南京市在婚男男性行为人群HIV感染状况及其相关行为特征调查

目的了解南京市在婚MSM(男男性行为)人群HIV感染状况及性行为特征。方法 2014年在南京通过"滚雪球"方法共招募220名在婚MSM人群,进行问卷调查和HIV抗体检测。结果在婚MSM人群HIV阳性检测率为12.7%;有77.7%的调查对象最近6个月与同性发生过肛交性行为,肛交性行为时坚持使用安全套的比例是43.9%,最近一次肛交安全套的使用比例为60.8%;有53.2%的调查对象最近6个月与女性发生过性行为,异性性行为时坚持使用安全套的比例为29.1%,55.6%在最近1次异性性行为时未使用安全套。调查对象中,HIV感染者最近1年做过HIV抗体检测的比例是42.9%,17.9%最近1年曾诊断罹患性病。感染者最近6个月中:78.6%与同性发生肛交性行为;22.7%坚持使用安全套;42.9%与异性发生性行为,性行为时坚持使用安全套的比例是33.3%。结论南京在婚MSM人群的HIV感染率较高,且无保护性的同性和异性性行为同时存在,将加剧HIV在MSM人群和在婚女性之间的传播。     

云南省2010－2013年男男性行为人群艾滋病相关危险因素变化趋势分析

目的 了解云南省MSM人群知晓率、行为等艾滋病相关危险因素的变化趋势及其安全套使用的影响因素,为干预策略制定和效果评价提供依据。方法 2010-2013年在云南省连续开展MSM哨点监测,调查该人群一般人口学特征、艾滋病相关知识、性行为及安全套使用、吸毒行为、干预措施覆盖等情况,进行趋势和影响因素分析。结果 共调查9 073人,艾滋病知识知晓率、与同性发生性行为比例及安全套使用率均呈逐年上升趋势(P<0.01),与异性发生性行为时安全套使用率明显低于同性,吸毒比例和患性病比例呈下降趋势(P<0.01).同居、低知晓率、外省/外籍、居住时间不足一年、文化程度低、未接受过干预、肛交次数多、未曾做过HIV抗体检测等因素为影响MSM坚持使用安全套的危险因素。结论 云南省近4年MSM艾滋病综合干预效果初显,但多项指标仍处于较低水平,仍需重点关注同居、文化程度低、流动性较大、肛交次数多、有异性性行为的MSM干预,扩大干预覆盖面,继续强化落实HIV动员检测、安全套推广使用等核心干预措施。     

VCT门诊在婚男男性行为人群性行为及HIV感染状况

目的了解自愿咨询检测(VCT)门诊咨询检测在婚男男性行为(MSM)人群性行为及HIV感染状况。方法以2010—2017年苏州市VCT门诊咨询检测的在婚MSM为对象,问卷调查收集人口学和行为学信息,采血进行HIV和梅毒检测。结果纳入研究的在婚MSM共707人,年龄中位数为40岁;77.4%在本地居住2年以上。最近6个月内有同性性行为、异性性行为比例分别为87.6%、60.3%,有双性性行为比例为52.5%;无保护同性肛交、无保护异性性行为比例分别为59.4%、41.2%。检出HIV阳性183例(25.9%),梅毒感染69例(9.8%)。多因素logistic回归分析显示,最近6个月无保护同性肛交性行为(OR=1.924,95%CI:1.329～2.785)、既往梅毒感染(OR=1.865,95%CI:1.198～2.903)和现症梅毒感染(OR=2.844,95%CI:1.684～4.804)是HIV感染相关因素。183例HIV阳性者中,最近6个月54.6%有异性性行为,其中60.0%最近1次异性性行为中未使用安全套。结论 VCT门诊在婚MSM人群HIV阳性检出率较高,主要与同性无保护肛交行为和梅毒感染有关;HIV阳性者无保护异性性行为较普遍,HIV传播风险大。     

杭州市同性恋浴池MSM人群既往HIV检测行为相关因素分析

目的 了解杭州市同性恋浴池MSM人群HIV既往检测行为的相关影响因素。方法 2015年10月至2016年1月,在杭州市同性恋浴池开展时间-场所抽样调查,招募最近6个月与同性发生口交或肛交性行为的同性恋浴池MSM,主要收集最近6个月HIV检测行为及相关信息。运用SPSS 22.0软件分析HIV最近6个月HIV检测行为、性行为和安全套使用情况等相关因素,数据分析采用χ²检验、logistic回归法分别进行单因素和多因素分析。结果 共招募480人,实际调查465名MSM。最近6个月接受HIV检测的比例为47.3%（220/465）。多因素logistic分析结果表明,已婚（OR=0.35,95% CI：0.18~0.69）,接受同伴教育（OR=4.31,95% CI：1.32~14.09）,最近6个月有同性肛交性行为（OR=1.85,95% CI：1.08~3.14）,最近6个月有非婚异性性行为（OR=4.12,95% CI：2.45~6.91）可能是促进检测的相关因素。结论 已婚、最近6个月发生过同性肛交性行为、非婚异性性行为、接受过同伴教育可能是促进浴池MSM人群进行检测的相关因素。因此,需加强对浴池MSM的同伴教育,提高其高危行为后的检测意识,促进其进行检测。     

天津市2016－2018年哨点监测男男性行为人群HIV感染状况及相关因素分析

目的 了解2016－2018年天津市MSM人群HIV感染状况及其相关因素。方法 按照全国艾滋病哨点监测方案要求,采用横断面调查方法,于2016－2018年4－6月,连续监测并收集天津市MSM人群的艾滋病知识知晓率、相关性行为、以及HIV、梅毒、HCV感染等信息,各年样本量400人。结果 2016－2018年天津市监测MSM共1 200人,最近6个月同性肛交坚持使用安全套的比例为45.4%（544/1 198）,网络招募的MSM既往接受过HIV检测的比例呈现下降的趋势（趋势χ²=42.742,P<0.001）。HIV感染率为3.3%（40/1 200）,HIV-1新发感染率为2.6%（95% CI：1.7%～3.5%）,梅毒感染率为6.7%（80/1 200）,HCV感染率为0.8%（9/1 200）。多因素logistic回归分析结果显示,离异或丧偶（与未婚者相比,aOR=7.137,95% CI：1.621～31.419）、梅毒抗体阳性（与梅毒抗体阴性者相比,aOR=3.684,95% CI：1.520～8.932）是MSM人群感染HIV的危险因素;最近6个月同性肛交坚持使用安全套（与不坚持使用安全套者相比,aOR=0.343,95% CI：0.126～0.932）、既往检测过HIV抗体（与既往未检测HIV抗体者相比,aOR=0.314,95% CI：0.123～0.801）是MSM人群感染HIV的保护因素。结论 2016－2018年天津市MSM人群的HIV感染率较高,梅毒感染风险不容忽视,同性肛交坚持使用安全套的比例较低,应该采取有效措施促进MSM坚持使用安全套和定期检测HIV抗体。     

2010-2014年徐州市MSM人群性行为特征及艾滋病感染状况分析

目的分析徐州市2010-2014年男男性行为(MSM)人群性行为特征,及HIV、梅毒、HCV血清学检测情况,为制订防治策略提供依据。方法通过滚雪球抽样等方法招募近1年内有同性性行为MSM人群,开展面对面的问卷调查,并采血进行HIV、梅毒和HCV抗体检测。结果5年间共招募调查对象1 968人,MSM肛交中最近1次安全套使用率为53.92%~68.57%,最近6个月坚持每次使用安全套比例为33.11%~45.71%;1 968人中存在异性性行为者占33.92%,异性接触最近1次使用安全套比例为53.49%;5年间HIV感染率为4.48%~8.50%,整体呈现上升趋势。结论徐州市MSM人群危险性行为方式比例较高,安全套使用率较低,应采取有效针对措施加大干预力度。     

2010-2013年云南省大理市男男性行为人群艾滋病性病哨点监测结果分析

[目的]了解云南省大理市近年不同年龄段男男性行为人群(MSM)艾滋病病毒(HIV)感染情况及知识知晓、行为特征,为下一步制定完善有效的干预策略措施及资源的合理分配提供依据。[方法]2010-2013年采用滚雪球法对大理市MSM人群进行一对一问卷调查并采血进行HIV、梅毒、丙肝检测,分析不同年龄组知识、行为、HIV检测结果,并比较其差异性。[结果]2010-2013年共调查MSM人群1038人,各年龄组艾滋病知识知晓率、最近一次与同性发生肛交性行为时使用安全套的比例、最近六个月与同性发生过商业性行为的比例无差异;最近六个月与同性发生过肛交性行为的比例有差异;最近一周与同性发生过肛交性行为的比例、最近六个月与同性发生肛交性行为时每次使用安全套的比例、最近六个月与异性发生过性行为的比例、最近一年接受过艾滋病干预服务的比例、最近一年做过艾滋病检测的比例、HIV阳性率均有显著性差异。[结论]大理市MSM人群各年龄段在行为方面存在差异,应从具体对象角度考虑干预及动员检测的模式,针对性地设计活动及分配资源。     

男男性行为人群与男性性伴和女性性伴的性行为特征及影响因素

  目的  了解安徽省男男性行为人群（men who have sex with men,MSM）与其男性性伴和女性性伴的性行为特征及影响因素。  方法  以合肥、芜湖和六安3个城市为研究现场,采用滚雪球法和网络招募法招募MSM人群,对符合纳入标准的MSM进行匿名问卷调查。采用多因素Logistic回归分析模型分析MSM人群最近6个月发生异性性行为的危险因素。  结果  共招募1 200名MSM,最近6个月78.3% MSM与男性性伴有过肛交性行为,20.9%与女性性伴有过异性性行为,16.5%最近6个月与男性性伴、女性性伴均有过性行为。最近6个月异性性行为中的安全套坚持使用率（29.9%）明显低于同性性行为的安全套坚持使用率（53.0%）,在最近一次异性性行为中的安全套使用率（52.2%）也明显低于同性性行为中的安全套使用率（79.6%）（均有P < 0.05）。多因素分析结果显示,已婚（包括在婚/同居/离异/丧偶）、在调查城市居住时间>2年、有同性商业性行为的MSM更容易发生异性性行为。  结论  MSM人群存在较高比例的双性性行为,且安全套坚持使用率较低,应该加强对他们的性健康教育、风险感知教育和行为干预。     

2008年聊城市男男性行为者艾滋病高危行为调查

[目的]了解男男性行为者(MSM)的社会学特征、艾滋病高危性行为、知识知晓及HIV感染情况。[方法]2008年6～9月应用同伴推动抽样法(RDS)对聊城市的MSM进行抽样,通过现场问卷调查和血清学检测了解其高危行为因素及HIV感染等情况,资料分析使用RDSAT、Excel软件完成。[结果]调查204名MSM,有58.33%的自我认同为同性恋;艾滋病防治知识知晓率为61.27%;有76.47%的MSM与同性发生过口交性行为,有78.38%的MSM与同性发生过肛交性行为,有60.29%的MSM与异性发生过性关系。发生以上高危性行为的MSM,最近6个月内,有89.32%与多个同性发生过肛交,有89.71%与多个同性发生过口交,有86.99%与异性发生过性行为,但最近6个月肛交性行为时安全套使用率仅为25.53%;检出HIV感染者2例,感染率为1.51%。[结论]聊城市MSM人群有较强的认同感,艾滋病知识知晓率低,性伴多且不固定,安全套使用率低,存在HIV在MSM人群中传播的危险。     

2010年镇江市男男性行为者队列基线调查

目的了解江苏省镇江市男男性行为者(men who have sex with men,MSM)艾滋病高危行为特征、感染情况及其影响因素。方法采用分类滚雪球抽样的方法于2010年2—9月,在镇江市范围内招募MSM进行问卷调查,了解其社会人口学及艾滋病高危行为特征,并采集血样进行人类免疫缺陷病毒(HIV)抗体、梅毒抗体、丙型肝炎病毒(HCV)抗体的检测。结果共调查456名MSM,77.0%最近6个月发生过同性口交性行为,其中61.0%有多个同性口交性伴;87.1%最近6个月发生过同性肛交性行为,其中55.3%有多个同性肛交性伴,14.9%最近1周发生过多次同性肛交性行为;11.3%最近6个月与同性发生过商业性行为,34.9%与异性发生过性行为;最近6个月与同性发生口交性行为时坚持使用安全套的比例为16.0%,肛交时坚持使用安全套的比例是40.3%,与同性发生商业性行为时坚持使用安全套的比例是40.0%,与异性发生性行为时坚持使用安全套的比例为26.4%。456名调查者均采集血样进行了血清学检测,初筛HIV阳性人数40人,确证HIV阳性人数35人,阳性率为7.3%(95%CI 5.40%～10.51%);确证梅毒抗体阳性人数为48人,阳性率为10.5%(95%CI7.86%～13.71%);确证HCV抗体阳性人数为2人,阳性率为0.4%(95%CI0.05%～1.58%);确证HIV抗体与梅毒抗体合并阳性人数为4人,合并阳性率为0.9%(95%CI 0.24%～2.23%)。在多因素logistic回归模型中,月收入为1 000～3 000元(OR=0.40,95%CI 0.18～0.87)与HIV感染的关系具有统计学意义。结论镇江市MSM中无保护性性行为较为普遍,HIV和梅毒感染率较高,应在该人群中加强包括艾滋病宣传和安全套推广在内的艾滋病干预措施,控制艾滋病等性传播疾病的流行。     

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 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.     

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.     

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.     

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.     

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.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.