门诊肌肉注射患者健康教育需求调查

目的探讨门诊肌肉注射患者的健康教育需求及方法。方法采用自设问卷对300例门诊肌肉注射患者进行基本知识掌握情况、对健康教育的认识、对教育内容和教育形式需求的调查。结果肌注知识缺乏者占94．3％;认为有健康教育必要性者占83．0％;教育内容需求依次为药物知识、所患疾病知识、操作配合、不良反应防治;教育形式需求依次为个别指导、宣传小册、健康宣传栏、影像宣传。结论患者普遍缺乏肌肉注射基本知识,并有开展健康教育的相关需要。护士应根据患者需求,采取形式多样的教学方法来开展健康教育,以提高服务水平。     

青光眼患者的健康教育需求调查分析

目的探讨对青光眼患者进行有效健康教育的方法内容。方法采用自行设计的调查问卷，对74例青光眼患者进行疾病防护知识和健康教育方式、需求等现况调查。结果54．0％的患者不知本病临床表现，只有10．8％的患者了解青光眼易发生的并发症：患者自护能力处于低水平；90．5％患者希望通过医护人员的指导学习相关知识和举办疾病专题护理讲座(87．8％)，以及进行个案指导(83．8％)等方式，从医护人员处获得知识和护理技能。结论青光眼患者有多方面的知识需求，医护人员应重视青光眼患者的健康教育．有针对性地进行宣教和指导，有利于降低术后复发率，提高手术的成功率。     

黄浦区499例随访肿瘤患者需求调查

目的了解社区随访肿瘤患者的需求,从而有针对性地进行宣传和指导,更好地开展肿瘤随访工作。方法采用随机整群抽样的方法,对上海市黄浦区某社区随访管理的肿瘤患者进行无记名问卷调查。问卷分为基本情况和患者需求两部分,用EPIDATA3．02建立数据库,用SPSS统计软件进行分析。结果收到有效问卷499张,需要心理支持者占94．0％;对健康教育内容的需求依次为转移复发知识（53．9％）、肪癌知识（40,7％）和癌症诊疗知识（27．7％）。对随访医生指导服务需求依次为饮食指导（52．3％）、康复指导（38．7％）、用药指导（32．3％）。对饮食方面的需求依次为治疗期间的饮食要求（69．7％）,食物的营养成分（54．5％）,饮食结构（30．3％）对康复方面的需求不同年龄、职业、文化程度和病种的患者所需求的健康教育内容无差异。结论绝大多数患者及其家属需从不同方面了解与疾病有关的知识,同时对随访人员提出要求。     

农村留守妇女健康教育需求调查

目的调查农村留守妇女的健康需求，为制定淮安市楚州区农村关爱工程中的留守妇女健康教育内容和方式提供依据。方法采取分层整群抽样的方法抽取2066名留守妇女，对其进行健康教育需求调查和访谈。结果留守妇女初中文化程度的有1052人，占50．9％，小学797人，占38．6％，文盲138人，占6．7％。留守妇女对健康知识需求占前6位的分别是：性病预防知识、妇女卫生保健知识、病毒性肝炎预防知识、肿瘤预防知识、饮食卫生知识、高血压预防知识。分别占95．6％、92．7％、92．3％、90．9％、89．4％、85．4％。调查对象认为获得健康知识的最佳途径是录像／电视、卫生知识讲座、健康教育知识资料人户等。结论农村留守妇女健康知识缺乏，学历层次不高，健康知识需求较高，应采取有效的、灵活多样的、有针对性的健康传播方式以满足调杏对象希卑获得的健康知识。     

2型糖尿病患者健康教育方式需求和知识掌握情况

目的了解2型糖尿病患者对不同健康教育方式的需求状况及其对糖尿病知识掌握程度，为进一步有效开展糖尿病教育提供依据。方法采用横断面研究，以方便抽样法抽取广州市5家医院就诊的349例2型糖尿病患者，以问卷的方式调查其糖尿病知识来源、对来源的信任度、知识需求内容、教育途径的选择意愿和知识知晓程度。结果患者对糖尿病知识需求愿望强烈（95．1％），其中71．6％的人希望了解治疗方面信息；最希望选择的受教育途径以医务人员讲座（49．9％）、个别教育（31．5％）占主导；患者知识来源为多向性，大众媒体信息受质疑；近10％患者对医务人员信任不足；患者技能训练不足。结论提倡以医务人员直接教育为主导的综合性教育；加强健康信息来源和医疗行业管理；重视社会、家庭支持作用。     

42例系统性红斑狼疮患者健康教育需求调查分析

目的：了解系统性红斑狼疮患者（SLE）健康教育知识掌握程度和需求状况,探讨适合SLE患者的健康教育方式,为SLE专科护士实施健康教育提供依据。方法：采用自行设计问卷调查表对42例SLE患者自身疾病健康教育有关知识掌握程度和对健康教育需求进行调查,对调查结果进行分析。结果：42例SLE患者自身疾病健康教育有关知识平均得分（44．8±1．2）分,满分64分,与性别、年龄无关,与文化程度、病程长短有关,差异有统计学意义。文化程度高、病程较长者健康教育知识掌握得分偏高;患者对健康教育需求方面,需要者占96．1％;患者对健康教育方式的选择方面,61．9％的SLE患者选择“由医护人员告知”最好。结论：医护人员需要提高SLE健康教育水平,改进教育方式,找出适合SLE患者的教育方式,提高患者健康教育知识掌握水平,满足其对疾病知识的需求。     

某干休所离休干部不良生活方式及对健康需求调查分析

目的了解离体干部的不良生活方式、健康知识与行为及对健康教育的需求，指导其调整改变不良生活方式，改进健康教育方法，从而有效地防治疾病。方法采用问卷法进行调查，然后进行统计学分析。结果吸烟（85．71％）、经常饮酒（32．74％）、多盐高脂饮食（75．00％）和少食水果（61．90％）是该人群中存在的主要不良生活方式。该人群能够较好地遵循和执行医护人员的指导（85．71％），正确使用治疗药物（76．19％），对教育方法的需求具有多样性，最受欢迎的方法是个别指导（91．07％）。结论建议加强不良生活方式的干预，改进健康知识与行为及健康教育知识的宣传教育。     

农村婚检对象生殖健康知识状况及需求调查

目的 了解农村婚检对象生殖健康知识状况和需求。方法 采取以问卷的形式对1528例来自农村的婚检对象的生殖健康知识和需求进行了调查。结果 调查中,小学、初中和高中文化分别占13．5％、48．3％和21．3％。职业中,非农业占72％。85．6％有婚前性生活,35．7％未婚先孕,18．62％有过经期性生活。性生活懂得避孕的占53．24％,不懂避孕的占21．61％。对生殖健康服务需求依次为：孕期营养知识77．33％,防病卫生知识52．36％,避孕知识46．9％,性知识42．03％,优生优育知识32．46％。结论 农村婚检对象的性知识、避孕知识、优生优育及防病卫生知识仍需加强。     

COPD患者健康知识认知与健康教育需求调查分析及策略

目的：了解COPD患者健康知识认知与健康教育需求情况,以便为患者提供适宜的健康教育服务。方法：采用自行设计的问卷调查表,对2011年3-11月在本院呼吸科住院的90例COPD患者进行健康知识认知与健康教育需求调查。结果：COPD患者对健康知识的认知总得分为（67．40±24．65）分;很想了解健康知识的患者有42．22％,比较想了解的患者有44．44％;55．56％的患者最想了解的内容为病情控制,43．33％为复发预防,35．56％为肺康复锻炼,33．33％为发病原因;58．89％的患者选择一对一健康教育方式;51．11％的患者希望每月举办讲座1次;30％的患者与65．56％的患者出院后非常需要和比较需医护人员进行健康指导;64．44％的患者出院后仍希望医护人员定期进行电话随访指导。结论：COPD患者对健康知识的认知水平低,对健康教育的需求迫切,想了解的内容和选择的教育方式多。因此,医护人员应根据患者需要开展多形式、系统化与个性化健康教育,定期进行出院后的随访指导,满足患者的健康需求。     

脑梗塞患者家属健康教育需求调查

目的了解脑梗塞患者家属对患者疾病相关知识了解程度和患者家属对患者疾病认知态度、健康教育的需求程度、需求内容及目前存在的问题。方法对100例脑梗塞患者家属进行了健康教育自制问卷调查。结果所有被调查的脑梗塞患者家属均认为有必要时患者及家属进行健康教育,90%以上脑梗塞患者家属认为健康教育应在平时或发病初期进行。对健康教育内容需求依次为治疗方法、饮食调配、发病诱因、护理知识、预防知识、康复训练、并发症预防。对健康教育方式的选择上依次为医护专业人员讲课、专业宣传手册、宣传栏等。结论患者家属对脑梗塞相关知识有不同程度的认知和需求,应根据患者家属认识现状及教育需求情况采取有针对性的个体化的健康教育。     

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.