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Evidence-based Healthcare and Public Health最新文献

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Healthcare public health in disasters and emergencies 灾害和紧急情况下的公共卫生
Pub Date : 2020-08-19 DOI: 10.1093/oso/9780198837206.003.0016
E. Jessop
Public health and health systems must prepare a plan for the emergencies and disasters that will inevitably occur sooner or later. Such plans are needed at global, national, and local levels. A basic framework for emergency preparedness will include a cycle of plan–prepare–respond–recover–report. Planning includes consideration of all events that may occur, prioritized by severity and likelihood. Preparation includes consideration of staff, supplies, structures, and systems—including decision and communication systems. For mass casualty incidents, public health will likely have a lesser role in the response phase; but for pandemics, public health expertise is crucial. A prolonged recovery phase must be expected, even for acute incidents such as earthquakes and terrorism. Post-disaster incident reports allow learning to be shared; such reports also feed back into a revised plan. Mental healthcare and service abroad require specific attention. The concept of ‘everyday resilience’ can help systems to cope.
公共卫生和卫生系统必须为迟早不可避免发生的紧急情况和灾害制定计划。在全球、国家和地方各级都需要这样的计划。应急准备的基本框架将包括一个计划-准备-应对-恢复-报告周期。计划包括考虑所有可能发生的事件,按严重性和可能性排序。准备工作包括考虑人员、供应、结构和系统——包括决策和通信系统。对于大规模伤亡事件,公共卫生在应对阶段的作用可能较小;但对于流行病,公共卫生专业知识至关重要。即使是地震和恐怖主义等严重事件,也必须预料到恢复阶段会很长。灾后事件报告可以分享经验教训;这些报告也会反馈到修订后的计划中。国外的心理保健和服务需要特别关注。“日常恢复力”的概念可以帮助系统应对。
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引用次数: 0
Health services for health promotion and disease prevention 促进健康和预防疾病的保健服务
Pub Date : 2020-08-19 DOI: 10.1093/oso/9780198837206.003.0013
J. Smith, J. Mapstone
The importance of social and environmental factors in determining the health status of a population provides the context for the role of health services in health promotion and disease prevention. Health service providers play important roles as advocates, leaders, and partners in disease prevention and health promotion strategies. The initial sections of this chapter discuss the definition of prevention, levels of prevention, and the place of population-wide and high-risk approaches. It then discusses some of the public health skills that are required in prevention programmes, including assessing needs and priorities, evidence of effectiveness, the role of behavioural and implementation sciences, and the importance of evaluation. The chapter illustrates these principles using examples from communicable and non-communicable disease control.
社会和环境因素在决定人口健康状况方面的重要性为保健服务在促进健康和预防疾病方面的作用提供了背景。卫生服务提供者作为疾病预防和健康促进战略的倡导者、领导者和合作伙伴发挥着重要作用。本章的开头几节讨论了预防的定义、预防水平以及全民和高风险方法的位置。然后讨论了预防规划所需的一些公共卫生技能,包括评估需求和优先事项、有效性证据、行为科学和实施科学的作用以及评估的重要性。本章用传染病和非传染性疾病控制方面的例子说明了这些原则。
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引用次数: 0
Access to healthcare in the remote and resource-poor region of the Brazilian Amazon 在巴西亚马逊偏远和资源贫乏地区获得医疗保健
Pub Date : 2020-08-19 DOI: 10.1093/oso/9780198837206.003.0002
Rodrigo Tobias, J. Schweickardt, M. Harris
Access to healthcare is a particular challenge in extreme, remote contexts, particularly in low- and middle-income countries. In Brazil, the primary care and social care policies of the early 1990s have led to remarkable improvements in healthcare access in urban, peri-urban, and rural contexts. This chapter examines the strategies that the Brazilian government has developed to address access in its most extreme context—the Amazon region. The chapter explores how these policies have had to be adapted to account for the extreme environments of the vast, impenetrable rainforest region of the Amazon and the particular needs of indigenous populations and fluvial communities.
在极端偏远地区,特别是在低收入和中等收入国家,获得医疗保健是一项特别挑战。在巴西,20世纪90年代初的初级保健和社会保健政策显著改善了城市、城郊和农村地区的医疗保健服务。本章考察了巴西政府在其最极端的情况下——亚马逊地区——为解决接入问题而制定的战略。这一章探讨了这些政策是如何调整的,以适应亚马逊广阔、密不透风的热带雨林地区的极端环境,以及土著居民和河流社区的特殊需求。
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引用次数: 1
Involving patients and publics in healthcare 让患者和公众参与医疗保健
Pub Date : 2020-08-19 DOI: 10.1093/oso/9780198837206.003.0004
C. McKevitt, N. Fudge, C. Pinel
Patients and patient organizations, and other members of the public and communities are widely recognized as important stakeholders in processes through which healthcare systems and services are designed, delivered, and monitored. Their involvement in these processes is promoted not only as a strategy to enhance the quality of systems and services, but also as an act of democratic participation. Yet putting involvement into practice is not straightforward. This chapter outlines the field of involvement in healthcare, focusing on some of the key areas of debate. These include definitions of involvement, the rationales put forward, involvement as represented in policy, and the methods used. The chapter summarizes some current key debates in relation to questions of who is involved, power, and evidence of effectiveness.
在设计、交付和监测医疗保健系统和服务的过程中,患者和患者组织以及其他公众和社区成员被广泛认为是重要的利益相关者。促进它们参与这些进程不仅是作为提高制度和服务质量的战略,而且也是作为民主参与的一种行为。然而,将参与付诸实践并非易事。本章概述了医疗保健领域的参与,重点讨论了一些关键的辩论领域。其中包括参与的定义、提出的理由、政策所代表的参与以及所使用的方法。本章总结了当前一些关于谁参与、权力和有效性证据等问题的关键争论。
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引用次数: 0
Population screening 人口筛查
Pub Date : 2020-08-19 DOI: 10.1093/oso/9780198837206.003.0014
A. Streetly, N. Houssami
This chapter outlines the concept and definition of population screening. It identifies key challenges and considerations in converting the simple concept of early identification of disease into population screening programmes. Ethical considerations are important in evaluating the potential benefits and harms of screening programmes. These inform the criteria used to determine whether it is appropriate to introduce screening. Screening tests must usually be sensitive to maintain public confidence in a screening programme, but specific tests are also required because false positives may often outnumber true positives in a population screening context. Assessment of screening programme effectiveness usually requires randomized controlled trials that minimize the potential effects of lead time and length bias. The chapter concludes by discussing policy decisions involving starting, stopping, and changing programmes, as well as how screening programme performance can be measured.
本章概述了人口筛查的概念和定义。它确定了将早期发现疾病的简单概念转化为人口筛查方案的主要挑战和考虑因素。在评估筛查计划的潜在利弊时,伦理考虑是很重要的。这些信息提供了用于确定是否适合进行筛查的标准。筛查测试通常必须敏感,以保持公众对筛查计划的信心,但也需要进行特定测试,因为在人口筛查中,假阳性可能经常超过真阳性。评估筛查方案的有效性通常需要随机对照试验,以尽量减少前置时间和长度偏差的潜在影响。本章最后讨论了涉及启动、停止和改变规划的政策决定,以及如何衡量筛选规划的绩效。
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引用次数: 0
Evaluating healthcare systems and services 评估医疗保健系统和服务
Pub Date : 2020-08-19 DOI: 10.1093/oso/9780198837206.003.0011
E. Jessop
Any jurisdiction needs to assess whether its healthcare system is performing well. There are many dimensions of evaluation, but a basic set includes saving life, relief of suffering, and treating patients with dignity: these may be monitored by statistics of mortality, quality of life, and patient experience. Sets of indicators can give a system-wide overview, and aspects of individual services can be evaluated by clinical audit. Confidential enquiries are useful for rare, serious events. Investigation may need to be followed by action, but the decision to act is never simple. New health systems can be evaluated by the standard research designs, but qualitative investigation is important.
任何司法管辖区都需要评估其医疗体系是否运行良好。评估有许多方面,但基本的一套包括挽救生命、减轻痛苦和有尊严地治疗病人:这些可以通过死亡率、生活质量和病人经历的统计数据来监测。一组指标可以提供全系统的概述,并且可以通过临床审计对个别服务的各个方面进行评估。机密询问对于罕见的、严重的事件是有用的。调查之后可能需要采取行动,但采取行动的决定从来都不简单。新的卫生系统可以通过标准的研究设计进行评估,但定性调查是重要的。
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引用次数: 1
Fire safety and adherence to medication resources 消防安全,坚持用药资源
Pub Date : 2005-12-01 DOI: 10.1016/j.ehbc.2005.09.012
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引用次数: 0
Comprehensive care in heart failure 心力衰竭的综合护理
Pub Date : 2005-12-01 DOI: 10.1016/J.EHBC.2005.09.003
B. Ltd.
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引用次数: 1
RETRACTED: Domestic smoke alarms 撤回:家用烟雾报警器
Pub Date : 2005-12-01 DOI: 10.1016/J.EHBC.2005.09.009
B. Ltd.
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引用次数: 0
Dissemination of science, FUTON bias and open access: implications for evidence-based medicine 科学传播、FUTON偏见和开放获取:对循证医学的影响
Pub Date : 2005-12-01 DOI: 10.1016/J.EHBC.2005.09.011
N. Murali, A. Ghosh
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引用次数: 3
期刊
Evidence-based Healthcare and Public Health
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