HIV感染者和AIDS患者的避孕套使用状况调查

目的:了解人免疫缺陷病毒(HIV)感染者和人类获得性免疫缺陷综合征(AIDS)患者的避孕套使用情况及其影响因素,为艾滋病的防治提供相应的对策和建议。方法:采取定量和定性结合的研究方法,通过结构式问卷调查和个人深入访谈的形式,深入了解中国5省市的HIV+/AIDS患者的社会、心理、医疗服务等方面的需求及避孕套使用现状。结果:本研究共调查HIV+/AIDS患者111例,其中HIV感染者55例,艾滋病患者56例。吸毒静脉注射感染45例,占40.54%;有偿献血或输血感染31例,占27.93%;性接触感染35例,占31.53%。感染前后最近3次性生活中HIV+/AIDS患者避孕套使用比例相对都较低,感染前111例HIV+/AIDS患者中仅有19.82%使用避孕套,感染后该比例为24.32%,75%左右的对象感染前后均未使用避孕套。多因素统计分析显示:感染后个人年收入5000元以上和血液途径感染的HIV+/AIDS患者更倾向在性生活中使用避孕套。结论:HIV+/AIDS患者的避孕套使用率较低,应采取有效措施提高其使用率,从而有效控制HIV传播。     

娱乐场所女性从业人员艾滋病相关知识知晓率调查及干预效果评价

艾滋病(AIDS)是一种由人类免疫缺陷病毒(HIV)感染所致的，病死率极高的严重传染病。而商业性行为为HIV的感染和蔓延创造了重要的条件。有报道显示商业性工作者中抗-HIV阳性率明显高于普通人群。另外。Lau等通过对高危人群的调查发现，在避孕套使用率较低的地区性病发病率则较高。正确使用避孕套不仅能避孕，还能减少感染AIDS、STD的危险。为了解本地区娱乐场所女性从业人员性病(STD)、     

龙岩市宾馆的餐厅、客房中女服务员性病艾滋病知识和高危行为调查

目的　调查龙岩市宾馆的餐厅、客房场所中的女服务员性病艾滋病知识掌握情况 ,探讨HIV/AIDS流行趋势 ,为制定适合本地的HIV/AIDS干预措施提供科学依据。方法　分层随机抽取宾馆的餐厅、客房场所的女服务员 44 1名为调查对象 ,采用问卷调查方式进行AIDS有关知识、避孕套使用及高危行为的调查。结果　 48名的女服务员有婚前性行为 ,对经血液、性接触传播途径认识率较高 ,分别为 94 3 %和 87 0 % ,认为母婴和共用注射器可传播艾滋病的比例较低 ,分别占 64 8%和5 5 0 % ,性生活中每次使用避孕套的只占 12 5 % ,认为使用避孕套可预防艾滋病的占 11 0 %。结论　龙岩市宾馆的餐厅、客房服务员提供性服务的比率虽然比较低 ,但她们的AIDS有关知识知晓率也处在一个很低的水平 ,提示在开展高危人群的艾滋病干预工作的同时 ,应在这类场所中的服务员开展HIV/AIDS防治知识和安全性行为的宣传教育工作 ,并实施干预活动 ,从而减少HIV的传播 ,保护人们的身体健康     

河南省HIV/AIDS患者安全套使用情况调查

目的 了解河南省艾滋病高发区人类免疫缺陷病毒(HIV)感染者/获得性免疫缺陷综合征(AIDS)患者的安全套使用情况,为开展艾滋病健康教育、阻断传播途径提供基础资料.方法 采用访谈法调查安全套使用情况,分析HIV感染者/AIDS患者(HIV/AIDS)安全套使用的影响因素及其特征.采用SPSS 12.0软件进行统汁分析.结果 艾滋病患者的安全套使用率为41.6%,高于对照人群(χ2=220.62,P＜0.05).每次性生活均使用安全套的HIV感染者/AIDS患者对HIV性传播途径、安全套预防艾滋病的认知好于性交时非每次均使用安全套者,差异均有统计学意义.多因素Logistic回归分析结果显示,婚姻状况(OR=1.504;95%CI=1.128～2.007)、文化水平(OR=6.234;95%CI=3.860～10.069)、健康状况(OR=0.744;95%CI=0.615～0.900)、接受上门健康教育(OR=1.461;95%GI=1.107～1.927)、年龄(OR=0.337;95%CI=0.244～0.465).结论 河南省HIV感染者/AIDS患者的避孕意识较高,但安全套使用率较低,尚未达到国家的控制目标;婚姻状况、年龄、文化程度、身体状况、接受健康教育情况是HIV/AIDS患者安全套使用的主要影响因素.     

艾滋病病毒感染者家庭推广使用避孕套可接受性研究

目的了解农村地区已婚艾滋病病毒(humanimmtmodeficiencyvirus,HIV)感染者家庭推广使用避孕套可接受性及其效果.方法对某地90个HIV感染的家庭采用入户方式进行防病知识宣传和使用避孕套技巧培训,并免费发放避孕套.在干预前后对研究对象采取匿名方式进行两次断面调查,比较干预前后性生活中避孕套使用率的变化.结果90个家庭参加试点项目,84个家庭完成了最后的评价调查,随访率93.3%.研究对象在艾滋病传播途径、非传播途径和预防方法知识方面都有显著提高(P＜0.001).每次性生活都使用避孕套率由干预前的2.6%上升到干预后的71.4%(P＜0.001).控制其他混杂因素的影响,干预活动是促进感染者家庭使用避孕套的主要影响因素.结论在农村地区HIV感染者及其配偶中开展推广使用避孕套是可以接受的,应当尽早通知已发现的HIV感染者家庭并开展避孕套推广工作,减少夫妻间传播.     

农民工艾滋病防治知识、行为及感染状况调查

目的 了解外出农民工的艾滋病(AIDS)防治知识、行为和人类免疫缺陷病毒(HIV)感染状况,为制定艾滋病防治措施提供科学依据.方法 对2007年春节期间回家的外出务工人员进行艾滋病防治知识问卷调查,并采集血液检测HIV抗体.结果 2006名农民工中,97.41%听说过艾滋病,对艾滋病的传播途径回答正确率29.21%,HIV/AIDS相关知识知晓率11.57%,不安全性行为中安全套使用率较低,检出HIV感染者1例,感染率为0.5‰.结论 农民工对艾滋病防治知识的知晓仍处于较低水平.亟需对他们普及艾滋病防治知识,消除对艾滋病的恐惧和歧视,防止艾滋病向农村传播.     

244名HIV感染者/AIDS病人及其性伴的性行为特征分析

目的了解艾滋病感染者和病人及其性伴的性行为现状及特征,为进行干预提供依据。方法在云南省澜沧县对已确诊的HIV/AIDS进行问卷调查。结果 52.87%的感染者有临时性伴,HIV/AIDS与固定性伴、非商业非固定性伴和商业异性性伴性生活频率比感染前明显下降,性生活中安全套坚持使用率分别为40.00%、25.00%和62.50%;78例HIV/AIDS的性伴中检出13例HIV阳性,部分性伴存在多性伴现象。结论澜沧县部分HIV/AIDS及其性伴存在多性伴现象、性生活活跃,今后要进一步加强艾滋病经性途径传播的宣传和干预,减少HIV经性传播。     

钟山县“一站式服务”对艾滋病单阳家庭随访干预效果

目的了解钟山县实施检测与治疗"一站式服务"干预前后,艾滋病病毒感染者和艾滋病病人(简称HIV/AIDS)的配偶干预效果,为制定预防艾滋病家庭内传播措施提供依据。方法从国家艾滋病综合防治信息系统筛选出2010—2014年新报告现住址为钟山县、有配偶且配偶首次检测为阴性的单阳家庭病例资料,分析比较实施"一站式服务"前后单阳家庭随访指标变化及其配偶HIV感染情况。结果 190例已婚HIV/AIDS患者被纳入分析,100%进行了配偶告知及检测。干预组69例,在确认后1个月内进行抗病毒治疗比例为89.86%;89.56%的病例坚持使用安全套;81.16%的病例性生活频次4次/月。对照组121例,在确认后1月内抗病毒治疗比例、坚持使用安全套比例及4次/月的性生活频次比例分别为19.83%、53.72%、59.50%。各指标两组间的差异均有统计学意义(P0.05)。HIV抗体阳转率对照组为0.83/100人年,干预组为0人年。结论钟山县已婚HIV/AIDS单阳病例家庭,通过"一站式服务",加强综合干预,可有效提高干预效果,降低艾滋病病毒在配偶间传播。     

2013年芜湖市暗娼人群艾滋病哨点监测结果分析

目的了解芜湖市暗娼人群对艾滋病(AIDS)知识的知晓率、性行为特征、接受AIDS预防相关服务情况及人类免疫缺陷毒(HIV)、梅毒、丙型肝炎(丙肝)感染状况,为对该人群开展AIDS综合防治和有效干预提供依据。方法由接受过培训的高危行为干预工作队工作人员,进入芜湖市娱乐场所,采用《全国艾滋病哨点监测实施方案》中暗娼人群问卷进行现场调查,采集血液标本进行HIV、,梅毒螺旋体(TP)、丙肝病毒(HCV)、血清学检测。结果共对400名暗娼进行了调查,AIDS相关知识知晓率为92.75%,最近1次与客人发生性行为时安全套使用率为96.00%,最近1个月内与客人发生性行为时每次使用安全套的比例为71.50%。每次坚持使用安全套(OR=0.099,95%CI:0.041~0.239)是TP感染保护因素。在接受艾滋病相关服务方面,接受过"安全套宣传发放/艾滋病咨询与检测"的人数占所有调查人数的91.00%;接受过"同伴教育"的占45.75%。调查对象HIV、TP、HCV感染率分别是0.25%,7.50%,1.25%。结论芜湖市暗娼人群对艾滋病知识知晓率较高,安全套每次使用率低,TP感染率高,虽然现在HIV感染率较低,但暗娼人群感染HIV的风险依然较高,需要继续加强对该类人群的针对性行为干预和监测工作。     

重庆市主城区建筑农民工艾滋病防治知识、态度和高危行为调查

目的:了解重庆市主城区建筑农民工免疫缺陷病毒(HIV)/艾滋病(AIDS)防治知识、态度及高危行为。方法:随机选取重庆市主城区3个区建筑农民工,由专业人员进行问卷调查,内容包括HIV/AIDS相关知识、态度及高危行为等。结果:共调查1 243人,8个HIV/AIDS防治知识问题中回答正确占33.95%～80.13%,全部回答正确的占总调查人数的15.12%;10种获得艾滋病知识途径中处于前3位的分别是:电视53.50%、广播37.01%、宣传材料31.62%;最近1年与配偶(或同居者)发生性关系每周≥1次占44.2%,最近1年从未使用过安全套的占44.0%;发生过商业性行为占14.9%,其中使用安全套的占21.1%;7.9%与临时性伴发生过性关系,使用安全套的占58.2%;性疾病感染人数为75人(6.03%),3个区感染率差异有统计学意义(χ2=24.54,P<0.05)。结论:重庆市主城区农民工HIV/AIDS防治知识全面掌握率较低,存在商业性行为和临时性伴发生性行为,安全套使用率较低,是艾滋病传播的高危人群。     

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.