河南省艾滋病高发区不同人群艾滋病相关知识态度行为调查

目的 了解艾滋病高发地区HIV感染者/AIDS患者和一般健康人群对艾滋病传播途径的知晓情况、对艾滋病的态度以及采取的防治措施情况.方法 采用自制的问卷对河南省4个项目县10个乡/镇居民进行调查,利用Epi Data 3.0软件建立数据库,SAS 9.13软件进行资料分析.结果 河南省艾滋病高发区居民艾滋病相关知识的总体知晓率为79.00％,其中HIV/AIDS组知晓率为81.62％,一般健康人群知晓率为76.47％,差异有统计学意义( P＜0.001);HIV/AIDS组和一般健康人群组对亲戚朋友HIV/AIDS态度上的差异有统计学意义(P=0.038,P=0.019);在日常性行为中HIV/AIDS组中39.59％的人坚持每次都使用安全套,而一般健康人群组中仅占11.08％.结论 河南省艾滋病高发区居民艾滋病相关知识的知晓率较高,病例组均高于一般健康人群组;安全套的使用率较低,艾滋病的性传播危险性较大,需要加强艾滋病健康教育和安全性行为干预.     

HIV感染者安全套使用情况及影响因素分析

目的 了解人类免疫缺陷病毒(HIV)感染者的安全套使用情况及影响因素.方法 2006年1月-2008年6月,采用方便抽样方法,对946例被告知HIV阳性的感染者采用匿名问卷调查法调查其一般情况、艾滋病知识知晓情况、被告知HIV阳性检测结果后的性行为及安全套使用情况等.结果 调查对象经吸毒感染占22.1%,经性传播感染占69.6%.艾滋病知识知晓率为93.4%;655人过去6个月发生过性行为,平均安全套使用率为55.3%;97人最近1次与固定性伴发生性行为时使用了安全套.单因素和多因素Logistic回归分析结果均显示,不同民族(OR=5.61,95%CI=1.66～18.94)、免费安全套的可及性(OR=0.33,95%CI=0.13～0.85)、家庭人均月收入(OR=0.26,95%CI=0.10～0.69)等因素与最近1次性行为时是否使用安全套有关.结论 知晓自己感染状态的HIV阳性人群艾滋病知晓率普遍较高,但仍有相当数量的感染者发生性行为时不能坚持使用安全套甚至不使用安全套,危险性行为的发生率仍然较高.     

乌鲁木齐市1516名吸毒人员HIV、HCV和梅毒感染率和高危行为特征调查

目的了解2010年乌鲁木齐市吸毒人群人类免疫缺陷病毒(HIV)感染率及相关行为特征。方法查询公安部门资料结合滚雪球办法招募吸毒人员,进行面对面的问卷调查,采集血样进行HIV、丙型肝炎病毒(HCV)和梅毒抗体检测。结果本组共调查和采样吸毒人员1 516名,检出HIV、HCV和梅毒的感染者分别占20.38%(309/1 516)、36.02%(546/1 516)和2.24%(34/1 516)。高危行为分析吸毒者中男性(OR:0.62;95%CI:0.40～0.96)、维吾尔族(OR:0.45;95%CI:0.34～0.60)、未接受过预防艾滋病服务者(OR:2.32;95%CI:1.65～3.26)共用注射器的比例高;安全套的使用上维吾尔族(χ2=11.98,P=0.0005),艾滋病基本知识得分低者(χ2=4.85,P=0.0275)安全套的使用率低。结论乌鲁木齐市吸毒人群HIV流行形势严峻,如何采取行之有效的干预措施降低高危行为势在必行。     

我国中部农村地区艾滋病病毒感染者高危性行为特征研究

目的了解我国中部农村地区艾滋病病毒(HIV)感染者高危性行为特征。方法2003年12月~2004年5月采用横断面研究方法调查HIV感染者的社会人口学特征,婚内、婚外性行为和安全套使用情况。结果提供知情同意和符合纳入标准的HIV感染者832人,其中95.7%(796人)的感染者过去有献血史,27.5%(229人)的感染者不知道自己感染了HIV。婚内、婚外性行为100%使用安全套的分别为35.9%(180/501)和18.7%(3/22),年龄(OR=0.65;95%CI为0.44~0.95)、文化程度(OR=1.71;95%CI为1.11~2.64)、是否知道自己感染HIV(OR=1.58;95%CI为1.04~2.04)和近3个月婚内性行为是否100%使用安全套具有统计学意义。结论我国中部农村地区HIV感染者100%安全套使用率较低,应加强HIV感染者检测后结果告知和咨询工作,以及为其免费提供安全套以降低HIV的性传播。     

西藏暗娼艾滋病知识知晓现状及对安全套使用情况影响

目的了解西藏自治区暗娼艾滋病知识知晓和安全性行为现状,为控制艾滋病经性传播提供依据。方法 2019年采用分层随机抽样和整群抽样方法在西藏7个国家级监测点共调查暗娼2 047人,采用一般描述性分析、χ~2检验、多因素非条件logistic回归分析探讨暗娼艾滋病知识知晓现状及其对安全套使用情况的影响。结果 2019年西藏自治区暗娼艾滋病知识知晓率为83.93%(1 718/2 047),最近1次安全套使用率为71.71%(1 468/2 047),最近1月安全套从未使用、有时使用、每次使用的比例分别为20.86%(427/2 047)、36.59%(749/2 047)、42.55%(871/2 047)。婚姻状况为同居(OR=3.31,95%CI=1.14～9.64)、文化程度为高中及以上(OR=1.78,95%CI=1.25～2.54)、高档(OR=2.07,95%CI=1.38～3.11)工作场所、接受艾滋病咨询检测服务(OR=2.94,95%CI=2.28～3.79)是暗娼艾滋病知识知晓情况的促进因素。控制其他变量后,知晓艾滋病知识的暗娼其安全套使用率是不知晓者的1.72倍(95%CI=1.32～2.24,P 0.001)。结论 2019年西藏自治区暗娼艾滋病知识知晓率、安全套使用率均处于较低水平,知晓艾滋病知识可有效提高暗娼安全套使用率。     

2009—2018年河南省艾滋病二线抗病毒治疗病毒抑制失败影响因素分析

目的 探讨河南艾滋病中医项目地区转服二线抗病毒治疗的艾滋病病毒(human immunodeficiency virus, HIV)感染者/艾滋病人(acquired immune deficiency syndrome, AIDS)治疗1年后发生病毒抑制的失败率和影响因素。方法 通过河南省“艾滋病常规治疗数据库”收集河南省艾滋病中医项目地区2009年1月至2018年12月期间转服二线抗病毒药物HIV/AIDS患者抗病毒情况的相关信息等数据。采用logistic回归分析二线抗病毒治疗的HIV/AIDS患者治疗1年后发生失败的影响因素。结果 4 118名患者HIV/AIDS患者纳入本回顾性队列研究进行分析，多因素分析显示：年龄>50岁(OR=1.235,95%CI:1.053～1.448),感染途径为输血(OR=1.566,95%CI:1.238～1.980),HIV阳性时长>6年(OR=1.676,95%CI:1.206～2.330),抗病毒治疗初始方案为D4T+3TC+EFV/NVP(OR=1.385,95%CI:1.135～1.691),CD4+T淋巴细胞计数小于200...     

四川省凉山州HIV/AIDS患者安全套使用情况与社会规范的关联性分析

目的了解四川省凉山州HIV/AIDS患者最近6个月安全套的使用情况与社会规范的关系,为制定艾滋病相关行为干预措施提供参考。方法采用自行编制的问卷开展人口学特征、安全套使用情况及相关社会规范的调查,利用χ~2检验、二元logistic回归等方法进行分析。结果共调查729名HIV/AIDS患者,有436人最近6个月与固定性伴发生过性行为,其中33.26%(145/436)能够坚持使用安全套。安全性行为规范维度得分越高(OR=0.69,95%CI:0.61～0.77),患者越倾向于坚持使用安全套。小学文化程度(OR=0.57,95%CI:0.34～0.98)、有生育打算(OR=3.67,95%CI:1.99～6.74)、医生发放安全套的频率(3～12次/年组OR=0.33,95%CI:0.20～0.55;12次/年组OR=0.36,95%CI:0.15～0.88)与最近6个月安全套的使用情况相关。结论凉山州HIV/AIDS患者坚持使用安全套的比例低,在今后推广安全套的工作中,需充分考虑当地社会规范、医疗服务情况以及患者的文化程度、生育需求等因素。     

安徽省HIV感染未治疗者安全套使用情况及影响因素研究

目的 了解和掌握安徽省艾滋病病毒(human immunodeficiency virus,HIV)感染未治疗者安全套的使用情况及其影响因素.方法 采用自行设计的问卷,以面对面的调查方式,对安徽省不同地区的HIV感染未治疗者进行问卷调查.结果 本研究共调查HIV感染未治疗者270人,艾滋病(acquired immunodeficiency syndrome,AIDS)相关知识知晓率较高,为92.96％.40.74％的人配偶/恋人未感染HIV,配偶/恋人已感染的调查对象比配偶/恋人未感染者更愿意告知对方自己的感染情况,差异有统计学意义(x2=13.21,P＜0.001).89.47％的人在性行为中增加了安全套的使用,48.95％的人做到在每次性行为时均使用安全套,且在近6个月性行为中是否每次使用安全套与民族、感染HIV时间以及感染HIV后是否增加安全套的使用有关.多因素分析结果表明:民族(OR=0.19,95％CI:0.04～0.97)和已感染HIV的时间(OR=3.54,95％ CI:1.56～8.04)与每次性行为都使用安全套有关.结论 HIV感染者中存在不能坚持使用安全套的问题,因此要提高人群的自我防范意识,提高安全套的使用率,更好的预防HIV通过性行为传播.     

我国HIV感染者/AIDS患者晚发现发生率及影响因素的meta分析

目的 系统评价我国人类免疫缺陷病毒（human immunodeficiency virus,HIV）感染者/艾滋病（acquired immuno deficiency syndrome,AIDS）患者晚发现情况及影响因素，为相关预防措施提供依据。方法 系统检索中国知网、万方、维普、中国生物医学文献数据库、Web of Science、PubMed、Embase和Cochrane Library数据库，搜集有关我国HIV感染者/AIDS患者晚发现影响因素的横断面研究。检索时限为建库至2022年7月，采用Stata 15.0软件进行meta分析。结果 共纳入20篇研究，总样本量为141 424例。Meta分析结果显示，我国HIV感染者/AIDS患者晚发现发生率为35%(95%CI:32%～38%)，男性（OR=1.444,95%CI:1.266～1.647）、年龄高（OR=3.027,95%CI:2.522～3.634）、已婚有配偶（OR=1.403,95%CI:1.237～1.591）、离异或丧偶（OR=1.350,95%CI:1.236～1.476）、职业（农民、民工、工人）（OR...     

2014年襄阳市MSM人群艾滋病哨点监测结果分析

目的 了解襄阳市男男性行为人群艾滋病病毒感染状况及其相关影响因素.方法 在襄阳市采用滚雪球和网络招募MSM,进行问卷调查,并采集血样进行艾滋病病毒(HIV)抗体检测.监测数据进行描述性,单因素和多因素分析.结果 调查400人,艾滋病病毒感染率5.00%.单因素分析显示,年龄,文化程度,活动场所,与女性婚姻状况,艾滋病防治知识得分,最近6个月安全套坚持使用6个因素与MSM人群HIV感染有统计学关联(p< 0.10).多因素分析显示,最近6个月同性性行为时坚持使用安全套(OR=0.19,95%CI=0.04~0.85)是HIV感染率的保护性因素,与女性婚姻状况为离异或丧偶(OR=5.28,95%CI=1.02~30.19),年龄50岁及以上(OR=1.62,95%CI=1.14~2.74)是危险因素.结论 襄阳市MSM人群艾滋病病毒感染率较高.应加强对50岁以上,与女性婚姻状况为离异或丧偶的MSM人群的综合干预措施,提高安全套坚持使用率.     

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.     

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.