天津市医务人员和监狱服刑人员对丙型肝炎的认知情况及干预效果

目的 了解天津市医务人员和监狱服刑人员对丙型肝炎(以下简称丙肝)的认知现状及对其健康干预的工作效果.方法 调查人群选自天津市医疗机构的医务人员和在天津监狱的服刑人员;采用编制的丙肝知识调查表,干预前调查对丙肝知识的知晓情况及危险行为,经过健康干预后,用相同问卷再次调查知晓情况.结果 医务人员干预前丙肝知识知晓率为74.96％,干预后达97.83％ (P ＜0.01);服刑人员干预前丙肝知晓率为28.65％,干预后增至99.91％ (P ＜0.01).监狱服刑人员既往共用过注射器的占33.20％,共用牙刷或剃刀的占34.40％,输血和美容美体合计占32.80％.结论 医务人员对丙肝防治知识掌握不够全面准确;服刑人员既往感染危险行为比例高,知识认知情况较差;通过人群宣传干预,可明显提高知晓率.     

溧阳市输入性疟疾社区健康干预效果评价

目的 评价溧阳市输入性疟疾社区健康干预项目的 实施效果,为探索输入性疟疾社区健康教育工作模式提供参考.方法 根据输入性疟疾病例分布,2017年选择溧阳市竹箦镇前村村为干预村、西芮村为对照村.将建立出国劳务人员登记制度,进行社区宣传和入户干预,以及开展专题讲座和知识宣传作为干预措施.采用疟疾防治知识、信念和行为问卷,调查目标人群在实施健康干预前、后的疟疾防治健康知识知晓率、正确信念持有率和健康行为形成率.结果 实施健康干预后,干预村村民疟疾防治健康知识知晓率、正确信念持有率和健康行为形成率较实施前有所提高,分别由干预前的17.72％、39.94％和38.78％上升至79.01％ (P＜0.01),80.45％ (P＜0.01)和92.98％ (P ＜0.01);对照村村民疟疾防治健康知识知晓率、正确信念持有率和健康行为形成率由第一次调查的4.32％、14.23％和32.98％上升至第二次调查的41.74％(P＜0.01)、53.70％ (P＜0.01)和86.20％ (P＜0.01).实施干预后,干预村村民疟疾防治健康知识知晓率和正确信念持有率均高于对照村,差异均有统计学意义(P值均＜0.01);健康行为形成率与对照村相比,差异无统计学意义(P＜0.01).结论 社区宣传与入户干预有效结合的模式用于输入性疟疾防治健康教育工作,可提高目标人群疟疾防治健康知识知晓率、正确信念持有率和健康行为形成率,值得推广应用.     

健康教育对改进中山市古镇基层医务人员高血压相关知识、态度、行为的效果

目的 调查健康教育对改进中山市古镇基层医务人员高血压相关知识态度、行为的效果。方法 以集中授课的方式对中山市古镇基层医务人员开展高血压健康教育。采用分层抽样方法，按3个级别，抽取中心医院1家、卫生院两家、卫生站18家的172名内科医生，在健康教育前后，以调查问卷的方式开展调查。结果 培训后高血压知识率明显提高，中心医院医生的知识率高于卫生院及卫生站的医生。培训后各级医院医生高血压医疗行为的肯定回答率明显高于培训前。总之，医疗机构级别越高，医生的医疗行为提高得越明显。结论 健康教育有利于提高基层医务人员高血压相关知识、态度、行为。     

贵阳市基层医务人员麻风病防治知识知晓情况调查

目的了解贵阳市基层医务人员对麻风病相关知识的知晓情况,评价对基层医务人员短期、强化培训的效果。方法随机抽取5个区(县),以闭卷测试的方式对234名基层医务人员进行调查。结果调查对象中只有60人(占25.6%)接触过麻风病人,有174人(占74.4%)从未接触过麻风病人。基层医务人员对麻风病防治相关知识了解程度参差不齐,培训后医务人员对于麻风病防治知识答对率有明显提高(P均0.05),但在对于麻风病导致畸残及常见的足底溃疡的处理问题上,培训前和培训后答对率差异无统计学意义(P=0.113)。结论基层医务人员麻风病相关知识知晓率低,对其进行短期、强化培训是迅速提高其麻风病相关知识的有效方法。     

即墨市公共场所女性从业人员性病/艾滋病干预效果评价

[目的]探讨县级城市辖区内公共场所女性从业人员性病/艾滋病健康促进和行为干预的模式并进行效果评价.[方法]2006年9月,在即墨市对浴池足疗业、理发按摩业、中小旅馆业及歌舞厅等60家公共场所的女性从业人员进行有关性病/艾滋病预防知识的集中培训和健康教育行为干预,并进行效果评价.[结果]干预前调查510人,干预后调查481人,除个人原来就较高的知识外,其他性病/艾滋病知识的知晓率均有明显提高(P＜0.01);对安全性知识的知晓率和安全套使用知识知晓率均明显提高(P＜0.01);承认有性交易者干预前为269人,干预后为309人,其中性交易时每次全程使用安全套者所占比例分别为66.54%、94.82%(P＜0.01).基线调查时调查510名检出性病患者40例,感染率为7.63%;干预后检测481名,检出性病患者13例,感染率为2.70%(P＜0.01).[结论]即墨市对公共场所女性服务人员进行性病/艾滋病防治干预已取得显著效果.     

农村居民高血压知信行健康教育干预效果评价

目的 了解高血压健康教育对农村居民高血压相关知识、态度、行为的干预效果,为高血压预防提供参考依据.方法 采用随机整群抽样方法对在山东省菜芜市寨里镇抽取的2个农村社区共439名30～60岁农村常住居民进行高血压健康教育干预前后的问卷调查.结果 干预3个月后农村居民对高血压的临界值、高血压的危险因素及高血压的危害等12项相关知识的知晓率均高于干预前,差异均有统计学意义(P＜0.05);干预后农村居民相信高血压能预防、相信遵医嘱服药可以控制血压和相信改善生活方式可以控制血压者的比例分别为91.0％、83.6％和90.4％,均高于干预前的74.9％、65.6％和82.1％,差异均有统计学意义(P＜0.05);干预后农村居民饮酒者的比例为34.6％,低于干预前49.5％,差异有统计学意义(x2=19.3,P=0.000),干预后农村居民坚持低盐和低脂饮食者的比例分别为20.6％和24.9％,均高于干预前的7.5％和12.2％,差异均有统计学意义(P＜0.05).结论 高血压健康教育能提高农村居民高血压相关知识知晓率,改变其高血压相关态度和行为.     

某三甲医院门诊手卫生工作干预效果研究

目的 评价某三甲医院门诊手卫生干预措施的效果.方法 采用手卫生集中培训、建立质控护士管理制度、改善手卫生设施等措施实施干预,评价干预前后门诊医务人员洗手依从性、手卫生理论与操作考核评分以及门诊患者对手卫生工作满意度的变化.结果 门诊医务人员7～9月洗手的平均不依从率较前6个月降低了31.4％;与培训前相比,培训后的理论考核成绩95.0(IQR=91.3 ～96.0,Z=-6.04,P＜0.001)与操作考核成绩98.0(IQR=97.0 ～100.0,Z=-5.45,P＜0.001)均有所上升,门诊患者对手卫生工作的满意度也从56.0％上升至78.0％(x2 =5.47,P=0.019).结论 实施手卫生系列干预措施可有效地提高门诊医务人员对手卫生知识的认识,增强洗手操作规范性,提高洗手的依从性.     

辽宁省丹东市城市社区高血压健康教育综合干预效果评价

目的评价辽宁省丹东市城市社区高血压健康教育综合干预效果。方法在丹东市区选择2个经济条件相同、人口构成相似的社区,抽取2个社区中35岁以上居民分别组成干预组和对照组,干预组进行高血压健康教育综合干预,对照组进行常规社区慢性病健康教育。基线调查、干预中期和干预终期分别对调查对象高血压相关知识、行为和高血压治疗情况进行调查,评价干预效果。结果共调查社区居民843人,其中干预组416人,对照组427人。终期评估时,干预组高血压相关知识总知晓率由41．3％提高至80．6％（P〈0．01）;对照组由42．1％提高至49．4％（P〈0．01）,但提高幅度不大;干预组各项高血压相关知识知晓率均高于对照组（P〈0．01）。终期评估时,干预组吸烟率由35．4％下降至22．7％,饮酒率由35．6％下降至24．5％,低脂饮食比例由40．5％提高至50．2％,差异均有统计学意义（P〈0．05）;对照组各项行为均无明显改变（P〉0．05）;干预组的吸烟率、饮酒率低于对照组,低脂饮食比例高于对照组（P〈0．01）。终期评估时,干预组高血压患者的治疗率和控制率分别为70．2％和55．3％,较基线调查时明显提高（P〈0．01）,也明显高于对照组（P〈0．01）。结论综合性社区健康教育干预对高血压的防治具有良好的控制效果。     

深圳市基层卫生人员职业病相关知识培训的效果

目的 了解深圳市基层卫生人员职业病相关知识培训效果,为进一步提高基层卫生人员职业病相关知识水平提供参考.方法 采用分层随机抽样法,在深圳市7个区随机抽取106家单位(包括区级医院、街道医院、社区健康中心、工厂医务室等)医务人员,进行职业病相关知识调查及培训,调查及培训内容包括职业病防治法律法规、有机溶剂中毒、尘肺病、重金属中毒、噪声聋等相关知识,分析培训前后基层卫生人员职业病相关知识知晓率的差异.结果 共发放350份问卷,回收有效问卷276份,有效回收率为78.86％.培训前后基层卫生人员的职业病相关知识的总知晓率分别为56.82％、70.73％,与培训前比较,培训后调查对象对“尘肺病”、“重金属中毒”、“噪声聋”、“有机溶剂中毒”、“职业病防治相关法律法规”等相关知识知晓率均明显提高,差异有统计学意义(P＜0.05).结论 通过开展培训,深圳市基层卫生人员职业病相关知识的知晓率明显提高,但依然较低,应该进一步加强其职业病相关知识的培训.     

健康教育处方在大学新生结核病防治中的效果评价

目的 了解大学新生对结核病防治知识的掌握情况,探索结核病防治健康教育的有效方法 .方法 在新生入学后进行基线调查后,发放结核病防治知识健康教育处方,自学15 d后进行效果评价.结果 干预前、后新生结核病知识总知晓率分别为48.5%和83.9%,差异有统计学意义(P＜0.01);结核病相关行为正确率干预后均明显提高,差异有统计学意义(P＜0.01).结论 在高校开展结核病防治知识健康教育对提高大学生结核病知识效果理想.发放"结核病防治知识健康教育处方"是经济、有效的健康教育措施.     

Investigation and Control of Anthrax Outbreak at the Human–Animal Interface,Bhutan, 2010

In 2010, we investigated anthrax outbreak in Bhutan. A total of 43 domestic animals died, and cutaneous anthrax developed in 9 persons, and 1 died. All affected persons had contact with the carcasses of infected animals. Comprehensive preparedness and response guidelines are needed to increase public awareness of anthrax in Bhutan.     

Dengue Virus Transmission by Blood Stem Cell Donor after Travel to Sri Lanka; Germany, 2013

Three days after donation of peripheral blood stem cells to a recipient with acute myeloblastic leukemia, dengue virus was detected in the donor, who had recently traveled to Sri Lanka. Transmission to the recipient, who died 9 days after transplant, was confirmed.     

Long-Term Survival Among Histological Subtypes in Advanced Epithelial Ovarian Cancer: Population-Based Study Using the Surveillance,Epidemiology, and End Results Database

BackgroundActual long-term survival rates for advanced epithelial ovarian cancer (EOC) are rarely reported.ObjectiveThis study aimed to assess the role of histological subtypes in predicting the prognosis among long-term survivors (≥5 years) of advanced EOC.MethodsWe performed a retrospective analysis of data among patients with stage III-IV EOC diagnosed from 2000 to 2014 using the Surveillance, Epidemiology, and End Results cancer data of the United States. We used the chi-square test, Kaplan–Meier analysis, and multivariate Cox proportional hazards model for the analyses.ResultsWe included 8050 patients in this study, including 6929 (86.1%), 743 (9.2%), 237 (2.9%), and 141 (1.8%) patients with serous, endometrioid, clear cell, and mucinous tumors, respectively. With a median follow-up of 91 months, the most common cause of death was primary ovarian cancer (80.3%), followed by other cancers (8.1%), other causes of death (7.3%), cardiac-related death (3.2%), and nonmalignant pulmonary disease (3.2%). Patients with the serous subtype were more likely to die from primary ovarian cancer, and patients with the mucinous subtype were more likely to die from other cancers and cardiac-related disease. Multivariate Cox analysis showed that patients with endometrioid (hazard ratio [HR] 0.534, P<.001), mucinous (HR 0.454, P<.001), and clear cell (HR 0.563, P<.001) subtypes showed better ovarian cancer-specific survival than those with the serous subtype. Similar results were found regarding overall survival. However, ovarian cancer–specific survival and overall survival were comparable among those with endometrioid, clear cell, and mucinous tumors.ConclusionsOvarian cancer remains the primary cause of death in long-term ovarian cancer survivors. Moreover, the probability of death was significantly different among those with different histological subtypes. It is important for clinicians to individualize the surveillance program for long-term ovarian cancer survivors.     

Risk for Travel-associated Legionnaires’ Disease,Europe, 2009

Legionnaires’ disease is underreported in Europe; notification rates differ substantially among countries. Approximately 20% of reported cases are travel-associated. To assess the risk for travel-associated Legionnaires’ disease (TALD) associated with travel patterns in European countries, we retrieved TALD surveillance data for 2009 from the European Surveillance System, and tourism denominator data from the Statistical Office of the European Union. Risk (number cases reported/number nights spent) was calculated by travel country. In 2009, the network reported 607 cases among European travelers, possibly associated with 825 accommodation sites in European Union countries. The overall risk associated with travel abroad was 0.3 cases/million nights. We observed an increasing trend in risk from northwestern to southeastern Europe; Greece had the highest risk (1.7). Our findings underscore the need for countries with high TALD risks to improve prevention and control of legionellosis; and for countries with high TALD risks, but low notification rates of Legionnaires’ disease to improve diagnostics and reporting.     

Travel-associated Diseases,Indian Ocean Islands, 1997–2010

Data collected by the GeoSentinel Surveillance Network for 1,415 ill travelers returning from Indian Ocean islands during 1997–2010 were analyzed. Malaria (from Comoros and Madagascar), acute nonparasitic diarrhea, and parasitoses were the most frequently diagnosed infectious diseases. An increase in arboviral diseases reflected the 2005 outbreak of chikungunya fever.     

Outbreak of Panton-Valentine Leukocidin–Associated Methicillin-Susceptible Staphylococcus aureus Infection in a Rugby Team,France, 2010–2011

Staphylococcus aureus strains that produce Panton-Valentine leukocidin are known to cause community infections. We describe an outbreak of skin abscesses caused by Panton-Valentine leukocidin–producing methicillin-susceptible S. aureus (clonal complex 121) in a professional rugby team in France during July 2010–February 2011. Eight team members were carriers; 7 had skin abscesses.     

大龄单身女性寻求生育力保存的伦理问题探析

近年来,在肿瘤和卵巢相关疾病发生率逐年增加、不少大龄单身女性渴望为自己购买一份“生殖保险”等社会及个人因素催化下,人类对于生育力保存的需求急剧增加,满足这一需求正在或将成为重大挑战。对于寻求进行生育力保存的大龄单身女性来说,在合适的年龄应用玻璃化冷冻技术将其卵母细胞冻存是目前可采用的最佳生育力保存手段。而单身女性卵子冷冻将面临来自伦理道德、社会乃至法律的巨大挑战。本文概述国内外大龄单身女性卵子冷冻的现状,并对其可能涉及的相关伦理问题及解决途径进行综述,以促进理性正视单身女性卵子冷冻问题。     

Raccoons and skunks as sentinels for enzootic tularemia

We analyzed sera from diverse mammals of Martha's Vineyard, Massachusetts, for evidence of Francisella tularensis exposure. Skunks and raccoons were frequently seroreactive, whereas white-footed mice, cottontail rabbits, deer, rats, and dogs were not. Tularemia surveillance may be facilitated by focusing on skunks and raccoons.     

Haemophilus ducreyi Associated with Skin Ulcers among Children,Solomon Islands

During a survey of yaws prevalence in the Solomon Islands, we collected samples from skin ulcers of 41 children. Using PCR, we identified Haemophilus ducreyi infection in 13 (32%) children. PCR-positive and PCR-negative ulcers were phenotypically indistinguishable. Emergence of H. ducreyi as a cause of nongenital ulcers may affect the World Health Organization’s yaws eradication program.