河北省农村沼气建设与健康教育需求研究

目的了解农村沼气建设及其综合利用对庭院环境卫生和农民健康状况的影响,探讨农村沼气建设及与农民健康促进工作的工作模式。方法选择两个沼气项目县,对402户进行问卷调查和6个村的骨干人群进行专题小组讨论,并采集沼液、沼渣101份进行了寄生虫虫卵检查。结果有沼气户的庭院卫生、厨房卫生、厕所卫生明显好于无沼气户,有效改善了农村脏、乱、差和“五乱”现象;沼气综合利用知识知晓率及健康行为形成率,有沼气户显著高于无沼气户。沼气中寄生虫卵的杀灭效果达100%,使粪便完全达到了无害化。农民获得沼气有关知识的主要途径是通过电视媒体和宣传品。结论沼气建设及其综合利用具有显著的环境卫生改善效果,应充分利用电视、宣传品等渠道和传播材料,广泛传播沼气综合利用的知识,尤其注重推广、普及沼气的广泛用途,提高沼气的综合利用效能。     

农村沼气建设对农民卫生知识行为改变的调查

沼气在我国农村作为一种新能源被开发利用。为了解沼气建设对改善农村环境卫生和农民健康状况的影响，2004年由农业部、卫生部共同设立“农村沼气建设及其综合利用健康促进项目”，以亿万农民健康促进行动为平台，并于2005年分别对江西、贵州、河北、陕西4省骨干人群及沼气使用农户进行了定量问卷调查研究。     

血吸虫病防治宣传画效果评价报告

目的评价针对血吸虫病重点流行地区不同目标人群特点制作的血吸虫病防治宣传画的传播效果和经验。方法在下发过宣传画的血吸虫流行县，对随机抽取中小学生采用自填调查问卷的方法进行定量分析；对随机抽取的家庭妇女、村干部、医生、教师等重点人群采用专题小组讨论的方法进行定性分析。结果中学生对宣传画传播的血吸虫病防治相关知识的知晓率为69.844％～96.82％之间；小学生为87．64％～98.88％之间；中小学生回答能够理解3张血吸虫病防治宣传画分别是82．54％和93．26％；重点人群专题访谈时，均能讲出宣传画的相关卫生知识要点。结论此套宣传画的核心信息与知识要点，中小学生和重点人群等均能认同和理解，具有较好的针对性、科学性和趣味性。     

沼气建设对农村骨干人群健康相关知识、态度和行为影响的定性研究

目的了解沼气建设对农民健康相关知识、态度、行为影响因素,探讨农民健康教育需求状况。方法采用定性研究方法,对沼气建设示范村骨干人群和乡村医生进行专题小组访谈,共45组。结果90%以上的乡村骨干人群对沼气建设及其综合利用的好处持赞赏态度,认为沼气建设是一件清洁再生能源、促进农民健康、建设社会主义新农村的好事,但需要进行科学和规范化。医生普遍认为沼气建设有助于农民卫生行为形成,促进农民的健康意识和生活质量的提高。结论乡村骨干人群是农村沼气建设的核心力量,该人群和已经持证上岗技术员的健康相关知识、态度和行为,是影响农村沼气建设与促进环境卫生改善的关键因素,也是加快农村沼气建设,促进预防常见传染病、提高农民健康意识的重要因素。     

改水地区骨干人群健康相关知识、态度、行为状况调查分析

通过 1998～ 2 0 0 2年在河北、湖北、江西、内蒙古和云南 5省 (区 )实施世界银行贷款第三期中国农村供水与环境卫生项目 ,对项目村骨干人群在项目实施前进行深入访谈研究 ,了解项目实施地区健康教育环境支持条件 ,分析当地开展健康教育的资源状况 ,及农村骨干人群参与此项活动的意愿、要求和建议。对象与方法1 对象　 2 0个项目村骨干人群 :村主任或支书、村妇女主任、村医生和小学教师共 75名。2 方法　每个项目省随机选择 2个具有代表性的项目县 ,每个项目县选取 2个有代表性的项目村 ,对其骨干人群进行调查。3 内容　项目村骨干人群对…     

贵州省儿童计划免疫IEC策略宣传画及预防接种证插页预试验研究

目的了解IEC策略传播材料与目标人群的相关性、可接受性、可行性及适用性。方法在贵州省IEC策略需求评估地区，针对宣传画和预防接种证插页传播材料共进行两轮预试验，分别调查了115名和128名村民，并分别对27名和45名儿童家长进行小组讨论和个人深入访谈。结果第一轮预试验中，只有60．5％的目标人群能够理解宣传画的文字含义，存在易混淆词语；能完全看懂图画含义的目标人群更少（占7．8％），图画内容极容易产生歧异，根据村民的意见和建议进行修改、完善；第二轮预试验，在能认读宣传画文字的村民中，91．7％的人能完全理解含义，大部分村民能看懂图画的内容，对宣传画的接受性、认同性较高。预防接种证插页是宣传画的黑白形式，修改后95．6％的村民可以看懂大部分内容，97．8％的村民对预防接种证加插页表示认同和接受。结论传播材料在应用到健康促进策略前有必要进行预实验。经两轮预试验后，IEC策略宣传画和预防接种证插页传播材料定稿，建议在IEC传播策略中使用。     

计划免疫民歌多媒体传播策略的探讨

目的 探讨民歌VCD形式在贵州少数民族地区进行儿童计划免疫IEC策略传播方式.方法 VCD母带制作完成后,在贵州省黔东南州榕江和剑河县进行2轮预试验.共组织12组(每组6～14人)目标人群的小组讨论,对6个预试验村的村长/支书/组长,共15人和20名村医进行了个人深入访谈.结果 根据需求评估结果,初步确定民歌VCD的传播媒介和传播途径,经过2轮预试验,结合目标人群的需求以及当地实情,对民歌VCD的传播媒介进行了完善,最终确定了适合项目地区民歌VCD的传播策略.结论 为保证传播效果,传播策略的设计应适合目标人群的需求.     

云南省老项目试点县路南县《生命知识》传播终期效果评估

本文报告了自１９９３年５月至１９９５年５月在老项目试点县路南昌，对全县目标人群（月５岁以下孩子母亲、孕妇、新婚未孕妇女）进行《生命知识》传播效果的评估，以７５％的目标人群知晓７５％的《生岗知识》信息的目标为终期传播效果评估指标。结果表明，传播后较传播前目标人群对《生命知识》信息知晓率和采纳正确妇幼卫生行为率分别提高５％—６０％和４％—６０％左右，效果十分显著，制已超过了项目终期评估指标。本文还报告了以人际传播为主，大众传播为辅，并铺以友放传播材料的传播策略符合我国农村的实际情况，尤真在老少边穷省份的农村是行之有效的重要手段。     

广西农村《生命知识》核心信息相关行为变化定性调查与传播策略研究

为了解农村目标人群的《生命知识》核心信息及相关行为改变的影响因素，为中国／UNICEF健康教育与健康促进合作项目制定新的《生命知识》传播策略提供依据，本研究选择广西壮族自治区恭城瑶族自治县，并深入该县平安乡和莲花镇的各两个村进行了现场调查。现将定性研究结果报告如下。[第一段]     

农村沼气建设及其综合利用的卫生效果项目预试验分析

目的评价农村沼气建设及其综合利用的卫生效果与健康教育需求调研方案的科学性和可行性，验证问卷和访谈提纲与调查方案目的和要求的一致性，检查问卷及访谈提纲的针对性、通俗性、可操作性和数据库的有效性。方法调查人员采用现场观察和随机抽样问卷调查的定量方法进行；对村骨干人群采用专题小组讨论的定性研究方法；调查人员进行调查前培训，考核达标后分组参加预试验调查。在卫生效果指标中选择了对调查户沼气池内的沼液沼渣混合物抽样显微镜检查寄生虫卵的方法。结果通过两轮预试验，验证了调研方案的组织管理体系的有效性；调研问卷在一般情况、卫生状况、KAP等35项问题中，共发现有20个问题的26项存在着逻辑顺序、内容重复和遗漏项目等方面的问题；正确地修改和完善了调查问卷和访谈提纲；确定了沼液沼渣混合物寄生虫卵镜检样本的抽取方法和家庭环境卫生指标的观察标准，审核了数据库录入和统计分析的方法。结论预试验的有效实施，为最终全面实施调研方案的确定提供了科学依据。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.