重庆市男男性行为人群艾滋病干预效果初步研究

目的 评估重庆市男男性行为者(MSM)的艾滋病综合干预项目实施效果.方法 2006年与2007年对MSM人群采用"滚雪球"法进行二次面对面的问卷调查,比较干预前后MSM人群知识、行为和HIV及梅毒患病率的变化隋况,采用SPSS 12.0软件进行统计分析.结果 干预后,MSM人群艾滋病防治知识知晓率明显提高,由干预前的74.3%上升到干预后的82.4%(P=0.01);最近一次与男性发生肛交性行为时安全套使用率由56.4%上升到65.5%(P=0.00);最近6个月与男性发生肛交时每次都使用安全套率也由2006年干预前的31.8%上升至41.9%(P=0.00).干预前后HIV感染率分别为10.4%和10.8%,梅毒患病率分别为9.3%和7.3%,干预前后HIV和梅毒的患病率差异均无统计学意义.结论 MSM人群干预后艾滋病防治知识明显提高,安全套使用率也有所提高,干预工作产生明显效果.     

南宁市男男性接触者艾滋病相关知识及危险行为调查

目的 了解男男性接触者人群艾滋病相关知识知晓率和高危险行为,为制定有效的干预措施提供科学依据.方法 采用滚雪球抽样法和方便抽样法选择对象,用自行设计的问卷采用匿名问卷形式进行调查,共调查230名MSM.结果 MSM人群艾滋病传播途径相关知识的知晓率达85.24%.93.48%有过肛交,92.17%有过口交,83.49%有过互相手淫,首次性行为年龄最小11岁,平均年龄20.88岁.首次性行为对象为男性占73.5%,女性占26.5%,目前完全同性为51.3%,双性为47.4%.过去1年平均男性伴数6.56个,最近1个月平均男性伴数1.58个.最近1次肛交和口交时安全套使用率分别为72.44%、13.47%,最近6个月肛交、口交安全套使用率分别为42.86%、3.62%,肛交、口交从不使用安全套率分别为11.22%、62.18%.结论 南宁市MSM人群普遍存在多性伴和安全套使用率低危险性行为,应加强对MSM人群的健康教育、行为干预.     

高档酒吧男男性行为者艾滋病知识知晓及安全套使用情况调查

[目的]了解高档酒吧男男性行为者(MSM)艾滋病知识知晓及安全套使用情况,为艾滋病干预提供科学依据。[方法]2009年4~7月对青岛市某一MSM活动的高级酒吧与男性发生过口交、肛交并自愿接受HIV抗体检测的男性400人,在知情同意的前提下,对MSM进行匿名问卷调查。[结果]调查MSM人群400人,平均年龄27.51±6.49岁,艾滋病知识知晓率为80.00%。最近6个月内与同性发生肛交性行为时每次都使用安全套者占7.25%;最近6个月内与同性发生商业性行为时每次都使用安全套者占8.82%;最近6个月内与异性发生性行为时每次都使用安全套者占5.83%。与同性发生性关系时,艾滋病知识知晓率越高,安全套使用率越高,而与同性发生商业性性行为及与异性发生性行为时,未发现艾滋病知识知晓率与安全套使用率之间的相关性。[结论]艾滋病知识知晓率是促进MSM人群降低危险性行为的有利因素,但存在着知识态度与行为相分离的现象。     

济南市部分男男性接触者艾滋病相关知识、危险行为与感染状况调查

[目的]了解男男性接触者(MSM)有关艾滋病的预防知识、高危行为情况,为在该人群中开展有针对性的干预工作提供依据。[方法]2006年3~7月,对到济南市疾病预防控制中心自愿接受艾滋病咨询的400名MSM进行调查,并对其中282人进行抗-HIV和梅毒抗体检测。[结果]调查400人,各项艾滋病防治知识的知晓率均在70%以上,60%以上的相关知识通过报纸、杂志、电视、广播获取;首次性行为的年龄为(19.93±2.87)岁,34.75%的调查对象同时与女性有性行为,16.00%的与11~50个同性发生过性行为;近6个月与女性进行阴道交、肛交时每次使用安全套的占27.50%(22/80)和16.67%(2/12),与男性进行肛交或接受肛交时每次使用安全套的占30.94%(116/375)和33.79%(99/293)。检测282名MSM,HIV感染率为1.06%,梅毒感染率为9.57%。[结论]济南市MSM中存在着艾滋病流行,并有向普通人群扩散的潜在危险。     

重庆市某区男男性接触者艾滋病综合干预效果评价

目的评价男男性接触者艾滋病综合干预效果,为预防控制艾滋病传播提供科学依据。方法通过滚雪球的方式招募男男性接触者进行面对面的问卷调查,主要采用计数资料的统计学分析方法,对干预前后的综合效果进行客观的评价。结果干预后MSM人群艾滋病知识知晓率从35.6%提高到65.2%,最近一次与男性发生肛交时安全套使用率从64.3%增加到75.8%,最近六个月与男性发生肛交时每次都使用安全套的率从40.9%增加到50.2%,与女性发生性行为时安全套使用情况没有显著性改变。结论通过一年的综合干预,MSM接受艾滋病咨询检测的比例和接受到干预服务的比例较干预前显著增加,达到了有效地预防HIV在男男性接触人群中传播。     

云南省蒙自市男男性行为人群艾滋病感染率及影响因素

目的了解蒙自市男男性行为人群（MSM）人群艾滋病感染率及危险因素。方法 2013年4—7月,采用分类滚雪球方式招募蒙自市MSM人群进行问卷调查并采集静脉血液样本进行HIV抗体、梅毒抗体检测。结果共调查MSM人群102人,平均年龄（28.6±9.4）岁。文化程度以初中及以下为主,但艾滋病知晓率高达100%。HIV感染率8.82%,梅毒阳性率1.96%,6个月内与男性、女性发生性行为每次坚持使用安全套的比例分别为74.51%、14.81%。MSM人群HIV感染与近6个月同性肛交安全套使用频率呈负相关（OR=0.03,P〈0.05）。结论蒙自市MSM感染HIV的主要危险因素为不坚持使用安全套,存在比较严重的知行分离的现象。     

2011-2013年贵阳市男男性行为哨点监测结果

目的了解贵阳市男男性行为者(MSM)艾滋病病毒(HIV)感染现况及相关危险行为。方法对2011-2013年贵阳市MSM哨点监测数据进行分析。结果调查MSM 762名,以20~30岁年龄组(占73.6%)、未婚/离异(占91.5%)、大专以上文化程度(占65.0%)、本省户籍(占87.0%)为主。2011-2013年MSM艾滋病知识知晓率为90.9%,呈逐年上升趋势(P0.05)。最近半年内,有肛交行为者占89.1%,其中每次都使用安全套比例为30.2%;有异性性行为史者占5.9%,其中每次都使用安全套比例为44.4%。HIV、HCV、梅毒感染率分别为24.0%、7.7%、0.4%。结论贵阳市MSM人群安全套坚持使用率较低,HIV感染率较高,需采取有效综合干预方式,促使行为改变,提高安全套使用率,降低该人群HIV感染率。     

2003-2008年西安男男同性性行为者艾滋病监测分析

目的了解西安地区男男性接触者人群艾滋病及其相关高危行为流行情况,为在该人群中开展艾滋病防治工作提供依据。方法分析2003-2008年西安地区该人群艾滋病监测相关资料。结果2003-2008年MSM人群艾滋病监测中,监测对象以20～30岁年龄组最多,占48.3%～61.3%。58%～89%的监测对象在近6个月内有肛交行为,且肛交时每次使用安全套的比率历年最高仅43.5%;有同性性伴人数平均为2.54～7.70人,近6个月内有女性性伴者占22%～41%。HIV抗体阳性检出率逐年升高,为0.39%～3.25%。结论西安地区MSM人群艾滋病流行加重,同时具有向普通人群扩散的潜在危险。     

云南省2010年13州(市)男男性行为者艾滋病综合监测

目的 了解云南省男男性行为者(MSM)的艾滋病知识水平、行为特征和艾滋病病毒(HIV)感染率.方法 2010年首次在云南省13个州(市)通过“滚雪球”抽样法对可接触到的MSM进行面对面行为学问卷调查,并采集血液样本进行HIV和梅毒抗体检测.结果 在云南省13个州(市)共调查1237名MSM,艾滋病基本知识知晓率为93.2％,81.1％最近6个月与男性发生过肛交性行为,最近6个月与男性发生肛交性行为时49.7％坚持使用安全套,29.0％最近6个月与女性发生过性行为.HIV感染率为8.2％,梅毒感染率为3.9％,不坚持使用安全套和梅毒阳性是MSM感染HIV的主要危险因素.结论 云南省MSM危险行为比例较高,HIV感染率高,该人群艾滋病预防控制问题值得高度关注.     

芜湖市男男性行为者艾滋病知识行为状况调查

目的评估芜湖市男男性行为人群的艾滋病知识行为状况,为控制艾滋病在男男性行为人群中流行提供依据。方法通过2008～2009年两次横断面调查,比较干预前后MSM人群艾滋病相关知识、高危行为及梅毒患病率情况。结果共调查1 551名MSM,干预前后2组MSM人群艾滋病知识知晓率分别为67.26%和77.53%,最近一次发生肛交时安全套使用率分别是49.71%和61.17%;最近6个月肛交时安全套使用率分别为24.89%和27.80%,差异有统计学意义（P〈0.05）;H IV感染率分别为0.89%和0.77%;梅毒患病率为1.11%和2.77%。结论干预后MSM人群艾滋病防治知识行为水平明显提高。     

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.     

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.     

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.     

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.     

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.