2012—2014年鞍山市男男性行为人群的HIV感染情况及其影响因素

目的了解鞍山市男男性行为者(MSM)的人类免疫缺陷病毒(HIV)感染情况及其影响因素,为开展有针对性的监测和干预工作提供依据。方法对鞍山市2012—2014年MSM艾滋病哨点的监测数据进行统计分析。结果 1 208例MSM调查对象,HIV阳性率为6.71%,梅毒阳性率6.71%,丙型肝炎(丙肝)阳性率0.99%;艾滋病知识知晓率为92.80%。最近6个月,82.78%的调查对象发生过肛交性行为,最近1次肛交性行安全套使用率为88.80%,安全套坚持使用率为65.70%;近1年中,93.87%的MSM接受过安全套宣传和发放/艾滋病咨询与检测或同伴教育服务;单因素分析结果 ,是否接受过艾滋病预防服务和安全套使用情况是该人群HIV感染的主要影响因素(P<0.05);logistic多因素分析显示,接受过艾滋病预防服务的MSM人群的HIV感染率较低(OR=0.402,P<0.05),梅毒抗体检测结果呈阳性的MSM人群感染HIV的风险较高(OR=0.655,P<0.05)。结论 MSM的HIV感染率达到了较高水平,危险因素广泛存在,建议深入开展艾滋病宣传、安全套推广以及规范性病诊疗等综合干预工作,控制HIV的传播。     

男男性行为人群艾滋病流行趋势及安全套使用影响因素分析

目的 了解男男性行为人群（MSM）艾滋病知识知晓率、行为、干预服务和艾滋病感染率的变化趋势及使用安全套的影响因素,初步评价综合干预的效果.方法 利用2010-2012年杭州市MSM人群监测数据,分析MSM人群艾滋病的知识、行为、干预服务和艾滋病感染率的变化趋势;采用多因素非条件Logistic回归分析安全套使用的影响因素.结果 2010-2012年艾滋病感染率分别为8.45%、8.17%和8.07%;接受过宣传咨询和同伴教育者的比例逐年递减;艾滋病防治知识知晓率、同性性行为时每次使用和最近一次使用安全套比例以及吸毒者所占比例均无明显变化.来自酒吧/歌舞厅/茶室/会所（OR=1.745,95%CI：1.099～2.771）、未婚（OR=1.514,95%CI：1.113～2.059）以及曾经检测过HIV（OR=1.553,95%CI：1.205～2.000）的男男性行为人群更容易坚持每次使用安全套.结论 近三年杭州市男男性行为人群艾滋病感染率变化不大,进一步降低感染率还需加强同伴教育和宣传咨询等干预服务工作;扩大人群检测既能及早发现感染者,又可以促进安全套使用.     

成都市男男性行为艾滋病哨点监测分析

目的描述成都市男男性行为（MSM）人群HIV感染率变化趋势,评价现阶段干预效果,为未来干预策略提供依据。方法使用滚雪球法募集成都市MSM人群1223人,开展问卷调查并采集血样,对HIV、梅毒和丙肝感染情况开展血清学检测。结果成都市MSM人群HIV感染率2009-2012年分别为14.9%、15.1%、16.3%和13.9%。MSM人群近6个月安全套使用率逐年上升。MSM人群最近6个月肛交时每次使用安全套的行为与是否做过HIV咨询检测（χ2=22.68,P〈0.01）和接受过安全套宣传/发放（χ2=7.441,P=0.006）相关。结论应将艾滋病防治知识健康教育与HIV咨询检测工作相结合,加大安全套宣传、发放工作力度。     

2009-2013年佛山市男男性行为者艾滋病哨点监测结果分析

目的分析佛山市男男性行为者(MSM)艾滋病知识、行为、HIV感染状况及接受艾滋病相关服务情况,为该市开展MSM人群艾滋病防治工作提供参考依据。方法收集2009—2013年佛山市MSM艾滋病哨点监测数据,采用描述性流行病学方法进行分析。结果 2009—2013年共监测MSM 1 522人,艾滋病知识总知晓率为85.1%(1 295/1 522)。最近6个月与同性发生过肛交性行为的比例为81.1%(1 235/1 522),每次都使用安全套的比例为45.0%(556/1 235);HIV抗体总阳性率为10.4%(159/1 522),HIV抗体阳性率呈上升趋势(P0.01),从2009年的2.9%上升到2013年的12.7%,上升了337.9%。单因素分析结果显示,HIV抗体阳性率与年龄、文化程度、安全套使用频率、吸毒史、性病史及是否接受过安全套宣传和发放/艾滋病咨询与检测服务有关(P0.05或P0.01)。结论佛山市MSM人群安全套使用率偏低,HIV抗体阳性呈上升趋势,今后应大力开展安全套推广使用促进工作,以降低该人群的HIV感染率。     

南平市MSM人群性行为特征及HIV感染状况

目的了解南平市男男性行为(MSM)人群HIV感染状况及危险因素,为制定干预措施提供依据。方法对南平市2013年MSM人群监测数据进行分析,包括问卷调查及HIV、梅毒、丙肝抗体血清学检测。结果共调查115人,平均年龄(30.6±9.1)岁,未婚占62.6%,本地居住超过2年者占73.9%,高中或中专以上学历占76.5%,本省户籍占95.7%;艾滋病防治知识知晓率89.6%,HIV检出率7.8%,梅毒19.1%。同性性行为时每次使用安全套的占53.9%,异性性行为时每次使用安全套占43.5%。感染梅毒、近1年未接受安全套宣传和发放/艾滋病咨询与检测、近1年未做过AIDS检测是HIV感染的危险因素。结论南平市MSM人群HIV、梅毒感染严重,应进一步扩大宣传、咨询和检测覆盖面,提高安全套使用率。     

绵阳市MSM人群艾滋病预防服务及规范性病诊疗促进效果

目的 探索针对男男性行为者(MSM)人群特征的有效艾滋病预防服务及规范性病诊疗促进方法.方法 建立疾病预防控制中心(CDC)主导与MSM志愿者骨干实施相结合的MSM人群艾滋病性病防治组织模式,以核心同伴宣传(POL)干预方法为主,结合网络宣传、外展服务等进行MSM人群艾滋病、性病预防性服务和规范性病诊疗活动.2006年12月、2007年7月、2008年1月分别采用应答者驱动招募法(RDS)对MSM人群进行基线、中期及期终评估招募调查,对调查结果进行比较分析.结果 基线调查201人,中期200人,期终203人.基线、中期、期终调查比较,过去6个月接受过安全套免费发放的分别为54.7%、69.5%、6 9.0%,接受艾滋病检测服务的为12.9%、36.0%、54.2%,艾滋病健康咨询服务为21.9%、38.0%、45.1%,接受过同性朋友预防艾滋病宣传的为28.9%、56.0%、45.3%,差异均有统计学意义,上升趋势显著(P＜0.05);患性病期间,发生性行为使用安全套的分别为58.6%、76.7%、79.6%,差异有统计学意义(χ2=7.041,P=0.030),变化趋势显著(χ2=5.935,P=0.015);性伴通知、就诊方式差异无统计学意义.结论 CDC主导与MSM志愿者骨干实施相结合的以POL干预为主,结合外展、网络宣传等,有效提高了MSM人群艾滋病预防性服务覆盖面和性病期间安全套使用率,是适合MSM人群特点的一种有效预防服务和行为干预手段,但在如何针对MSM人群特点,更有效地促进性伴通知、检查治疗,提高规范就医比例上应继续进行探索.     

贵港市大龄女性性工作者梅毒感染情况及其影响因素

目的 探索贵港市大龄女性性工作者（OFSWs）梅毒感染情况及其影响因素,为该人群梅毒防控制定切实有效的措施和策略提供科学的理论依据。方法 2010-2016年按照《全国艾滋病哨点监测实施方案》的要求,在贵港市各女性性工作者（FSWs）哨点抽取调查对象,经过培训的调查人员使用《国家艾滋病哨点监测FSW调查问卷》对调查对象进行面对面匿名咨询调查,同时采血检测其梅毒等感染情况。结果 共调查贵港市2 851名OFSWs,以在婚/同居、外省户籍、汉族、小学文化程度以及低档场所来源为主,中位年龄41（四分位间距：38~45）岁。2 851名OFSWs中,梅毒、HIV和HCV抗体阳性率分别为17.33%、2.84%和1.89%;有5.02%在最近一年诊断过性病,88.46%在最近一次商业性性行为时使用了安全套,57.42%在最近一个月的商业性性行为中每次都使用安全套。接受过安全套宣传和发放/艾滋病咨询与检测和同伴教育干预服务的OFSWs分别为87.93%和34.86%。多因素分析发现,低档场所、壮族、文盲、年龄≥ 35岁、未接受过安全套宣传和发放/艾滋病咨询与检测干预服务、HIV和HCV抗体检测阳性为OFSWs感染梅毒的独立危险因素。结论 贵港市OFSWs梅毒感染情况严峻,低档场所、壮族、文盲、年龄≥ 35岁、未接受过安全套宣传和发放/艾滋病咨询与检测干预服务、HIV和HCV抗体检测阳性的OFSWs感染梅毒的风险较高。应加强该人群安全套宣传和发放等干预服务,提高该人群安全套的使用率,对梅毒、HIV和HCV等性传播疾病采取综合防控措施。     

湖州市男男性行为人群艾滋病哨点监测结果分析

目的了解湖州市男男性行为(MSM)的艾滋病相关知识知晓程度及高危行为发生情况,为落实艾滋病防治措施提供依据。方法通过艾滋病自愿咨询检测或QQ群等招募最近12个月有同性性行为的15~65岁男性,调查艾滋病防治相关知信行水平并检测HIV、梅毒和丙肝(HCV)。结果共调查MSM 400人,艾滋病相关知识知晓率为73.50%。调查对象最近6个月与同性发生过肛交行为的占75.50%;坚持使用安全套的占40.40%;接受过HIV抗体检测并知晓检测结果的占52.75%。调查对象HIV抗体阳性率为2.50%(95%CI:0.96%~4.03%),梅毒阳性率为1.50%(95%CI:0.30%~2.69%),未检出HCV抗体阳性者。结论湖州市MSM人群存在明显的艾滋病防治知行分离现象,安全套使用率较低,感染艾滋病/性病的风险较高。     

绵阳市男男性行为者艾滋病预防服务覆盖及影响因素分析

目的了解男男性行为者(MSM)艾滋病预防服务覆盖现状及影响因素。方法 2013-04/10,以四川省绵阳市辖区所有9个县(市、区)MSM为对象,在固定场所经知情同意,应用滚雪球抽样法,进行调查对象招募和自填式匿名行为学调查及生物学检测。结果共调查861名,近1年接受过安全套宣传和发放/艾滋病咨询检测79.1%(681/861)、同伴教育70.7%(609/861)、做过艾滋病病毒(HIV)检测69.2%(596/861),预防服务覆盖率84.8%(727/861),不同地区差异有统计学意义(P均=0.000)。多因素分析结果,性取向同性恋、知晓艾滋病知识、酒吧/浴室/家庭型寻找性伴、认识当地MSM朋友数6人~、认识当地MSM朋友数10人、近1周肛交次数≥3、近6月肛交有保护性是MSM接受预防服务的促进因素(OR分别为2.558、10.526、4.177、2.701、5.067、4.399和2.217,P均0.05)。结论 MSM预防服务达较高水平,地区间不平衡,预防服务促进了艾滋病知识知晓和行为改变,应持续开展和加强。     

2010年山东省男男性行为者艾滋病知识知晓情况及其影响因素分析

[目的]了解山东省男男性行为者(MSM)人群艾滋病知识知晓情况,探讨其相关影响因素,并为针对MSM人群开展的艾滋病的防治、健康教育及行为干预提供依据。[方法]2010年4～7月,在山东省济南、青岛、淄博、烟台、济宁、聊城、滨州、菏泽8市,抽取半年内有过插入性口交或肛交同性性行为的3 086名MSM人群进行调查。[结果]调查3 086人,艾滋病知识总体知晓率为83.31%,其中8题基本知识均知晓的占45.79%,知道蚊虫叮咬不会传播艾滋病的占73.01%,知道与HIV感染者或艾滋病病人一起吃饭不会感染HIV的占80.88%,知道与HIV感染者共用注射器有可能得艾滋病的占91.22%,正确使用安全套可以减少艾滋病的传播的占90.99%。多因素非条件Logistic回归分析结果,MSM艾滋病知识总知晓率,与来自酒吧/歌舞厅/茶室/会所者相比,来自浴池/桑拿/足疗/按摩场所者较低,来自艾滋病自愿免费咨询检测者较高;与≤20岁者相比,21～29岁较高,≥40岁者较低;与初中及以下文化程度者相比,高中/中专文化者和大专及以上者较高;本省户籍、最近1年接受过同伴教育和最近1年做过HIV抗体检测者较高。[结论]山东省MSM人群艾滋病知识知晓率一般;文化程度高、最近1年做过HIV抗体检测者艾滋病知识知晓率较高。     

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.     

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.     

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.     

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.