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1.
In this paper, we argue that understanding and addressing the problem of poor-quality medical products requires a more interdisciplinary approach than has been evident to date. While prospective studies based on rigorous standardized methodologies are the gold standard for measuring the prevalence of poor-quality medical products and understanding their distribution nationally and internationally, they should be complemented by social science research to unpack the complex set of social, economic, and governance factors that underlie these patterns. In the following sections, we discuss specific examples of prospective quality surveys and of social science studies, highlighting the value of cross-sector partnerships in driving high-quality, policy-relevant research in this area.  相似文献   
2.
《Vaccine》2020,38(19):3582-3590
BackgroundConcern about adverse events following immunization is frequently cited by both those who receive or decline vaccines. Neurological adverse events are especially concerning.ObjectivesOur aim was to detect associations between seasonal influenza vaccination and the occurrence of severe anesthesia/paresthesia or severe headaches.MethodsData were analyzed from the Canadian National Vaccine Safety network. Events occuring on days 0–7 were self-reported and prevented daily activity, led to school or work absenteeism, or required medical attention. Controls were the previous year’s vaccinees; events in controls were collected prior to the start of the influenza vaccination program of each year (2012/13 through 2016/17). Multivariable logistic regression was used to determine the association between seasonal influenza vaccination and the occurrence of anesthesia/paresthesia or severe headaches.ResultsThe total sample was 107,565 for investigating anesthesia/paresthesia and 97,420 for investigating severe headaches. Anesthesia/paresthesia was reported by 104/107,565 (0.10%) participants; 63/69,129 (0.09%) vaccinees and 41/38,436 (0.11%) controls (adjusted odds ratio (aOR) = 0.89; 95% CI = 0.60, 1.32). Severe headaches were reported by 1361/97,420 (1.40%) participants; 907/61,463 (1.48%) vaccinees and 454/35,957 (1.26%) controls (aOR = 1.21; 95% CI = 1.08, 1.36). No specific vaccine product was associated with severe headaches.ConclusionsOur study found no association between severe anesthesia/paresthesia and seasonal influenza vaccination. While there was an association with severe headaches as an adverse event following influenza vaccination, the rates of these events are similar to rates reported from clinical trials and are not a cause for additional concern.  相似文献   
3.
《Vaccine》2016,34(20):2349-2353
BackgroundIn October 2011, the Advisory Committee on Immunization Practices (ACIP) issued updated recommendations that all pregnant women routinely receive a dose of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine.ObjectivesWe characterized reports to the Vaccine Adverse Event Reporting System (VAERS) in pregnant women who received Tdap after this updated recommendation (2011–2015) and compared the pattern of adverse events (AEs) with the period before the updated recommendation (2005–2010).MethodsWe searched the VAERS database for reports of AEs in pregnant women who received Tdap vaccine after the routine recommendation (11/01/2011–6/30/2015) and compared it to published data before the routine Tdap recommendation (01/01/2005–06/30/2010). We conducted clinical review of reports and available medical records. The clinical pattern of reports in the post-recommendation period was compared with the pattern before the routine Tdap recommendation.ResultsWe found 392 reports of Tdap vaccination after the routine recommendation. One neonatal death but no maternal deaths were reported. No maternal or neonatal deaths were reported before the recommendation. We observed an increase in proportion of reports for stillbirths (1.5–2.8%) and injection site reactions/arm pain (4.5–11.9%) after the recommendation compared to the period before the routine recommendation for Tdap during pregnancy. We noted a decrease in reports of spontaneous abortion (16.7–1%). After the 2011 Tdap recommendation, in most reports, vaccination (79%) occurred during the third trimester compared to 4% before the 2011 Tdap recommendation. Twenty-six reports of repeat Tdap were received in VAERS; 13 did not report an AE. One medical facility accounted for 27% of all submitted reports.ConclusionsNo new or unexpected vaccine AEs were noted among pregnant women who received Tdap after routine recommendations for maternal Tdap vaccination. Changes in reporting patterns would be expected, given the broader use of Tdap in pregnant women in the third trimester.  相似文献   
4.
IntroductionEndoscopic surveillance guidelines for patients with repaired esophageal atresia (EA) rely primarily on expert opinion. Prior to embarking on a prospective EA surveillance registry, we sought to understand EA surveillance practices within the Eastern Pediatric Surgery Network (EPSN).MethodsAn anonymous, 23-question Qualtrics survey was emailed to 181 physicians (surgeons and gastroenterologists) at 19 member institutions. Likert scale questions gauged agreement with international EA surveillance guideline-derived statements. Multiple-choice questions assessed individual and institutional practices.ResultsThe response rate was 77%. Most respondents (80%) strongly agree or agree that EA surveillance endoscopy should follow a set schedule, while only 36% claimed to perform routine upper GI endoscopy regardless of symptoms. Many institutions (77%) have an aerodigestive clinic, even if some lack a multi-disciplinary EA team. Most physicians (72%) expressed strong interest in helping develop evidence-based guidelines.ConclusionsOur survey reveals physician agreement with current guidelines but weak adherence. Surveillance methods vary greatly, underscoring the lack of evidence-based data to guide EA care. Aerodigestive clinics may help implement surveillance schedules. Respondents support evidence-based protocols, which bodes well for care standardization. Results will inform the first multi-institutional EA databases in the United States (US), which will be essential for evidence-based care.Level of EvidenceThis is a prognosis study with level 4 evidence.  相似文献   
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深圳市南山区医疗机构消毒效果分析   总被引:1,自引:0,他引:1  
目的:了解南山区各医院及个体诊所卫生消毒状况。方法:对2002~2003年间区属各医院及个体诊所消毒效果的监测结果进行统计分析。结果:2002年与2003年区镇医院消毒效果平均合格率分别为94.4%和97.1%,个体诊所平均合格率分别为87.6%和89.8%。结论:区(镇)医院消毒效果优于个体诊所,空气合格率普遍较低,卫生防疫机构要加大力度进行监督检测,同时加强对医务人员进行消毒知识培训。  相似文献   
8.
2005~2006年江西省血吸虫病疫情监测点螺情调查结果分析   总被引:1,自引:0,他引:1  
目的分析2005~2006年江西省12个国家级血吸虫病疫情监测点螺情调查结果,掌握各监测点钉螺消长情况。方法依据《全国血吸虫病疫情监测点方案》,对各监测点钉螺孳生环境与可疑环境进行调查,比较两年的各项螺情指标。结果2006年12个监测点的有螺面积较2005年下降17.27%,但各监测点有螺面积下降幅度不相一致,有10个监测点查出有阳性钉螺分布;另外各监测点活螺密度、阳性螺密度也有较大波动。结论各监测点螺情依然严重,应加强控制钉螺的防治力度。  相似文献   
9.
甘肃省1995年共报告15岁以下儿童急性弛缓性麻痹(AFP)病例90例,发病率为1.32/10万。省脊髓灰质炎(脊灰)实验室收到AFP病例的粪便标本共79例,占88%;双份合格粪便标本采集率为68%(61/90);粪便标本7天内送省脊灰实验室的占65%(52/79)收到粪便标本后7天内分离培养的占89%(70/79);分离培养结果及时报告率为87%(69/79)。病毒分离阳性率13.92%(11/79),其中脊灰病毒(PV)Ⅱ型5株,Ⅲ型1株,非脊灰肠道病毒(NPEV)5株。收到AFP病例密切接触者粪便标本3l8份,病毒分离阳性率5.66%(18/318),其中PVⅡ型8株,NPEV10株。全部送检粪便标本NPEV分离率3.78%(15/397)。所分离的PV均为疫苗株,且Ⅱ型居多。  相似文献   
10.
目的:观察急性迟缓性麻痹病例(AFP)在我市的发病状况。方法:对96例急性迟缓性麻痹病人采集48h内粪便进行病毒分离,并进行个案调查与随访。结果:96例中,7例分布于城镇,89例分布于农村;格林-巴利综合征55例(57.3%)-横断性脊髓炎16例(16.6%)、神经炎11例(11.5%)、重症肌无力12例(12.5%)、与疫苗相关的脊髓灰质炎AFP病例(VAPP)2例(2.08%)。结论:防疫部门与各级医院加强合作和直接管理能及时了解发病状况。市髓灰质炎减毒疫苗(OPV)免疫工作尚存不足,宣讲教育应进一步加强。  相似文献   
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