An overview of disease surveillance and notification system in Nigeria and the roles of clinicians in disease outbreak prevention and control

While outbreaks of infectious diseases have long presented a public health challenge, especially in developing countries like Nigeria; within recent years, the frequency of such outbreaks has risen tremendously. Furthermore, with the recent outbreaks of emerging and re-emerging infectious diseases such as Ebola virus disease and other epidemic prone diseases in Nigeria demanding immediate public health action, there is a need to strengthen the existing notifiable disease surveillance and notification system with increased clinicians’ involvement in timely reporting of notifiable diseases to designated public health authorities for prompt public health action. Hence, this paper provides the opportunity to increase awareness among clinicians on the importance of immediate reporting of notifiable diseases and intensify engagement of clinicians in disease notification activities by describing various notifiable diseases in Nigeria using their surveillance case definition, outlines the reporting channel for notifying these diseases and highlights the roles of clinicians in the current disease surveillance and notification network for early disease outbreak detection and public health response in Nigeria.     

Impact of the role of senior dual disability coordinator on the perceived self-efficacy and job satisfaction of mental health clinicians

Abstract

Purpose: This study aimed to evaluate a new service role in mental health services, namely, the senior dual disability coordinator role (SDDC) for its impact on the perceived self-efficacy of mental health clinicians in managing clients with dual disability (mental illness and acquired brain injury and/or intellectual disability) and their job satisfaction. Method: Mental health clinicians from a health service district in Queensland, Australia who contacted the SDDC for clinical consultation and liaison between July 2011 and July 2013 were asked to complete a questionnaire assessing perceived self-efficacy in working with clients with dual disability as well as their job satisfaction, prior to (T1) and following (T2) their contact with the SDDC. Results: Twenty-five clinicians completed and returned pre- and post-measure questionnaires. Self-reported knowledge of dual disability, clinical skills in dual disability, service knowledge in dual disability as well as perceived self-efficacy, and job satisfaction increased significantly from T1 to T2. There were no significant differences across professional discipline or years of service. Conclusions: The delivery of a clinical consultation liaison service as part of the role of SDDC may assist mental health clinicians with self-efficacy and job satisfaction, regardless of the number of years they have worked in the service or their professional discipline. Mental health clinicians with improved self-efficacy for working with clients with dual disability may be more likely to consider the client suitable for services through mental health and follow-up with treatment and linking the client with other identified suitable services.

• Implications for Rehabilitation

• Dual disability (mental illness and acquired brain injury and/or intellectual disability) presents specific challenges for mental health services Specific strategies are needed to build capacity among mental health practitioners in order to meet the needs of people with dual disability and provide appropriate services.

• Introducing dual disability coordinators as a specific position within a health service district may assist to improve self-efficacy and job satisfaction of mental health practitioners assisting people with dual disability.

     

中国医师对上消化道症状理解情况的问卷分析

目的了解中国医师对上消化道症状的理解情况。方法对全国9个省市临床医师进行上消化道症状理解情况的问卷调查。比较不同职称、专业及学历的医师对症状的理解是否存在差异。结果被调查者普遍对"餐后饱胀、早饱感、烧心、上腹烧灼、反流"症状的认识较好。单个症状理解的正确率分别为80.4%、77.34%、69.74%、83.44%和50.23%。对以上5个症状都能正确理解的医师占27.9%,能正确理解其中4个的占49.7%,高学历者及消化专科医师的正确率显著高于学历较低者及非消化专科医师(P均<0.01)。被调查者对"上腹部"的范围、"disten-sion"、"bloating"的理解较差。单个问题回答的正确率分别为42.17%、4.2%和43.33%。不同职称、学历及专业的医师之间无明显差异(P均>0.05)。结论临床医生普遍能正确理解上消化道症状,高年资、高学历及专科医师的认识较好。但对"上腹部"范围、"distension"和"bloating"的理解较差,各级临床医师需重视对消化不良症状,尤其是罗马Ⅲ标准的解读。     

多种途径并举搞好西藏部队医院临床医师继续教育工作

对临床医师进行继续教育培训是使临床医师不断更新医学知识、提高临床诊治水平的必然要求。西藏部队医院临床医师队伍的特点与现状是青年医师较多,临床经验相对欠缺,对现代临床医学科学研究进展了解甚少,医学理论知识更新较慢。搞好西藏部队医院临床医师继续教育培训工作的主要经验有:①委派尽可能多的临床医师到军区总医院、军医大学附属医院进修学习;②选派内地部队医院高职称医师到西藏部队医院带职工作;③邀请军医大学附属医院专家教授到西藏部队医院短期讲学;④有计划地选派部分临床医师参加内地学术会议与专题学习班;⑤西藏军区定期举办各种专业学习班,对临床医师进行短期培训;⑥利用远程教学系统对临床医师进行培训。     

少数民族地区临床医生糖尿病防治知识水平调查

目的：评价甘肃省少数民族地区临床医生对糖尿病防治知识的掌握程度,分析存在原因,制定培训计划和对策。方法：以甘肃省甘南藏族自治州和临夏回族自治州为中心,抽取该地区临床内科和全科医生321人进行问卷调查,用不记名笔试的方法,在规定时间内完成答题,调查问卷当场收回,调查后集中审查、整理。结果：少数民族地区基层医务人员对糖尿病发病机理及诊断掌握情况糖尿病诊断标准掌握率41.7%,对1型及2型糖尿病鉴别要点的掌握57.6%,对Hb A1c检测意义的知晓率42.8%,对糖尿病急性并发症诊断知晓率56.9%;对糖尿病慢性并发症治疗原则了解率仅47.9%,对眼底视网膜病变分期准确率34.8%,糖尿病肾病分期知晓率43.6%,糖尿病神经病变知晓率42.6%,低血糖临床表现认知率62.8%;对糖尿病饮食计算方法掌握率仅47.6%;糖尿病患者如何进行运动治疗知晓率61.4%;对糖尿病降糖药物了解率低,使用知识欠缺。结论：结果表明：甘肃省少数民族基层医务人员糖尿病防控知识欠缺,尤其是在民族地区糖尿病防治技术亟待普及与提高,糖尿病防治整体状况堪忧。     

临床医生的压力来源及其与工作满意度的关系研究

目的探讨临床医生的压力来源及其与工作满意度之间的关系,为进一步加强医院管理和调节医生心理健康提供依据。方法对来自武汉市4家三甲医院临床医生的问卷调查数据进行相关分析。结果医生压力来源与工作满意度之间存在显著差异。结论工作压力是临床医生满意度的重要原因。     

Genetic counselling in post-genomic era-to be or not to be

With the surge of genetic tests and technologies, genetic counsellors are faced with the challenge of translating emerging scientific knowledge into practical information for patients, clinicians and public health policy makers. The new tests and technologies also are associated with new psychosocial and ethical considerations. New guidelines are needed for each new discovery of the genomic impact on phenotype, pathology and disease while “old” syndromes and “old” pathology, continue to require attention. In the new post-Human Genome Project era, genetic counsellors will be an integral part of translating genomic discoveries into beneficial impact on human disease, health care, and medical benefits. The needs for genetic counselling should be designed into genomic research at the onset. Genetic counsellors need to handle old while rapidly assimilating new information and the principal challenge is to be up to date and updated.     

提高临床医师中医诊疗能力对策探讨

根据中医临床医师面临的问题,提出提高临床医师中医诊疗能力的对策。认为加强中医经典著作的学习,可以拓宽思路;为临床医师创造再学习条件,知识的"回炉"可以提升应对各种疑难杂症的能力;科研政策的优惠可以调动临床医师的积极性;注重理论研究者和临床医师之间的沟通,可以优势互补,取得双赢的效果。     

临床医师普及手术分类知识的尝试

某院以卫计委颁布的〈三级综合医院评审标准（2011版）〉中的重点手术为抓手,针对临床医师的专业特点开展了按照手术分类原则进行病案首页手术信息的规范化填写培训,包括向临床医师普及对重点手术的知晓、手术分类基础知识、主要手术的选择、专科手术分类要点,并注重沟通及扩充编码工作,普及了ICD-9-CM3知识,促进了评审工作开展,提高疾病分类编码的准确率.