The use of benzodiazepines among injecting drug users

Benzodiazepine use among injecting drug users (IDUs) presents a major clinical and public health problem that may increase in importance. The current paper examines the research on the extent of benzodiazepine use among IDUs and the harmful consequences associated with such use. Numerous studies have found benzodiazepine use to be widespread among IDUs, and to be associated with greater levels of risk-taking and polydrug use, and poorer psychosocial functioning than other IDUs. The injection of benzodiazepines has also been reported, and presents problems in itself. The implications of existing research for both clinical practice and research are discussed.     

Estimating the human immunodeficiency virus infection curve of intravenous drug users in Lombardia,Italy

We present a model to estimate the infection curve of the human immunodeficiency virus in intravenous drug users in Lombardia. We based estimates on AIDS incidence data, according to a backcalculation model accounting for therapy and changes in the surveillance definition of AIDS.     

Failure rates among perfect users and during perfect use: a distinction that matters

To make an informed decision when choosing a contraceptive, women and couples need to know how effective different methods are when used perfectly, where perfect use is defined as following the directions for use. In this article, we show that unbiased estimates of pregnancy rates during perfect use can be guaranteed only if information on consistency and correctness of use is available for each menstrual cycle. The estimated probability of pregnancy during a year of perfect use among the subset of women who always used a method perfectly will be biased upward.     

浅谈护士长的公关意识及作用

本文从5个方面论述了公关意识及其临床作用。即①塑造形象的意识;②服务公众的意识;③沟通交流的意识;④创新审美的意识;⑤真诚互惠的意识。通过对其作用的论述,旨在引起广大护理工作者对公共关系的重视,从而促进护理学科发展。     

Coinfections by HIV, hepatitis B and hepatitis C in imprisoned injecting drug users

In order to know the prevalence and risk factors for coinfections by human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) among injecting drug users (IDUs), a cross-sectional study was carried out in two prisons of the province of Cantabria, northern Spain. Three hundred and sixty-two IDU inmates were recruited. All inmates were interviewed and their blood tested for HIV, HBV and HCV. Crude and multiple risk factor adjusted for (by polychotomous logistic regression) odds ratios were calculated. Prevalence of HBV-HCV coinfection (42.5%) was higher than HIV-HBV-HCV coinfection (37.3%), whereas monoinfections were very uncommon (overall: 13%). Long-term injectors and reincarceration were the foremost risk factors for both coinfections, showing a trend between the degree of association and the number of viruses infecting a patient. No significant relationship between coinfection status and sexual practices was observed. The results related to coinfections are consistent with previous studies of prevalence and risk factors for HIV, HBV and HCV, in indicating that the high rates of coinfections among IDU inmates emphasise the need to harm-reduction policy across prisons in Spain.     

Direct and indirect acquisition of syringes from syringe exchange programmes in Baltimore, Maryland, USA

Syringe exchange programmes (SEPs) are a fundamental source of sterile syringes and other health services for injection drug users (IDUs). However, various obstacles prevent many individuals from obtaining syringes from this source. As a result, some IDUs acquire syringes from “secondary exchangers”. The current study assessed the acquisition of syringes from the Baltimore City Needle Exchange Program (BNEP) as well as factors associated with obtaining syringes from the BNEP. Participants were asked to identify the colour of the cap of the most recently obtained syringe (red or grey cap suggested BNEP origins). In addition, support and risk network variables were examined. Although 38% reported using a syringe with a grey or red cap, only 7% reported that the BNEP was their primary source of syringes. Multivariate analyses showed that reporting the most recent syringe cap as red or grey was associated with obtaining syringes from the BNEP, obtaining syringes from a spouse, obtaining syringes from friends/neighbours, and number of drug users in their network. Based on these findings, encouraging secondary exchange is an effective method of providing injectors with syringes.     

公立医疗机构补偿机制改革的思考

该文以当前卫生改革的热点为题,通过深入分析公立医院补偿机制的4方面问题,提出了相应的改革思路。     

加强公立医院改革完善公立医院体制机制

分析了当前公立医院面临的主要困难,评价了三十年医疗卫生改革所取得的成绩与不足,提出在公立医院改革中应因地制宜,切合实际;完善医疗收费价格体系,明确基本医疗服务范畴;建立医疗集团或医疗联合体,规范病人的就医行为;确立公立医院的法人治理结构.     

室内装修后空气中甲醛浓度的变化趋势

目的 :研究室内装修后空气中甲醛浓度的变化趋势。方法 :选择装修后不同时间段的居民住宅 5 4家和公共场所经营单位 5 2家进行室内空气中甲醛浓度的测定。结果 :甲醛浓度在居民住宅装修 1年之内的超标率为 79.9%～ 85 .4 % ,1年～ 2年之间的超标率为 5 0 .0 % ,2年之后为 18.3% ,3个时间段甲醛浓度超标率差异有显著性 (P<0 .0 5 )。公共场所装修半年之内甲醛含量的超标率为 6 5 .5 %～ 81.3% ,半年～ 1年为 36 .84 % ,1年之后小于 15 .4 % ,3个时间段甲醛浓度超标率差异有显著性 (P<0 .0 5 )。结论 :室内装修后甲醛浓度随着装修时间的延长而逐渐降低 ,居民住宅约需 2年 ,公共场所需 1年才能达到国家卫生标准     

社区中静脉吸毒人群梅毒感染危险因素研究

目的　了解四川省凉山地区静脉吸毒人群梅毒感染情况及相关危险因素。方法　以社区为基础招募吸毒人员 ,调查静脉吸毒人群梅毒感染的危险因素。结果　静脉吸毒人群中梅毒感染率为15 3% (5 8/ 379)。在单因素卡方分析和多因素Logistic回归模型分析中 ,梅毒感染的危险因素包括与性行为相关的因素 :近 6个月是否有性伙伴以性交为条件给你提供了毒品、物品或住处 (商业性性行为 )、近 6个月性伴人数、近 6个月新性伴人数、近 6个月与非主要性伴的性交频率和近 1个月是否与非主要性伴有过阴道性交。结论　需加强对四川省凉山地区静脉吸毒人群吸毒行为和性行为的健康教育和干预措施来控制性病和艾滋病传播