公共场所喷泉水嗜肺军团菌污染贝叶斯网络预警模型研究

目的构建喷泉水嗜肺军团菌污染贝叶斯网络预警模型,为预防和控制喷泉水军团菌污染提供科学依据。方法选择2015年深圳市公共场所正运行的70座喷泉作为研究对象,采用问卷调查、现场监测及实验室检测等方法收集相关数据,构建贝叶斯网络预警模型。选择2016年深圳市公共场所正运行的30座喷泉作为研究对象,收集相关数据对模型预警结果进行验证。结果深圳市喷泉水嗜肺军团菌检出率为42.00%(42/100)。从构建的贝叶斯网络模型结构看,对喷泉水中嗜肺军团菌最具有影响的因素有定期清洗、浊度、游离性余氯和溶解性总固体。该模型ROC曲线最佳诊断临界点为0.475,利用该临界点进行嗜肺军团菌阳性诊断ROC曲线下面积为0.941(95%CI:0.893~0.998),诊断灵敏度为92.90%,特异度为90.90%,预测准确率为93.33%(28/30)。结论本研究构建的贝叶斯网络模型预测准确率较高,可以满足喷泉水嗜肺军团菌污染预警要求,对公共场所喷泉水嗜肺军团菌污染的判定具有一定的参考价值。     

公共场所集中空调冷却水嗜肺军团菌污染的环境影响因素研究

目的分析影响公共场所集中空调冷却水中嗜肺军团菌污染的环境因素,为预防和控制军团病提供科学依据。方法于2013年随机抽取深圳市南山区安装有集中空调的36家公共场所,检测其冷却塔周围环境相关指标、冷却水理化指标及冷却水嗜肺军团菌,运用logistic回归分析影响冷却水嗜肺军团菌污染的相关因素。结果共随机抽取了36家公共场所集中空调冷却塔冷却水,其冷却水嗜肺军团菌检出率为38.9%(14/36),经多因素logistic回归分析发现嗜肺军团菌污染与集中空调冷却水浊度(OR=1.268)和溶解性总固体(OR=1.104)有关。结论南山区公共场所冷却水军团菌污染较为严重,其主要影响因素为浊度和溶解性总固体。     

深圳市公共场所集中空调冷却塔水嗜肺军团菌污染预警模型研究

摘要:目的　构建深圳市公共场所集中空调冷却塔水嗜肺军团菌污染预警模型,为预防控制军团菌病提供科学依据。方法　于2013年随机选择深圳市50家安装有集中空调的公共场所进行冷却塔卫生学调查,并进行现场相关指标检测,同时采集50份冷却水水样进行微生物指标、理化指标和嗜肺军团菌检测。结合文献报道及专家咨询利用卫生学调查、现场检测和实验室检测结果构建贝叶斯网络预警模型。于2014年随机选择30家公共场所集中空调冷却塔,并收集相关数据,利用2014年收集数据对预警模型进行验证和评价。结果　本研究构建的贝叶斯网络预警模型显示,对嗜肺军团菌最具有影响的因素有浊度、溶解性总固体、日照强度和防腐剂投放。该模型ROC曲线诊断临界点为0.338,利用该临界点进行嗜肺军团菌阳性诊断的灵敏度为100.0%,特异度为72.7%。结论　本研究所得的贝叶斯预警模型预测的灵敏度和特异度符合风险预警的要求,可以快速判断出冷却水嗜肺军团菌污染情况。     

中山市公共场所集中空调系统冷却塔水嗜肺军团菌污染调查

目的对中山市公共场所集中空调系统冷却塔水嗜肺军团菌污染现状及冷却塔卫生状况开展调查,为有效控制军团菌污染提供依据。方法于2014年6—11月随机采集中山市43家公共场所集中空调系统冷却塔水82份,进行嗜肺军团菌检测,对冷却塔卫生状况进行问卷调查。结果 43家公共场所中有8家检出嗜肺军团菌,总检出率为18.6%。不同类型公共场所、集中空调系统使用年限、冷却塔清洗周期和冷却塔水是否消毒对嗜肺军团菌检出率影响均无统计学意义(P0.05);冷却塔水水质有定期检测的嗜肺军团菌检出率为10.0%,未定期检测的嗜肺军团菌检出率为41.7%,两者差异有统计学意义(P0.05)。结论中山市公共场所集中空调系统冷却塔水存在嗜肺军团菌污染,应加强冷却塔设计安装的监督力度,规范冷却塔及水质清洗消毒的方法和程序,采取综合措施降低嗜肺军团菌污染的危险。     

公共场所集中空调冷却水水质及其与嗜肺军团菌污染的关系

[目的]分析集中空调冷却水水质及其与嗜肺军团菌污染间的相关性,为预防和控制军团菌病提供科学依据。[方法]对深圳市南山区安装有集中空调的36家公共场所冷却水进行检测,检测指标有冷却水嗜肺军团菌微生物指标和水质理化指标。[结果]集中空调冷却水水温较一般自来水高,中位数为30．0℃;细菌总数中位数为6．8CFU／mL,浊度中位数为3．5NTU,均超过生活饮用水卫生标准。多因素logistic回归分析显示,浊度、溶解性总固形物是冷却水嗜肺军团菌阳性率的影响因素,其比值比（OR及95％CI）分别为1．300（1．011—1．672）和1．102（1．016～1．196）。[结论]冷却水浊度和溶解性总固形物可能是影响嗜肺军团菌生长繁殖的重要因素,加强冷却水水质管理对预防军团菌病有重要公共卫生学意义。     

福建省公共场所中央空调冷却塔水嗜肺军团菌污染影响因素分析

目的对福建省2008年公共场所中央空调冷却塔水嗜肺军团菌污染影响因素进行调查,为防控提供依据。方法采集5个设区市114家场所116份空调冷却塔水进行嗜肺军团菌的培养和鉴定,并用PCR检测KatB基因,对影响因素进行分析。结果嗜肺军团菌污染率为40.4%（46/114）,冷却塔水检出率40.5%（47/116）;KatB基因的检出率为33.3%（5/15）;冷却塔水水质处理频率以每月3～4次的检出率最低（16.0%）。结论福建省公共场所嗜肺军团菌污染较严重,冷却塔水水质处理频率和此菌的污染存在关联性,应采取综合措施,降低嗜肺军团菌污染的潜在危险性。     

基于贝叶斯网络的集中空调系统冷却水中嗜肺军团菌生长繁殖风险预警模型研究

目的建立冷却水中嗜肺军团菌生长繁殖风险预警模型,实现对军团菌病预防控制的快速响应并为制定集中空调系统卫生管理政策提供科学依据。方法该研究主要包括现场监测及模型模拟两部分内容。在上海市选取使用集中空调的公共场所100家,在江苏省南京、苏州、常州三城市选取使用集中空调的公共场所148家,筛选冷却水及相关环境指标进行现场监测。通过上海市现场所测各指标数值辅以文献报道先验知识及专家经验建立贝叶斯网络模型,以江苏省3座城市的监测数据对模型预警结果进行验证。结果上海市冷却水嗜肺军团菌阳性率达到了79%,江苏省三城市阳性率达到了75%,基于贝叶斯网络的预警模型显示,从定性关系上看,对嗜肺军团菌最具影响的因素是日照强度及浊度,其中浊度又分别与余氯、溶解性总固体、菌落总数、电导率、水温等因素存在着联系。在定量层面上,可预测出嗜肺军团菌阳性或阴性概率水平,按照预测阳性概率0.8,0.5～0.8,0.5分为高、中、低3个预警等级。模型评价结果显示,该模型对冷却水中嗜肺军团菌的预测敏感性水平达到85.2%(52/61),特异性水平为8.3%(1/12)。结论本模型可以满足目前嗜肺军团菌预警的要求,阴性结果预测准确度有待提高,可通过加大监测样本量,特别是阴性结果样本量予以改进。     

福建省公共场所集中空调冷却塔水及冷凝水军团菌污染调查

目的 调查福建省公共场所集中空调冷却塔水及冷凝水嗜肺军团菌的污染状况及主要血清型.方法 2009年采集全省106家集中空调冷却塔水113份及52家冷凝水79份,进行嗜肺军团菌分离鉴定及血清分型,用PCR验证.结果 106家公共场所污染率27.4％(29/106);冷却塔水嗜肺军团菌检出率25.7％(29/113),以血清1型为优势(62.1％).52家冷凝水污染率为19.2％(10/52);冷凝水嗜肺军团菌检出率13.9％(11/79).受污染的7个设区市的冷却塔水检出率有差异;受污染的4个设区市的冷凝水检出率类似.结论 福建省公共场所集中空调冷却塔水及冷凝水受到嗜肺军团菌不同程度污染,冷却塔水检出率高于冷凝水;应加强集中空调系统监测,预防军团菌病的发生.     

泉州市2012—2013年公共场所集中空调军团菌污染调查

目的分析泉州市公共场所集中空调通风系统嗜肺军团菌污染情况,调查影0响因素,为预防控制军团病提供依据。方法采集2012—2013年泉州市有集中空调通风系统的公共场所57家共计93份水样进行嗜肺军团菌检测,同时按《外环境水样采集及中央空调调查表》进行问卷调查。结果 2012年嗜肺军团菌检出率为23.4%,2013年检出率为10.3%。抽检的各县(市、区,)除南安市、泉港区、经济技术开发区除外,各类场所均有嗜肺军团菌检出。结论泉州市公共场所嗜肺军团菌污染仍然存在,应采取综合措施,降低嗜肺军团菌污染的潜在危险。     

2012年漳州市部分公共场所中央空调冷却水军团菌污染情况调查

目的了解漳州市公共场所中央空调冷却水军团菌污染情况,为防制提供依据。方法于2012年对漳州市12家公共场所中央空调系统冷却塔水48份样品进行军团菌培养及鉴定。结果采集12家空调冷却塔水48份标本中,检出军团菌5株,阳性率占10.42%。其中,嗜肺军团菌1株,阳性率占2.08%;非嗜肺军团菌4株,阳性率占8.33%。结论漳州市公共场所中央空调系统军团菌污染情况值得关注,需加强监测,督促定期消毒和清洗,以预防军团菌病发生。     

Trends in meningococcal disease in Italy in 1988

Meningococcal disease in Italy decreased 15% in 1988 from the previous year (290 vs. 342 cases). The decline was particularly evident in military cases (1.7/100,000 in 1988 vs. 5/100,000 in 1987) reflecting the full coverage of bivalent serogroup (A + C) meningococcal polysaccaride vaccine in army recruits, achieved since January 1988. The highest proportion of cases was seen in people older than 25 years of age (25%). Serogroup C constituted 60% of the isolates, while 19% belonged to serogroup B. The proportion of strains resistant to sulphonamides was 45%, while 15% were resistant to Minocycline and none to Rifampin. Out of the five military cases, only one (due to serogroup C) was attributable to the vaccine failure. A single coprimary case, but no secondary cases occurred among civilians. These findings are consistent with the trends reported in Italy in the previous years.     

Benzene in blood and phenol in urine in monitoring benzene exposure in industry

Determinations of benzene concentration in blood and of phenol in urine were made by head-space gas chromatography techniques on samples taken near the end of the work day from two groups of workers potentially exposed to low levels of benzene in the work-place atmosphere. Preliminary results suggest that benzene in blood is more reliable than phenol tests for assessing both exposure and uptake of benzene. Normal values of phenol in urine (10 mg/liter or less) were found in nearly all those cases in which benzene was detected in the blood.     

2015年郑州市饮用水放射性水平状况调查

目的了解郑州市不同地区、不同季节、不同水源类型的放射性水平。方法分别于丰水期和枯水期采集郑州市区黄河水源水、井水源水、丹江口水源水、出厂水和末梢水各一份;以县为单位,每单位采集出厂水、末梢水、水库水、河水、井水各1份,按《生活饮用水生活标准检验方法》(GB/T 5750.13-2006)检测饮用水中总α和总β放射性水平,依据《生活饮用水卫生标准》(GB 5749-2006)进行判定。结果丰水期、枯水期水体总α、总β放射性水平均低于国家标准限值。结论郑州市不同水源类型均处于正常的天然放射性本底水平。     

Occupational stress in nurses in psychiatric institutions in Taiwan

Nurses are known to be exposed to occupational stress. However, occupational stress is not well documented for nurses in psychiatric institutions in Taiwan. A cross-sectional study was conducted to explore the work-related stress and risk factors of nurses in psychiatric institutions in Taiwan. A structured questionnaire was distributed to nurses at five state-owned psychiatric hospitals in Taiwan in 2001. Demographic information, working environment, and personal health status were inquired. Occupational stress was assessed based on the Chinese version of Job Content Questionnaire (JCQ). General health status and mental health were evaluated by the International Quality of Life Assessment Short Form-36 (IQOLA SF-36). A total of 573 questionnaires were disseminated to nurses and 518 (90.4%) were satisfactorily completed by nurses, including 408 female full-time nurses who had been in their current work for more than 6 months. In the past one month, 17.2% of nurses reported being under significant stress often or always. Assault episodes were reported by 45.1% of nurses in the past 6 months. Among the nurses, 16.9%, 25.2%, 50.0%, and 7.8% belong to the "High strain", "Low strain", "Active", and "Passive" groups, respectively. Perceived occupational stress was associated with young age, widowed/divorced/separated marital status, high psychological demand, low workplace support, and threat of assault at work. Lower general health score was associated with low job control, high psychological demand, and perceived occupational stress. A lower mental health score was associated with low job control, high psychological demand, low workplace support, and perceived occupational stress. We concluded that nurses in psychiatric institutions are under significant stress related to work factors.     

Changes in nursing administration in supporting transplantation in Brazil

This historical and bibliographic study aimed to understand how Nursing was organized to support care in transplantation. The HISA, LILACS, BDENF, PERIENF and DEDALUS databases were consulted, and thirteen references were found, ten of which were scientific articles, two were master's dissertations and one was a doctoral thesis. The span of time chosen for study ranges from the date of the first kidney transplant in Brazil (1965), to the date of publication of the last scientific article found in the databases mentioned above (2003). After reading these articles, the ones that were similar in topic were grouped together, thus creating the thematic axis for the presentation of the results. The results showed that the Nursing profession has played an important and active role in transplants ever since the first procedure in 1965.     

2019年中国肿瘤流行病学研究进展

恶性肿瘤已成为中国居民的主要死因之一。近些年来,中国政府积极推进肿瘤预防和控制领域的研究工作,取得了很大的进步。本文简要汇总中国在肿瘤流行病学领域的研究进展,具体包括2019年的肿瘤负担、癌症危险因素及其干预、筛查和早期发现、癌症防治专项行动(2019-2022年)方案等方面,以期为我国肿瘤防治工作的有效开展提供技术支撑和理论依据。     

2012年绵阳市蔬菜中农药残留状况

目的 了解绵阳市2012年市售蔬菜中农药残留情况,为食用蔬菜监管提供依据.方法 全部样品均按照GB/T 5009-2003的方法进行农药的残留检测.依据GB 2763-2005《食品中农药最大残留限量》进行判定.结果 2012年共检测蔬菜165份,农药检出率和超标率分别为72.12％和23.64％.豆类、根茎类、叶菜类、瓜果菜类和食用菌类蔬菜检测农药残留超标率分别为8.00％、23.53％、36.00％、5.26％和27.03％,差异有统计学意义(x2=11.41,P＜0.01).不同种类农药超标率差异有统计学意义(x2 =62.42,P＜0.01).夏季和冬季蔬菜农药超标率差异无统计学意义(x2=3.44,P＞0.05).结论 绵阳市叶菜类蔬菜中农药残留情况较为严重,应采取有效措施,加强蔬菜的监督管理,从源头禁止高毒农药的使用,加大蔬菜种植、销售环节的监测,确保市民食用蔬菜的安全.