陕西省新生儿乙型肝炎疫苗接种率及影响因素调查分析

目的　了解陕西省新生儿乙型肝炎(乙肝)疫苗(HepB)接种现况和影响接种的因素。方法　于2 0 0 3年8～9月,采用分层多阶段随机抽样方法调查了全省82 2名适龄儿童。结果　全省HepB首针及时接种率、全程接种率、全程及时接种率分别为6 4 . 4 %、6 7 .6 %、6 1. 2 % ;不同经济水平地区儿童HepB首针及时接种率、全程及时接种率差异均有非常显著或显著的统计学意义;家中和医院出生儿童HepB首针及时接种率、全程接种率、全程及时接种率差异均有非常显著的统计学意义。HepB全程及时接种儿童家长乙肝相关知识知晓率高于未全程及时接种儿童家长;首针未及时接种的主要原因是不知道要接种占4 7 .86 % ;家长获得HepB接种信息的主要来源于医生占71 .4 %～96 .6 %。结论　提高住院分娩率和儿童家长乙肝相关知识知晓率,尤其是注重医务人员和儿童家长的人际交流均是提高HepB接种率的重要措施。     

农村乙型肝炎疫苗接种率及影响因素调查

为了解农村地区乙型肝炎 (乙肝 )疫苗免疫效果及影响因素 ,提出相应措施提高乙肝疫苗的保护效果。在南江、旺苍两县 ,采用多阶段随机整群抽样方法 ,抽取 5 2 7名 2 0 0 0年出生儿童及其 4 99名母亲 ,采血检测血清乙肝病毒表面抗原 (HBsAg)。结果显示 :儿童乙肝疫苗免疫接种率和全程免疫接种率分别为 99 0 5 %、95 4 5 % ;首针及时接种率和全程及时接种率分别为 6 8 39%、6 1 6 9%。住院分娩和在家分娩儿童首针及时接种率分别为 83 5 9%、5 6 90 % ,两者的差异有非常显著的统计学意义 (P <0 0 1)。≥第 2胎儿童的首针及时接种率非常明显的低于第 1胎儿童 (χ2 =34 1178,P <0 0 1)。被调查儿童母亲的HBsAg阳性率为 6 6 1% ;儿童HBsAg阳性率为 1 5 2 % ,7例均为阳性母亲所生儿童。由此可见 ,在农村推广乙肝疫苗免疫接种将大大降低HBsAg阳性率。在经济欠发达的边远地区和山区农村 ,对孕妇进行HBsAg筛查 ,重点对HBsAg阳性产妇的新生儿及时接种乙肝疫苗 ,将会取得事半功倍的效果     

河北省乙型肝炎疫苗扶贫项目实施效果初评

为了解乙型肝炎(乙肝)疫苗扶贫项目县乙肝疫苗的接种率和乙肝病毒表面抗原(HBsAg)携带状况及其影响因素,在涞水和巨鹿县随机抽取58个村514对2000年出生的儿童和母亲为调查对象,用胶体金试纸条法检测母亲和儿童血清HBsAg.结果显示儿童乙肝疫苗全程接种率、全程及时接种率、首针及时接种率分别为92.2%、90.9%、92.2%;住院分娩和家庭分娩儿童首针及时接种率分别为96.7%、80.8%,两者差异有非常显著的统计学意义(χ2＝36.9028,P＜0.01);第1胎儿童首针及时接种率高于≥2胎儿童,两者差异有非常显著的统计学意义(χ2＝15.1274,P＜0.01).被检测母亲HBsAg阳性者10人(1.95%),儿童HBsAg阳性者2人(0.39%).这2名儿童乙肝疫苗首针和全程接种均为及时接种,免疫失败原因是母亲HBsAg和乙肝病毒e抗原(HBeAg)双阳性,宫内感染的可能性较大.儿童家长/监护人对乙肝和乙肝疫苗的有关知识回答正确率平均为81.8%,新生儿要接种乙肝疫苗的了解途径94.2%是从医生那里得来的.据此建议(1)加大其它途径的宣传,以便使儿童家长/监护人有更多渠道了解乙肝和接种乙肝疫苗的知识,有效地提高乙肝疫苗的接种率.(2)对孕妇进行筛检,尤其是在贫困地区对孕妇进行筛检,密切关注HBsAg和HBeAg双阳性母亲及其新生儿,对其采取特殊的保护措施,更有效地减少HBsAg携带者.     

甘肃省<15岁儿童乙肝疫苗免疫现状调查

目的了解乙肝疫苗(HepB)纳入免疫规划12年后,甘肃省15岁儿童HepB接种情况,为制订乙肝预防控制策略提供参考。方法 2014年采用分层二阶段整群随机抽样方法首针,调查甘肃省1~14岁常住人口HepB接种情况以及基本情况。结果在调查的1 592名1~14岁儿童中,HepB1首针接种率、HepB1首针及时接种率和HepB全程接种率分别为96.36%、88.57%和95.85%,接种率均随年龄减小而明显升高(P0.001)。不同性别、民族儿童HepB1接种率、HepB1及时接种率和HepB全程接种率均无明显差异(P0.05)。城市儿童HepB1接种率、HepB1及时接种率和HepB全程接种率均明显高于农村儿童(P0.001)。在调查的儿童中,住院分娩率为93.53%;其中57.29%的儿童出生在县级医院,分娩地点在市级以上医院、乡级医院、在家和不详的分别占17.96%、18.28%、4.33%和2.14%。市级以上医院出生儿童HepB1接种率和HepB1及时接种率最高,分别为99.30%和95.45%;在家分娩或出生地点不详儿童HepB1接种率和HepB1及时接种率最低,分别为83.50%和59.22%。不同地点出生儿童HepB1接种率(χ2=56.173,P0.001)和HepB1及时接种率(χ2=1.053,P0.001)差异均有统计学意义。结论甘肃省HepB纳入免疫规划后15岁儿童HepB全程接种率和首针及时接种率明显提高,并保持在较高水平。提高住院分娩率是提高儿童HepB1及时接种率的关键。     

广西壮族自治区乙型肝炎疫苗纳入儿童计划免疫血清流行病学本底调查

为广西壮族自治区将乙型肝炎 (乙肝 )疫苗纳入儿童计划免疫的实施提供本底资料 ,采用多阶段整群系统随机抽样方法 ,于 2 0 0 3年调查了 0～ 3岁儿童 5 6 70人 ,儿童母亲 12 16人。结果显示 :0～ 3岁儿童乙肝疫苗接种率、全程接种率和首针及时接种率分别为 76 16 %、73 4 4 %、32 6 6 % ;乙肝病毒表面抗原 (HBsAg)与抗体 (抗 HBs)、乙肝病毒核心抗体 (抗 HBc)阳性率分别为 3 37%、4 0 18%、5 17%。与 1992年调查结果相比较 ,乙肝疫苗接种率提高了 77 6 1% ,HBsAg携带率由 9 6 8%降至 3 37% ,保护率为 6 5 19%。首针及时接种、全程接种乙肝疫苗儿童的HBsAg、抗 HBc阳性率非常显著地低于未接种的儿童 ,HBsAg阳性母亲儿童的HBsAg、抗 HBc阳性率非常显著地高于其他儿童。提高首针及时接种率、全程接种率 ,降低阳性母亲儿童的HBsAg、抗 HBc阳性率成为今后乙肝控制工作的重点     

宁波市2013-2018年乙型肝炎表面抗原阳性母亲所生儿童乙型肝炎疫苗和乙型肝炎免疫球蛋白接种率北大核心

目的分析宁波市乙型肝炎(乙肝)表面抗原(HBsAg)阳性母亲所生儿童乙肝疫苗(HepB)和乙肝免疫球蛋白(HBIG)接种率。方法通过宁波市产科预防接种信息系统收集2013-2018年宁波市HBsAg阳性母亲所生儿童HepB和HBIG接种信息,描述性分析接种率和及时接种率,采用Logistic回归分析及时接种的影响因素。结果本研究共纳入2013-2018年HBsAg阳性母亲所生儿童18397名,首剂HepB(HepB1)接种率为99.93%,出生24h内及时接种率为88.11%;HBIG接种率为87.93%,出生24h内及时接种率为80.59%;HepB1+HBIG联合接种率为87.90%,出生24h内及时接种率为74.83%;HepB全程(HepB1-3)接种率为95.33%,在6月龄内及时接种率为77.78%。Logistic回归分析显示,儿童出生年份、户籍、居住地区、出生医院、出生体重、胎次是影响HepB1+HBIG、HepB1-3及时接种的显著性因素。结论宁波市HBsAg阳性母亲所生儿童HepB和HBIG接种率高但及时接种率低,需采取针对性措施提高HepB和HBIG接种及时性。     

大同市儿童乙型肝炎疫苗接种率及影响因素的探讨

为制定有效的免疫措施和策略 ,提高乙型肝炎 (乙肝 )疫苗接种率 ,对大同市 11个县 (区 ) 2 0 0 0年 7月 1日～2 0 0 1年 6月 30日出生的儿童乙肝疫苗接种率及影响因素 ,采用标准组群抽样的方法进行了调查。结果显示 :2 311名调查儿童的乙肝疫苗全程接种率为 71 83% ,首针及时接种率为 18 2 2 % ,全程及时接种率为 15 84 %。首针及时接种率、全程及时接种率均远远低于全程接种率 ;住院分娩儿童的全程接种率、首针及时接种率、全程及时接种率均高于家庭分娩儿童 ;第 1胎的儿童高于≥ 2胎的儿童 ;母亲乙肝防治知识知晓程度良好的高于差的 ;有户口的高于无户口的 ,差异有显著的统计学意义。由此可见 ,住院分娩有利于新生儿乙肝疫苗的接种 ,家长对乙肝防治知识的知晓程度是影响接种率提高的重要因素 ,超生儿童、流动儿童乙肝疫苗接种是今后工作的重点。     

新生儿首针乙型肝炎疫苗免疫接种583例情况分析

目的了解新生儿乙型肝炎疫苗(HepB)首针及时接种情况及其影响因素。方法对资料进行回顾性分析,两样本之间的统计分析采用χ2检验。结果常住户口新生儿首针及时接种率为87.81%,暂住户口新生儿首针及时接种率为60.77%,差异有非常显著的统计学意义(χ2=55.81,P<0.01)。未住院分娩是导致HepB未及时接种的主要原因,其次是新生儿疾病。结论提高暂住孕妇的住院率,加强工作人员责任心可提高HepB首针及时接种率;提高孕妇HBsAg筛查率,有助于增加阳性者的新生儿乙肝免疫保护率。     

尧都区农村地区乙肝疫苗接种率影响因素分析

为了解农村地区乙型肝炎(乙肝)疫苗免疫接种及影响因素,提高乙肝疫苗的免疫效果。采用多阶段随机整群抽样方法,从尧都区10个乡镇抽取527名2002年出生儿童及其母亲499名,血清检测乙肝病毒表面抗原(HBsAg)。结果显示:儿童乙肝疫苗接种率和全程免疫接种率分别为99.05%、95.45%;首针及时接种率和全程及时接种率分别为68.39%、61.69%。住院分娩和在家分娩儿童首针及时接种率分别为83.59%、56.90%,两者统计有显著性差异(P<0.01)。≥2胎儿童的首针及时接种率明显低于第1胎儿童(x2=34.1178,P<0.01)。被调查儿童母亲和儿童的HBsAg阳性率分别为6.61%、1.52%,HBsAg阳性的儿童7例,均为阳性母亲所生。由此可见,乙肝疫苗的接种大大降低了HBsAg阳性率。在部分地区尤其是经济欠发达的农村地区,对孕妇进行HBsAg筛查,重点对HBsAg阳性产妇的新生儿及时接种乙肝疫苗,对预防乙肝病毒的感染起着至关重要的作用。     

韶关市实施乙肝疫苗免疫规划对控制人群乙肝感染的现况研究

目的了解韶关市2002—2008年乙肝疫苗（HepB）免疫规划的实施情况,评价韶关市2002—2008年HepB免疫规划的实施效果。方法2002年开始韶关市对全市新生儿按照0、1、6个月免疫程序全程接种3针;2008年3—9月对全市2002年1月1日至2006年12月31日期间出生的儿童按照全程3针差几针补几针的原则开展HepB查漏补种工作;2008年对韶关市城乡在幼儿园（托几所）1～5岁按照0、1、6月程序完成5μg重组HepB3针全程接种的儿童1485名,每名采集静脉血3mL进行HBsAg与抗．HBs测定;2010年5—7月,随机抽取母亲乙肝标示物阴性且按0、1、6月HepB免疫程序完成基础免疫后1个月的7～12月龄的55名婴儿进行HBsAg、HBsAb检测。评价指标：（1）HepB接种情况：儿童HepB免疫规划接种率、2002年以后出生儿童HepB查漏补种率;（2）乙肝病毒表面抗原（HBsAg）携带情况：5岁以下儿童HBsAg携带率和表面抗体（抗-HBs）阳性率;（3）HepB免疫成功率：新生儿HepB接种后抗-HBs阳转率。结果韶关市3区7县2002-2008年HepB常规免疫平均全程接种率为98．99％,平均首针及时接种率为85．49％,城市平均全程接种率为98．52％,平均首针及时接种率为88．95％,农村平均全程接种率为99．21％,平均首针及时接种率为83．63％;2008年HepB查漏补种率为96．40％;1～5岁儿童HBsAg阳性率为0．88％,抗-HBs阳性率为65．84％。城市儿童HBsAg阳性率为0．83％,抗-HBs阳性率为65．42％;农村儿童HBsAg阳性率为0．91％,抗-HBs阳性率为66．27％。HepB免疫成功率为90．91％。结论韶关市儿童HepB常规免疫接种率、新生儿及时接种率和查漏补种率高,HepB免疫成功率高,HepB免疫规划工作实施情况和实施效果良好,对控制人群乙肝感染达到了预期效果。     

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.     

Die sogenannte Vinylchlorid-Krankheit—eine berufsbedingte Systemsklerose?

Zusammenfassung Es wurden 13 Arbeiter untersucht, die zwischen 1 3/4 und 18 Jahren in einem PVC-herstellenden Betrieb beschäftigt waren. 8 von ihnen wiesen sklerodermieartige Hautveränderungen (Abb. 2) auf, die histologisch charakterisiert sind durch Verbreiterung und Homogenisierung der kollagenen Faserbündel (Abb. 3 u. 4) sowie Fragmentation und Rarefizierung der elastischen Fasern (Abb. 5). Bei 7 Patienten bestanden trommelschlegelartige Auftreibungen einzelner Fingerendphalangen (Abb. 1). 11 Patienten zeigten Durchblutungsstörungen der Extremitäten (4 von diesen ein Raynaud-Syndrom) und 6 Patienten Acroosteolysen einzelner Fingerendphalangen (Abb. 6, Tabellen 1–3).Darüber hinaus bestand bei allen Patienten eine Thrombocytopenie, bei 12 Patienten eine Splenomegalie, bei 11 Patienten eine Einschränkung der Leberfunktion (erhöhte BSP-Retention). An der Leber ließ sich histologisch bei den 5 laparoskopierten Patienten eine deutliche Fibrosierung der Portalfelder nachweisen. Bei 4 Patienten bestanden Oesophagusvaricen (Tabellen 4 u. 5). 8 Patienten zeigten eine Partialinsuffizienz mit Hinweisen für vorwiegend restriktive Veränderungen.Die hier beschriebenen Veränderungen gehen weit über das bisher bekannte Acroosteolysesyndrom hinaus. Es wird der dringende Verdacht geäußert, daß langfristige Vinylchlorid-Exposition dieses komplexe Krankheitsbild verursacht. Daher wird für diese systemische Krankheit die Bezeichnung Vinylchlorid-Krankheit vorgeschlagen.Wir danken Frau E. Voigtländer für die Herstellung der klinischen und histologischen Abbildungen.     

Empathic processes: perception by medical students of patients'' anxiety and depression

Perceptions by medical students of patients' affective states were investigated, and the effect of the students' own emotions on such perceptions. One hundred and one fourth-year medical students rated the levels of anxiety and depression of three women patients presented on videotape, rated their own levels of anxiety and depression and completed a questionnaire on aspects of the rating process. Students had widely different and often inappropriate perceptions of patients' levels of anxiety and depression. Students who consistently overrated anxiety or depression in patients, compared to those who consistently underrated, were themselves significantly more anxious or depressed. These data suggest a need in medical education for systematic teaching of empathic skills and for recognition of potential bias in clinical decision-making arising from the clinician's own emotional state.     

The reported incidence of work-related ill-health in Scotland (2002-2003)

BACKGROUND: Although incidence data for work-related ill-health in the UK are available, more detailed information for smaller geographical areas has hitherto been unpublished. AIMS: To estimate the incidence of work-related ill-health reported by clinical specialists in Scotland, 2002-2003. METHODS: THOR (The Health and Occupation Reporting network) is a UK wide reporting scheme for work-related ill-health. In 2002-2003, 241 out of 2162 physicians in THOR were based in Scotland. We have summarized the reported cases and calculated incidence rates for categories of ill-health by age, gender and industry. The UK Labour Force Survey (2002) was used to provide denominator data, with comparisons made between rates for Scotland and the rest of the UK. RESULTS: In 2002-2003, 4043 estimated cases were reported from Scotland. Mental ill-health was most frequently reported (41%); followed by musculoskeletal disorders (31%), skin disorders (16%), respiratory disease (10%), hearing disorders (2%) and infection (1%). The reported average annual incidence rate per 100,000 employees for all work-related ill-health in Scotland was 86.0. The highest reported rate for mental ill-health was found for employees in public administration and defence (76.7 per 100,000), and health and social work (72.3 per 100,000). The construction industry had the highest reported rate of musculoskeletal disorders (41.6 per 100,000), while hairdressers appeared at most risk of developing occupational contact dermatitis (rate=86.4 per 100,000). CONCLUSIONS: Despite its limitations, THOR has indicated types of work-related ill-health and related industries for targeted disease prevention in Scotland.     

Function of the protein RPE65 in the visual cycle

A protein called RPE65 performs a key role in the trans-cis isomerization of retinol in the retinal pigment epithelium of the eye. The palmitoylation of RPE65 serves to switch off the visual cycle in darkness and to switch it on in the light.     

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.     

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.     

Acute symptoms following work with pesticides

BACKGROUND: Serious accidental poisoning by pesticides is rare in the UK, but more minor pesticide-related illness may be under-reported. Anecdotally, use of sheep dip has been linked with flu-like symptoms. AIM: To explore the frequency, nature and determinants of acute symptoms following work with pesticides. METHODS: A postal survey of men in three rural areas of England and Wales provided data on occupational use of five categories of pesticide, occurrence of 12 specified symptoms within 48 h of using pesticides and tendency to somatize. Risk factors for pesticide-related symptoms were assessed by modified Cox regression. RESULTS: Of 10 765 responders (response rate = 31%), 4108 had at some time used pesticides occupationally, including 935 (23%) who reported symptoms following such work on at least one occasion. In two areas, acute symptoms were most frequent following use of sheep dip (29 and 32% of users), but in the third area the rate was significantly lower (13% of users). The relative frequency of symptoms was similar for all five categories of pesticide, and flu-like symptoms did not cluster unusually among users of sheep dip. Risk of pesticide-related symptoms increased with somatizing tendency (prevalence ratio for highest versus lowest category 2.4, 95% confidence interval 2.0-3.0) and was higher in men who had used pesticides most often or handled concentrate. CONCLUSION: Acute symptoms are common following work with pesticides, but in many cases the illness may arise through psychological rather than toxic mechanisms.