基于区域卫生信息平台的实践与思考

在区域卫生信息平台大数据资源的基础上,将分散在各业务系统中的数据进行整合、分析,利用数据仓库和数据挖掘技术开发各类应用,从而为管理者、医务人员及居民提供一个信息化、智能化的管理与服务平台。     

基于区域卫生信息平台的实践与思考简

在区域卫生信息平台大数据资源的基础上,将分散在各业务系统中的数据进行整合、分析,利用数据仓库和数据挖掘技术开发各类应用,从而为管理者、医务人员及居民提供一个信息化、智能化的管理与服务平台。     

数据整合技术在军队卫生信息管理中的应用

依托数据仓库技术，实现卫生数据整合，构建面向总部、军区两级的卫生管理数据平台。在对海量卫生统计数据的计算机技术处理、规范完善卫生统计上报制度、提高机关工作管理水平等方面进行了探索尝试。     

数据挖掘技术在医院管理中的应用

数据挖掘技术可为医院管理者提供更高层次的数据分析功能，为医院制定竞争策略提供有力的技术支持。作者明确了数据挖掘中的数据抽取、分类发现、聚类及关联规则等4项任务，介绍了数据挖掘的常用方法，指出数据挖掘技术在医疗质量管理、门急诊管理、病区管理、医院资源配置及跃院经济管理中具有广泛的应用性，提出随着信息技术广泛而深入的应用，医院管理水平将得到显著地提高。     

医院信息化技术在卫生经济管理中的作用

信息化技术是医院加强卫生经济管理研究,提高卫生经济管理水平的重要手段。利用信息化技术,可以保障网络数据的真实性与准确性,更充分利用网络数据,搭建统一数据平台,为医院的卫生经济管理提供权威、丰富、高效的决策支持数据,为医院发展打下良好基础。     

数据挖掘在口岸卫生检验检疫中的应用分析

数据挖掘是利用各种分析工具在海量数据中发现模型和数据间关系的过程。本文阐述了数据的主要任务、方法、步骤和挖掘工具,对在口岸卫生检验检疫管理中的数据挖掘应用进行了研究和探讨。     

北京医院信息管理系统智能化综合数据分析功能及实现

本文以建立北京医院信息数据整合及综合分析系统的实际工程项目为背景,在综合分析其所面临的海量数据基础上,依据医院管理信息需求提出了对北京医院现有信息管理系统进行数据挖掘的思路;采用数据联邦及数据ETCL技术提供安全实时的数据整合及数据ETCL解决方案。利用0racle数据库管理和开发工具开发了综合数据分析系统。本文主要介绍了该系统中的两大重要模块,即综合分析模块和医疗质量监管模块。在综合分析功能方面,实现了综合数据分析系统的业务数据整合与构建,可以以灵活多样的方式展示医疗业务数据;在医疗质量监管功能方面,实现了医疗质量管理的数据采集、分析及预警系统,可以实现病人费用追踪、医疗质量管理和特殊用药监控的功能。文中重点从方法、架构和开发等层次,对如何在数据整合和新功能开发方面的相关内容进行了阐释。结果表明。采用先进的数据挖掘技术进行数据整合,可以解决目前医院“信息孤岛”的问题;将此系统应用于实际应用,取得了较好的结果。同时表明由于系统和业务的复杂性,有许多功能还需要不断完善,这是在今后的工作中需要继续研究的问题。     

慢性病大数据分析平台设计

大数据信息化战略为慢性病管理分析提供了新的思路。本文概述医疗大数据应用现状,详细阐述了慢性病大数据平台的设计思路以及实现方法。旨在通过数据挖掘技术与统计分析方法结合,为卫生主管部门更加及时、准确、全面推动慢性病防控的工作提供参考依据。     

军队区域疾病监控及军人健康监控平台建设

以军民区域协同医疗服务系统为基础,应用数据挖掘技术构建基于数据元、数据集标准的疾病监测和健康监控相关主题指标库,最终建立军队区域内疾病监控、军人健康监控和健康服务平台,促进了军队卫生管理、官兵健康水平和部队战斗力的提高。     

基于数据挖掘的艾滋病综合防治居民健康档案管理信息系统设计与实现

目的 提高居民艾滋病综合防治水平,动态监测居民艾滋病防治信息,实现与其他信息管理系统的互联互通、资源共享,方便数据挖掘.方法 根据《国家基本公共卫生服务规范》及《艾滋病疫情信息报告管理规范》等文件规定要求,结合艾滋病防治工作,采用B/S结构,SSH框架,ORACLE10.0数据库,基于数据挖掘技术建立数据库,开发居民健康档案信息管理系统.结果 基于数据挖掘技术,开发了居民健康档案信息管理系统.结论 建立艾滋病综合防治新型电子健康档案,完成4个项目县2 365 680人基本信息数据资料的建档工作,除对数据进行基本统计分析外,将数据导出后采用决策树、关联规则、神经网络等挖掘技术对数据进行分析,取得了较好效果.将信息网络覆盖到4个项目地区的卫生行政部门及县、乡、村3级艾滋病防治机构,并使系统正常运行,实现了对居民艾滋病防治信息健康的动态管理.     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Fatigue and health in a seafaring population

Background Occupational fatigue is relatively common withinthe general population and has been linked to reduced performance,injury and longer term ill-health. Despite growing acknowledgementof this problem in the maritime sector, little research hasbeen conducted into the risk factors, prevalence and consequencesof seafarers' fatigue. Aims To examine the prevalence of fatigue among seafarers, identifypotential risk factors and assess possible links with poor performanceand ill-health. Methods Cross-sectional questionnaire survey of seafarers workingin the offshore oil support, short-sea and deep-sea shippingindustries. A number of tools were used including the fatiguesubscale of the profile of fatigue-related symptoms, the CognitiveFailures Questionnaire, the General Health Questionnaire andthe SF36 General Health scale. Results In all, 1855 questionnaires were completed giving anoverall response rate of 20%. Fatigue symptoms were associatedwith a range of occupational and environmental factors, manyunique to seafaring. Reporting a greater number of risk factorswas associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35)for those with three or four risk factors and OR = 9.54 (6.95–13.09)for those with five or more risk factors]. There was also astrong link between fatigue and poorer cognitive and healthoutcomes, with fatigue the most important of a number of riskfactors, accounting for 10–14% of the variance. Conclusions Seafarers' fatigue could impact on safety withinthe industry and may be linked to longer term individual ill-health.It can only be addressed by considering how multiple factorscombine to contribute to fatigue.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.