中国疾病预防控制中心因公出国（境）任务现状及15年变化分析

目的分析中国疾病预防控制中心(中国疾控中心)2015—2019年因公出国(境)任务,与2005—2014年有关数据比较,探讨我国公共卫生领域国际合作在2015—2019年间的发展趋势。方法对因公出国(境)任务人员基本构成、出访事由、出访国家和地区、经费来源进行分析;资料录入和数据整理使用Excel软件,统计学分析使用GraphPad Prism 8软件。结果中国疾控中心2015—2019年派出因公出国(境)人员共2 895人次,具有高级职称者占80.1%;派出本单位人员2 878人次,传染病防控单元占59.1%,技术支撑与管理单元占17.7%,慢性非传染性疾病防控单元占12.2%,公共卫生管理单元占11.0%。2015—2019年因公出国(境)任务出访事由中,会议占65.7%,访问/考察/交流/培训占14.3%,项目合作研究占6.7%,专家工作占1.5%,援外/海外应急占11.8%;事由构成比例与2005—2009年和2010—2014年比较,差异具有统计学意义(χ~2=807.9,P 0.01)。2015—2019年共出访102个国家和地区(不含港澳台地区),各目的地累计到访合计2 886人次,发达国家和地区占60.0%,发展中国家和地区占40.0%,其中非洲国家占17.2%,高于2005—2009年和2010—2014年。经费来源方面,2015—2019年我方支付占57.8%,双方支付占19.2%,外方支付占23.0%;与2005—2009年和2010—2014年比较,外方支付比例持续降低,我方支付和双方支付进一步增加,差异具有统计学意义(χ~2=808.0,P 0.01)。结论 2015—2019年中国疾控中心因公出国(境)人员以高级职称、从事传染病防控工作为主,事由以参会为主;目的地仍以发达国家为主,经费来源以我方支付为主且占比进一步提高。     

科研机构国际交流与合作的分析与思考--以中国疾控中心环境所专业人员因公出国(境)任务为例

目的通过对中国疾控中心环境所专业人员过去15年(2003-2017年)因公出国(境)任务情况进行梳理,总结以往国际交流与合作情况。方法通过查阅档案、公务访谈、座谈和资料查询等方法,收集和整理国际交流与合作资料并建立数据库。采用单样本Kolmogorov-Smirnov检验和卡方检验进行统计分析。结果环境所在过去15年因公出国(境)任务以参加国际学术会议为主(58.2%,89/153)。出访人员主要集中在空气污染与健康(34.5%,81/235)、饮用水与健康(13.6%,32/235)和气候变化与健康(11.9%,28/235)3个学科(领域)。大多数出访人员具有高级技术职称(81.3%,191/235),出访经费多数由邀请方承担(60.1%,92/153)。出访发达国家和地区占比较高(70.8%,114/161)。分层分析显示,3个五年间(2003-2007年、2008-2012年、2013-2017年)年均出访批次(F=0.97,P>0.05)、出访人数(F=3.55,P>0.05)以及3个主要学科(领域)的年均出访人数差异无统计学意义(F值分别为3.46、2.08和2.96,P>0.05),而环境所本单位经费占比差异具有统计学意义(χ2=40.3,P<0.01)。结论环境所国际交流与合作活动日益频繁且效果逐步凸显。但出访人员学科(领域)和技术职称分布不尽合理,出访目的地主要集中在发达国家和地区。建议今后进一步强化国际交流与合作效果评估,促进学科(领域)和人才队伍均衡发展,加强与"一带一路"沿线国家的交流与合作。     

加强国际合作 探讨公共卫生人才培养新途径

文章以福建省疾病预防控制中心(CDC)为例,对2006-2015年期间以因公出国(境)对外交流培养人才的形式进行分析,简要展示了加强国际合作在公共卫生专业技术人才培养方面发挥的作用.     

人口发展“十一五”规划终期评估总体方案

<正>为掌握人口发展领域"十一五"时期发展目标进展和主要任务完成情况,根据《人口发展"十一五"和2020年规划》(国办发〔2006〕107号)的要求,制定本方案。     

从因公出访分析中国疾病预防控制中心与“一带一路”合作国家的合作趋势

目的 通过分析中国疾病预防控制中心（以下简称中国疾控中心）2005-2019年赴“一带一路”合作国家因公出访情况，研究与有关国家公共卫生合作交流现状与趋势。方法 对目的地为“一带一路”合作国家的2005-2019年中国疾控中心因公出访任务的人员职能、事由、经费来源等进行分析。结果 2005-2019年出访“一带一路”合作国家人次占所有出访的38.8%，其中2014-2019年年均占比（44.3%）显著高于2005-2013年（35.5%）（P=0.002）。赴东亚-东南亚国家最多，赴非洲国家自2014年迅速增加；出访人员职能多为传染病防控（67.5%）。出访事由中会议占70.8%；援外/海外应急占比从2005-2013年的0.6%增加至2014-2019年的24.7%，其中赴非洲国家增长最快。出访经费来源呈现外方支付比例下降，我方支付比例上升的趋势。结论 中国疾控中心因公出访“一带一路”合作国家的比例在2014年后显著增加，目的地以东亚-东南亚地区为主，出访人员职能以传染病防控为主；事由以会议为主，2014年后以援非为主的援外/海外应急大幅增长；经费来源由外方为主转变为我方为主。     

2020年新型冠状病毒肺炎疫情下北京市肺结核病例发现情况分析

目的探讨2020年新型冠状病毒肺炎(coronavirus disease 2019,COVID-19,以下简称新冠肺炎)疫情对北京市肺结核病例发现带来的不利影响及成因,以便及时调整应对策略。方法对2015-2020年北京市肺结核报告发病情况及2018-2020年北京结核病控制研究所(以下简称"市所")就诊人次进行回顾性分析比较。结果 2015-2020年,北京市肺结核报告发病数分别为8 691、8 361、8 619、7 993、7 479和6 380例,整体呈下降趋势(Z=2.711,P=0.007),报告发病率分别为40.39/10万、38.52/10万、39.67/10万、36.82/10万、34.72/10万和29.62/10万,亦呈下降趋势(Z=2.572,P=0.010)。2015-2019年北京市肺结核报告发病数年均递降率为3.71%,报告发病率年均递降率为3.69%,但2020年较2019年报告发病数下降了14.69%,报告发病率下降了14.67%。2020年1-8月北京市肺结核报告发病数均较2019年同期下降,1-5月下降最为显著,降幅分别为35.99%、29.90%、56.65%、27.12%和33.03%,平均降幅为37.24%,7月之后报告发病数逐渐回升,至11月超过2019年同期水平。2018-2020年市所就诊人次分别为11 984、12 081和8 406人次,2018、2019年大致持平,但2020较2019年下降了30.42%。2020年1-11月就诊人次均较2019年同期下降,2-5月下降最为显著,降幅分别为50.06%、54.74%、48.67%和47.88%,平均降幅为50.34%,10月之后就诊人次逐渐回升,至12月恢复至2019年同期水平。结论新冠肺炎疫情下,2020年北京市肺结核病例发现水平和市级定点医疗机构就诊人次明显下降,特别是在疫情较严重的上半年下降更为显著,不利于肺结核的及时发现、诊断及治疗。应积极采取应对措施,在新冠肺炎疫情常态化防控形势下保证结核患者正常就诊,并进一步加强肺结核病例的发现工作,最大限度消除新冠肺炎疫情的影响。     

基于GM(1,1)灰色模型的四川省“十三五”民营医院发展趋势预测分析

目的预测四川省"十三五"期间民营医院发展趋势,为制定更加切合实际的社会办医政策提供参考。方法根据2009-2015年民营医院发展指标,应用灰色理论,建立预测模型,进行外推预测。结果针对各指标建立的灰色模型,C值小于0.35,P值大于0.95,-a小于0.3,模型精度好,可用于中长期外推预测。2020年四川省民营医院机构数、床位数、医师数、护士数和年诊疗人次数分别较2015年增长126.95%、217.62%、119.20%、215.04%和123.17%。结论灰色模型可运用于对民营医院发展趋势预测;"十三五"期间,要进一步促进民营医院发展相关政策落地,推动民营医院做大做强。     

马军教授主持的卫生公益性行业科研专项顺利通过结题验收

正2016年3月24日,国家卫生和计划生育委员会科教司发布了2011,2012年度部分卫生公益性行业科研专项结题验收结果。北京大学公共卫生学院马军教授负责承担的2012年度卫生公益性行业科研专项"学生重大疾病防控技术和相关标准研制及应用"(201202010,简称"1147计划")通过验收。"1147计划"立项是基于"国家中长期科技发展规划纲要(2006—2020年)"强调的疾病防治重心前移的原则;落实《中共中央     

河北省疾病预防控制系统在职人员控烟干预效果评价

目的 了解河北省疾病预防控制(简称"疾控")系统在职人员实施控烟干预措施的效果.方法 于2006-2008年在河北省疾控系统内实施健康教育、参加有奖戒烟竞赛、创建无烟疾控中心等多项干预措施,并于干预前后监测省、市、县三级疾控机构在职人员吸烟率、男性吸烟者平均吸烟量.结果 2006年共调查河北省三级疾病控制机构174家,在职人员9 931人,总吸烟率为25.69%,男性为51.28%,女性为0.68%,省、市、县级男性吸烟率分别为50.92%,49.48%和51.72%;男性吸烟者平均每天吸烟量为(15.0±9.3)支.2008年共调查三级疾病控制机构189家,在职人员9 139人,总吸烟率为25.07%,男、女性分别为52.26%,0.43%;省、市级男性吸烟率分别为43.93%,46.18%,较2006年下降;县级男性吸烟率为53.98%,较2006年升高;男性吸烟者平均每天吸烟量为(12.4±8.3)支,低于2006年水平,差别有统计学意义(P<0.05).无烟疾控中心达标单位男性吸烟率为48.o%,低于未达标单位(56.9%).结论 河北省疾病预防控制系统男性职工吸烟率较高,采取的综合控烟干预措施对降低职工吸烟率和吸烟量有一定作用.     

2016—2020年四川省猩红热流行病学特征分析

目的 分析四川省猩红热的流行特征及其变化规律，为进一步做好猩红热防控与疾病预测提供科学依据。方法 从国家传染病报告信息管理系统导出四川省2016—2020年的猩红热病例资料，使用SPSS 24.0软件对猩红热病例的时间、地区和人群分布特征进行描述，率的比较采用χ²检验，P<0.05表示差异有统计学意义。结果 2016—2020年四川省猩红热累计报告病例数共10 146例。2016—2020年四川省猩红热整体发病率维持在较低水平，在0.94/10万～3.17/10万之间波动；男性发病率(2.88/10万)高于女性(2.00/10万)(χ²=331.31,P<0.001)。以10岁以下儿童为高发人群，其中以幼托儿童与散居儿童为主，占总病例的60.48%；报告发病数最高为成都市(占总病例数的39.91%)，最低为甘孜藏族自治州(占总病例数的0.07%)。结论 2016—2019年四川省猩红热发病率较稳定，2020年四川省受新冠肺炎疫情影响，人群采取较严格的防控措施，发病率出现明显下降，提示应继续做好个人防护措施。猩红热发病存在明...     

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.     

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.     

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.     

Psychopathological features of a patient population of targets of workplace bullying

BACKGROUND: A strong association between workplace bullying and subsequent anxiety and depression, indicated by empirical research, suggests that bullying is an aetiological factor for mental health problems. AIMS: To evaluate levels of stress and anxiety-depression disorder developed by targets of workplace bullying together with outcome at 12 months and to characterize this population in terms of psychopathology and sociodemographic features. METHODS: Forty-eight patients (36 women and 12 men) meeting Leymann Inventory of Psychological Terror criteria for bullying were included in a prospective study. Evaluations were performed at first consultation and at 12 months using a standard clinical interview, a visual analogue scale of stress, the Hospital Anxiety and Depression (HAD) scale, the Beech scale of stress in the workplace and a projective test (Picture-Frustration Study). RESULTS: At first consultation, 81% of patients showed high levels of perceived stress at work and 83 and 52% presented with anxiety or depression, respectively. At 12 months, only 19% of working patients expressed a feeling of stress at work. There was a significant change in symptoms of anxiety while there was no change in symptoms of depression. Stress at work and depression influenced significatively capacity to go back to work. At 12-month assessments, workers showed a significantly better score on the HAD scale than non-workers. Over half the targets presented a neuroticism-related predominant personality trait. CONCLUSION: Workplace bullying can have severe mental health repercussions, triggering serious and persistent underlying disorders.     

The rise and fall in incidence of malignant mesothelioma from a British Naval Dockyard, 1979-1999

BACKGROUND: The incidence of malignant mesothelioma in Britain is predicted to rise over the next 15-25 years because of past failure to protect the workforce against inhalation of asbestos. In British Naval dockyards, alternative insulation materials and respiratory protection were introduced from the mid-1960s. Aims This study was carried out to investigate the effects of these control measures on mesothelioma deaths in dockyard workers. METHODS: Cases of mesothelioma of the pleura and peritoneum between 1979 and 1999 in workers from the Devonport Naval Dockyard, south-west England, were sought from coroners' and medico-legal records. RESULTS: Three hundred and one cases were identified, 7% peritoneal. The peak incidence occurred in 1991 with 25 cases per annum (quadratic model fit R(2) = 74.2%, P < 0.001) and we predict that by 2003 the incidence will fall to fewer than five cases per annum. The mean time between first exposure and presentation was 48.5 years [95% confidence interval (CI) = 47.3-49.8], but this was significantly shorter in the more heavily exposed trades, when compared with the less heavily exposed (42 years, 95% CI = 39.0-45.0, versus 49.5 years, 95% CI = 48.2-50.9). Those with higher exposure were also at significantly greater risk of peritoneal disease (P < 0.023, Fisher's exact test). CONCLUSION: The reduction in incidence of mesothelioma is greater than can be accounted for by reduction in numbers of dockyard workers over the last 50 years. Changes in insulation materials and improved industrial hygiene measures introduced into the Devonport Dockyard from the mid-1960s have resulted in an earlier decline in the incidence of malignant mesothelioma than that predicted for the British workforce as a whole.     

Organophosphate toxicity and occupational exposure

The ubiquitous organophosphates present a continuing health hazard in agriculture, public health eradication programmes and as chemical warfare agents. Despite significant progress in understanding the potential mechanisms of toxicity far beyond the commonly accepted mechanism of cholinesterase inhibition in intentional exposures, the precise health effects following occupational exposures are yet to be completely defined. A much greater understanding exists of the clinical features of organophosphate poisoning. These are characterized by a triphasic response involving an initial acute cholinergic phase, an intermediate syndrome (both associated with high mortality) and a disabling but non-lethal delayed polyneuropathy. The delayed polyneuropathy may occur in the absence of the cholinergic or intermediate phases. However, progress is still required in order to improve the quantification and assessment of occupational exposures and the implementation of appropriate preventive measures. Finally, evidence-based guidelines for appropriate or optimal therapeutic interventions following poisoning are required urgently and collaborative work with colleagues in developing countries, where the occurrence of organophosphate exposures is more frequent, may provide the answers.     

Miliaria rubra of the lower limbs in underground miners

This report documents a case series of miliaria rubra of the lower limbs in miners at a deep underground metalliferous mine in tropical arid Australia. During the summer months of February and March 1999, all cases of miliaria rubra of the lower limbs in underground miners seen at the mine's medical centre were clinically examined and administered a questionnaire. Twenty-five patients were seen, an incidence of 56.4 cases per million man-hours. Miliaria rubra was most often located between the ankle and knee (88% of cases). Twenty-four percent had concurrent folliculitis and 20% had concurrent tinea. Thirty-two percent had a personal history of asthma. Walking through ground-water and splashing of the legs was common. Three to 4 weeks of sedentary duties in air conditioning was generally required to achieve resolution of miliaria rubra. The incidence of miliaria rubra of the lower limbs is 38% of the incidence of heat exhaustion at the same mine. The length of disablement is greater, however. Atopics may be at increased risk of miliaria rubra. Control measures are discussed.     

Planning research

The starting point for any research project should be a question.Once this has been defined and the relevant scientific literaturereviewed, a protocol should be drawn up. This will be used notonly as a guide to the conduct of the study and in the preparationof the final report, but also in seeking any financial supportand approvals that are required for the investigation. A protocolis normally arranged in sections covering the background tothe study, the question(s) that it will address, the methodsthat will be used for the collection and analysis of data, thestatistical power of the investigation (where relevant), anyethical considerations, and the financial input that will beneeded. A pilot study is often helpful where aspects of thestudy method are untried or of uncertainvalidity.     

Stress in the Norwegian police service

BACKGROUND: High levels of stress have been attributed to the conditions of police work, but there is little empirical evidence for this. AIMS: To develop a new instrument to measure job stress in the police; to assess the most severe and frequent police stressors; to compare levels of stress according to the demographic and organizational factors; and to study stress in relation to personality traits, work locus of control and coping strategies. METHODS: A comprehensive nationwide questionnaire survey of 3272 Norwegian police at all hierarchical levels, including the Norwegian Police Stress Survey (NPSS), the Job Stress Survey, the Basic Character Inventory, the Work Locus of Control Scale, and the Coping Strategies Scale. RESULTS: Work injuries were appraised as the most stressful but least frequent stressor and job pressure was reported the least severe but most frequent stressor. Females experienced job stressors less frequently, but appraised them as more severe than men did. Older police officers reported more job pressure severity and fewer work injuries. The police in districts where peer support was planned but not implemented, and who worked in districts with more than 50,000 inhabitants, perceived the lack of support more severely than others. The correlations between stress and personality traits, work locus of control, and coping were moderate. CONCLUSIONS: The NPSS captures police-specific stressors that are not adequately measured by global stress instruments. The study of stress in police work should preferably involve a nationwide use of police-specific stress instruments.