatients in community health care institutions in Dongcheng district. METHODS: The outpatient prescriptions of patients aged 60 and above in community health care institutions in Dongcheng district in 2017 were analyzed. The proportion of PIM prescriptions and the utilization rate of PIM drugs were calculated according to the criteria of potentially inappropriate medications for older adults in China (2017). Logistic model was built to analyze the influence factors of PIM. RESULTS: The 1 045 269 prescriptions were collected in this study. The 12.9% prescriptions had at least one PIM prescribed. The top 3 drugs in PIM prescriptions were clopidogrel (42.5%), estazolam (24.2%) and ibuprofen (11.4%). The logistic regression analysis revealed that the significant predictors for PIM prescription were: visits of healthcare center; doctors′ male gender and lower-class title; patients′ male gender, elder age, more illness and more drugs. CONCLUSION: The situation of PIM prescriptions needs to be improved for the elderly inpatients in community health care institutions in Dongcheng district. To reduce the incidence of PIM in elderly patients, the criteria of potentially inappropriate medications for older adults in China requires further promotion.

Participation in community centralized service by clinical laboratories by public tertiary hospitals / 中华医院管理杂志

This article introduced the practice of tertiary hospitals′ clinical laboratories in making full use of its advantageous medical resources ,and using community centralized detection service. The authors hold that public hospitals have more advantage and needs to use this service ,and such a centralized model requires further innovation and improvement. Participation in centralized service by these clinical laboratories enjoys a good development prospect .

Experience on general practitioner training in community health care center / 中华全科医师杂志

General practitioner represents the core competency of community health care center and also the key for sustainable discipline development.Talent developing is regard as critical issue for both discipline construction and community health service development.Community health care center,as a platform for internship,practice and continue medical education of medical professionals,plays an important role in career development of general practitioner.We clearly defined the role and responsibility of community health care center in general practicing talent development,and built an excellent career development platform.We integrated project-talent-discipline three-in-one to promote clinical research and talent development;applied two-factor theory to set up effective talent plan and incentive mechanism.This article summarized our approach and experience in talent development as a reference for colleagues in other community centers.

The model and version upgrade of community health care reform:A case study of Changning District of Shanghai / 中国卫生政策研究

Any reform needs to be converted into a series of institutional arrangements or micro behavior incen-tive mechanism,not only to ensure basic behavioral strategies of incentive compatibility between actors are motivated, but also to ensure that the behavior mode of grass-roots actors and policy direction are consistent. From the practice of community health reform of Changning District of Shanghai,it has generally gone through four stages:standardization construction and organization establishment,service model and mechanism reform, incentive mechanism design and connotation construction,platform build and performance improvement. Changning medical reform in the continuous deepening of policy trials and solve all kinds of new problems in the new medical reform policy implementation gener-ated by the process of policy and system innovation in the test(such as doctors weakened incentive problems after two lines of revenue and expenditure) and its compatibility with the environment problem. In order to realize the system of health care policy and provide stable behavioral expectations for the stakeholders to improve the welfare of stake-holders thereby continuously reducing the potential resistance to the implementation of the policy of grass-roots actors, and gradually guide the behavior of various actors to guide the direction consistent with the policy objectives

Needs analysis for career development and work-life balance to support female medical students in undergraduate medical education in Japan / 日本プライマリ・ケア連合学会誌

<b>Introduction</b> : With the increase in proportion of female physicians in Japan, breaks in their career associated with life events have become more apparent. We are making efforts to improve the program of work-life balance for female students at Jichi Medical University (JMU) who have a 9-year obligation to practice in a rural area following graduation. The purpose of this study is to research the needs for career development and work-life balance programs desired by female students at JMU.<br><b>Methods</b> : A questionnaire was distributed to all 187 female students enrolled at JMU.<br><b>Results</b> : The proportions of those wanting to marry and give birth during their 9-year obligation term were 71% and 68.6%, respectively. The proportions of those feeling anxious about childbirth and work-life balance after graduation were 80.0% and 78.1%, respectively. Over 80% of subjects answered that they wanted to attend lectures by female physicians and group meetings with such physicians, and to receive information regarding support systems and career development. <br><b>Conclusion</b> : Female students at JMU tend to have greater concerns about life-events, but have an advantage in having opportunities for contact with female physicians who have contributed to rural practice. Clarifying role models for female medical students appears to be an expectation that our students have from our work-life balance programs.

Impact of essential medicine system on rational drug use in Community Health Care Center of Chun′an District / 药学实践杂志

Objective To study the impact of essential medicine system on rational drug use in Community Health Care Center of Chun′an District .Methods Essential drug system in Community Health Care Center of Chun′an District in Zhejiang Province was taken as the intervention group ,and before implementation was taken as contrast group ,the essential medicin system was analyzed whether it was or not to promote the rational use of drugs by prescription surveys .Results Average num-ber of drugs per encounter was lower from 2 .68 to 2 .23(P< 0 .05) ,average expenditure per encounter was lower from 42 .11 yuan to 37 .75 yuan(P<0 .05) ,the use of essential medicines was riser from 79 .90% to 89 .81% (P<0 .05) ,the three in-dexes had significant difference ,the percentage of injections per encounter was lower from 37 .87% to 28 .50% (P>0 .05) ,the percentage of antibiotics per encounter was lower from 36 .52% to 24 .46% (P> 0 .05) ,the two indexes had no significant difference .Conclusion After execution of essential medicine system in Community Health Care Center of Chun′an District ,av-erage number of drugs and average expenditure per encounter were lower and the use of essential medicines was riser ,but the percentage of antibiotics and percentage of injections were not been improved ,belonged to irrational category ,although there had essential medicines manual ,but effective promoting measures still was deficient .

Assessing the Diagnosis of Uncomplicated Malaria after Introduction of Malaria Rapid Diagnostic Tests.

Background: Morbidity and mortality resulting from malaria remains a serious obstacle for social and economic development. Accurate diagnosis and prompt treatment are therefore essential components of case management strategy. The aim of this study therefore was to examine the diagnostic procedure of uncomplicated malaria, and patients’ understanding and satisfaction of treatment in Community Health Care Facilities, three years after the deployment of Malaria Rapid Diagnostic Tests in Ghana. Methodology: A prospective and data collation was done randomly, by means of cluster and stratified multistage surveyat three government hospitals and three private pharmacies in Kumasi, Ghana, between July and September, 2013. Patients treated for uncomplicated malaria, while leaving the health facility, upon consent, were selected and requested to answer questionnaires which served as a source of data to address the objective of the study. Bivariate statistics from the SPSS v 19 was employed to predict the relationships between health institutions and mode of diagnosis, patients’ understanding and satisfaction of services. Results: Fifty-three (53) out of 65 patients responded. The study indicated presumptive diagnosis [44 (83.0%)] to be predominantly used over test-based diagnosis [9 (17.0%)]. The mean age of patients was 34.44±14.8 years (Range 17-66). Out of 52 patients who provided information on educational level, those with tertiary education were 24 (46.2%), secondary were 9 (17.3%), primary were 14 (26.9%) and no formal education were 14 (26.9%). Male patients were 25 (47.2%) and female 28 (52.8%). All 53 patients were given Artemisinin-based Combination Therapy at the various health facilities. Of 35 patients at hospitals/clinics, 15 (42.9%) rated “very good value” to explain their understanding and satisfaction of services provided, and of 18 patients from private pharmacies, 10 (55.6%) rated as “very good value”. Patients with tertiary education [14/25 (56.0%)] showed better understanding and satisfaction of services than those with no formal education [1/25 (4.0%)]. Not a single use of Malaria Rapid Diagnostic Tests for diagnosis was recorded. Conclusion: Diagnosis of malaria at the periphery of health systems is still mainly presumptive three years after deployment of the Malaria Rapid Diagnostic Test. Patients’ good rating on the diagnosis of uncomplicated malaria at private pharmacies, should be an advantage to introducing the Malaria Rapid Diagnostic Tests by healthcare practitioners.

The Utilization of Oral Health Services in Community Health Centers in Korea: A Study Using Data from the 2011-2012 Community Health Survey / 대한구강보건학회지

OBJECTIVES: To determine the utilization of oral health services in community health centers in Korea. METHODS: This cross-sectional study involved secondary analysis of data obtained from the 2011-2012 Community Health Survey. The data were analyzed to determine the utilization of community oral health services. A total of 458,417 people (weighted sample was 80,268,227) were included. A multistage probability proportional systematic sampling method was used. The dependent variable was the utilization of community oral health services. The independent variables were region (city, town, and district), demographic characteristics (gender, age, education, income, occupation, and basic livelihood security), oral health status, and overall health status. The differences in the utilization of community oral health services related to independent variables were analyzed using an independent t-test and ANOVA. Additionally, a Scheffe post-hoc test was performed. Statistical analysis was performed using PASW statistics 20.0 (SPSS Inc., Chicago, IL, USA), at the 5% significance level. RESULTS: The average utilization rate was 26.3% for community health care services and 4.3% for oral health services during the study period in Korea. Utilization was associated with old age and lower education and income levels (P<0.01). Furthermore, residents having poor oral health, chewing discomfort, and unmet dental needs most frequently used the community oral health services. CONCLUSIONS: The utilization of community oral health services was low in Korea. The needs and circumstances of communities should be considered and unique regional structural characteristics should be identified to plan and execute oral health programs and incorporate them with community health care services for overall community health.

Design and implementation of wireless multi parameter remote monitoring system based on community health car e / 中国医学装备

Objective:In order to achieve the use of community medical care and branch doctor resources, to provide monitoring of remote diagnosis, providing more convenient, safe and efficient medical service for patients and hospital objective. Methods:Multi parameter remote monitoring system design of special model of WIFI wireless technology, including special new WIFI module, wearable multi parameter telemetry monitor, wireless relay box network and medical monitoring software, testing and data transmission of ECG, respiration, blood oxygen using a wireless network, can the patient monitoring in normal life condition. Results:Whenever and wherever possible the electrophysiological data sent to the hospital, the doctor can according to the electrophysiological data of the patient for remote diagnosis and further treatment. The accuracy of the stability, the reliability of the system and the parameters of the tested strictly, data transmission accurate rate reaches more than 98%. Conclusion: The patients and doctors have been received good feedback, clinical trials, has very practical clinical significance.

Introduction of collaborative drug therapy management (CDTM) into a community healthcare system in Japan / 日本プライマリ・ケア連合学会誌

<b>Introduction</b> : As one of the strategies for the introduction of collaborative drug therapy management (CDTM) into a community healthcare system in Japan, we constructed a ‘positive list’ which was agreed by a family physician in advance, and subsequently validated the effects on healthcare insurance fees, the number of prescription question and the changes of utilization rate for generic drugs.<br><b>Methods</b> : The items that replaced prescription questions with regard to ex post facto approval were defined as ‘Resolved Questions’ in our constructed positive list. By adopting the ‘Resolved Questions’, we then examined the effect on healthcare insurance fees, prescription questions and the changes of utilization rates for generic drugs.<br><b>Results</b> : Among all prescription questions accepted from January through May 2012 inclusive, 178 (22.7%) were ‘Resolved Questions’, without there being change in the therapeutic strategies by the prescribing physicians. During this period, 17,455 healthcare insurance fees were reduced. In addition, the utilization rate for generic drugs were increased up to 46.6%.<br><b>Conclusion</b> : The reduction of healthcare insurance fees, prescription questions and the increased utilization rates of generic drugs were facilitated by prudent pharmacist judgements based on ‘Resolved Questions’.

TCM“Preventive Treatment for Disease”in community health care / 中华医院管理杂志

The application of TCM“Preventive Treatment for Disease”in community health care is a major approach to implementing the prevention-first health policy and realizing access to basic health services for all.Covered first in the paper is the significance of TCM“Preventive Treatment for Disease”in community health care.It is followed by a systematic description of the innovative community health care model in Hangzhou in 2008.This innovation started in 2009 to apply the TCM“Preventive Treatment for Disease”in community health care.The authors described the preliminary practice,specific measures and the main results of TCM“Preventive Treatment for Disease”in community health care.They went on to recommend the service model of TCM“Preventive Treatment for Disease”in community health care and provide references for application of TCm in community health care.

Supplementing the effects of a stroke unit with community health services for stroke patients / 中华物理医学与康复杂志

Objective To evaluate the clinical efficacy of a stroke unit combined with community health services for treating stroke survivors. Methods A total of 120 stroke patients were randomly divided into a " stroke unit combined with community medicine" group ( combined group) , a stroke unit group and a general treatment group. Patients in the former 2 groups were treated in a hospital stroke unit during their hospitali-zation. The general treatment group was given conventional medical treatment. After discharge, the combined group continued to receive regular rehabilitation therapy and guidance in the form of community medical services, while the stroke unit group received follow-up only. Assessment was by means of Fugl-Meyer scores, the Barthel index and self-rating on a depression scale ( SDS). The patients were assessed at admission, on discharge and 3 months after discharge. Results There were no significant differences in average limb motor function, ability in the activities of daily living ( ADL) or depressive mood among the 3 groups on admission, but at discharge, limb motor function and ADL ability in the combined group and stroke unit groups were significantly superior to those in the general therapy group. Limb motor function and ADL ability in the combined and stroke unit groups had improved further 3 months after discharge, with more significant improvements in the combined group. No significant change in depression was observed in any group at discharge, but average depression scores in the combined and stroke unit groups improved significantly in the 3 months after discharge, and there was a statistically significant difference between the combined group and the general group. Conclusion Supplementing the work of a stroke unit with community health services significantly improves stroke patients' recovery of limb motor function and ADL ability.

Analysis of treatment outcomes for patients diagnosed with type 2 diabetes in Jiangninglu Neighborhood of downtown Shanghai / 中华全科医师杂志

Objective To understand treatment outcomes of patients diagnosed with type 2 diabetes aged over 30 years in Jiangninglu Neighborhood of downtown Shanghai. Methods Total 642 patients diagnosed as type 2 diabetes aged over 30 were investigated by cluster sampling in Jiangninglu Neighborhood of downtown Shanghai. Status of optimal control of diabetes in them was analyzed based on the recommendations proposed by International Diabetes Federation (IDF) for Western Pacific Region. Results and serum level of glycosylated hemoglobin Alc (HbAlc) of less than 6.5% was achieved in 37.5% (241/were achieved in 23.8% (153/642) and 18.1% (116/642) of them, respectively, and beth systolic and mmol/L was achieved in 21.7% (139/642) of all the participants investigated, triglyceride of less than 1.5 mmol/L in 46.6% (299/642), low-deusity lipoprotein-cholesterol (LDL-C) of less than 2.5 mmol/L in 23.7% (152/642) and high-density lipoprotein-cholesterol of greater than 1.1 mmol/L in 62.1% (399/of their blood glucose, blood pressure and serum LDL-C (defined as HbAlc less than 6.5%, blood pressure less than 130/80 mm Hg and LDL-C less than 2.5 retool/L). Conclusions Only 2.6% of all the patients diagnosed with diabetes aged over 30 in downtown Shanghai get optimal control of their blood glucose, blood pressure and serum lipid, so comprehensive prevention and control for diabetes shall be strengthened for them at community-level of urban areas.

The major role of community medical care and rural health units in establish life long medical education system / 中华医学教育探索杂志

The article demonstrates three characters of health service system in community and the countryside: equalitarianism,universality and suitability,and puts forward major functions: strengthening propaganda,universalizing life long education,making prevention and health care education and producing psychologic health education.