2008年巍山县女性性工作者艾滋病相关情况调查

[目的]了解女性性工作者艾滋病、梅毒感染情况及艾滋病相关知识、性行为情况,为卫生部门制订艾滋病控制措施提供科学依据。[方法32008年10月,对巍山县85名暗娼进行调查。[结果]调查85人,检出HIV感染者4人（感染率为5．80％）,检出梅毒感染者1人（感染率为1.45％）;艾滋病相关知识回答正确率为86．76％;最近1次与客人发生性行为时安全套使用率为97．65％．最近1个月与客人发生性行为时,每次均使用安全套的占85．00％;最近1年出现过性病症状体征的占34．12％。[结论]巍山县女性性工作者中已发现HIV感染者,艾滋病相关知识知晓率较高,与客人发生性行为时安全套使用率较高。     

美沙酮门诊HIV感染者配偶艾滋病知识、行为调查

[目的]调查美沙酮门诊HIV感染者配偶的艾滋病知识及高危行为情况。[方法]对云南省13个美沙酮门诊HIV阳性海洛因成瘾人员的配偶107名进行问卷及血清学检查,将结果进行统计分析。[结果]调查对象的艾滋病知识总知晓情况为90．7％,文山州三个门诊的知晓率与其他门诊知晓率存在差异,是否接受性病／艾滋病免费咨询服务,是否接受过安全套免费发放的服务对知晓程度的影响有显著性差异。调查对象中29．9％曾有过注射吸毒行为,近一个月发生过生行为的对象当中27．8％有不安全性行为。[结论]为针对美沙酮门诊HIV感染者的配偶做好艾滋病预防工作,需要对其加强相关教育培训及服务,特别是提供性病／艾滋病免费咨询服务和安全套免费发放服务。     

安徽省项目地区居民艾滋病知识和行为调查分析

目的了解安徽省项目地区全球基金项目两年执行情况，为后3年项目计划提供依据。方法中期评估采用普查和分层整群抽样的方法，在我省8个示范区／全球基金艾滋病项目县分别对性工作者（普查）和感染者／病人、流动人口、居民、学生（分层整群抽样）等人群进行问卷调查。利用项目基线资料评价项目中期效果。结果7336名调查对象的艾滋病知识平均知晓率是83．78％，其中暗娼90．17％、感染者／病人86．90％、流动人口82．61％、居民（重点乡镇）87．38％、居民（非重点乡镇）73．09％、居民（城镇）86．26％、中学生（83．24％）、吸毒人群84．00％（x^2=904．32，P〈0．001）。8个项目县平均知晓率分别为96．95％、92．26％、89．84％、88．32％、85．26％、81．70％、77．60％和77．11％（x^2=392．42，P〈0．001）。暗娼最近1次与客人发生性关系时使用安全套的有303人（84．4％），最近3次每次使用安全套的有264人（73．5％）。感染者／病人最近1次与配偶过性生活时使用安全套有639人（56．7％），最近3次每次都使用安全套的有572人（50．8％）。与基线相比，除了吸毒人群外，所有人群的艾滋病知识知晓率均有不同程度的提高；所有人群对10个艾滋病知识点的答对率都有所提高；暗娼和感染者／病人的安全套使用率有所提高。结论我省项目地区居民的艾滋病相关知识知晓率和安全性行为形成率较项目启动时明显提高，但不同地区和不同人群的知识和行为不平衡，仍需要加大力度全面开展艾滋病健康教育和行为干预工作。     

湖南省国家艾滋病综合防治示范区基线调查结果分析

目的 探明湖南省国家艾滋病综合防治示范区与艾滋病防治有关的资源，各类高危人群的人数与分布，艾滋病KAP（知识、态度、行为）水平及HIV感染情况。方法 召开政府多部门协调会议，进行知情访谈，问卷调查，采集血样检测。结果 6个示范区用于防艾经费仅为16．8万元，查出HIV感染者55例，估计感染者和病人分别有457和150例；吸毒人群HIV感染率最高为8．9％。高危人群安全套使用率仅为27．6％，艾滋病知识知晓率均在50％以下，获得知识的最佳途径是电视。结论 6个示范区艾滋病防治工作处于起步阶段，防艾经费投入很少，高危人群数量多，行为感染HIV的危险性高，此次基线调查为示范区下一步开展有针对性艾滋病防治工作提供了重要依据。     

1 126例艾滋病病毒感染者和病人相关知识行为调查

目的了解安徽省艾滋病综合防治示范区/全球基金艾滋病项目地区艾滋病病毒感染者/病人的艾滋病知识和行为状况,为评估项目前期执行效果和制订后期计划提供依据。方法采取整群抽样方法,对8个县(市、区)1 126名艾滋病病毒感染者/病人进行问卷调查。结果艾滋病知识知晓率为92.01%,传播途径和非传播途径知晓率分别为82.42%和86.59%;与配偶最近1次安全套使用率和最近3次安全套坚持使用率分别达91.42%和81.83%,明显高于基线调查结果;在婚外性行为中,最近1次安全套使用率和最近3次安全套坚持使用率分别为77.78%和55.56%;VCT服务的利用率达到94.05%,无偿献血知识知晓率为57.02%。结论我省项目地区艾滋病病毒感染者/病人艾滋病知识知晓率和配偶间安全套使用率有所上升,但无偿献血知识知晓率和婚外性行为安全套使用率较低。因此今后应大力开展艾滋病防治知识和无偿献血知识宣传,增强安全套使用的干预力度,提高感染者和病人的安全套使用率和知识知晓率。     

2005年新泰市艾滋病资料分析

[目的]明确新泰市今后艾滋病防治的重点人群,为制定艾滋病防治战略规划和决策提供依据。[方法]2006年1月,对新泰市艾滋病的流行现状、各种影响因素及开展艾滋病防治工作的有利因素进行调查分析。[结果]截止2005年底,新泰市累积发现艾滋病病毒（HIV）感染者15例（均为有既往有偿献血史的农民）,现存活HIV感染者9例,其中艾滋病病人2例。大众人群、青少年、性服务人员、HIV感染者、流动人口艾滋病防治知识知晓率分别为62．53％、64．15％、72．26％、75．56％、51．33％;性服务人员最近1次性服务安全套使用率为64．96％,HIV感染者夫妻间最近1次性生活安全套使用率为4／9。目前既往有偿献血（浆）人员5505人中5504人已接受HIV抗体检测。估计有性服务人员600余人,男男同性恋者76人,流动人口51347人,在校学生17万余人。乡村诊所医用高压锅拥有率为67．94％,治疗室紫外线灯拥有率为52．89％,33．61％的医务人员知道普遍性防护原则。[结论]性传播、医源性传播是新泰市今后艾滋病流行的潜在危险因素,HIV感染者与艾滋病病人及其配偶（性伴）、暗娼、性病病人、流动人口、同性恋、医疗卫生人员、青少年是艾滋病防治的重点人群。     

2007年聊城市男男性接触人群艾滋病高危险行为及HIV感染状况调查

[目的]了解男男性接触者（MSM）的社会学特征、艾滋病防治知识、高危性行为及艾滋病病毒（HIV）感染情况。[方法]2007年6～7月,应用同伴推动抽样法（RDS）对居住在聊城市的132名MSM进行调查。[结果]调查132名MSM,58．50％自我认同为同性恋;8项艾滋病知识平均知晓率为80．07％,28．20％全部知晓。87．06％的调查对象最近6个月与不同的男性发生过性行为;最近1次与男性发生性行为时安全套使用率为59．09％,最近1次与女性发生性行为时使用率为32．05％,最近1次通过付钱与提供性服务的男性肛交时使用率为28．57％,最近1次为了得到钱为其他男性提供肛交时使用率为33．33％,最近6个月与男性或女性发生性行为时每次都使用安全套的比例均低于40％。132名MSM的HIV感染率为1.51％。[结论]聊城市MSM有较强的认同感,艾滋病知识知晓率较低,多性伴．安全套使用率低,存在HIV感染者。     

安徽省暗娼艾滋病相关知识、行为调查

目的了解安徽省示范区／全球基金艾滋病项目地区暗娼人群的艾滋病知识水平和行为状况，为评估项目前期执行效果和制定后期计划提供依据。方法采取普查的方法，对8个项目县（市、区）的360名暗娼进行面对面匿名问卷调查。结果艾滋病知识知晓率90．17％；传播途径和非传播途径知晓率分别为93％和72．4％（χ^2=53．38，P〈0．001）；与嫖客最近一次性行为时安全套使用率和最近3次安全套坚持使用率分别达84．4％和73．5％：无偿献血知识知晓率为56．3％；自原咨询检测（VCT）服务的知晓率为86．1％，利用率为50．7％。艾滋病知识知晓率和安全套使用率明显高于基线调查结果。结论项目地区暗娼人群艾滋病知识知晓率和安全套使用率有所上升，但无偿献血知识知晓率和VCT服务利用率较低，安全套使用率离项目要求还有差距。     

澜沧县暗娼艾滋病监测结果分析

[目的]了解2010～2011年澜沧县暗娼人群的—般情况及对艾滋病的知识知晓、行为、感染情况,为艾滋病预防控制及效果评价提供科学依据。[方法]对暗娼人群进行艾滋病相关情况的问卷调查,同时采血做艾滋病和梅毒抗体检测。[结果]701例暗娼的艾滋病相关知识整体知晓率为96。3％,2010年和2011年知晓率分别为94％、98％,两年知晓率差异有统计学意义。最近1次商业性行为时安全套使用率为95．1％,2010年和2011年使用率分别为92．4％、97．3％,两年使用率差异有统计学意义。文化程度高中以上者安全套每次使用率为97．3％,初中及以下的每次使用率为90．7％。发现HIV阳性5例,未检出梅毒。[结论]2010-2011年暗娼的艾滋病的相关知识知晓率和安全套使用率有所提高。虽然所调查的701例暗娼人群HIV感染处于较低水平,但仍存在不用安全套及吸毒的高危行为,而且HIV自愿检测率也较低。因此暗娼高危行为不容忽视,需继续加强艾滋病的宣传、暗娼监测和干预的力度。     

安徽省县区居民艾滋病知识和行为调查

目的了解安徽省城区居民（包括流动人口）对艾滋病的认知水平和行为状况，评估项目前期工作效果和为制定后期计划提供依据。方法采用整群抽样方法，在安徽省8个艾滋病综合防治示范区／全球基金项目县的城区抽取1654名居民作为调查对象，采用自行设计的调查问卷面对面进行匿名问卷调查。结果在1614份有效问卷中，艾滋病知识平均知晓率为84．3％；3种传播途径的知晓率为93．5％，6条非传播途径的知晓率为82．6％，二者差异有统计学意义（χ^2=325．94，P〈0．001）。自愿咨询检测（VCT）服务知晓率为76．5％，使用率为17．5％。无偿献血知识知晓率为55．7％。流动人口中婚外性行为的比例为3．7％，坚持安全套使用率为36．7％。结论安徽省项目地区城区居民艾滋病知识知晓率较高，但艾滋病知识认知不全，无偿献血知识知晓率不高，VCT服务知晓率和利用率低。今后应加强艾滋病健康教育和行为干预工作，全面提高各类城区居民的艾滋病（包括无偿献血和VCT）知识知晓率，提高安全性行为的形成率和VCT服务利用率。     

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.     

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.     

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.     

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.     

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.