Objective: According to RFM model theory of customer relationship management, data mining technology was used to group the chronic infectious disease patients to explore the effect of customer segmentation on the mana...Objective: According to RFM model theory of customer relationship management, data mining technology was used to group the chronic infectious disease patients to explore the effect of customer segmentation on the management of patients with different characteristics. Methods: 170,246 outpatient data was extracted from the hospital management information system (HIS) during January 2016 to July 2016, 43,448 data was formed after the data cleaning. K-Means clustering algorithm was used to classify patients with chronic infectious diseases, and then C5.0 decision tree algorithm was used to predict the situation of patients with chronic infectious diseases. Results: Male patients accounted for 58.7%, patients living in Shanghai accounted for 85.6%. The average age of patients is 45.88 years old, the high incidence age is 25 to 65 years old. Patients was gathered into three categories: 1) Clusters 1—Important patients (4786 people, 11.72%, R = 2.89, F = 11.72, M = 84,302.95);2) Clustering 2—Major patients (23,103, 53.2%, R = 5.22, F = 3.45, M = 9146.39);3) Cluster 3—Potential patients (15,559 people, 35.8%, R = 19.77, F = 1.55, M = 1739.09). C5.0 decision tree algorithm was used to predict the treatment situation of patients with chronic infectious diseases, the final treatment time (weeks) is an important predictor, the accuracy rate is 99.94% verified by the confusion model. Conclusion: Medical institutions should strengthen the adherence education for patients with chronic infectious diseases, establish the chronic infectious diseases and customer relationship management database, take the initiative to help them improve treatment adherence. Chinese governments at all levels should speed up the construction of hospital information, establish the chronic infectious disease database, strengthen the blocking of mother-to-child transmission, to effectively curb chronic infectious diseases, reduce disease burden and mortality.展开更多
Introduction: In Burkina Faso, as in most developing countries, limited access to biological tests forces practitioners to resort very often to probabilistic antibiotic therapy. The objective of this study is to deter...Introduction: In Burkina Faso, as in most developing countries, limited access to biological tests forces practitioners to resort very often to probabilistic antibiotic therapy. The objective of this study is to determine the extent of this prescription. Patients and Methods: This was a cross-sectional study with retrospective data collection of patients hospitalized in the infectious diseases department in the period from January 1, 2005 to December 31, 2020. The records of patients who received probabilistic antibiotic therapy were included. Results: During the study period, 330 patients had received probabilistic antibiotic therapy. The majority of patients were male (53%), with a sex ratio of 1.12. The mean age of the patients was 33 years ± 14. The age range of 20 to 40 years was the most represented (42%). Fifteen percent (15%) of patients were living with HIV. The majority of patients were from urban areas (56.4%). Forty-nine percent (49%) of the patients worked in the informal sector. Clinically, the reasons for consultation were dominated by fever, alteration of general condition, neurological disorders, digestive disorders, respiratory signs, urinary signs and diffuse pain. The physical examination showed that 48.1% of the patients had meningeal irritation syndrome, 10% had convulsions and 10% had focal signs, trismus was present in 4% of the patients and facial paralysis in 3%. In the digestive system, hepatomegaly was present in 29% of patients and digestive candidiasis in 31%. Respiratory examination showed crepitus and fluid effusion syndrome in 26.83% and 20.62% of patients respectively. The presumptive diagnosis was dominated by bacterial meningitis, salmonellosis and bronchopneumonia with banal germs. In terms of treatment, the beta-lactam family of drugs was the most prescribed. They were followed by aminoglycosides and fluoroquinolones. The evolution was marked by the death of 50 patients (15%). Conclusion: The most prescribed molecules belong to the family of Beta-lactam. And this prescription improved the outcome of patients. Bacterial susceptibility studies will allow better orientation of probabilistic antibiotic therapy in order to limit the emergence of multi-resistant bacteria.展开更多
By providing a means of separating the airborne emissions of patients from the air breathed by healthcare workers(HCWs),vented individual patient(VIP)hoods,a form of local exhaust ventilation(LEV),offer a new approach...By providing a means of separating the airborne emissions of patients from the air breathed by healthcare workers(HCWs),vented individual patient(VIP)hoods,a form of local exhaust ventilation(LEV),offer a new approach to reduce hospital-acquired infection(HAI).Results from recent studies have demonstrated that,for typical patient-emitted aerosols,VIP hoods provide protection at least equivalent to that of an N95 mask.Unlike a mask,hood performance can be easily monitored and HCWs can be alerted to failure by alarms.The appropriate use of these relatively simple devices could both reduce the reliance on personal protective equipment(PPE)for infection control and provide a low-cost and energy-efficient form of protection for hospitals and clinics.Although the development and deployment of VIP hoods has been accelerated by the coronavirus disease 2019(COVID-19)pandemic,these devices are currently an immature technology.In this review,we describe the state of the art of VIP hoods and identify aspects in need of further development,both in terms of device design and the protocols associated with their use.The broader concept of individual patient hoods has the potential to be expanded beyond ventilation to the provision of clean conditions for individual patients and personalized control over other environmental factors such as temperature and humidity.展开更多
Objective To enhance the quality of medical service for Chinese patients through research of service quality from Chinese medical personnel. Methods Serv Qual scale was used for infection medical staffs randomly by sa...Objective To enhance the quality of medical service for Chinese patients through research of service quality from Chinese medical personnel. Methods Serv Qual scale was used for infection medical staffs randomly by sampling questionnaire in Beijing, Shanghai, Chengdu, Chongqing, Guangzhou and Nanning. The data collected were entered and analyzed using SPSS 20.0. Statistical methods included frequency, factor analysis, reliability analysis, correlation analysis, independent samples t test, one-way analyses of variance, simultaneous regression analysis and structural equation model analysis. Results The Kaiser-Meyer-Olkin value for the factor analysis of the scale was 0.970. The Cronbach's α for the reliability analysis was 0.975. The Pearson correlation coefficients were 0.624-0.874 and statistically significant. Undergraduates felt good, Ph D students felt bad; the doctors felt bad; managers felt good. Standard 5 dimensions of the regression coefficients were positive, including empathy(β = 0.288), reliability(β = 0.241) impacting on perceived service quality mostly. The control ability and stability of the standard error of perceived service quality directly effected value were 0.646 and 0.382, respectively. Conclusions Medical staffs of infectious disease department have poor perception of service quality. Hospitals should improve awareness and of clinicians and deepen the reform of the medical care system.展开更多
The coronavirus disease 2019(COVID-19)pandemic increased the burden on many healthcare systems and in the process,exposed the need for medical resources and physical space.While few studies discussed the efficient uti...The coronavirus disease 2019(COVID-19)pandemic increased the burden on many healthcare systems and in the process,exposed the need for medical resources and physical space.While few studies discussed the efficient utilization of medical resources and physical space so far.Therefore,this study aimed to summarize experiences related to facilities used for centralized isolation for medical observation and treatment during the COVID-19 pandemic in China and to provide suggestions to further improve the management of confirmed cases,suspected cases,and close contacts.In China,three types of facilities for centralized isolation(Fangcang shelter hospitals,refitted non-designated hospitals,and quarantine hotels)underwent retrofitting for the treatment and isolation of confirmed and suspected cases.These facilities mitigated the immediate high demand for space.Moreover,in order to minimize infection risks in these facilities,regulators and governmental agencies implemented new designs,management measures,and precautionary measures to minimize infection risk.Other countries and regions could refer to China’s experience in optimally allocating social resources in response to the COVID-19 pandemic.As a conclusion,government should allocate social resources and construct centralized isolation and quarantine facilities for an emergency response,health authorities should issue regulations for centralized isolation facilities and pay strict attention to the daily management of these facilities,a multidisciplinary administration team is required to support the daily operation of a centralized isolation facility,in-depth studies and international collaboration on the centralized isolation policy are encouraged.展开更多
BACKGROUND Understanding a virus shedding patterns in body fluids/secretions is importantto determine the samples to be used for diagnosis and to formulate infectioncontrol measures.AIM To investigate the severe acute...BACKGROUND Understanding a virus shedding patterns in body fluids/secretions is importantto determine the samples to be used for diagnosis and to formulate infectioncontrol measures.AIM To investigate the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)shedding patterns and its risk factors.METHODS All laboratory-confirmed coronavirus disease 2019 patients with completemedical records admitted to the Shenzhen Third People’s Hospital from January28, 2020 to March 8, 2020 were included. Among 145 patients (54.5% males;median age, 46.1 years), three (2.1%) died. The bronco-alveolar lavage fluid(BALF) had the highest virus load compared with the other samples. The viralload peaked at admission (3.3 × 108 copies) and sharply decreased 10 d afteradmission.RESULTS The viral load was associated with prolonged intensive care unit (ICU) duration.Patients in the ICU had significantly longer shedding time compared to those inthe wards (P < 0.0001). Age > 60 years [hazard ratio (HR) = 0.6;95% confidenceinterval (CI): 0.4-0.9] was an independent risk factor for SARS-CoV-2 shedding,while chloroquine (HR = 22.8;95%CI: 2.3-224.6) was a protective factor.CONCLUSION BALF had the highest SARS-CoV-2 load. Elderly patients had higher virus loads,which was associated with a prolonged ICU stay. Chloroquine was associatedwith shorter shedding duration and increased the chance of viral negativity.展开更多
The frequent and sudden occurrence of both known and unknown infectious diseases can cause global social panic.If the source of infection can be effectively controlled in the early stages of an outbreak,the spread of ...The frequent and sudden occurrence of both known and unknown infectious diseases can cause global social panic.If the source of infection can be effectively controlled in the early stages of an outbreak,the spread of infectious diseases can be prevented.In view of this situation,this study developed for infectious or suspected infectious patients a negative pressure isolation hood which effectively achieves direct individual isolation during the early stages of disease outbreak,and facilitates long-distance transport.The hood body is made of flexible transparent polyvinyl chloride(PVC)material,and the combination of the hood material is airtight.The unique inflatable column support structure and the design of the inflatable neck sleeve effectively ensure both stiffness and air tightness of the hood body.The electrical exhaust system maintains a stable negative pressure environment inside the hood,and polluted air inside the hood can be purified by a high efficiency filter.Test results showed that the internal noise of the hood was 68±1 dB(A),the air exhaust volume of the electric exhaust system was not<200 L/min,and the filtration efficiency of the filter to 0.3μm particles was>99.99%,indicating that the hood achieved effective isolation protection for patients with respiration infectious diseases.展开更多
文摘Objective: According to RFM model theory of customer relationship management, data mining technology was used to group the chronic infectious disease patients to explore the effect of customer segmentation on the management of patients with different characteristics. Methods: 170,246 outpatient data was extracted from the hospital management information system (HIS) during January 2016 to July 2016, 43,448 data was formed after the data cleaning. K-Means clustering algorithm was used to classify patients with chronic infectious diseases, and then C5.0 decision tree algorithm was used to predict the situation of patients with chronic infectious diseases. Results: Male patients accounted for 58.7%, patients living in Shanghai accounted for 85.6%. The average age of patients is 45.88 years old, the high incidence age is 25 to 65 years old. Patients was gathered into three categories: 1) Clusters 1—Important patients (4786 people, 11.72%, R = 2.89, F = 11.72, M = 84,302.95);2) Clustering 2—Major patients (23,103, 53.2%, R = 5.22, F = 3.45, M = 9146.39);3) Cluster 3—Potential patients (15,559 people, 35.8%, R = 19.77, F = 1.55, M = 1739.09). C5.0 decision tree algorithm was used to predict the treatment situation of patients with chronic infectious diseases, the final treatment time (weeks) is an important predictor, the accuracy rate is 99.94% verified by the confusion model. Conclusion: Medical institutions should strengthen the adherence education for patients with chronic infectious diseases, establish the chronic infectious diseases and customer relationship management database, take the initiative to help them improve treatment adherence. Chinese governments at all levels should speed up the construction of hospital information, establish the chronic infectious disease database, strengthen the blocking of mother-to-child transmission, to effectively curb chronic infectious diseases, reduce disease burden and mortality.
文摘Introduction: In Burkina Faso, as in most developing countries, limited access to biological tests forces practitioners to resort very often to probabilistic antibiotic therapy. The objective of this study is to determine the extent of this prescription. Patients and Methods: This was a cross-sectional study with retrospective data collection of patients hospitalized in the infectious diseases department in the period from January 1, 2005 to December 31, 2020. The records of patients who received probabilistic antibiotic therapy were included. Results: During the study period, 330 patients had received probabilistic antibiotic therapy. The majority of patients were male (53%), with a sex ratio of 1.12. The mean age of the patients was 33 years ± 14. The age range of 20 to 40 years was the most represented (42%). Fifteen percent (15%) of patients were living with HIV. The majority of patients were from urban areas (56.4%). Forty-nine percent (49%) of the patients worked in the informal sector. Clinically, the reasons for consultation were dominated by fever, alteration of general condition, neurological disorders, digestive disorders, respiratory signs, urinary signs and diffuse pain. The physical examination showed that 48.1% of the patients had meningeal irritation syndrome, 10% had convulsions and 10% had focal signs, trismus was present in 4% of the patients and facial paralysis in 3%. In the digestive system, hepatomegaly was present in 29% of patients and digestive candidiasis in 31%. Respiratory examination showed crepitus and fluid effusion syndrome in 26.83% and 20.62% of patients respectively. The presumptive diagnosis was dominated by bacterial meningitis, salmonellosis and bronchopneumonia with banal germs. In terms of treatment, the beta-lactam family of drugs was the most prescribed. They were followed by aminoglycosides and fluoroquinolones. The evolution was marked by the death of 50 patients (15%). Conclusion: The most prescribed molecules belong to the family of Beta-lactam. And this prescription improved the outcome of patients. Bacterial susceptibility studies will allow better orientation of probabilistic antibiotic therapy in order to limit the emergence of multi-resistant bacteria.
文摘By providing a means of separating the airborne emissions of patients from the air breathed by healthcare workers(HCWs),vented individual patient(VIP)hoods,a form of local exhaust ventilation(LEV),offer a new approach to reduce hospital-acquired infection(HAI).Results from recent studies have demonstrated that,for typical patient-emitted aerosols,VIP hoods provide protection at least equivalent to that of an N95 mask.Unlike a mask,hood performance can be easily monitored and HCWs can be alerted to failure by alarms.The appropriate use of these relatively simple devices could both reduce the reliance on personal protective equipment(PPE)for infection control and provide a low-cost and energy-efficient form of protection for hospitals and clinics.Although the development and deployment of VIP hoods has been accelerated by the coronavirus disease 2019(COVID-19)pandemic,these devices are currently an immature technology.In this review,we describe the state of the art of VIP hoods and identify aspects in need of further development,both in terms of device design and the protocols associated with their use.The broader concept of individual patient hoods has the potential to be expanded beyond ventilation to the provision of clean conditions for individual patients and personalized control over other environmental factors such as temperature and humidity.
基金supported by the year 2014 Key Research Project of the Party of the Education and Health of Shanghai(NO:201420)Scientific Research in Hospital Construction Project of Chinese Medical Doctor Assoclation
文摘Objective To enhance the quality of medical service for Chinese patients through research of service quality from Chinese medical personnel. Methods Serv Qual scale was used for infection medical staffs randomly by sampling questionnaire in Beijing, Shanghai, Chengdu, Chongqing, Guangzhou and Nanning. The data collected were entered and analyzed using SPSS 20.0. Statistical methods included frequency, factor analysis, reliability analysis, correlation analysis, independent samples t test, one-way analyses of variance, simultaneous regression analysis and structural equation model analysis. Results The Kaiser-Meyer-Olkin value for the factor analysis of the scale was 0.970. The Cronbach's α for the reliability analysis was 0.975. The Pearson correlation coefficients were 0.624-0.874 and statistically significant. Undergraduates felt good, Ph D students felt bad; the doctors felt bad; managers felt good. Standard 5 dimensions of the regression coefficients were positive, including empathy(β = 0.288), reliability(β = 0.241) impacting on perceived service quality mostly. The control ability and stability of the standard error of perceived service quality directly effected value were 0.646 and 0.382, respectively. Conclusions Medical staffs of infectious disease department have poor perception of service quality. Hospitals should improve awareness and of clinicians and deepen the reform of the medical care system.
文摘The coronavirus disease 2019(COVID-19)pandemic increased the burden on many healthcare systems and in the process,exposed the need for medical resources and physical space.While few studies discussed the efficient utilization of medical resources and physical space so far.Therefore,this study aimed to summarize experiences related to facilities used for centralized isolation for medical observation and treatment during the COVID-19 pandemic in China and to provide suggestions to further improve the management of confirmed cases,suspected cases,and close contacts.In China,three types of facilities for centralized isolation(Fangcang shelter hospitals,refitted non-designated hospitals,and quarantine hotels)underwent retrofitting for the treatment and isolation of confirmed and suspected cases.These facilities mitigated the immediate high demand for space.Moreover,in order to minimize infection risks in these facilities,regulators and governmental agencies implemented new designs,management measures,and precautionary measures to minimize infection risk.Other countries and regions could refer to China’s experience in optimally allocating social resources in response to the COVID-19 pandemic.As a conclusion,government should allocate social resources and construct centralized isolation and quarantine facilities for an emergency response,health authorities should issue regulations for centralized isolation facilities and pay strict attention to the daily management of these facilities,a multidisciplinary administration team is required to support the daily operation of a centralized isolation facility,in-depth studies and international collaboration on the centralized isolation policy are encouraged.
基金Supported by Startup Fund forYouth Faculty of ShenzhenUniversity, No. 2018009.
文摘BACKGROUND Understanding a virus shedding patterns in body fluids/secretions is importantto determine the samples to be used for diagnosis and to formulate infectioncontrol measures.AIM To investigate the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)shedding patterns and its risk factors.METHODS All laboratory-confirmed coronavirus disease 2019 patients with completemedical records admitted to the Shenzhen Third People’s Hospital from January28, 2020 to March 8, 2020 were included. Among 145 patients (54.5% males;median age, 46.1 years), three (2.1%) died. The bronco-alveolar lavage fluid(BALF) had the highest virus load compared with the other samples. The viralload peaked at admission (3.3 × 108 copies) and sharply decreased 10 d afteradmission.RESULTS The viral load was associated with prolonged intensive care unit (ICU) duration.Patients in the ICU had significantly longer shedding time compared to those inthe wards (P < 0.0001). Age > 60 years [hazard ratio (HR) = 0.6;95% confidenceinterval (CI): 0.4-0.9] was an independent risk factor for SARS-CoV-2 shedding,while chloroquine (HR = 22.8;95%CI: 2.3-224.6) was a protective factor.CONCLUSION BALF had the highest SARS-CoV-2 load. Elderly patients had higher virus loads,which was associated with a prolonged ICU stay. Chloroquine was associatedwith shorter shedding duration and increased the chance of viral negativity.
基金Thanks for the funding projects of Ministry of Science and Technology of the People's Republic of China:Major infectious diseases such as AIDS and viral hepatitis prevention and control of major projects of China(2017ZX10304403-004-001).
文摘The frequent and sudden occurrence of both known and unknown infectious diseases can cause global social panic.If the source of infection can be effectively controlled in the early stages of an outbreak,the spread of infectious diseases can be prevented.In view of this situation,this study developed for infectious or suspected infectious patients a negative pressure isolation hood which effectively achieves direct individual isolation during the early stages of disease outbreak,and facilitates long-distance transport.The hood body is made of flexible transparent polyvinyl chloride(PVC)material,and the combination of the hood material is airtight.The unique inflatable column support structure and the design of the inflatable neck sleeve effectively ensure both stiffness and air tightness of the hood body.The electrical exhaust system maintains a stable negative pressure environment inside the hood,and polluted air inside the hood can be purified by a high efficiency filter.Test results showed that the internal noise of the hood was 68±1 dB(A),the air exhaust volume of the electric exhaust system was not<200 L/min,and the filtration efficiency of the filter to 0.3μm particles was>99.99%,indicating that the hood achieved effective isolation protection for patients with respiration infectious diseases.
