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.

Analysis of CDC’s Role in Public Health Emergencies

Objective:To explore the role of the Centers for Disease Control and Prevention(CDC)in public health emergencies.Methods:The details of 12 public health events that occurred between January 2021 to December 2022 were analyzed to explore the roles of the CDC.Results:There were 160 patients involved in 10 public health events in 2021 and 48 patients involved in 2 public health events in 2022.Besides,the proportion of school public health events in 2022 was 0%,which was lower than in 2021,which was 80%(P<0.05).99.38%of patients during public health events were sent to the hospital promptly in 2022,which was higher than that in 2021,which was 81.25%(P<0.05).Furthermore,the average time taken for the CDC to control public health events in 2022 was 20.11±1.62 hours,and the average time taken to send inspection reports was shorter than that in 2021.The public satisfaction score was also higher in 2022 compared to 2021(P<0.05).Conclusion:The role of the CDC is to control infectious diseases.Therefore,it is important to pinpoint the existing problems in the strategies implemented by the CDC so that more improvements can be made to better prevent infectious diseases.

Enlightenment from the COVID-19 Pandemic:The Roles of Environmental Factors in Future Public Health Emergency Response

The coronavirus disease 2019(COVID-19)pandemic is challenging the current public health emergency response systems(PHERSs)of many countries.Although environmental factors,such as those influencing the survival of viruses and their transmission between species including humans,play important roles in PHERSs,little attention has been given to these factors.This study describes and elucidates the roles of environmental factors in future PHERSs.To improve countries’capability to respond to public health emergencies associated with viral infections such as the COVID-19 pandemic,a number of environmental factors should be considered before,during,and after the responses to such emergencies.More specifically,to prevent pandemic outbreaks,we should strengthen environmental and wildlife protection,conduct detailed viral surveillance in animals and hotspots,and improve early-warning systems.During the pandemic,we must study the impacts of environmental factors on viral behaviors,develop control measures to minimize secondary environmental risks,and conduct timely assessments of viral risks and secondary environmental effects with a view to reducing the impacts of the pandemic on human health and on ecosystems.After the pandemic,we should further strengthen surveillance for viruses and the prevention of viral spread,maintain control measures for minimizing secondary environmental risks,develop our capability to scientifically predict pandemics and resurgences,and prepare for the next unexpected resurgence.Meanwhile,we should restore the normal life and production of the public based on the“One Health”concept,that views global human and environmental health as inextricably linked.Our recommendations are essential for improving nations’capability to respond to global public health emergencies.

Development Path and Urgency of Further Strengthening Construction of Public Hospitals Based on Novel Coronavirus Pneumonia Treatment

During the outbreak of novel coronavirus pneumonia(NCP)in Wuhan,public hospitals have played an important role in intensive care,case guidance and scheme optimization.At the same time,it also faces unprecedented challenges and tests.Based on the treatment of severe patients in Wuhan,combined with the treatment practice in Tongji Hospital affiliated to Tongji Medical College,Huazhong University of Science and Technology,this paper puts forward the urgency of further strengthening the construction of public hospitals,discusses the feasible path for promoting the development of public hospitals,so as to meet the growing medical needs of the people,improve the ability to respond to major public health emergencies,and effectively guarantee the safety of people's lives and the promotion of a healthy China construction.

Effects of policies and containment measures on control of COVID- 19 epidemic in Chongqing

BACKGROUND Coronavirus disease 2019(COVID-19)is an emerging,rapidly evolving disease that spreads through the respiratory system and is highly contagious.In March 2020,the World Health Organization declared the COVID-19 outbreak a pandemic.In China,the pandemic was controlled after 2 mo through effective policies and containment measures.Describing the detailed policies and containment measures used to control the epidemic in Chongqing will provide a reference for the prevention and control of COVID-19 in other areas of the world.AIM To explore the effects of different policies and containment measures on the control of the COVID-19 epidemic in Chongqing.METHODS Epidemiological data on COVID-19 in Chongqing were prospectively collected from January 21 to March 15,2020.The policies and prevention measures implemented by the government during the epidemic period were also collected.Trend analysis was performed to explore the impact of the main policy measures on the effectiveness of the control of COVID-19 in Chongqing.As of March 15,the cumulative incidence of COVID-19 in Chongqing was 1.84/100000(576 cases)and the infection fatality rate was 1.04%(6/576).The spread of COVID-19 was controlled by effective policies that involved establishing a group for directing the COVID-19 epidemic control effort;strengthening guidance and supervision;ensuring the supply of daily necessities and medical supplies and equipment to residents;setting up designated hospitals;implementing legal measures;and enhancing health education.Medical techniques were implemented to improve the recovery rate and control the epidemic.Policies such as“the lockdown of Wuhan”,“initiating a first-level response to major public health emergencies”,and“implementing the closed management of residential communities”significantly curbed the spread of COVID-19.Optimizing the diagnosis process,shortening the diagnosis time,and constructing teams of clinical experts facilitated the provision of“one team of medical experts for each patient”treatment for severe patients,which significantly improved the recovery rate and reduced the infection fatality rate.CONCLUSION The prevention policies and containment measures implemented by the government and medical institutions are highly effective in controlling the spread of the epidemic and increasing the recovery rate of COVID-19 patients.

Centralization and perceived control of COVID-19 during the pandemic:A cross-sectional study

Objective:To uncover the impact of centralization of COVID-19 and perceived control of COVID-19 on society during the pandemic.Methods:We recruited a total of 1041 people in this cross-sectional study.The data were collected using a questionnaire booklet covering demographics,a COVID-19-related information form,the Centrality of Event Scale,and the Perception of Control of COVID-19 Scale.We utilized independent samples t-test,chi-square test,and one-way analysis of variance to analyze the data.Results:1041 questionnaires were collected and no questionnaire were excluded from our study.Slightly more than half of the participants(51.2%)stated that social isolation impaired public mental health,while 30.1%reported adverse impacts of the pandemic on their sleep quality.Participants with changes to their sleep patterns were found to centralize COVID-19 more.Moreover,measures against COVID-19 and constant announcements of the daily number of cases in the media brought both positive and negative effects on people and further contributed to the participants’centralization of COVID-19.Individuals with low centralization scores were concluded to perceive COVID-19 as a minor disease.Healthcare professionals without a relative diagnosed with COVID-19 and those satisfied with treatment opportunities had a higher perceived control of COVID-19,while those who were not interested in statistical data on COVID-19 and who had difficulty complying with the rules had a lower perceived control of COVID-19.Besides,poorer perceived control of COVID-19 was found to adversely affect sleep quality.Furthermore,healthcare professionals scored higher on the inevitability subscale of the Perception of Control of COVID-19 Scale.Finally,among the participants,most COVID-19 survivors thought COVID-19 to be an avoidable disease.Conclusion:In addition to its physical impacts,COVID-19 adversely impacts on mental health,and these effects are closely linked to a society’s centralization of COVID-19 and perceived control of COVID-19.

基层疾病预防控制机构2017—2022年政务热线案件特征分析

目的通过分析2017—2022年某基层疾控机构政务热线诉求反映的问题,为基层疾控机构政务热线处理提供参考。方法回顾性对比分析2017—2019年(常态化防控期)与2020—2022年(动态化防控期)受理的市民热线政务工单,通过比较诉求原因分类及受理科室分布,探讨不同时期市民诉求的变化情况。结果该基层疾控机构在动态化防控期(6974件)受理热线工单量较常态化防控期(284件)增加了23.6倍。常态化防控期“公共卫生服务质量”类(7.75%)、“公共卫生服务可及性”类(49.30%)诉求引发的案件占比高于动态化防控期同类型案件占比(3.63%和19.29%)。动态化防控期“管理措施”类(27.37%)案件占比低于常态化防控期同类案件(33.10%),“数据信息化”类案件受理量在动态化防控期间更为突出。结论动态化防控政策直接影响了市民获得公共卫生服务的体验,导致市民诉求原因的变化。基层疾控机构应通过完善公共卫生服务能力建设,以诉求问题为导向,加强沟通培训等措施提高政务热线处理能力。

重大公共卫生事件下西安市采供血情况纵向对比分析及启发

目的探讨重大公共卫生事件下西安市采供血情况。方法采用回顾性资料分析法,比较2020年1月25日至2月28日、2021年12月23日至2022年1月24日、2022年3月6日至3月28日西安市突发三轮公共卫生事件期间悬浮红细胞和血小板的采供量、血液调配情况和献血者人口学特征。结果2020年1月第1轮事件期间悬浮红细胞日库存一度跌至接近0;2022年3月第3轮事件期间悬浮红细胞日出库不断升高。三轮事件期间血小板日库存与日出库量均呈现较大波动。第1轮与第3轮事件期间悬浮红细胞供应主要靠本单位采集,而第2轮事件期间悬浮红细胞供应则主要依靠血液调配;三轮事件期间血小板供应主要依靠本单位采集。三轮事件期间献血人群越来越年轻化,专科学历献血者占比上升。结论重大公共卫生事件对西安市血液保障工作造成影响的同时有助于积累宝贵的工作经验。采供血机构应根据政府防控措施及事件发生发展的趋势灵活应对,及时调整工作思路和重点,不断完善采供血应急保障机制。

公共卫生监测对传染病预防控制的影响分析

目的分析传染病预防控制中公共卫生监测的影响和价值。方法选取2021年6月—2023年7月本院收集的传染病信息300例进行研究,随机分为对照组和观察组,每组150例。其中,对照组(2021年6月—2022年6月)未进行公共卫生监测,观察组(2022年7月—2023年7月)实施公共卫生监测,分析公共卫生监测前后传染性疾病的患病情况、患者生活质量等。结果观察组肺结核、乙肝和流感发病率低于对照组,组间差异有统计学意义(P<0.05);观察组躯体功能、心理功能、社会功能和物质生活水平高于对照组,组间差异有统计学意义(P<0.05);观察组交流沟通、工作实效和整体印象评分高于对照组,组间差异有统计学意义(P<0.05);观察组监测满意度高于对照组,组间差异有统计学意义(P<0.05)。结论在传染病防控体系中,强化公共卫生监测是至关重要的一环。采用高效且科学的卫生监测措施,对于遏制传染病的蔓延、改善公众健康状况具有明显成效。此外,这也是应对公共卫生挑战、防止感染性疾病扩散的有效方式,从而确保广大民众的健康安全得到坚实守护。

护理人员传染病突发事件防控能力的研究进展

介绍护理人员传染病突发事件防控能力的内涵及现状,其主要能力有临床实践能力、学习与教育能力、心理抗压能力;总结影响护理人员传染病突发事件防控能力的主要因素,包括个人因素(如性别、年龄、学历、参与培训的个人意愿等)、工作因素(如工作满意度、工作年限、职业角色、是否参加培训演练、是否具备相关救援经历等)及组织因素(如医院级别和组织支持等);采用的评估工具有葛森医院安全氛围量表、护士重大传染病疫情应急能力调查问卷等。提出提升护理人员传染病突发事件防控能力的相关策略,以期为提升护理人员传染病突发事件防控能力提供参考。

传染病防控中的知情同意:走向一种新的范式

知情同意是一项重要的医学伦理原则,在临床治疗和医学科研中得到了广泛的应用。然而,这一原则在传染病防控工作中并不完全适用。传染病防控的技术手段与治理措施的公共性特征,会导致知情同意部分要素的缺失或者伦理标准的改变。知情同意原则具有维护个体权益的重要作用,因此又不能忽视其实践价值。一种解决方式是对知情同意原则的内涵与实践路径进行新的界定,包括在知情过程中强调群体知情和个体知情的结合,在同意过程中把握好自主的界限以及明确法定同意的方式和范围等,从而建构出适用于传染病防控工作的知情同意原则范式。

上海市社区公共卫生人才队伍建设现状调查研究

在“大健康”背景下,我国公共卫生人才队伍在防控疾病方面起着非常关键的作用。近年来,上海市公共卫生人员配置得到了一定的优化,但在社区防控范围内存在公共卫生专业技术人员数量不足和分布不均等问题。截至2021年年底,上海市每千常住人口公共卫生人员数量仅为0.576,低于全国0.640的平均水平,并离预期目标均有较大差距。此次社区公共卫生工作中工作人员遇到的困难主要是工作量大、人手不够,没有先前案例可供学习以及物资紧张等。未来社区公共卫生人才队伍建设应从多个方面入手,转换公共卫生人才培养模式,培养复合型人才,助力构建强大公共卫生体系、织密织牢公共卫生防控网。

突发公共卫生事件中微生物检验质量的控制措施探讨

目的:分析突发公共卫生事件中微生物检验质量的控制措施。方法:对2021年1月—2022年12月实验室微生物检验管理模式进行研究,2021年1—12月实施常规管理模式(对照组),2022年1—12月实施微生物检验质量规范化管理(研究组),分别以300份微生物检验标本为例,选择10名微生物检验人员。比较规范化管理前后,微生物检验质量控制的整体水平(标本合格率以及各维度控制质量)。结果:研究组微生物检验标本不合格率0.67%(2/300)低于对照组[3.33%(10/300)],差异有统计学意义(χ^(2)=5.442,P=0.020)。研究组检验人员配置、样本采集与准备、检验设备检查、生物安全防护、操作流程规范性评分高于对照组,差异有统计学意义(P<0.05)。结论:加强实验室微生物检验质量控制管理,能够针对突发公共卫生事件有效且及时应对,保证微生物检验结果精准性,为后续疾病防控措施制定奠定基础。

公共卫生事件下应急点位设置和安排的动态策略

在公共卫生事件爆发初期,运用更高效的经济高效的核酸点的窗口数量和点位位置设置策略对于抗击疫情有积极意义。依托哈夫模型,迪杰特拉斯算法和排队论,以北京天通苑社区为例,基于当地各项人口数据、基础设施规模和通勤模式等因素,可以计算出当前模型下点位设置的最优方案。本文结果给出了截至2023年7月25日的核酸检测样本采集点点位分布的理论承载人数和最优窗口数量设置。核酸检测样本采集点点位设计方案的策略优化,在公共卫生管理上,能够降低经济成本,具有较好的防控效果,且能提高传染病预防管理的质量。

Validating the CorrectWearing of Protection Mask by Taking a Selfie:Design of a Mobile Application“CheckYourMask”to Limit the Spread of COVID-19

In a context of a virus that is transmissive by sputtering,wearing masks appear necessary to protect the wearer and to limit the propagation of the disease.Currently,we are facing the 2019-2020 coronavirus pandemic.Coronavirus disease 2019(COVID-19)is an infectious disease with first symptoms similar to the flu.The symptom of COVID-19 was reported first in China and very quickly spreads to the rest of the world.The COVID-19 contagiousness is known to be high by comparison with the flu.In this paper,we propose a design of a mobile application for permitting everyone having a smartphone and being able to take a picture to verify that his/her protection mask is correctly positioned on his/her face.Such application can be particularly useful for people using face protection mask for the first time and notably for children and old people.The designed method exploits Haar-like feature descriptors to detect key features of the face and a decision-making algorithm is applied.Experimental results show the potential of this method in the validation of the correct mask wearing.To the best of our knowledge,our work is the only one that currently proposes a mobile application design“CheckYourMask”for validating the correct wearing of protection mask.

我国国境生物安全防控体系现代化建设研究

在全球性传染病疫情频发的背景下,加快推动国境口岸传染病防控体系建设是我国生物安全工作的重中之重。本文从口岸生物安全形势、口岸卫生检疫防线、口岸传染病防控组织架构等方面系统分析了我国国境生物安全防控能力及体系建设的现状,在与美国、欧盟等国家和地区的国境生物安全防控能力及体系进行横向与纵向比较的基础上,对我国口岸传染病防控体系存在的短板和弱项进行了深入分析。研究发现,我国国境口岸生物安全存在多部门分段管理,传染病监测与预警网络配制分散、生物安全态势感知薄弱,口岸卫生检疫能力水平参差不齐等问题。为此,本文提出了我国国境生物安全现代化体系建设路径:建立常态化的部门间体系互认机制,推动传染病联防联控工作机制常态化,加强各部门间信息共享;推进境外传染病监测哨点建设,建立卫生检疫官工作机制,完善境外生物安全风险监测,建立多点触发预警机制,积极参与国际公共卫生合作网络;加强口岸实验室能力建设,提升病原检测和识别能力,推动适用于口岸应用场景的检测设备开发,加快口岸生物安全实物资源库建设。

4R危机管理理论视域下高校突发公共卫生事件应急短板及防控策略探析

高校如何应对突发公共卫生事件,保障教育教学的正常开展,已成为高校管理者必须思考的问题。高校作为区域社会的一个子系统,师生密集度高、社会关注度高、师生活跃性强,对高校突发公共卫生事件应急管理提出了新要求。文章通过分析高校应对突发公共卫生事件的主要特点、存在的应急短板,基于4R危机管理理论,提出从“缩减、预备、反应、恢复”四个方面对高校处置突发公共卫生事件策略进行分析,以期为高校科学精准应对公共卫生突发事件提供参考。

基层疾控机构公共卫生人员核心能力评价指标构建研究

目的构建基层疾控机构公共卫生人员核心能力评价指标体系,为公共卫生人才评价和培养发展提供参考。方法2019年9月—2020年5月,采用文献综合和Delphi法初步构建公共卫生人员核心能力指标体系,运用层次分析法计算各指标权重。结果经两轮专家咨询,形成公共卫生人员核心能力指标体系共6个一级指标和19个二级指标、75个三级指标。一级指标的权重值为0.0861~0.2832,二级指标的组合权重为0.0281~0.1312,三级指标的组合权重为0.0010~0.0732。结论公共卫生人员核心能力指标体系具有较好的可靠性,对基层公共卫生人员的培养具有较好的参考价值。

突发公共卫生事件社区联防联控中社区卫生服务机构的定位与功能分析

社区联防联控是应对突发公共卫生事件的有效路径,社区卫生服务机构是突发公共卫生事件的“第一现场反应人”,在社区联防联控中具有特殊地位。本文对社区卫生服务机构社区联防联控中的角色定位与功能进行分析,提出社区卫生服务机构在联防联控中承担前沿“哨点”、专业技术保障、社区健康管家和健康教育四大重要角色;梳理当前社区卫生服务机构发挥联防联控职能面临的挑战,归纳形成职责不清晰、应急物资储备和分配机制不完善和能力建设不足三大主要问题,并进一步提出充分发挥其在社区联防联控中重大作用的建议。

公共卫生管理在传染病预防中的定位与干预研究

我国是一个人口基数大的国家,在传染病突发公共事件的预防工作中也具有一定的难度,需要制定科学的预防机制,从而能够在很大程度上实现传染病的预防和控制。传染病的预防和控制是一项系统性的工作,需要医疗机构和相关部门的共同努力。在传染病预防工作中,公共卫生管理具有非常重要的意义,不但可以及时发现和控制疫情,还可以为后续治疗工作提供重要的参考数据。本文首先阐述公共卫生管理工作的意义,然后分析传染病预防工作存在的问题,最后提出加强传染病预防工作的措施,以期为相关人员提供参考,并明确公共卫生管理在传染病预防中的推广价值、监测价值、隔离价值及源头查询价值。