Epidemic syncope in jazz bandslogistic aspects of an investigation

Summary At a fete at Hollinwell, in the District of Ashfield, Nottinghamshire, on Sunday, 13 July 1980, children in the marching bands section were taken ill. Persons attending a gymkhana in the same field at the same time were unaffected. The first children collapsed at 10.30 a.m., and new cases occurred over the next 21/2 hours. Members of the St John Ambulance and Police gave immediate assistance but were overwhelmed by numbers and eventually 414 persons were taken to 4 hospitals, 67 by ambulance and the rest by coach or private vehicle. The episode was dramatic and alarming to all those present. No organic cause was found to account for the incident. During the following week a few new or return cases attended hospital but all patients were discharged after a few hours or at the most in a day or two. The main features of the incident, its investigation and the considerable public interest aroused by it, are described.     

Women's experience of colposcopy: a qualitative investigation

Background  

The last comprehensive investigation of women's experience of the colposcopy service in the UK was conducted in the 1980's. It highlighted women's anxiety and lack of information, resulting in recommendations for improvements. Since then the colposcopy service has changed substantially. It is therefore time to re-visit women's experience of this service and reflect upon the success of service changes in improving experience and reducing anxiety. The aim of this study was to investigate women's experience of being referred for, and attending, colposcopy appointments, and identify potential service improvements.     

From flying doctor to virtual doctor: an economic perspective on Australia's telemedicine experience

Current funding mechanisms can impede the efficient use and integration of telemedicine services. Telemedicine has developed in Australia against a background of complex funding arrangements and interwoven health-care responsibilities. These impediments are not unique to telemedicine but are accentuated by its ability to cover different locations, clinical areas and purposes. There is also a link between economic evaluation and funding mechanisms for telemedicine. While economic evaluations provide important information for the efficient allocation of resources, the funding environment in which telemedicine is established is also crucial in ensuring that services are efficient. Given these complexities, should telemedicine be funded? We conclude that this will depend on: the objectives and priorities of the health system; the efficiency of telemedicine relative to that of other forms of health-care delivery; and the funding environment. In terms of resource allocation processes, the optimum scenario is likely to be where the decision to invest in telemedicine services is made taking local needs into account, but where considerations such as market structure and network compatibility are examined on a broader scale and balanced against the principles of efficiency and equity.     

From risk-based health surveillance to health promotion: an evidence-based experience in a health care setting

In the European countries the health surveillance may be provided as a part of the national health system intervention. In Italy, the legislative Decree (626/94) makes the health surveillance compulsory for all those workers who are exposed to occupational risks. The aim of this study was to describe the introduction of preventive and protective measures, according to the new regulations, in the teaching hospital of the University of Modena. The population examined in 2000 included 1523 workers. Specific health surveillance protocols were prepared on the grounds of the risk characteristics based on the scientific evidence and on the risk perception. The intervention was oriented towards health promotion. The subjects were classified into 10 groups according to the risk characteristics. The percentage of workers ranged from 4% to 42%, depending on the exposure-related health changes. Moreover, the study explored some of the health surveillance benefits: an improvement in worker's satisfaction, an improvement in relationship between stakeholders, an early detection of health changes and a sickness absence reduction after the influenza vaccination program.     

安庆市郊乌岭村结核病流行病学调查

为了解安庆市郊的结核病疫情,估计今后发病情况,研究结核病的防治对策,采取整群抽样的方法确定了市郊乌岭村为调查点.现将结果报告如下.     

2006年四川省菌痢暴发疫情分子流行病学分析

目的 了解四川省2006年8起菌痢疫情的传染来源和传播链,为预测疫情和制定防治措施提供依据.方法 分析四川省2006年8起菌痢事件病原菌分子特征、菌痢暴发疫情分离的菌株与菌株之间,各疫情分离的菌株之间的遗传相关性;用PCR检测侵袭性质粒H抗原(ipaH基因)、志贺肠毒素1(Shigella enterotoxin 1,SET1)、志贺肠毒素2(SET2)、志贺菌增殖和侵袭相关的毒力基因(ial基因);脉冲场凝胶电泳(PFGE)对菌株进行分子分型,以BioNumerics V4.0软件UPGMA方法进行聚类分析.结果 8起菌痢疫情的20株痢疾SET2、ial、ipaH基因均为阳性,所有菌株的SET1基因均为阴性.对20株菌以Xba Ⅰ酶切后PFGE可分为4个型别.结论 同一暴发疫情分离菌株的PFGE型别相同,暴发疫情分离菌株都存在侵袭性致病大质粒;提示不同时间地点暴发的四川2006年8次暴发疫情可能有共同的传染来源;同一疫情来自相同的污染源;具有地区流行株的特性,应该加强监测,以控制进一步的暴发、流行.     

2002-2006年宜宾市钩端螺旋体病流行特征

目的分析2002-2006年宜宾市钩端螺旋体病流行规律,为有效预防和控制钩体病的发生与流行提供依据。方法对宜宾市2002-2006年钩端螺旋体病疫情资料进行描述性流行病学分析。结果2002-2006年宜宾市钩端螺旋体病共报告病例393例,死亡2例,平均发病率为1.52/10万;该病有明显的季节性,发病主要集中在每年8～9月份,男女性别比为2.14∶1,10～35岁组人群为该病的主要发病人群,职业分布以农民、学生为主,占发病总数的97.46%。结论宜宾市近5年钩端螺旋体病发病率处于相对较高水平,应该采取包括加强钩端螺旋体病传染源控制与管理、健康教育、接种钩端螺旋体菌苗等综合性防治措施。     

非肺炎型军团菌病的流行病学调查及防制措施研究

目的了解非肺炎型军团菌病的流行病学特征,分析影响感染的因素,探索消除中央空调系统冷却水军团菌的有效方法。方法对抽样得到的3个场所不同人群收集1年呼吸道感染资料,对其中符合病例定义的对象开展人户流行病学调查,并采血检测军团菌抗体。开展3个场所军团菌污染情况调查,并分析环境污染与人群感染的关系。调查数据用SPSS13．0进行Х^2检验、Logistic回归分析。结果符合病例军团菌阳性总检出率为16．47％,以Lp1感染为主。不同场所环境污染和人群感染差异有统计学意义（Х^2=37．804,P〈0．001;Х^2=7．001,P=0．030）。38．18％的感染发生在7月份。平均病程3．48d。肌肉酸痛症状明显（OR=2．837）、鼻塞流涕少见（OR=0．386）。外出旅游（OR=4．774）、小区喷泉等景观喷淋设施（OR=7．363）与军团菌感染有关。结论发热人群中存在一定比例的非肺炎型军团菌感染。中央空调系统污染是导致军团菌感染的潜在危险因素之一。ZG微电脑杀菌器能有效杀灭军团菌。应加强军团菌监测、预防和控制,加强宣教提高居民防病意识。     

From testimony to advocacy: a humanitarian NGO's experience

Doctors of the World France (Médecins du Monde, MdM) is an international humanitarian aid NGO working to support access to health care to vulnerable populations of the world excluded from these services. MdM has fixed two strategies to "cure and give witness," especially in light of the flagrant injustices lived by the populations they work with. Based on the need to improve the situation of these populations, and using the Anglo-Saxon model, the association wanted to take their strategy one step further by progressively developing advocacy actions in partnership with other organizations. This case study shows the different success obtained through advocacy actions in two campaigns: one against the World Bank's promotion of health systems' privatization in 1993 and another one for the increase in training of health care workers in the Southern hemisphere in 2006.     

1957-2005年贵州黔南州法定报告传染病流行分析

目的分析黔南州1957-2005年传染病流行特征,为制定预防与控制策略提供科学依据。方法收集全州历年疫情资料和专题调查报告,应用描述流行病学方法分析疫情资料。结果1957-2005年,累计报告传染病20种2618244例,死亡26284人,平均发病报告率2064/10万,病死率1.01%;20世纪80年代前发病处于高发状态,之后平缓下降,至2000年后降至历史最低点。20世纪90年代后期有艾滋病报告,并呈逐年上升趋势。结论黔南州传染病自20世纪80年代后发病率呈平缓态势,相应时期的传染病谱已有所变化,提示黔南州传染病的预防与控制对策应有针对性调整。     

2003-2007年宜宾县流行性腮腺炎流行病学特征分析

目的分析2003—2007年宜宾县流行性腮腺炎发病的流行趋势,探索其流行规律,为有效预防和控制流行性腮腺炎的发生与流行提供依据。方法对宜宾县2003—2007年流行性腮腺炎疫情资料进行描述流行病学分析。结果2003—2007年宜宾县流行性腮腺炎共报告病例560例,无死亡病例,平均发病率为11．96／10万;主要集中在每年4～7月份,占全年发病的59．29％;男女性别比为1．80：1,15岁以下年龄组人群发病占总发病的88．75％;幼托儿童、散居儿童、学生占发病总数的91．96％。结论流行性腮腺炎是危害宜宾县青少年儿童身心健康的主要疾病之一应该加强对流行性腮腺炎防治工作的投入和管理,加强宣传教育,积极开展流行性腮腺炎疫苗的预防接种工作。     

郴州市2005-2006年传染病暴发疫情分析

目的分析郴州市2005-2006年传染病暴发疫情流行特征,为有效预防和控制传染病暴发疫情提供科学依据。方法收集、整理2005-2006年该市发生的19起传染病暴发疫情资料,并运用描述性流行病学方法进行综合分析。结果⑴学校内暴发疫情较多,罹患对象为学生;⑵传染病暴发病种以肠道、呼吸道传染病较多,尤其是甲肝、流感;⑶发生该市历史上未曾出现过的传染病(人禽流感)疫情一起。结论加强农村卫生工作,加大学校卫生管理是有效控制疫情发生的主要措施。     

1996-2005年慈溪市成人麻疹流行病学特征

目的了解慈溪市≥18岁成人麻疹的流行病学特征,控制探讨麻疹的措施。方法应用流行病学方法对1996-2005年慈溪市≥18岁成人麻疹发病情况进行分析。结果1996-2005年慈溪市共报告成人麻疹133例,发病率波动在0.20/10万～4.31/10万,构成比波动在7.69%～45.45%之间。3～5月份为麻疹发病高峰,占成人麻疹发病总数的71.43%。病例男女性别比0.49∶1。职业分布以民工、农民、工人为主,3者共占73.68%。有90.98%的成人麻疹病例无免疫史或免疫史不详。本地户籍病例83例,占发病数的62.41%,外地户籍病例50例,占发病数的37.59%。两者有免疫史比例差异无统计学意义(χ2=1.58,P>0.05)。结论无麻疹疫苗免疫史及免疫失败人群、外来人口是慈溪市成人麻疹发病的高危人群。要确保MV高接种率和免疫成功率,特别是要加强外来人口的管理,是控制成人麻疹的关键。