太原市煤矿、建筑工人艾滋病知信行调查

[目的]了解太原市煤矿、建筑工人艾滋病相关知识、态度和行为状况,探讨三者之间的相关性. [方法]采用整群随机抽样方法.对太原市部分建筑工人和煤矿工人进行问卷调查,同时运用卡方检验、Logistic回归分析和相关分析对数据进行统计分析. [结果]共调查694人,其中建筑工人339(48.8%)人,煤矿工人355(51.2%)人.调查发现,艾滋病基本知识总知晓率为46.3%,两人群之间的比较差异无统计学意义(χ2=2.23,P>0.05).在所有被调查者中,仅有32.0%的人表示愿意与艾滋病人或其家属继续交往.在发生过性行为的调查对象中,仅有31.4%的人在最近一次性行为中使用了安全套.相关性分析结果显示,对艾滋病感染者或家属的态度与知识总分之间的相关系数(rs=0.231,P<0.01),是否有过不健康性行为与知识总分之问的相关系数(rs=0.113,P<0.05). [结论]太原市煤矿工人与建筑工人艾滋病防治知识水平有待进一步提高.由于知识、态度、行为三者问的相关性比较弱,所以在普及防治知识的同时,还需要加大对积极态度与健康行为的宣传教育.     

某中学301名新入校学生艾滋病防治知识、态度、行为的干预效果分析

目的了解新入校中学生艾滋病防治知识知晓程度、态度、行为现状,探讨对中学生艾滋病知识宣传及行为干预的有效方式。方法在某中学随机抽取301名新入校学生参加讲座,讲座前后分别进行问卷调查,收集调查对象对艾滋病防治相关知识、态度和行为等相关信息。结果干预前后有效应答率为90.03%、86.71%。干预后学生对艾滋病相关知识知晓率有了明显提高（P〈0.01）,除对拒绝吸毒和婚前性行为态度无明显改变外（P〉0.05）,对待其他艾滋病相关态度和行为均有明显的转变（P〈0.01）;干预前初一与高一学生艾滋病防治知识知晓率、相关态度、行为差异有统计学意义（P〈0.05或P〈0.01）。结论在中学生中开展艾滋病防治教育效果明显。在初中阶段开展艾滋病防治教育,更具有积极和广泛的意义。艾滋病防治知识健康教育作为预防艾滋病有效可靠的疫苗,应该作为初中生健康必修课,并考虑将初中生掌握艾滋病防治知识纳入毕业考核。     

农村教师艾滋病防治知识、态度、行为和效能调查分析

目的了解农村教师艾滋病防治知识、态度、行为和效能情况,为开展艾滋病防治的信息、教育、沟通(IEC)技能训练提供科学依据。方法对1200名农村教师进行《艾滋病防治问卷》调查。结果农村教师艾滋病防治知识比较欠缺,相关态度和行为有待改善,艾滋病防治上的自我效能感亟待提高。结论对农村教师开展艾滋病防治知识的健康教育十分必要。     

某高校学生艾滋病防治知识、态度、行为的干预效果分析

目的 为了解高校学生艾滋病防治知识知晓程度、态度、行为现状,探讨对高校学生艾滋病知识宣传及行为干预的有效方式.方法 随机抽取某高校学生295名,其中大一学生129名,其它年级学生166名,通过成立艾滋病防治知识讲师团,举办艾滋病防治知识讲座、宣传版面展示、提供咨询、发放宣传资料、张贴宣传画等方式开展一系列的艾滋病防治宣传教育活动,并在干预前后,以问卷调查方式,收集调查对象对艾滋病防治相关知识、态度和行为等相关信息.结果 在该校干预前后分别随机抽取的295名学生艾滋病防治相关知识、态度和行为等相关信息的调查应答率分别为:95.6%、97.6%.干预后学生对艾滋病相关知识知晓率有了明显提高(P<0.01),态度和行为也有了明显的转变(P<0.01),同时干预前大一学生与其他年级学生艾滋病防治知识知晓率比较也存在明显的差异(P<0.05).结论 在高校开展艾滋病防治知识的健康教育有明显效果,并且艾滋病防治工作必须从新生人校时抓起,因此,应继续加大宣传教育力度,进一步提高学生艾滋病防治知识知晓率和自我保护意识,促使他们树立健康、安全的性观念和行为,从而远离艾滋病的威胁.     

山东省某地农村外来妇女艾滋病知识、态度与行为调查

目的了解山东省农村外来妇女的艾滋病知识知晓情况、对艾滋病感染者和病人的态度及相关行为特征,为开展综合防治提供科学依据。方法采用整群抽样的方法,对某县级市1990年以来由外省(外国)迁入并与当地农村男性结婚的妇女进行艾滋病相关知识、态度与行为问卷调查。结果共调查963名外来妇女,关于什么是艾滋病、艾滋病是传染病、艾滋病三种主要传播途径等三项知识的知晓率分别为69.2%(66.1%~72.0%)、57.9%(54.7%~61.1%)、50%;对艾滋病病毒携带者和艾滋病人恐惧的占35.4%(32.4%~38.6%),讨厌的占8.3%(6.7%~10.3%);2.2%(1.4%~3.4%)的外来妇女有婚外性行为,0.3%(0.1%~1.0%)的外来妇女有吸毒史。结论该地外来妇女艾滋病防治知识缺乏,并且存在一定的高危行为,应及时开展形式多样的艾滋病相关知识的宣传教育和行为干预等综合防治工作。     

观澜社区居民艾滋病知识、态度、行为调查分析

目的了解社区居民艾滋病知识的知晓状况及态度、行为情况,探讨进行艾滋病健康教育的有效措施。方法采用问卷调查方式对社区居民艾滋病知识、态度、行为等方面进行现况调查。结果人群艾滋病相关知识总知晓率为72.6%,对待艾滋病的态度总正确率为67.6%,而赞同婚前性行为和婚外性行为的有29.4%。结论应加强社区居民艾滋病防治知识的宣传,让广大居民完整地了解艾滋病知识,坚定信念,转变态度,加强安全性教育。     

中老年艾滋病患者认知行为、态度调查

目的对中老年艾滋病患者的相关认知水平、行为、态度进行调查和分析,为更好地制定艾滋病防治措施提供参考。方法对2010年12月—2013年12月确诊为艾滋病的50例中老年患者进行匿名访谈式问卷调查。自行设计调查问卷,内容包括患者的一般资料、性病防治知识的认知、行为、态度等。统计调查结果,并进行分析,以便为艾滋病防控措施的制定提供数据支持。结果调查结果显示,中老年艾滋病患者对艾滋病知识的认知情况不理想,多数艾滋病知识题目回答正确的比例低于60%,尤其是艾滋病传播方面的题目回答正确的比例仅在30%左右;患者采用安全行为的比例不高,部分患者经常存在高危行为,一些患者有多个性伴侣;除了性行为相关态度,患者对艾滋病的相关态度较好,绝大部分患者支持尊重和保护感染者。结论中老年艾滋病患者普遍存在认识不全面、高危行为频繁的问题,必须进一步加强对其健康教育和干预,以尽可能切断传播途径。     

安徽省新闻媒体记者艾滋病防治知识、态度现状调查报告

新闻媒体对传播艾滋病防治知识可发挥重要作用。为了解安徽省新闻媒体记者艾滋病防治相关知识、态度状况，安徽省疾病预防控制中心于2006年7—8月对省、市、县3级新闻媒体记者进行了艾滋病防治知识、行为、态度现状调查。     

公共场所等从业人员艾滋病相关知识、态度、行为调查分析

[目的]了解食品、公共场所及饮用水从业人员的艾滋病相关知识、态度和行为及其影响因素,为制定艾滋病社区干预效果评价标准提供依据。[方法]采用横断面研究设计,对食品、公共场所及饮用水从业人员进行艾滋病相关知识、态度和行为状况的问卷调查,通过单因素分析、直线相关分析其影响因素。[结果]食品、公共场所及饮用水从业人员总体上对艾滋病基本知识缺乏了解,知识水平普遍较低,尤其是文盲和小学文化程度者、年龄偏大者、女性、农村居民和低收入者相关知识水平更低。对HIV感染者和AIDS病人的态度总体上较消极,而对待HIV/AIDS高危行为的态度较积极。食品、公共场所及饮用水从业人员的高危行为主要是婚前性行为和婚外性行为。自我保护能力和意识比较薄弱,但接受艾滋病和性病知识宣传教育的意愿较强烈。[结论]食品、公共场所及饮用水从业人员的艾滋病防治工作值得引起高度重视。     

艾滋病相关知识、态度对男男性行为人群高危性行为的影响

目的探索男男性行为人群(men who have sex with men,MSM)艾滋病相关知识、态度与高危性行为之间的关系,为开展艾滋病高危行为干预提供科学依据。方法采用自制评估问卷对前来自愿咨询检测(voluntarycounseling and testing,VCT)门诊/同志活动中心咨询的MSM进行艾滋病相关知识和态度评估,分析艾滋病相关知识、态度与高危性行为的关系。结果 199例调查对象艾滋病知识总体知晓率为66.3%,15.1%认为自己对艾滋病预防知识非常了解,40.2%对艾滋病持正向态度。艾滋病预防知识自评"了解一些/不了解"的调查对象无保护肛交性行为发生的风险是"大致了解/非常了解"的2.05倍;艾滋病相关态度呈负向的调查对象无保护肛交性行为发生的风险是正向态度的2.61倍。结论 MSM对艾滋病防制知识尤其是安全性行为的知识缺乏全面的认识,艾滋病相关知识认知不足,态度呈负向的MSM发生无保护肛交性行为风险较高。     

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.     

Fatigue and health in a seafaring population

Background Occupational fatigue is relatively common withinthe general population and has been linked to reduced performance,injury and longer term ill-health. Despite growing acknowledgementof this problem in the maritime sector, little research hasbeen conducted into the risk factors, prevalence and consequencesof seafarers' fatigue. Aims To examine the prevalence of fatigue among seafarers, identifypotential risk factors and assess possible links with poor performanceand ill-health. Methods Cross-sectional questionnaire survey of seafarers workingin the offshore oil support, short-sea and deep-sea shippingindustries. A number of tools were used including the fatiguesubscale of the profile of fatigue-related symptoms, the CognitiveFailures Questionnaire, the General Health Questionnaire andthe SF36 General Health scale. Results In all, 1855 questionnaires were completed giving anoverall response rate of 20%. Fatigue symptoms were associatedwith a range of occupational and environmental factors, manyunique to seafaring. Reporting a greater number of risk factorswas associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35)for those with three or four risk factors and OR = 9.54 (6.95–13.09)for those with five or more risk factors]. There was also astrong link between fatigue and poorer cognitive and healthoutcomes, with fatigue the most important of a number of riskfactors, accounting for 10–14% of the variance. Conclusions Seafarers' fatigue could impact on safety withinthe industry and may be linked to longer term individual ill-health.It can only be addressed by considering how multiple factorscombine to contribute to fatigue.     

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.     

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.