潍坊市肾综合征出血热空间分布特征研究

目的 分析潍坊市肾综合征出血热（heworrhagic fever with revnal syndrom, HFRS)病例的空间聚集性,探索疾病高发地区。方法 以乡镇为单位收集2005-2018年潍坊市HFRS病例报告数据,分析全局空间相关性和局部空间相关性。利用ArcGIS软件使其可视化。 结果 潍坊市HFRS报告病例数由2005年612例下降到2011年153例, 2018年报告病例数上升到253例;全局空间自相关分析显示,潍坊市2005-2018年报告病例数Moran’s I值在（3.8509,11,3158）均>0且P<0.001,病例地区分布有明显空间正相关性;局部空间自相关分析显示,潍坊市HFRS报告病例存在低发病区域和高发病区域,低发病区主要在奎文区、潍城区、坊子区,高发病区主要在青州市、临朐县、高密市与诸城市。结论 潍坊市2005-2018年HFRS报告病例数总体上处于下降趋势,近年来报告病例数有所回升。各地区报告病例数在空间分布非随机分布,存在一定的空间正相关,具有明显的地区聚集性。     

2005-2006年吉林省肾综合征出血热疫情分析

目的分析2005-2006年吉林省肾综合征出血热（HFRS）的疫情概况,疫区分布及流行特点。方法收集2000-2006年吉林省（HFRS）的疫情资料并进行分析。结果从2006年开始,全省总体疫情平稳并有所下降,有新疫区的出现,也有个别地区报告发病数增加。结论近年来吉林省（HFRS）发病基本上处于一种平稳下降的趋势,应继续加强监测并采取有效的综合性防制措施。     

北京市顺义区1997-2010年肾综合征出血热监测分析

北京市顺义区1997年报告首例肾综合征出血热(HFRS)病例,之后发病数逐渐增加,疫区范围迅速扩大,发病率曾多年位居全区法定报告传染病前列。2004年HFRS疫情达到历史高峰,之后疫情总体呈下降趋势。为掌握顺义区HFRS的流行规律,指导防控工作,本研究对HFRS近年来的流行趋势和流行特征进行了分析。1材料与方法1.1资料来源历年HFRS发病及宿主动物监测资料来自顺义区疾病预防控制中心(CDC)防病科;人口资料来源于顺义区     

1980～2001年湖南省肾综合征出血热流行规律变化的分析

通过分析 2 2年来我省肾综合征出血热 (简称 HFRS)疫情监测资料 ,找出我省 HFRS流行规律的变化趋势 ,并以此作为制定合理、有效防治对策的依据。分析中发现 ,90年代较 80年代发病数下降了 9.19% ,改变了以往的上升趋势 ;但季节分布特征没有改变 ;过去一些老的肾综合征出血热高发地区近年来发病率明显下降 ,而其他地区近年来病例明显增多 ;感染人群职业分布构成比发生了一些变化 ;因此有必要调整 HFRS防治策略 ,探求新的控制方法     

内蒙古自治区1955-2009年肾综合征出血热疫情分析

目的分析内蒙古自治区1955-2009年肾综合征出血热(HFRS)流行特征,为采取有效防制措施提供科学依据。方法依据各年度疫情报告资料,运用计算机EXCEL97、SPSS2.0软件进行统计分析。结果内蒙地区HFRS流行特征如下:病例分布相对集中与稳固;2001-2009年报告发病数呈下降趋势;病区逐年增多;近年春峰、秋冬峰病例构成变化。结论如何在高发区HFRS继续开展以疫苗接种为主综合防制策略,巩固免疫成果;如何在新发和底发地区开展以健康教育为主综合防制策略控制流行仍然是我区严峻的现实。     

2010—2013年日照市肾综合征出血热疫情监测分析

目的根据日照市2010-2013年肾综合征出血热(HFRS)的疫情资料,分析HFRS流行特征和变化趋势。方法采用描述性流行病学方法和圆形分布对资料进行分析。结果 2010-2013年日照市累计报告HFRS病例633例,死亡5例,年均发病率为5.65/10万。HFRS发病有明显地季节性,9¹2月为主要流行季节。各区县东港区发病数最高。3012月为主要流行季节。各区县东港区发病数最高。30⁶9岁的男性农民发病占大多数。2010-2013年HFRS实验室诊断比例显著提升,4年间实验室诊断率的差异具有统计学意义(χ2=149.20,P<0.05)。结论日照市肾综合征出血热的主要传染源为姬鼠。农村是出血热的重点防控地区,男性青壮年农民是HFRS的高发人群。日照市各级医疗机构开展HRFS的实验室检测比例和检测准确率逐步上升。     

2012年大连市肾综合征出血热患者抗体IgM监测结果分析

目的通过对监测结果的统计分析,掌握大连市肾综合征出血热(HFRS)的流行规律,为防制HFRS提供科学依据。方法收集HFRS发病资料,描述HFRS病例分布特征;检测临床确诊或疑似出血热患者血清IgM抗体。结果大连市2012年50份患者血清标本,流行性出血热IgM抗体阳性率为70%,其中男性检测阳性率为58%,女性为12%,发病数男:女为4.83:1;职业以农民为主,阳性率为68%,城镇人群为12%;年龄以中老年为多,>55岁人群占总阳性数的38%;HFRS全年各月均有发病,发病的季节性分布日趋不明显,有呈现全年散发的态势。结论疑似病人血清IgM抗体检测是肾综合症出血热早期诊断依据。肾综合征出血热IgM抗体男性阳性率较高,应当加强农村野外地区HFRS的监测和防控。     

潍坊市肾综合征出血热季节性空间特征分析

目的 分析潍坊市肾综合征出血热(hemorrhagic fever with renal syndrome, HFRS)空间聚集性,探索HFRS病例的季节性流行特征。方法 以乡镇为单位收集2005—2019年潍坊市HFRS病例报告数据,描述HFRS病例的月度发病情况及地区分布情况,利用ArcGIS软件分析全年累计病例及不同发病高峰的全局空间相关性和局部空间相关性。结果 近年来潍坊市发病率在2.80～7.18/10万,总体上呈下降趋势;潍坊市HFRS病例报告出现春夏季(2—8月)和秋冬季(9月—次年1月)两个发病周期,潍坊市HFRS累计报告病例、不同发病高峰Moran’s I值在(0.5894,0.6977)且P<0.001,有明显空间正相关性;潍坊市HFRS报告病例存在青州-临朐交汇处、诸城南部2个高发聚集区和中心城区1个低发聚集区。结论 潍坊市HFRS病例报告存在2个病例高发区和1个病例低发区,有明显的空间聚集性,不同流行季节高发聚集区不同。     

太湖县1998～2007年肾综合征出血热流行病学分析

太湖县位于皖西南大别山南麓，属肾综合征出血热低发地区。2007年初，我县某乡镇暴发了1起输人性肾综合征出血热（HFRS）。为了全面掌握太湖县肾综合征出血热发病趋势和流行规律，研究制定防制对策，现对1998—2007年的疫情资料进行统计分析如下。     

江苏省2007年～2009年肾综合征出血热监测结果分析

目的：了解江苏省肾综合征出血热（Hemorrhagic fever with renal syndrome,HFRS）流行特征和流行因素,为制定防制对策提供科学依据。方法：对2007年～2009年全省HFRS疫情资料进行流行病学特征分析;设立固定监测点,调查鼠密度、鼠带病毒率、带病毒鼠指数及人群抗体阳性率。结果：2007年～2009年全省报告HFRS病例739例,平均发病率为0.32/10万,且以青壮年农民发病居多。春季和秋冬季各有一发病高峰,苏北秋冬峰病例占其发病总数的70.97%,且病例数有增多的趋势,苏南春峰占其发病总数的56.36%。混合鼠密度及优势鼠种密度均呈下降趋势,混合带病毒鼠指数在0.0073～0.0207间波动,一般人群平均抗体阳性率为12.84%。结论：江苏省2007年～2009年HFRS疫情维持在较低水平,但苏北和苏南流行特征明显不同,苏北部分城市疫情有上升趋势,流行因素仍然存在。     

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.     

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.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.