参与式山区预防艾滋病健康教育综合干预效果评价

[目的]对参与式山区预防艾滋病健康教育综合干预效果进行评价. [方法]采用社会实验研究设计,在所抽取的干预及对照社区,于干预前后对农村常住居民和外出务工人员进行知识、态度问卷调查.[结果]干预后,综合干预县的艾滋病相关知识知晓率,正确态度持有率与对照组比较明显提高. [结论]参与式山区预防艾滋病健康教育综合干预是一种有效的工作模式.     

平原农村参与式预防艾滋病健康教育综合干预效果分析

[目的]分析针对平原农村居民开展参与式预防艾滋病健康教育综合干预的效果及影响因素. [方法]采用现场实验研究方法,选择平原农村干预人群和对照人群,进行参与式预防艾滋病健康教育综合干预活动,并于干预前后对研究对象进行艾滋病知识、态度问卷调查. [结果]干预组干预前后的艾滋病相关知识知晓率提高24.4%以上,正确态度持有率提高13.1%以上,5项指标干预组提高程度均高于对照组(P＜0.001).传播途径知晓率的提高程度女性高于男性.正确态度持有率提高与文化程度相关. [结论]在平原农村开展参与式预防艾滋病健康教育综合干预效果显著,同时提示我们在实施综合干预的过程中应特别关注青年农民、妇女和文化程度低的人群.     

沈阳市大学生艾滋病健康教育效果评价

目的评价在沈阳市大学生中开展预防艾滋病健康教育的近期效果,为制定沈阳市大学生预防性病艾滋病宣传教育方案提供依据。方法选取沈阳市4所高校的1 546名在校本科学生作为研究对象,每所大学随机分为一个对照组和7个干预组,每组2、3年级各半。结果通过健康教育,干预组学生对艾滋病知识的正答率普遍好于对照组,对艾滋病及艾滋病病人的态度也随艾滋病知识水平的提高而有所改善。同时,参与式教学较其他干预方法效果更好,差异有统计学意义(P<0.05)。结论采用参与式教学方式在大学生中展开展艾滋病健康教育效果显著。     

河北省农村妇女预防艾滋病健康教育效果评价

目的:在农村妇女中开展参与式预防艾滋病健康教育综合干预及其效果评价。方法:采用社会实验研究设计,在干预及对照社区对农村妇女(干预前776人、788人,干预后804人、803人)进行知识、态度问卷调查,评价干预措施效果。结果:干预后干预组农村妇女传播途径知晓率、非传播途径知晓率、一般知识知晓率、自我保护正确态度持有率、对待艾滋病人/感染者的正确态度持有率比干预前分别提高24.38%、29.69%、28.80%、16.27%、21.08%;对照组分别为4.85%、0.14%、3.86%、-0.13%、3.13%。干预组艾滋病知识知晓率、正确态度形成率显著高于对照组(P<0.01)。结论:农村参与式预防艾滋病健康教育综合干预模式是有效和可行的。     

流出地农村外出务工人员预防艾滋病健康教育综合干预效果评价

[目的]在流出地对农村外出务工人员预防艾滋病健康教育综合干预效果进行评价。[方法]采用社区干预试验方法,对干预地区实施参与式预防艾滋病健康教育综合干预措施。于干预前后,对干预地区(干预组)和对照地区(对照组)采用问卷调查农村外出务工人员的艾滋病知识、态度,干预前、后分别调查1006人和1010人。[结果]干预后,干预组艾滋病相关知识知晓率由29.38%提高到55.72%,正确态度总持有率由43.38%提高到57.41%;与对照组比较明显提高(P<0.001)。[结论]参与式农村预防艾滋病健康教育综合干预在农村外出务工人员中是一种有效的工作模式。     

农村居民参与式艾滋病健康教育干预效果评价

目的 对参与式农村预防艾滋病健康教育综合干预的实施效果进行评价.方法 采用现场调查方法,在干预及对照社区,于干预前后对农村常住居民和外出务工人员进行知识、态度问卷调查,干预前分别调查2 142人和1 006人,干预后分别调查2 225人和1 010人.同时,进行社会支持环境和目标人群相关行为调查.结果 干预后,综合干预县的社会支持环境明显改善,目标人群自愿咨询检测(VCT)人数和电话热线咨询人数分别由35人次/年和88人次/年提高到128人次/年和132人次/年;艾滋病相关知识知晓率由干预前29.45%提高到54.18%,正确态度持有率由42.48%提高到57.59%,与对照组比较差异有统计学意义(P<0.001).结论 农村参与式预防艾滋病健康教育综合干预是一项有效措施.     

参与式健康教育综合干预对农村居民艾滋病认知的效果评价

目的 对参与式农村预防艾滋病健康教育综合干预后农村常住居民认知水平的变化进行效果评价.方法 采用社会实验研究设计,于干预前后对干预组及对照组农村常住居民进行知识、态度问卷调查,干预前后分别调查2 142人和2 225人.结果 干预后,干预组目标人群艾滋病相关知识知晓率和正确态度持有率显著提高:传播途径、非传播途径和一般知识知晓率分别由干预前的55.91％、19.04％、13.32％提高至76.51％、45.26％、40.02％;自我保护态度、对待艾滋病病人/感染者的正确态度持有率分别由干预前的65.49％、17.73％提高至80.04％和35.32％,与自身干预前和与对照组干预后比较均有显著性差异(P＜0.001).结论 参与式健康教育综合干预是提高农村居民艾滋病认知水平的有效方法,值得进一步推广应用.     

职校学生预防艾滋病同伴教育干预效果评价

目的 评价开展以参与性教学方法为主的同伴教育活动对职校学生艾滋病知识、态度、行为的干预效果,为开展学校艾滋病健康教育提供参考.方法 选取上海市普陀区1所职校学生261名为干预组,另一所职校学生370名为对照组.干预组开展由学生自己担任教育者的同伴教育活动,对照组未采取任何干预措施.采用定性访谈和问卷调查的方式对同伴教育干预效果进行评价.结果 开展同伴教育后,干预组学生的艾滋病知识答对率组内、组间均明显提高(P值均＜0.05),态度有所转变;干预组学生对婚前性行为持反对态度的比例明显上升,愿意与艾滋病病人和感染者同班学习的比例由46.74%上升到了62.34%,但行为意向改变不明显(P＞0.05).结论 同伴教育可以有效提高职校学生的艾滋病知识水平,促进态度的转变,但对于行为转变的影响还有待于活动的长期开展.     

社会动员在农村预防艾滋病健康教育综合干预中的应用

探索在农村地区开展预防艾滋病健康教育的有效途径,采用社会动员策略与参与式干预相结合的方法,进行农村预防艾滋病健康教育综合干预模式的实证研究.通过社会动员,可广泛开发利用社会资源,形成社会网络,调动广大干部、群众参与预防艾滋病健康教育活动,以获得良好的社会效果.     

参与式方法对大学生开展艾滋病健康教育效果分析

目的 分析以参与式研究方法在大学生中开展预防性病/艾滋病健康教育的近期效果,为青少年预防性病/艾滋病健康教育提供参考 .方法 应用参与式研究方法培训志愿者,志愿者用参与式研究方法在同伴中进行健康促进活动.结果 健康教育后,大学生对艾滋病知识知晓率有显著提高,与艾滋病相关的态度方面有明显好转,而行为意向方面也有提高.结论 应用参与式方法对大学生开展健康教育活动,可有效提高其艾滋病的相关知识、改变其相关态度和行为意向.而性行为的改变还需持续的促进活动才能实现.     

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.