凯里市2010年儿童入托入学查验预防接种证及疫苗补种工作情况分析

目的了解凯里市入托入学查验预防接种证工作开展情况,为凯里市入托入学查验预防接种证工作今后更加规范和管理提供依据。方法按照《贵州省入托入学查验接种证制度操作手册(2009年修订)》的要求,对凯里市公办、私营、未注册的幼儿园、小学开展查验预防接种证工作及对凯里市2010年入托入学查验预防接种证工作资料进行统计分析。结果 2010年,全市托幼机构、小学在入托、入学查验预防接种证时,持证率分别为92.59%、80.09%;经入托、入学查验证补证后持证率均为100%。全市托幼机构、小学查验证时和补种后的脊灰疫苗、百白破疫苗(小学为百白破疫苗+白破)、麻疹疫苗、乙肝疫苗报告全程接种率分别为68.83%、78.46%、75.71%、67.81%;96.92%、96.98%、97.35%、78.73%。各疫苗的补种率分别为86.96%、81.40%、85.00%、31.46%。入托儿童报告全程接种率高于入学儿童,补种率低于入学儿童(除乙肝疫苗外)结论入托入学查验预防接种证工作取得了明显成效,但补种率有待提高,教育、卫生部门相互协调配合有待于更进一步的加强。     

2008年潍坊市坊子区入托入学儿童预防接种证查验

目的了解潍坊市坊子区儿童预防接种证查验和计划免疫工作现状。方法按照统一方案对潍坊市坊子区2008年入托入学儿童预防接种证进行查验。结果全区托幼机构、学校预防接种证查验率、登记率均达100%,入托入学儿童预防接种证率为93.02%。疫苗漏缺种程度从高到低依次为乙脑疫苗、麻疹疫苗、流脑疫苗、脊灰疫苗、白破疫苗、百白破疫苗、乙肝疫苗、卡介苗。结论查验儿童预防接种证,对于提高疫苗接种率,保护儿童身体健康具有重要的作用。     

Approaches in the risk assessment of genetically modified foods by the Hellenic Food Safety Authority.

Risk analysis has become important to assess conditions and take decisions on control procedures. In this context it is considered a prerequisite in the evaluation of GM food. Many consumers worldwide worry that food derived from genetically modified organisms (GMOs) may be unhealthy and hence regulations on GMO authorisations and labelling have become more stringent. Nowadays there is a higher demand for non-GM products and these products could be differentiated from GM products using the identity preservation system (IP) that could apply throughout the grain processing system. IP is the creation of a transparent communication system that encompasses HACCP, traceability and related systems in the supply chain. This process guarantees that certain characteristics of the lots of food (non-GM origin) are maintained "from farm to fork". This article examines the steps taken by the Hellenic Food Safety Authority to examine the presence of GMOs in foods. The whole integrated European legislation framework currently in place still needs to be implemented in Greece. Penalties should be enforced to those who import, process GMOs without special licence and do not label those products. Similar penalties should be enforced to those companies that issue false certificates beyond the liabilities taken by the food enterprises for farmers' compensation. We argue that Greece has no serious reasons to choose the use of GMOs due to the fact that the structural and pedologic characteristics of the Greek agriculture favour the biological and integrated cultivation more. Greece is not in favour of the politics behind coexistence of conventional and GM plants and objects to the use of GMOs in the food and the environment because the processor has a big burden in terms of money, time and will suffer a great deal in order to prove that their products are GMO free or that any contamination is adventitious or technically unavoidable. Moreover, Greece owns a large variety of genetic material that should try to protect from patenting and commercialisation. Finally, we should be aware of the requirements of movement of GMOs within borders, i.e. GMOs grown or used in other countries but which are not intended to cross into Greece, since Greece is very close to countries that are non-EU. This is where the development of a new, integrated, trustworthy and transparent food quality control system will help to satisfy the societal demands for safe and quality products. On the other hand, Greece should not be isolated from any recent scientific technological development and should assess the possible advantages for some cultivation using a case by case approach. Finally, the safety assessment of GM foods and feed has been discussed according to the risk assessment methodology applied by EFSA.     

Like a Frog in Boiling Water: The Public, the HFEA and Sex Selection

This paper analyses the British Human Fertilisation and Embryology Authority's 2002 public consultation on sex selection, a consultation that was mainly concerned with sex selection for non-medical reasons. Based on a close reading of the consultation document and questionnaire it is argued that the consultation is biased towards certain outcomes and can most plausibly be construed as an attempt not to investigate but to influence public opinion.     

Work-related fatalities in the agricultural production and services sectors, 1980-1989

A total of 6,727 workers died of work-related injuries in the agricultural production and agricultural services sectors between 1980 and 1989, as established by data from the National Institute for Occupational Safety and Health (NIOSH) National Traumatic Occupational Fatalities (NTOF) surveillance system. The agricultural production sector accounted for the higher fatality rate (22.9 deaths per 100,000 workers), due largely to deaths caused by machinery and motor vehicles. The leading cause of death in the agricultural services sector was being struck by falling objects, primarily trees. Fatality rates were highest in the East South Central United States and lowest in the New England states. Blacks had the highest fatality rate (26.4 deaths per 100,000 workers) while workers other than white or black had the lowest rate (18.9 per 100,000 workers). Males were at higher risk of death than females, with the 65 years of age and older male group having the highest rate (60.5 deaths per 100,000 workers). Males 16-24 years of age exhibited the largest decrease in their average annual fatality rate during the 10-year period, down to 7.2 from 20.6 deaths per 100,000 workers. Possible reasons for this decrease are suggested.     

Accuracy of Birth Certificate and Hospital Discharge Data: A Certified Nurse-Midwife and Physician Comparison

Objectives: Birth certificate and hospital discharge data are relied upon heavily for national surveillance and research on maternal health. Despite the great importance of these data sources, the recording accuracy in these datasets, comparing birth attendant type, has not been evaluated. The study objective was to assess the variation in chart documentation accuracy between certified nurse-midwives (CNMs) and physicians (MDs) for selected maternal variables using birth certificate and hospital discharge data. Methods: Data was obtained on women delivering in 10 Washington State hospitals that had both CNM and MD-attended births in 2000 (n = 2699). Using the hospital medical record as the gold standard of accuracy, the true positive rate (TPR) for selected maternal medical conditions, pregnancy complications, and intrapartum and postpartum events was calculated for CNMs and MDs using birth certificate data, hospital discharge data, and both data sources combined. Results: The magnitude of TPRs for most recorded maternal medical conditions, pregnancy complications, and intrapatum and postpartum events was higher for CNMs than for MDs. TPRs were significantly higher in birth certificate records for pregnancy-induced hypertension, premature rupture of membranes, labor augmentation, induction of labor, and vaginal birth after cesarean (VBAC) for CNM-attended births relative to MDs. Among combined data sources, CNM TPRs were significantly higher for pregnancy-induced hypertension and premature rupture of membranes. Conclusions: CNMs had consistently higher accuracy of recorded maternal medical conditions, pregnancy complications, and intrapartum and postpartum events when compared to MDs for all data sources, with several being statistically significant. Our findings highlight discrepancies between CNM and MD hospital chart documentation, and suggest that epidemiologic researchers consider the issue of measurement error and birth attendant type.     

手术室护理中有关法律问题的探讨

医疗法规的日渐完善 ,对医疗安全的要求和医护人员的工作行为及其职责的约束更加严格。探讨手术室护理工作中的有关法律问题包括 :手术室护理工作中的法律文件、越职行为、失职行为、病人的隐私权、医护人员的语言、手术室护士的法律意识等 ,对防止有关的护理缺陷的发生 ,减少医疗纠纷具有重要的意义     

COPD-Related Mortality and Co-morbidities in Northeastern Italy, 2008-2012: A Multiple Causes of Death Analysis

Introduction: Analysis of COPD mortality based only on the underlying cause of death (UCOD) derived from death certificates underestimates disease burden. We analyzed the burden of COPD, as well as the pattern of reporting COPD and its co-morbidities in death certificates, using multiple-cause of death (MCOD) records.

Methods: All 220,281 death certificates of decedents aged ≥40 years in the Veneto region (northeastern Italy) were analyzed through 2008–2012. The UCOD was selected by the Automated Classification of Medical Entities software. COPD was defined by ICD-10 codes J40-J44 and J47 based either on the UCOD or on any mention of COPD in death certificates (MCOD). Annual age-standardized COPD death rates were computed for 40–85 year-old subjects.

Results: COPD was mentioned in 7.9% (and selected as the UCOD in 2.7%) of death certificates. In about half of these, COPD was mentioned in Part II only. After circulatory and neoplastic diseases, the most frequent chronic diseases reported in certificates with any mention of COPD were diabetes (15.2%) and dementia/Alzheimer (8.9%). Between 2008 and 2012, age-standardized death rates (/100,000/year) decreased from 39.8 to 34.0 in males and from 12.7 to 11.3 in females in the UCOD analyses. These trends were confirmed, although figures were three times greater, in the MCOD analyses.

Conclusions: MCOD analysis should be adopted to fully evaluate the burden of COPD-related mortality. Our findings support a decreasing trend in COPD-related mortality in northeastern Italy between 2008 and 2012, in line with other recent studies in Europe and beyond.     

基于德尔菲法的区域卫生信息管理平台指标体系构建

目的构建适合区域卫生信息管理平台的指标体系,为卫生行政管理提供有效、经济和便捷的信息化服务。方法采用德尔菲法筛选指标。首先,以电子邮件的方式将问卷发给专家,由专家评分;其次,回收专家评分表进行数据统计分析,根据指标筛选规则来剔除不符合要求的指标;最后,经过2~3轮德尔菲法咨询后形成指标体系。结果经过两轮德尔菲咨询后,专家意见基本一致,两轮专家问卷回收率及有效率均为100%,专家权威系数0.721,专家的权威性较高。按照专家意见,在第一轮咨询后删除16个三级指标,第二轮专家咨询后删除15个三级指标,最后形成包含4个一级指标、13个二级指标、98个三级指标的指标体系。结论应用德尔菲法建立指标体系,具有一定的科学性和权威性,可以为后续平台开发提供依据,进而为卫生行政管理部门提供便捷的信息化服务。