公共卫生信息系统建设中应注意问题探讨

2003年“非典”疫情灾害，使公共卫生信息系统经受了严峻的考验，暴露出了我国公共卫生信息系统建设中的一系列问题。可以说“非典”是公共卫生信息系统建设的分水岭，这场疫情的深刻教训使我们认识到了进行公共卫生信息系统建设的重要性，此后系统建设步人了快速发展时期，国家主导，统筹规划，地方参与，国家及省市的公共卫生信息系统不断建立。在公共卫生信息化建设过程中，有必要对其建设中需要注意的问题进行研究，以不断推动公共卫生信息化建设。结合近几年来北京市公共卫生信息系统建设过程中的经验教训并参考国外有关的实践事例，对当前公共卫生信息化建设中应该注意的问题进行了初步探讨。     

大型医院人才建设路径的探索和实践

就大型医院人才建设的内涵、重要性进行了探讨、分析，结合实际就其建设路径进行了阐述，并提出了要把握的几个方面问题。     

浅论医院数据中心

本文对医院数据中心的建设进行了探讨，指出了数据信息在医院使用中的现状，指出了数据中心对于实现医院数据的共享，提高维护人员的工作效率，改善主机系统的使用环境的作用，提出了数据中心建设的几个重点：机房系统的建设；主机系统的建设；网络系统的建设；备份系统的建设；数据库的设计；网络管理软件的使用。     

关于整体手术室建设的探讨

手术室是医院现代化建设的重要标志之一，整体手术室的建设解决了微创手术中设备的多样化与差异性，满足了患者对治疗的更高要求，提高了医疗质量。本文对整体手术室的建设进行了有意义的探讨。     

军队医院规划建设探讨

医院规划建设是医院发展建设的顶层设计，直接关系到医院发展建设的统筹性、协调性以及可持续性，对提高发展效率、避免建设浪费、有效配置资源、加快发展速度有若现实指导意义。本就军队医院规划建设的步骤、项目、内容和规划建设要则进行了探讨，并就如何进一步提高军队医院规划建设质量，不断增强规划的法规意识和全员意识进行了探讨。     

江西省宜春市农村药品"两网"建设情况评估

为了检查农村药品“两网”建设试点工作，促进农村药品“两网”建设，对宜春市3个县的“两网”建设情况进行了调查与评估。结果表明，宜春市3个县均达到了“两网”建设的预期目标。     

数字化医院建设成本效益分析

数字化医院建设的成本效益分析，是医院数字化建设决策的重要依据之一。本文阐述了数字化医院建设成本效益分析的基本原则，即全面性原则、客观性原则和定量分析与定性分析相结合的原则。完整地提出了数字化医院建设成本效益分析的基本结构，其中成本包括硬件成本、软件成本、人力成本、转型期成本和运行成本，效益包括社会效益、经济效益、科研教学效益和管理决策效益，并结合数字化医院建设应用实践进行了实证分析，对一系列新的成本效益概念及其内容进行了探讨。提出应正确认识数字化医院建设的成本和效益，做好建设决策，更好地控制建设成本，提升数字化效益。     

卫生监督工作向农村延伸的实践与建议

乡镇卫生监督机构建设是整个卫生监督体系链条上的关键环节。江苏省通过对本省部分市、县乡镇卫生监督机构建设情况的调查分析，针对乡镇卫生监督机构建设的运行现况，以及乡镇卫生监督机构建设存在的问题和困难，提出了加强乡镇卫生监督机构建设的建议，特别是在机构、职能、人员、用房、设备等方面设计了乡镇卫生监督机构建设的标准，对卫生监督工作如何向农村延伸进行了有益的探索。     

关于加强高等学校实验技术队伍建设的思考

实验技术队伍是高等学校队伍建设的重要组成部分，高校实验技术队伍的建设，直接影响到高校实验室建设，进而影响到高校的教学、科研等工作的正常开展，直接影响到高校对高素质创新人才的培养。文章对当前高等学校实验技术队伍建设存在的问题进行了分析。并对如何加强实验技术队伍建设提出了建议。     

弘扬卫生行业新风尚塑造文明平安形象

1 强化领导，确保创建活动取得实效 为切实把卫生行业建设成人民满意、党和政府放心的行业，近年来，岱岳区卫生局在不断总结创建活动经验的基础上，认真分析全区卫生行业所面临的发展形势、存在问题和不足，局党委定期召开专题会议进行研究，2005年制定了岱岳区卫生系统《党风廉政建设暨创建文明行业活动实施意见》，把创建文明行业与党风廉政建设进行有机结合，召开了创建活动动员会议，安排部署了全区创建活动的任务，明确了目标和要求。     

应用圆形分布探讨保山市疟疾发病时间分布特征

目的分析保山市的疟疾发病季节性特征,为防治工作提供科学依据。方法采用圆形分布法进行分析。结果 1986—1990年、1991—1995年、1996—2000年、2001—2005年、2006—2008年各年代疟疾发病的高峰日分别为8月2日、7月16日、6月25日、6月3日、5月30日,高峰时期分别为5月23日-10月13日、4月26日-10月6日、3月26日-9月24日、2月20日-9月13日、3月3日-8月28日。结论保山市疟疾发病的高峰日呈现了提前趋势,在疟疾发病高峰期之前,开展疟疾防制工作意义极其重大,能减少疟疾发病,从而更好的保护人民群众的身体健康。     

2007～2008年江苏省淡色库蚊和家蝇的抗性研究

目的了解江苏省蚊蝇对常用杀虫剂的抗药性情况,指导蚊蝇防治的科学用药。方法蚊虫抗药性检测采用幼虫浸渍法,家蝇采用点滴法。结果南京市家蝇对敌敌畏、溴氰菊酯、高效氯氰菊酯和残杀威的抗药性均相对较高,而淮安市均为最低;4种杀虫剂中,残杀威抗性均为最高,其次为敌敌畏,溴氰菊酯抗性均为最低。淡色库蚊对高效氯氰菊酯、溴氰菊酯和仲丁威的抗性在淮安市均为最高,对双硫磷抗性在苏州市为最高;4种杀虫剂中,仲丁威抗性均为最高,溴氰菊酯除在淮安高于双硫磷外,抗性均为最低。结论在蚊蝇防治时应避免使用抗性较高的残杀威、仲丁威和敌敌畏,优先考虑使用溴氰菊酯等拟除虫菊酯类杀虫剂。     

Barriers and motivators to exercise for older adults: A focus on those living in rural and remote areas of Australia

To identify the barriers and facilitators for exercise in older adults (50 years or over) specific to those living in rural and remote areas in Australia and to identify how this relates to falls prevention exercise programs in these areas. Literature review. Search of the databases of Medline, Scopus and Social Sciences Citation Index. Rural and remote areas. Searching identified 56 articles relating to barriers or facilitators to exercise in older adults in general, of which 25 are discussed in the article. Five of these articles specifically related to rural and remote areas, of which all were from studies in the United States. No literature specifically relating to rural and remote Australia was identified. Therefore, articles included in the final review were from three different domains – world literature (excluding those specific to rural and remote areas of Australia), rural and remote literature (note not Australian), and Australian literature to enable a comparison between the different populations to occur. There are similarities and differences between the barriers and facilitators in various populations, and no one factor alone will enable exercise in older adults. Research needs to be conducted on the barriers and facilitators to exercise in older adults living in rural and remote areas in Australia. Falls prevention exercise programs need to be tailored to suit the unique needs of the rural and remote older population.     

Learning from our apartheid past: human rights challenges for health professionals in contemporary South Africa

Central to South Africa's democratic transformation have been attempts to understand how and why human rights abuses were common under apartheid. In testimony to the Truth and Reconciliation Commission evidence has emerged of a wide range of past complicity in human rights abuses by health professionals and their organisations. This has presented a major challenge to the health sector to develop ways to operationalize a commitment to human rights in the future. This paper argues that only after a process of self-reflection, both personal and institutional, which enables a thorough and accurate analysis of why things went so wrong, can the health sector effectively move forward. The authors' perspective draws on the submission to the TRC Health Sector Hearings by the Health and Human Rights Project in 1997, which provides a systemic and case-based analysis of the health sector's role in human rights abuses under apartheid. However, human rights responses have to take account of a changing national and global terrain in which human rights issues are no longer as morally absolute as previously encountered, and in which seemingly insuperable resource constraints, inimical economic policies, and the demobilization of civil society, are serious obstacles. Moreover, the politics of transformation has generated expediencies that threaten to rewrite history in ways that fundamentally cheapen human rights. To address this contradiction, the authors propose a set of objectives that places accountability of health professionals in a human rights framework. These objectives are intended to give substance to the main tasks facing the health sector--to develop and infuse the capacity to recognise and integrate both the 'new' and traditional human rights dilemmas, and to effect personal and institutional transformation. A matrix is presented, linking these objectives to key role players in the health sector and identifying activities specific for each role player. As the health sector in South Africa grapples with the challenges framed in this model, key lessons for the international community may emerge that further our understanding of the complex relationship between health and human rights and how best to implement strategies for the attainment of human rights in health.     

2009-2018年上海市6~17岁儿童青少年超重和肥胖的变化趋势

目的 分析2009-2018年上海市6~17岁儿童青少年超重和肥胖的变化趋势,为预防和控制儿童青少年超重肥胖提供依据。方法 采用2009-2018年上海市连续10年的学生常见病监测项目横断面调查数据,选取资料完整的523 112名6~17岁儿童青少年作为研究对象。超重和肥胖判定标准采用2007年世界卫生组织(WHO)制定的儿童青少年生长参照标准(WHO标准)。采用多元线性回归模型分析儿童青少年体重指数变化趋势,Logistic回归模型分析超重和肥胖率的变化趋势。结果 2018年上海市6~17岁儿童青少年超重和肥胖总体检出率分别为19.37%、10.78%,男生分别为22.33%、16.27%,女生分别为16.31%、5.13%,超重和肥胖检出率男生均高于女生(超重:χ²=253.26,P<0.001;肥胖:χ²=1 404.73,P<0.001)。调整年龄、性别后,超重和肥胖率分别由2009年的16.94%、9.22%增加至2018年的19.37%、10.78%(P_趋势<0.001)。结论 2009-2018年上海市6~17岁儿童青少年体重指数、超重和肥胖率均呈增加趋势,增长速度放缓,但仍处于流行状态。     

Influenza in the Asia-Pacific region: Findings and recommendations from the Global Influenza Initiative

The fourth roundtable meeting of the Global Influenza Initiative (GII) was held in Hong Kong, China, in July 2015. An objective of this meeting was to gain a broader understanding of the epidemiology, surveillance, vaccination policies and programs, and obstacles to vaccination of influenza in the Asia-Pacific region through presentations of data from Australia, Hong Kong, India, Indonesia, Malaysia, New Zealand, the Philippines, Taiwan, Thailand, and Vietnam.As well as a need for improved levels of surveillance in some areas, a range of factors were identified that act as barriers to vaccination in some countries, including differences in climate and geography, logistical challenges, funding, lack of vaccine awareness and education, safety concerns, perceived lack of vaccine effectiveness, and lack of inclusion in national guidelines. From the presentations at the meeting, the GII discussed a number of recommendations for easing the burden of influenza and overcoming the current challenges in the Asia-Pacific region. These recommendations encompass the need to improve surveillance and availability of epidemiological data; the development and publication of national guidelines, where not currently available and/or that are in line with those proposed by the World Health Organization; the requirement for optimal timing of vaccination programs according to local or country-specific epidemiology; and calls for advocacy and government support of vaccination programs in order to improve availability and uptake and coverage.In conclusion, in addition to the varied epidemiology of seasonal influenza across this diverse region, there are a number of logistical and resourcing issues that present a challenge to the development of optimally effective vaccination strategies and that need to be overcome to improve access to and uptake of seasonal influenza vaccines. The GII has developed a number of recommendations to address these challenges and improve the control of influenza.     

北京25～64岁人群1984～1999年体重指数和超重率变化趋势的研究

目的：分析1984－1999年北京地区25－64岁人群平均体重指数（BMI）、超重率的变化趋势。方法：在北京地区心血管病监测人群中，分别进行了5次心血管病危险因素的横断面调查。结果：1984－1999年25－64岁人群平均BMI由23．3增加到24．0，超重率由27．5％增加到35．9％。男性人群超重率由23．5％增加到43．4％。男性各年龄组及城乡地区的超重率均呈增加趋势。女性人群在城乡地区的超重率呈不同变化趋势，城市女性超重率由36．0％下降到23．3％，农村女性超重率由28．4％增加到46．0％。城市人群的超重率由29．1％增加到31．8％，农村人群的超重率由22．1％增加到49．6％。研究早期城市人群的平均BMI和超重率大于农村人群（P＜0．05），到研究后期农村人群的BMI和超重率赶上并超过城市人群（P＜0．05）。结论：城市男性和农村男女两性人群BMI和超重率均呈上升趋势，但农村人群的上升速度较快，且平均BMI和超重率目前已高于城市人群。     

Characteristics of senior medical students at Belfast

This paper analyses and discusses the degree of homogeneity existing in the medical school student population of the Queen's University, Belfast, in relation to certain characteristics: social class, academic attainment, admission standards, intelligence test scores, and personality. Findings are compared with those reported in earlier studies elsewhere. No sex difference in social class distribution of Queen's medical students is noted. There is a much lower proportion of social class I students and a higher social class III proportion, than shown elsewhere in Britain ( Johnson, 1971 ). Women constitute 38% of the medical school student population, a proportion in line with the 40% reported as the overall British percentage ( Brit. Med. J., 1976 ). Females are shown to have a significantly better overall academic record than males, related to intelligence, aptitude for certain subjects and probably to behavioural and attitudinal differences to study and medical care. No significant sex differences are noted in relation to entry qualifications, intelligence, and the personality factors of extraversion and neuroticism. Male A-level scores in the present study are useful predictors of academic success in the medical course, but this is only true for females up to 2nd M.B. stage. General practice is the exception for both sexes, there being no significant correlations with general practice scores. Highly intelligent females and males below their group intelligence mean performed significantly better in learning situations in general practice as reflected in general practice scores, than highly intelligent males. The data may reflect different attitudes to whole person care and varying abilities to integrate knowledge and to define problems in primary care. These findings, including the sex differences in the factors related to academic attainment in the later clinical years of the medical curriculum, may have implications with regard to present selection procedures to most medical schools based solely on A-level grades.     

Immunisation of migrants in EU/EEA countries: Policies and practices

In recent years various EU/EEA countries have experienced an influx of migrants from low and middle-income countries. In 2018, the “Vaccine European New Integrated Collaboration Effort (VENICE)” survey group conducted a survey among 30 EU/EEA countries to investigate immunisation policies and practices targeting irregular migrants, refugees and asylum seekers (later called “migrants” in this report). Twenty-nine countries participated in the survey. Twenty-eight countries reported having national policies targeting children/adolescent and adult migrants, however vaccinations offered to adult migrants are limited to specific conditions in seven countries. All the vaccinations included in the National Immunisation Programme (NIP) are offered to children/adolescents in 27/28 countries and to adults in 13/28 countries. In the 15 countries offering only certain vaccinations to adults, priority is given to diphtheria-tetanus, measles-mumps-rubella and polio vaccinations. Information about the vaccines given to child/adolescent migrants is recorded in 22 countries and to adult migrants in 19 countries with a large variation in recording methods found across countries. Individual and aggregated data are reportedly not shared with other centres/institutions in 13 and 15 countries, respectively. Twenty countries reported not collecting data on vaccination uptake among migrants; only three countries have these data at the national level. Procedures to guarantee migrants’ access to vaccinations at the community level are available in 13 countries. In conclusion, although diversified, strategies for migrant vaccination are in place in all countries except for one, and the strategies are generally in line with international recommendations. Efforts are needed to strengthen partnerships and implement initiatives across countries of origin, transit and destination to develop and better share documentation in order to guarantee a completion of vaccination series and to avoid unnecessary re-vaccination. Development of migrant-friendly strategies to facilitate migrants' access to vaccination and collection of vaccination uptake data among migrants is needed to meet existing gaps.     

Medical education in France, Germany, Italy and the United Kingdom compared

1. The purpose of the visit was to compare postgraduate medical education and training in the United Kingdom with that in France, the Federal Republic of Germany, and Italy. 2. Except in Italy, there appeared to be widespread agreement that specific postgraduate training for general practitioners was essential to improve the quality of practice and to relieve the undergraduate curriculum from the necessity to provide comprehensive medical training to prepare a graduate for independent practice. The main difficulty appeared to be the development of good 'teaching' practices. 3. Direct comparison between training programmes for specialist practice is not straightforward in view of the different staffing structure in continental hospitals and the existence of private specialist practice to which patients have direct access. Training appears to be generally longer in the United Kingdom, possibly due to the necessity of passing postgraduate diploma examinations, but outside the university hospitals the fully trained specialist (consultant) enjoys a higher status and independence than most hospital specialists in other countries. The absence of equivalent bodies to the Royal Colleges and Faculties places responsibility upon universities for specialist training on the continent; standards are not coordinated nationally, and vary significantly from region to region. 4. The need for continuing medical education for all doctors is accepted; this is essentially voluntary, although there are variable direct and indirect incentives. Programmes are organized on a local or regional basis in most countries, but in Germany and the U.K. there is a growing trend towards national coordination of both training programmes and the provision of continuing education. 5. The recent reorganization of the National Health Service in the United Kingdom provides opportunities for 'public health' doctors to become involved in the coordination of clinical services and to relate these to the needs of the public at large, as well as to provide preventive health services. These opportunities do not exist in France, Germany and Italy, where public health services remain discrete from clinical medicine, and postgraduate training is largely confined to formal teaching at designated institutes which are university based only in Italy. Opportunities for university staff to become involved in the organization and delivery of health care appear to be greater, therefore, in the United Kingdom than in other countries.