南宁市注射吸毒人群共用针具行为及影响因素分析

目的了解南宁市注射吸毒人群共用针具现状及分析影响因素。方法采用匿名填写问卷的方式,对来自社区和戒毒所的733名注射吸毒人员进行艾滋病预防知识和行为的问卷调查。结果该市注射吸毒人群曾经共用针具的比例为53.3%。391名曾经共用针具的注射吸毒者中有51人在最近一次注射吸毒时仍然共用针具。对是否与别人共用过针具的多因素lgistic回归分析显示,文化程度、首次吸毒年龄、是否在戒毒所戒过毒、最近一年是否与商业性伴发生过性关系是具有统计学意义的影响因素。对与商业性伴发生性关系的多因素lgistic回归分析显示,性别、首次注射吸毒年龄、是否与他人共用过注射器是具有统计学意义的影响因素。对最近一次注射吸毒是否共用针具的多因素logistic回归分析显示,文化程度、是否在戒毒所戒过毒是具有统计学意义的影响因素。结论文化程度是影响注射吸毒者曾经共用针具和最近一次注射吸毒共用针具行为的共同因素;在戒毒所接受过戒毒的注射吸毒者其共用针具行为会发生改变;掌握艾滋病预防知识不一定能减少注射吸毒人群共用针具的行为。在加强艾滋病防治知识宣教的同时,要更加侧重于行为的干预。     

珠海市2006—2012年吸毒人群艾滋病哨点监测结果分析

目的了解珠海市吸毒人群艾滋病病毒(HIV)的感染情况,评价对本地吸毒人员所采取的干预措施的效果,为政府制定防制策略和措施提供参考依据。方法按照国家哨点监测方案的要求,对2006—2012年新进入珠海市某戒毒所的吸毒人员进行高危行为、艾滋病知识知晓情况等内容的问卷调查,并采集血清样本进行HIV抗体检测。结果 2006—2012年珠海市哨点共监测吸毒者2 707人,检出HIV抗体阳性57例,阳性率为2.11%;阳性率从2006年的5.37%(24/447)逐年下降到2012年的0.49%(2/407)(P<0.01)。注射吸毒者的HIV抗体阳性率为3.99%(47/1 178),非注射吸毒者的HIV抗体阳性率为0.65%(10/1 529),差异有统计学意义(P<0.01)。共用针具注射吸毒者的HIV抗体阳性率为10.7%(44/411),无共用针具的注射吸毒者的HIV抗体阳性率为0.39%(3/767),差异有统计学意义(P<0.01)。2 707名吸毒者中发生商业性行为813人,占30.03%;发生商业性行为时每次都使用安全套者224人,安全套使用率为27.55%。吸毒者艾滋病知识知晓率为85.34%(1 397/1 637)。结论近年珠海市吸毒人群HIV感染率持续下降,但共用针具吸毒和商业性行为等感染HIV的高危因素依然存在。今后在加强对该人群艾滋病防治知识宣传教育同时,应进一步扩大针对该人群的美沙酮维持治疗、清洁针具交换、安全套推广等行为干预的覆盖面。     

甘肃省静脉吸毒人员共用针具高危行为及影响因素分析

目的了解甘肃省静脉吸毒人群共用针具的高危行为及其影响因素。方法收集2009年甘肃省吸毒人群综合、省级哨点监测数据,进行共用针具高危行为、艾滋病相关知识及HIV抗体检测等数据分析。结果静脉吸毒人员中共用针具者占37.24%;共用针具静脉吸毒人员HIV总体知晓率为85.80%;不同文化程度的共用针具静脉吸毒人员的HIV相关知识知晓率差异有统计学意义(χ2=9.88,P=0.04);共用针具组丙肝感染率(74.80%)明显高于非共用针具组(28.04%),(χ2=70.31,P=0.00);多因素logistic回归分析表明吸毒者的注射吸毒频率为发生共用针具高危行为的影响因素。结论甘肃省静脉吸毒人员共用针具的高危行为比较严重,注射吸毒频率为发生共用针具高危行为的主要影响因素。     

珠海市2006-2012年吸毒人群艾滋病哨点监测结果分析

目的了解珠海市吸毒人群艾滋病病毒（HIV）的感染情况,评价对本地吸毒人员所采取的干预措施的效果,为政府制定防制策略和措施提供参考依据。方法按照国家哨点监测方案的要求,对2006--2012年新进入珠海市某戒毒所的吸毒人员进行高危行为、艾滋病知识知晓情况等内容的问卷调查,并采集血清样本进行HIV抗体检测。结果2006--2012年珠海市哨点共监测吸毒者2707人,检出HIV抗体阳性57例,阳性率为2．11％;阳性率从2006年的5．37％（24／447）逐年下降到2012年的0．49％（2／407）（P〈0．01）。注射吸毒者的HIV抗体阳性率为3．99％（47／1178）,非注射吸毒者的HIV抗体阳性率为0．65％（10／1529）,差异有统计学意义（P〈0．01）。共用针具注射吸毒者的HIV抗体阳性率为10．7％（44／411）,无共用针具的注射吸毒者的HIV抗体阳性率为0．39％（3／767）,差异有统计学意义（P〈0．01）。2707名吸毒者中发生商业性行为813人,占30．03％;发生商业性行为时每次都使用安全套者224人,安全套使用率为27．55％。吸毒者艾滋病知识知晓率为85．34％（1397／1637）。结论近年珠海市吸毒人群HIV感染率持续下降,但共用针具吸毒和商业性行为等感染HIV的高危因素依然存在。今后在加强对该人群艾滋病防治知识宣传教育同时,应进一步扩大针对该人群的美沙酮维持治疗、清洁针具交换、安全套推广等行为干预的覆盖面。     

共用针具的男性吸毒人群的高危行为调查

目的了解共用针具的男性吸毒人群的高危行为。方法2006年6月,采用匿名自填问卷的方式对广东省珠海市某强制戒毒所全部男性吸毒人员进行调查,内容包括共用针具的高危行为和性行为。结果在397名吸毒者中,125名进入戒毒所前1个月发生过共用针具行为。其中93人(74.4%)曾与他人直接共针,108人(86.4%)曾与他人共用同一瓶水洗针或用同一棉球、容器溶解过滤毒品,76人(60.8%)上述两种情况都有发生;共用注射器的主要原因是夜间注射买不到针(50.0%)和着急注射时身边没有针(43.5%);共用注射器前往往不进行任何处理(12.5%)或只用冷水冲洗(67.0%);该类人群多性伴占68.0%(85/125),最近1个月与固定性伴和临时性伴每次都使用安全套的比例分别为5.2%(5/96)和12.0%(9/75);不愿意进行针具交换的比例达86.9%(106/122);认为自己有感染HIV可能性的只占24.8%(31/125)。结论该人群直接和间接共用针具的行为频繁、安全套使用率低以及对共用针具的危害缺乏认识,因此应在该类人群中尽快开展宣传教育、美沙酮治疗、针具交换和安全套推广。     

针具交换对注射吸毒人群高危吸毒行为及HIV感染的影响

目的评价广西针具交换项目通过影响注射吸毒人群高危吸毒行为达到预防艾滋病传播的效果。方法选择吸毒较严重的2个市(县/区)的针具交换点作为研究现场,采取面对面访谈的方式开展结构式问卷调查,内容包括人口学特征、参加针具交换情况及其影响因素、高危吸毒行为等;并采集研究对象的血样进行HIV抗体检测。采用χ2检验、单因素及多因素Logistic回归分析来评价针具交换项目对注射吸毒人群高危吸毒行为及HIV感染的影响。结果共调查355名注射吸毒者,其中近1年参加针具交换项目的为304人,未参加者51人。多因素Logistic分析结果显示,参加针具交换者有利于降低注射吸毒者重复使用1支针(OR=0.15,95%CI=0.07~0.33)和共用针具(OR=0.08,95%CI=0.07~0.33)注射吸毒的不安全注射行为;而长时间的吸毒年限、每天注射吸毒、重复使用及共用针具是注射吸毒者感染HIV的危险因素。结论针具交换项目能有效降低注射吸毒人群共用针具的行为,在预防艾滋病传播中具有重要作用。     

东莞市吸毒人群艾滋病KABP及感染情况的调查

[目的]了解东莞市吸毒人群HIV感染情况、危险因素及与艾滋病有关的知识、态度和行为,为制定吸毒人群的艾滋病防控措施提供依据。[方法]对2004～2006年在东莞市强制戒毒所戒毒的1 032名吸毒者进行血清HIV抗体检测,同时采用统一的问卷搜集每名研究对象的人口学、行为学等相关资料。将所有资料输入EPIDATA 3.0,采用STATA 10.0软件进行统计分析。[结果]东莞市吸毒人群的HIV感染率为5.04%。男性吸毒人群的感染率（5.53%）高于女性（0.92%）,差异有统计学意义（χ^2=4.3262,P=0.038）;注射吸毒的感染率（7.09%）高于口吸毒品者（0.61%）,差异有统计学意义（χ^2=19.6072,P=0.000）;共用针具吸毒者的感染率（11.84%）高于未共用针具者（4.62%）,差异有统计学意义（χ^2=12.9877,P=0.002）。东莞市吸毒人群注射吸毒率68.31%、针具共用率34.75%;艾滋病防治知识知晓率39.34%;商业性性行为发生率22.09%,买淫和卖淫时每次均使用安全套率50.26%和46.81%。[结论]东莞市吸毒人群HIV感染率持续上升的势头已得到初步遏制,但吸毒人群中仍然存在着共用针具、商业性性行为、安全套使用率低、艾滋病防治知识欠缺等危险因素,建议在吸毒人群中采取宣传教育和行为干预并重的防控措施。     

中山市2005年静脉吸毒人群艾滋病相关行为调查

目的 了解中山市静脉吸毒者艾滋病的相关危险行为因素.方法 对中山市戒毒所内戒毒者和社区吸毒者进行面对面行为学问卷调查.结果 共调查225名静脉吸毒者,在最近1个月中,77.3%的静脉注射吸毒每天有2次以上注射毒品;最近1次吸毒16.4%有共用针具行为,最近半年中共用针具的比例显著低于2002年广东省的调查结果（75.7%,x^2=8.29,P＜0.05）.吸毒者与临时性伴的安全套使用率为63.26%,与固定性伴的使用率仅为34.00%;最近半年内与临时性伴使用安全套的情况比2002年的调查结果有所提高,但差异无统计学意义（x^2=3.66,P＞0.05）.接受过自愿咨询检测（VCT）者占27.11%,男性低于女性（x^2=5.26,P＞0.05）.结论 中山市针对静脉吸毒者的艾滋病宣传教育初见成效,共用针具的比例有所下降,但是,还应进一步降低无保护性行为的比例,加大VCT的力度.     

福州市部分在戒吸毒人员艾滋病知识和相关危险行为分析

[目的]了解福州市吸毒人员艾滋病相关危险行为,为制定艾滋病防治措施提供依据。[方法]对福州市两戒毒所内在戒吸毒人员进行问卷调查。[结果]455名吸毒者中有76.3%有注射吸毒史;30.0%有共用针具史;52.5%有临时性伴,35.1%最近一次与临时性伴发生性行为时使用安全套。[结论]吸毒者中普遍存在感染HIV相关危险行为,应尽快采取有效措施,控制艾滋病在吸毒人群中的传播和蔓延。     

新旧注射吸毒人群HIV传播因素研究

目的探讨和分析新旧注射吸毒者的人口学特征及HIV传播因素,为预防控制艾滋病流行提供科学依据。方法选取针具交换点和戒毒所新旧人群为研究对象,采用面对面问卷调查,问卷内容包括新旧人群的人口学特征、艾滋病相关知识、干预服务参号隋况、高危行为学特征及HIV传播影响因素。应用SPSS16．0软件进行统计分析。结果共调查474例注射吸毒者,其中新人群（注射吸毒≤5年）及旧人群（注射吸毒〉5年）分别为157例（33．1％）和317例（66．9％）。调查对象的HIV感染率为20．5％,HIV感染率与吸毒年限呈正相关趋势（_=0．83,P=0．004）,且在5年内的变化速率最快。多因素Logistic回归模型结果显示,在〈30岁的新人群中,男性、重复使用及共用针具是HIV传播的影响因素;在30～40岁的旧人群中,男性、知晓共用注射辅助材料的危害及共用针具是HIV传播的影响因素;在〉40岁的旧人群中,男性、文化程度初中及以上、参加过针具交换及共用针具是HIV传播的影响因素。结论加强对新旧人群的宣传教育力度,倡导针具交换、有套性交、扩大干预服务覆盖面,知而信、信而行,是预防控制HIV传播与流行的有效措施。     

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.     

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.     

Planning research

The starting point for any research project should be a question.Once this has been defined and the relevant scientific literaturereviewed, a protocol should be drawn up. This will be used notonly as a guide to the conduct of the study and in the preparationof the final report, but also in seeking any financial supportand approvals that are required for the investigation. A protocolis normally arranged in sections covering the background tothe study, the question(s) that it will address, the methodsthat will be used for the collection and analysis of data, thestatistical power of the investigation (where relevant), anyethical considerations, and the financial input that will beneeded. A pilot study is often helpful where aspects of thestudy method are untried or of uncertainvalidity.     

Stress in the Norwegian police service

BACKGROUND: High levels of stress have been attributed to the conditions of police work, but there is little empirical evidence for this. AIMS: To develop a new instrument to measure job stress in the police; to assess the most severe and frequent police stressors; to compare levels of stress according to the demographic and organizational factors; and to study stress in relation to personality traits, work locus of control and coping strategies. METHODS: A comprehensive nationwide questionnaire survey of 3272 Norwegian police at all hierarchical levels, including the Norwegian Police Stress Survey (NPSS), the Job Stress Survey, the Basic Character Inventory, the Work Locus of Control Scale, and the Coping Strategies Scale. RESULTS: Work injuries were appraised as the most stressful but least frequent stressor and job pressure was reported the least severe but most frequent stressor. Females experienced job stressors less frequently, but appraised them as more severe than men did. Older police officers reported more job pressure severity and fewer work injuries. The police in districts where peer support was planned but not implemented, and who worked in districts with more than 50,000 inhabitants, perceived the lack of support more severely than others. The correlations between stress and personality traits, work locus of control, and coping were moderate. CONCLUSIONS: The NPSS captures police-specific stressors that are not adequately measured by global stress instruments. The study of stress in police work should preferably involve a nationwide use of police-specific stress instruments.