Silver Alerts: A Notification System for Communities with Missing Adults

ABSTRACT

As the U.S. population ages, the prevalence of dementia will grow and communities will face the problem of older adults wandering or becoming lost. Silver Alert systems are programs designed to locate missing older adults with dementia or other mental disabilities. Such programs have been initiated in all but five states. Data collection for these programs is often minimal or incomplete. Social workers should be involved in prevention, follow up and education with caregivers, community members and law enforcement officers. When reviewing Silver Alert policy, special attention must be given to ethical concerns and protection of older adults‘ civil rights.     

新型农村合作医疗的疾病风险分担能力研究 ——基于9省调研的实证分析

 基于9省调研,本文对目前新型农村合作医疗对农户疾病风险的分担能力及目标约束下的筹资规模方法进行了实证与比较分析。研究显示,农村居民中疾病风险分布的差异性较大;不同补偿方案下,新型农村合作医疗对农户疾病经济风险的分担能力差异较大;新型农村合作医疗制度目标的实现程度决定了筹资规模的大小。     

促进还是抑制:疾病负担对农村妇女非农就业的影响研究

本文利用2017年湖北省的微观调查数据,实证分析疾病负担对农村妇女非农就业的影响。研究发现:疾病经济负担显著促进农村妇女从事非农就业,而疾病照料负担显著抑制农村妇女从事非农就业,这种影响力度随着治愈时间增加而消减。进一步异质性分析表明,不同家庭成员患病对农村妇女非农就业的影响机制不同,老人患大病所产生的照料负担会驱使农村妇女增加非农就业,且儿童患大病所产生的经济负担也会迫使农村妇女减少非农就业。基于此,本文从农村疾病防治、集体照料和灵活工作制三个方面提出相关政策建议。     

医务社会工作在贫困肾衰竭患者治疗中的介入——以山东省立医院肾衰竭救助项目为例

医务社会工作自产生之日起,便以其特有的专业技能,在协助患者(家属)解决因病产生的各种社会以及心理问题,在促使患者早日康复中起着积极的作用。在中国大陆地区,专业化的医务社会工作尚处于起步阶段,本文以山东省立医院肾衰竭救助项目为例,通过医务社会工作在肾衰竭患者治疗过程中的介入,讨论医务社工在经济上如何对患者进行救助以及在心理上如何为其减压,并对医务社会工作者在介入工作中的方式与方法做一些探讨。     

Research Synthesis Methods in an Age of Globalized Risks: Lessons from the Global Burden of Foodborne Disease Expert Elicitation

We live in an age that increasingly calls for national or regional management of global risks. This article discusses the contributions that expert elicitation can bring to efforts to manage global risks and identifies challenges faced in conducting expert elicitation at this scale. In doing so it draws on lessons learned from conducting an expert elicitation as part of the World Health Organizations (WHO) initiative to estimate the global burden of foodborne disease; a study commissioned by the Foodborne Disease Epidemiology Reference Group (FERG). Expert elicitation is designed to fill gaps in data and research using structured, transparent methods. Such gaps are a significant challenge for global risk modeling. Experience with the WHO FERG expert elicitation shows that it is feasible to conduct an expert elicitation at a global scale, but that challenges do arise, including: defining an informative, yet feasible geographical structure for the elicitation; defining what constitutes expertise in a global setting; structuring international, multidisciplinary expert panels; and managing demands on experts’ time in the elicitation. This article was written as part of a workshop, “Methods for Research Synthesis: A Cross‐Disciplinary Approach” held at the Harvard Center for Risk Analysis on October 13, 2013.     

Modeling Undetected Live Poliovirus Circulation After Apparent Interruption of Transmission: Pakistan and Afghanistan

Since most poliovirus infections occur with no paralytic symptoms, the possibility of silent circulation complicates the confirmation of the end of poliovirus transmission. Based on empirical field experience and theoretical modeling results, the Global Polio Eradication Initiative identified three years without observing paralytic cases from wild polioviruses with good acute flaccid paralysis surveillance as an indication of sufficient confidence that poliovirus circulation stopped. The complexities of real populations and the imperfect nature of real surveillance systems subsequently demonstrated the importance of specific modeling for areas at high risk of undetected circulation, resulting in varying periods of time required to obtain the same level of confidence about no undetected circulation. Using a poliovirus transmission model that accounts for variability in transmissibility and neurovirulence for different poliovirus serotypes and characterizes country‐specific factors (e.g., vaccination and surveillance activities, demographics) related to wild and vaccine‐derived poliovirus transmission in Pakistan and Afghanistan, we consider the probability of undetected poliovirus circulation for those countries once apparent die‐out occurs (i.e., in the absence of any epidemiological signals). We find that gaps in poliovirus surveillance or reaching elimination with borderline sufficient population immunity could significantly increase the time to reach high confidence about interruption of live poliovirus transmission, such that the path taken to achieve and maintain poliovirus elimination matters. Pakistan and Afghanistan will need to sustain high‐quality surveillance for polioviruses after apparent interruption of transmission and recognize that as efforts to identify cases or circulating live polioviruses decrease, the risks of undetected circulation increase and significantly delay the global polio endgame.     

U.K. Foot and Mouth Disease: A Systemic Risk Assessment of Existing Controls

This article details a systemic analysis of the controls in place and possible interventions available to further reduce the risk of a foot and mouth disease (FMD) outbreak in the United Kingdom. Using a research‐based network analysis tool, we identify vulnerabilities within the multibarrier control system and their corresponding critical control points (CCPs). CCPs represent opportunities for active intervention that produce the greatest improvement to United Kingdom's resilience to future FMD outbreaks. Using an adapted ‘features, events, and processes’ (FEPs) methodology and network analysis, our results suggest that movements of animals and goods associated with legal activities significantly influence the system's behavior due to their higher frequency and ability to combine and create scenarios of exposure similar in origin to the U.K. FMD outbreaks of 1967/8 and 2001. The systemic risk assessment highlights areas outside of disease control that are relevant to disease spread. Further, it proves to be a powerful tool for demonstrating the need for implementing disease controls that have not previously been part of the system.     

绝经后女性冠心病患者性激素改变与血脂水平的研究

目的探讨绝经后女性冠心病(CHD)患者性激素水平的变化及与血脂的关系.方法对30例绝经后女性CHD患者和30例绝经后女性正常对照者的血清总胆固醇(TC)、甘油三脂(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、雌二醇(E2)、孕酮(P)、睾酮(T)、卵泡刺激素(FSH)、促黄体生成素(LH)进行了检测.结果两组间年龄、绝经年数差异无显著性.绝经后女性CHD患者较正常对照组的E2、E/T、HDL-C明显降低(P＜0.001、P=0.002、P=0.001),TC、TG、LDL-C增高(P=0.027、P=0.041、P＜0.001),两组T、P无显著性差异(P＞0.05).相关分析表明绝经后女性CHD患者的E2与TC、TG、LDL-C均呈显著负相关,与HDL-C呈显著正相关.E/T与TC、TG亦呈显著负相关.结论绝经后女性CHD患者血脂异常与雌激素水平明显降低有关,它们共同参与绝经后女性CHD的发生和发展.     

水产动物疾病学PBL教学模式实践效果

水产动物疾病学是水产养殖专业核心课程,具有较强的实践性和应用性.目前高等院校水产动物疾病学课程普遍存在教学方式单一死板、授课过程枯燥乏味、学生缺乏学习兴趣等问题,在水产动物疾病学教学改革中应用PBL教学模式的探索与实践表明,PBL教学模式使课堂教学变得通俗易懂、趣味十足,学生的学习兴趣大大提高,增加了对课程所授内容的理解和掌握,教学效果和质量显著提高.