Leadership,communication,and science:three pillars essential to public health emergency response and closing the gap in the HIV response among key populations

Globally,there have been multiple public health emergencies in recent decades.High rates of morbidity,occasionally mortality,and economic instability are usually associated with pandemics.One of the epidemics that has significantly increased morbidity and mortality worldwide is the human immunodeficiency virus(HIV)and acquired immune deficiency syndrome(AIDS)pandemic.HIV has a disproportionately negative impact on key populations.Strong leadership,effective communication,and sound science are necessary for public health emergency(PHE)responses to be successful.These three PHE response pllars are also essential for bridging the HIV response gap among key populations in the setting of restrictive laws.In this review,we explored the importance of these three pillars of successful PHEs responses,and how they are essential to closing the gap in the HIV response among key populations.Leaders must make decisions and instil a sense of authority in the populace during PHEs to foster trust and confidence.Leaders should base their choices on scientific evidence.Effective communication during PHEs should be proactive,polite,imaginative,innovative,and constructive.To address gaps in the HIV response among key populations,leaders must create a supportive environment for effective communication and scientific research,communication should be used to raise awareness of HIV and to dispel stigma and discrimination,while science should provide evidence of efficacy and effectiveness of interventions amongkey populations.

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.

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.

REDISSE in Benin and Lessons Learned for the Management of Public Health Emergencies after Five Years of Implementation

Introduction: Benin was embarked on phase 3 of the REDISSE Benin project (Regional Disease Surveillance Systems Enhancement) which began in 2018. The objectives were in five key components namely, Surveillance and health information;Laboratory capacity building;Emergency preparedness and response;Human resources management for effective disease surveillance and epidemic preparedness;and Institutional Capacity Building, Project Management, Coordination and Advocacy. After five years of implementation, this study aimed at the documentation of lessons learned and best practices. Methods: A descriptive cross-sectional study. Apart from individual semi-structured interviews, a thematic workshops bringing together the project’s main stakeholders recruited on an exhaustive way by component to identify and validate lessons learned, good practices and propose improvement mechanisms to be taken into account by the sector. Criteria were set up and used to validate best practices and lessons learned. Results: A total 54 (Surveillance workshop), 47 (Preparedness & response workshop), 53 (Human Resources workshop), 26 (Laboratories workshop) participated to the thematic workshops, and five interviews. The good practices (33: 9 for animal health, 7 for human health and 17 crosscutting) and lessons learned (10: 3 for animal health and 7 for human health) have been identified and have been the subject, depending on the case, of proposals for improvement or conditions necessary for their maintenance. Discussion: The richness of a project lies not only in the immediate achievement of its results, but also and above all, in its usefulness for similar interventions, whether in the local, regional, national or international context. It is in this context that the REDISSE project has set out to make public the various lessons learned and best practices from the implementation of its activities over a period of some five consecutive years.

Leveraging the Public Health Emergency Operation Center (PHEOC)for pandemic response: opportunities and challenges

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.

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.

急诊科护士突发公共卫生事件心理弹性培训方案的构建与初步应用研究

目的构建基于Kumpfer心理弹性框架理论与国际心理弹性研究计划项目组(the International Resilience Research Project,IRRP)心理弹性训练策略的心理弹性培训方案,探讨其在急诊科护士突发公共卫生事件下的应用效果。方法2022年1-6月,采用简单随机抽样法选择上海市某三级医院的急诊科护士为研究对象,按随机数字表分为对照组和观察组各30例,对照组采用常规培训和管理方法,观察组在对照组的基础上实施心理弹性培训方案。评价并比较两组护士干预前后心理弹性及应急能力的变化。结果干预后,观察组护士的心理弹性、应急能力得分均高于对照组(均P<0.05)。结论心理弹性培训方案在突发公共卫生事件下能有效提升急诊科护士的心理弹性水平,保障突发公共卫生事件应急处置工作有序开展。

基于三方演化博弈的突发公共卫生事件应急响应及仿真研究

突发公共卫生事件中地方政府、社会组织与公众的相互配合、协同响应是及时高效进行应急管理的必然选择。本文以新型冠状病毒肺炎为背景,考虑应急响应过程中多主体之间的相互影响与博弈关系,基于有限理性假设,构建地方政府、社会组织与公众三方博弈主体的演化博弈动态模型。然后,运用演化博弈理论和Lyapunov判别法分析三方主体演化模型的均衡点和渐进稳定性,得到在不同条件下三方主体的演化稳定策略。最后,对突发公共卫生事件不同阶段的三方主体应急响应的博弈行为进行仿真分析,探讨地方政府的补贴政策、奖惩措施以及社会组织成本对博弈各方策略选择的影响。研究结果表明:(1)在突发公共卫生事件应急响应的不同阶段,各主体的决策选择是动态演变的;(2)地方政府的补贴政策、奖惩措施以及社会组织成本对于主体的应急响应行为作用明显;(3)各主体的初始参与意愿强弱对突发公共卫生事件应急响应的影响效果显著。

职责视角下的突发公共卫生事件时期疫苗管理政策差异量化研究

目的:量化分析突发公共卫生事件时期针对暴发传染病的疫苗管理与常规疫苗管理在管理职责和职责主体方面存在的差异。方法:构建我国疫苗管理职责框架,从管理职责、职责主体和疫苗类型三个维度对我国中央层面的疫苗政策文本进行量化处理,使用统计分析、共现聚类和中心性测算的方法进行差异比较。结果:突发公共卫生事件传染病疫苗的接种、生产和研发方面的职责受到更多重视,落实接种政策与宣传科普工作使得更多政策实施主体承担了疫苗管理职责,疫苗的保障措施贯穿管理的各个阶段。卫生健康部门和药品监管部门是管理核心职责部门,科技部门、工业信息化部门具有较多协同合作职责,教育部门、发展改革部门承担较大联通协调职责。结论:突发公共卫生事件时期传染病疫苗管理职责更多,需要多部门高效合作,在疫苗的流通和信息管理方面予以更多重视,充分发挥疾控部门在基层人才队伍与信息监测方面的优势,科学落实国家防疫政策,引导非行政主体承担管理职责,并强化核心责任主体“枢纽”作用。

互联网模式下专家咨询专线对儿童保健需求的影响

目的:探讨互联网模式下,新型诊疗模式对儿童保健需求的影响。方法:采用横断面观察性研究,对通过《儿童健康有约》专家在线栏目咨询保健需求问题的484例研究对象,采用电话咨询收集其一般资料,在1周后对其监护人进行随访,将单因素分析差异有统计学意义的变量进行Logistic回归分析,探讨影响儿童就医问题的独立影响因素。结果:共纳入研究对象484例,就医问题解决度达80.58%(390/484),单因素分析结果显示,在儿童保健需求的就医过程中,获取资讯途径与咨询内容是其影响因素(P<0.05),Logistic回归分析显示,获取资讯途径是儿童保健就医问题解决度的独立影响因素(P<0.05)。结论:开通电话专线是解决儿童保健问题(80.58%)的重要举措;获取资讯途径可以作为一种特殊儿童保健需求的应对措施,可以有效解答儿童保健问题。

医联体内护士传染病相关应急能力现状及影响因素调查

目的探讨医联体内护士传染病突发公共卫生事件应急能力的现状及影响因素。方法采用便利抽样的方法,选取2022年1月—2023年1月404名医联体内护士进行问卷调查分析。统计404名不同特征护士应急能力得分、应急能力得分较低和较高的条目、应急能力得分情况,采用logistic多元分层回归分析医联体内护士传染病突发公共卫生事件应急能力得分的影响因素。结果一级指标准备得分最高的项目为“救援能力”(126.67±10.89)分,得分最低的项目为“风险沟通能力”(3.02±0.77)分;二级指标得分最高项目为“预防能力评分”(13.67±1.07)分,得分最低的项目是“应急演练评分”(3.43±0.78)分。三级医院、男性、年龄>39岁、临床经验>14年、硕士、有救援工作经验、有突发事件应急救援经验、过去5年参加过新发传染病事件应急演练、过去5年参加过常见传染病或新发传染病培训的护士应急能力得分高于一二级医院、女性、年龄<31岁和31~39岁、临床经验<6年和6~14年、本科和专科、无救援工作经验、无突发事件应急救援经验、过去5年未参加过新发传染病事件应急演练、过去5年未参加过常见传染病或新发传染病培训的护士,差异有统计学意义(P<0.05)。性别、年龄、学历、医院级别、临床经验、突发事件应急救援经验、过去5年参加新发传染病事件应急演练、过去5年参加常见传染病或新发传染病培训均为应急能力的主要影响因素(P<0.05)。结论医联体内护士应急能力评分处于中等水平。护理管理人员应选择适当的方法对医联体内护士进行传染病突发事件应急能力的演练和培训,以提高其应急能力。

时空大数据在突发公共卫生事件应急指挥中的应用与挑战

时空是人类生存和发展一切活动的基础,时空大数据是同时具有时间和空间维度的、与地理位置有关的大数据,是突发公共卫生事件应急指挥与控制的重要支撑。针对我国在新冠肺炎疫情应急响应中出现的各种问题,总结时空大数据在新冠肺炎疫情应急响应中的应用。在此基础上分析我国突发公共卫生事件应急指挥系统存在的问题、时空大数据在突发公共卫生事件应急指挥中面临的挑战。提出面向突发公共卫生事件的时空大数据应急指挥技术框架,以期深化时空大数据在突发公共卫生事件领域的应用。

突发公共卫生事件居民响应时空关联特征分析

客观认识城市居民在突发公共卫生事件不同防控阶段的响应模式,对提升应急管理能力、促进居民心理健康恢复至关重要。本文基于武汉市社交媒体、政策与病例数据,综合运用自然语言处理技术与空间分析等方法,在社区尺度上探究突发公共卫生事件不同防控阶段下居民响应的时空特征。结果表明:(1)居民对突发公共卫生事件的响应趋向于负面,事件相关的微博关注度随时间的变化与事件发展趋势同步;居民在封控时期情感状况较为平稳,防控政策放开后短期内负面情绪增加,而后逐渐恢复。(2)不同防控阶段下的居民响应与事件严重程度均具备时空关联特性,关注度与病例指数均呈正相关,而情感响应则呈负相关。典型区域如医院周边情感较为乐观,而产业园区则以负面情绪为主。

公立医院卫生应急工作的实践与展望

公立医院是医疗服务的主体,承担的卫生应急工作使命光荣,意义重大。文章通过分析公立医院卫生应急能力建设的意义、现状、存在的弱项,并与国外医疗机构应急响应机制进行对比研究,探索更为完善的、适合我国国情的公立医院卫生应急工作发展思路,为推动卫生应急工作建设高质量发展提供可行路径。

面向信息公开的突发公共卫生事件知识表示模型构建

近年来,突发公共卫生事件频发给政府应急管理带来了极大挑战。政府及时公开事件信息有助于消除公众恐慌,对于疫情防控和社会经济发展至关重要。然而,当前突发公共卫生事件信息以碎片化、不连续、不完整方式散落在不同位置,未能较好地集成融合。如何对海量、多样、变化的信息进行描述与组织是政府应急管理的关键。因此,本文面向信息公开,融合知识图谱和事理图谱,构建突发公共卫生事件知识表示模型,并对其中的核心概念及关系进行表示,提出了一种既能刻画疫情时空演化状态,又能展示疫情信息的突发公共卫生事件信息组织方法。研究结果显示,本文构建的知识表示模型具有较好的垂直性质,能够展示较为丰富的概念关系和属性特征,大部分类能够得到实例填充。本文提出的知识表示模型为突发事件知识库构建提供新思路,扩充了突发事件信息组织的方法体系,有助于存量信息公开与价值释放,进一步满足公众的信息需求,提升应急管理效果。

基层护士突发公共卫生事件应急能力的潜在剖面分析及影响因素

目的:了解基层护士突发公共卫生事件时的应急能力水平,并分析其潜在剖面的亚组特征。方法:采用便利抽样法于2021年1月—3月选取云南省基层医院的889名临床护士为研究对象,采用一般资料调查表、护士突发公共卫生事件应急能力量表进行调查,使用Mplus 8.3软件对护士应急能力特征进行潜在剖面分析,采用多分类Logistic回归分析探究突发公共卫生事件基层护士应急能力的影响因素。结果:基层护士突发公共卫生事件时应急能力存在3个潜在类别,分别命名为应急能力高水平组(34.1%)、中等水平组(53.3%)、低水平组(12.6%);Logistic回归分析结果显示,性别、工作年限、聘用方式、是否参加过突发公共卫生事件应急培训、有无突发公共卫生事件救援活动经历是基层护士突发公共卫生事件时高水平应急能力的影响因素(P<0.05)。结论:基层护士突发公共卫生事件时,应急能力处于中等偏上水平,护理管理者应根据护士不同应急能力类别的主要特征调整培训策略,开展培训。

突发公共卫生事件桌面推演联合实战演练方案的构建及应用研究

目的构建突发公共卫生事件桌面推演联合实战演练方案,并评价其应用效果。方法通过文献回顾及专家会议法构建桌面推演联合实战演练方案。采用便利抽样法,选取2023年6月—8月在广西南宁市参加多部门联合应对突发公共卫生事件培训的103名急诊护士作为研究对象。培训前、后采用急诊护士突发公共卫生事件应急能力问卷、自制应急救援知识理论考核试题进行评价,并调查参与者的满意度。结果培训后,急诊护士的应急知识水平、抢救能力、评判性思维能力、沟通能力、组织与协调能力较培训前提高,差异有统计学意义(P<0.05)。总体培训满意度为(58.33±3.04)分。结论突发公共卫生事件桌面推演联合实战演练方案有助于提升急诊护士突发公共卫生事件应对能力。

云南省护士突发公共卫生事件应急能力现状及影响因素分析

目的调查云南省临床护士突发公共卫生事件应急能力现状并分析其影响因素,以期为今后应急能力培训方案的构建提供依据。方法便利抽取云南省43家医院的4821名临床护士,应用一般资料调查表、护士突发公共卫生事件应急能力量表、应急态度量表进行横断面调查,借助逐步多重线性回归进行影响因素分析。结果云南省临床护士突发公共卫生事件应急能力总分为(70.35±14.08)分,突发公共卫生事件应急态度总分为(42.26±6.14)分,性别、科室、医院等级、工作年限、是否参加突发公共卫生事件应急培训、是否经历突发公共卫生事件救援活动、突发公共卫生事件应急态度是护士突发公共卫生事件应急能力的影响因素(P<0.05),共解释总变异的29.0%。结论云南省临床护士突发公共卫生事件应急能力总体处于中等偏上水平,但应急知识方面仍存在明显不足,需进行针对性培训,护理管理应结合影响因素构建针对性的分层培训方案,增强护士突发公共卫生事件应急能力。

大安全大应急下公共卫生应急管理人才培养的实施路径

为适应公共卫生应急管理工作需要,以及适应大安全大应急下社会经济发展对人才需求变化而作出相应调整的需要,分析公共卫生应急管理人才培养的不足及需求,基于此定位公共卫生应急管理人才培养中的核心要素,包括培养目标、培养类型、培养模式和课程建设,探索大安全大应急下完善的公共卫生应急管理人才培养的实现路径。结果表明:更新完善公共卫生应急管理人才教育理念,开展多层次实践教学、实验教学及案例教学,引入跨学科培养,提升合作能力和综合能力,建立科学公共卫生应急管理评价体系,完善实践考核方式,能有效完善公共卫生应急管理人才培养体系的构建。

安徽省医疗机构突发公共卫生事件应急药品供应保障现状分析

目的 通过深入探析安徽省医疗机构突发公共卫生事件应急药品供应保障现状,分析应急药品在不同医疗机构的可获得性及短缺障碍因素,为完善我国应急药品供应保障体系建设提供思路。方法 2022年9―11月运用文献研究法、问卷法等,向安徽省171家医疗机构进行调查,实际回收150份问卷,除无效问卷及废卷,共139家医疗机构纳入研究。参考安徽省药学会药物经济学专委会委员所在医疗机构的级别比例,其中三级医疗机构73家,二级医疗机构53家,一级医疗机构13家。比较该省不同等级的医疗机构应急药品准备能力的差异,从解决实际问题的角度完善应急药品供应保障体系的建设。结果 调研显示,在应急药品准备能力的三个方面,该省各级医疗机构总体上差异有统计学意义(P<0.05),医疗机构等级越高,应急药品准备能力越强,二级与一级医疗机构之间差距很小。该省应急药品短缺障碍因素总体上差异无统计学意义,但对各级医疗机构来说,其中有7个应急药品短缺障碍因素差异有统计学意义,它们分别是药品价格偏低、原材料短缺、药品市场需求量小、企业不愿意生产、药品生产质量管理规范认证改造或未通过认证、药品生产企业数量少、存在可替代的高价新药、利润过低导致经营企业不愿意经营药品。结论 突发公共卫生事件下,该省医疗机构应急药品供应保障形势仍很严峻,各等级医疗机构之间有差距,三级医疗机构应急药品准备能力最强。努力提升基层医疗机构的应急药品准备能力,克服应急药品短缺的障碍因素,能辅助健全该省医疗机构突发公共卫生事件应急药品供应保障体系。