Identification of Early Warning Signals of Infectious Diseases in Hospitals by Integrating Clinical Treatment and Disease Prevention

The global incidence of infectious diseases has increased in recent years,posing a significant threat to human health.Hospitals typically serve as frontline institutions for detecting infectious diseases.However,accurately identifying warning signals of infectious diseases in a timely manner,especially emerging infectious diseases,can be challenging.Consequently,there is a pressing need to integrate treatment and disease prevention data to conduct comprehensive analyses aimed at preventing and controlling infectious diseases within hospitals.This paper examines the role of medical data in the early identification of infectious diseases,explores early warning technologies for infectious disease recognition,and assesses monitoring and early warning mechanisms for infectious diseases.We propose that hospitals adopt novel multidimensional early warning technologies to mine and analyze medical data from various systems,in compliance with national strategies to integrate clinical treatment and disease prevention.Furthermore,hospitals should establish institution-specific,clinical-based early warning models for infectious diseases to actively monitor early signals and enhance preparedness for infectious disease prevention and control.

Feeding Management and Disease Prevention and Control of Pet Guinea Pigs

Guinea pig is widely used in clinical drug experiments as a laboratory animal.Because of its small and lovely size,guinea pig is often kept as a pet by many families.However,there are few reports on the feeding management and disease prevention and control of pet guinea pigs.This article introduced the experience and technology of feeding management and disease prevention of pet guinea pigs,in order to provide a reference for the feeding management and disease prevention of pet guinea pigs.

Discussion on Relationship between Meteorological Elements and Animal Husbandry Production or Animal Disease Prevention and Control

Based on knowledge of meteorology, pastoral meteorology and medical meteorology, the paper discusses relationship between various meteorological elements and animal husbandry production or animal disease prevention and control.

Teaching Form Reform of "Prevention and Control of Poultry and Poultry Diseases" Course in Higher Vocational Colleges

[ Objective] To meet the needs of ＂Prevention and Control of Poultry and Poultry Diseases＂ course in higher vocational colleges in new period. [Method] In order to introduce theoretical knowledge, enhance practical ability and train quality, teaching content, teaching methods and practical teaching of the course were explored according to trends of academic development and personnel training. [ Result] The reform of teaching form improved the teaching effect, mobilized the learning enthusiasm and initiative of students, and enhanced their ability to solve practical prob- lems. [ Conclusion] The teaching form of ＂Prevention and Control of Poultry and Poultry Diseases＂ course has been successfully reformed.

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.

上海区级疾病预防控制机构现代化建设思考与展望

本文根据国家关于推动疾病预防控制事业高质量发展指导意见的要求,结合上海市疾病预防控制体系现代化建设进展与经验,总结了近年来上海区级疾控机构的建设成效,并结合当前超大城市疾病预防控制各项任务需求与下阶段疾控事业发展目标要求,梳理作为直辖市和超大城市基层疾控机构建设发展所面临的紧迫问题。在监测预警、检验检测、应急处置、信息化建设、学科人才发展和区域协同联动等方面对加强区级疾控机构建设,推进区域疾控体系同质化、一体化发展提出若干思考和建议,为下阶段做好推动落实疾病预防控制高质量发展各项任务,以及各地相关政策规划的制定提供参考。

超大城市公共卫生社会治理体系之群防群控调查分析

目的了解居民对群防群控工作的参与、认知情况以及疫情防控中需要关注的重点方面,为应对疫情防控以及突发公共卫生事件提供参考。方法采用问卷调查法,收集居民参与群防群控工作情况。共收到有效问卷8574份,采用频数、构成比等进行描述性分析,采用卡方检验与Wilcoxon秩和检验进行统计分析。结果38.14%的调查对象认为来自社会的支持度和认可度不高,73.08%的调查对象认为应加强参与群防群控人员的应急管理能力,调查对象认为需要重点关注独居老年人(占92.22%)、慢性病患者(占76.37%)、儿童(占71.37%)和孕妇(占67.44%)。结论群众群防群控意识提高,为疫情防控平稳过渡到新阶段打下基础;加强群众与社会多方参与,提高防控自治能力;优化群防群控薄弱环节,关注重点人群需要。

应用德尔菲法探索消毒人员队伍建设和培养思路

目的探索构建符合上海市传染病防控需要的消毒人员队伍建设和培养的思路。方法通过德尔菲法结合需求调研、专家咨询,对职业化消毒人员队伍建设和培养思路进行调研。结果疾病预防控制机构、卫生监督、专业学会协会等20名专家参加了咨询,问卷回收率达100.00%。消毒人员重要性评分依次为事中职责、保障措施、事前准入和事后考核。三类消毒人员需求各不相同,消毒核心人员消毒知识技能以及承担工作的能力要求最高,分别为(4.73±0.46)分和(4.73±0.47)分。消毒服务人员任职资格最重要,为(4.90±0.45)分。消毒从业人员承担工作的能力要求最高,为(4.83±0.39)分。培训和知识技能在3类人员中都有着重要地位,且最重要的技能均为个人防护,其次为实际操作能力。结论本次调查专家积极程度和协调程度高,发现目前消毒人员专业队伍建设面临较大挑战。建议加强消毒员的职业认定和保障,同时针对性地分类培养,满足各类消毒人员的职业需求。

疾病预防控制机构深化党建带群建工作的理论基础与实践例证

习近平新时代中国特色社会主义思想实现了马克思主义中国化时代化新的飞跃。其中,党的群团工作百年经验开创了中国特色社会主义群团发展道路,推动了马克思主义群团观的中国化时代化进程。研究基于马克思主义的理论与实践辩证统一关系,以党的群团工作百年经验为理论基础,指引形成疾病预防控制机构深化党建带群建工作的实践思路与内容:聚焦“制度建设”,加强党的群团工作制度化、规范化;聚焦“人才队伍与组织架构建设”,夯实党的群团工作组织基础;聚焦“能力提升”,提升党的群团工作服务能力和水平。最终,在党建带群建工作的计划性与连续性、群团组织内部工作的整体性与联动性、党建带群建工作的服务意识和实践能力等方面取得显著的实践成效。

江苏省卫生应急人员对传染病防控资源支持情况的评价

目的 了解江苏省卫生应急人员对传染病防控资源支持的评价,为进一步合理科学地改进资源统筹与调配、提升传染病防控能力提供参考。方法 采用多阶段分层随机抽样方法,选取江苏省卫生健康委应急部(处)/疾控局(处)、疾病预防控制中心、传染病专科医院等部门/机构的专业卫生应急人员作为研究对象,就传染病防控资源的支持情况(人力资源支持、物质资源支持、组织制度支持、组织文化氛围支持和决策资源支持)进行现场调查。结果 评价最高的是“组织文化氛围支持”(3.810±0.725)分,评价最低的是“决策资源支持”(2.827±1.047)分;不同机构的卫生应急人员对物质资源支持和组织文化氛围支持的评价差异分别有统计学意义(P <0.05)。结论江苏省传染病防控资源存在决策资源支持不足、应急队伍专业人员配备不足、物质资源投入重医轻防等问题,需要继续积极稳妥地推进地方疾病预防控制机构改革,落实“将健康融入所有政策”,优化资源投入结构,改善公共卫生人员福利待遇,提升风险防范水平,规范社会参与力量。

The strategic framework of tuberculosis control and prevention in the elderly:a scoping review towards End TB targets

With the rapid pace of population ageing,tuberculosis(TB)in the elderly increasingly becomes a public health challenge.Despite the increasing burden and high risks for TB in the elderly,targeted strategy has not been well understood and evaluated.We undertook a scoping review to identify current TB strategies,research and policy gaps in the elderly and summarized the results within a strategic framework towards End TB targets.Databases of Embase,MEDLINE,Global health and EBM reviews were searched for original studies,review articles,and policy papers published in English between January 1990 and December 2015.Articles examining TB strategy,program,guideline or intervention in the elderly from public health perspective were included.Nineteen articles met the inclusion criteria.Most of them were qualitative studies,issued in high-and middle-income countries and after 2000.To break the chain of TB transmission and reactivation in the elderly,infection control,interventions of avoiding delay in diagnosis and containment are essential for preventing transmission,especially in elderly institutions and aged immigrants;screening of latent TB infection and preventive therapy had effective impacts on reducing the risk of reactivation and should be used less reluctantly in older people;optimizing early case-finding with a high index of suspicion,systematic screening for prioritized high-risk groups,initial empirical and adequate follow-up treatment with close monitoring and evaluation,as well as enhanced programmatic management are fundamental pillars for active TB elimination.Evaluation of TB epidemiology,risk factors,impacts and cost-effectiveness of interventions,adopting accurate and rapid diagnostic tools,shorter and less toxic preventive therapy,are critical issues for developing strategy in the elderly towards End TB targets.TB control strategies in the elderly were comprehensively mapped in a causal link pathway.The framework and principals identified in this study will help to evaluate and improve current program,develop targeted strategy,as well as raise more discussions on the research priority settings and policy transitions.Given the scarceness of policy and evaluated interventions,as well as the unawareness of shifting TB epidemiology and strategy especially in developing countries,the increasing need of a ready TB program for the elderly warrants further research.

Novel SARS-CoV-2 outbreak and COVID19 disease;a systemic review on the global pandemic

Since the beginning of the 21st century,several viral outbreaks have threatened humankind and posed a new challenge to the modern healthcare system.The recent outbreak in Wuhan(December 2019),China,represents a beta coronavirus classified as novel Severe Acute Respiratory Syndrome Corona Virus-2(SARS-CoV-2)which belongs to the Coronaviridae family.Novel SARS-CoV-2 represents a significant similarity with previous coronaviruses such as SARS-CoV in 2002,China and MERS-CoV in 2015,Middle East.However,preliminary research investigations have shown the novel SARS-CoV-2 evolved with several mutations and developed the capacity to cross the species,i.e.,animal to human.The initial findings have shown that spike proteins are vital molecules target hACE2 receptor for its attachment and entry into cells.After successful entry virus primarily focuses on respiratory airway cell lines and triggers a massive immune response leading to mucus generation.In severe conditions,the virus is capable of forcing viral pneumonia leading to the collapse of the respiratory system,i.e.,COVID19.So far,there is a lack of immunity against the virus in humans.At the same in the absence of therapeutic interventions,many countries experienced high mortality,such as the United States,European countries,i.e.,Italy,Spain,France,and the United Kingdom.The vaccine development is underway and experiencing challenges,as many reports demonstrated genetic variations in viral genome and proteins as well.The present study provides a complete comprehensive overview of the novel SARS-CoV-2 outbreak,human transmission,and global spread.

我国传染病防控人员有效激励水平

目的分析2002—2017年全国31省(自治区、直辖市)传染病防控人力资源的有效激励水平及变化趋势,针对人员激励现状探讨有效激励因素的地区分布情况。方法系统收集中国知网(CNKI)和Web of Science数据库中1997—2017年发表的全国31个省(自治区、直辖市)关于传染病防控人员激励问题的研究文献,运用内容分析法进行评阅,判断人员激励问题的严重程度。将文献中提到的人员激励问题的影响因素分成4类并计数,运用卡方检验分析各地区人员有效激励因素的分布情况。结果当前我国传染病防控队伍的有效激励水平不高,仅为31.84%;而且地区差异大,2017年结果显示,地区之间变异系数为32.44%。2002—2017年,各地传染病防控队伍有效激励的改进幅度有限,增长幅度仅为11.13%。全国范围内,经济类因素成为影响传染病防控人员工作积极性的主要原因,在各类因素中占46.25%。在地区层面,中部地区人员激励水平(28.03%)一直落后于东部地区(35.90%)和西部地区(30.67%)。在有效激励因素上,东部地区对教育类因素的关注度(东部地区为17.53%,中部地区为6.82%,西部地区为6.25%)和西部地区对个人与专业支持类因素的关注度(东部地区为15.46%,中部地区为18.18%,西部地区为35.71%)明显高于其他地区。结论我国传染病防控人员激励机制有待完善,特别是中部地区尤为迫切。经济类因素如薪酬待遇已然成为全国范围内影响人员队伍稳定性的主要因素。此外,西部地区应在改善卫生人员生活与工作条件方面继续加强,而东部地区仍可在人才培养、继续教育方面进一步完善激励机制。

我国慢性病防治人员素质分析

目的分析我国31个省(自治区、直辖市)慢性病防治人员素质及变化趋势,探讨我国慢性病防治人员素质的区域差异、变化原因及提升建议。方法收集1995—2017年所有涉及我国各省(自治区、直辖市)慢性病防治人力资源的文献,摘录慢性病防治人员素质的相关表述,综合计算慢性病防治人员素质适宜程度,描述2000—2017年我国各省(自治区、直辖市)慢性病防治人员素质的现状及变化趋势。结果从全国来看,2017年我国慢性病防治人员素质适宜程度的平均水平为40.3%,与适宜标准(85.0%)相差52.6%。从各省(自治区、直辖市)来看,东部地区慢性病防治人员的素质较高(适宜程度为42.3%),中西部地区慢性病防治人员素质的适宜程度在36.0%左右。2000—2017年我国各省(自治区、直辖市)慢性病防治人员素质大幅提升,适宜程度的平均水平提升了417.6%。结论我国慢性病防治人员素质存在区域差异。2000年以来防治人员素质稳步提升,但距适宜标准仍有较大差距。建设高素质慢性病防治人才队伍任重道远。

鲁豫两地慢性病防控机构组织架构健全程度

目的了解鲁豫两地慢性病防控组织架构健全程度,比较其差异并分析其变化趋势。方法对鲁豫两地慢性病防控政策与文献中的相关文段进行文本分析,量化测算慢性病防控机构组织架构健全程度,基于Spearman相关分析与线性回归分析探究健全程度与相关指标的关系。结果2010—2017年鲁豫两地慢性病防控机构组织架构总体健全程度分别由1.6%、11.5%上升到41.4%、52.4%。鲁豫两地慢性病防控机构组织架构健全程度与卫生总费用占国内生产总值(gross domestic product,GDP)比例、每千人口卫生人员数正相关。山东省卫生总费用占GDP的比例对总体健全程度变化的解释程度达92.3%,高于河南省的72.7%。山东省总体健全程度对每千人口卫生人员数变化的解释程度达91.8%,高于河南省的74.5%。河南省慢性病防控机构组织架构健全程度与高血压患病率负相关,总体健全程度对高血压患病率变化的解释程度为78.8%。结论鲁豫两地慢性病防控体系逐步完善,但存在职能交叉、力量分散等问题。建议构建“三位一体”的慢性病防控机制,促进慢性病防、治、管的整体融合,从政府层面构建稳定的经费渠道。

贵州省疾病预防控制机构资源配置现状及公平性

目的了解贵州全省疾病预防控制机构(以下简称“疾控机构”)资源配置现状,分析基层疾控机构资源配置公平性,为推进贵州等中西部欠发达地区疾病预防控制能力建设提供基线数据和决策建议。方法通过对贵州省的省、市、县三级疾控机构2020年人力资源、财政保障、基础设施、实验室装备和检测能力4个维度调查,了解资源配置现状,采用集中指数和资源聚集度分析2020年基层疾控机构资源配置公平性。结果2020年末,贵州全省三级疾控机构在编人员5162人,专业技术人员占比及卫生专业技术人员占比分别为84.71%和79.70%,学历以大学本科为主(占55.13%)。全省疾控机构总收入为167486.89万元,其中,财政补助占比为91.11%;总支出为154917.69万元。省级疾控机构建筑面积达到标准要求,市级疾控机构7家(占77.78%)达标,县级疾控机构59家(占67.05%)达标。省级疾控机构可开展的实验项目数为1325项,市级疾控机构中位数为360项,县级疾控机构中位数为73项,基础设施建设和实验室能力是市、县两级机构的主要短板。县级疾控机构资源配置相对基本公平,实验室装备(50万元以上检测设备台套数)资源配置存在不公平。各市、州间县级疾控资源配置公平性存在差异。结论建议继续加大全省疾控机构能力建设,尤其是提升基层疾控机构服务能力。结合服务人口数、区域面积、辖区经济水平三大因素,制定省、市、县分级配置标准,继续加大对疾控人员招录,补足人员缺口。经济欠发达地区在加大对疾控工作的重视和政策宏观调控的同时,还应提供相对充足的财政保障,加大基础设施建设力度,强化实验室能力提升,尤其是加大大型实验室设备的投入。

国内外慢性病防控从业者循证能力提升方案

目的了解国内外干预项目的内容及成果经验,为以后在我国慢性病防控从业群体中推广循证慢性病防控提供参考。方法检索知网、万方、维普、PubMed、Web of Science和Scopus数据库中1995年1月1日—2019年11月31日发表的与慢性病防控循证能力干预相关的文献,最终纳入45篇文献进行分析。结果国内极为缺乏针对提升公共卫生从业者慢性病防控循证能力的干预项目。发达国家较早实践提升医务人员慢性病能力的干预措施,包括各类面对面课程、研讨会、网络课程、书籍等,但干预课程设置普遍遇到的问题包括慢性病防控机构缺乏数据库权限,未对不同循证认知层次和工作环境的从业者进行有针对性的分类。结论我国应积极借鉴慢性病防控的国外经验,开发各类干预途径并加以推广和应用。

Study on the Effects of Infant Fostering Interventions in Xuhui District,Shanghai

Objective To assess the effects of fostering interventions on the infants and their families through the community. Methods A total of 309 infants born on 1st August, 2003 to 30th August, 2004 and their families were recruited as participants by cluster sampling in Longhua and Kantian sub-districts of Xuhui district, Shanghai. The newborns were randomly assigned to intervention group （156 cases） and control group （153 cases）. The infants and their families will be followed up during 3-year interventions. Results After 6 months＇ intervention, the proportion of infants who could turn over the body in the intervention group （88.46%） was higher than that in control group （75.16%）. The morbidity of upper-respiratory tract infection in intervention group （20.51%） was significantly lower than that in control group （32.68%）. The incidence rates of pneumonia, diarrhea and anemia in intervention group were all lower than that in control group, except for pneumonia, the differences were not significant. Both of the knowledge about how to foster infants and service utility in intervention group were higher than that in control group. Conclusion The fostering interventions through the community promote the prevention and control of infants disease, increase the knowledge level and service util ity of families.