新洲区第四次结核病流行病学抽样调查结果与分析

目的调查新洲区结核病疫情，分析疫情变化及流行趋势，考核防治效果，为制定防治措施提供科学依据。方法采取随机整群分层抽样方法抽取3个调查点进行调查，通过结素试验、X线及痰结核菌检查发现肺结核病人。结果调查4408人，发现活动性肺结核31例，菌阳肺结核10例，活动性肺结核患病率为703．3／10万，涂阳患病率为181．5／10万，涂菌阳患病率为226．9／10万。结论新洲区结核病疫情较高，形势十分严峻，且有上升趋势，呈农村疫情明显高于集镇，贫困地区疫情明显高于富裕地区的特点。     

内蒙古锡林郭勒盟2004-2010年结核病管理状况分析

内蒙古锡林郭勒盟是结核病的高流行区，1990年全国第三次结核病流行病学调查，活动性肺结核患病率为741．20／10万，涂阳肺结核患病率为178／10万。特别是在农村、牧区，结核病疫情严重的影响着农牧民的正常生产、生活秩序，成为农牧民因病致贫、因病返贫的重要原因。自2004年以来，我盟加强了结核病控制工作，     

2003～2007年宁波市海曙区流动人口肺结核患病情况分析

目的掌握流动人口肺结核病患病情况，以制订流动人口相关预防控制措施。方法对宁波市海曙区登记的流动人口结核病年报表、登记本及治疗管理卡等资料进行统计分析。结果2003～2007年共发现流动人口肺结核病人187例，性别比例为2．34：1。发病年龄以15～44岁为主，职业以民工、农民和工人为主。流动人口结核病发病率逐年升高，由2003年的16．16／10万上升到2007年的36．78／10万，流动人口结核病发病数占全区结核病人的24．77％。结论流动人口结核病发病率高，有逐年上升的趋势，应加强健康教育力度，并将流动人口结核病纳入区域预防控制规划。     

青岛市黄岛区1995～2004年结核病发病情况分析

[目的]分析黄岛区1995-2004年肺结核发病情况。[方法]对1995～2004年黄岛区肺结核疫情数据采用描述流行病学方法进行分析。[结果]1995～2004年黄岛区流动人口活动性肺结核登记率由59．0／10万上升到70．1／10万，涂阳肺结核登记率由21．1／10万上升到38．4／10万，户籍人口活动性肺结核登记率由33．6／10万上升到37．81／10万，涂阳肺结核登记率由13．1／10万上升到13．6／10万。1995-2004年涂阳肺结核病人治愈率为98．4％。[结论]黄岛区的肺结核登记率呈上升趋势，流动人口肺结核登记率上升幅度对全区登记率有较大影响，结核病的控制效果显著。     

安徽省1993～2003年结核病控制现况分析

中国是全球22个结核病高负担国家之一，安徽省结核病疫情及流行在全国属于较严重的省份，2000年第四次全国结核病流行病学调查表明，活动性肺结核患病率为504／10万。为总结安徽省近11年结核病控制成效，分析目前现状及其对策，本文利用近11年结核病年报表进行综合分析如下。     

汕头市疾病监测点1990－2000年传染病发病趋势分析

目的：了解汕头市国家疾病监测点法定报告传染病1990－2000年的发病趋势,为传染病预防控制提供依据。方法：对该市疫病监测点11年的疫情进行动态分析。结果：1990－2000年汕头市法定报告传染病总年均发病率为480．05／十万,其中甲、乙类和丙类年均发病率分别为265＝74／十万和214．31／十万。1990－1995年（前期）与1996－2000年（后期）比较,总年均发病率由前期的517．42／十万降至后期442．64／十万;肠道传染病由149．98／十万下降至54．64／十万,其中后期的甲肝和痢疾发病率分别上升4．18、100．50倍;呼吸道传染病由13．71／十万上升至115．61／十万,肺结核上升15．57倍;前期共爆发7宗疫情,总发病例数183人。1996年后发生1宗疫情（1例病人）。结论：监测点肠道传染病和爆发疫情的控制措施取得成效,今后传染病防治重点是遏制血源和性传播传染病和肺结核的流行。     

祥云县结核病流行病学变化趋势分析

[目的]了解祥云县结核病的流行病学情况及近年来的变化趋势，为制定防治策略提供科学依据。[方法]对全国历次结核病流行病学调查样本县的抽样资料进行收集与整理，并做统计分析。[结果]祥云县是西部地区结核病高感染率、高发病率、高患病率的地区，传染性肺结核有下降趋势，活动性结核病患病人数随着年龄的增长而增加，男性患病数明显高于女性。[结论]祥云县结核病疫情自1979年以来，有缓良上升之势，现处于高发病的平台期，结核病控制工作正处于攻坚阶段。     

综合医院医护人员预防结核病的几个问题

在抗结核化疗时代以前,结核病曾经被认为是医护人员的一种职业危害,随着全球结核病疫情的下降,这一观点已发生改变。但是,近年来全球结核病流行趋势十分严峻,由于耐药菌株的产生与扩展,结核病与艾滋病的双重感染,导致全球结核病疫情明显上升,一些发达国的发病率也出现了回升。我国部分地区疫情居高不下,结核病仍是单一病菌引起死亡最多的传染病。因此,院内感染又引起了人们的关注。1 医护人员仍然是结核病的高危人群 据北京一家医院统计,1986～1991年全体职工发生活动性肺结核11例,平均新登记率3.2‰。据我院统计,1996～1998年医护人员中发生活动性肺结核6例,平均新登记率6.8‰。二者     

江苏省结核病流行病学调查报告

目的：了解江苏省结核病流行现状和趋势，为制定防治对策提供科学依据。方法：采用分层等比例整群随机抽样，对＜15岁儿童先进行结核 素试验，反应≥10mm的儿童以及≥15岁的成人进行胸透，对有异常阴影者拍片，同时进行抗酸杆菌镜检。结果：实验21474人，活动性肺结核患病率为391／10万，菌阳肺结核患病率为214／10万，涂阳肺结核患病率为168／10万，与1979年相比分别下降了56．12％，29．37％和38．01％，与1990年相比则分别上升了2．36％，20．22％和32．28％。结论：江苏省结核病流行依然十分严重，近10年来有上升趋势，故必须严格执行DOTS策略，加强对结核病的预防控制。     

2003年山东省肾综合征出血热资料分析

[目的]了解2003年山东省肾综合征出血热(HFRS)的流行规律，更好地制订防制措施。[方法]分析2003年山东省HFRS人间疫情和鼠间感染资料。[结果]2003年全省发病3603例，发病率为3．99／10万；死亡16例，病死率为0．44％；发病率居前6位的是日照、淄博、滨州、潍坊、临沂和莱芜市；15～55岁组发病与死亡人数分别占总数的85．48％和75．00％．农民发病数占79．13％；发病的季节分布不明显。宿主动物以褐家鼠为优势种，鼠平均带病毒率为5．11％。[结论]山东省2003年HFRS处于流行低潮期，流行的重点地区、重点人群与主要宿主动物没有改变。     

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.     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

Fatigue and health in a seafaring population

Background Occupational fatigue is relatively common withinthe general population and has been linked to reduced performance,injury and longer term ill-health. Despite growing acknowledgementof this problem in the maritime sector, little research hasbeen conducted into the risk factors, prevalence and consequencesof seafarers' fatigue. Aims To examine the prevalence of fatigue among seafarers, identifypotential risk factors and assess possible links with poor performanceand ill-health. Methods Cross-sectional questionnaire survey of seafarers workingin the offshore oil support, short-sea and deep-sea shippingindustries. A number of tools were used including the fatiguesubscale of the profile of fatigue-related symptoms, the CognitiveFailures Questionnaire, the General Health Questionnaire andthe SF36 General Health scale. Results In all, 1855 questionnaires were completed giving anoverall response rate of 20%. Fatigue symptoms were associatedwith a range of occupational and environmental factors, manyunique to seafaring. Reporting a greater number of risk factorswas associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35)for those with three or four risk factors and OR = 9.54 (6.95–13.09)for those with five or more risk factors]. There was also astrong link between fatigue and poorer cognitive and healthoutcomes, with fatigue the most important of a number of riskfactors, accounting for 10–14% of the variance. Conclusions Seafarers' fatigue could impact on safety withinthe industry and may be linked to longer term individual ill-health.It can only be addressed by considering how multiple factorscombine to contribute to fatigue.     

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.     

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.     

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.     

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.