建水县110名男男性接触者健康状况调查分析

目的 摸清建水县男男性接触者艾滋病知晓率、安全套使用率、HIV感染率,为探索和建立男男性接触者综合干预模式提供科学依据.方法 对年龄在18周岁以上,一年内与男性发生过口交或肛交性行为的110名男男性接触者开展健康问卷调查,同时采集静脉血进行HIV抗体、梅毒检测.结果 110名男男性接触者艾滋病知识知晓率为80.57%,安全套使用率为2454%,HIV感染率为7.27%,梅毒感染率为5.45%.结论 建水县男男性接触人群艾滋病知晓率、安全套使用率低,HIV感染率高,加强男男性接触人群的行为干预,提高安全套使用率是遏制男男性接触者中艾滋病和性病传播与流行的重要措施.     

遵义市男男性行为人群HIV、梅毒、HCV感染状况及其行为学特征

目的了解遵义市男男性行为者(MSM)艾滋病病毒(HIV)、梅毒和丙型肝炎病毒(HCV)感染状况,以及艾滋病性病相关高危行为,为制定艾滋病性病防治策略和干预措施提供依据。方法采取横断面调查,对中心城区MSM人群进行问卷调查,同时抽取血样进行HIV、梅毒和HCV实验室检测。结果调查MSM人群109例,HIV感染率为10.09%;梅毒感染率为0.92%,HCV感染率为0.92%,对艾滋病的知晓率为96.33%,最近6个月发生同性肛交时,每次性行为使用安全套的比例为20.51%,最近6个月发生异性性交时,每次性行为使用安全套的比例为7.70%。结论遵义市MSM人群"知识-行为分离"现象严重,安全套使用率低,应进一步加强该人群的行为干预措施,控制艾滋病性病经性途径传播。     

2009—2011年北京市西城区暗娼艾滋病知识行为调查分析

目的了解2009—2011年北京市西城区暗娼(FSW)人群艾滋病知识认知水平、行为特征和人类免疫缺陷病毒(HIV)、梅毒感染率,为开展有针对性的行为干预和宣教工作提供依据。方法使用问卷每年对200人进行艾滋病防治相关知识与行为调查;采集静脉血标本,检测HIV、梅毒螺旋体抗体。结果 2009—2011年,FSW的艾滋病知识知晓率分别为77.5%、81.0%和99.0%,差异有统计学意义(χ2=43.78,P0.01)。最近1次商业性行为时安全套使用率分别为56.5%、46.0%和93.0%(P0.01)。梅毒检出率分别为1.5%、1.0%和1.0%,HIV抗体阳性检出率分别为0.5%、0、0。结论 2009—2011年,北京市西城区FSW人群艾滋病知识知晓率逐年上升。2011年最近1次商业性行为时安全套使用率较2009和2010年明显上升,但安全套坚持使用率仍较低,应继续加强安全套推广工作,继续做好对该人群艾滋病性病的宣传教育及干预工作。     

135例MSM人群行为学特征与行为干预实践

目的了解岳阳市部分男男同性性行为人群（MSM）行为学特征与艾滋病相关危险行为及其艾滋病病毒（HIV）和梅毒（SP）感染状况,探讨行为干预实践。方法采用横断面调查,在外展活动中对男同性恋者进行问卷调查,包括基本信息、与艾滋病感染的危险行为和艾滋病相关知识。抽取血样进行HIV和梅毒的实验室检测,同时开展知识讲座、免费发放安全套和宣传资料等。结果 MSM人群平均年龄26岁,将近50%的人受过高等教育,74%的人为未婚,三分之一的人是绝对同性恋,主要性行为是插入肛交（56.30%）,其次为相互手淫（50.37%）,与男性发生插入性行为时有14.1%的人从未使用过安全套。艾滋病性病防治有关知识知晓率达到92.6%以上。HIV感染率4.27%,梅毒抗体阳性率8.54%。结论岳阳市MSM人群危险性行为普遍存在,安全套使用率低,HIV、梅毒感染率较高,需进一步加强对该人群有效的宣传教育和行为干预,以控制HIV的传播。     

2013年厦门市男男性行为人群艾滋病哨点监测结果分析

目的了解2013年厦门市男男性行为(MSM)人群HIV感染状况、艾滋病防治知识知晓率、艾滋病相关行为情况。方法按照《全国艾滋病哨点监测实施方案》,对辖区男男性行为人群进行问卷调查,采静脉血进行HIV、丙肝、梅毒抗体检测。结果 2013年HIV、梅毒、丙肝感染率分别为:9.0%、4.7%、0.0%。艾滋病知识综合知晓率为92.1%。近6个月有发生过同性肛交性行为的人中使用安全套的比例为93.2%。近6个月有过商业同性性行为的人群中安全套使用率为100%。近6个月与异性发生性行为的比例为18.1%。结论根据监测所得出的艾滋病知识知晓的薄弱环节和不同情况下安全套使用率的不同,应对当地MSM人群进行有针对性的宣教与干预,进一步提高艾滋病干预服务的覆盖率,加强MSM人群健康意识,提高其安全套使用率和性病治疗率,从而减缓艾滋病在该人群的蔓延。     

厦门市2013年吸毒人群艾滋病哨点监测结果

目的了解厦门市2013年吸毒人群HIV、丙肝和梅毒感染状况,以及艾滋病防治知识知晓率和相关行为。方法按照《全国艾滋病哨点监测实施方案》,对辖区吸毒人群进行问卷调查,采静脉血进行HIV、丙肝和梅毒抗体检测。结果 2013年共调查405人,HIV、梅毒和丙肝感染率分别为0、3.5%和65.7%。艾滋病知识综合知晓率为82.2%。毒品以海洛因为主,注射毒品为73.8%,曾共用针具为5.4%,最近1次性行为使用安全套为13.8%。结论厦门市吸毒人群艾滋病防治知识知晓率较低,共用针具现象仍存在,安全套使用率不高。应加强对吸毒人群艾滋病干预力度,加大毒品危害宣传,倡导安全性行为,减少艾滋病及相关疾病在吸毒人群的传播。     

2013年芜湖市暗娼人群艾滋病哨点监测结果分析

目的了解芜湖市暗娼人群对艾滋病(AIDS)知识的知晓率、性行为特征、接受AIDS预防相关服务情况及人类免疫缺陷毒(HIV)、梅毒、丙型肝炎(丙肝)感染状况,为对该人群开展AIDS综合防治和有效干预提供依据。方法由接受过培训的高危行为干预工作队工作人员,进入芜湖市娱乐场所,采用《全国艾滋病哨点监测实施方案》中暗娼人群问卷进行现场调查,采集血液标本进行HIV、,梅毒螺旋体(TP)、丙肝病毒(HCV)、血清学检测。结果共对400名暗娼进行了调查,AIDS相关知识知晓率为92.75%,最近1次与客人发生性行为时安全套使用率为96.00%,最近1个月内与客人发生性行为时每次使用安全套的比例为71.50%。每次坚持使用安全套(OR=0.099,95%CI:0.041~0.239)是TP感染保护因素。在接受艾滋病相关服务方面,接受过"安全套宣传发放/艾滋病咨询与检测"的人数占所有调查人数的91.00%;接受过"同伴教育"的占45.75%。调查对象HIV、TP、HCV感染率分别是0.25%,7.50%,1.25%。结论芜湖市暗娼人群对艾滋病知识知晓率较高,安全套每次使用率低,TP感染率高,虽然现在HIV感染率较低,但暗娼人群感染HIV的风险依然较高,需要继续加强对该类人群的针对性行为干预和监测工作。     

农民工艾滋病防治知识、行为及感染状况调查

目的 了解外出农民工的艾滋病(AIDS)防治知识、行为和人类免疫缺陷病毒(HIV)感染状况,为制定艾滋病防治措施提供科学依据.方法 对2007年春节期间回家的外出务工人员进行艾滋病防治知识问卷调查,并采集血液检测HIV抗体.结果 2006名农民工中,97.41%听说过艾滋病,对艾滋病的传播途径回答正确率29.21%,HIV/AIDS相关知识知晓率11.57%,不安全性行为中安全套使用率较低,检出HIV感染者1例,感染率为0.5‰.结论 农民工对艾滋病防治知识的知晓仍处于较低水平.亟需对他们普及艾滋病防治知识,消除对艾滋病的恐惧和歧视,防止艾滋病向农村传播.     

徐州市泉山区嫖娼人群性病/艾滋病感染状况调查

目的了解徐州市泉山区嫖娼人群HIV/梅毒感染情况及预防知识知晓率。方法对泉山区北山看守所嫖客进行现场问卷调查和静脉采血,进行HIV/梅毒抗体检测。结果共调查93名嫖客,STD相关知识总知晓率仅为66.7%,艾滋病知识总知晓率仅为60.2%;最近一次与暗娼发生性行为时安全套使用率为54.8%,最近一年与暗娼发生性行为时每次都用安全套的比例为50.5%;血清学检测梅毒抗体阳性4例,感染率为4.3%,无HIV感染者。结论泉山区嫖娼人群STD/AIDS相关知识缺乏,商业性行为中安全套长期使用率较低,应加强干预。     

2013年柳州市低档涉性娱乐场所嫖客艾滋病知识行为及感染状况调查分析

目的了解2013年柳州市低档涉性娱乐场所嫖客人群的艾滋病(acquired immunodeficiency syndrome,AIDS)相关知识、行为及艾滋病病毒(human immunodeficiency virus,HIV),梅毒的感染状况,为制定艾滋病性病防治策略提供科学理论依据。方法选择柳州市路边店、出租屋和街头等低档涉性娱乐场所的嫖客人群进行问卷调查,并采集静脉血样进行HIV和梅毒的血清学检测。结果共调查207名低档娱乐场所嫖客,其AIDS相关知识知晓率为46.4%,最近一年发生商业性行为坚持使用安全套的比例为10.4%,HIV阳性感染率为1.93%,梅毒的阳性感染率为13.53%。多因素Logistic回归分析显示,艾滋病知识的知晓是柳州市低档娱乐场所嫖客人群发生商业性行为坚持使用安全套的保护因素。结论柳州市低档涉性娱乐场所嫖客人群艾滋病知识知晓率和商业性行为中安全套坚持使用率均较低,处于感染艾滋病性病的高风险中,需要制定针对性的干预策略,遏制艾滋病经性传播途径由高危人群向一般人群的蔓延。     

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.