The epidemic process as a system. I. The structure of the epidemic process

A new epidemiological concept (socio-ecological) has been formulated on the basis of the principles of the theory of systems and the theory of information. In accordance with this concept, the epidemic process is organized on the same principle as living matter, and the stability of this process at all levels of its organization is ensured by the processes of self-regulation. The conditions of the life of human society have been shown to be organically incorporated into the structure of the epidemic process as a regulating subsystem on the socio-ecological level.     

The system of epidemiological surveillance as a reflection of the structure of the epidemic process

The socio-ecological concept in epidemiology, formulated by the author in his earlier works and regarding the epidemic process as a biosocial hierarchical, integral system, can serve as a theoretical basis for the epidemiological surveillance of infectious and parasitic diseases. In accordance with the structure of the epidemic process, the system of epidemiological surveillance is subdivided into the following monitoring levels: molecular, microbiological, clinical, biocenological, statistical and sociological. The functions of epidemiological surveillance should be performed by the existing and newly organized All-Union Centers for the corresponding nosological forms.     

社会-生态系统恢复力的测量方法综述

恢复力和社会-生态系统研究的理论及实践近年来在西方较为流行,然而经过几十年发展,学术界仍旧没有对恢复力的概念达成一致,相应的测量方法更是多种多样。基于恢复力理论对系统相对稳定状态和边界的假设以及恢复力概念3个阶段的演变和理论的发展,总结了测量恢复力的5种方法,得出恢复力测量的3个发展现状或趋势:阈值和断裂点方法依旧是量化恢复力的基本方法;恢复力测量从关注时间转向空间,关注生态转向社会和社会-生态;复杂学和多学科融合的方法是未来发展的主要方向。     

基于适应性循环理论与压力-状态-响应框架的区域社会-生态系统演进研究

21世纪以来都市圈快速扩张对区域社会-生态系统的可持续发展构成威胁,基于动态演进视角的区域社会-生态系统运行机制解析备受关注。以南京都市圈为例,从区域和城市两个尺度,基于适应性循环理论与压力-状态-响应框架解析2000—2019年近20年来都市圈社会-生态系统的交互适应循环阶段,以及每个阶段系统的差异化应激响应机制。研究表明南京都市圈社会-生态系统整体经历了3个适应循环周期,现处于新一轮的适应性循环阶段,系统适应性呈上升趋势,但社会子系统和生态子系统尚未取得协调。都市圈内各城市的社会-生态系统演进类型有所不同,可分为稳定增长型、波动增长型、不均衡发展型和生态危机型四类。未来需要采取差异化的社会-生态系统治理策略,确保都市圈整体优化发展。     

Malaria and social health determinants: a new heuristic framework from the perspective of Latin American social medicine

Traditionally, malaria research and study have followed the positivist scientific paradigm and its biomedical conception of disease. From this perspective, diverse control actions and strategies have been designed. However, despite a century of scientific experience and the depth and thoroughness achieved in the knowledge of malaria, this has not been translated into a constant and progressive decrease of its epidemiological burden. This essay argues for the need for a change in malaria conception, reconfiguring it as a process of biological and social character, where the geno-phenotypical possibilities of the host-parasite relationship and of the diseases clinical expression are articulated with the historic and social dynamics of the spaces in which they occur. In addition, it proposes rethinking the epidemiological research of this entity on the basis of the visualization of the dynamic, heterogeneous, dialectic and complex character of biosocial organizations that constitute the reality of malaria (from the social structure to the genetic and phenotypic level of parasite individuals, vectors and humans). To achieve this, it is suggested that: 1) the Latin American perspective on the social determinants of health be adopted; 2) new analytical categories (for instance, malaria social territory) and new investigation tools (matrices of critical processes of social determination) be incorporated, and 3) the conventional epidemiological categories of infectious diseases such as the transmission and infectiousness be reinterpreted.     

社会-生态网络方法研究进展

社会-生态系统是由一个或多个社会和生态子系统交互作用形成的复杂的、非线性的、动态耦合系统。理解社会与生态子系统之间的复杂交互关系对于实现有效、可持续的环境治理至关重要。社会-生态网络方法是网络理论在社会-生态交互作用研究中应用与发展的产物,在定量刻画社会-生态系统结构、分析系统动态变化、推动系统适应性治理等方面具有重大的应用潜力。系统梳理了国内外现有的社会-生态网络研究,首先从网络的类型、构建模式、分析方法3个方面介绍社会-生态网络方法,并阐述其在资源管理、社会-生态匹配、社会-生态适应性治理领域中的应用,探讨社会-生态网络方法在研究社会-生态交互作用中的优势和挑战,最后提出未来社会-生态网络研究的重点方向,即社会-生态网络的动态变化过程以及社会-生态网络结构与功能关系。研究旨在深化网络分析可用于描述人—自然关系的认识,为社会-生态系统的网络研究提供实践指导,以期促进社会-生态网络方法在我国社会-生态系统研究中的应用。     

Functional outline of the epidemic process

The present study has shown that on the level of the parasitic system the epidemic process is a biological system, wherein the host population serves as the internal regulator, the mechanism of transmission serves as the external regulator and the parasite population, as the regulated object. The biological regulating mechanisms of the epidemic process have fundamental differences in the groups of infectious with various mechanisms of transmission, and the specific nature of the mechanism of transmission determines the peculiar features of the biological mechanism which governs the self-regulation of the epidemic process. In contrast, on a higher level of the organization of the epidemic process, i. e. on the level of the socio-ecological system, the epidemic process is a biosocial system, wherein the human society serves as the regulator, the parasitic system serves as the regulated object and the mechanism of transmission plays the role of the filter which determines the scope of social factors, most important in the regulation of the epidemic process in a given infection. The spontaneous regulation of the epidemic process is the freed forward channel from the regulator to the regulated object, and the controlled regulation is the feedback channel.     

Analysis of the possible mechanisms of the action of socioeconomic factors on the epidemic process whose biological base is an open parasitic system

The mechanism of action of socioeconomic factors on the epidemic process have been analyzed on the basis of the study of the influence, exerted on the biological properties of infective agents by environmental factors resulting from human activities, and the theory of the self-regulation of the parasitic system. Such mechanisms can be subdivided into the mechanisms affecting the epidemiological triad (the source of infection, the mechanism of transfer, and the susceptibility of the population) and the mechanisms facilitating the formation of infective agents with selective advantages (decreased virulence, resistance to antimicrobial preparations, etc.) under the influence of environmental factors resulting from human activities. The former mechanisms suppress and tend to localize the epidemic process, while the latter ones activate this process under the conditions becoming more complicated for the spread of the infective agent.     

Significance of epidemiological analysis for the development of epidemiology

The significance of epidemiological analysis for the study of the epidemic process is substantiated. The historical stages of the development of the doctrine on the epidemic process along with the role of epidemiological analysis in social and hygienic monitoring and epidemiological surveillance from the viewpoint of systemic approach are presented. The conclusion has been made on the necessity of the development of the systemic methodology of controlling the epidemic process and the sanitary and epidemiological situation.     

Doctrine of the transmission of the causative agents of infections and social and ecologic concepts of the epidemic process

The concept on social and ecologic determination of the epidemic process in its direct connection with L.V. Gromashevsky's doctrine on the transmission mechanism of the causative agents of infection is presented. The role of this concept in the development of epidemiological science is discussed.     

A system for the operative management of hospital infections in maternity hospitals]

A system for controlling the epidemic process of hospital infections in maternity hospitals and departments of infant pathology has been created. The specific feature of the proposed method is the prospective character of epidemiological surveillance: from the cause to the effect, and not vice versa. This is achieved by using the results of follow-up of the preconditions of the epidemic process activation (preterm delivery, gestosis, dry labor, birth injuries in mothers and infants) and the precursors of the beginning aggravation of the epidemic situation (the level of the contamination of infants with hospital microflora). Early information in this respect will help foresee the possible activation of the epidemic process of hospital infections and take necessary measures when infant infection rate is just elevated.     

The mechanism of the development of the epidemic process in Sonne dysentery

An epidemic outbreak of Sonne dysentery has been studied. The data of epidemiological monitoring before and after the epidemic have been analyzed. The real prognostication value of controlling the biological properties of Shigella sonnei and the increase of their intrapopulation heterogeneity at the period of the activation of the epidemic process of Sonne dysentery has been established.     

The general characteristics of the epidemic process and of the circulating streptococcal strains during an upsurge in scarlatina morbidity in Leningrad

The dynamics of scarlet fever morbidity in Leningrad for many years was studied and the absence of any effect produced by the existing system of preventive measures against this disease for the last 30 years was shown. On the basis of epidemiological and bacteriological data the authors came to the conclusion on the unity of the epidemic process of scarlet fever in the whole city and the relatively autonomous character of the process in individual districts. The necessity of the realization of epidemiological surveillance on streptococcal infection, with special emphasis on the multilevel social structure of the city and the wide use of the bacteriological diagnosis of streptococcal diseases, is substantiated.     

基于文化与政治生态学的社会生态系统演进机制研究 ——以杭州与西湖为例

科学认识社会生态系统演进机制是对其进行有效管理的重要基础。以文化与政治生态学为理论基础,提出适合杭州—西湖社会生态系统的综合研究框架,识别了杭州—西湖社会生态系统的5个演进阶段,并分析出系统演进中的3种潜在状态。自然、政治、经济以及社会驱动力是影响杭州—西湖社会生态系统的主导因素,人类行为影响整个生态系统中扰动的频率、大小和形式并改变西湖生态系统的结构与功能,进而影响西湖为城市提供生态系统服务的潜能。在不同历史时期,基于自然、社会、经济、文化等多层面的需求,西湖在不同系统状态下为城市供给不同类别和质量的生态系统服务,总体而言供给与调节服务比例逐渐下降,文化服务逐渐上升,并且后者逐步成为最主要的生态系统服务类别。杭州与西湖在长期的互馈共生中建立了社会生态系统的自适应性调节机制,其背后的生态智慧可为现代风景园林规划提供重要启示。     

The epidemiological differential diagnostic signs of viral hepatitis A and viral hepatitis E]

A retrospective epidemiologic analysis of cases diagnosed as hepatitis A (HA) has been made in territories characterized by high intensity (4 towns in Central Asia) and low intensity (Novomoskovsk, Tula Province) of the epidemic process development. Morbidity structures for different age and social groups of the population, as well as the morbidity time course, both annual and over many years, were analyzed over 1973-1986. Specific features in the development of the epidemic process in HA and hepatitis E (HE), formerly called hepatitis non-A, non-B with the fecal/oral mechanism of the infection transmission, were studied. Twelve epidemiological differential diagnostic signs of these two infections were formulated, classified, and validated. Contribution of centralized water supply and sewage systems to the development of HE epidemic process and the regulating role of infectious immunological mechanisms in the development of HA epidemic process were demonstrated.     

山区社会-生态系统转型测度——以三峡典型库区为例

三峡库区是集农村和山区为一体的社会-生态系统,研究其系统内部的相互作用和系统间的耦合转型有利于推动库区高质量的可持续发展。通过构建社会-生态系统耦合转型研究框架,采用地形位指数、耦合协调度模型等方法,以库区腹地草堂溪流域为例,揭示其社会-生态系统转型与否、转型路径的多样性及其驱动机制。结果表明：(1)2000—2020年三峡库区社会-生态系统数量-结构-功能均发生了显著变化,表明库区社会-生态系统发生了转型;(2)库区低地形位社会-生态系统表现为由社会生态型向生态经济型转变,中地形位表现为由生态社会型向生态主导、生态经济为辅转变,高地形位则表现为由生态调节型愈加趋向于生态主导型;(3)农户和政府需求变化是驱动社会-生态系统由传统耕地种植系统向新型经果林种植系统转型的根本因素;(4)研究方法证实对山区具有普适性,构建的研究框架较适合刻画山区社会-生态系统转型路径,在其他地方也能同样适用。     

社会-生态系统恢复力研究综述

目前国内外对脆弱性的论述很多,然而关于恢复力的研究却刚刚起步且困难重重。1973年Holling创造性地将恢复力引入到生态系统稳定性的研究中,并将其定义为系统吸收干扰并继续维持其功能、结构、反馈等不发生质变的能力。30多年来这一术语的概念和内涵在大量的案例研究中得到了丰富和完善,然而这些研究对恢复力的不同解释亦造成了大量的混淆,因此需要在统一的理论基础上,根据控制系统变化的属性来构建恢复力的概念并进行应用研究。在社会-生态系统框架下,分析了恢复力研究的基础理论——适应性循环及扰沌,对其概念及内涵做了进展综述,回顾了恢复力的应用案例,探讨了定量化问题,在此基础上对社会．生态系统恢复力的研究进行了展望,提出了面临的关键问题及今后的研究方向。     

Biological impact of social disruption resulting from epidemic disease

Whereas previous research on the disruptive effects of epidemic disease have focused on the ways in which epidemics affect social structure and function, this study focuses on the biological impact of social disruption. The hypothesis is that social disruption resulting from the occurrence of epidemic disease increases the biological impact of the epidemic, as assessed by disease incidence. This hypothesis is explored in terms of a "level of response" model, borrowed from Slobodkin and Rapoport (Q. Rev. Biol. 49:181-200, 1974). The Human Area Relations File (HRAF) provides ethnographic reports of social responses to epidemics. The most frequently reported response in the HRAF is flight or migration away from the locus of the epidemic, followed in frequency by extraordinary preventive and/or therapeutic measures and scapegoating. The model proposes a continuum of responses beginning with responses that are already part of the indigenous response to disease and proceeding through disruptive processes, including flight and rejection of authority systems. Social disruption increases the biological impact of epidemics by robbing the social group of important participants, dismantling public health programs, or producing general economic hardship. The model proposes a scheme for identification of situations under which particular social group responses are "biologically appropriate."     

Characteristics of the mechanism of the development of the epidemic process in meningococcal infection in organized collectives

The specific features of the epidemiology of meningococcal infection in organized groups have been established after comprehensive (epidemiological, microbiological and immunological) studies, evaluated from the viewpoint of the law of the autoregulation of the epidemic process. The studies have revealed the phenomenon of the adaptive biological variability of meningococci with their prolonged reservation due to the transformation of typical bacterial forms of meningococci characterized by strict serogroup specificity and typical fermentative activity into serologically and biochemically undifferentiated forms, capable of prolonged persistence in human populations. The model demonstrating the development of the epidemic process in meningococcal infection in an organized group has been worked out.     

基于传统生态智慧的江南水网空间韧性机制及实践启示

传统江南水网空间是一种典型的社会—生态系统,人文社会系统和自然生态系统之间的良性互动对于其韧性构建有着重要的积极作用。基于柯林斯等人提出的压力—冲击动态（PPD）模型,以平江府为典型代表,研究传统江南水网空间如何通过生态系统服务的桥梁搭建水网物质空间与人类社区发展之间的联系,从而厘清社会—生态系统在此过程中如何培育、优化和提升江南水网空间韧性。在此基础上,创新性地从生态系统服务供需关系的角度提出社会—生态韧性构建的生态智慧,并倡导以恢复力、适应力与变革力韧性机制培育为导向的、江南地区构建现代社区实践的若干启示,旨在引导江南水网空间实现具有韧性的社会—生态系统转型发展。