在吸毒人群中开展针具交换服务点转介模式的探讨

目的探讨通过针具交换服务点对吸毒人群进行有效转介的可行性，建立一个以针具交换为中心，把吸毒人员转介到各服务平台，以达到最有效的降低危害模式。方法通过问卷调查及健康教育方式对吸毒人群进行评估。结果针具交换点的外展服务对象中仅有42．5％的吸毒者能完整说出艾滋病的3大传播途径；在戒毒机构中，70．8％的人听说过美沙酮维持治疗，听说过抗病毒治疗的仅9．2％，18．7％的吸毒者什么都未听说；在接受针具交换点服务的吸毒者中仅6．1％听说过妇女健康中心，听说过自愿咨询检测的仅35．0％，72．0％的人知道清洁针具交换服务，而未接受针具交换的吸毒者中没人知道妇女健康中心。结论在吸毒人群中，对艾滋病防控的5种干预平台知晓率不高，应加强吸毒人群艾滋病知识的宣传教育，因此，建立有效的转介服务显得十分必要和重要。     

洪江区吸毒人群清洁针具交换预防艾滋病的研究

目的了解洪江区吸毒人群分布状况,探索在吸毒人群中开展针具交换对预防艾滋病传播的可行性。方法采用艾滋病自愿咨询、公安机关配合登记询问、健康教育及关爱支持等措施,在社区和戒毒所内开展清洁针具销售和针具回收等干预措施,应用共用针具率、男性安全套使用率、艾滋病防治知识知晓率、针具交换覆盖率等指标评价干预效果。结果洪江区吸毒人群以城区人口、青壮年、低文化程度男性及未婚者为主,干预后吸毒人群的艾滋病传播危险性行为降低,针具销售大幅度上升,艾滋病防治知识知晓率有较大幅度上升。结论在吸毒人群中开展清洁针具交换有助于提高吸毒者预防艾滋病知识水平,改变HIV感染各种危险行为,控制艾滋病蔓延传播。     

洪江区吸毒人群清洁针具交换预防交滋病的研究

目的 了解洪江区吸毒人群分布状况，探索在吸毒人群中开展针具交换对预防艾滋病传播的可行性。方法 采用艾滋病自愿咨询、公安机关配合登记询问、健康教育及关爱支持等措施，在社区和戒毒所内开展清洁针具销售和针具回收等干预措施，应用共用针具率、男性安全套使用率、艾滋病防治知识知晓率、针具交换覆盖率等指标评价干预效果。结果 洪江区吸毒人群以城区人1：3、青壮年、低文化程度男性及未婚者为主，干预后吸毒人群的艾滋病传播危险性行为降低，针具销售大幅度上升，艾滋病防治知识知晓率有较大幅度上升。结论 在吸毒人群中开展清洁针具交换有助于提高吸毒者预防艾滋病知识水平，改变HIV感染各种危险行为，控制艾滋病蔓延传播。     

吸毒人群接受艾滋病预防干预服务现状分析

目的 了解不同场所的吸毒人群注射吸毒与共用针具情况,分析吸毒者接受的艾滋病预防干预服务,为在吸毒者中开展进一步的预防干预服务与资源分配提供依据.方法 采用分类滚雪球非概率抽样方法 ,从武汉市16家社区美沙酮药物维持治疗门诊选取新入组且符合筛选条件的吸毒者,由同伴招募社区和当地自愿戒毒所内的吸毒人群,进行问卷调查.结果 来自社区和美沙酮门诊的吸毒人群80%以上的人群曾注射过毒品.30～40岁之间的吸毒人群毒品注射率达83.33%,其针具共用率达21.85%.吸毒人群接受较多的预防干预服务是美沙酮,其次是艾滋病、性病宣传材料,最少的为针具交换或清洁针具发放.结论 吸毒人群中毒品注射率较高,接受到的针具交换或清洁针具发放较少.要结合吸毒人群的行为特点,开展切实有效的预防干预活动.     

对古城区吸毒人群进行艾滋病预防干预的效果评价

[目的]评价吸毒人群针具交换干预预防艾滋病传播的效果。[方法]对古城区社区内活动的静脉吸毒者和古城区戒毒所进行强制戒毒人员进行艾滋病健康教育活动;比较干预前后艾滋病知识知晓率、艾滋病传播危险行为学指标和HIV抗体阳性率,以评价干预效果。[结果]干预后吸毒人群的艾滋病知识知晓率由85.3%提高至97.9%;吸毒人群最近6个月注射吸毒共用针具的比例由40.8%下降到12.5%;HIV抗体阳性率由9%下降到3.7%。[结论]在吸毒人群中开展针具交换干预可有效控制艾滋病在吸毒人群中的传播。     

在吸毒人群中开展减低危害预防艾滋病效果分析

目的了解柳州市吸毒人群状况,探讨在吸毒人群中开展针具交换和美沙酮维持治疗对预防艾滋病传播的可行性。方法通过艾滋病自愿咨询检测、在社区内开展美沙酮维持治疗、清洁针具交换和针具回收及公安机关配合戒毒所开展健康教育关爱支持等措施。结果柳州市吸毒人群干预后艾滋病传播危险性降低,共用针具大幅度下降,艾滋病感染率从2000年的24.88%下降到2008年的13.10%。结论在吸毒人群中开展美沙酮维持治疗、清洁针具交换有利于提高吸毒者预防艾滋病的能力,改变HIV感染各种危险行为,控制艾滋病蔓延和传播。     

2010年遂宁市船山区静脉吸毒者性病艾滋病知识及行为调查

目的了解遂宁市船山区静脉吸毒者艾滋病防治现况,为对该人群实施干预提供依据。方法用全国统一的静脉吸毒者行为监测问卷,在社区以滚雪球方式抽取92名静脉吸毒者进行面对面问卷调查。调查问卷用Ep idata录入,SAS 9.1软件分析。结果静脉吸毒者对艾滋病知识知晓率为84.63%,对艾滋病预防措施知晓率为79.66%,静脉吸毒者获得艾滋病知识主要途径是电视和医务工作者,最近1次共用注射器率为1.09%;最近6个月共用注射器率为5.43%,最近1次与固定性伴发生性关系未使用安全套的为73.33%,最近与非固定性伴发生过性关系未使用安全套的为70%;最近1次与客人或暗娼发生性关系未使用安全套的为60%。做过艾滋病自愿咨询检测并知道结果的为51.09%,最近1年接受过针具交换服务的为30.43%,接受过性病艾滋病咨询服务的为48.91%,接受过美沙酮服务的为86.96%。结论有必要进一步对船山区静脉吸毒者采取健康教育、针具交换、自愿咨询检测、美沙酮替代治疗、安全套促进等综合干预措施,从而降低静脉吸毒者感染艾滋病的风险。     

在吸毒人群中开展减低危害预防艾滋病效果分析

目的了解柳州市吸毒人群状况,探讨在吸毒人群中开展针具交换和美沙酮维持治疗对预防艾滋病传播的可行性。方法通过艾滋病自愿咨询检测、在社区内开展美沙酮维持治疗、清洁针具交换和针具回收及公安机关配合戒毒所开展健康教育关爱支持等措施。结果柳州市吸毒人群干预后艾滋病传播危险性降低,共用针具大幅度下降,艾滋病感染率从2000年的24．88％下降到2008年的13．10％。结论在吸毒人群中开展美沙酮维持治疗、清洁针具交换有利于提高吸毒者预防艾滋病的能力,改变HIV感染各种危险行为,控制艾滋病蔓延和传播。     

广东省社区吸毒者针具交换项目试点效果评价

目的　探讨社区中开展针具交换预防艾滋病在吸毒人群中传播的可行性。方法　本研究为设立对照组的社区干预试验。干预区采用针具交换措施 (同伴教育员和医务人员在吸毒人群中宣传安全注射观念、提供免费针具、回收用过的注射器 ) ,对照区不采取任何干预措施 ,为期 10个月(2 0 0 2年 9月至 2 0 0 3年 6月 )。干预前后分别采用滚雪球的方式抽取注射吸毒者进行横断面调查以评估干预效果。结果　干预前后分别对干预区 (42 8名 )和对照社区 (42 9名 )静脉吸毒者进行调查。结果显示 ,干预区的艾滋病知识知晓率由 2 9 4 %上升到 5 8 7% ;多因素logistic分析结果表明 ,看过艾滋病宣传折页或宣传画者知晓率高 ;同基线调查相比 ,干预区中最近 30d内共用针具率由基线的4 8 9%下降到 2 0 4 % ,而在对照区中共用针具率同基线相比无明显改善 ;干预后干预区最近 30d共用针具的原因中“夜间买不到针、到朋友家打针人多针少、害怕被抓不敢买针和没钱买针”的现象相对基线情况有明显改善。结论　针具交换项目可以有效降低社区吸毒者共用针具现象。为控制艾滋病在吸毒人群中的传播 ,针具交换措施应尽快在全国范围内推广。     

建水县静脉吸毒者高危行为及艾滋病认知状况调查

[目的]了解建水县吸毒人群HIY相关危险行为状况及对艾滋病相关知识知晓情况,为进一步对吸毒人群行为干预提供依据.[方法]2007年9月在建水县社区、村委会、戒毒所内,采用全国统一的行为调查问卷对360名静脉吸毒者进行调查.[结果]360例静脉吸毒者中,吸毒年限>10年占61.4%,共用过针具占81.1%,固定性伴吸毒者占18.4%;最近一个月注射毒品时共用过针具占11.0%,最近一次性行为未使用安全套占76.4%;不同文化程度的静脉吸毒者对HIV经血液传播、母婴垂直传播及蚊虫叮咬是否传播的知晓率上存在着统计学差异(P<0.05).[结论]当地吸毒人群HIV相关危险行为发生率较高,应加强吸毒者安全行为的健康教育,扩大针对吸毒和高危性行为干预的覆盖面;针对不同文化程度的静咏吸毒者应开展与之相对应的宣传教育及干预措施.     

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.