路边店暗娼艾滋病相关行为干预效果分析

目的了解路边店暗娼的人口学特征与艾滋病相关知识、行为等,评价在路边店实施100%安全套使用项目后的效果。方法按项目方案要求对路边店有高危行为人群进行综合性干预活动,并对其进行干预前后的问卷调查和健康体检,评估干预效果。结果路边店暗娼以低年龄和未婚者居多,路边店暗娼与城区娱乐场所暗娼,平均年龄分别为20.68岁和24.04岁（χ2=4.11,P〈0.05）,未婚比例分别为82.65%和56.10%（χ2=13.90,P〈0.01）;干预后暗娼艾滋病相关知识平均知晓率由66.98%上升到92.38%,差异有统计学意义（χ2=146.07,P〈0.01）;干预后暗娼的高危行为明显改变,性病发病率降低,在商业性性行为中安全套使用率从干预前的77.5%上升到98.8%（χ2=18.40,P〈0.01）。结论路边店全面推行100%安全套使用项目能提高暗娼人群的艾滋病相关知识知晓率和高危行为发生率,使该人群性病发病率降低。     

1301例暗娼艾滋病相关知识和行为调查

[目的]通过对普洱市2010年国家级哨点暗娼人群的艾滋病相关知识和行为学进行分析,了解普洱市不同层次暗娼人群艾滋病相关知识知晓率、高危行为干预工作覆盖率和安全套使用率是否存在差异,为决策部门评估艾滋病防治工作及制定暗娼人群干预策略提供科学根据。[方法]根据全国哨点监测统一方案要求,以横断面调查的方法对暗娼人群进行监测。[结果]2010年共进行1301份暗娼人群艾滋病相关知识和行为学问卷调查,艾滋病相关知识知晓率为90．78％,不同档次、不同文化程度暗娼知识知晓率差异有统计学意义（P〈0．01）;接受过艾滋病相关干预服务的比例为83．32％,不同档次暗娼接受过艾滋病相关服务的比例差异有统计学意义（P〈0．01）;调查对象最近一次与客人发生性关系时安全套使用率为90．85％,最近一个月与客人发生性行为时安全套的使用率为84．47％;不同档次、不同文化程度暗娼最近一次与客人发生性关系时安全套使用率差异无统计学意义（P〉0．01）。[结论]通过反复的艾滋病相关知识的宣传和行为干预,不同层次的暗娼艾滋病相关知识知晓率、接受过艾滋病相关干预服务的比例和与客人发生性关系时安全套使用率均比较高,但不同层次的暗娼艾滋病相关知识知晓率、接受干预服务比例存在差异,为了降低艾滋病在低档暗娼中的传播谜度,应积极探索有效的干预模式,继续加强此类人群的高危行为干预,提高安全套的可及性。     

安徽省暗娼艾滋病相关知识、行为调查

目的了解安徽省示范区／全球基金艾滋病项目地区暗娼人群的艾滋病知识水平和行为状况，为评估项目前期执行效果和制定后期计划提供依据。方法采取普查的方法，对8个项目县（市、区）的360名暗娼进行面对面匿名问卷调查。结果艾滋病知识知晓率90．17％；传播途径和非传播途径知晓率分别为93％和72．4％（χ^2=53．38，P〈0．001）；与嫖客最近一次性行为时安全套使用率和最近3次安全套坚持使用率分别达84．4％和73．5％：无偿献血知识知晓率为56．3％；自原咨询检测（VCT）服务的知晓率为86．1％，利用率为50．7％。艾滋病知识知晓率和安全套使用率明显高于基线调查结果。结论项目地区暗娼人群艾滋病知识知晓率和安全套使用率有所上升，但无偿献血知识知晓率和VCT服务利用率较低，安全套使用率离项目要求还有差距。     

云南省男性流动人群艾滋病高危行为现况分析

摘要:目的　了解云南省男性流动人群艾滋病高危行为现况,为制定干预策略提供依据。方法　采用社区概率抽样方法和整群抽样法对云南省保山市、红河州、昆明市3个州（市）男性流动人群进行横断面调查,通过一对一问卷调查,收集人口学及高危行为等相关信息,采用SPSS17.0进行统计学分析。结果　被调查对象共2405人,艾滋病总知晓率为95.8%,红河州流动人群知晓率低于保山及昆明（χ2＝101.846,47.75,均 P＜0.01）;最近1年与配偶发生性行为安全套使用率为3.8%;最近1年有5.0%的调查对象与临时性伴发生过性行为,安全套使用率为27.3%;最近1年4.4%的调查对象与暗娼发生过商业性行为,安全套使用率为36.2%。多因素Logistic回归显示,被调查对象与临时性伴及暗娼发生性行为时未坚持使用安全套的主要危险因素有:未婚、年龄大于35岁、本地居住12个月以上、属于建筑工人、对艾滋病知识不知晓。总吸毒率为0.2%（5/2405）。接受艾滋病咨询检测干预的比例为65.8%,接受同伴教育总干预比例为28.4%,最近1年做过艾滋病检测并知晓结果的比例为27.1%。结论　艾滋病知识知晓率较高,安全套使用率较低,干预力度及覆盖面有待提高。应重点加大建筑工人、单身、大年龄、外出时间较长及对艾滋病知识知晓较少的流动人群的干预力度。     

2011-2012年泸西县暗娼人群艾滋病哨点监测结果分析

[目的]了解泸西县暗娼(FSW)人群艾滋病相关知识和行为水平,为制定艾滋病干预措施和评价干预效果提供依据。[方法]对2011-2012年泸西县508名暗娼进行艾滋病相关知识、行为学及血清学监测。[结果]高、中、低档暗娼,艾滋病知识知晓率分别为:100.0%、100.0%、96.9%,差异有统计学意义(χ2=10.07,P<0.01);最近1个月与客人发生性行为时坚持使用安全套的比例分别为:93.8%、95.6%、82.3%,差异有统计学意义(χ2=19.38,P<0.01)。2011年和2012年,暗娼人群艾滋病知识知晓率分别为:100.0%、98.8%;最近1个月与客人发生性行为时坚持使用安全套的比例分别为:92.9%、92.5%。检出HIV抗体阳性5例、梅毒抗体阳性16例。[结论]泸西县暗娼人群艾滋病知识总体知晓率、安全套使用率保持在较高水平,但低档暗娼艾滋病知识知晓率、安全套使用率低于中高档暗娼,建议提高暗娼人群干预工作覆盖面,加强低档暗娼干预工作频次和质量。     

415名暗娼艾滋病知识、性行为特征及安全套使用情况调查

[目的]掌握银川市暗娼人群艾滋病防治知识、性行为特征及安全套使用情况,为开展暗娼人群干预工作提供可借鉴的依据。[方法]选择银川市娱乐场所为调查地点,开展艾滋病知识、性行为特征及安全套使用情况的问卷调查,并提供性病艾滋病相关问题的咨询服务。[结果]暗娼人群艾滋病防治知识知晓率为76.38%,最近一次安全套使用率为52.8%。[结论]银川市暗娼人群艾滋病防治知识知晓率和安全套使用率低,需加强暗娼人群艾滋病防治知识的宣传教育,提高安全套使用意识。     

东莞市吸毒人群艾滋病KABP及感染情况的调查

[目的]了解东莞市吸毒人群HIV感染情况、危险因素及与艾滋病有关的知识、态度和行为,为制定吸毒人群的艾滋病防控措施提供依据。[方法]对2004～2006年在东莞市强制戒毒所戒毒的1 032名吸毒者进行血清HIV抗体检测,同时采用统一的问卷搜集每名研究对象的人口学、行为学等相关资料。将所有资料输入EPIDATA 3.0,采用STATA 10.0软件进行统计分析。[结果]东莞市吸毒人群的HIV感染率为5.04%。男性吸毒人群的感染率（5.53%）高于女性（0.92%）,差异有统计学意义（χ^2=4.3262,P=0.038）;注射吸毒的感染率（7.09%）高于口吸毒品者（0.61%）,差异有统计学意义（χ^2=19.6072,P=0.000）;共用针具吸毒者的感染率（11.84%）高于未共用针具者（4.62%）,差异有统计学意义（χ^2=12.9877,P=0.002）。东莞市吸毒人群注射吸毒率68.31%、针具共用率34.75%;艾滋病防治知识知晓率39.34%;商业性性行为发生率22.09%,买淫和卖淫时每次均使用安全套率50.26%和46.81%。[结论]东莞市吸毒人群HIV感染率持续上升的势头已得到初步遏制,但吸毒人群中仍然存在着共用针具、商业性性行为、安全套使用率低、艾滋病防治知识欠缺等危险因素,建议在吸毒人群中采取宣传教育和行为干预并重的防控措施。     

415名暗娼芨滋病知识、性行为特征及安全套使用情况调座

[目的]掌握银川市暗娼人群艾滋病防治知识、性行为特征及安全套使用情况,为开展暗娼人群干预工作提供可借鉴的依据。[方法]选择银川市娱乐场所为调查地点,开展艾滋病知识、性行为特征及安全套使用情况的问卷调查,并提供性病艾滋病相关问题的咨询服务。[结果]暗娼人群艾滋病防治知识知晓率为76.38%,最近一次安全套使用率为52.8%。[结论]银川市暗娼人群艾滋病防治知识知晓率和安全套使用率低,需加强暗娼人群艾滋病防治知识的宣传教育,提高安全套使用意识。     

岑溪市2014年暗娼哨点监测结果分析

目的了解岑溪市暗娼人群艾滋病、梅毒等性传播疾病流行情况和相关危险行为,为制定防治策略和措施提供科学依据。方法于2014年4—6月在岑溪市娱乐场所按比例抽样选择暗娼进行现场问卷调查,同时采集血样检测HIV和梅毒抗体。结果共调查400名暗娼,其艾滋病知识知晓率为96.00%,其中城区娱乐场所暗娼的知晓率为99.44%,高于乡镇的65.00%(χ2=102.438,P0.01)。中档娱乐场所暗娼安全套使用率为98.48%,高于低档场所暗娼的81.75%(χ2=37.481,P0.01);城区娱乐场所暗娼安全套使用率为94.52%,高于乡镇暗娼的65.00%(χ2=50.897,P0.01)。暗娼HIV和梅毒阳性率分别为0.75%和6.00%,其中乡镇娱乐场所暗娼的梅毒阳性率为22.50%,高于城区的4.17%(χ2=21.454,P0.01)。结论岑溪市乡镇低档场所暗娼艾滋病知识知晓率和安全套使用率均比较低。暗娼人群,尤其是乡镇低档娱乐场所暗娼是今后艾滋病干预的重点人群。     

2009年-2018年浙江省台州市暗娼人群艾滋病相关行为知识及感染状况调查

目的分析台州市暗娼(FSWs)HIV/梅毒感染及相关行为知识情况。方法2009年-2018年,根据《全国艾滋病哨点监测实施方案》要求,调查台州FSWs人口学特征、艾滋病知识知晓率及性行为特征,进行HIV和梅毒血清学监测。结果2009年-2018年共调查FSWs 222641人次,年龄≥30岁、高中及以上文化程度、在婚、本省户籍、高档场所者占比呈增长趋势。HIV平均感染率为0.02%;梅毒为1.14%,无显著变化趋势。艾滋病基本知识知晓率(χ^2趋势=131.53,P<0.001)和近一年干预服务接受率(χ^2趋势=606.26,P<0.01)呈上升趋势;吸毒比例较低且呈下降趋势(χ^2趋势=11.76,P=0.001)。最近一月商业性行为安全套坚持使用率呈下降趋势(χ^2趋势=226.87,P<0.001),但较未接受干预服务和未知晓者,接受干预服务和知识知晓者安全套坚持使用率更高(P<0.05)。结论台州暗娼HIV和梅毒感染率较低,安全套坚持使用率呈下降趋势,应继续对其采取针对性干预措施。     

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.     

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.