中美公共卫生信息学教育比较及对策

概述公共卫生信息学的内涵与特点,分别介绍中美公共卫生信息学教育及学科建设现状并进行比较,分析我国公共卫生信息学教育和学科发展在学科体系建设、人才培养教育模式等方面面临的挑战并提出发展对策。     

公共卫生统一数据采集交换平台的设计与买现

整合基层医疗卫生机构的采集业务,打破目前各系统数据独立采集、缺少协同、难以其享的模式,建立灵活通用的公共卫生统一数据采集交换平台,实现强大的数据定制采集、数据管理和数据交换功能,满足基层医疗卫生机构数据一次录入,各业务系统共享利用的目的。     

2009年全国法定传染病网络直报信息质量评价及指标探讨

目的 对2009年全国(未包括香港、澳门和台湾地区,下同)传染病网络直报信息质量进行评价,并对评价指标进行探讨。 方法 按终审日期为2009年1月1日至12月31日导出疾病监测信息报告管理系统内全部法定传染病个案卡片,不包括已删除卡片,采用SAS 9.1软件对个案信息按月和年对县(区)零缺报率、及时性和准确性进行分析。 结果 2009年全国67 671个医疗卫生机构共报告甲乙丙类传染病报告卡6 487 969张,县(区)零缺报率月平均为1.65%,西部地区占绝大多数;报告及时率为98.09%,从诊断到报告的时间中位数为0.86 d,审核及时率为99.69%,从报告到审核的时间中位数为0.10 d,甲类及按甲类管理传染病及时性较差;月平均重卡率为0.02%,与2008年相比,报告卡信息错误率有大幅下降。 结论 2009年传染病信息网络报告质量进一步提高,但仍存在问题。各级政府应加强传染病网络直报系统运维保障,特别是西部地区必要的经费支持;加强甲类及按甲类管理传染病、慢性传染病的报告和科学管理。对传染病网络直报信息质量的评价应该结合现场综合开展,指标有待进一步完善。     

影响基于误差逆传播神经网络的医疗机构传染病报告质量的因素

2004年1月1日在全国范围内启动传染病网络直报系统,各级各类医疗机构在发现传染病患者或疑似患者后,直接通过传染病网络直报系统报告传染病个案信息,2005年对传染病网络报告质量调查发现有漏报、不及时等问题[1-2].王希江和曾光[3]认为疫情管理人员素质、疫情管理专职人员数量、疫情报告管理规章制度执行与检查是影响传染病报告质量的因素.     

中国1 8~45岁男性人群行为习惯与代谢综合征的关系

目的 分析吸烟、饮酒、睡眠及体力活动等行为习惯因素与中国18～45岁男性代谢综合征(MS)的关系.方法 资料来源于"2002年中国居民营养与健康状况调查"(在31个省、自治区、直辖市采用多阶段分层整群随机抽样方法,调查内容包括询问调查、医学体检、实验室检查和膳食调查).结果 MS各项指标及行为习惯资料填写完整的共4937人.MS患病率为6.9%(329/4937);目前饮酒率为49.4%、吸烟率为54.4%,70.5%的被研究对象平均每天睡眠时间为7～8 h,41.9%的被研究对象每周体力活动时间超过7 h.单因素分析结果,吸烟量＞600包以及饮酒与MS危险性增加有关,每天平均睡眠时间及每周体力活动时间与MS无显著联系.多因素分析结果,与不吸烟者相比,吸烟量＞600包者的MS危险性增加;吸烟量为600～899包,RR=1.443,95%CI:1.044～1.993;吸烟量≥900包,RR=1.765,95%CI:1.150～2.708.与不饮酒者相比,每周饮酒1～2次,RR=1.525,95%CI:1.135～2.048;每周饮酒3～4次,RR=2.322,95%CI:1.671～3.255;几乎每天饮酒,RR=2.033,95%CI:1.478～2.796.结论 吸烟、饮酒与MS危险增加有关.

Abstract：

Objective To analyze the relationship between prevalence of metabolic syndrome (MS) and behavior habits such as smoking,alcohol intake,physical activity,sleeping hours.Methods A multi-stage stratified cluster sampling was conducted in 31 provinces,autonomous regions,and municipalities in China according to the program of National Nutrition and Health Survey.Questionnaire survey,interview,physical examination,measurement of biochemical indices,and dietary investigation were done.In total,4937 men aged 18 to 45 years old were selected.Results The MS prevalence was 6.9%(329/4937).The rate of drinking was 49.4% and smoking rate was 54.4%.The percentage of sleeping was hours from 7 to 8 was 70.5%.The percentage of spending time on physical activity over 420 minutes/week was as high as 41.9%.Data from single logistic regression showed volume of smoking more than 600 packs and alcohol intake were associated with high risk of MS and no significantly associations were found between MS and the duration of physical activity and the sleeping time.Multivariate logistic regression showed that the risk of MS in smokers with the volume more than 600 packs age increased significantly as compared to nonsmokers with the odds ratio as 1.443 (95%CI:1.044-1.993 ) and 1.765 (95%CI:1.150-2.708) in smokers with volume from 600 to 899 packs age,and more than 900 packs age respectively.Compared to the nondrinkers,the odds ratios were 1.525 (95%CI:1.135-2.048),2.322(95%CI:1.671-3.255) and 2.033 (95%CI:1.478-2.796) in subjects volume of alcohol dranking as 1 to 2 times per week,3 to 4 times per week and more than 5 times per week respectively.Conclusion Tobacco and alcohol were associated with high risks of MS.     

餐饮业引发食源性疾病的主要危险因素

Objective To study main risk factors that cause foodborn diseases in food catering business.Methods Data from references and investigations conducted in food catering units were used to establish models which based on @ Risk 4.5 with Monte Carlo method referring to food handling practice model(FHPM)to make risk assessment on factors of food contamination in food catering units.The Beta-Poisson models on dose-response relationship to Salmonella(developed by WHO/FAO and United States Department of Agriculture)and Vibrio parahaemolyticus(developed by US FDA)were used in this article to analyze the dose-response relationship of pathogens.Results The average probability of food poisoning by consuming Salmonella contaminated cooked meat under refrigeration was 1.96×10-4 which was 1/2800 of the food under non-refrigeration(the average probability of food poisoning was 0.35 at room temperature 25℃).The average probability by consuming 6 hours stored meat under room temperature was 0.11 which was 16 times of 2 hours storage(6.79×10-3).The average probability by consuming contaminated meat without fully cooking was 1.71 X 10-4 which was 100 times of consuming fully cooked meat(1.88×10-6).The probability growth of food poisoning by consuming Vibrio parahaemolyticus contaminated fresh seafood was proportional with contamination level and prevalence.Condusion The primary contamination level,storage temperature and time,cooking process and cross contamination are important factors of catering food safety.     

流行病学动态数据采集平台在公共卫生调查中的应用

使用流行病学动态数据采集平台（Epidemiological Dynamic Data Collection platform, EDDC）开展公共卫生信息化人才队伍调查,从调查问卷定制、任务发布与管理和数据采集方面阐述平台功能的实现。实践证明该平台可节约调查成本,提高调查的效率和数据的质量,为公共卫生调查提供有效保障。     

流行病学动态数据采集平台用户权限管理体系的设计

由于缺乏完善的用户权限管理体系,流行病学动态数据采集平台（EDDC）在运行过程中出现了用户分工不明、用户管理混乱、数据安全不能保障等问题。为解决这些问题,讨论了用户权限管理体系的设计思路,建立了流行病学调查用户体系,提出了相应的授权机制。     

来自户外就餐的压力

随着经济的发展 ,人民生活水平的提高 ,选择户外就餐的人数和频次越来越高。户外就餐的迅猛增长 ,不仅丰富了人们的饮食种类 ,也在一定程度上促进了国民经济。同时 ,这种增长也增加了急、慢性疾病发生的潜在危险 ,并且给食品与营养卫生 ,监督执法 ,卫生决策以及餐饮业自身都带来了很大的压力     

心理咨询对HIV感染者生活质量及社会支持状况的效果

目的:探讨心理咨询对HIV感染者生活质量及社会支持状况的影响.方法:采用生活质量问卷和社会支持量表对94例HIV感染者进行问卷调查分析.结果:HIV感染者心理咨询后生活质量情况有了明显的变化.躯体功能分(男61.2;女56.3)、社会功能分(男91.6;女89.1)、心理功能分(男60.8;女57.3)和物质生活分(男53.3;女52.4)4个因子得分均高于心理咨询前躯体功能分(男33.9;女31.3)、社会功能分(男67.0;女68.3)、心理功能分(男45.0;女32.1)和物质生活分(男53.2;女52.3),其中前3个因子分经统计学检验P<0.05;心理咨询后HIV感染者的社会支持情况发生了改变.心理咨询后的客观支持分(男4.8;女5.0)和对支持的利用度分(男4.7;女4.4)两个得分高于心理咨询前的客观支持分(男3.6;女3.8)和对支持的利用度分(男3.6;女3.5),并且经统计学检验P<0.05.结论:对HIV感染者进行心理咨询可以帮助他们提高生活质量和社会支持状况.