导 读

正公共卫生设计、测量、评价与标准化(design,measurement,evaluation and standardization in public health,DMES)是一门方法学,同时也是一种思维与决策的过程和模式。它是基于研究目的,综合利用多学科的理论和方法,从规范化查阅资料、研究设计,到测量、再到结果解释和评价,将公共卫生研究及实践的各个环节融为一体,综合考量并付诸实践的系统过程。DMES秉承标准化的理念,强调各项公共卫生研究的规范花和可推广性,从而最终促使各项公共卫生资源的利用能够获得最佳秩序和取得较好的社会效益。     

2016年8月全国突发公共卫生事件及需关注的传染病风险评估

目的 评估2016年8月国内外突发公共卫生事件及需要关注传染病的风险。方法 根据国内外突发公共卫生事件报告及重点传染病监测等各种资料和部门通报信息,采用专家会商法,并通过视频会议形式邀请省（直辖市、自治区）疾病预防控制中心专家参与评估。结果 根据既往传染病和突发公共卫生事件监测数据,预计8月报告的突发公共卫生事件为全年较低水平。近期我国的寨卡病毒病、黄热病等蚊媒传染病输入可能性较年初有所下降,但蚊媒条件更加适宜,发生本地传播的风险逐渐升高;而登革热已开始在南方部分省份发生本地传播,进一步流行的风险加大。感染性腹泻病的流行强度会逐渐增强,容易出现暴发疫情。有毒野生菌、集体聚餐（如升学宴、农村喜丧宴）等导致的食物中毒风险较高。高温中暑事件将会持续高发。另外,8月份全国降水仍然较多,需要关注极端气象条件导致的洪涝灾害相关公共卫生风险。结论 2016年8月我国的突发公共卫生事件可能达到全年的最低水平,但仍需重点关注伊蚊媒介传染病（如寨卡病毒病、登革热、黄热病）、洪涝灾害,一般关注感染性腹泻病、食物中毒和高温中暑所引发的公共卫生风险。     

老年多器官功能不全综合征多学科综合救治模式

目的：探讨多学科协作救治老年多器官功能不全综合征（MODSE）的模式。方法：通过分析MODSE救治过程中多学科协作的必要性及传统学科间会诊存在的问题,提出MODSE多学科综合救治模式。结果：建立了MODSE多学科综合救治模式,并对其组织体系、人员构成、工作方式等进行了规范。结论：MODSE多学科综合救治模式能够有效动员多学科主动参与、强调会诊时效性和连续性、体现多学科救治患者共同责任、及时利用多学科先进救治技术、使MODSE患者及时得到最佳救治。     

2017年12月全国突发公共卫生事件及需关注的传染病风险评估

目的 评估2017年12月国内外突发公共卫生事件及需要关注传染病的风险。方法 根据国内外突发公共卫生事件报告及重点传染病监测等各种资料和部门通报信息,采用专家会商法,并通过视频会议形式邀请省（直辖市、自治区）疾病预防控制中心专家参与评估。结果 根据近期传染病和突发公共卫生事件监测数据,结合既往突发公共卫生事件发生情况及传染病流行特点分析,预计12月全国总报告事件数和病例数将与11月相当,主要以发生在学校的水痘、流行性感冒、流行性腮腺炎、手足口病、其他感染性腹泻病等传染病暴发事件为主。我国内地将继续出现人感染H7N9及其他亚型禽流感或动物流感散发病例。流行性感冒活动水平将继续上升。病毒性腹泻暴发可能会持续增加。仍可能出现学校结核病聚集性疫情。非职业性一氧化碳中毒和重污染天气（雾霾）相关健康事件均处于冬季高发季节。结论 2017年12月我国的突发公共卫生事件及传染病疫情发生态势将与11月相当;需关注人感染禽流感、流行性感冒、病毒性腹泻、结核病等传染病疫情和非职业性一氧化碳中毒、重污染天气（雾霾）相关事件引发的公共卫生风险。     

在芬兰心理卫生保健机构的见闻

芬兰和英国的护理教育相当不同。在英国护理学科的理论和实践两部分的课程需时3年半,其中2年半是基础护理,1年是内科、外科、麻醉、精神病学、儿科学或公共卫生保健。在芬兰经过理论和基本技能训练后,进一步掌握专业护理就比较容易,不过由于多学科的发展,要求护理工作领域延伸得比较     

玻璃体内注射抗血管内皮生长因子药物在糖尿病性黄斑水肿治疗中的应用

糖尿病性黄斑水肿（DME）是由糖尿病引起的黄斑中心区2倍于视盘直径范围内的视网膜增厚、局部的或弥漫性水肿,有或无硬性渗出。其临床表现为视力减退或视物变形或症状不明显,可伴有相对或绝对性中心暗点。未经治疗的1型和2型糖尿病患者在3年内将出现25％～30％的临床显著型黄斑水肿（CSME）。黄斑功能直接影响到患者的视锐度,DME已成为糖尿病患者视力受损甚至失明的主要原因。DM E的治疗包括黄斑激光光凝术、睫状环玻璃体切割手术、玻璃体注射曲安奈德等,但是这些治疗方法又各自具有局限性。由于血管内皮生长因子（VEGF）在糖尿病性视网膜病变（DR）及DM E发病中的作用逐渐被重视,因而从抑制VEGF的角度治疗DR、DME的研究近年逐渐兴起。现对于最常见三种抗VEGF药物进行玻璃体内注射治疗DME的研究现状作一综述。     

2022年5月中国大陆需关注的突发公共卫生事件风险评估

  目的  评估2022年5月在我国大陆地区发生或者可能由境外输入的突发公共卫生事件风险。  方法  根据国内外突发公共卫生事件报告及重点传染病监测等各种资料和部门通报信息,采用专家会商法,并通过视频会议形式邀请省（自治区、直辖市）疾病预防控制中心专家参与评估。  结果  总体上,预计5月全国新型冠状病毒肺炎（COVID-19）疫情整体形势将继续呈现趋稳向好态势,但仍然存在反弹风险,需要加快局部聚集性疫情处置,及时完善防控措施,做好疫情应对准备。 进食毒蘑菇导致的中毒事件预计在5月以后逐渐上升。 英国等多国报告儿童不明原因急性肝炎疫情,需要跟踪相关监测和研究进展。  结论  需要对COVID-19予以特别关注,对毒蘑菇中毒予以一般关注。     

用SWOT分析法探讨南岸区公共卫生发展现状和对策

优势、劣势、机会、威胁（SWOT）分析法是企业竞争分析常用的方法之一,广泛应用于企业战略研究与竞争分析,目前在我国公共卫生领域研究应用较少。运用SWOT法对南岸区公共卫生体系进行选择性分析,就是将与南岸区公共卫生发展密切相关的4个方面因素,即优势、劣势、机会和威胁,通过调查研究进行综合分析,从而得到影响南岸区公共卫生事业发展的各种因素,为探讨发展对策,制定发展规划提供科学依据。     

缓释激素治疗糖尿病性黄斑水肿的研究现状

糖尿病性黄斑水肿（DME）是一种具有多因素发病机制的慢性疾病,是糖尿病患者视力丧失的重要原因。当前,玻璃体内注射抗血管内皮生长因子（VEGF）药物及激光光凝是DME的主要治疗方式,但抗VEGF及激光光凝后仍有部分患者无反应或反应欠佳,一些患者出现顽固性的DME。与抗VEGF药物相比,激素既能抑制VEGF的表达,又能抑制炎性因子的分泌。研究发现,其他治疗无效的DME患者改用激素治疗后取得较好的效果。近年来,激素缓释系统长效的、持续释放药物受到广泛关注。本文就激素玻璃体腔给药治疗DME的研究现状进行阐述。     

福建省儿科护士突发公共卫生事件应急能力培训现状调查

目的 调查福建省儿科护士突发公共卫生事件应急能力培训现状,提出针对性的干预策略。 方法 采用自行设计的“福建省儿科护士突发公共卫生事件应急能力培训现状调查问卷”对全省134家医院3379名儿科护士进行横断面问卷调查。结果 全省2470名（73.10%）儿科护士接受了突发公共卫生事件应急能力相关培训,近5年平均培训次数为3.62次;培训内容主要聚焦儿童危重症护理（59.39%）及基础生命支持部分（66.48%）;接受系统、完整儿童突发公共卫生事件应急能力培训的只有218名,占比8.83%。结论 福建省儿科护士参与突发公共卫生事件应急能力培训比例相对较高,但培训内容参差不齐,以急危重症护理及基础生命支持培训为主,接受系统、完整公共卫生事件应急能力培训的比例较低,迫切需要建立科学化、标准化、多元化的应急培训体系并在全省推广培训,从而提升全省儿科护理队伍应对突发公共卫生事件的应急能力水平。     

Study Designs and Evaluation Models for Emergency Department Public Health Research

Public health research requires sound design and thoughtful consideration of potential biases that may influence the validity of results. It also requires careful implementation of protocols and procedures that are likely to translate from the research environment to actual clinical practice. This article is the product of a breakout session from the 2009 Academic Emergency Medicine consensus conference entitled "Public Health in the ED: Screening, Surveillance, and Intervention" and serves to describe in detail aspects of performing emergency department (ED)-based public health research, while serving as a resource for current and future researchers. In doing so, the authors describe methodologic features of study design, participant selection and retention, and measurements and analyses pertinent to public health research. In addition, a number of recommendations related to research methods and future investigations related to public health work in the ED are provided. Public health investigators are poised to make substantial contributions to this important area of research, but this will only be accomplished by employing sound research methodology in the context of rigorous program evaluation.     

Academic–Practice Partnerships for Community Health Workforce Development

Despite increasing attention to academic–practice partnerships for health practice and workforce development, guidelines for how to implement such partnerships are few. The Kansas Public Health Workforce and Leadership Development (WALD) Center provides a successful example of such a partnership. The WALD Center implements public health education and training projects through a collaborative process of health needs identification, program conceptualization, research, and program evaluation. Such coordination allows for continuous practitioner-oriented program development and the sharing of a rural state's scarce resources between interconnected projects. The WALD Center's methods provide a model for academic–practice partnerships for community health practice and workforce development, even in environments with scarce health resources.     

Academic-practice partnerships for community health workforce development

Despite increasing attention to academic-practice partnerships for health practice and workforce development, guidelines for how to implement such partnerships are few. The Kansas Public Health Workforce and Leadership Development (WALD) Center provides a successful example of such a partnership. The WALD Center implements public health education and training projects through a collaborative process of health needs identification, program conceptualization, research, and program evaluation. Such coordination allows for continuous practitioner-oriented program development and the sharing of a rural state's scarce resources between interconnected projects. The WALD Center's methods provide a model for academic-practice partnerships for community health practice and workforce development, even in environments with scarce health resources.     

Women''s Health and the Practice of Public Health Nurses in Northern British Columbia

This study explored women's health and the practice of public health nurses in northern British Columbia using a phenomenological methodology. Ten public health nurses in northern British Columbia were interviewed to determine their perspectives on their practice in the area of women's health. Findings reveal three central themes: women's health, public health nursing practice, and rural context. Several subthemes elaborate on the central themes. Women's health is described in terms of women's health needs, how women stay healthy in northern communities, and conditions that affect women's health. Public health nursing practice is described in terms of activities, strengths, conditions, and ways to strengthen practice. Definitions of rural context are provided and some of the benefits and challenges of living and working in northern communities are presented. Health promotion and illness and injury prevention needs of women are clearly evident in the findings. Public health nurses are well placed in the North to help women meet their health care needs. However, further attention to women's health needs and the expansion of public health nursing services would facilitate improved health for women who live in isolated northern settings. In addition, further research is needed to explicate women's health and public health nursing practice in isolated northern settings in Canada.     

突发重大疫情背景下公共卫生伦理原则在临床诊疗中的应用

公共卫生的宗旨是组织全体社会成员共同努力预防和控制疾病、促进健康.医务工作者和医疗机构是公共卫生系统不可或缺的重要组成部分,了解公共卫生伦理学的概念和原则,有助于改进医疗决策、提升医疗质量.医务工作者的临床实践既要符合临床伦理学原则,又要兼顾公共卫生伦理学原则,尤其在突发重大疫情背景下,公共卫生伦理学在临床诊疗和医疗资...     

Building Community Capacity for Health Promotion: A Challenge for Public Health Nurses

Abstract The centennial celebration of public health nursing is a strong reminder of the tradition and practice of public health nursing's commitment to communities. Partnerships with communities give public health nurses fiduciary responsibility to be actively involved in public health reform to advance health promotion and health protection. Public health nurses must rise to the challenge to build community capacity through facilitating community participation, enhancing community health services, and coordinating public policy to achieve core public health responsibilities of assessment, policy, and assurance. This paper explicates strategies for building community capacity for health promotion.     

From function to competency in public health nursing, 1931 to 2003

Explaining the content of public health nursing practice is not a new phenomenon. This historical narrative examines two documents published in the first Public Health Nursing journal, in which the National Organization for Public Health Nursing (NOPHN) described the nature of public health nursing for the profession and for those who administered programs employing public health nurses. While changes in language reflect evolution of both the nursing profession and public health practice, consistencies in purpose and the core understanding of public health nursing link these documents conceptually to the recent statement of Public Health Nurse Competencies (Quad Council, 2003).     

Use of PHN competencies and ACHNE essentials to develop teaching-learning strategies for generalist C/PHN curricula

This paper provides a useful tool for the undergraduate community/public health nursing (C/PHN) faculty member to design courses and learning activities, and to interpret C/PHN education needs to undergraduate curriculum committees and administrators. Specifically, this paper provides a tangible bridge between the Public Health Nursing Competencies (Quad Council of Public Health Nursing Organizations, 2004) and the Association of Community Health Nursing Educators (ACHNE) Essentials of Baccalaureate Education (2000) for both didactic and clinical learning experiences. The tables may be used in multiple ways, including curriculum monitoring and improvement, course development and instructional design, clinical practice planning, and as a foundation for evaluation of conceptual learning and practice competence for the C/PHN generalist. Because C/PHN experiences in undergraduate education are unique and context based, the tables exemplify how two key guiding documents mutually frame the C/PHN educational experience supported by specific learning activities. Further, at a minimum, MSN preparation as a C/PHN specialist is clearly necessary for the teaching and learning of baccalaureate curricular components of C/PHN.     

The ExploreSurge Trail Guide and Hiking Workshop: discipline-specific education for public health nurses

Generic preparedness education and training for the public health workforce has increased in availability over the past 5 years. Registered Nurses also have more opportunities available for participation in emergency and disaster preparedness curricula. Discipline- and specialty-specific training and education for public health nurses (PHNs) incorporating their population-based practice, however, remains a largely unexplored area that is not accessible except for sporadic local venues. The Public Health Nursing Surge Curriculum provides 50 hr of nursing continuing education and activity-based aggregate focused learning experiences that are completed within a 12-month period, including an in-classroom seminar. The Public Health Nursing Surge Curriculum was developed on a foundation of 25 competencies linking PHNs and their population-based practice to surge capability. The curriculum was built in partnership with statewide public health directors of nursing over a 12-month period and is evaluated by a 3-level process to include self-rated confidence in performance. The curriculum's use of a blended learning methodology enables staff-level PHNs to master individual competencies toward surge capability within the public health response system.