四川省1起甲型肝炎暴发的流行病学分析

目的探讨四川省阆中市西山中心校甲型肝炎(甲肝)暴发因素和控制措施.方法应用描述性流行病学方法对西山中心校甲肝暴发疫情进行分析.结果本次甲肝暴发,发病77例,罹患率120.1‰.发病年龄主要集中在11～16岁(占77.92%),患者中有55例(71.43%)为住校学生,住校生罹患率是走读生的3.64倍.结论报告迟缓,疫情蔓延历时54 d,而学生普遍未进行甲肝疫苗接种,造成易感人群的大量积累是本次暴发的直接原因.     

一起因聚餐所致霍乱疫情的调查分析

目的分析本次霍乱发病原因,为今后霍乱疫情防控制提供科学依据。方法调查所有聚餐人员及接触者,按《霍乱防治手册》确定病例。结果调查高危人群788人,发现病例1例,带菌者3例,病原学确认均为O139血清型。结论本次霍乱疫情由聚餐引起,发病原因可能为食用的甲鱼、蟹或虾污染霍乱弧菌所致,提示应加强餐饮业监督管理和培训工作,加大对公众霍乱防治知识宣传力度。     

一种医院科室病人信息记录系统的应用

采用Access 2000构建一个小型数据库系统。通过需求分析确定数据库结构,并设计出主界面和查询界面。采用拆分数据库的方式实现了数据库的"服务器/客户端"管理结构,设置用户权限和密码保护提高数据安全性。     

Interaction between a medical group and a school of public health: a case study of a productive affiliation

As schools of the health sciences come under increasing financial pressures and providers must cope with the increasing complexity of the health care system, mutually supportive arrangements may become more common and more important to both parties. Underlying such arrangements is the expectation that the schools of the health sciences may gain sources of support for professional education and access to training opportunities and that the providers may gain in operational capacity and access to specialized expertise. We have developed a collaborative relationship between a school of public health and a multispecialty group medical practice. Although in some respects an improbable combination, the relationship has yielded benefits and may be of interest to other institutions.     

Impact of a postcard versus a questionnaire as a first reminder in a postal lifestyle survey.

STUDY OBJECTIVE--The study aimed to consider the impact of two different types of reminder on response rates and costs in a postal survey. DESIGN--The study was a cross sectional survey. A self-completion lifestyle questionnaire was used. Those who did not respond after the initial mailing were randomly allocated to receive either a postcard or questionnaire as a first reminder. All outstanding non-responders received a questionnaire as a second reminder. SUBJECTS--A representative sample of 698 adults aged 16-70 was used, drawn from a family health services authority register. MAIN RESULTS--Postcard reminders were as effective as questionnaire reminders in increasing response whether one or two reminders are sent. The costs per response were calculated. Two questionnaires as reminders were found to be 1.7 times more expensive than a postcard plus questionnaire. Including the initial mailing, the cost per response using all questionnaires was 1.3 times the cost when a postcard was used for the first reminder. CONCLUSIONS--To increase the response to a postal survey effectively and economically, two reminders should be sent--first a postcard and then a questionnaire.     

Building a network on a legacy of teamwork

The nine hospitals that belong to the Hospital Consortium of Greater Rochester have a long history of working together to control health care costs in this upstate New York community. Now they're focusing on creating an electronic health information network. The project has the support of major local employers, which want to keep unnecessary care to a minimum to reduce costs. Electronic networking also will support longstanding efforts in Rochester to ensure that hospitals don't needlessly duplicate services. And the network will allow providers to more easily draw on a treasure trove of information already stored in clinical data bases.     

一起学校甲型副伤寒暴发疫情的调查分析

2009年7月,位于湖北西南部的宣恩县李家河乡某中学发生一起甲型副伤寒暴发疫情,共发生病例40例,罹患率为2.65%,这是宣恩县近年来发生在学校的较大的一起甲型副伤寒疫情.     

Emergent Literacy: a case-study of a two-year-old

Observations of the spontaneous behaviors and comments of one child aged 24 to 36 months pertinent to emergent literacy are reported. The child was not an early reader. The following areas were addressed: letter/numeral naming, the meaning of print, the communicative function of print, conception of meaning-units or words, language games, awareness of the sound of language, and the relationship between spoken words and specific characteristics of print. The child's responses at the age of 34 months to testing, on some of these topics, are described. Discussion treats cultural aspects, as the child was not exposed to book reading or television. An obstacle the child must overcome in order to understand print, to grasp that letters in text are sequentially ordered, is also discussed.     

Intravenous feeding of a complete diet in a child: report of a case.

A 5-month-old white infant with Hirschsprung's disease, complicated by a digestive upset and upper respiratory infection, developed a most extreme picture of marasmus which gave every indication of an impending fatal termination. The baby was given a complete intravenous feeding for five days with fats, carbohydrate, and amino acids in proportions and quantities recommended in a normal infant's diet. There was a prompt dramatic improvement in the nutrition, permitting eventual successful treatment of the Hirschsprung's disease with prostigmine. We believe that this is the first case on record of complete feeding by vein alone for a significant period of time. The success in this child suggests strongly that total feedings by vein can be a practical and lifesaving procedure, especially applicable to children who are marasmic, or are for any reason unable to handle an adequate diet by mouth, or in whom it is desirable to withhold oral feedings for therapeutic purposes.     

Determinants of a merger in a publicly-funded health system: a political-economy perspective

This article reports the results of a case study, spanning a period of 10 years, of the merger of two hospitals in a publicly-funded health system. A political economy model was used to analyse the determinants of the merger. Results show that external political economy factors, mainly pressure from the state to rationalize health services and the organization's needs to acquire critical resources, significantly contributed to the merger decision. At the internal political economy level, groups and individual strategies also played a determinant role. Our study suggests that merger in the public sector may not necessarily result from efficiency motives.     

Evaluation of a high dose to a finger from a 60Co accident

Electron spin resonance and fluorescence in situ hybridization were used to evaluate the dose to the finger of a worker who accidentally touched a radiotherapy 60Co therapy source in November 1995. In September 1999, the middle finger was amputated. We estimated the dose to the bone of the finger to be 6.4 +/- 0.5 Gy using the electron spin resonance additive dose method and a corrected dose of about 20 +/- 3 Gy could be inferred by translocation analysis in peripheral lymphocytes using the fluorescence in situ hybridization method. This retrospective dosimetry was performed for the victim 4 y after the accident, but the compatibility of the results obtained by physical and biological methods reinforce their validity, although in the case of partial-body exposure the biological method has limitations and demonstrates the need to find appropriate correction factors.