2002-2005年邯郸市乙型肝炎疫苗接种情况分析

目的 探讨利用移动平均数法和传染病网络直报系统监测数据开展传染病疫情预警.方法 收集整理2004、2005年传染病网络直报疫情数据,计算发病基线,确定概率界值及界值,利用公式W=-Xni+Si计算ni预警值,绘制预警控制图,引入2006年发病数据,进行判读与反应.结果 根据传染病病种的危害性、严重性及可控制性等特点,确定概率界值为0.01,则(单位)2,计算各周的预警值.根据绘制预警控制图,可判定第1周、第2周副疫情有流行趋势.结论 移动平均数法预警适合发病数较多的传染病疫情,预警基线数据和预警概率界值是预警成功的关键数据.     

2008-2011年广东省中山市传染病自动预警系统效果评价

目的 对广东省中山市传染病自动预警系统(CIDARS)暴发预警效果进行评价,为完善和优化预警系统提供参考依据。 方法 收集整理中山市2008年4月21日至2011年12月31日移动百分位数法、累计和控制图法预警的数据,以及同期突发公共卫生事件相关信息,对CIDARS预警及时性、灵敏度和特异度进行回顾性评价。 结果 CIDARS发出预警信号3543条,信号响应率为100%;经初步核实,13条预警信号被判定为疑似事件,预警信号阳性率为0.37%。其中,高发传染病预警时间(发生暴发到首次发出预警信号的平均时间)为1 d,灵敏度为83.33%,特异度为74.20%;低发传染病预警时间为0 d,灵敏度为100.00%,特异度为96.32%;新纳入法定报告传染病手足口病预警时间为0 d,灵敏度为100%,特异度为76.18%。 结论 预警系统对于低发传染病的暴发预警及时性、灵敏度和特异度均优于高发传染病,对于低发传染病预警特异度优于新纳入法定报告传染病;预警系统已初步实现传染病暴发的早期探测预警,但仍需进一步完善,设置合理的预警阈值,减少错误预警信号。     

基于网络直报的传染病监测自动预警信息系统概念模型

目的利用监测信息资源,对基于网络直报的传染病监测如何实现以日为单位动态自动预警提出概念模型,实现对传染病暴发的早期自动预警。方法采用历史参比资料,运用移动百分位数法的基本思路,建立统计方法概念模型。结果通过监测信息平台建立预警信息系统,配置调节参数,动态校正预警阈值的灵敏度和特异度,实现监测传染病的动态预警。结论为各级传染病监测机构基于网络直报的传染病监测信息自动预警提供了指导性概念模型和验证方法。     

护理人员开展医院传染病症状监测预警的可行性分析

传染病疫情防控形势日益严峻,护理人员在应对传染病疫情防控和开展救护工作中的作用十分重要。通过政策查阅和文献检索,结合医院传染病症状监测预警发展现况,分析我国护理人员在医院开展传染病症状监测预警的可行性,并对未来护理人员开展传染病症状监测预警在资源优化、岗位职责落实以及能力培训方面进行探讨,为护理人员开展传染病监测预警工作,提升医院传染病防控能力提供参考。     

2008-2012年陕西省传染病自动预警系统运行效果评价

目的 分析2008-2012年陕西省传染病自动预警信息的运行状况,为进一步完善传染病自动预警信息系统的预警效果提供依据。 方法 采用描述性流行病学研究方法对2008-2012年陕西省传染病自动预警系统生成的预警信号、预警病种、响应时间、核实方式等进行分析。 结果 2008-2012年陕西省自动预警系统共发出预警信号51 245条,预警阳性率为0.05%。各地市均有预警信息,预警信号数与法定传染病发病总数存在正相关关系,r=0.973(P结论 传染病自动预警系统运行稳定,对及时发现重点病例和早期发现暴发疫情起到重要作用。但在实际应用中存在一些局限性,预警阈值有待进一步优化。     

浙江省象山县传染病自动预警信息系统运行情况分析

目的探讨自动预警信息系统功效。方法利用传染病自动预警信息系统平台,从预警信息敏感性、有效性和及时性三方面进行分析和评价。结果传染病自动预警信息系统发出预警信号较多的5种传染病依次为其他感染性腹泻病、流行性腮腺炎、麻疹、流行性感冒和急性出血性结膜炎。结论传染病自动预警信息系统非常敏感,有效提高了象山县传染病监测预警的工作效率。     

现阶段传染病监测预警工作的重点、难点和优化思路

传染病监测预警是我国疾病预防控制工作的重要内容之一。 本文简要回顾了我国传染病监测预警工作的发展历史,就如何增强早期监测预警能力,分析现阶段传染病监测预警工作的重点和难点,并提供相对应的优化思路,以期为传染病监测预警相关研究和实践提供参考。     

按照地域分层进行传染病暴发早期探测的效果分析

目的 分析按照地域分层进行传染病暴发早期探测方法的应用效果,为有效改进与完善预警方法提供依据。 方法 采用Microsoft Excel软件和Visual Basic for Application程序自行研制传染病实时监控预警系统,预警周期一般选择7 d,预警阈值依据国家规定的突发公共卫生事件、暴发疫情判定标准进行设置。从传染病网络直报系统中下载报告卡,导入传染病实时监控预警系统,在县、乡、村级和学校三个层面,逐层缩小地域范围,分别将预警传染病的实际发病数与预警阈值对比,最终定位于病例集中的村级或学校,从而获取预警信息,并对其进行响应与处理。对预警传染病的报告病例数、预警信息数、初步核实和现场调查结果进行分析,以预警信息响应率、疑似事件信息比例、现场调查率、灵敏度和阳性预测值作为评价指标。 结果 2007-2013年,按照地域分层进行传染病暴发早期探测,共获取预警信息148条,涉及14种传染病。经过初步核实,判定为疑似事件的共计10种传染病的127条预警信息,2 h内响应率为100.00%,疑似事件信息比例为85.81%;通过现场调查,证实85起暴发事件,24 h内现场调查率为100.00%,暴发探测灵敏度为100.00%,阳性预测值为57.43%。 结论 本预警方法能够早期探测传染病暴发疫情,实用性强,准确性高,但在许多方面还需要进一步改进与探索。     

2008-2013年贵州省安顺市传染病自动预警运行情况分析

目的分析2008-2013年传染病自动预警信息系统在贵州省安顺市的运行情况,探讨如何通过监测预警信息做好传染病疫情的防控工作。方法利用Excel 2003软件进行统计、汇总,应用描述流行病学方法对所获资料进行统计分析。结果安顺市2008-2013年共接收了4059起传染病自动预警信息,覆盖了21个病种,初步判断为疑似事件的有393起,疑似事件率为9.68%,经专业人员现场核实为暴发的有59起,预警信号阳性预测值为1.45%。预警处置及时率为98.10%,不同预警方法的响应及时率不同,单病种预警响应及时率为91.45%;时间系列预警响应及时率为98.51%。结论安顺市传染病自动预警系统运行状况良好,能及时发出传染病聚集性病例的预警,对早期发现暴发疫情起到非常重要的作用,但预警信号阳性预测值较低,县区疾控机构预警响应及时率需要提高。     

大数据在传染病监测预警中的主要研究与应用进展

开展传染病监测预警是有效防控传染病的重要途径。然而,我国从2004年建立法定传染病网络直报系统和2008年正式启用传染病自动预警系统至今,发现其存在数据来源单一、内容简单、预警时间关口相对滞后等问题,难以满足新突发传染病及不明原因疾病等的早期预警需求。近年来,随着信息技术的不断发展与应用,传染病诊疗和监测技术手段不断提升,与大数据有关的传染病早期预警研究与实践已逐渐成为热点。本文简要介绍了大数据的定义及特征,系统梳理了传染病相关大数据中各类数据源在传染病监测预警中的发展、应用实践、优势与局限性,概述了大数据的主要分析技术方法,以期为我国建立基于大数据的传染病监测预警机制和平台提供参考,进一步提升传染病监测预警的能力。     

Management of the airway without the use of neuromuscular blocking agents: the use of remifentanil

Remifentanil belongs to opioid drugs, and its pharmacokinetic characteristics make it unique in this class of drugs and appropriate for use during intubation without neuromuscular blockage. This up‐to‐date review aims to summarize the findings of recent studies regarding remifentanil and intubation. Remifentanil combined either with propofol or with inhaled anesthetic agents has been proved to provide acceptable intubating conditions. Regarding children patients, remifentanil can be used safely, and as far as intubating conditions are concerned, its effectiveness is as excellent as with neuromuscular blockage. Strong evidence exists that illuminates the usefulness of the drug in cases of difficult airway as well as in neuromuscular diseases. Beyond all these favorable characteristics, anesthesiologists must be conscious with the use of remifentanil.     

Shaping the practice of home care: critical case studies of the significance of the meaning of home

Changes in health-care service delivery have resulted in the transfer of care from formal spaces, such as hospitals and institutions, towards informal settings, such as home. As the home environment not only designates a dwelling but also represents a multitude of meanings such as personal identity, security and privacy that may vary according to the socio-economic and social demographic variables, it presents a complex site for study. This article uses two contrasting in-depth qualitative case studies to refine the application of the Health at Home Model in Home Healthcare Practice (HHMHHCP) (Roush and Cox, 2000). An addition to the original three dimensions of the model (home as familiar, home as centre and home as protector) is suggested--home as locator. Research directions to further understand the role of caregiving in contributing to the experience and meaning of the home environment by informal caregivers are discussed.     

小儿支原体肺炎肺外并发症82例临床分析

目的分析小儿支原体肺炎（MP）常出现的肺外病变表现。方法选择本院儿科收治的150例支原体肺炎患者，均经ELISA方法检测，肺炎支原体特异抗体滴度≥1：80。其中82例出现不同程度的并发症，发生率54．7％。结果在出现并发症的患者中，渗出性胸膜炎28例、心血管系统疾病25例、神经系统疾病11例、消化系统疾病9例、泌尿系统疾病7例。结论肺炎支原体感染是小儿吸道感染常见的病因，呈逐年上升趋势，且常累及多个脏器，病程迁延，治疗首选红霉素，重者短期应用激素，可显著缩短病程，减轻肺外系统损害。     

Ultrasonography of carotid plaque for the prevention of stroke

A carotid ultrasonography is a non-invasive technique that provides an accurate and reliable characterization of the broad spectrum of carotid arteriosclerosis, from the intima-media thickness to the atherosclerotic plaque. Carotid ultrasonography has become a useful tool for identifying patients at high risk of stroke and selecting those who can benefit most from revascularization therapies such as carotid endarterectomy and stenting. In addition to the degree of stenosis, plaque echomorphology has emerged in recent years as an important contributory factor to stroke risk. Changes in plaque echogenicity, as measured by the quantitative computer-assisted ultrasonography index, could be a marker of plaque instability as well as an indicator of plaque remodeling, thereby providing the means for monitoring anti-atherosclerosis drugs such as statins.     

An analysis of the concept of risk

The meaning of the word "risk" has changed throughout history. Once a neutral term, risk has come to represent a combination of probability and something adverse or dangerous. Phenomena that were previously referred to as hazards, dangers, or uncertainties are now labeled as risks. Although risk touches every aspect of health and human welfare, the dimensions of risk as conceptualized in the fields of epidemiology, nursing science, medical science, and lay health are qualitatively different. Risk has not been examined as a concept in nursing literature or research, although risk and related terms are defined in a few nursing textbooks. Using the evolutionary method of concept analysis, risk is examined as a concept. This analysis was undertaken to define and clarify the concept and dimensions of risk as they relate to risk for disease. A sound understanding of risk as a concept is critical for developing an empirical knowledge base in nursing and directing nursing research examining issues related to risk for developing diseases such as cancer.     

美国康复咨询职业发展

本文概述康复咨询职业在美国的发展.它最早在政府部门扮演一个为身体伤残人提供简单的职业建议和指导的角色.今天它已经发展成为一个复杂的行业,要求从业者具备职业和残疾的知识、心理测试和评定、就业相关的法律知识,当然还包括咨询技巧.专业化的硕士学位课程将为从业者提供相关知识和技能的学习.早期的就业机会主要局限在公共和政府机构,现在已经扩展到公共、社区和私营康复机构,以及教育和学术机构.尽管这一职业的发展带有美国特色,但它的职业技能和训练方法 也能为其他文化所利用.     

儿童食物不耐受28例误诊分析

目的分析儿童食物不耐受的临床特点、诊断方法及误诊原因。方法回顾性分析我院2017年7月—2020年7月收治的28例误诊为其他疾病的食物不耐受患儿临床资料。结果本组28例患儿表现为反复发作的阵发性哭闹、大便次数增多、大便性状改变、腹痛、腹胀,部分患儿生长发育滞后。其中14例误诊为感染性腹泻,10例误诊为胃肠功能紊乱,4例误诊为肠系膜淋巴结炎,误诊率为15.1%。采用《食物不耐受与儿童生长发育调查表》辅助诊断,确诊后均采用食物排除治疗,其中23例临床症状消失,5例临床症状明显改善。结论食物不耐受临床症状多样,且缺乏特异性,临床医师必须熟知食物不耐受的临床特征和鉴别诊断要点,并综合分析病史,以提高诊断准确率。     

Nurses' perceptions of the value of written reflection

Reflective writing is increasingly becoming a feature of professional practice as nurses seek to provide evidence of their continuing development and competence. This study reports the process and findings of a study using grounded theory to explore how nurses are using and developing writing techniques as a tool for facilitating and supporting their development in practice. Two focus group interviews were conducted with 12 experienced nurses completing a professional course which involved reflective writing as the assessment component over a calendar year. These interviews generated the broad base of concepts and categories which direct the later stages of a grounded theory study. These preliminary categories suggest that firstly, the skills of reflective writing need to be learnt rather than being assumed as a natural capacity; secondly, that this leads to the acceptance of writing as a learning strategy in its own right; thirdly, reflective writing is considered to be a tool which helps the practitioner to develop analytical and critical abilities; finally, the nurses identified their own personal, as well as professional growth as being facilitated by reflective writing. Lincoln and Guba's (1985) criteria for establishing rigour in qualitative studies, and Strauss and Corbin's (1990) criteria for judging a grounded theory study are used as benchmarks throughout the paper.