外来务工人员艾滋病知识及影响因素分析

目的 了解清华大学校园内外来务工人员艾滋病知识知晓现状。方法 采用随机抽样的方法，对清华大学校园内1150名外来务工人员进行艾滋病相关知识的问卷调查。结果 调查对象对艾滋病三大传播途径的知晓率比较高。为83．996。对非传播途径知晓率普遍低。个别问题仅有30．596的调查对象能正确回答。对国家制定的相关政策知晓率更低，所有5个问题能正确回答的均不超过半数。单因素分析结果显示，性别、居住地、年龄、职业、文化程度、婚姻状况及收入与艾滋病知识综合得分有关。多因素Logistic回归分析结果显示，性别、年龄、文化程度、居住地、获取知识的态度、是否受过艾滋病知识培训是影响综合得分的6个因素。结论 应针对流动人口知识薄弱环节开展宣教，充分发挥社区服务中心的力量，切实做好该高危人群性病、艾滋病的健康教育工作。     

农村外出务工人员艾滋病相关知识态度及影响因素调查

目的调查农村外出务工人员对艾滋病相关知识态度及其影响因素,为制定有针对性的健康教育措施提供依据。方法采用分层-整群抽样抽取农村外出务工人员1006人,逐人进行问卷调查。结果农村外出务工人员对艾滋病传播途径、非传播途径、一般知识知晓率分别为55.3%、22.0%、8.8%,艾滋病相关知识知晓率受到文化程度以及是否在务工地接受宣传教育的影响;调查对象对艾滋病病毒感染者/患者的接受率、正确自我保护态度持有率分别为18.2%和63.9%。结论农村外出务工人员对艾滋病相关知识较低,应针对有关影响因素制定相关的健康教育措施。     

四川省农村外出务工人员重点传染病预防知识认知水平及影响因素研究

目的调查了解农村外出务工人员对重点传染病预防知识的认知水平,并分析其相关影响因素,为开展有针对性的重点传染病预防提供科学依据。方法采用自行设计的调查表,对四川省581名农村外出务工人员进行重点传染病防治知识的问卷调查。结果调查显示能正确区分传染病的农村外出务工人员仅占12.56%,能正确回答艾滋病三大传播途径(血液传播途径、性传播途径、母婴传播途径)的有155人,占26.68%;仅有17.56%的调查对象完全知道乙肝的传播途径;肺结核的临床症状知晓率较高,占73.49%。影响农村外出务工人员重点传染病认知水平的因素主要有年龄(P0.05)、文化程度(P0.01)。结论农村外出务工人员对各种传染病防治知识及相关政策的认知水平均较低,卫生部门应加强对其传染病预防知识的普及教育,以降低传染病的发病率,从而提高其健康水平。     

天津市汉沽区流动人口艾滋病知信行现况调查

目的了解天津市汉沽区外来务工人员艾滋病知识知晓情况。方法调查问卷参照中国疾病预防控制中心性病艾滋病预防控制中心制定的《艾滋病性病综合监测指南及方案》中的监测问卷,自行设计调查问卷,对汉沽区543名外出务工人员进行艾滋病相关知识问卷调查。结果调查分析显示外来务工人员对艾滋病知识知晓率普遍较低,知晓率存在明显的人群差异。结论应针对流动人口艾滋病知识薄弱环节开展宣传教育,切实做好该高危人群性病、艾滋病的健康教育工作。     

农村外出务工人员艾滋病知识、态度和行为调查

目的 了解农村外出务工人员对艾滋病相关知识、态度和行为情况,探索适合农村外出务工人员预防控制艾滋病的教育措施,为有关部门制定相关的政策提供基础资料.方法 选取安徽省濉溪县某乡镇外出务工人员408人进行问卷调查.结果 农村外出务工人员艾滋病知识来源主要是通过电视广播(77.7%)、宣传画(56.9%)、报刊杂志(55.0%)和卫生防疫人员(39.2)等途径.外出务工人员对艾滋病知识的知晓率为66.3%,其中艾滋病传播途径的知晓率为77.0%,非传播途径的知晓率为63.9%;不同性别以及初中文化程度的调查对象,其传播途径与非传播途径知晓率之间比较,差异均有统计学意义(P＜0.01).传播途径和非传播途径的知晓率在不同文化程度间的差异也均有统计学意义(P＜0.01).只有21.3%的外出务工人员认为自己处于感染艾滋病的危险之中,大多数人仍觉得这种威胁离他们很遥远,但有91.2%的人能主动学习预防艾滋病知识.农村外出务工人员在打工期间婚外性行为方面男女之间差异无统计学意义,但对婚前性行为的看法以及在性生活中使用安全套的比例在男女之间差异有统计学意义(P＜0.01).男性安全套的使用率高于女性.结论 对农村外出务工人员应深入开展形式多样和有针对性的预防艾滋病健康教育,尤其是非传播途径的教育,以提高其艾滋病相关知识的知晓率,从而控制艾滋病的蔓延.     

农村外出务工人员艾滋病知识、态度及高危行为分析

目的了解农村外出务工人员艾滋病防治知识、相关态度和高危行为状况,为开展艾滋病干预工作提供科学依据。方法采用多阶段抽样方法,在流出地选择返乡外出务工人员454人,利用自制问卷面对面调查。结果外出务工人员对艾滋病3大传播途径回答正确率为43．6％～68．6％,对一般日常生活接触是否传播MDS的知晓率偏低,如蚊虫叮咬不会传播的知晓率只有19．3％;93．1％的外出务工人员认为自己感染艾滋病的机会很小,仅有48．1％的人表示同情并愿意给予艾滋病患者帮助;21．6％的人有婚前性行为,71．0％的人与固定性伴发生性关系时从不使用安全套。结论外出务工人员艾滋病防治知识缺乏,普遍存在危险性行为。     

2011年大新县外出务工人员艾滋病相关知识与感染状况调查

[目的]了解大新县外出务工人员艾滋病相关知识的知晓情况及艾滋病感染状况,为有针对性地开展艾滋病防治知识的宣传教育和行为干预提供科学依据。[方法]2011年1月20日至2月10日,随机抽取8个乡镇中的40个村,每村抽取外出打工超过3个月以上的返乡人员进行调查,并检测HIV抗体。[结果]调查4 183人,艾滋病相关知识知晓率为67.85%,传播途径知识知晓率为75.19%,非传播途径知晓率为50.25%;艾滋病相关态度正确率为36.55%;获得艾滋病知识的主要途径为广播和电视,占81.40%,其次是朋友占33.33%;发生婚前和婚外性行为的占16.26%,其中有17.79%的人最近1年发生性行为时坚持每次都使用安全套。检测4 240人,检出HIV抗体阳性9例,阳性率为0.21%。[结论]大新县外出务工人员对艾滋病相关知识认识不足、存在误区。迫切需要建立一套针对外出务工人员艾滋病宣传教育和行为干预的长效工作机制。     

深圳市宝安区足浴场所从业人员艾滋病相关知识、态度及其影响因素

目的了解足浴场所从业人员艾滋病知识知晓情况,为进一步实施干预提供依据。方法对深圳市宝安区324名足浴从业人员进行艾滋病相关知识问卷调查。结果从业人员对艾滋病三大传播途径的知晓率较高,但对非传播途径的知晓率普遍较低,仅有33.48%的人认为艾滋病病毒不会通过蚊虫叮咬传播。该人群对艾滋病患者较为友好,有67.08%的人愿意关爱或象普通人一样对待艾滋病患者。64.38%的人希望从疾病预防和卫生监督部门获取艾滋病知识。单因素分析结果显示,艾滋病基本知识得分与文化程度、性别、户籍、来深圳工作年限和居住方式有关。多因素logistic回归分析显示,来深圳工作年限、文化程度、居住方式和户籍是艾滋病基本知识得分的影响因素。结论应针对该场所从业人员艾滋病知识薄弱环节开展宣传教育,并应充分发挥疾病预防控制中心和卫生监督部门的影响力,做好该高危人群性病、艾滋病的健康教育工作。     

河北省艾滋病低流行山区农民艾滋病认知现状调查及影响因素分析

[目的]了解河北省低流行山区居民对艾滋病(AIDS)防治知识知晓情况、对感染者态度倾向现状及相关影响因素.[方法]采用分层-整群-随机抽样方法,以河北省艾滋病低流行区石家庄、保定市有艾滋病病例报告的各2个县共12个山区村1074名常住居民和478名外出务工人员作为调查对象,采用逐个匿名问卷方式.[结果]河北省艾滋病低流行山区农民艾滋病相关知识、态度倾向总正确率62%.常住居民与外出务工人员知识得分和态度倾向得分差异无统计学意义(P值均>0.05).传播途径知晓率为79%,非传播途径知晓率为57%;50%～55%的农民认为应该把艾滋病感染者或病人隔离起来,近70%认为应减少或断绝与之来往.影响艾滋病认知得分的因素为性别、婚姻状况、文化程度(P值均<0.05);年龄对此无影响(P>0.05).[结论]山区居民对艾滋病传播途径知晓率较高,对艾滋病的基本认识和不传播途径错误率较高,对艾滋病感染者和病人存在歧视态度.未婚者、低文化层次、女性是艾滋病健康教育知识干预的重要人群.     

宁阳县外出务工人员防治艾滋病健康教育与行为干预效果评价

[目的]做好外出务工人员的艾滋病防治工作,防止艾滋病疫情输入、蔓延。[方法]2008年,宁阳县疾病预防控制中心协调有关部门,实施了＂外出务工人员防治艾滋病多部门参与模式探讨＂项目,对外出务工人员进行艾滋病健康教育、行为干预和监测研究。[结果]活动实施前与实施1年后各调查750人。艾滋病防治知识总体知晓率分别为60.07%、87.77%（P〈0.01）;艾滋病态度、行为正确率,实施前为37.53%,实施后为64.2%（P〈0.01）。外出务工人员自愿咨询检测,实施前的1年为226人;实施期间的1年为502人,检出1例HIV抗体阳性者。实施期间主动检测108人,检出HIV抗体阳性者2例（外地到本地打工人员）。[结论]对外出务工人员实施的艾滋病宣传教育和行为干预工作取得明显效果。     

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.     

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.     

Psychopathological features of a patient population of targets of workplace bullying

BACKGROUND: A strong association between workplace bullying and subsequent anxiety and depression, indicated by empirical research, suggests that bullying is an aetiological factor for mental health problems. AIMS: To evaluate levels of stress and anxiety-depression disorder developed by targets of workplace bullying together with outcome at 12 months and to characterize this population in terms of psychopathology and sociodemographic features. METHODS: Forty-eight patients (36 women and 12 men) meeting Leymann Inventory of Psychological Terror criteria for bullying were included in a prospective study. Evaluations were performed at first consultation and at 12 months using a standard clinical interview, a visual analogue scale of stress, the Hospital Anxiety and Depression (HAD) scale, the Beech scale of stress in the workplace and a projective test (Picture-Frustration Study). RESULTS: At first consultation, 81% of patients showed high levels of perceived stress at work and 83 and 52% presented with anxiety or depression, respectively. At 12 months, only 19% of working patients expressed a feeling of stress at work. There was a significant change in symptoms of anxiety while there was no change in symptoms of depression. Stress at work and depression influenced significatively capacity to go back to work. At 12-month assessments, workers showed a significantly better score on the HAD scale than non-workers. Over half the targets presented a neuroticism-related predominant personality trait. CONCLUSION: Workplace bullying can have severe mental health repercussions, triggering serious and persistent underlying disorders.     

The rise and fall in incidence of malignant mesothelioma from a British Naval Dockyard, 1979-1999

BACKGROUND: The incidence of malignant mesothelioma in Britain is predicted to rise over the next 15-25 years because of past failure to protect the workforce against inhalation of asbestos. In British Naval dockyards, alternative insulation materials and respiratory protection were introduced from the mid-1960s. Aims This study was carried out to investigate the effects of these control measures on mesothelioma deaths in dockyard workers. METHODS: Cases of mesothelioma of the pleura and peritoneum between 1979 and 1999 in workers from the Devonport Naval Dockyard, south-west England, were sought from coroners' and medico-legal records. RESULTS: Three hundred and one cases were identified, 7% peritoneal. The peak incidence occurred in 1991 with 25 cases per annum (quadratic model fit R(2) = 74.2%, P < 0.001) and we predict that by 2003 the incidence will fall to fewer than five cases per annum. The mean time between first exposure and presentation was 48.5 years [95% confidence interval (CI) = 47.3-49.8], but this was significantly shorter in the more heavily exposed trades, when compared with the less heavily exposed (42 years, 95% CI = 39.0-45.0, versus 49.5 years, 95% CI = 48.2-50.9). Those with higher exposure were also at significantly greater risk of peritoneal disease (P < 0.023, Fisher's exact test). CONCLUSION: The reduction in incidence of mesothelioma is greater than can be accounted for by reduction in numbers of dockyard workers over the last 50 years. Changes in insulation materials and improved industrial hygiene measures introduced into the Devonport Dockyard from the mid-1960s have resulted in an earlier decline in the incidence of malignant mesothelioma than that predicted for the British workforce as a whole.     

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.     

Organophosphate toxicity and occupational exposure

The ubiquitous organophosphates present a continuing health hazard in agriculture, public health eradication programmes and as chemical warfare agents. Despite significant progress in understanding the potential mechanisms of toxicity far beyond the commonly accepted mechanism of cholinesterase inhibition in intentional exposures, the precise health effects following occupational exposures are yet to be completely defined. A much greater understanding exists of the clinical features of organophosphate poisoning. These are characterized by a triphasic response involving an initial acute cholinergic phase, an intermediate syndrome (both associated with high mortality) and a disabling but non-lethal delayed polyneuropathy. The delayed polyneuropathy may occur in the absence of the cholinergic or intermediate phases. However, progress is still required in order to improve the quantification and assessment of occupational exposures and the implementation of appropriate preventive measures. Finally, evidence-based guidelines for appropriate or optimal therapeutic interventions following poisoning are required urgently and collaborative work with colleagues in developing countries, where the occurrence of organophosphate exposures is more frequent, may provide the answers.     

Miliaria rubra of the lower limbs in underground miners

This report documents a case series of miliaria rubra of the lower limbs in miners at a deep underground metalliferous mine in tropical arid Australia. During the summer months of February and March 1999, all cases of miliaria rubra of the lower limbs in underground miners seen at the mine's medical centre were clinically examined and administered a questionnaire. Twenty-five patients were seen, an incidence of 56.4 cases per million man-hours. Miliaria rubra was most often located between the ankle and knee (88% of cases). Twenty-four percent had concurrent folliculitis and 20% had concurrent tinea. Thirty-two percent had a personal history of asthma. Walking through ground-water and splashing of the legs was common. Three to 4 weeks of sedentary duties in air conditioning was generally required to achieve resolution of miliaria rubra. The incidence of miliaria rubra of the lower limbs is 38% of the incidence of heat exhaustion at the same mine. The length of disablement is greater, however. Atopics may be at increased risk of miliaria rubra. Control measures are discussed.     

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.