农村公共卫生管理政府责任缺位的应对措施

目的：探讨农村公共卫生管理政府责任缺位的应对措施。方法针对我地区农村公共卫生管理政府责任缺位,提出建议民营资本进驻的建议,并提供具体方法,分析其实际效果。结果干预后农村医疗总床位数及初级以上执业人员均显著多于干预前（P＜0.05）,干预后患者总住院时间短于干预前（P＜0.05）,均次医疗费用少于干预前（P＜0.05）。结论提高政府对农村医疗资源的支持,能有效减低医疗费用,提高农村基层医务人员工作积极性。     

Evaluation of the Public Health Emergency Response to the COVID-19 Pandemic in Daegu,Korea During the First Half of 2020

ObjectivesThis study evaluated the response in Daegu, Korea to the first wave of the coronavirus disease 2019 (COVID-19) pandemic according to a public health emergency response model.MethodsAfter an examination of the official data reported by the city of Daegu and the Korea Centers for Disease Control and Prevention, as well as a literature review and advisory meetings, we chose a response model. Daegu’s responses were organized into 4 phases and evaluated by applying the response model.ResultsIn phase 1, efforts were made to block further transmission of the virus through preemptive testing of a religious group. In phase 2, efforts were concentrated on responding to mass infections in high-risk facilities. Phase 3 involved a transition from a high-intensity social distancing campaign to a citizen participation–based quarantine system. The evaluation using the response model revealed insufficient systematic preparation for a medical surge. In addition, an incorporated health-related management system and protection measures for responders were absent. Nevertheless, the city encouraged the participation of private hospitals and developed a severity classification system. Citizens also played active roles in the pandemic response by practicing social distancing.ConclusionsThis study employed the response model to evaluate the early response in Daegu to the COVID-19 pandemic and revealed areas in need of improvement or maintenance. Based on the study results, creation of a systematic model is necessary to prepare for and respond to future public health emergencies like the COVID-19 pandemic.     

Nosocomial pseudoepidemics and pseudoinfections: an increasing problem.

The infection control practitioner often relies on microbiologic data in order to conduct nosocomial infection surveillance and control activities. On the basis of a review of the medical literature, false positive culture and stained smear results representing pseudoinfection are being reported with greater frequency. Documented cases and clusters of pseudoinfectons are reviewed, and the epidemiologic characteristics and methods for detection and prevention of this increasingly recognized problem are discussed.     

“毒胶囊”事件舆情分析及其对医学情报工作创新的启示

以"毒胶囊"事件为案例进行舆情监测分析,总结这一事件舆情演变的管理警示,探讨医学情报机构如何在应激事件中开展舆情分析服务,及时为政府提供决策咨询,以推动医学情报工作创新与发展。     

Effect of Classroom Illuminance on the Development and Progression of Myopia in School Children

PurposeTo evaluate the effect of classroom illuminance on the development and progression of myopia in elementary school children.MethodsThe daylight factor, a ratio of inside and outside illuminance, was obtained in 50 elementary schools. The first-grade students in the school with the lowest daylight (LD) factor (LD school, 145 subjects; 0.51%) and with the highest daylight (HD) factor (HD school, 147 subjects; 13.35%) were selected. A survey was conducted to evaluate parental myopia, the amount of near-work and outdoor activities. The refractive error and axial length (AL) were measured at initial and after 6 months. The spherical equivalent, AL, and the survey results were compared between the two schools. The mean AL of the emmetropic children was obtained, and all subjects were divided into two groups, more and less than mean AL. Changes in refractive errors and AL were also compared according to AL.ResultsThe amount of change in spherical equivalent and AL after 6 months were not different between the two schools. Initial prevalence of myopia was high in the HD school. However, it became similar between the two schools after 6 months. The mean AL of 155 emmetropic children was 22.7 ± 0.63 mm. In the 185 children with AL ≥22.7 mm, there was no difference in the AL change between the two schools. However, the change in AL in 107 children with AL <22.7 mm was significantly larger in the LD school (0.19 mm) than that in the HD school (0.15 mm, p = 0.049). Parental myopia, near-work and outdoor activities were not different between the two schools.ConclusionsHigh classroom illuminance during the day reduced axial elongation in eyes of children with a shorter AL. Increase in classroom light level by permitting more sunlight can be a protective measure against the development of myopia.     

广州市居民人禽流感及流感大流行信息需求的电话调查

目的了解广州市公众对人禽流感及流感大流行的信息需求,制定有针对性的沟通信息,为人禽流感及流感大流行发生时,与公众进行有效沟通做准备。方法采用电话问卷调查方法获得所需信息。自制调查表,经预调查修订后,再进行正式调查。结果共拨打4121个电话号码,电话调查有效应答率为52.4%。广州发生动物禽流感及人禽流感疫情后,被调查者49.3%对事件不感兴趣,仅10%关注事件。政府公布信息后,11.6%的公众认为政府隐瞒了信息。在信息沟通方面(健康教育宣传),0.7%的公众认为宣传资料内容太多,分不清主次;3.5%感到宣传资料太专业,看不明白;4.4%认为政府提供的信息不是个人想得到的。假设广州发生流感大流行,害怕这种状况发生的公众优先选择的3项措施为不去人多的地方(51.8%)、不吃鸡肉(50.4%)、勤洗手(44.2%),仅6.2%的公众选择打喷嚏时捂嘴。公众对人禽流感需要的主要信息为一般性的知识问题,如人禽流感的现状是怎样的(66.7%)、与疫苗相关的问题(42.4%)、怎样预防禽流感(36.3%)、是否有治疗和预防的药物(25.8%)、如何消毒(21.9%)等。公众对流感大流行的主要信息需求为与隔离有关的问题(62.2%)、希望得到政府的及时公告(50.9%)、政府的控制措施是什么(35.7%)、个人能做什么准备工作(30.1%)、大流行发生时,公众应该做什么(23.4%)等。结论电话调查应答率较高,广州市居民可以接受电话访问的调查方式。90%的公众不关注禽流感事件,公众对流感大流行的相关信息了解较少。     

公立医院管理体制改革的模式和特点

管理体制是公立医院改革的关键点.公立医院管理体制改革的本质是管理权和监督权的结构调整.文章首先将公立医院管理体制分为融合型和分立型两种模式,阐述两种管理体制的主要特点和基本逻辑.提出了推进融合型公立医院管理体制改革的政策建议,即以供需矛盾为客观形势、以管制失灵为假设、以下放管理权为关键、以上收监督权为保障、以活力和秩序均衡为目的、以利义兼得为结果的制度重构过程.     

Spatial Learning Drives Rapid Goal Representation in Hippocampal Ripples without Place Field Accumulation or Goal-Oriented Theta Sequences

The hippocampus is critical for rapid acquisition of many forms of memory, although the circuit-level mechanisms through which the hippocampus rapidly consolidates novel information are unknown. Here, the activity of large ensembles of hippocampal neurons in adult male Long-Evans rats was monitored across a period of rapid spatial learning to assess how the network changes during the initial phases of memory formation and retrieval. In contrast to several reports, the hippocampal network did not display enhanced representation of the goal location via accumulation of place fields or elevated firing rates at the goal. Rather, population activity rates increased globally as a function of experience. These alterations in activity were mirrored in the power of the theta oscillation and in the quality of theta sequences, without preferential encoding of paths to the learned goal location. In contrast, during brief “offline” pauses in movement, representation of a novel goal location emerged rapidly in ripples, preceding other changes in network activity. These data demonstrate that the hippocampal network can facilitate active navigation without enhanced goal representation during periods of active movement, and further indicate that goal representation in hippocampal ripples before movement onset supports subsequent navigation, possibly through activation of downstream cortical networks.SIGNIFICANCE STATEMENT Understanding the mechanisms through which the networks of the brain rapidly assimilate information and use previously learned knowledge are fundamental areas of focus in neuroscience. In particular, the hippocampal circuit is a critical region for rapid formation and use of spatial memory. In this study, several circuit-level features of hippocampal function were quantified while rats performed a spatial navigation task requiring rapid memory formation and use. During periods of active navigation, a general increase in overall network activity is observed during memory acquisition, which plateaus during memory retrieval periods, without specific enhanced representation of the goal location. During pauses in navigation, rapid representation of the distant goal well emerges before either behavioral improvement or changes in online activity.