迈向消除阶段我国血吸虫病防控应急演练的思考

本文分析了迈向消除阶段血吸虫病应急演练的重要性,就血吸虫病应急演练中的桌面推演、功能演练、专题演练和全面演练四种应急演练形式进行了详细阐述,以期为推动血吸虫病应急演练的科学化、规范化和常态化提供参考。     

情景模拟应急演练对培养外科护理人员应急能力的效果探讨

目的探讨临床情景模拟应急演练对培养外科护理人员应急能力的应用效果。方法对该院外科80名护理人员开展临床情景模拟应急演练,对演练前后各项急救技能、应急能力进行考核评分和对比分析。结果经过一年的情景模拟培训后,80名外科护理人员考核结果为优秀35名（43.8%）,良好26名（32.5）%,较好12名（15.0%）,一般7名（8.8%）,与培训前比较有明显提高,差异具有统计学意义（P〈0.05）。结论情景模拟演练可有效提高外科护理人员应急能力和急救技能。     

新疆疾病预防控制中心首次举办核与辐射突发事件医学应急救援演练

为提高新疆维吾尔自治区疾病预防控制中心应对核和辐射突发事件卫生应急反应和处置的能力,锻炼专业应急救援队伍,检验核和辐射突发事件医学应急预案的实用性和可操作性,并进一步完善核和辐射突发事件卫生应急体制和机制,加强应急能力建设,科学、规范、有序、有效地开展辐射监测和辐射防护等卫生应急工作,根据新疆维吾尔自治区卫生厅的统一安排,2011年5月13日上午新疆维吾尔自治区疾病预防控制中心和新疆维吾尔自治区人民医院分别开展了核与辐射突发事件医学应急救援演练及地震灾害突发事件医学救护应急演练。     

新疆生产建设兵团卫生应急能力评估分析

目的了解新疆生产建设兵团(简称兵团)卫生应急能力现状,为科学而规范地指导兵团的卫生应急能力建设、提升各地的卫生应急能力提供依据。方法按照国家卫生计生委《卫生应急能力评估标准》,对兵团、师、团三级卫生应急能力进行评估和量化评分。结果对照国家评估标准,兵团整体卫生应急能力还有相当差距,兵团、师、团三级能力依次递减,尤其是团级能力较差,占总分的28.3%,仅具备国家要求能力的约三分之一;兵团本级卫生应急能力差距较大的前三项依次是宣教科研、善后评估、培训演练,分别占国家要求能力的10.0%、25.0%和55.7%;师级卫生应急能力差距较大的前三项依次是善后评估、应急处置、装备储备,分别占国家要求能力的39.5%、43.2%和49.5%;团级卫生应急能力差距较大的前三项依次是应急处置、善后评估、装备储备,分别占国家要求能力的25.4%、29.6%和39.4%。结论兵团各级应加强卫生应急体系和卫生应急能力建设,以突发公共卫生事件应急处置为抓手,做好卫生应急准备工作,提升卫生应急的处置能力。     

抽组卫勤力量应对重大疫情的应急培训模式探讨

[摘要]　以新型冠状病毒肺炎（新冠肺炎）为代表的重大传染病疫情处置工作中,军队卫生机构抽组的应急卫勤力量发挥着重要作用。然而,对口专业人员和技能的缺乏,传染病隔离防护训练的不足,以及指挥人员应对疫情组织管理经验的欠缺等问题制约了处置效能的发挥。根据新冠肺炎疫情处置任务实际,结合重大传染病疫情特点,对抽组卫勤力量应对疫情应急培训模式的构建展开思考。     

应用谷歌地球建立血吸虫病地理信息系统

目的 利用Google Earth平台,建立血吸虫病地理信息系统（GIS）。 方法 在Google Earth平台上,通过添加地标、路径、多边形、图像叠加层等方法,建立血吸虫防治相关的地理信息。 结果 建立了血吸虫病GIS。该系统包含“流行区”、“水系”、“流行示意图”、“有螺环境”、“新发及复现钉螺环境”、“急性血吸虫病”等6个模块。通过操作GIS平台,在3D地图上,实时查看血吸虫病相关信息。 结论 基于Google Earth的血吸虫病GIS,操作简单易学,功能比较完善,非常适合在血防基层机构推广使用。     

2015年江西省"三甲医院"寄生虫病检验技能竞赛成绩分析

目的 了解江西省综合性三甲医院检验人员寄生虫病检测能力。方法 全省20家综合性三甲医院组队参赛,每队2名选手。竞赛分为笔试和技能操作两部分（各100分）。笔试内容涉及寄生虫生活史、免疫学基础、检测技术、病原诊断等;技能操作包括厚、薄血涂片及改良加藤厚涂片的制片和镜检阅片。结果 共40名选手参赛,总成绩平均分为（97.3±22.4）分,及格率为15.0%;其中笔试平均成绩为（56.6±12.8）分,及格率为52.5%;技能操作平均成绩为（40.8±12.4）分,及格率为5.0%。笔试成绩中,土源性线虫生活史得分率最高（90.0%）,食源性寄生虫病防治基础知识得分率最低（31.5%）。选手血涂片制作、镜检及格率均高于加藤片,差异均有统计学意义（P均 < 0.05）;间日疟原虫、恶性疟原虫、卵形疟原虫和阴性片的镜检检出率依次为38.8%、45.0%、35.0%和25.0%;蠕虫卵检出率以鞭虫卵最高（87.5%）,曼氏迭宫绦虫卵最低（2.5%）。省级医院选手加藤片制作和镜检得分均高于市级医院 （P均 < 0.05）;教学医院选手加藤片制片成绩高于非教学医院（P < 0.05）。结论 江西三甲医院检验专业人员寄生虫病检测技能水平难以满足当前寄生虫病诊断的需要,应引起卫生主管部门和医院的高度重视。     

2016-2017年度中国大陆流行性感冒监测分析

目的 对2016-2017监测年度中国内地流行性感冒的监测结果及流行形势进行分析总结。方法 统计“中国流感监测信息系统”以及“突发公共卫生事件信息管理系统”2016-2017监测年度全年中国内地的ILI监测数据以及流感样病例暴发疫情数据。结果 2016-2017监测年度,南方省份流感活动未出现明显的夏季活动高峰,南、北方省份2017年秋冬流感流行季节均早于上一个监测年度,但流行高峰水平低于2015-2016监测年度。整个年度全国的流感流行优势病毒分别就经历了B型、A(H3N2)和甲型H1N1的交替。全国报告的ILI暴发疫情总起数低于2015-2016年度,南方片区高于北方片区。结论 各地继续高度重视近期流感病毒活动情况,密切关注全球及我国疫情形势,加强监测数据的分析和利用,跟踪流感病毒的活动水平、变异和耐药性变化,及时开展流感暴发疫情的调查处置和应对工作。     

创建山东省结核病预防控制工作规范县的效果分析

目的 总结山东省结核病预防控制工作规范县创建活动的效果。
方法 依据《结核病预防控制工作规范》（简称《规范》）制定《山东省结核病预防控制工作规范县标准》（简称“标准”）,38个山东省结核病防治示范县中,由县级卫生行政部门自愿申报,市级卫生行政部门初审,省卫生厅审核同意,最终确定19个县（市、区）为规范县创建单位。省级提供经费支持与业务指导,县级按照《标准》要求规范结核病控制工作,通过省卫生厅考核验收,打造符合《规范》要求的“规范县”。
结果 19个创建单位中,17个已获得“规范县”命名。获得命名的“规范县”县级配套结核病防治经费均已达到全人口人均0.3元以上（未获得“规范县”命名的2个县未达到全人口人均0.3元以上）;人员配备符合《规范》要求,县级结核病防治机构至少有8名有经验的专业技术人员,超过40万人口的县区,人口每增加5万技术人员增加1名;初诊患者占总人口的比例基本达到300/10万以上,摄X线胸片率和查痰率基本达到100%,新涂阳患者治愈率保持在85%以上,非结核病防治机构报告患者总体到位率达到90%以上。
结论 通过“规范县”创建活动,基层结核病防治机构的能力得到了全面提高,为更好地开展结核病控制工作奠定了基础。     

重庆市A区基层公共卫生应急管理现况调查

目的 分析重庆市A区基层公共卫生应急管理现况,探讨基层公共卫生应急管理能力的提升措施。方法2021年7—9月,使用自制问卷对A区辖区内所有卫生行政部门、基层医疗机构开展线上调查,调查内容包括卫生应急管理基本情况、人才队伍建设情况、物资储备情况和应急能力提升需求等。结果 共调查20家单位,其中17家单位设置部门承担卫生应急工作;共有工作人员130人,其中医学相关专业占79.2%,本科及以上学历占65.4%,高级职称仅占11.5%;11家单位曾开展实战演练,14家单位按照标准对卫生应急队伍进行装备,仅4家单位认为应急物资满足需要;多家单位对人员队伍（7家）、资金投入（6家）、培训和演练（7家）提出需求。结论 重庆市A区基层公共卫生应急管理在物资储备、人员装备、人才保障、信息化建设、实战演练等方面还存在一定短板。建议加强应急物资储备与管理,完善卫生应急人员与装备建设,优化信息化建设,强化培训指导与实战演练,从而不断提升基层公共卫生应急管理整体实力,促进该区公共卫生事业持续发展。     

Hospital trauma care in multiple-casualty incidents: a critical view

During a multiple-casualty incident, a large casualty caseload adversely affects the quality of trauma care given to individual patients. From a trauma care perspective, the goal of the hospital emergency plan is to provide severely injured patients with a level of care that approximates the care given to similar patients under normal conditions. Therefore, the realistic admitting capacity of the hospital is determined primarily by the number of trauma teams that the hospital can recruit. Effective triage of these casualties is often not straightforward, with high overtriage rates. Simplified triage algorithms may be a practical alternative to more elaborate schemes. The concept of minimal acceptable care is the key to a staged management approach during a mass-casualty incident. Discrete-event computer simulation and war game tabletop exercises for key personnel are 2 new modalities that are supplementing the traditional mock disaster drill as effective planning and training tools.     

Evaluation of limited hand mobility in systemic sclerosis patients by using “prayer sign” and “tabletop sign”

Clinical Rheumatology - To determine limited joint mobility (LJM) of the hand in patients with systemic sclerosis (SSc). LJM was evaluated with “prayer sign” and “tabletop...     

Knowledge about cardiovascular disease in Portugal

Objectives

To characterize specific knowledge on cardiovascular disease, particularly stroke and myocardial infarction (MI), and its relationship with sociodemographic factors, health literacy and clinical history, among the Portuguese population.

2012-2016年芜湖县血吸虫病疫情分析

目的 分析2012-2016年芜湖县血吸虫病疫情,为制定下一阶段的血吸虫病防治措施提供参考依据。方法 收集2012-2016年芜湖县血吸虫病防治工作年报及全县面上防治资料进行纵向分析。结果 2012年芜湖县人群血吸虫感染率为0.187%,自2013年后人群血吸虫感染率逐年下降,2016年降至0;2012-2016年全县均未查出血吸虫感染阳性家畜。2012-2015年全县有螺面积逐年下降,2016年出现大幅回升;5年间均未发现血吸虫感染阳性钉螺。结论 芜湖县血吸虫病疫情已得到有效控制,下一阶段应重点加强钉螺和输入性传染源控制,以巩固已取得的防治成果。     

芜湖水域麦穗鱼感染华支睾吸虫囊蚴的调查

目的 旨在了解芜湖地区部分水域野生麦穗鱼感染华支睾吸虫囊蚴情况,为华支睾吸虫病的防治工作提供参考。方法 从芜湖地区部分水域(牛屯河、扁担河、漳河、奎湖和龙窝湖)捕捞麦穗鱼,采用鱼肉直接压片镜检法和胃蛋白酶消化法从麦穗鱼肌肉中分离囊蚴,并利用获得的囊蚴感染家猫,证实麦穗鱼所感染华支睾吸虫囊蚴。结果 芜湖5个水域中的麦穗鱼均有华支睾吸虫囊蚴感染,其平均感染率为34% (34/100),平均感染度为120.1个/条,且阳性麦穗鱼背部肌肉(前背肌肉、中背肌肉、后背肌肉)均有华支睾吸虫囊蚴的感染,腹部肌肉和尾部肌肉的感染率较低。结论 芜湖地区部分水域野生麦穗鱼感染华支睾吸虫囊蚴的情况较为普遍,应加强宣传和防治工作,以防止华支睾吸虫病的流行。     

Which delivery model innovations can support sustainable HIV treatment?

The rapid scale-up of antiretroviral treatment (ART) for HIV since the mid-2000s, mostly through disease-specific or “vertical” programmes, has been a highly successful undertaking, which averted millions of deaths and prevented many new infections. However, the dynamics of the HIV epidemic and changing political and financial commitment to fight the disease will likely require new models for the delivery of ART over the coming decades if the promises of universal treatment are to be met. Delivery model innovations for ART are intended to improve both the effectiveness and efficiency of the HIV treatment cascade, reaching new people who require ART and providing ART to more people without an increase in resources. We describe twelve models for ART delivery, which could be achieved through five categories of delivery innovations: integrating ART (“vertical ART plus”, “partially-integrated ART” and “fully-integrated ART”); modifying steps in the ART value chain (“professional task-shifted ART”, “people task-shifted ART” and “technology-supported ART”); eliminating steps in the ART value chain (“immediate ART” and “less frequent ART pick-up”); changing ART locations (“private-sector ART”, “traditional-sector ART” and “ART outside the health sector”); and keeping the status quo (“vertical ART”). The different delivery model innovations are not mutually exclusive and several could be combined, such as “vertical ART plus” with “task-shifted ART”. Suitability of the models will highly depend on local and national contexts, including existing health systems resources, available funding, and type of HIV epidemic. Future implementation research needs to identify which models are the best fit for different contexts.     

Interdisciplinary Collaboration in Gerontology and Geriatrics in Latin America: Conceptual Approaches and Health Care Teams

The underlying rationale to support interdisciplinary collaboration in geriatrics and gerontology is based on the complexity of elderly care. The most important characteristic about interdisciplinary health care teams for older people in Latin America is their subjective-basis framework. In other regions, teams are organized according to a theoretical knowledge basis with well-justified priorities, functions, and long-term goals, in Latin America teams are arranged according to subjective interests on solving their problems. Three distinct approaches of interdisciplinary collaboration in gerontology are proposed. The first approach is grounded in the scientific rationalism of European origin. Denominated “logical-rational approach,” its core is to identify the significance of knowledge. The second approach is grounded in pragmatism and is more associated with a North American tradition. The core of this approach consists in enhancing the skills and competences of each participant; denominated “logical-instrumental approach.” The third approach denominated “logical-subjective approach” has a Latin America origin. Its core consists in taking into account the internal and emotional dimensions of the team. These conceptual frameworks based in geographical contexts will permit establishing the differences and shared characteristics of interdisciplinary collaboration in geriatrics and gerontology to look for operational answers to solve the “complex problems” of older adults.     

A new explanatory model of an SIR disease epidemic: a knowledge-based, probabilistic approach to epidemic analysis

A new explanatory model for epidemic analysis is presented; it has a knowledge based component and a probabilistic computational component. The former assembles details of household characteristics, social networks and connectivity in the community--'knowledge'--which is used to determine the structure of the computational component. The latter links individuals and households through statistically-defined opportunities for contacts and, by repeated trials, determines an average longitudinal time course (epidemic curve) of the simulated infection as it spreads through the community from inception to extinction of the epidemic. The model thus aims to describe the epidemic itself, rather than any abstraction of it. In application to a 1955-56, self-contained epidemic of an SIR disease, variola minor, the model generates 1 dominant longitudinal pattern that matches closely the epidemic curve of observed daily case rates; it is suggested that other patterns indicate different ways in which the epidemic might have evolved. The model can be used to show how differing community characteristics would affect the simulated epidemic.