新婚育龄妇女对免费孕前优生健康检查的知识、态度、行为调查

目的：了解新婚育龄妇女的免费孕前优生健康检查相关知识、态度、行为（KAP）,为探索制定适宜高效的一级预防干预模式提供依据.方法：对2011年9月～2012年8月在吴川县和惠城区民政部门新婚登记的育龄女性进行出生缺陷一级预防和免费孕前优生健康检查的KAP调查.结果：1 178名新婚育龄妇女年龄25.19±3.34岁,71.39％妇女准备妊娠.83.4％的对象知道预防出生缺陷须从妊娠前开始准备;76.4％知道出生缺陷是由遗传与环境因素共同作用导致的;86.76％对象愿意参加免费孕前检查.关于孕前优生健康检查项目相关信息,调查对象对临床实验室检查了解最多,其次是健康检查,而关于地中海贫血、G6PD缺乏、其他遗传病筛查、优生四项筛查和免费咨询指导、健康教育和风险评估等内容了解较少.准备妊娠或已经妊娠妇女更希望享受免费优生检查;亲戚朋友参加过免费孕前优生健康检查的对象参与检查的意愿较强;化验结果的可靠性和保密性以及生育风险的评估等能增强对象参加免费孕前优生健康检查的意愿.结论：加强出生缺陷知识科普宣传和孕前保健,按需提供出生缺陷干预服务,改善计划生育技术服务水平,可提高目标人群孕前优生健康检查参与率.     

重庆市孕前优生健康检查人群出生缺陷与优生知识现状分析

目的了解重庆市参加国家免费孕前优生健康检查人群对出生缺陷与优生知识的掌握水平和需求情况,有针对性的为参检人群提供优生健康教育和服务。方法本研究采取分层随机抽样的方法 ,抽取2013年6~12月重庆市自愿参加免费孕前优生健康检查的育龄人群1 009名作为调查对象,对其进行问卷调查。结果参检人群的出生缺陷与孕前优生知识得分,不及格率57.0%,良好率仅21.5%。不同年龄、性别以及职业因素对出生缺陷与孕前优生知识的知晓情况差异比较有统计学意义(P0.05)。参检人群获得优生知识的途径主要为网络和书籍,参检人员希望获得优生知识和指导的途径有宣传册(58.1%),面对面咨询(56.9%),科普讲座(42.9%),电话咨询(29.5%)等方式。结论在开展国家免费孕前优生检查的过程中要加强对参检人员的预防出生缺陷与优生知识的教育和指导,针对不同人群特征制订措施,多渠道普及优生知识。     

农村已婚育龄妇女出生缺陷知识知晓和需求的调查

目的：了解农村已婚育龄妇女对预防出生缺陷知识的知晓状况、态度和需求,为建立出生缺陷一级预防模式和经常性工作机制提供依据。方法：随机选择河北省永清县7个乡镇已婚育龄妇女为调查对象,采用自行设计的问卷进行调查。结果：与出生缺陷相关的生物因素知晓率为13.40%～30.37%,物理因素知晓率为20.71%～56.04%。82.04%愿意接受预防出生缺陷知识宣传,〉85%认为优生咨询和检测有必要。获取预防出生缺陷知识的最佳人选是医生和计划生育工作者,最适宜方式是面对面咨询,最希望的服务为良好的孕产期保健。结论：农村已婚育龄妇女预防出生缺陷知识十分匮乏且需求广泛,建立一个有效的出生缺陷一级预防模式和经常性工作机制势在必行。     

育龄妇女对免费孕前优生健康检查的知识、态度和行为调查

目的对接受健康检查的育龄妇女进行调查,了解其对免费孕前优生健康检查的知识掌握、态度和行为方式,以加强对育龄妇女优生措施的制定提供重要的生物学材料。方法选取自2014年3月15日—2016年5月2日来安阳市文峰区妇幼保健所接受健康检查的待孕妇女共1 365名作为研究对象,采用事先设计好的问卷进行免费孕前优生健康检查的知识、态度和行为状况的调查。结果其中知道出生缺陷定义者占35.31%,知道性病与出生缺陷有一定相关性者占15.24%,知道孕前须进行优生检查者占65.35%,知道优生检查免费者46.38%,知道通过孕前优生检查能够有效避免出生缺陷者占60.95%。工人对妊娠前开始就可导致出生缺陷的知识知晓率最高,文职人员对性病与出生缺陷之间存在一定关系中知晓率最高,技术人员和文职人员对需要进行孕前优生检查知晓率较高,技术人员和文职人员对需要孕前优生性病筛查知晓率较高,对孕前可以进行风险评估及免费咨询指导文职人员知晓率最高,需要进行健康检查技术人员知晓率最高,而文职人员对实验室检查知晓率最高,技术人员对遗传病筛查、地中海贫血和G6PD缺乏知晓率最高。正准备妊娠、已妊娠,有意向、希望检查结果准确可信,有亲戚、朋友参加、可评估生育风险和保密性好几个因素能够影响育龄妇女接受健康检查。结论不同职业人群对免费孕前优生健康检查的知识、态度和行为不同,应该加强对不同职业人群的健康教育宣传。     

西安地区围孕期妇女出生缺陷KAP调查分析

目的 了解西安地区围孕期妇女的出生缺陷相关知识水平、态度、行为以及出生缺陷预防及优生促进服务人群需求状况,为一级预防干预提供技术支持.方法 2010年分阶段随机抽取西安市7个区县中准备妊娠及妊娠期妇女319人作为调查对象,采用访谈及问卷进行知识、态度、行为(KAP)调查,回收有效问卷315份.结果 西安地区围孕期妇女出生缺陷知识总体水平偏低,平均得分6.9分(10分制),农村妇女的知识掌握水平明显低于城郊地区(t＝4.327,P<0.001).但受教育程度的增加可显著提升妇女的知识掌握水平(P<0.01).态度方面,迫切希望参与出生缺陷预防及优生促进相关培训的妇女比例高达92.4%,但仅有38.1%的妇女是通过培训渠道获取的知识.行为方面,婚前检查和孕前优生检查的参与率偏低,分别为45.7%、58.1%,均显著低于88.3%的孕期常规产检率(P<0.001),而受教育程度的增加可明显提高三项检查的参与率(P<0.05).小剂量叶酸服用率达到79.2%,但正确服用率却仅为19.5%;居住农村,受教育程度低以及家庭经济状况差的人群,其叶酸服用率明显降低(均P<0.05).结论 西安地区围孕期妇女出生缺陷知识水平及相关医学检查参与程度均偏低,叶酸服用不规范,以农村为甚.优生促进培训服务急待增强.出生缺陷一级预防及优生促进工作需要全面深入开展.     

社区早孕妇女预防出生缺陷相关知识调查与对策

目的了解社区早孕妇女预防出生缺陷相关知识知晓情况，以更好地做好社区出生缺陷的一级预防工作。方法对早孕门诊中234名早孕妇女进行预防出生缺陷相关知识的问卷调查。结果本组调查对象中，28．2％（66／234）的早孕妇女知晓出生缺陷相关知识。其中，本市户籍知晓率为31．6％，显著高于非本市户籍的13．6％（P〈0．05）。大专及以上文化程度知晓率为38．2％，显著大于大专以下的9．8％（P〈0．01）。各年龄组间，出生缺陷知识知晓率的差异无统计学意义（P〉0．05）。所有孕妇对神经管畸形（NTDS）的预防知晓率最低，为53．0％。结论社区应宣传、普及孕前、孕期保健知识，做好出生缺陷的一级预防。     

重庆市育龄妇女孕前优生健康检查认知程度与知识获取途径研究

目的探讨重庆市育龄妇女对孕前优生健康检查的认知程度和服务获取途径,分析影响其主动获取孕前保健服务的原因,为有针对性的完善和制定有效的孕前保健推广策略提供科学依据。方法采取分层整群随机抽样的方法,对重庆市5大功能区10个区县育龄妇女进行问卷调查,调查其对孕前保健知识、免费孕前优生健康检查项目了解情况及知晓的途径等。采用χ~2检验和Kruskal-Wallis Test秩和检验进行数据分析。结果收回有效问卷2 100份。研究对象对孕前保健和建立健康生活方式知晓率69. 00%;对国家免费孕前优生健康检查知晓率81. 62%;对优生相关的传染病、病毒、遗传病的知晓程度依次降低,结果差异有统计学意义(χ~2=317. 746 5,P0. 000 1);不同职业间获取孕前优生知识的途径差异有统计学意义(χ~2=44. 329 7,P=0. 044 5)。结论找准目标人群对孕前优生健康检查的有效开展起重要作用。不同人群免费孕前优生检查知晓率有差异,应针对不同人群选用特定途径进行宣传。     

基层免费孕前优生健康检查现状浅析

<正>免费孕前优生健康检查项目以实施出生缺陷一级预防为主要内容,以孕前优生健康检查为重点,把预防关口前移,为广大育龄群众提供优生指导和服务,降低出生缺陷的发生风险。2012年抚宁县作为第三批国家试点县开展了该项目,2012、2013年共为6188对农村待孕夫妇提供了免费孕前优生健康检查,目标人群覆盖率分别为86.6%、93.83%。本文对抚宁县两年来免费孕前优生健康检查项目开展情况进行总结分析,浅谈开展该项目的工作体会。     

初次孕检女性出生缺陷一级预防认知现状调查分析

目的:了解孕前及孕期女性对出生缺陷及一级预防措施的认知情况,进一步提高出生缺陷一级预防健康教育的针对性,保证出生缺陷一级预防质量。方法:使用分层整群随机抽样问卷调查的方法,对2011年1月~2012年1月在早孕建册门诊进行初次孕检的孕妇400人进行问卷调查。结果:该区的出生缺陷一级预防知识认知情况总体较好,及格率75.00%,常住人口明显优于流动人口;孕期女性对出生缺陷预防知识的了解程度受孕妇年龄、职业、文化程度以及孕周等因素的影响;孕前及早孕期间对出生缺陷一级预防的认知直接影响后续的出生缺陷二级预防及孕产期保健等措施的实施。结论:1流动人口的优生健康教育方式需要改变;2准孕及早孕人群需要套餐式出生缺陷一级预防服务模式;3全面开展出生缺陷预防干预,首先要做好一级出生缺陷预防工作。     

育龄妇女免费孕前优生健康检查服务中综合干预的应用效果

目的观察育龄妇女免费孕前优生健康检查服务中综合干预的运用效果。方法选取辖区内的1 200例育龄妇女,均行免费孕前优生健康检查。按照检查服务中的不同干预措施将其分成对照组与观察组各600例,对照组给予常规干预,观察组给予综合干预,比较两种干预措施的运用效果。结果观察组育龄妇女对健康检查、优生检查、遗传病筛查、风险评估的知晓率均明显高于对照组,差异有统计学意义(P0.05);对照组新生儿的出生缺陷发生率为3.2%,观察组新生儿的出生缺陷发生率为0.8%,观察组明显低于对照组,差异有统计学意义(P0.05);对照组育龄妇女的满意度为85.8%,观察组育龄妇女的满意度为96.3%,观察组明显高于对照组,差异有统计学意义(P0.05)。结论综合干预在育龄妇女免费孕前优生健康检查服务中的运用效果满意,可明显降低出生缺陷发生率,提高服务满意度,值得推广。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.