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.

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.

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.

Prevention and control measures to further optimize COVID-19 response

On November 11,2022,the Chinese government released the Scientific and Targeted Prevention and Control Measures to Optimize COVID-19 Response.Since that time,adjusted measures have been implemented throughout China,leading to major shifts in implementation of the national prevention and control strategy.On the basis of the current situation of the epidemic and the evolving SARS-Cov-2 variants,an additional 10 specifications(referred to as“the 10-point measures”)were officially released on December 7,2022,in an effort to further optimize the prevention and control measures.The latest adjustments pertain to the specification of:precise delineation of high-risk areas,nucleic acid testing scheme,isolation and health monitoring,restriction and lifting of high-risk areas,medicine supply,vaccination rollout among older people,health status of key populations,social functioning,and campus response.

Scientific and targeted prevention and control measures to optimize COVID-19 response

Since the outbreak of the COVID-19 pandemic,under the strong leadership of the Central Committee of the Communist Party of China and President Xi Jinping,China has made firm decisions to prioritize people's lives and health.Efforts have been made to avoid foreign imported infection and domestic rebound of COVID-19 cases;the“dynamic zero COVID”policy has been executed without wavering;and the prevention and control measures have been optimized and improved in response to changing circumstances,actively responding to the impact caused by multiple waves of COVID-19 surge globally.China has made extraordinary efforts to safeguard people's lives and health.Meanwhile,prevention and control measures were timely updated to coordinate with economic and social development.On November 10,the Standing Committee of the Central Political Bureau held a meeting to discuss the latest situation of the COVID-19 pandemic in China.Twenty measures(referred to as“the 20-point measures”)were officially announced to further optimize the COVID-19 response.The latest prevention and control measures involve the requirements and guidance for isolation at home,high-risk area delineation,nucleic acid testing,international inbound flights and travelers,vaccination rollout,medical resource preparedness,and protection for special places and vulnerable population.

Sustainable Community Epidemic Prevention Countermeasures against Public Health Emergencies

How to deal with public health emergencies is an important issue related to the normal life of community residents. However, after the corresponding understanding, it is found that a series of unsustainable epidemic prevention factors have been exposed in the community in the COVID-19, such as blocked access to basic materials, unsafe living environment, and lack of social platforms. In view of these problems, based on Maslow’s hierarchy of needs, the changes in the hierarchy of needs of residents during the epidemic were analyzed, and sustainable community epidemic prevention strategies were proposed from five aspects of material storage, safe environment, social platform, respect opportunity and self-worth realization, so as to provide effective reference for future response to public health emergencies.

The impact of accountability on local officials’behavior in the pandemic prevention and control in China based on utility maximization

Background:The COVID-19 pandemic is a public health crisis and an inspection of national governance systems and crisis response capabilities of countries globally.China has adopted a tough accountability system for officials and has succeeded in containing the spread of the pandemic.This study aimed to assess the impact of accountability on local officials’behavior in the pandemic prevention and control based on the official promotion tournament theory and utility maximization analysis framework.Methods:The panel data of 237 Chinese cities were extracted with local officials’characteristics,confirmed cases,Baidu migration index,Baidu search index according to city names,and data were excluded with local officials’relocation or sub-provincial cities between January 1,2020 and May 5,2020.Promotion gain and accountability cost were constructed by adopting promotion speed indicator,and the research hypotheses were assumed based on the utility maximization.It was the first time to apply the interaction model to empirically investigate the relationship between the promotion speed of local officials and the COVID-19 confirmed cases.Results:Our study showed that the promotion speed of provincial governors and mayors significantly affected the number of confirmed cases(β=−11.615,P<0.01).There was a significant interaction between the promotion speeds of provincial governors and mayors(β=−2594.1,P<0.01),indicating that they had a coordinated effect on the pandemic control.Additionally,mayors with different promotion speeds made a significant difference in controlling the imported cases and those who promoted faster better controlled the imported cases(β=−0.841,P<0.01).Mayors with full-time postgraduate education,titles,and majors in science and engineering had a better effect on controlling the number of confirmed cases.Conclusions:Our study provides evidence that the official accountability system has played an important role in containing the pandemic,which suggests that local officials motivated by the accountability system would respond to the pandemic actively for higher utility.Furthermore,provincial governors and mayors have played a coordinated effect in pandemic control.The above evidences reveal that implementing the official accountability system could improve the government’s emergency management capability and the efficiency of pandemic control.Therefore,adopting a strict accountability system could be effective in pandemic containment globally,especially in centralized countries.

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.

Factors influencing the tobacco control policy process in Egypt and Iran:a scoping review

Introduction:Tobacco control policy is essential for addressing the growing tobacco consumption seen in the Eastern Mediterranean Region,the single greatest preventable contributor to the non-communicable disease epidemic.Egypt and Iran have had varied success in using policy to combat this issue.The study aims to identify and compare the factors which have influenced different stages of the policy process-evidence generation,development and implementation.Methods:A scoping review was conducted with a systematic search of 7 databases which was conducted along with searches of Google Scholar,and the World Health Organisation and Eastern Mediterranean Regional Office websites to identify influencing factors at each stage of the policy process.Results:Twenty-seven relevant articles were identified from the literature search.Factors identified as influencing tobacco control policy in these countries were lobbying by the tobacco industry,the rise of water-pipe smoking,lack of political commitment and the lack of resources to for policy implementation.Iran was found to be leading Egypt on all three areas of the policy process.Implementation was found to be the most pivotal part of the policy process and the area in which Egypt was weakest compared to Iran.Conclusion:This study addresses a gap in knowledge concerning tobacco control in the Middle East and has identified multiple factors which are potentially slowing the process of enforcing policy to address tobacco consumption.Iran is the regional leader for tobacco control and it is important for Egypt to assess the transferability of its tactics and immediately start implementing measures to control tobacco use.

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.

云南省州(市)级疾控中心卫生应急能力现况调查及评估

[目的]了解云南省州(市)级疾控中心卫生应急能力现状,为下一步疾控中心卫生应急能力建设提供参考。[方法]采用自制问卷对云南省16个州(市)级疾控中心开展横断面调查,调查内容包括卫生应急工作组织建设、应急队伍建设和管理、突发事件现场处置情况等。使用Excel建立数据库,使用SPSS 25.0进行主成分分析计算卫生应急综合能力得分。[结果]云南省16个州(市)级疾控中心均组建了应急队伍,9个单位(56.3%)设立了独立应急办。应急队伍专业处置、后勤保障、综合管理岗位队员比例平均为17∶2∶1,现场流调箱、个人携行装备等主要装备全覆盖配置率为75.0%。应急队伍后勤保障装备主要依托云南省“双提升”工程配备。2020-2022年,各单位均组织过应急培训和演练,演练队员参与率76.3%、装备使用率50.2%;16个单位共派出5130人次对611起突发事件开展现场处置;抽查的173起突发公共卫生事件采样检测率86.6%、实验室判明率80.2%。各单位卫生应急综合能力得分区间为-1.4305分~5.6047分。[结论]云南省州(市)级疾控中心卫生应急能力正逐步发展,但地区间发展不平衡。云南省“双提升”工程很大程度提升了各单位应急装备水平,但州(市)级卫生应急队伍现有人员、装备和技术能力尚不满足实际工作需求。

突发重大公共卫生事件中信息疫情防治策略研究

突发重大公共卫生事件涉及范围广泛、影响区域庞大,对社会发展以及人民生命健康构成重大威胁。信息疫情防治策略的研究在突发重大公共卫生事件中起着举足轻重的作用。本文从背景、挑战、策略以及未来展望4个方面,探讨了突发重大公共卫生事件背景下的信息疫情防治策略。通过运用信息化技术构建突发重大公共卫生事件防控体系,普及健康教育和卫生知识,建立突发重大公共卫生事件知识库,将能够更为有效地预防和控制突发重大公共卫生事件的扩散,保障社会稳定以及人民身心健康。

2023年江苏省疾控机构公共场所卫生监测能力现状调查

目的了解2023年江苏省各级疾控机构公共场所卫生监测能力现状,分析存在的问题及其原因。方法于2023年6月,采用普查的方式,问卷调查江苏省所有市级和县级疾控机构公共场所卫生监测能力(人员配置、指标检测能力及其计量认证通过率)现状,并对不同级别、不同地区疾控机构进行比较分析。结果调查覆盖江苏省全省13个设区市,95个县(市、区)。共回收疾病预防控制机构调查问卷111份,其中市级13份,县级98份;调查内容涵盖人员队伍状况和实验室检测能力5大类31项检测指标。在人员配置方面,市级疾控机构环境卫生岗位设置以专职为主,县级以兼职为主。31项检测指标中,以市级为单位,13家市级总指标计量认证通过率为86.1%(347/403),以县级为单位,98家县级总指标计量认证通过率为51.2%(1555/3038);在计量认证通过率方面,市级疾控机构高于县级。在具备检测能力且通过计量认证指标监测能力方面,室内空气PM2.5等8项;公共用品用具pH值等2项;游泳池水、浸脚池水及沐浴水浊度等5项指标监测能力在不同级别疾控机构之间存在差异(χ2为3.87~42.05,P<0.05)。不同地区疾控机构在31项检测指标中,室内空气类氨和集中空调通风系统冷却水及沐浴水类嗜肺军团菌在不同地区疾控机构之间存在差异(χ^(2)分别为8.81和6.39,P<0.05)。监测能力整体评估显示,市级疾控机构公共场所卫生监测能力普遍高于县级,且苏中地区监测能力超过苏南和苏北地区。结论按监测能力综合评估,江苏省县级疾控机构公共场所监测能力总体较低,不同级别疾控机构中市级在人员配置及卫生监测能力上均高于县级,不同地区疾控机构在人员配置及卫生监测能力上存在地区差异,苏北地区以年轻人为主,苏中地区监测能力超过苏南和苏北地区。

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。

本质安全视域下健全平安建设长效机制的思考——以H省为研究样本

本质安全作为一种高层次的安全管理理念,强调从源头防范化解系统性风险和预防事故的发生。H省自2021年9月践行本质安全理念以来,持续致力于健全平安建设长效机制,坚持控增量、减存量、防变量的原则,在“预”字上下足功夫,在“防”字上做好文章,全力以赴打击犯罪,积极化解积案和矛盾纠纷,开展了一系列有益探索。结合多地实践来看,平安建设的长效机制构建还存在一些问题。对此,基于本质安全视角客观审视这些问题,建议从强化社会治理共同体、创新公共安全体制机制、完善社会治安防控体系、筑牢舆情风险立体化防控体系、健全应急管理体系等方面着手促进长效机制建设,为平安建设更高水平、可持续发展打造坚实的支撑。

公共卫生管理在传染病预防中的作用及对预防能力的影响

目的分析公共卫生管理在传染病预防中的作用及对预防能力的影响。方法选取2022年7月—2023年7月福清市疾病预防控制中心的40名医务人员为观察对象,根据单双号分发法分组,单号的20名医务人员被划分至常规组(开展常规预防管理干预),双号的20名医务人员被划分至研究组(常规组的基础上开展公共卫生预防管理干预)。分析2组医务人员的预防能力评分、应急能力评分、健康宣教评分、操作技术评分、心理护理能力评分、配合度评分等。结果测评医护人员的预防能力评分、应急能力评分结果显示,研究组各项评分为(9.31±0.22)分、(9.41±0.25)分,均高于常规组(6.21±0.23)分、(6.42±0.24)分(P<0.05);测评医护人员的健康宣教评分、操作技术评分、心理护理能力评分、配合度评分结果可知,研究组各项评分为(9.42±0.26)分、(9.36±0.22)分、(9.21±0.13)分、(9.32±0.27)分,均高于常规组(7.39±0.25)分、(8.35±0.18)分、(7.12±1.14)分、(8.34±0.25)分(P<0.05)。结论在传染病预防中应用公共卫生管理干预可以有效提升医护人员的预防能力、操作技术水平及应急能力,预防传染病发生率,应用效果十分显著。

公共卫生管理在传染病预防中的应用策略

传染病预防工作在近些年备受社会关注,预防传染病的管理方案也越来越多样化,当前比较常见的传染病有艾滋病、流行性感冒、乙型肝炎等,这些病症都具有流行性特征,且病原体传播速度非常快,能够在短时间内产生大量传染病患者,为公共卫生管理工作带来很大负担,而科学预测与防范控制传染病对保障公众健康生命权益极为有利,彰显公共卫生管理的地位。就传染病预防角度分析,公共卫生管理内容具有广泛性,其实施要点在于传染病预防知识宣传与创建应急预案,以全方位疾病防控工作,增强传染病预防成效。所以,对各级卫生机构、疾控预防中心等公共卫生管理机构来说,强化公共卫生管理,可有效控制传染病传播,严格落实传染病预防管理工作,有助于提升公共卫生管理质量。社会实践中,公共卫生管理成效得到很大提升,充分发挥了公共卫生管理对民众身心健康的保护作用,为大众构建了和谐的城乡发展环境。

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。

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。