福建省2011年新报告HIV/AIDS首次随访及影响因素分析

目的 了解福建省新报告HIV感染者/AIDS病人完成首次随访情况及影响因素,以加强随访管理.方法 从全国艾滋病综合防治信息系统下载福建HIV/AIDS病例卡,用SPSS软件统计分析.结果 截至2011年8月31日,全省首次随访的新报告HIV/AIDS 702例,随访完成率94.0％;男性、有登记身份证、联系电话及由疾控中心报告和现住我省的病例,首次随访完成率较高.结论 应强调责任报告单位作用,改善与患者的沟通技能,提高病例信息收集质量,以提高病例首次随访完成率.     

厦门市集美区2010-2019新报告HIV/AIDS病例晚发现状况及其影响因素

目的 了解2010-2019年厦门市集美区新报告的人类免疫缺陷病毒(HIV)/艾滋病(AIDS)病例晚发现率及其影响因素,为制定针对性的措施提供理论依据.方法 按照现住址浏览,审核日期选择2010-01-01-2019-12-31,从《艾滋病综合信息管理系统》导出病例信息,剔除重卡、外籍及港澳台病例,描述晚发现率的变化...     

2008年全国艾滋病疫情网络直报工作质量分析

目的 了解当前艾滋病网络直报工作存在的问题,以采取相应措施,进一步提高艾滋病疫情报告的质量,并为拟制定的管理指标提供参考依据. 方法 于2009年1月1日下载艾滋病网络直报系统中2008年报告HIV/AIDS的定时数据库及相关工作表,对艾滋病网络直报个案数据进行统计分析. 结果 2008年主要报告单位为疾病预防控制中心(占67.5%)和医院(占25.0%).身份证号、工作单位、联系电话和填卡医生等非必填项则有一定比例空白项.2008年"传播途径"填写率达100%,但途径不详占16.9%.2008年流调率为90.2%,诊断后15 d内报告者占85.0%.结论 2008年艾滋病报告及时率、流调率等较2006年、2007年进一步得到提高,针对存在的问题,在今后工作中针对性地加强.     

2011-2014年钟山县新报告艾滋病病例流行病学分析

目的：分析2011—2014年钟山县新报告HIV感染者和AIDS病人流行病学特征,为艾滋病防治工作提供依据。方法对2011—2014年钟山县新报告艾滋病感染病例个案资料进行描述性流行病学分析。结果2011—2014年现住址为钟山县的艾滋病感染者及病人（HIV/AIDS）累计报告479例,男女性别比为2.80∶1;已婚有配偶居多,占55.95%;50岁及以上人群占49.27%;小学及以下人群占68.27%;职业以农民为主,占83.92%;感染途径以异性传播为主,占96.45%;有明显的地区聚集性;新报告病例以 HIV 感染者为主,首次发现即为 AIDS 的比例逐年上升,新报告病例主要来源于医疗机构,占77.45%;抗病毒治疗比例为67.22%,呈逐年上升趋势;当年报告当年死亡病例占16.49%,呈逐年下降趋势。结论钟山县新报告HIV/AIDS病例以异性传播为主要传播途径,感染人群以中老年、农民及低文化人群为主。应有针对性地对重点人群开展宣传教育工作,在医疗机构推广艾滋病自愿咨询检测（VCT）,对HIV初筛阳性者实施“一站式服务”,早发现、早管理、早治疗,有效控制艾滋病的传播,降低艾滋病病死率。     

2010-2020年河南省青年人群HIV/AIDS流行特征

目的 掌握河南省青年人群HIV/AIDS流行特征,为制定青年人群艾滋病防治措施提供依据.方法 通过中国艾滋病防治基本信息系统,收集2010-2020年河南省15～24岁人群HIV/AIDS病例信息,应用描述性流行病学方法分析流行特征.结果 2010-2020年河南省新报告青年人群HIV/AIDS共6 704例,新发现率...     

1989-2010年云南省德宏州艾滋病病毒感染者死因分析

目的 了解1989- 2010年云南省德宏州艾滋病病毒感染者/艾滋病患者(HIV/AIDS)20年病死率及死因变化。方法在“艾滋病综合防治数据信息管理系统”中,下载1989-2010年的历史卡片,对相关数据进行调查核实和统计分析。结果1989-2010年共报告现住址及户籍地为德宏州的HIV/AIDS 13493例,其中HIV8569例,死亡2036例;AIDS 4924例,死亡2251例。少数病例已存活达15～20年。2004年以前报告的发病病例中,死亡病例数高于存活病例数,而此后历年报告的发病病例中,存活病例数则高于死亡病例数。HIV/AIDS当年发病当年死亡的病例数占当年发病总病例数的比例在1989-2010年的20年间则表现出由低到高再到低的变化趋势,其中2001-2003年该比例均高于10.0％,2003年达到最高的18.9％,此后逐年稳步下降,2010年该比例为5.8％;而年初存活当年死亡的比例则自2007年起逐年下降。HIV/AIDS死亡病例中,因艾滋病而死亡的比例逐年上升而因吸毒过量而死亡的比例下降,其中,曾接受过CD4+T淋巴细胞计数检测和抗病毒治疗的比例也逐年上升,至2010年时分别达到89.9％和25.5％。结论德宏州HIV/AIDS病死率近年来呈下降趋势,扩大CD4+T淋巴细胞计数检测和抗病毒治疗、降低病死率仍是今后一个时期艾滋病防治工作重点。农村地区应加强AIDS死因监测。     

柳州市2010年艾滋病疫情流行病学分析

目的 分析柳州市2010年艾滋病病毒(human immunodeficiency virus,HIV)感染者和艾滋病(acquired immunodeficiency syndrome,AIDS)病人流行病学特征及趋势,为进一步预防控制艾滋病的蔓延提供依据.方法 通过AIDS疫情监测网络报告,对HIV/AIDS发病资料进行描述流行病学分析.结果 柳州市2010年报告HIV/AIDS病例2 083人,其中死亡523人;报告病例中以男性青壮年居多,10 ～49岁1 482例,占报告病例71.15％,50岁及以上老年人576人,占27.65％;以农民居多,占43.78％;报告病例中以异性性传播感染途径为主,占77.48％,血液传播占13.15％;57.7％的病例当年首次报告即为AIDS病人,69.4％的病例当年首次报告即在当年死于艾滋病.结论 柳州市艾滋病疫情严峻,已经进入了发病和死亡高峰,在继续加大宣传和综合干预的同时,提高检测和治疗力度,做到“早发现、早管理、早治疗”,最终控制柳州市艾滋病的持续蔓延.     

2008-2012年湖北省新发现HIV/AIDS随访情况分析

目的了解2008-2012年湖北省新发现艾滋病病毒感染者/艾滋病患者(HIV/AIDS)随访状况及其影响因素。方法从全国艾滋病综合防治信息系统下载湖北省历史卡片,对2008-2012年湖北省新发现HIV/AIDS的人口学特征、感染途径、地区类别、样本来源等因素对后续随访比例的影响分别进行单因素和多因素分析。结果2008-2012年湖北省累计新发现HIV/AIDS 6 078人,其中完成首次随访5 657人,失访48人,查无此人247人,未随访126人。完成首次随访后,婚姻状况不详、职业不详、感染途径不详、文化程度低、注射吸毒、现住址非报告地的HIV/AIDS失访比例较高。结论 HIV/AIDS病例报告和首次随访时信息的收集质量影响后续的随访比例,应加强病例报告和首次随访时信息收集的质量。     

2005-2015年武汉市新洲区艾滋病流行特征分析

目的 分析武汉市新洲区艾滋病病毒感染者(HIV)/艾滋病患者(AIDS)的流行病学特征和变化趋势,为艾滋病预防提供依据.方法 对武汉市新洲区2005-2015年上报的HIV/AIDS个案资料进行双录入核实和统计学分析,HIV/AIDS病例均为确证病例,且现住址均在武汉市新洲区所辖范围.结果 截止到2015年底,武汉市新洲区累计报告HIV/AIDS 145例,其中男性122例,女性23例,男女性别比5.3∶1;145例HIV/AIDS中同性传播85例,异性传播58例,共用注射器吸毒传播2例;年龄最小18岁,最大80岁,其中20 ～49岁共计100例,占比68.97％,50岁以上共计42例,占比28.97％;145例HIV/AIDS中,未婚56例,占比38.62％,已婚有配偶64例,占比44.14％,离异或丧偶25例,占比17.24％;小学及文盲33例(22.76％);初中52例(35.86％);高中或中专34例(23.45％);大专及以上26例(17.93％).结论 武汉市新洲区HIV/AIDS呈低度流行态势,近11年来发病例数呈逐年上升趋势.性传播为AIDS主要传播途径,2011年以后通过MSM传播的比例增加明显.     

2011-2020年玉林市15～24岁青少年男性HIV/AIDS病例流行病学特征分析

目的 分析2011-2020年玉林市15～24岁青少年男性艾滋病病毒感染者/艾滋病病人(HIV/AIDS)的流行病学特征,为制定青少年人群的艾滋病防控策略提供参考依据.方法 在中国疾病预防控制信息系统传染病监测子系统中的艾滋病防治基本信息模块中,筛选出2011-2020年报告的现住址为玉林市的15～24岁男性HIV/AIDS病例的信息,采用描述性流行病学方法对其进行分析.结果 2011-2020年玉林市共报告15～24岁男性病例395例,平均年龄为(21.38±2.22)岁,未婚占91.6％,初中及以下教育程度者占52.9％,学生占11.6％;样本来源为检测咨询者占43.0％、为诊疗行为检测者占39.2％;感染途径为异性传播者占53.7％、为同性传播者占44.1％.病例的教育程度越高,其样本来源为检测咨询所占的比例相对越高(趋势x2=13.413,P＜0.001),以同性传播为主要感染途径的比例就越高(趋势x2=40.995,P＜0.001).校内青少年以同性传播为主要感染途径的比例高于校外(x2=18.838,P＜0.001);调查人群年龄越小,以同性传播为主要感染途径的比例相对越高(趋势x2=18.045,P＜0.001).结论 玉林市15～24岁男性HIV/AIDS病例以未婚、低学历为主;校内青少年的感染途径以同性传播为主;同性传播途径感染者教育程度相对较高,年龄趋于更低.提示对上述群体的艾滋病防控工作应给予特别重视,针对群体感染特征采取相应的防控措施,减少艾滋病对该人群的危害.     

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.