河南省HIV感染者/AIDS患者生存质量评价

目的了解河南省HIV感染者/AIDS患者生存质量状况及其影响因素,为改善HIV感染者/AIDS患者生存质量提供参考依据。方法采用世界卫生组织艾滋病生存质量简表对河南省艾滋病高发区112例HIV感染者/AIDS患者生存质量及相关因素进行问卷调查。结果 HIV感染者/AIDS患者生存质量总分为(72.00±10.10)分;HIV感染者/AIDS患者得分除精神支柱/个人信仰领域高于中国常模外(P<0.05),其他领域得分及总评分均低于中国常模,差异有统计学意义(P<0.05);不同抑郁状况(t=-6.31,P=0.00)、相关症状数(t=-2.32,P=0.02)、家庭支持度(t=3.66,P=0.00)HIV感染者/AIDS患者生存质量比较,差异有统计学意义。结论 HIV感染者/AIDS患者的生存质量低于一般人群,对HIV感染者/AIDS患者医疗救助的同时进行心理咨询可以提高其生存质量。     

艾滋病毒感染者/艾滋病患者与其家属艾滋病相关羞辱和歧视的研究

目的 了解某农村社区艾滋病毒感染者/艾滋病患者(HIV/AIDS)与其家属遭遇的羞辱和歧视,并分析造成相关羞辱和歧视的原因.方法 采用自制调查问卷,对某农村艾滋病流行区的117例HIV/AIDS及其相应的190名健康家属进行面对面问卷调查.结果 HIV/AIDS与其家属遭受到的羞辱和歧视可分为两类,即内在的羞辱和歧视及外在的羞辱和歧视;这两种羞辱和歧视在HIV/AIDS与其家属之间的差异有统计学意义(t=-12.540,P=0.000);且HIV/AIDS与其家属遭受的内在的羞辱和歧视要高于外在的羞辱和歧视.艾滋病内在的羞辱和歧视与研究对象的自我效能(OR=0.558,P=0.041)、家庭功能(OR=0.650,P=0.027)、是否感染HIV(OR=2.116,P=0.004)等因素有关.艾滋病外在的羞辱和歧视与研究对象的自我效能(OR=0.468,P=0.028)、家庭功能(OR=0.427,P=0.000)、是否感染HIV(OR=3.412,P=0.001)有关.结论 某农村社区HIV/AIDS与其家属在社会环境中均遭受到一定的内在、外在的羞辱和歧视,应采取有针对性的策略和措施,减少并消除这种羞辱和歧视.     

广州市HIV感染者/AIDS患者抑郁影响因素的性别差异

目的探讨广州市不同性别的HIV感染者/AIDS患者抑郁影响因素的性别差异。方法通过方便抽样的方法,于2013年3—5月,采用自行设计的调查问卷对广州市第八人民医院的HIV感染者/AIDS患者进行问卷调查。主要包括一般人口社会学特征、HIV感染相关因素、抑郁状况、社会支持和自我效能状况、HIV相关羞辱和歧视感等。对调查结果进行描述性分析,并采用单、多因素分析方法对调查对象的抑郁状况及其影响因素进行分析。结果本研究共调查409例HIV感染者/AIDS患者,调查对象中男性占69.9%(286/409),女性占30.1%(123/409);平均年龄为(36.26±8.82)岁。男性调查对象抑郁平均得分为(16.13±10.97)分,抑郁发生率为49.0%(140/286);女性调查对象抑郁平均得分为(16.15±12.71)分,抑郁发生率为46.3%(57/123),两者差异无统计学意义(P0.05)。多因素logistic分析结果显示,自我效能得分(OR=0.232)、HIV相关羞辱和歧视感得分(OR=3.082)和性别与社会支持的交互作用(OR=0.663)是HIV感染者/AIDS患者抑郁的影响因素。相比较于获得较高社会支持的男性感染者,获得较高社会支持的女性感染者其发生抑郁的风险更低(OR=0.663)。基于性别的分层分析结果显示,对于男性感染者来说,较高的HIV相关羞辱和歧视感得分(OR=3.102)会增加抑郁的风险,而较高的自我效能得分(OR=0.176)可降低抑郁的风险。对于女性感染者而言,较高的HIV相关羞辱和歧视感得分(OR=4.309)会显著增加抑郁的风险,而有外出打工经历(OR=0.363)和较高的社会支持(OR=0.333)则降低抑郁的风险。结论广州市HIV感染者/AIDS患者抑郁状况较为严重。除了HIV相关羞辱和歧视感外,影响HIV感染者/AIDS患者抑郁状况的因素具有性别差异,男性感染者主要受到自我效能的影响,女性感染者主要受到社会支持的影响。     

艾滋病对不同人群个人及其家庭社会影响的调查分析

目的:了解艾滋病高发区HIV/AIDS对个人及其家庭社会的影响,为当地艾滋病防治工作的开展提供参考依据。方法 :采用问卷调查方法进行调查,通过问卷调查HIV/AIDS组与正常对照组的健康状况、社会交往、心理状况等,进行两组社会影响对比分析。结果:22.51%的艾滋病患者不能独立完成日常活动,而对照组为5.02%,差异具有统计学意义(P=0.000)。HIV/AIDS患者与亲戚、朋友和邻居来往的频率明显低于对照组,差异均有统计学意义(P=0.000)。HIV/AIDS患者的心理精神状况明显差于对照组,4.08%的患者曾经自杀过或有过自杀的想法,对照组仅为0.95%;27.47%的HIV/AIDS患者感到悲伤害怕,而对照组仅为8.17%。结论:HIV/AIDS影响着患者个人及其家庭社会活动的多个方面,健康状况较差,社会交往频度降低,心理压力较大,对患者个人及其家庭产生较大的社会影响。     

HIV感染者和AIDS病人心理状况及影响因素分析

目的了解艾滋病病毒(HIV)感染者和艾滋病(AIDS)病人的心理状态及其影响因素,为制定相关的干预策略提供科学依据。方法采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、社会支持评定量表(SSS)对36名HIV感染者和AIDS病人进行面对面的问卷调查,资料用SPSS11.5统计分析。结果 HIV感染者和AIDS病人SAS得分是38.72±3.04,SDS得分是47.36±3.67,均显著高于全国常模(分别为t=5.783,t=7.445,P均<0.01);SSS总分是29.69±1.80,显著低于全国常模(t=5.301,P<0.01)。性别、婚姻状况、配偶HIV感染状况和社会支持情况是负面情绪的影响因素。结论在HIV感染者/AIDS病人中普遍存在焦虑抑郁情绪,应加强心理咨询和心理干预。     

河南省HIV/AIDS患者安全套使用情况调查

目的 了解河南省艾滋病高发区人类免疫缺陷病毒(HIV)感染者/获得性免疫缺陷综合征(AIDS)患者的安全套使用情况,为开展艾滋病健康教育、阻断传播途径提供基础资料.方法 采用访谈法调查安全套使用情况,分析HIV感染者/AIDS患者(HIV/AIDS)安全套使用的影响因素及其特征.采用SPSS 12.0软件进行统汁分析.结果 艾滋病患者的安全套使用率为41.6%,高于对照人群(χ2=220.62,P＜0.05).每次性生活均使用安全套的HIV感染者/AIDS患者对HIV性传播途径、安全套预防艾滋病的认知好于性交时非每次均使用安全套者,差异均有统计学意义.多因素Logistic回归分析结果显示,婚姻状况(OR=1.504;95%CI=1.128～2.007)、文化水平(OR=6.234;95%CI=3.860～10.069)、健康状况(OR=0.744;95%CI=0.615～0.900)、接受上门健康教育(OR=1.461;95%GI=1.107～1.927)、年龄(OR=0.337;95%CI=0.244～0.465).结论 河南省HIV感染者/AIDS患者的避孕意识较高,但安全套使用率较低,尚未达到国家的控制目标;婚姻状况、年龄、文化程度、身体状况、接受健康教育情况是HIV/AIDS患者安全套使用的主要影响因素.     

中国HIV/AIDS患者抑郁影响因素的META分析

目的 探讨中国HIV感染者/AIDS患者抑郁的影响因素。方法 检索PubMed、Web of Science、The Cochrane Library、Embase、中国知网、万方数据库、维普数据库和中国生物医学数据库,查找自建库至2021年3月期间国内外公开发表的有关中国HIV感染者/AIDS患者抑郁影响因素分析的文献。用RevMan 5.3软件进行数据分析,根据异质性检验结果采用固定效应模型或随机效应模型进行分析,并对结果进行敏感性分析和发表偏倚评价。结果 共纳入22篇文献,研究对象共7101例。有8个因素的合并OR值有显著意义。结果显示年龄［OR=1.52,95%CI(1.18,1.95)］、居住情况［OR=1.35,95%CI(1.05,1.74)］、户籍类型［OR=1.50,95%CI(1.14,1.97)］、CD4水平［OR=1.56,95%CI(1.28,1.91)］、疾病分期［OR=1.79,95%CI(1.08,2.95)］、感知羞辱或歧视［OR=6.07,95%CI(4.50,8.19)］、社会支持［OR=0.50,95%CI(0.41,0.61)］、经济状况［OR=0.51,95%CI(0.39,0.66)］是中国HIV/AIDS患者抑郁的影响因素。结论 年龄≥50岁、户籍为农村、独居、CD4+T淋巴细胞＜200个/μl、疾病分期为艾滋病期、感知歧视或羞耻是HIV感染者/AIDS患者抑郁的危险因素,经济水平和社会支持较好是保护因素。     

艾滋病相关社会歧视的差序格局研究

目的了解艾滋病毒感染者/艾滋病患者(PLWHA,people living with HIV/AIDS)、PLWHA的家属和普通村民对PLWHA及其家属的社会歧视差序格局,并分析造成艾滋病相关社会歧视的原因。方法自制调查问卷,对乡村艾滋病流行区的117名PLWHA、190名相应的PLWHA的家属、非艾滋病流行区的216名普通村民,进行面对面的问卷调查。结果艾滋病相关社会歧视在艾滋病流行区的PLWHA、PLWHA的家属和非艾滋病流行区的普通村民之间存在统计学差异(F=351.088,P=0.000),且这种差异有一定的格局,基本上随着关系的亲疏而呈递增递显的趋势。多因素Logistic回归分析发现与PLWHA的接触程度(OR=0.268,P=0.000)、艾滋病知晓得分(OR=0.825,P=0.001)、对PLWHA处境的理解(OR=1.102,P=0.000)与艾滋病相关社会歧视存在关联,可能是艾滋病相关社会歧视的影响因素。结论目前我国仍普遍存在对PLWHA及其家属的社会歧视,且这种社会歧视存在差异格局的特点,因此应针对这些特点提出可行的策略和措施。     

河南农村HIV/AIDS者的家庭功能和社会支持研究

目的 了解河南农村艾滋病流行地区人类免疫缺陷病毒(HIV)感染者/艾滋病(AIDS)患者的家庭功能和社会支持现状,为相关部门管理和关爱艾滋病患者提供依据.方法 选取河南省周口汤庄乡6个行政村的150名HIV感染者/AIDS患者进行调查,采用一般情况问卷、家庭关怀度指数问卷(APGAR问卷)和社会支持评定量表(SSRS)进行问卷调查.结果 64.67％的HIV感染者/AIDS患者家庭功能良好,25.33％的家庭功能中度障碍,10.00％家庭功能严重障碍.家庭功能不同的HIV感染者/AIDS患者客观支持得分、主观支持得分、支持的利用度和总分差异均有统计学意义(p＜0.05).结论 HIV感染者/AIDS患者社会支持总分和各维度得分越高,其家庭功能状态越好.应积极倡导开展适合农村HIV感染者/AIDS患者的家庭关怀与支持.     

新确诊感染HIV的中青年男男同性性行为人群压力现状及影响因素研究

目的了解新确诊感染人类免疫缺陷病毒(human immunodeficiency virus, HIV)的中青年男男同性性行为人群(men who have sex with men, MSM)压力现状,并探讨其影响因素。方法采用便利抽样法选取新确诊感染HIV的中青年MSM,采用HIV/AIDS压力评量表对感染者压力水平进行测评,采用一般情况调查表、艾滋病相关知识问卷、社会支持量表、医学应对方式量表、Berger艾滋病感知歧视量表、慢性病自我效能量表收集可能影响中青年MSM中HIV感染者/AIDS患者压力的社会心理因素,并利用多元回归方程等探讨这些因素与HIV/AIDS压力之间的关系。结果新确诊HIV阳性的中青年MSM压力得分为24.00(13.00～35.00)分,社会压力为其主要的压力源;影响新确诊HIV阳性中青年MSM压力水平的主要因素有饮酒频率(t=2.102,P=0.036)、HIV相关临床症状(t=2.889,P=0.004)、屈服(t=10.717,P=0.000)和回避(t=2.900,P=0.004)、自我效能(t=-3.233,P=0.001)及社会支持(t=-2.889,P=0.004)。结论新确诊感染HIV的中青年MSM普遍面临着HIV相关压力,社会组织及医务工作者应采取针对性的措施,缓解其压力水平。     

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.