1986—2005年乐山市沙湾区麻疹流行病学特征分析

目的 通过对乐山市沙湾区1986-2005年间麻疹发病情况进行分析,掌握麻疹流行病学特征和发病规律,探讨控制麻疹的策略和措施. 方法 对乐山市沙湾区1986-2005年的麻疹病例进行描述流行病学分析. 结果 1986-2005年,乐山市沙湾区共发生确诊麻疹病例326例,年平均报告发病率为7.86/10万;流行模式以散发为主,偶有暴发;4～5月为高发季节;3～14岁人群发病较多,近年小于8月和大于18岁年龄组麻疹发病有增多趋势;病例无免疫史者占10.75%,未全程免疫占54.30%,免疫史不详占28.50%. 结论 保持儿童麻疹疫苗有效的高水平的基础免疫,加强麻疹疫苗的复种工作,适时开展强化免疫,建立牢固的免疫屏障.同时,提高对麻疹病例监测的敏感性,防止麻疹的扩散蔓延.     

2005～2006年贵州省麻疹流行病学监测结果分析

目的 掌握该省麻疹发病动态,对当前麻疹监测系统进行连续的评价.方法 收集2005～2006年贵州省麻疹监测系统报告资料进行描述流行病学分析.结果 2年共报告麻疹病例1 367例,其中确诊病例540例,确诊发病率分别为0.49/10万和0.89/10万,2006年比2005年上升了82.7%.病例高度散发,发病以10岁以下儿童为主,2005～2006年占确诊病例的90.0%,2005年发病高峰在1～5月,2006年发病高峰在9～12月.结论 麻疹疫苗补充免疫活动后,麻疹发病率下降,但2006年较2005年有所回升,说明高质量的常规免疫接种率、完善的入托入学查验接种证制度和流动儿童管理制度是巩固麻疹疫苗补充免疫成果的不可缺少的条件.     

2005年丹阳市麻疹流行病学特征分析

[目的]了解丹阳市2005年麻疹流行病学特征,总结麻疹控制经验。[方法]对丹阳市2005年麻疹监测系统数据和疫情报告数据进行描述性流行病学分析。[结果]2005年麻疹发病率为12.4/10万,为20年内历史最高水平。本地人口中麻疹发病以15岁以上成人为主,占71.4%（30/42）,流动人口中麻疹发病以15岁以下儿童为主,占88.2%（30/34）,未接种麻疹疫苗是造成发病的主要原因。[结论]加强流动人口儿童的免疫规划工作,提高流动人口的麻疹疫苗免疫接种率,每5～10年对50岁以下人群进行麻疹疫苗强化免疫,加强麻疹主动监测、做好麻疹病例密切接触者应急接种工作,是今后控制麻疹的重点。     

十年来麻疹流行病学特征分析与控制对策

目的 进一步了解新兴县麻疹流行情况,为加速控制麻疹提供科学依据.方法 运用描述性流行病学的统计方法对该县1999～2009年麻疹疫情及麻疹病例的监测资料进行分析.结果 新兴县1999～2009年麻疹共118例,年平均报告发病率为2.36/10万,4～6月为高发季节,占总发病数的69.49%.发病人群主要是10岁以下的儿童,占90.67%,3～13岁儿童无免疫史和免疫史不详,占83.73%.结论 新兴县的麻疹流行处于低发病水平,但距离消除麻疹的目标仍待观察,要实现消除麻疹的目标,建议落实儿童入学的查证制度与查漏补种,重点是流动儿童,实施8月龄～14岁的人群麻疹强化免疫的策略,必要时对没接种过麻疹疫苗的成年人补种疫苗,提高免疫覆盖率.     

延安市2000～2005年麻疹流行特征

目的了解延安市2000~2005年麻疹流行病学特征,为制订科学的控制麻疹策略提供依据。方法对2000~2005年麻疹发病及监测资料采用描述性流行病学方法进行分析。结果2000~2005年共报告麻疹2 580例,年平均发病率为21.47/10万;全市13个县(区)均有麻疹病例发生;发病年龄以0~7岁儿童为主,占病例总数的79.03%;各月均有麻疹病例发生,3~6月为高峰,共1 757例,占总病例数的68.10%;无免疫史或免疫史不详占74.53%。结论0~7岁儿童是麻疹发病的高危人群;接种麻疹疫苗是控制麻疹的基础;提高麻疹监测质量是加速控制麻疹的关键。     

惠州市2004-2010年麻疹流行病学特征分析

目的 了解惠州市麻疹流行特征和预防控制措施,为进一步控制和消除麻疹提供科学依据.方法 采用描述性流行病学方法,分析2004-2010年惠州市麻疹疫情特点;采用酶联免疫吸附试验(ELISA)检测血清麻疹IgM抗体.结果 2004-2010年惠州市共报告麻疹病例2 842例,年平均发病率11.69/10万,发病模式以散发为主,病例分布广泛,并有明显的季节性,5～7月是麻疹高发季节,14岁以下年龄组为麻疹高发年龄.病例中无免疫史和免疫史不详者占90.04％.结论 应进一步加强麻疹疫苗(measles vaccine,MV)的基础免疫接种工作,消除免疫空白,适时开展MV强化免疫,提高免疫覆盖率.同时要考虑对大年龄组人群接种MV,继续加强麻疹监测.     

盱眙县2005—2016年麻疹流行病学特征

目的了解盱眙县2005—2016年麻疹流行病学特征,为制定防控措施提供依据。方法通过传染病报告管理系统和麻疹监测信息报告管理系统,收集2005—2016年盱眙县麻疹报告病例资料,采用描述性流行病学方法进行分析。结果盱眙县2005—2016年共报告麻疹确诊病例153例,年平均发病率为1.65/10万。1-6月为高发季节,4月为发病高峰。男性88例,女性65例,男女比为1.35∶1。发病年龄最小2月龄,最大53岁。≥20岁组占41.18%,1~9岁组占24.84%,10~19岁组占16.99%,<1岁组占16.99%,其中≤8月龄儿童占<1岁组的73.08%。有免疫史占8.50%,无免疫史占20.92%,免疫史不详占70.59%。结论应加强麻疹疫情监测,重点做好适龄儿童含麻疹成分疫苗首针及时接种及复种,及20岁以上重点人群的麻疹疫苗接种工作,同时积极探索≤8月龄儿童的麻疹防控策略。     

2005-2010年新乡市麻疹监测结果分析

目的了解河南省新乡市近些年麻疹流行特征。方法采用描述流行病学的方法对2005-2010年法定传染病疫情报告资料和麻疹监测资料进行流行病学分析。结果 2005-2010年新乡市共报告麻疹病例2 778例,年均发病率为8.04/10万,2005年、2006年、2008年和2010年3～6月为发病高峰,2007年和2009年1～4月为发病高峰,2010年强化免疫后无病例报告;6岁以下儿童是麻疹发病主要人群。8月龄以下儿童发病数占发病总数的17.78%;全市各县(市、区)均有病例报告;≥8月龄病例中无免疫史和免疫史不详分别占28.50%、40.17%。结论常规免疫接种率不高是麻疹高发的主要原因。应进一步提高麻疹疫苗常规免疫接种率和及时率,针对麻疹高发地区开展高质量强化免疫或查漏补种。     

亳州市2005-2012年麻疹疫情分析

目的了解亳州市麻疹发病的流行病学特征,为消除麻疹工作提供依据。方法采用描述性流行病学方法对亳州市2005-2012年麻疹病例进行分析。结果亳州市2005-2012年累计确诊麻疹病例1 541例,年平均发病率为36.84/100万,其中2008年最高(109.20/100万)、2012年最低(4.09/100万);病例报告集中在市区;每年2-5月份为流行季节;年龄主要集中在14岁及以下,病例占总病例数的84.56%(1 303/1 541),其中0~2岁组为高发年龄;职业以散居儿童791例(51.33%)和学生402例(26.09%)为主;男女发病比例为1.60︰1。2009-2012年麻疹病例中,无免疫史和免疫史不详者是麻疹病例高发人群。结论全面实施以提高含麻类疫苗常规免疫接种率和及时接种率、加强麻疹疫情监测、适时开展重点人群麻疹疫苗强化免疫或查漏补种、预防院内感染、每年开展入托、入学儿童预防接种证查验等综合性防控策略来加速消除麻疹。     

攸县1998-2007年麻疹流行病学分析

目的 了解攸县麻疹发病的规律,探讨控制麻疹的策略和措施. 方法 对攸县1998-2007年疾病监测报告管理系统和麻疹监测系统的数据进行描述性流行病学分析. 结果 1998-2007年攸县共报告麻疹病例339例,年均发病率为4.46/10万.病例主要集中在5～10岁儿童,共发病247例,占总病例数的72.86%,发病高峰期为3-6月份,共发病262例,占总病例数的77.29%.病例中无免疫史和免疫史不详的病例分别为241例和60例,各占总病例数的71.09%和17.70%. 结论 未接种麻疹疫苗是造成麻疹发病的主要原因.攸县麻疹接种工作还存在薄弱的地区和环节,应加强麻疹常规免疫,提高免疫接种率,及时对适龄儿童进行麻疹疫苗复种并有计划地开展麻疹疫苗强化免疫.     

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.