珠海市传染病网络直报能力现状探讨

[目的]准确掌握珠海市法定传染病网络直报系统运转状况，为做好珠海市的传染病疫情报告工作提供科学依据。[方法]调查珠海市传染病疫情网络直报能力。[结果]珠海市已初步建立覆盖到乡镇级以上医疗卫生机构的传染病直报网络，2005年系统运转基本正常，通过持续改进。疫情报告及时性、敏感性和准确性不断提高。[结论]珠海市乡镇级以上医疗卫生机构基本实现了传染病网络直报，基本完成了从旧的逐级报告系统到网络直报系统的过渡。但仍存在乡镇卫生院系统缺乏运行和维持经费、培训不到位，传染病报告诊断到报告时间偏长等亟待解决的问题。     

光山县2012年法定报告传染病疫情网络直报质量分析

目的了解光山县2012年法定报告传染病疫情网络直报质量现状及存在的主要问题,为进一步提高网络直报工作质量提供科学依据。方法查阅“国家疾病监测信息报告管理系统”中的光山县2012年法定报告传染病报告卡的质量统计模块数据,根据《传染病疫情网络直报系统质量评价指标及统计规则》进行质量综合评价与分析。结果光山县2012年医疗卫生机构平均未及时报告率为1．01％,县级疾病预防控制中心平均未及时审核率为0．03％,重卡病率为0．02％,县区零缺报率为1．04％。2012年法定报告传染病疫情网络直报质量明显比2011年有明显进步。结论光山县2012年法定报告传染病疫情网络直报质量总体情况较好,医疗卫生机构的报告及时性和县级疾病预防控制中心的审核及时性需要进一步提高。     

福州市网络直报前后传染病疫情报告的时效性

传染病疫情监测报告是传染病预防控制的重要前提，及时、准确的疫情报告对控制重大传染病疫情具有决定性作用。我国于2004年1月1日起正式启用法定传染病监测系统，各医疗、疾控机构直接进行法定传染病的报告，基本实现了疫情监测资料从县级到中央的实时报告与管理，改变了以往疫情信息层层上报导致疫情信息滞后的落后模式。我们利用福州市2001-2004年上报的传染病个案，分析网络直报系统运行前后传染病报告情况及其影响因素，为进一步提高传染病疫情报告的时效性，提出改进措施，提供了科学依据。     

浙江省传染病疫情网络直报质量分析

目的为了解浙江省传染病网络直报系统运行情况、报告卡片质量、报告和审核的及时率,探讨存在的主要问题。方法从法定传染病网络直报信息系统导出数据建EXCEL数据库进行统计分析。结果98.10%的县级及以上医疗卫生机构、80.39%的乡镇级医疗卫生机构建立了网络直报。全省报告的卡片中约有1.87%重复报告卡片。县级疾控中心卡片审核及时率为98%,医院报告到审核的时间平均为4h。结论全省网络直报系统建设基本完成,报告审核及时。     

2004-2011年周口市传染病网络直报系统应用效果评价

目的分析2004-2011年周口市传染病网络直报系统既疾病监测信息报告管理系统(Diseases Reporting lnformation System,DRIS)运行情况,对2004-2011年周口市传染病网络报告信息质量进行评价,为进一步提高报告信息质量提供科学依据。方法分析周口市的10个县(市、区,下同)2004～2011年通过DRIS是报告的传染病病例数据库,评价DRIS的主要运转指标。根据国家《传染病疫情网络直报系统质量评价指标及统计规则》对周口市各年传染病网络直报信息质量进行评价。结果 2004-2011年周口市医疗卫生机构平均未及时报告率为1.84%,县区级疾病预防控制中心平均未及时审核率为0.90%,重卡病率为0.02%,县区零缺报率为0。报告质量逐年提高。结论 2004-2011年周口市法定传染病疫情网络直报信息质量较好,并经过实践证明取得了显著的社会效益。     

2008年周口市法定报告传染病疫情网络直报质量分析

目的了解2008年周口市法定报告传染病疫情网络直报质量现状及存在的主要问题,为今后进一步提高网络直报工作质量提供科学依据。方法查阅"国家疾病监测信息报告管理系统"中的2008年周口市法定报告传染病报告卡的质量统计模块数据,根据《传染病疫情网络直报系统质量评价指标及统计规则》进行质量综合评价与分析。结果2008年周口市医疗卫生机构平均未及时报告率为0.27%,县区级疾病预防控制中心平均未及时审核率为0.35%,重卡病率为0.00%,县区零缺报率为0.00%。2008年法定报告传染病疫情网络直报质量比2007年有明显进步。结论2008年周口市法定报告传染病疫情网络直报质量总体情况较好,医疗卫生机构的报告及时性和县区级疾病预防控制中心的审核及时性需要进一步提高。     

2004-2005年霞浦县法定传染病疫情分析

2004-01-01始,我国法定传染病报告改变了以往由医疗单位邮寄传染病报告卡,县级疾病预防机构按旬逐级统计汇总上报的方式,全国实现了法定传染病监测信息网络直报.2004年霞浦县3所县级医院实现了传染病网络直报,乡镇卫生院疫情由县疾病预防机构代为网络直报,2005-01-01全县13个乡(镇)卫生院全面实现了传染病网络直报.为了解采用网络直报模式后全县的传染病监测工作情况,对霞浦县2004-2005年法定传染病疫情进行分析,以更好地指导传染病监测工作,提高传染病报告率和疾病预测预报能力.现将全县报告疫情分析如下.……     

宝鸡市2010年传染病疫情报告质量评价

宝鸡市2004年在全市县级以上医疗机构实现网络直报,2005年网络直报的覆盖范围由最初的县级以上医疗单位延伸到了乡镇卫生院,初步建立了连接乡镇、县(区)、市三级传染病信息网络平台,宝鸡市262个医院机构(112个医院,150个乡镇卫生院)通过疾病监测信息报告管理系统对辖区内发现的39种传染病个案进行报告.根据宝鸡市2010年网络报告数据,对网络直报系统总体运行情况及报告质量进行初步评价.     

常州市天宁区医疗卫生机构的传染病疫情报告工作

2004年1月1日起，我国开始实施传染病个案报告的网络直报，使我国传染病疫情报告达到实时直报，减少上报的中间环节，提高了疫情报告的及时性和敏感性。从天宁区2004年疫情网络直报运行的情况看，各级医疗卫生机构都按时实施了传染病疫情网络直报工作，在传染病疫情报告的日常审核和督导中发现存在着一些亟需解决的薄弱环节。为此，我们对属地各级医疗卫生机构2004年传染病疫情报告工作做出全面评价，分析存在问题及影响因素并找出对策，从而不断提高各级医疗卫生机构传染病报告率和报告质量。     

2009年青海省法定报告传染病疫情网络直报质量分析

[目的]对2009年青海省法定报告传染病疫情网络直报质量现状进行评价,为今后进一步提高网络直报工作质量提供科学依据。[方法]查阅"国家疾病监测信息报告管理系统"中的2009年青海省法定报告传染病报告卡的质量统计模块数据,根据《传染病疫情网络直报系统质量评价指标及统计规则》进行质量综合评价与分析。[结果]2009年青海省医疗机构平均及时报告率为90.46%,县区级疾病预防控制中心平均及时审核率为96.74%,重卡率为0.26%,县(区)零缺报率为13.77%。[结论2009年青海省法定报告传染病疫情网络直报质量总体情况不是很理想,医疗卫生机构的报告及时性和县区级疾病预防控制中心的审核、查重及时性需要进一步提高。     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.     

Assessing occupational and environmental exposure

Exposure assessment is a poorly understood component of the science of epidemiology. The relationship between exposure to chemicals and ill-health outcomes is often calculated using crude exposure measures such as ever/never exposed or duration. When investigating subtle effects, exposures need to be characterized much more fully in terms of intensity, frequency, duration and route. While occupational exposures tend to be much greater than those experienced from the wider environment there is a need to remember that, for many chemicals, exposure can occur occupationally, environmentally and through consumer use of products containing the material of interest. Inhalation exposure has generally been the traditional focus for most epidemiological investigations but there is now growing awareness of the importance of the dermal and ingested routes of contact and internalization. Quantification of the exposure also needs to be related to a biological mechanism of action and exposure metrics need to be selected accordingly. Occupational exposures can generally be measured using simple well-validated techniques. Environmental exposures require much more sensitive instruments and are more difficult to assess. Exposure modelling, particularly for the environmental fate of chemicals has undergone many recent developments and Monte Carlo techniques can be used to characterize model uncertainty and variability. This approach to exposure assessment can now be used in the setting of the wider environment and will enable a far better understanding of the relationship between exposure and disease.     

Mercury toxicity due to the smelting of placer gold recovered by mercury amalgam

A 19-year-old man developed tremor in both hands and fatigue after starting work at a placer gold mine where he was exposed to mercury-gold amalgam. Examination revealed an intention tremor, dysdiadochokinesis and mild rigidity. The 24-h urinary mercury concentration reached a peak of 715 nmol/l (143 ug/l) shortly before the clinical examination, after which he was removed from working in the gold room [Mercury No. Adverse Effect Level: 250 nmol/l (50 ug/l)]. On review 7 weeks later his tremor had almost resolved and the dysdiadochokinesis and rigidity had gone. The 24-h urinary mercury concentration had fallen to 160 nmol/l (32 ug/l). The principal exposure to mercury was considered to be the smelting of retorted gold with previously unrecognized residual mercury in it. The peak air concentration of mercury vapour during gold smelting was 0.533 mg/m3 (Mercury Vapour ACGIH TLV: 0.05 mg/m3 TWA). Several engineering and procedural controls were instituted. This episode occurred at another mine site, unrelated to Mount Isa Mines Limited.     

How Adults with Acquired Brain Damage Perceive Computer Training as a Rehabilitation Tool: A Focus-group Study

The aim of this study was to explore and describe how adult outpatients with acquired brain damage and referred to occupational therapy perceive computer training with the RehaCom programs, in order to evaluate the method of treatment as a tool in the rehabilitation of persons with cognitive disorders. By using focus-group discussions as a qualitative method of research when analysing the result, five themes with corresponding categories emerged, describing a development of understanding and learning about capacities. Themes describing how the participants could apply strategies to overcome shortcomings in daily occupations and the therapeutic role of the occupational therapist were identified as well. The result shows that a computer training program such as RehaCom can be used as an educational tool, for example, to guide a person who is trying to adopt compensatory strategies to avoid overload by taking pauses. It was found that anything the participants learned was also applicable to occupational performance in daily life.