Survey on the Status Quo of Emergency Response Capabilities of Public Health Emergencies in Grassroots Disease Control Institutions in a Certain Area

Objective:To survey and study the emergency response capabilities of grassroots disease control institutions in a certain area for public health emergencies,and to put forward suggestions for rectification.Methods:The study was carried out from March 2022 to March 2023.Field surveys,questionnaire surveys,and interviews were used to investigate and analyze the emergency response capabilities of public health emergencies in 5 county Centers for Disease Control and Prevention(CDCs)in the region.Results:Through the survey,it was found that the professional level of the existing emergency team personnel of the grassroots disease control institutions in this region needs to be improved.There was an overall lack of emergency plans,and the compliance rate of the equipment,inspection,and testing items was low.The health emergency system of the CDCs in the region and the ability of the talent team need to be further improved.Conclusion:The emergency response capacity of grassroots disease control institutions in this region needs to be improved.For this reason,government departments need to increase investment and strengthen the construction of talent teams and hardware settings,and grassroots disease control institutions need to strengthen the construction of the public health emergency system to improve the ability to respond to public health emergencies.

Study on the demand for public health professional after the COVID-19 epidemic in Zhejiang Province, China: A survey based on human-machine collaboration

To understand the needs of public health institutions in Zhejiang Province,China for public health personnel,and provide basis for training public health personnel.Methods:512 public health institutions in Zhejiang Province were randomly selected from different levels and regions,and the number of ublic health professional and the demand for professional ability were investigated by questionnaire.Results:The preventive medicine personnel in public health institutions in Zhejiang Province are insufficient;There is a certain disjunction or dislocation between the abilities and needs of public health professional;The way of continuing education for public health professional is single and the opportunities are few.Conclusion:Zhejiang Province should appropriately expand the enrollment of preventive medicine majors,especially high-level preventive medicine talents,deepen the education and teaching reform of preventive medicine majors,and strengthen the continuing education and training of public health professional to meet the needs of public health services after the COVID-19 epidemic.

The Role of Library and Information Science Education in the Development of Community Health Information Services for People Living with HIV/AIDS: Perspectives of Directors and Managers of Public Libraries

This article identifies the role of library and information science (LIS) education in the development of community health information services for people living with HIV/AIDS (PLWHA). Preliminary findings are presented from semi- structured qualitative interviews that were conducted with eleven directors and managers of local branches in the Knox County Public Library (KCPL) System that is located in the East Tennessee region in the United States. Select feedback reported by research participants is summarized in the article about strategies in LIS education that can help local public librarians and others in their efforts to become more responsive information providers to PLWHA. Research findings help better understand the issues and concerns regarding the development of digital and non-digital health information services for PLWHA in local public library institutions.

Research on the Construction of Pharmacy Organization and the Development of Pharmaceutical Services in China’s Primary Medical and Health Institutions—Based on the Survey of 5 Provinces

Objective To explore the current situation and problems of the pharmacy organization and pharmaceutical services in primary medical and health institutions so as to provide a reference for improving relevant policies.Methods Multi-stage stratified random sampling was used to collect questionnaires from primary medical and health institutions in 5 provinces,and 102 questionnaires were distributed.Then Excel 2016 and IBM SPSS 21.0 software were applied for descriptive statistical analysis,chi-square test and multiple response analysis.Results and Conclusion A total of 92 primary medical and health institutions participated in the survey,and 92 valid questionnaires were recovered.The survey shows that 54.1%of the institutions have established more than 8 pharmaceutical administration regulations.63.5%and 31.8%of the institutions have formulated pharmaceutical administration and pharmacotherapy team charters(or management systems).29.7%of institutions have pharmacy personnel in accordance with relevant regulations.The higher proportion of pharmacy services are prescription review and adjustment,medication guidance,collecting and reporting adverse reactions,medication errors and medication hazard information.Primary medical and health institutions still need to further improve their pharmaceutical administration system,organizational structure,pharmacy professional training and clinical pharmacy service.

Business Process Analysis and Simulation: The Contact Center of a Public Health and Social Information Office

This article proposes a framework, called BP-M* which includes: 1) a methodology to analyze, engineer, restructure and implement business processes, and 2) a process model that extends the process diagram with the specification of resources that execute the process activities, allocation policies, schedules, times of activities, management of queues in input to the activities and workloads so that the same model can be simulated by a discrete event simulator. The BP-M* framework has been applied to a real case study, a public Contact Center which provides different typologies of answers to users’ requests. The simulation allows to study different system operating scenarios (“What-If” analysis) providing useful information for analysts to evaluate restructuring actions.

The situation of primary care institutions under the background of new medical reform in China

[目的] 分析新医改背景下我国基层医疗卫生机构的发展现状,探讨存在的问题,为进-步完善基层 卫生事业改革发展提供参考.[方法]利用2008 - 2 0 1 2年中国卫生统计年鉴数据,对基层医疗卫生机构基础设 施、人才配置和卫生服务利用状况进行分析.[结果] 2008 - 2 0 1 2年我国基层医疗卫生机构总数量年平均增速 为 1.55%,其中西部地区的机构数量最少、但年平均增速最快,中部地区的数量比西部多比东部少;在三大基 层医疗卫生机构当中,社区卫生服务中心（ 站）、乡镇卫生院和村卫生室机构数量年平均增长率分别为8 . 4 4 %、 -1.3%和 1.6%; 三大基层机构卫生技术人员数量年平均增长率分别为2 0 . 2 5 %、3% 和 5 . 0 2 % ; 三大基层机构 诊疗人次数年平均增长率分别为2 3 . 6 8 %、3. 96% 和 8. 92 %.截至2 0 1 2年 ,社区卫生服务中心卫生技术人员的 学历以大专为主（占40. 9%）,职称以师级/助理为主 （占32. 8%）; 乡镇卫生院卫生技术人员的学历以中专为 主 （占51. 3%）,职称以士级为主（占40. 2%）.[结论]新医改后我国基层医疗卫生机构发展迅速,但资源分 布仍不均衡;基层卫生技术人员数量不断增加,但学历职称层次仍偏低;基层医疗卫生机构卫生服务利用增 加 ,但患者就医仍缺乏有效引导.

The Limits of the Intervention of Public Power in Individual Health Choices——From the Perspective of the Realization of the Right to Health in the Prevention and Control of Chronic Diseases

Noncommunicable chronic diseases have become the most important public health problem in the world today,so the focus of public health services should be shifted from the traditional area of communicable diseases to the prevention and control of chronic diseases.Since bad living habits are the most direct cause of chronic diseases,the most effective measure to prevent and control chronic diseases is to promote healthy lifestyles for the individual citizen.The theories of equal health opportunity,the right to health from the perspective of human rights,and determinants of a healthy society provide justified reasons for the intervention of public power in individual health choices.In the current legal system,the intervention of public power is limited to flexible measures such as health education,which shows respect for individual autonomy.However,it is inconsistent with the needs of current public health practice.We should expand diversified intervention means to encourage individuals to make healthy choices under the guidance of the management model.The“ladder of intervention”outlines a panoramic view of the intervention measures available.However,for the selection of specific measures,it is necessary to consider the public health objectives and the invasion of individual freedom,introduce the“legal reservation principle”and“proportionality principle”as policy analysis tools,and reasonably choose intervention measures at different levels on the ladder to properly handle the tension between public power and private rights.

Effectiveness of the Service Mapping Method in Re-designing the Bariatric Surgery Clinical Pathway of a Public Hospital

Background： Nowadays obesity is the world＇s common disease. Bariatric surgery is the only therapy that providessignificant cost savings within Public Health Service, but the lack of diagnostic paths universally accepted causes enormous waste ofresources and disruptions. Service Mapping is the ideal methodology to describe work＇s organization and to plan a new service model.Methods： The Service Mapping has been used to represent the actual state of the bariatric surgery service and starting from the criticalaspects found, we have developed a desirable state of the service. Results： Experience-based design has given centrality to thebeneficiary, making the bariatric service sensitive to patient＇s needs and expectations. The micro-organization of work has improvedprofessionals＇ integration, avoiding the creation of new operational entities or additional costs. The service has been simplified both forclinicians and hospital managers. The strategic repositioning of the dietician and general practitioner＇s recognition within the bariatricpath allowed us to achieve better clinical outcomes. Conclusions： Service Mapping has highlighted clinicians＇ difficulties in providingthe service, emphasizing the importance of the beneficiary. The iconic representation is a powerful explicit framework, fundamental formanagement purposes, to understand the role of every subject involved in the service, to rationalize work＇s organization, and integratehealthcare activities.

From institutional merger integration to institutional strategic transformation:A case study of the strategic management paradigm at Shanghai Library

This article attempts to apply the strategic management theory to the subsequent shaping up of a readjusted strategic development policy for Shanghai Library after its merger with the Institute of Scientific and Technological Information of Shanghai(ISTIS)in 1995.It also tries to analyze and explicate such an empirical implementation of institutional reintegration process through strategic management at Shanghai Metropolitan Library.By doing so,it aims to present an objective case study of activities based on the strategic management paradigm at a major Chinese metropolitan public library.

Impact of colorectal cancer screening participation in remote northern Canada:A retrospective cohort study

BACKGROUND Screening provides earlier colorectal cancer(CRC)detection and improves outcomes.It remains poorly understood if these benefits are realized with screening guidelines in remote northern populations of Canada where CRC rates are nearly twice the national average and access to colonoscopy is limited.AIM To evaluate the participation and impact of CRC screening guidelines in a remote northern population.METHODS This retrospective cohort study included residents of the Northwest Territories,a northern region of Canada,age 50-74 who underwent CRC screening by a fecal immunohistochemical test(FIT)between January 1,2014 to March 30,2019.To assess impact,individuals with a screen-detected CRC were compared to clinically-detected CRC cases for stage and location of CRC between 2014-2016.To assess participation,we conducted subgroup analyses of FIT positive individuals exploring the relationships between signs and symptoms of CRC at the time of screening,wait-times for colonoscopy,and screening outcomes.Two sample Welch t-test was used for normally distributed continuous variables,Mann-Whitney-Wilcoxon Tests for data without normal distribution,and Chi-square goodness of fit test for categorical variables.A P value of<0.05 was considered to be statistically significant.RESULTS 6817 fecal tests were completed,meaning an annual average screening rate of 25.04%,843(12.37%)were positive,629 individuals underwent a follow-up colonoscopy,of which,24.48%had advanced neoplasia(AN),5.41%had CRC.There were no significant differences in stage,pathology,or location between screen-detected cancers and clinically-detected cancers.In assessing participation and screening outcomes,we observed 49.51%of individuals referred for colonoscopy after FIT were ineligible for CRC screening,most often due to signs and symptoms of CRC.Individuals were more likely to have AN if they had signs and symptoms of cancer at the time of screening,waited over 180 d for colonoscopy,or were indigenous[respectively,estimated RR 1.1895%CI of RR(0.89-1.59)];RR 1.523(CI:1.035,2.240);RR 1.722(CI:1.165,2.547)].CONCLUSION Screening did not facilitate early cancer detection but facilitated higher than anticipated AN detection.Signs and symptoms of CRC at screening,and long colonoscopy wait-times appear contributory.

Antibiotics prescribed to febrile under-five children outpatients in urban public health services in Burkina Faso

Appropriate use of antibiotics remains critical for success in achieving MDG4. The aim of this study was to investigate antibiotics prescribing practices to febrile under-five children outpatients in urban public health services in a low income country. Methods: From March to April 2013, a cross-sectional epidemiological study of care facilities visit by under-five age, for febrile illness, was carried out in urban health services in Bobo-Dioulasso, Burkina Faso. Patient demographics, diagnoses and medications were recorded. We calculated for each diagnoses several indicators for antibiotics use. Results: Our study showed an over-prescription of antibiotics at the university teaching hospital (78.08%) and at the first level facilities (57.71%) for under-five outpatients for febrile illness. There was evidence of high antibiotic prescription in children with diarrhea (more than 9 on 10 at university teaching hospital of diarrhea cases and 60% at the first level facilities), in children with Upper respiratory tract infections (respectively 60% and 85.2% of cases at university teaching hospital and at the first level facilities) and in children with malaria (respectively 47.5% and 17.6% of cases at university teaching hospital and at the first level facilities). Overuse, misuse and inappropriately prescribed antibiotic coexisted in our results: at university teaching hospital 90.9% of diarrhea cases, 60% of URTI cases,?47.5% of malaria cases received antibiotic prescription;at first level heath care facilities 85.2% of URTI, 17.6% of malaria cases received an prescribed antibiotic and 11.8% of LRTI did not received a prescribed antibiotic. Developing countries have poor access to newer antibiotics and irrational antibiotics use remains a global problem. Overuse and misuse of antibiotics combat, rigorous infectious diseases diagnosis, antimicrobial resistance consequences education of users and health professional’s prescribers, and improved surveillance of antimicrobial resistance, must be strengthened.

The Prevention and Control Measures of COVID-19 in the People’s Hospital of Pingchang County

COVID-19 (COVID-19) or COVID-19 is pneumonia caused by the novel coronavirus infection in patients in 2019. COVID-19 pneumonia epidemic is widespread, wide, and deep. To effectively combat the further spread of COVID-19: the overall protocol of the hospital: “three lines of defense” of community prevention and control, fever clinic and face-to-face treatment;grasp the good three-time limits: “2 hours, 12 hours and 24 hours”;do a good job of three key points: key areas and places and groups;carry out four early prevention and control measures: early detection, early reporting, early isolation and early treatment;management of confirmed, suspected, fever, close contact “four types of personnel”;implement l responsibility system;doing all receivable, should be treated, should be checked, should be separated by “four should be”;do investigation, control, supervision, education, and care “five in place”. Through the above methods, the People’s Hospital of Pingchang County has effectively controlled COVID-19.

Assessing the academic achievement of United States orthopaedic departments

BACKGROUND Assessing academic productivity allows academic departments to identify the strengths of their scholarly contribution and provides an opportunity to evaluate areas for improvement.AIM To provide objective benchmarks for departments seeking to enhance academic productivity and identify those with significant improvement in recent past.METHODS Our study retrospectively analyzed a cohort of orthopaedic faculty at United States-based academic orthopaedic programs.5502 full-time orthopaedic faculty representing 178 programs were included in analysis.Variables included for analysis were National Institutes of Health funding(2014-2018),leadership positions in orthopaedic societies(2018),editorial board positions of top orthopaedic journals(2018),total number of publications and Hirsch-index.A weighted algorithm was used to calculate a cumulative score for each academic program.This study was performed at a large,United States medical school.RESULTS All 178 programs included in analysis were evaluated using the comprehensive weighted algorithm.The five institutions with the highest cumulative score,in decreasing order,were:Washington University in St.Louis,the Hospital for Special Surgery,Sidney Kimmel Medical College(SKMC)at Thomas Jefferson University,the University of California,San Francisco(UCSF)and Massachusetts General Hospital(MGH)/Brigham and Women’s/Harvard.The five institutions with the highest score per capita,in decreasing order,were:Mayo Clinic(Rochester),Washington University in St.Louis,Rush University,Virginia Commonwealth University(VCU)and MGH/Brigham and Women’s/Harvard.The five academic programs that had the largest improvement in cumulative score from 2013 to 2018,in decreasing order,were:VCU,SKMC at Thomas Jefferson University,UCSF,MGH/Brigham and Women’s/Harvard,and Brown University.CONCLUSION This algorithm can provide orthopaedic departments a means to assess academic productivity,monitor progress,and identify areas for improvement as they seek to expand their academic contributions to the orthopaedic community.

Health Status and Access to Health Services in Indian Slums

This paper analyzes the state of health and access to health services among the urban poor in India. Analysis is based on data from a primary survey conducted among 2000 households, covering 10,929 individuals from four cities of India. Summary statistics and regressions (using STATA) are used for data analysis. Results show lack of government facilities and services, a very high preference for private health facilities, high expenses especially in private but also in public facilities, and a perception that private facilities are offering high quality services as important concerns. An econometric analysis of the determinants of acute illness indicates the insufficiency of basic amenities like sanitation, garbage disposal and potable water. Together with the lack of availability of government health facilities in the vicinity, these results indicate continued vulnerability of the urban poor, and the need for urgent government action.

医防融合的关键问题、机制创新与实现路径

我国医疗服务与公共卫生服务相互割裂的问题由来已久,医防融合是新时代背景下实现健康中国战略的重要举措。当前,在医防融合试点实践中,存在医疗卫生服务体系多头管理、紧密型医联体尚未真正形成、医院“重医轻防”理念仍未转变、医防信息不能互联互通等问题。对此,可以借鉴宿迁的经验,从组织管理、医防服务供给、卫生筹资、医防人才与医防信息等方面入手,实现医防融合的机制创新,在此基础上,将医防融合作为常态化制度持续向纵深推进。

“公共文化服务共同体”:大文化视野下的现代治理新路径——兼论公共文化设施质效测算模型构建

“公共文化服务共同体”建设是公共文化服务治理体系和治理能力现代化进程中的新产物,是具有中国特色的公共文化现代治理新路径。文章探讨在大文化视野下,公共文化设施的新型样态及其评价标准,提出公共文化设施质效测算模型,从公共文化设施的有效服务供给能力、有效资源保障能力、有效吸引能力和公众满意度四个方面进行测算,以期以统一的、简单的、少人工的指标进行实时动态数据分析,全面展现大文化视野下公共文化服务供给现状和实际质效,从而以科学决策促进“公共文化服务共同体”可持续发展,推动公共文化服务高质量发展。

我国公立医院医生的价值医疗服务动机探究——概念建构与量表测度

健康中国建设行动彰显了以患者为中心的价值医疗理念,对医生医疗服务行为的价值诉求也日益提高。本研究试图将一般公共组织中公共服务动机概念引入公立医院之中,提出“价值医疗服务动机”概念,作为公立医院医生的一种公共服务动机表达。本文通过质性分析和量化测度,建构出“公立医院医生价值医疗服务动机”的概念,包含责任承诺、专业坚守、声誉维护、规范遵从四个概念维度,据此形成价值医疗服务动机量表。研究发现我国公立医院医生具有多维价值特征的医疗服务动机,呈现不同动机表达或行为倾向,在实现以患者为中心的价值医疗目标实践中,不断处理与平衡其中的公共价值冲突。该量表能够为测度医生价值医疗服务动机提供有效工具,为进一步发现医生价值医疗服务动机的影响因素,提升公立医院医疗服务能力、改善医疗行为、促进医患信任等提供理论与实践支持。

基于明尼苏达量表的安徽省乡镇公共卫生服务从业人员工作满意度研究

目的了解安徽省基层公共卫生服务从业人员的工作满意度及影响因素,并提出相应的建议。方法2021年1—4月采用分层随机整群抽样方法在皖北、皖中、皖南分别抽取乡镇卫生院公共卫生服务从业人员进行问卷调查。采用明尼苏达满意度短式量表调查从业人员工作满意度情况,采用多元线性回归进行工作满意度的影响因素分析。结果共调查了39个县723家乡镇卫生院的5430名公共卫生服务从业人员。其中,男性2112人(占38.90%),女性3318人(占61.10%);40~49岁人群居多(2240人,占41.25%);学历以大专及以上为主(3934人,占72.45%);所学专业最多的为临床医学(2503人,占46.10%);来自一般乡镇卫生院更多(3091人,56.92%)。工作总体满意度得分为(2.02±0.78)分,内部满意度得分为(1.94±0.71)分,外部满意度得分为(2.19±0.89)分。其中“我的报酬与我所做的工作量”得分最高,为(2.46±1.02)分;“能够做不违背自己良心的事情”得分最低,为(1.74±0.65)分。性别、职称、工作机构规模和单位培训重视程度是影响乡镇公共卫生服务从业人员工作满意度的主要因素(t=−4.61、2.28、2.70、−41.78,P均<0.05)。结论安徽省基层公共卫生服务人员工作总体满意度较高,外部满意度稍逊于内部满意度。建议通过加强人才培养、改善工作条件、提升薪酬待遇等途径提高基层公共卫生服务人员工作满意度。