Objective:The study aims to review and discuss the outcomes of emergency preparedness training programs among nursing students.Methods:A scoping review was conducted based on the guidelines of Arskey and O’Malley.Dat...Objective:The study aims to review and discuss the outcomes of emergency preparedness training programs among nursing students.Methods:A scoping review was conducted based on the guidelines of Arskey and O’Malley.Databases through PubMed,Science Direct,and Google Scholar were used to obtain the relevant articles within the scoping review.Results:The researchers found 1175 articles.After manual review,28 articles were identified and assessed.The review reported that the emergency preparedness training program significantly affects preparedness,knowledge,performance,self-efficacy,learning motivation,self-confidence,satisfaction,critical decision-making,and problem-solving.Conclusions:Emergency training effectively increases knowledge,skills,confidence,satisfaction,and team performance.展开更多
The supply of highly concentrated oxygen positively affects cognitive processing in normal young adults. However, there have been few reports on changes in cognitive ability in elderly subjects following highly concen...The supply of highly concentrated oxygen positively affects cognitive processing in normal young adults. However, there have been few reports on changes in cognitive ability in elderly subjects following highly concentrated oxygen administration. This study investigated changes in cognitive ability, blood oxygen saturation (%), and heart rate (beats/min) in normal elderly subjects at three different levels of oxygen [21% (1 L/min), 93% (1 L/min), and 93% (5 L/min)] administered during a 1-back task. Eight elderly male (75.3 + 4.3 years old) and 10 female (71.1 + 3.9 years old) subjects, who were normal in cognitive ability as shown by a score of more than 24 points in the Mini-Mental State Examination-Korea, participated in the experiment. The experiment consisted of an adaptation phase after the start of oxygen administration (3 minutes), a control phase to obtain stable baseline measurements of heart rate and blood oxygen saturation before the task (2 minutes) and a task phase during which the 1-back task was performed (2 minutes). Three levels of oxygen were administered throughout the three phases (7 minutes). Blood oxygen saturation and heart rate were measured during each phase. Our results show that blood oxygen saturation increased, heart rate decreased, and response time in the 1-back task decreased as the concentration and amount of administered oxygen increased. This shows that administration of sufficient oxygen for optimal cognitive functioning increases blood oxygen saturation and decreases heart rate.展开更多
Cinnamon essential oil(CEO)and its combination with bamboo leaf flavonoid(BLF)have been shown to exhibit an additive antibacterial effect in vitro,but their functions in broilers were not clear.An experiment was condu...Cinnamon essential oil(CEO)and its combination with bamboo leaf flavonoid(BLF)have been shown to exhibit an additive antibacterial effect in vitro,but their functions in broilers were not clear.An experiment was conducted to investigate the effects of dietary graded levels of CEO and its combination with BLF on the growth performance,immune responses,antioxidative ability,and intestinal morphology and microbiota of broilers fed a corn-soybean meal basal diet.A total of 576 1-d-old Arbor Acres commercial male broilers were randomly allotted to 9 treatments with 8 replicates of 8 birds each in a completely randomized design.Birds were fed on a basal corn-soybean meal diet(control,without plant extracts and antibiotics),or the basal diet supplemented with 50 mg of aureomycin kg^-1,50,100,200,400,or 800 mg of CEO kg^-1,a combination of 100 mg of CEO and 16.7 mg of BLF kg^-1,or a combination of 200 mg of CEO kg^-1 and 33.3 mg of BLF kg^-1 for 42 d.Dietary treatment affected(P<0.05)the serum immune globulin M(IgM)contents on d 42,liver malondialdehyde(MDA)contents on d 21,duodenal crypt depth on d 42,relative abundance of Lactobacillus in the cecal contents on d 21,and relative abundances of Escherichia coli and Bifidobacterium in the cecal contents on d 42,but had no effect(P>0.16)on all other measured indices.The addition of 400 mg of CEO kg^-1 or a combination of 200 mg CEO kg^-1 and 33.3 mg BLF kg^-1 increased(P<0.02)serum IgM contents on d 42.Dietary supplementation with 100 or 200 mg CEO kg^-1,or 50 mg aureomycin kg^-1 decreased(P<0.003)liver MDA contents on d 21.In addition,the supplement of 100 mg CEO kg^-1 increased(P<0.002)the Lactobacillus relative abundance in caecum on d 21 and Bifidobacterium relative abundance in caecum on d 42,and decreased(P<0.0001)E.coli relative abundance in caecum on d 42.The results indicated that dietary supplementation with CEO,an alternative to aureomycin,improved the immune status,antioxidantative ability and cecal microbiota of broilers,and dietary supplementation with the combinations of CEO and BLF did not exhibit further effects.Dietary supplementation with 100 mg CEO kg^-1 is beneficial for broilers fed a corn-soybean meal basal diet.展开更多
Objective: A resilient health system plays a crucial role in pandemic preparedness and response. Althoughthe World Health Organization (WHO) has required all states parties to strengthen core capacities to respondto p...Objective: A resilient health system plays a crucial role in pandemic preparedness and response. Althoughthe World Health Organization (WHO) has required all states parties to strengthen core capacities to respondto public health emergencies under the International Health Regulations (2005), the actions of most countriesto combating coronavirus disease 2019 (COVID-19) has showed that they are not well-prepared. This crosssectionalstudy aimed to examine the health system resilience of selected countries and analyze their strategiesand measures in response to the COVID-19 pandemic.Methods: This study selected five countries including the Iran, Japan, Republic of Korea (South Korea), the U.K.,and the U.S., based on the severity of the national epidemic, the geographical location, and the developmentlevel. Cumulative number of death cases derived from WHO COVID-19 dashboard was used to measure theseverity of the impact of the pandemic in each country;WHO State Parties Self-Assessment Annual Reporting (SPAR)Scores and Global Health Security (GHS) Index were applied to measure the national health system resilience;and research articles and press materials were summarized to identify the strategies and measures adopted bycountries during response to COVID-19. This study applied the resilient health systems framework to analyzehealth system resilience in the selected countries from five dimensions, including awareness, diversity, selfregulation,integration and adaptation.Results: The SPAR Scores and GHS Index of the four developed countries, Japan, South Korea, the U.K. and theU.S. were above the global and regional averages;the SPAR Scores of Iran were above the global average whilethe GHI Index lain below the global average. In terms of response strategies, Japan, the U.K. and the U.S. investedmore health resources in the treatment of severe patients, while South Korea and Iran had adopted a strategyof extensive testing and identification of suspected patients. In terms of specific measures, all the five countriesadopted measures such as restrictions on entry and international travel, closure of schools and industries,lockdown and quarantine. Nevertheless, the effectiveness of implementing these measures varied acrosscountries, based on the response strategies.Conclusion: Although SPAR Scores and GHS Index have evaluated the national core capacities for preparednessand response, the actions to cope with the COVID-19 pandemic has revealed the fact that most countries stilldo not build resilient health systems in response to public health emergencies. Health system strengtheningand health security efforts should be pursued in tandem, as part of the same mutually reinforcing approach todeveloping resilient health systems.展开更多
This study attempted to interpret differential item discriminations between individual and cluster levels by focusing on patterns and magnitudes of item discriminations under 2PL multilevel IRT model through a set of ...This study attempted to interpret differential item discriminations between individual and cluster levels by focusing on patterns and magnitudes of item discriminations under 2PL multilevel IRT model through a set of variety simulation conditions. The consistency between the mean of individual-level ability estimates and cluster-level ability estimates was evaluated by the correlations between them. As a result, it was found that they were highly correlated if the patterns of item discriminations were the same for both individual and cluster levels. The magnitudes of item discriminations themselves did not affect much on correlations, as far as the patterns were the same at the two levels. However, it was found that the correlation became lower when the patterns of item discriminations were different between the individual and cluster levels. Also, it was revealed that the mean of the estimated individual-level abilities would not be necessarily a good representation of the cluster-level ability, if the patterns were different at the two levels.展开更多
As an earthquake-prone country, China has made sustained efforts in the study of earthquakes and disaster mitigation during the past several decades, with China Seismological Bureau (CSB) as the backbone of these effo...As an earthquake-prone country, China has made sustained efforts in the study of earthquakes and disaster mitigation during the past several decades, with China Seismological Bureau (CSB) as the backbone of these efforts. Working towards this purpose, a series of key projects were implemented in the “Ninth Five-Year Plan” (1995-2000) to upgrade earthquake monitoring systems and to improve the supporting infrastructure, significant results in earthquake science were achieved. In the new century, we have worked out a blueprint for earthquake preparedness and disaster mitigation in the “Tenth Five-Year Plan”, which emphases 3 systems (i.e. Seismic Monitoring & Prediction, Seismic Hazards Prevention, Emergency Response), and 10 key projects in earthquake science and technology.展开更多
BACKGROUND The treatment outcome of transarterial chemoembolization(TACE)in unresectable hepatocellular carcinoma(HCC)varies greatly due to the clinical heterogeneity of the patients.Therefore,several prognostic syste...BACKGROUND The treatment outcome of transarterial chemoembolization(TACE)in unresectable hepatocellular carcinoma(HCC)varies greatly due to the clinical heterogeneity of the patients.Therefore,several prognostic systems have been proposed for risk stratification and candidate identification for first TACE and repeated TACE(re-TACE).AIM To investigate the correlations between prognostic systems and radiological response,compare the predictive abilities,and integrate them in sequence for outcome prediction.METHODS This nationwide multicenter retrospective cohort consisted of 1107 unresectable HCC patients in 15 Chinese tertiary hospitals from January 2010 to May 2016.The Hepatoma Arterial-embolization Prognostic(HAP)score system and its modified versions(mHAP,mHAP2 and mHAP3),as well as the six-and-twelve criteria were compared in terms of their correlations with radiological response and overall survival(OS)prediction for first TACE.The same analyses were conducted in 912 patients receiving re-TACE to evaluate the ART(assessment for re-treatment with TACE)and ABCR(alpha-fetoprotein,Barcelona Clinic Liver Cancer,Child-Pugh and Response)systems for post re-TACE survival(PRTS).RESULTS All the prognostic systems were correlated with radiological response achieved by first TACE,and the six-and-twelve criteria exhibited the highest correlation(Spearman R=0.39,P=0.026)and consistency(Kappa=0.14,P=0.019),with optimal performance by area under the receiver operating characteristic curve of 0.71[95%confidence interval(CI):0.68-0.74].With regard to the prediction of OS,the mHAP3 system identified patients with a favorable outcome with the highest concordance(C)-index of 0.60(95%CI:0.57-0.62)and the best area under the receiver operating characteristic curve at any time point during follow-up;whereas,PRTS was well-predicted by the ABCR system with a C-index of 0.61(95%CI:0.59-0.63),rather than ART.Finally,combining the mHAP3 and ABCR systems identified candidates suitable for TACE with an improved median PRTS of 36.6 mo,compared with non-candidates with a median PRTS of 20.0 mo(logrank test P<0.001).CONCLUSION Radiological response to TACE is closely associated with tumor burden,but superior prognostic prediction could be achieved with the combination of mHAP3 and ABCR in patients with unresectable liver-confined HCC.展开更多
Public Health Emergency Operation Center (PHEOC) was conceptualized and established for coordinatinginformation and resources towards goal-oriented response in large scale public health emergency. Yet, theactivities u...Public Health Emergency Operation Center (PHEOC) was conceptualized and established for coordinatinginformation and resources towards goal-oriented response in large scale public health emergency. Yet, theactivities undertaken by PHEOCs and their intended goals have not been fully optimized in current scenario.This paper revisited the collective efforts invested in PHEOC conceptualization and development, identified theopportunities and challenges in compliance with standards and framework, demonstrated the accountabilityof PHEOC network, thereby promoted best practice guidance for global public health emergency preparednessand response. This review will help navigate emergency response complexities leveraging PHEOC partnershipsand advance the ability to detect and respond to public health emergencies in low resource settings. The reviewshows that the information on how to adapt best practice guidance to local circumstances could incentivizethe full implementation of prevention, early detection and response to outbreaks. Identifying and correctingdeficiencies in effectiveness evaluation will provide the basis for continuous PHEOC improvement. With thegradually reopening economies and public services in some countries, there is an urgent need to emphasize andvalidate the collective efforts undertaken by PHEOCs for tackling the COVID-19 pandemic.展开更多
Background:Global spread and impact of the coronavirus disease 2019(COVID-19)pandemic are determined to a large extent,by resistance to the pandemic and public response of all countries in the world;while a country...Background:Global spread and impact of the coronavirus disease 2019(COVID-19)pandemic are determined to a large extent,by resistance to the pandemic and public response of all countries in the world;while a country's resistance and response are in turn determined by its political and socio economic conditions.To inform future disease prevention and control,we analyzed global data to exam the relationship between state vulnerabilities and COVID-19 incidences and deaths.Methods:Vulnerability was measured using the Fragile States Index(FSI).FSI is created by the Fund for Peace to assess levels of fragility for individual countries.Total FSI score and scores for 12 specific indicators were used as the predictor variables.Outcome variables were national cumulative COVID-19 cases and deaths up to September 16,2020,derived from the World Health Organization.Cumulative incidence rates were computed using 2019 National population derived from the World Bank,and case fatality rates were computed as the ratio of deaths/COVID-19 cases.Countries with incomplete data were excluded,yielding a final sample of 146 countries.Multivariate regression was used to examine the association between the predictor and the outcome measures.Results:There were dramatic cross-country variations in both FSI and COVID-19 epidemiological measurements.FSI total scores were negatively associated with both COVID-19 cumulative incidence rates(β=-0.0135,P<0.001)and case fatality rates(β=-0.0147,P<0.05).Of the 12 FSI indicators,three negatively associated with COVID-19 incidences were E1(Economic Decline and Poverty),E3(Human Flight and Brain Drain),and S2(Refugees and Internally Displaced Persons);two positively associated were P1(State Legitimacy)and X1(External Intervention).With regard to association with case fatality rates,C1(Security Apparatus)was positive,and P3(Human Rights and Rule of Law)and X1 was negative.Conclusion:With FSI measures by the Fund of Peace,overall,more fragile countries are less likely to be affected by the COVID-19 pandemic,and even if affected,death rates were lower.However,poor in state legitimacy and lack of external intervention are risk for COVID-19 infection and lack of security apparatus is risky for COVID-19 death.Implications of the study findings are discussed and additional studies are needed to examine the mechanisms underpinning these relationships.展开更多
文摘Objective:The study aims to review and discuss the outcomes of emergency preparedness training programs among nursing students.Methods:A scoping review was conducted based on the guidelines of Arskey and O’Malley.Databases through PubMed,Science Direct,and Google Scholar were used to obtain the relevant articles within the scoping review.Results:The researchers found 1175 articles.After manual review,28 articles were identified and assessed.The review reported that the emergency preparedness training program significantly affects preparedness,knowledge,performance,self-efficacy,learning motivation,self-confidence,satisfaction,critical decision-making,and problem-solving.Conclusions:Emergency training effectively increases knowledge,skills,confidence,satisfaction,and team performance.
文摘The supply of highly concentrated oxygen positively affects cognitive processing in normal young adults. However, there have been few reports on changes in cognitive ability in elderly subjects following highly concentrated oxygen administration. This study investigated changes in cognitive ability, blood oxygen saturation (%), and heart rate (beats/min) in normal elderly subjects at three different levels of oxygen [21% (1 L/min), 93% (1 L/min), and 93% (5 L/min)] administered during a 1-back task. Eight elderly male (75.3 + 4.3 years old) and 10 female (71.1 + 3.9 years old) subjects, who were normal in cognitive ability as shown by a score of more than 24 points in the Mini-Mental State Examination-Korea, participated in the experiment. The experiment consisted of an adaptation phase after the start of oxygen administration (3 minutes), a control phase to obtain stable baseline measurements of heart rate and blood oxygen saturation before the task (2 minutes) and a task phase during which the 1-back task was performed (2 minutes). Three levels of oxygen were administered throughout the three phases (7 minutes). Blood oxygen saturation and heart rate were measured during each phase. Our results show that blood oxygen saturation increased, heart rate decreased, and response time in the 1-back task decreased as the concentration and amount of administered oxygen increased. This shows that administration of sufficient oxygen for optimal cognitive functioning increases blood oxygen saturation and decreases heart rate.
基金supported by the Special Fund for Agro-scientific Research in the Public Interest, China (201403047)the Special Funds of CAAS for Distinguished Scientists, China+2 种基金the earmarked fund for China Agriculture Research System (CARS-41)the Agricultural Science and Technology Innovation Program, China (ASTIP-IAS08)the Key Agricultural Science and Technology Program of Datong, Shanxi, China (2016047)
文摘Cinnamon essential oil(CEO)and its combination with bamboo leaf flavonoid(BLF)have been shown to exhibit an additive antibacterial effect in vitro,but their functions in broilers were not clear.An experiment was conducted to investigate the effects of dietary graded levels of CEO and its combination with BLF on the growth performance,immune responses,antioxidative ability,and intestinal morphology and microbiota of broilers fed a corn-soybean meal basal diet.A total of 576 1-d-old Arbor Acres commercial male broilers were randomly allotted to 9 treatments with 8 replicates of 8 birds each in a completely randomized design.Birds were fed on a basal corn-soybean meal diet(control,without plant extracts and antibiotics),or the basal diet supplemented with 50 mg of aureomycin kg^-1,50,100,200,400,or 800 mg of CEO kg^-1,a combination of 100 mg of CEO and 16.7 mg of BLF kg^-1,or a combination of 200 mg of CEO kg^-1 and 33.3 mg of BLF kg^-1 for 42 d.Dietary treatment affected(P<0.05)the serum immune globulin M(IgM)contents on d 42,liver malondialdehyde(MDA)contents on d 21,duodenal crypt depth on d 42,relative abundance of Lactobacillus in the cecal contents on d 21,and relative abundances of Escherichia coli and Bifidobacterium in the cecal contents on d 42,but had no effect(P>0.16)on all other measured indices.The addition of 400 mg of CEO kg^-1 or a combination of 200 mg CEO kg^-1 and 33.3 mg BLF kg^-1 increased(P<0.02)serum IgM contents on d 42.Dietary supplementation with 100 or 200 mg CEO kg^-1,or 50 mg aureomycin kg^-1 decreased(P<0.003)liver MDA contents on d 21.In addition,the supplement of 100 mg CEO kg^-1 increased(P<0.002)the Lactobacillus relative abundance in caecum on d 21 and Bifidobacterium relative abundance in caecum on d 42,and decreased(P<0.0001)E.coli relative abundance in caecum on d 42.The results indicated that dietary supplementation with CEO,an alternative to aureomycin,improved the immune status,antioxidantative ability and cecal microbiota of broilers,and dietary supplementation with the combinations of CEO and BLF did not exhibit further effects.Dietary supplementation with 100 mg CEO kg^-1 is beneficial for broilers fed a corn-soybean meal basal diet.
基金supported by the National Natural Science Foundationof China (No. 72042014).
文摘Objective: A resilient health system plays a crucial role in pandemic preparedness and response. Althoughthe World Health Organization (WHO) has required all states parties to strengthen core capacities to respondto public health emergencies under the International Health Regulations (2005), the actions of most countriesto combating coronavirus disease 2019 (COVID-19) has showed that they are not well-prepared. This crosssectionalstudy aimed to examine the health system resilience of selected countries and analyze their strategiesand measures in response to the COVID-19 pandemic.Methods: This study selected five countries including the Iran, Japan, Republic of Korea (South Korea), the U.K.,and the U.S., based on the severity of the national epidemic, the geographical location, and the developmentlevel. Cumulative number of death cases derived from WHO COVID-19 dashboard was used to measure theseverity of the impact of the pandemic in each country;WHO State Parties Self-Assessment Annual Reporting (SPAR)Scores and Global Health Security (GHS) Index were applied to measure the national health system resilience;and research articles and press materials were summarized to identify the strategies and measures adopted bycountries during response to COVID-19. This study applied the resilient health systems framework to analyzehealth system resilience in the selected countries from five dimensions, including awareness, diversity, selfregulation,integration and adaptation.Results: The SPAR Scores and GHS Index of the four developed countries, Japan, South Korea, the U.K. and theU.S. were above the global and regional averages;the SPAR Scores of Iran were above the global average whilethe GHI Index lain below the global average. In terms of response strategies, Japan, the U.K. and the U.S. investedmore health resources in the treatment of severe patients, while South Korea and Iran had adopted a strategyof extensive testing and identification of suspected patients. In terms of specific measures, all the five countriesadopted measures such as restrictions on entry and international travel, closure of schools and industries,lockdown and quarantine. Nevertheless, the effectiveness of implementing these measures varied acrosscountries, based on the response strategies.Conclusion: Although SPAR Scores and GHS Index have evaluated the national core capacities for preparednessand response, the actions to cope with the COVID-19 pandemic has revealed the fact that most countries stilldo not build resilient health systems in response to public health emergencies. Health system strengtheningand health security efforts should be pursued in tandem, as part of the same mutually reinforcing approach todeveloping resilient health systems.
文摘This study attempted to interpret differential item discriminations between individual and cluster levels by focusing on patterns and magnitudes of item discriminations under 2PL multilevel IRT model through a set of variety simulation conditions. The consistency between the mean of individual-level ability estimates and cluster-level ability estimates was evaluated by the correlations between them. As a result, it was found that they were highly correlated if the patterns of item discriminations were the same for both individual and cluster levels. The magnitudes of item discriminations themselves did not affect much on correlations, as far as the patterns were the same at the two levels. However, it was found that the correlation became lower when the patterns of item discriminations were different between the individual and cluster levels. Also, it was revealed that the mean of the estimated individual-level abilities would not be necessarily a good representation of the cluster-level ability, if the patterns were different at the two levels.
文摘As an earthquake-prone country, China has made sustained efforts in the study of earthquakes and disaster mitigation during the past several decades, with China Seismological Bureau (CSB) as the backbone of these efforts. Working towards this purpose, a series of key projects were implemented in the “Ninth Five-Year Plan” (1995-2000) to upgrade earthquake monitoring systems and to improve the supporting infrastructure, significant results in earthquake science were achieved. In the new century, we have worked out a blueprint for earthquake preparedness and disaster mitigation in the “Tenth Five-Year Plan”, which emphases 3 systems (i.e. Seismic Monitoring & Prediction, Seismic Hazards Prevention, Emergency Response), and 10 key projects in earthquake science and technology.
文摘BACKGROUND The treatment outcome of transarterial chemoembolization(TACE)in unresectable hepatocellular carcinoma(HCC)varies greatly due to the clinical heterogeneity of the patients.Therefore,several prognostic systems have been proposed for risk stratification and candidate identification for first TACE and repeated TACE(re-TACE).AIM To investigate the correlations between prognostic systems and radiological response,compare the predictive abilities,and integrate them in sequence for outcome prediction.METHODS This nationwide multicenter retrospective cohort consisted of 1107 unresectable HCC patients in 15 Chinese tertiary hospitals from January 2010 to May 2016.The Hepatoma Arterial-embolization Prognostic(HAP)score system and its modified versions(mHAP,mHAP2 and mHAP3),as well as the six-and-twelve criteria were compared in terms of their correlations with radiological response and overall survival(OS)prediction for first TACE.The same analyses were conducted in 912 patients receiving re-TACE to evaluate the ART(assessment for re-treatment with TACE)and ABCR(alpha-fetoprotein,Barcelona Clinic Liver Cancer,Child-Pugh and Response)systems for post re-TACE survival(PRTS).RESULTS All the prognostic systems were correlated with radiological response achieved by first TACE,and the six-and-twelve criteria exhibited the highest correlation(Spearman R=0.39,P=0.026)and consistency(Kappa=0.14,P=0.019),with optimal performance by area under the receiver operating characteristic curve of 0.71[95%confidence interval(CI):0.68-0.74].With regard to the prediction of OS,the mHAP3 system identified patients with a favorable outcome with the highest concordance(C)-index of 0.60(95%CI:0.57-0.62)and the best area under the receiver operating characteristic curve at any time point during follow-up;whereas,PRTS was well-predicted by the ABCR system with a C-index of 0.61(95%CI:0.59-0.63),rather than ART.Finally,combining the mHAP3 and ABCR systems identified candidates suitable for TACE with an improved median PRTS of 36.6 mo,compared with non-candidates with a median PRTS of 20.0 mo(logrank test P<0.001).CONCLUSION Radiological response to TACE is closely associated with tumor burden,but superior prognostic prediction could be achieved with the combination of mHAP3 and ABCR in patients with unresectable liver-confined HCC.
基金supported by the National Natural ScienceFoundation of China (No. 72042014).
文摘Public Health Emergency Operation Center (PHEOC) was conceptualized and established for coordinatinginformation and resources towards goal-oriented response in large scale public health emergency. Yet, theactivities undertaken by PHEOCs and their intended goals have not been fully optimized in current scenario.This paper revisited the collective efforts invested in PHEOC conceptualization and development, identified theopportunities and challenges in compliance with standards and framework, demonstrated the accountabilityof PHEOC network, thereby promoted best practice guidance for global public health emergency preparednessand response. This review will help navigate emergency response complexities leveraging PHEOC partnershipsand advance the ability to detect and respond to public health emergencies in low resource settings. The reviewshows that the information on how to adapt best practice guidance to local circumstances could incentivizethe full implementation of prevention, early detection and response to outbreaks. Identifying and correctingdeficiencies in effectiveness evaluation will provide the basis for continuous PHEOC improvement. With thegradually reopening economies and public services in some countries, there is an urgent need to emphasize andvalidate the collective efforts undertaken by PHEOCs for tackling the COVID-19 pandemic.
基金This paper was supported by the National Natural Science Foundation of China(No.72042014).
文摘Background:Global spread and impact of the coronavirus disease 2019(COVID-19)pandemic are determined to a large extent,by resistance to the pandemic and public response of all countries in the world;while a country's resistance and response are in turn determined by its political and socio economic conditions.To inform future disease prevention and control,we analyzed global data to exam the relationship between state vulnerabilities and COVID-19 incidences and deaths.Methods:Vulnerability was measured using the Fragile States Index(FSI).FSI is created by the Fund for Peace to assess levels of fragility for individual countries.Total FSI score and scores for 12 specific indicators were used as the predictor variables.Outcome variables were national cumulative COVID-19 cases and deaths up to September 16,2020,derived from the World Health Organization.Cumulative incidence rates were computed using 2019 National population derived from the World Bank,and case fatality rates were computed as the ratio of deaths/COVID-19 cases.Countries with incomplete data were excluded,yielding a final sample of 146 countries.Multivariate regression was used to examine the association between the predictor and the outcome measures.Results:There were dramatic cross-country variations in both FSI and COVID-19 epidemiological measurements.FSI total scores were negatively associated with both COVID-19 cumulative incidence rates(β=-0.0135,P<0.001)and case fatality rates(β=-0.0147,P<0.05).Of the 12 FSI indicators,three negatively associated with COVID-19 incidences were E1(Economic Decline and Poverty),E3(Human Flight and Brain Drain),and S2(Refugees and Internally Displaced Persons);two positively associated were P1(State Legitimacy)and X1(External Intervention).With regard to association with case fatality rates,C1(Security Apparatus)was positive,and P3(Human Rights and Rule of Law)and X1 was negative.Conclusion:With FSI measures by the Fund of Peace,overall,more fragile countries are less likely to be affected by the COVID-19 pandemic,and even if affected,death rates were lower.However,poor in state legitimacy and lack of external intervention are risk for COVID-19 infection and lack of security apparatus is risky for COVID-19 death.Implications of the study findings are discussed and additional studies are needed to examine the mechanisms underpinning these relationships.