Developing a conceptual framework for the health protection of United Nations peacekeepers against the COVID-19 pandemic from global health perspectives

The coronavirus disease 2019(COVID-19)pandemic has posed particular health risks to United Nations peacekeepers,which require prompt responses and global attention.Since the health protection of United Nations peacekeepers against the COVID-19 pandemic is a typical global health problem,strategies from global health perspectives may help address it.From global health perspectives,and referring to the successful health protection of the Chinese Anti-Ebola medical team in Liberia,a conceptual framework was developed for the health protection of United Nations peacekeepers against the COVID-19 pandemic.Within this framework,the features include multiple cross-borders(cross-border risk factors,impact,and actions);multiple risk factors(Social Determinants of Health),multiple disciplines(public health,medicine,politics,diplomacy,and others),and extensive interdepartmental cooperation.These strategies include multiple phases(before-deployment,during-deployment,and post-deployment),multi-level cooperation networks(the United Nations,host countries,troop-contributing countries,the United Nations peacekeeping team,and United Nations peacekeepers),and concerted efforts from various dimensions(medical,psychological,and social).

A Certifiable Framework for Health Monitoring and Management

The scope of this paper is to provide an E2 Eperspective of health monitoring and management(HMM)and structural health mornitoring(SHM)as an integrated system element of an integrated system health monitoring and management(ISHM)system.The paper will address two main topics:(1)The importance of a diagnostics and prognostic requirements specification to develop an innovative health monitoring and management system;(2)The certification of a health monitoring and management system aiming at a maintenance credit as an integral part of the maintenance strategies.The development of a maintenance program which is based on combinations of different types of strategies(preventive,condition-based maintenance(CBM)and corrective maintenance…)for different subsystems or components and structures of complex systems like an aircraft to achieve the most optimized solution in terms of availability,cost and safety/certification is a real challenge.The maintenance strategy must satisfy the technical-risk and cost feasibility of the maintenance program.

A data-driven health indicator extraction method for aircraft air conditioning system health monitoring

Prognostics and Health Management(PHM) has become a very important tool in modern commercial aircraft. Considering limited built-in sensing devices on the legacy aircraft model,one of the challenges for airborne system health monitoring is to find an appropriate health indicator that is highly related to the actual degradation state of the system. This paper proposed a novel health indicator extraction method based on the available sensor parameters for the health monitoring of Air Conditioning System(ACS) of a legacy commercial aircraft model. Firstly, a specific Airplane Condition Monitoring System(ACMS) report for ACS health monitoring is defined. Then a non-parametric modeling technique is adopted to calculate the health indicator based on the raw ACMS report data. The proposed method is validated on a single-aisle commercial aircraft widely used for short and medium-haul routes, using more than 6000 ACMS reports collected from a fleet of aircraft during one year. The case study result shows that the proposed health indicator can effectively characterize the degradation state of the ACS, which can provide valuable information for proactive maintenance plan in advance.

Restorating marine coastal ecosystem health as a new goad for integrated catchment management in Tolo Harbour,Hong Kong,China

The paper demonstrates why it is necessary to take the restoration of marine coastal ecosystem health as a new goal for integrated catchment management, in coastal area of the Tolo Harbour. The present goal of integrated catchment management (ICM) in the Tolo Harbour is to meet with Water Quality Objectives. The performance of an ICM plan, Tolo Harbour Action Plan (THAP), is evaluated by using marine coastal ecosystem health indicators including stress indicators and responses indicators. Since the implementation of THAP in 1988, some significant reduction in pollution loading has been observed - reduction of 83 % of BOD load and 82 % of TN between 1988 and 1999. There has been an improvement in the health state of Tolo Harbour marine coastal ecosystem as evidenced in the trends of the physical, chemical and biological indicators, although some reverse fluctuations in some periods exist. However, this can only be considered as the first sign of the ecosystem health restoration, since ecosystem health

Deep neural network based classification of rolling element bearings and health degradation through comprehensive vibration signal analysis

Rolling element bearings are machine components used to allow circular movement and hence deliver forces between components of machines used in diverse areas of industry.The likelihood of failure has the propensity of increasing under prolonged operation and varying working conditions.Hence, the accurate fault severity categorization of bearings is vital in diagnosing faults that arise in rotating machinery.The variability and complexity of the recorded vibration signals pose a great hurdle to distinguishing unique characteristic fault features.In this paper, the efficacy and the leverage of a pre-trained convolutional neural network(CNN) is harnessed in the implementation of a robust fault classification model.In the absence of sufficient data, this method has a high-performance rate.Initially, a modified VGG16 architecture is used to extract discriminating features from new samples and serves as input to a classifier.The raw vibration data are strategically segmented and transformed into two representations which are trained separately and jointly.The proposed approach is carried out on bearing vibration data and shows high-performance results.In addition to successfully implementing a robust fault classification model, a prognostic framework is developed by constructing a health indicator(HI) under varying operating conditions for a given fault condition.

On the study of ecosystem health:state of the art

Ecosystem health is a newly proposed concept that sets new goals for environmental management. Its definition, assessment indicators, and assessment methods are reviewed in this paper. Literature shows that the definitions and the assessment indicators cover a wide range of ecosystem health, and they differ in terms of researchers different scientific background. It is concluded that the concept of ecosystem health cannot be defined or understood simply in biological or ethical or aesthetic or historical terms and the assessment should be based on applying several indicators simultaneously to get overall picture of the health or integrity state of an ecosystem.

Frameworks for health systems performance assessment:how comprehensive is Ghana’s holistic assessment tool?

Background:Measuring the performance of a health system is an essential requirement in creating systems that generate efficient,equitable,patient-focused,accessible and sustainable results.A fundamental requirement for a performance measurement system is the development of an assessment framework within which specific performance measures could be defined and applied regularly.This paper examines the comprehensiveness of Ghana’s health system assessment framework called the Holistic Assessment Tool in relation to some of the internationally recognized frameworks.The paper also analyzes trends in the performance of the health system to understand whether or not an improvement has been recorded following the adoption and implementation of the Holistic Assessment Tool.Methods:Mainly secondary data were used in this analysis.Searches were conducted on Google Scholar,PubMed,Scopus and Science Direct between May and July,2019 for published documents on health system performance assessment.We also obtained unpublished documents from Ghana’s Ministry of Health,Ghana Health Service website,and Ghana Statistical Service database.Descriptive statistics were used to examine trends in the performance of the Ghanaian health system.Results:While the tool provides a national framework for evaluating the performance of the Ghana Health system in several domains,the Holistic Assessment Tool does not cover key health system domains such as information systems for health,access to essential medicines,and patient-centeredness.Also,the scope of the assessment program seems limited to the evaluation of the Ministry of Health’s annual plans,programs and projects.However,the health system has recorded improvements in population health indicators,such as life expectancy at birth,infant mortality,under-5 mortality,HIV prevalence and disease burden(in terms of disability adjusted life years).Conclusions:The Holistic Assessment Tool is a useful framework,but needs further refinement,both in scope and in conceptual robustness.Future studies should consider exploring factors influencing performance of the Ghanaian health system.Such information will help in strategizing for better and more improvements.

脑卒中患者主动健康行为概念框架的构建研究

背景脑卒中发病率逐年上升,行为控制是预防脑卒中直接有效的干预手段。主动健康医学模式提高了慢性病防控的主动性和可及性,而脑卒中患者主动健康行为概念内涵有待探索。目的探索脑卒中患者主动健康认知及行为方式,构建脑卒中患者主动健康行为概念框架。方法2023年8—10月,采用目的抽样方法,选取郑州大学第二附属医院神经内科的26例脑卒中住院患者作为研究对象,运用诠释主义扎根理论方法论,对26例脑卒中患者进行半结构式访谈,通过编码和持续性比较方法对资料进行分析。结果析出主题“脑卒中患者主动健康行为”的10项主范畴和4项核心范畴,包括“健康动机、健康责任、心理健康”3个内在行为,“生活方式管理”1个惯性行为,“主动遵医、社会关系、信息寻求”3个社会行为和“意识觉醒、自我控制、资源可及”3个干预条件,并确立概念框架。结论脑卒中患者主动健康行为概念框架包含内在行为、惯性行为、社会行为和干预条件,该框架有助于脑卒中患者主动健康行为测评工具的进一步开发和个性化干预措施的制订,对促进脑卒中患者主动健康行为的研究及实践具有指导意义。

The Sendai Framework for Disaster Risk Reduction and Its Indicators——Where Does Health Fit in?

The Sendai Framework for Disaster Risk Reduction 2015–2030 recognizes the strong connection between health and disasters and promotes the concept of health resilience throughout.Several of the seven global targets stated in the Sendai Framework are directly related to health in terms of reducing disaster mortality,the number of affected people,disaster damage to critical infrastructure,and disruption of basic services such as health facilities.The Sendai Framework also maintains close coordination with other United Nations landmark agreements relevant to health such as the Sustainable Development Goals.However,the measurement of healthrelated indicators is challenging.Issues arise,for example,in linking deaths to disasters because of the complex interplay between exposure,risk,vulnerability,and hazards.The lack of a universal classification of disasters also means that recording of health data in disasters is not standardized.Developing the guidelines to enable data onthe indicators to be collected and reported to support the Sendai targets requires detailed thinking,time,and consultation with a diverse range of stakeholders.Strong collaboration and partnership will be vital to achieving success.

Health Emergency and Disaster Risk Management (Health-EDRM):Developing the Research Field within the Sendai Framework Paradigm

The intersection of health and disaster risk reduction(DRR) has emerged in recent years as a field of critical inquiry.Health is recognized as an outcome and a goal of DRR,and the integration of both fields is essential to ensure the implementation of the Sendai Framework for Disaster Risk Reduction 2015–2030.Health Emergency and Disaster Risk Management(Health-EDRM) has emerged as an umbrella field that encompasses emergency and disaster medicine,DRR,humanitarian response,community health resilience,and health systems resilience.In September 2016,an international group of experts met in Hong Kong to assess the current status and potential of the Health-EDRM research field,a research area that these scholars characterized as underdeveloped and fragmented.Key challenges identified include research overlap,lack ofstrategic research agenda,absence of consensus regarding terminology,and limited coordination between stakeholders.The Sendai Framework provides a useful paradigm within which to shape the research field's strategic development.The WHO Thematic Platform for Health-EDRM Research Group was established to coordinate activities,promote information-sharing,develop partnerships,and provide technical advice to strengthen the Health-EDRM research field.This group will promote the generation of robust and scientific health research to support the meaningful implementation of the Sendai Framework.

Health Emergency and Disaster Risk Management: Five Years into Implementation of the Sendai Framework

The Sendai Framework for Disaster Risk Reduction 2015–2030 recognizes health at the heart of disaster risk management(DRM)at the global policy level.Five years on,it has catalyzed the rapid development of the field of Health Emergency and Disaster Risk Management(Health EDRM)by providing a mandate for building partnerships as well as enhancing scientific research.Key milestones achieved include publication of the World Health Organization’s Health EDRM Framework,development of the WHO Thematic Platform for Health EDRM and the WHO Health EDRM Research Network,and further application of health information principles to DRM.Furthermore,health actors at all levels have continued to engage in the Sendai Framework processes and have had a key role in its implementation and proposed monitoring.There have been significant gains made through the partnership of health and DRM,but the relationship has not been without its challenges.Many national,regional,and global initiatives continue to operate with a lack of consistency and of linkages to respond to the Sendai Framework’s call for embedding health resilience in DRM,and conversely,embedding DRM in health resilience.Overcoming this hurdle is important,and doing so will be a key marker of success of the next 10 years of partnership under the Sendai Framework.

基于PHM技术的动车组牵引设备健康管理系统分析

阐述基于PHM技术的动车组牵引设备健康管理系统的设计和应用,通过对系统的需求、功能架构设计以及关键技术的分析,为动车组牵引设备的健康管理提供一个全面、实用的框架。

中国人群健康相关生命质量概念框架构建:基于一般人群与疾病患者的质性研究

目的:探索中国人群对于健康相关生命质量(Health-related quality of life,HRQoL)定义的理解,构建中国人群HRQoL概念框架,用于指导中国人群HRQoL测量工具研发。方法:从全国31个省市招募中国一般人群与疾病患者样本,通过开展一对一半结构化质性访谈收集其对HRQoL的看法与理解。基于扎根理论对质性信息进行多层次编码,利用框架法对编码进行梳理、归纳,构建中国HRQoL概念框架。结果:共纳入68名受访者,研究从质性信息中提取1558个一级编码,分析整理为180个二级编码、31个三级编码,最终归纳出6个主题的中国人群HRQoL概念框架。结论:基于中国人群健康观念构建的HRQoL概念框架包含症状、身体功能、情绪、认知、活动、社会功能6个主题,其中尤以胃口/食欲、睡眠和疲乏维度显示出HRQoL概念的中国文化特异性。

《老年共病管理中国专家共识(2023)》要点解读

伴随着全球老龄化的快速进程,老年共病的患病率随增龄而增加,已成为威胁老年人群健康的重要问题。老年人的共病管理存在较大差异,目前尚无适用于我国老年共病患者管理的指南。2023年北京协和医院老年医学科牵头发布了《老年共病管理中国专家共识(2023)》,探讨了老年共病的概念及影响、管理目标、管理原则、管理策略;为老年共病管理实践提供具体建议,促进健康老龄化。该文旨在对该共识的要点进行解读,以期为我国老年人的共病管理提供参考。

基于CIPP模型的《健康管理》虚拟仿真教学评价指标体系构建研究

目的:“健康中国”战略背景下,为适应公共卫生相关专业课程的虚拟仿真实训建设,满足新时代健康管理的人才培养要求,本研究旨在为健康管理虚拟仿真教学构建一套系统的评价指标体系。方法:通过文献研究和访谈法,初步形成了以CIPP评价模型为整体框架的健康管理虚拟仿真教学评价指标池;以德尔菲法开展两轮专家咨询,结合界值筛选标准和专家意见,对指标进行增删、修改等调整;采用层次分析法,以Yaahp 12.0软件构建层次结构模型和判断矩阵,确定最终指标体系以及各级指标权重。结果:两轮专家咨询的积极系数均为100%,建议提出率分别为63.64%、18.18%,C_(r)分别为0.814、0.841,Kendall′s系数分别为0.181(0.084~0.231,P<0.001)、0.182(0~0.211,P<0.001);各级指标权重判断矩阵一致性良好(CR<0.1);最终建立了一个涵盖课程开发、课程输入、教学过程和教学效果四个维度,共有4项一级指标、17项二级指标和63项三级指标的健康管理虚拟仿真教学评价指标体系。结论:本研究所构建的健康管理虚拟仿真教学评价指标体系,内容全面且系统,专家参与度高、权威性强,咨询结果科学、可靠,能够适用于评价高校健康管理课程的虚拟仿真教学质量,为健康管理虚拟仿真教学的整体设计、内容输入、实施开展和课程效果等评价提供理论参考。

国内外儿童整合型健康管理服务模式的概念与框架的研究进展

我国儿童医疗资源和健康管理服务需求长期失衡,基层医疗卫生机构尤其突出。如何在基层医疗卫生机构现有存量的儿童医疗资源下实现整合和优化成为亟待解决的难题。本文主要归纳及分析了有关儿童整合型健康管理服务的概念和框架,包括儿童健康评估、早期干预、长期随访和案例研究与实践经验4个方面的内容,通过梳理国内外文献,总结了可实施的儿童整合型健康服务模式,通过本综述认为整合型健康管理服务具有广泛的潜力和应用前景,能为儿童提供个性化及高效的健康管理和干预新途径。

样本构成的异质性对基层慢性病管理质量调查结果影响的多重对应研究

背景医疗卫生机构慢性病管理能力评估是慢性病管理中很重要的内容,但研究者在使用相关量表时没有重视样本异质性对调查结果科学性的影响。目的基于成都市基层医疗卫生机构慢性病管理质量的调查,探讨样本构成的异质性对量表评价结果的影响并提出对策建议。方法2022年2月,采用多阶段分层整群抽样从成都市23个地级市、区(县)、46家基层医疗单位选取889名医务人员作为样本,使用中文版慢性病保健评估量表(ACIC)评估医疗单位的慢性病管理质量评分,采用多重对应分析探索性别、工作年限、职称、学历、岗位构成不同带来的样本异质性对评分的影响。结果医务人员慢性病管理能力总评分与其学历呈负相关,与职称呈正相关(P<0.05);研究对象慢性病管理能力决策支持维度评分与工作年限呈负相关(P<0.05);研究对象慢性病管理能力信息系统维度评分与工作年限呈负相关,与学历呈正相关(P<0.05)。多重对应分析结果提示:(1)总体上医务人员学历越高,给出的慢性病管理能力总评分越低;中级职称倾向于给予最高的评分。(2)决策支持评分维度,工作年限越长的医务人员倾向于给予越高的评分。(3)信息系统评分维度,工作年限越短的人员倾向于给予越高的评分;大专/本科学历倾向于给予最高的评分。结论样本构成的异质性对基层慢性病管理质量评价量表的结果会产生确切的影响,这意味着评价会发生偏差,特别是不利于机构间的公正比较,以上提示量表的制订需要严格规范适用范围,量表信效度检验及推广使用中需要重视样本的构成情况,保证其同质性,以确保基层慢性病管理质量评价的客观性、有效性。

武汉市结直肠癌筛查项目管理策略优化研究

目的优化武汉市结直肠癌筛查项目管理策略,以降低筛查成本,提高筛查效益。方法采用方便抽样法,选取39名关键知情人进行访谈。运用主题框架分析法对访谈资料进行整理分析。结果结直肠癌筛查流程包括宣传动员、实施筛查、结果告知、诊断治疗、随访管理5大关键环节,存在缺乏高危人群宣传动员方案、筛查项目开展时间较短、筛查流程较为复杂、样本质量不合格、采样包损耗、忽视健康宣教、对初筛阳性居民不能持续追踪、社区和定点医院信息共享不充分、结肠镜操作规范执行不严格等问题。结论应建立结直肠癌筛查长效机制,全面宣传动员,充分发挥基层医疗卫生机构作用,构建医院—社区闭环管理模式等。

重庆市某三甲医院医务人员体检数据分析

目的分析重庆市某三甲医院医务人员体检结果,了解医务人员健康状况及高发疾病,为制订健康管理策略、改善医护人员的整体健康水平提供科学依据。方法回顾性分析重庆市某三甲医院2021年及2022年医务人员的健康体检资料,统计分析一般情况、总体异常指标分布、不同性别异常指标检出率,比较2年不同性别异常指标变化情况。结果2021年与2022年的异常指标检出率分别为99.54%、99.55%,同时检出4项及以上异常指标检出率分别为53.98%、59.18%;2022年男性甘油三酯升高的检出率低于2021年,差异有统计学意义(P<0.05);2022年女性双侧乳腺增生、宫颈腺囊肿、甲状腺结节和子宫肌瘤检出率均高于2021年,差异均有统计学意义(P<0.05);排名前10的男女性共有检查项目异常指标包括尿酸升高、甲状腺结节、低密度脂蛋白胆固醇升高,男性医务人员该3项异常指标检出率2年变化情况比较,差异均无统计学意义(P>0.05);女性医务人员该3项异常指标中2022年尿酸升高、低密度脂蛋白胆固醇升高检出率均低于2021年,甲状腺结节检出率高于2021年,差异均有统计学意义(P<0.05)。结论医务人员有较严重的亚健康问题,男女性受检者2年所患疾病的种类与患病率变化情况均有所不同,应有针对性地进一步加强相关健康管理工作。

脑心健康管理师核心胜任力评价指标体系的构建

目的构建脑心健康管理师核心胜任力评价指标体系。方法以胜任力洋葱模型为理论框架,结合文献回顾、政策分析和半结构式访谈,建立了脑心健康管理师核心胜任力评价指标体系,并通过2轮德尔菲专家函询和层次分析法确定了各指标的权重。结果最终确定的脑心健康管理师核心胜任力评价指标体系由4个一级指标、16个二级指标和64个三级指标组成。2轮函询问卷的有效回收率均达100%;专家函询的判断依据达到了0.942;熟悉程度为0.919;权威系数为0.931;肯德尔和谐系数分别为0.202和0.243,均有统计学意义(P<0.05)。结论构建的脑心健康管理师核心胜任力评价指标体系科学合理、内容全面,可为脑心健康管理师的职责界定、评估和培训提供参考。