曲靖市2005年麻疹病例监测分析

为及时总结和分析我市2005年麻疹监测系统运转情况及麻疹流行病学特点,进一步完善和提高我市麻疹监测系统报告质量,对我市2005年麻疹病例进行流行病学分析,并对监测系统运转状况作出评价。     

曲靖市2006年麻疹流行病学分析

为及时总结和分析曲靖市2006年麻疹监测系统运转情况及麻疹流行病学特点,进一步完善和提高麻疹监测系统报告质量,对2006年麻疹病例进行流行病学分析,并对监测系统运转状作出评价.     

曲靖市2003年麻疹病例流行病学分析及监测系统状况评价

为及时总结和分析曲靖市2003年麻疹监测系统运转情况及麻疹流行病学特点,进一步完善和提高麻疹监测系统报告质量,现将相关情况报告如下。1资料来源曲靖市监测系统上报麻疹监测报表,人口资料来源于曲靖市统计局。2结果2.1麻疹病例流行病学特征2.1.1地区分布麻疹病例呈高度分散和     

医疗器械不良事件监测工作分析与管理

目的 总结医疗器械不良事件监测工作的现状,提出针对性改进对策,进一步完善制度,优化系统流程,降低不良事件的发生率,保障患者的医疗安全,为完善医疗器械不良事件监测工作提供数据支持.方法 采用回顾性分析的方法,统计医院2016—2020年上报的190例医疗器械不良事件的基本信息,分析发生率最高的科室、人群、伤害类型、机械故...     

流行病学监测系统评价体系的初步研究

目的探索流行病学监测系统评价的体制、机制及内容与指标,以期形成一套较为完善的系统评价体系。方法运用形式逻辑思维方法中的演绎推理、归纳推理、类比推理。结果流行病学监测系统的评价是一项复杂的系统工程,包括：评价体制、评价内容与指标、评价机制三方面内容。结论流行病学监测系统的评价对于及时发现系统运行过程中存在的问题、不断地完善系统,形成一套较完善的系统评价体系,对监测系统的发展有重要意义。     

监测系统对甲型H1N1流感防控作用评价

目的：评价疾病监测系统在甲型H1N1流感防控中的作用,为完善防控策略提供依据。方法：收集传染病疫情报告系统、流感哨点监测系统和暴发现场调查数据,进行描述流行病学分析。结果：各种监测数据为甲型H1N1流感防控提供科学依据,防控措施有效,症状监测对于集体暴发的预警意义重大。结论：进一步完善和丰富监测体系,重视监测系统评估工作。     

美国加强传染病流行病学与实验室监测的措施

为了加强对传染病监测与报告的基本职能,美国实施了“流行病学与实验室合作项目”(ELC),资助各个州及部分较大的县卫生机构引进新技术、完善监测系统、组织人员培训和添置办公与实验设备等。该项目共设有30个监测点,以下为6个点报告的实施项目情况。     

出入境人员疾病监测人群流行病学特征的研究

目的为更好地对出入境人员疾病监测结果进行科学、准确地分析提供参考依据。方法通过10年疾病监测资料。研究人群构成流行病学特征。结果出入境人员疾病监测工作已经走入规范化、科学化的轨道,并形成一门独特的系统性、专业性较强,与多学科相互联系、相互补充,并具有较强独立性的学科和研究领域,已经成为比较系统而完善的口岸流行病学。结论出入境人员数量易于受多种因素的影响而发生变化;各地区出入境人员数量、人群结构等存在着地域上的差异;人群的年龄、性别、职业及出入境人员类别等都存在着明显的不均衡性;人员来源及去向的广泛性以及在异域他乡人群高度密集和高度分散并存的特殊性以及实施疾病监测的广泛性与局限性并存的特殊性,显现出口岸流行病学人群特征区别于其他流行病学明显的特殊性。     

湖南省麻疹监测及其控制策略评价

目的　通过流行病学现场调查及传染病监测报告进一步对麻疹的流行病学特征、流行因素、免疫覆盖状况进行分析 ,评价。　方法　采用描述流行病学的方法 ,运用 EXCEL软件进行流行病学分析、评价。　结果　湖南麻疹疫情呈现湘东低、湘西高的流行趋势 ,其模式为散发与暴发共存 ;各地发病强度存在较大差别 ,反映了计划免疫工作进展不平衡 ;且 85 %的病例分布在散居儿童及小学生中 ;麻疹专报系统对麻疹病例的反应性尚欠敏感。　结论　EPI的实施有效地控制了麻疹的发病 ,但麻疹监测仍存在较多薄弱环节 ,监测系统的敏感性及完整性都需进一步完善     

EPI Info 2000在急性弛缓性麻痹病例监测系统中的应用研究

目的为解决计划免疫工作中急性弛缓性麻痹 (AFP)病例监测系统流行病学监测和实验室监测的数据库统一和完善变量设置 ,以便快速地进行AFP病例的录入、分析和统计。方法用EPI2000软件建立了计划免疫的急性弛缓性麻痹 (AFP)病例监测系统数据库 ,开发并完善了EPI2000软件在AFP监测系统中的应用研究。结果通过两年的应用和不断完善 ,解决了AFP监测中流行病学监测和实验室监测数据库统一并解决实际问题如麻痹部位、发病年龄、高危病例和聚集性高危病例在AFP监测系统数据库中的变量设置问题 ;完善了AFP监测系统的数据库及调查表视图中各种变量的分析统计及数据管理。结论EPI2000以其功能强大且容易与其他数据库进行数据转换 ,亲切的Windows界面和语言功能支持中文录入而方便中文信息的录入和分析应用 ,成功地应用于计划免疫急性弛缓性麻痹 (AFP)病例监测系统。     

Reasoning strategies and the use of biomedical knowledge by medical students

This paper reports one of a series of studies conducted to investigate the role of biomedical knowledge in clinical reasoning. It was motivated by findings from our earlier studies that demonstrate that when specific basic science information is provided to medical students prior to solving a clinical case, they are unable to use this information in explaining the patient problem. An experiment was designed to investigate the use of biomedical information in the explanation of a clinical problem without any basic science information (spontaneous explanation) and where basic science information was provided after the clinical case (biomedically primed explanation). The results are discussed in the context of a two-stage model of diagnostic reasoning. The first stage is referred to as data-driven reasoning, and is characterized by the triggering of inferences from observations in the data to hypotheses. The second stage is designated as predictive reasoning, and is characterized by the generation of inferences driven by hypotheses. The results show that, with the exception of final-year medical students, the use of biomedical information interfered with the data-driven reasoning process. However, it did facilitate the process of predictive reasoning by the students. It is proposed that a sound disease classification scheme is necessary before biomedical knowledge can facilitate both data-driven and predictive reasoning during clinical problem-solving.     

Role of epidemiological models in surveillance of communicable diseases (author's transl)]

The interpretation of basic information obtained through surveillance of communicable diseases requires knowledge of the expected trend of the epidemiological phenomena under observation. The more precise the epidemiological forecasts are, the more efficient the methods of surveillance will be. With a few examples the author describes briefly the role of epidemiological models to produce reliable previsions, the principles ruling their construction, their use on computer to simulate known epidemiological situations as well as the impact of interventions on the disease dynamics. Mention is also made of the model contribution to the cost-benefit and cost-effectiveness analyses of control programmes subjected to epidemiological surveillance.     

Evaluation of epidemiologic surveillance practice in the public health service in Brazil]

The results of a process evaluation of the epidemiological surveillance activities in 948 health units, situated in 98 of the most populated cities of each State in the country are presented. The survey was conducted towards the end of 1985. The following aspects were analyzed: information system, data analysis, epidemiological investigation. Institutional insertion, vaccination activities, management aspects and capacitation of the health worker were considered as potential determinants of performance. Data were submitted to correspondence analysis and a process of ascendant hierarchical classification, using the statistical package "Systeme Portable Pour L' Analise de Données-SPAD". The performance pattern was not found to be homogeneous. Six different classes of epidemiological surveillance practice in the health units were observed. In 53.7% of the services visited, even the most elementary norms of activity were not complied with. The presence of vaccination activities in the health units was associated with better performance in epidemiological surveillance. The study points to the need to review the epidemiological surveillance model in use in Brazil. It is no longer acceptable to restrict the practice of epidemiology in health services to communicable diseases, now to manage programs and services without epidemiological information.     

A critical narrative review of transfer of basic science knowledge in health professions education

Context

‘Transfer’ is the application of a previously learned concept to solve a new problem in another context. Transfer is essential for basic science education because, to be valuable, basic science knowledge must be transferred to clinical problem solving. Therefore, better understanding of interventions that enhance the transfer of basic science knowledge to clinical reasoning is essential. This review systematically identifies interventions described in the health professions education (HPE ) literature that document the transfer of basic science knowledge to clinical reasoning, and considers teaching and assessment strategies.

Methods

A systematic search of the literature was conducted. Articles related to basic science teaching at the undergraduate level in HPE were analysed using a ‘transfer out’/’transfer in’ conceptual framework. ‘Transfer out’ refers to the application of knowledge developed in one learning situation to the solving of a new problem. ‘Transfer in’ refers to the use of previously acquired knowledge to learn from new problems or learning situations.

Results

Of 9803 articles initially identified, 627 studies were retrieved for full text evaluation; 15 were included in the literature review. A total of 93% explored ‘transfer out’ to clinical reasoning and 7% (one article) explored ‘transfer in’. Measures of ‘transfer out’ fostered by basic science knowledge included diagnostic accuracy over time and in new clinical cases. Basic science knowledge supported learning – ‘transfer in’ – of new related content and ultimately the ‘transfer out’ to diagnostic reasoning. Successful teaching strategies included the making of connections between basic and clinical sciences, the use of commonsense analogies, and the study of multiple clinical problems in multiple contexts. Performance on recall tests did not reflect the transfer of basic science knowledge to clinical reasoning.

Conclusions

Transfer of basic science knowledge to clinical reasoning is an essential component of HPE that requires further development for implementation and scholarship.

     

Nowcasting influenza epidemics using non‐homogeneous hidden Markov models

Timeliness of a public health surveillance system is one of its most important characteristics. The process of predicting the present situation using available incomplete information from surveillance systems has received the term nowcasting and has high public health interest. Generally in Europe, general practitioners’ sentinel networks support the epidemiological surveillance of influenza activity, and each week's epidemiological bulletins are usually issued between Wednesday and Friday of the following week. In this work, we have developed a non‐homogeneous hidden Markov model (HMM) that, on a weekly basis, uses as covariates an early observation of influenza‐like illness (ILI) incidence rate and the number of ILI cases tested positive to nowcast the current week ILI rate and the probability that the influenza activity is in an epidemic state. We use Bayesian inference to find estimates of the model parameters and nowcasted quantities. The results obtained with data provided by the Portuguese influenza surveillance system show the additional value of using a non‐homogeneous HMM instead of a homogeneous one. The use of a non‐homogeneous HMM improves the surveillance system timeliness in 2 weeks. Copyright © 2012 John Wiley & Sons, Ltd.     

Fundamental issues in mosquito surveillance for arboviral transmission

Marked spatiotemporal variabilities in mosquito infection of arboviruses, exemplified by the transmission of West Nile virus (WNV) in America, require adaptive strategies for mosquito sampling, pool screening and data analyses. Currently there is a lack of reliable and consistent measures of risk exposure, which may compromise comparison of surveillance data. Based on quantitative reasoning, we critically examined fundamental issues regarding mosquito sampling design and estimation of transmission intensity. Two surveillance strategies were proposed, each with a distinct focus, i.e. targeted surveillance for detection of low rates of mosquito infection and extensive surveillance for evaluation of risk exposure with high levels of mosquito infection. We strongly recommend the use of indicators embodying both mosquito abundance and infection rates as measures of risk exposure. Aggregation of surveillance data over long periods of time and across broad areas obscures patterns of focal arboviral transmission. We believe that these quantitative issues, once addressed by mosquito surveillance programs, can improve the epidemiological intelligence of arbovirus transmission.     

Surveillance

The article presents an outline of development of epidemiological surveillance in history and basic characteristics of principal types of surveillance being used in contemporary epidemiology. The role of disease definition and classification of diseases is stressed. The main features of the surveillance system are characterized. Basic methods of evaluation of such systems are also presented.     

创建军事训练医学理论体系 促进部队战斗力生成

全军军事训练医学研究所为全面提高我军军训伤的整体防治水平,始终围绕创建我军军事训练医学理论体系而努力研究,其具体做法:一是创建《军事训练医学》新学科;二是编制军用标准《军事训练伤诊断标准及防治原则;》三是致力于全军范围内的军事训练医学教育;四是设立全军军训伤监控点系统;五是激活学术活动机制,壮大防治队伍;六是加强基础研究,形成军事训练医学理论体系可持续发展的良好趋势。使全军年度军训伤发生率降低。     

Basic Science in Medical Reasoning: An Artificial Intelligence Approach

A new generation of intelligent systems is growing up in the community of Artificial Intelligence in Medicine. The main goal of these systems is the representation and use of real theory of diseases, as they are represented in medical textbooks or in scientific articles, rather than the heuristic shortcuts of human experts. In this paper, we will argue that the difficulties in the integration of basic science and clinical knowledge in intelligent systems arise from ontological differences between these kinds of knowledge and that the solution can be found in their dynamic integration during the reasoning process. In order to illustrate this point, we will first describe an epistemological analysis of the interplay between basic science knowledge and clinical knowledge, and then we will provide the example of a computational architecture implementing this view. This revised version was published online in June 2006 with corrections to the Cover Date.