湖北省枣阳市全球基金项目疟疾基线调查报告

目的了解全球基金疟疾项目启动前枣阳市疟疾流行情况和实际发病人数,以及疟防措施落实情况。方法按照《全球基金疟疾基线调查技术方法》,根据近3年的疟疾疫情,采用分层随机不等比例抽样法。结果走访群众4 803人,发现病例70人,正规治疗率5.71%(4/70),疟史休治率12.85%(9/70),疫情报告率14.29%(10/70)。门诊抗疟处方疫情报告率19.48%(52/267),血检阳性疫情报告率93.54%(333/356);居民和中小学生的疟防知识知晓率分别为24.09%(285/1 182)和67.54%(514/761);居民蚊帐使用率为95.34%(4 579人/4 803)。9个村共有14个乡村医生,其中11个人经过培训。中小学生的荧光抗体阳性率1.55%(14/903)。部分门诊血检技能及质量较差。经用捕获-再捕获方法(CMR)估算,该市2002年疟疾发病18102例,是疫情报告数(2 588)的6.99倍。结论现症病人正规治疗率低,疟史病人休治率低,疟疾疫情漏报严重。     

百色水利枢纽工程地区疟疾流行现状的基线调查

目的了解百色水利枢纽建设工地及周围居民区疟疾流行的现状,为开展《百色水利枢纽工程对疟疾传播影响及其防制措施研究》和实施全球基金广西流动人口疟疾监测与控制项目评估提供基线数据。方法调查大坝工地施工队及民工的来源、人数和卫生状况;对工地周围3个乡(镇)3个行政村9个自然村部分居民和学生进行疟史、使用蚊帐和疟防知识知晓情况调查,查阅所调查的3个乡(镇)卫生院发热病人血检疟原虫阳性登记、医生开具抗疟药处方和疟疾疫情上报记录,统计走访调查查出的疟疾病人数与卫生院疟疾疫情报告数的符合率。结果2002年右江区疫情报告疟疾发病率为0.15‰0,居民蚊帐使用率98.05%,疟防知识知晓率,中、小学生和居民分别为72.40%、67.22%和27.32%。结论水利枢纽建设工地及周围地区疟疾发病率低,存在疟疾病例漏查漏报和输入疟疾病例的情况。对居民进行健康教育,加强疟疾监测,控制输入疟疾病例传播扩散,是防止工地疟疾暴发流行和巩固防治成果的重要措施。     

第一轮中国全球基金河南省疟疾项目工作结题报告

目的控制疟疾的流行和降低发病。方法根据第一轮中国全球基金疟疾项目规划书开展工作。结果5年共血检发热病人70 310人,年平均血检率为2.26%;疟疾病人比项目实施的第一年下降了88.13%（131/1 104）;978名各类人员,接受培训1 332人次,培训率136.19%;居民和中小学生疟防知识知晓率比项目启动前均提高70%以上。结论项目的实施有效控制了疟疾疫情,推进了疟防工作的开展。     

河南省淮滨县实施全球基金疟疾项目效果的评价

[目的]评价河南省淮滨县2003～2005年实施全球基金疟疾项目期间的疟疾疫情、防治措施及防治效果。[方法]收集淮滨县2003～2005年疟疾流行、防治措施、防治效果及媒介监测资料,分析流行情况,评价防治措施及效果。[结果]2003～2005年淮滨县共报告疟疾病例1765例,平均年发病率为8.93/万。2004年和2005年疟疾发病分别比上年下降53.58%和72.04%。建立发热病人镜检站18个,血检发热病人39070人,发现650例阳性病人。捕获中华按蚊4744只,未发现嗜人按蚊,疟疾暴发发点氟氯氰菊酯药物浸泡蚊帐340顶。氯、伯喹治疗现症病人1765人,休止期服药7571人,流行季节预防服药2471人。培训专业技术116人次,疟防宣传6259份,督导检查108次。居民和中小学生疟防知识知晓率由2003年的14.36%和9.36%提高到2004年的54.21%和47.36%。2005年144例疟疾病人平均确诊时间(2.82±2.89d)显著低于河南省的平均确诊时间(6.64±10.49d)(单样本t检验,t=-15.844,P=0.000)。[结论]在全球基金疟疾项目的支持下,河南省淮滨县疟防工作成绩显著,以项目管理促进疟防的方式值得推广。     

四川省青神县疟疾基线调查报告

目的了解青神县消除疟疾行动计划启动初疟疾流行情况、防治工作基础和能力状况,为达到消除疟疾目标提供基线数据。方法按四川省消除疟疾行动计划实施方案中基线调查方法开展疟疾流行情况、传疟媒介、防治工作和能力现状等调查。结果 2006年后无疟疾本地感染病例,人群疟疾抗体水平滴度均〈1：20,传疟媒介为中华按蚊,密度为4只/夜;居民、中小学生疟疾防治知识知晓率分别为53%、64%;县、乡、村临床医生接受疟疾知识培训比例分别为10%、52%、14%;县、乡接受疟原虫镜检培训比例分别为39%、27%。结论今后消除疟疾工作应加强临床医生和镜检人员知识培训与居民、学生、外出疟区务工人员疟防知识宣传。     

2004年鹿邑、遂平县疟疾监测结果分析

目的的了解疟疾流行现状及其影响因素,掌握疟疾流行规律和预测预报流行趋势,评价防治效和制定疟疾防治对策提供科学依据。方法及与疟疾流行有关的因素。结果监测区内疟疾发病率呈下降趋势,显示我省单一中华按蚊媒介地区疫情报告数字下降是可信的。豫南复媒介地区信阳、南阳发病占全省80%左右与当地的地理环境及媒介按蚊种群数量等因素有关。结论我省今后疟防工作重点仍是豫南区。     

武汉市2005～2008年疟疾发病情况及流动人口的管理措施

目的为了做好武汉市疟疾防控工作,评价疟防工作成效,为今后开展疟疾监测和防控提供依据。方法收集武汉市2005～2008年疟疾疫情报告、个案调查资料,分析武汉市2008年疟疾发病情况,比较2005～2008年疟疾发病趋势。结果武汉市近4年疟疾发病率均在1/10万以下,流动人口疟疾管理工作切实有效,国外输入性病例成为疟疾发病的主要群体,且恶性疟病例逐渐增多。结论武汉市疟疾发病率低,但不稳定因素增加,应加强流动人口疟疾管理工作。     

1999～2003年四川省疟疾监测分析

目的了解四川省疟疾流行现状,为制定新的疟疾防治措施提供科学依据.方法根据我省疟疾监测实施方案,采用疟疾防治中的常规技术和方法.结果四川省和各监测点的疟疾均呈逐年下降趋势;近2年血检确认的病例,已达到上报疫情数的90%以上,而且"二热"(初诊疟疾、疑似疟疾)血检阳性病人已占全部血检阳性病人的90%以上;按蚊密度人房中变化不大,牛房中按蚊密度呈逐年下降趋势.结论应进一步完善各项防治监测措施,抓好现症病人的治疗,提高疟防队伍的业务素质,强化发热病人的血检疟原虫工作,继续加强流动人口的疟疾管理和疫情报告制度.     

基层卫生防保组织对疟疾病例侦查作用探讨

对湖北省京山县孙桥镇１９９０～１９９３年开展发热病人血检疟原虫－疟疾病例侦查工作的调查与分析,结果表明,通过基层卫生防保组织对疟疾病例的主动与被动侦查工作,提高疟疾疫情报告的准确性,使现疟疾疾病人得到了及时,彻底的治疗,以保证疟防工作顺利开展。     

全球基金疟疾项目健康教育效果分析

目的了解全球基金疟疾项目在淮阴区开展情况及效果。方法按《中国全球基金疟疾项目终期评估方案》要求,干预前后分别对居民和中小学生进行疟疾防治相关知识知晓率调查,比较前后结果。结果疟疾防治知识知晓率,干预后居民从33.53%提高到70.93%;中学生从27.33%提高到79.11%;小学生从24.89%提高到71.11%,干预前后差异均有统计学意义(P<0.01)。结论淮阴区全球基金疟疾项目健康教育工作取得成效明显。     

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.     

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.     

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.     

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.