东莞市流动人口新生儿破伤风发病情况及控制措施分析

目的　了解东莞市流动人口新生儿破伤风发病情况,探讨综合干预措施对降低新生儿破伤风发病率的作用。方法　开展常规监测和主动监测,采取旨在提高住院分娩率的综合干预措施,并比较加强干预前后新生儿破伤风发病率。结果　1998～2 0 0 3年东莞市户籍人口无报告新生儿破伤风病例,流动人口新生儿破伤风年发病分别为10 1、95、116、112、6 9、6 1例。加强综合干预措施后,流动人口新生儿破伤风年平均发病率从1998～2 0 0 1年的0 6 8‰下降至2 0 0 2～2 0 0 3年的0 33‰(P <0 0 1)。结论　流动人口是控制新生儿破伤风的重点人群,加强综合干预措施对降低新生儿破伤风发病率有重要作用     

深圳市2001～2005年新生儿破伤风流行病学分析及干预措施

目的:了解深圳市新生儿破伤风的流行病学特征,为控制和消除新生儿破伤风提供科学依据。方法:用描述流行病学方法,对2001～2005年深圳市妇幼信息系统监测的资料进行统计学分析。结果:深圳市2001～2005年新生儿破伤风的发病率在0.42‰～2.07‰之间,死亡率在0.03‰～0.36‰之间,两率均呈明显的下降趋势,2001年全市6区中有5个区报告新生儿破伤风,2005年仅有3个区报告新生儿破伤风,2001年新生儿破伤风发生率>1‰的有宝安区、龙岗区,2005年新生儿破伤风发生率>1‰的区数已下降为零。宝安区和龙岗区合计占全市总例数的88.35%。流动人口新生儿破伤风发病率高于户籍加暂住人口新生儿破伤风发病率。352例新生儿破伤风均为院外分娩,新生儿破伤风的母亲均未接种破伤风类毒素。结论:新生儿破伤风多发生于流动人口中。不安全接生是新生儿破伤风发病的主要原因。采取综合干预措施可以控制新生儿破伤风的发病,提倡和推广住院分娩,是目前消除新生儿破伤风的主要措施。     

2006年广西新生儿破伤风监测报告

目的分析2006年广西新生儿破伤风(NT)的流行病学特征,为消除与控制新生儿破伤风提供科学依据。方法按照全国NT监测方案并纳入AFP监测系统运行。采用SPSS软件建立新生儿破伤风监测资料数据库并统计分析。结果2006年NT监测系统共监测到病例330例,死亡19例,年报告发病率为0.44‰,病死率5.76‰。全区98个县(市、区)有70个报告疑似病例,发病率大于1‰的仅为百色市,确诊发病率为1.29‰。全区病例以山区发病为主,占总病例的58.48%。45.36%病例由未受过培训的接生员接生,91.17%为不洁接生。100%患儿母亲未接种百白破/破伤风类毒素,23.03%的患儿母亲接受过产前检查。结论不洁接生、育龄妇女未接种百白破/破伤风类毒素和未建立对流动人口有效的管理措施是新生儿破生风发病的主要原因,应加强健康教育和健康促进的力度,动员孕妇住院接生,加强基层接生员培训,降低不洁接生的机率。     

珠海市2006～2010年新生儿破伤风流行病学特征及影响因素分析

目的:了解珠海市新生儿破伤风流行病学特征,为制定干预措施提供依据。方法:利用新生儿破伤风监测系统获得新生儿破伤风资料并进行统计分析。结果:2006～2010年珠海市新生儿破伤风发病率呈逐年下降趋势,年均发病率为0.46‰,年均病死率为7.69%,年均死亡率为0.035‰,病例全部为外来流动人群,分娩方式均为非住院分娩。结论:外来流动人群是新生儿破伤风发病的高危人群,非住院分娩是新生儿破伤风发病的主要原因。应采取综合干预措施提倡和推广住院分娩,消除新生儿破伤风。     

新生儿破伤风流行动态分析

目的:为了解龙岗区新生儿破伤风流行病学特征,掌握其流行动态,为政府相关部门制定干预措施提供依据,降低新生儿破伤风的发病率。方法:利用深圳市法定传染病报告系统和新生儿破伤风监测系统获得新生儿破伤风资料并进行统计分析。结果:龙岗区新生儿破伤风发病率和病死率呈逐年下降趋势;病例全部为流动人口;分娩方式均为院外分娩;94.74%的病例发病年龄在生后2周内;只有13.16%的母亲在孕期到医院进行过产前检查(次数≥1),85.09%的母亲未接种过破伤风类毒素疫苗。结论:结合新生儿破伤风的发病机制及流行病学特点,加强流动人口孕产妇管理,普及住院分娩、新法接生、开展育龄妇女破伤风类毒素接种是预防新生儿破伤风的有效措施。     

1990-1999年广西新生儿破伤风流行病学特点分析

目的 了解广西新生儿破伤风发病情况和特点，为实现2005年消除新生儿破伤风的目标提供科学依据。方法 收集广西1990年以来广西法定传染病报告系统和1999年以来广西新生儿破伤风监测系统的新生儿破伤风资料并进行分析。结果 在1995年进行突击接种后，广西的新生儿破伤风发病率有明显的下降，从1995年的1．40‰下降到1999年的0．94‰，高危县逐渐减少，但发病率仍较高，发现有明显的夏、秋高峰，报告发病率和死亡率男女性别比差异极大，分别为4．4：1和4．9：1，98．90％的病例母亲无破伤风类毒素(TT)接种史。结论 TT突击接种能迅速有效地降低新生儿破伤风的发病率。消除新生儿破伤风必须采取在高危地区实施TT突击接种的策略，加强监测、宣传和基础卫生服务等综合措施.     

福州市2000～2002年新生儿破伤风资料分析

[目的 ]了解福州市新生儿破伤风发病情况 ,为控制和消除该病提供科学依据。 [方法 ]对 2 0 0 0～ 2 0 0 2年福州市新生儿破伤风监测系统和法定传染病系统资料进行分析。 [结果 ]福州市 2 0 0 0～ 2 0 0 2年新生儿破伤风发病率为0 14‰～ 0 5 5‰ ,病死率为 12 5 0 %～ 18 75 % ;发病率农村高于城市 ;病人中 ,流动人口较多 ,男婴多于女婴 ,在家中分娩的、母亲未接种破伤风类毒素的较多。 [结论 ]提高群众的卫生意识 ,推广消毒接生 ,对育龄妇女接种破伤风类毒素 ,是减少新生儿破伤风发病的主要措施。     

崇左市近年新生儿破伤风疫情特点及防制策略

目的分析1999—2005年崇左市新生儿破伤风（NT）疫情特点，探讨防制策略，为消除新生儿破伤风提供科学依据。方法应用描述性流行病学方法对近年崇左市的NT疫情资料进行分析。结果NT发病率波动在0．31‰～1．99‰之间，年平均发病率为1．32‰，病死率为9．37％～28．21％；发病季节高峰不明显，男婴多于女婴。NT病例中，农村人口占63．82％，流动人口占34．21％，城镇人口占1．97％，所有患儿母亲均未注射破伤风类毒素。结论旧法接生和产前未注射破伤风类毒素以及流动人口是NT发病的主要因素，应采取综合措施，消除或减轻上述因素对新生儿破伤风发病的影响。     

三亚市新生儿破伤风监测

目的 确定新生儿破伤风(NNT)高危地区与人群,为消除NNT提供科学依据。方法 开展NNT监测,收集医疗单位NNT疫情报告及病例个案调查。结果 本市1995～2000年NNT监测发病率为1.51‰～2.79‰,汉族发病率为1.4‰,黎族为2.68‰,常住人口为1.95‰,流动人口为5.58‰。在家中不洁分娩的发病占87.36％,母亲无破伤风类毒素(TT)接种史的发病占96.55％。结论 高危地区与人群是黎族村庄和流动人口妇女所生的新生儿,必须提高清洁接生率和落实育龄妇女TT免疫接种,才能实现消除NNT。     

晋江市2008—2013年新生儿破伤风流行特征

目的为掌握晋江市近年新生儿破伤风(NT)流行特征,为制定干预措施提供依据。方法用描述流行病学方法分析2008—2013年大疫情系统中报告的NT监测资料和个案调查材料。结果晋江市2008—2013年共报告NT确诊病例32例,无死亡病例,年均发病率为0.3‰。发病主要为出生后5~30d,男性较多,均为流动人口,呈散发形式。不安全接生、产妇保健意识差、产前未接种破伤风类毒素是导致NT发病的主要因素。结论外来流动人口是NT发病的高危人群。应进一步推广住院分娩,提高流动人口卫生保健意识,对高危人群接种破伤风类毒素(TT)是目前预防和消除NT的主要措施。     

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.     

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.