《水产动物疾病学》课程教学改革的探索与实践

分析了《水产动物疾病学》课程教学存在的问题,通过对教学手段、教学内容和教学方法的探索与实践,提出了增强课堂趣味性、改进教学方法的课堂教学改革措施,以及实践教学改革的措施:(1)多媒体教学与传统教学相结合;(2)注重搜集和制备疾病标本;(3)增补细节菌性疾病的课程实习;(4)积极开辟第二课堂。     

浅议难诊治疾病的医疗损害赔偿

医疗损害赔偿是特殊的民事损害赔偿，由疑难病症引发的医疗损害赔偿更为特殊。医疗损害赔偿应该实行严格的过错责任原则，同时引入医疗责任险作为补充。难诊治疾病有别于普通疾病，其治疗过程与损害结果之间存在的因果关系不是必然，且难以界定。因此，对于在难诊治疾病治疗过程中，造成的医疗损害赔偿同样应该严格按照过错责任原则，且在赔偿范围和指标上略低于普通的医疗损害赔偿。同时，为了缓解患方的风险，尤其应在难诊治疾病的治疗中引入医疗责任险。     

Geoadditive models

Summary. A study into geographical variability of reproductive health outcomes (e.g. birth weight) in Upper Cape Cod, Massachusetts, USA, benefits from geostatistical mapping or kriging . However, also observed are some continuous covariates (e.g. maternal age) that exhibit pronounced non-linear relationships with the response variable. To account for such effects properly we merge kriging with additive models to obtain what we call geoadditive models . The merging becomes effortless by expressing both as linear mixed models. The resulting mixed model representation for the geoadditive model allows for fitting and diagnosis using standard methodology and software.     

A large-scale initiative to disseminate an evidence-based drug abuse prevention program in Italy: Lessons learned for practitioners and researchers

Across developed countries, experimentation with alcohol, tobacco, and other drugs often begins in the early adolescent years. Several evidence-based programs have been developed to prevent adolescent substance use. Many of the most rigorously tested and empirically supported prevention programs were initially developed and tested in the United States. Increasingly, these interventions are being adopted for use in Europe and throughout the world. This paper reports on a large-scale comprehensive initiative designed to select, adapt, implement, and sustain an evidence-based drug abuse prevention program in Italy. As part of a large-scale regionally funded collaboration in the Lombardy region of Italy, we report on processes through which a team of stakeholders selected, translated and culturally adapted, planned, implemented and evaluated the Life Skills Training (LST) school-based drug abuse prevention program, an evidence-based intervention developed in the United States. We discuss several challenges and lessons learned and implications for prevention practitioners and researchers attempting to undertake similar international dissemination projects. We review several published conceptual models designed to promote the replication and widespread dissemination of effective programs, and discuss their strengths and limitations in the context of planning and implementing a complex, large-scale real-world dissemination effort.     

Bayesian multivariate Poisson mixtures with an unknown number of components

In this paper we present Bayesian analysis of finite mixtures of multivariate Poisson distributions with an unknown number of components. The multivariate Poisson distribution can be regarded as the discrete counterpart of the multivariate normal distribution, which is suitable for modelling multivariate count data. Mixtures of multivariate Poisson distributions allow for overdispersion and for negative correlations between variables. To perform Bayesian analysis of these models we adopt a reversible jump Markov chain Monte Carlo (MCMC) algorithm with birth and death moves for updating the number of components. We present results obtained from applying our modelling approach to simulated and real data. Furthermore, we apply our approach to a problem in multivariate disease mapping, namely joint modelling of diseases with correlated counts.     

Disease clusters: should they be investigated, and, if so, when and how?

Individual cluster reports are subject to several difficulties in interpretation. Although they rarely lead to new aetiological insights, a public health response to delineate the size and extent of any excess risk may be warranted. Further investigation, where merited, should usually include an examination of data for different areas and/or different time periods. A statistical evaluation of disease clusters is often secondary to a detailed appreciation of issues such as the availability and quality of data, confounding and bias in the selection of areas for study.     

A model for markers and latent health status

We extend the bivariate Wiener process considered by Whitmore and co-workers and model the joint process of a marker and health status. The health status process is assumed to be latent or unobservable. The time to reach the primary end point or failure (death, onset of disease, etc.) is the time when the latent health status process first crosses a failure threshold level. Inferences for the model are based on two kinds of data: censored survival data and marker measurements. Covariates, such as treatment variables, risk factors and base-line conditions, are related to the model parameters through generalized linear regression functions. The model offers a much richer potential for the study of treatment efficacy than do conventional models. Treatment effects can be assessed in terms of their influence on both the failure threshold and the health status process parameters. We derive an explicit formula for the prediction of residual failure times given the current marker level. Also we discuss model validation. This model does not require the proportional hazards assumption and hence can be widely used. To demonstrate the usefulness of the model, we apply the methods in analysing data from the protocol 116a of the AIDS Clinical Trials Group.     

宋本《伤寒论》中“相搏”为“相Bao”之讹误考

从现存《伤寒论》早期传本以及历代治仲景学之名家对“相搏”的注解等方面 ,对“相搏”为“相”之讹误进行了考证 ,同时亦对其产生的原因作了相关分析。指出现行《伤寒论》诸本中之“相搏”多为“相”之讹误。建议中医学术界对此进行深入的研究考证。同时希望日后再版《伤寒论》及其各种注释本时 ,对各版本中之“相”的处理持审慎态度     

党建视野下疾病预防控制机构人才培养策略浅析

人才是实现民族振兴、赢得国际竞争主动权的战略资源。自十一届三中全会以来,党中央高度重视人才培养与发展,多次提出并深化人才强国战略、党管人才原则。在国家和上海市层面的政策指引下,人才是第一资源的理念已深入贯彻到上海市卫生健康领域党的建设重要工作中。面对新时期疾病预防控制机构(疾控机构)人才培养在总量稳定性、培养体系、工作获得感方面存在的问题,文章提出疾控机构人才培养策略的主体思路是坚持人才强卫战略、党管人才原则,把握公共卫生人才成长规律,注重人才结构优化和治理,培养出国内领先、国际一流的服务于居民健康需要和公共卫生服务需求的疾控机构人才队伍,为上海乃至全国各地的疾控机构人才培养策略提供经验借鉴和参考。