重庆市农村未婚年轻成人父母对给未婚青年提供生殖健康服务的态度调查

目的：通过向未婚年轻成人的父母了解未婚年轻成人未得到生殖健康需求服务的成因，以确定给未婚年轻成人提供生殖健康服务的最佳途径和可行方法。方法：采用小组访谈法，对重庆市农村地区18-24岁有婚前性行为年轻成人的父母分别访谈，讨论的内容包括父母对未婚年轻成人婚前性行为的态度，父母对婚前性行为和人工流产影响未婚年轻成人健康的认识，父母对给未婚年轻成人提供教育和服务的态度等。结果：农村父母也给子女提一些忠告，但对子女因婚前性行为导致未婚先孕，普遍采取事后补救等被动措施表现出极大忧虑。父母赞成向子女提供有针对性的相关教育和服务，希望政府和社会机构给予重视，结论：农村未婚年轻成人婚前性行为和人工流产的普遍，与其自身文化水平和科学知识不足，家庭观念落后，如父母，教师和社会相关人员生殖健康知识水平不高及社会未重视有关，建议成立青少年生殖健康促进中心，制订相应的媒体法规及将青少年生殖健康教育和生殖健康服务纳入计划生育服务范畴，将有利于保障青少年生殖健康的需求。     

残障青少年获取性教育与生殖健康服务的定性研究

了解学校老师对残障青少年获取性教育与生殖健康服务的态度、认识和建议以及学校开展残障青少年性教育面临的困难,为更好地满足残障青少年需求提供科学依据.方法 在上海、北京和陕西农村地区对视力、听力、肢体和智力障碍青少年的性教育相关老师、班主任/生活老师以及校医进行个别深入访谈,共完成个人深访29人.结果 多数受访老师认为有必要对残障青少年进行性教育,性教育相关老师对性教育内容的理解更全面.城市访谈涉及8所特殊学校,其性教育开展状况明显好于农村访谈涉及的4所普通学校和1所特殊学校,但缺乏统一的教学标准,内容也不全面.绝大多数受访老师认为残障青少年也需要生殖健康服务,但他们几乎都没听说过社会上有特别考虑残障青少年需求的生殖健康服务.结论 残障青少年获取性教育和生殖健康服务面临较多障碍.应提高相关政府部门及教育和服务机构对残障青少年性教育与生殖健康服务必要性和重要性的认识,推动学校性教育的开展,消除残障青少年获取生殖健康服务的障碍.     

家庭功能对在校医学生性行为的影响研究

当前,青少年性早熟及不良性行为问题日益突出,带来的生殖健康问题也广受关注[1-2].青少年行为问题与家庭环境关系密切,甚至会弱化同伴教育的效果[3].已有研究表明,家庭功能发挥越好,青少年的心理健康水平越高,问题行为越少[4].因此,对青少年进行家庭功能的调查,不仅可以了解家庭功能对青少年性行为的影响,帮助筛检健康教育的重点人群,还可为改善健康教育效果提供很好的信息.     

黔北农村留守儿童健康和抚育现状定性研究

目的 探究贵州北部农村留守儿童健康和抚育现状,为留守儿童教育和卫生保健工作的开展提供线索.方法 利用定性研究中的焦点团体访谈和个人深度访谈法,了解4个典型留守家庭中儿童生长发育、心理行为发育、常见疾病、发展期望等方面的现状.结果 留守儿童家庭经济状况较差；和非留守儿童相比,留守儿童在生长发育、心理行为发育方面无明显落后,常见疾病发病情况差异无统计学意义.但留守儿童表现出和父母之间依恋关系不强、言语交流差、学业成绩差等现象,其未来发展困难较大.结论 “留守”对儿童健康和抚育有一定不利影响.应充分利用儿童发展环境中的有利资源,促进留守儿童健康发展.     

重庆农村留守中学生生殖健康知识知晓现状

目的 了解重庆农村留守中学生生殖健康知识水平,为针对性地生殖健康干预提供依据.方法 随机抽取重庆农村地区4所农村中学,每个中学初一至高三各抽取2个班共2 089名中学生进行问卷调查.结果 985名留守中学生的生殖健康知识知晓率(23.5％)低于非留守中学生(29.1％) (x2=8.470,P=0.004);初中和高中留守中学生中女生知晓率(17.6％,34.4％)高于男生(9.4％,24.1％)(P值均＜0.05).多元Logistic回归分析显示,男生(OR =1.390)、低年级(OR=0.531)、父母离异或再婚(OR=0.668)、较少或未开展生殖健康教育(OR=0.693)均是留守中学生生殖健康知识低认知的危险因素.结论 重庆留守中学生生殖健康知识认知水平低于非留守中学生,女生生殖健康知识水平总体优于男生,知识结构存在性别差异,应加强对农村留守中学生的生殖健康教育,改善生殖健康状况.     

凤冈县青少年未婚先孕现象提前的状况分析

在生产力迅猛发展,中西方文化激烈碰撞和广泛交融的社会经济转型时期,青少年面临着较多的性与生殖健康问题,研究和开展适合青少年的性与生殖健康教育,帮助他们健康成长变得极为迫切和重要,家长是青少年社会化的第一课堂,与学校性教育相比,家庭教育更能提供个性化的指导。许多研究发现,父母与子女对性知识的沟通和交流,可以使父母及时了解子女的问题并传递正确的观念和态度,帮助子女提高预防性危险行为的能力,并推迟青少年首次性行为的年龄。     

上海市流动青少年生殖健康知信行及家庭支持状况调查

目的了解上海市流动青少年的性与生殖健康的知、信、行状况及其家庭支持状况,为制定流动青少年的性与生殖健康教育策略提供依据。方法采用问卷调查,对400名青少年及其父母进行知、信、行及家庭支持状况进行调查。其中,有效的青少年问卷396份,有效的家长问卷398份。同时进行10例个案访谈以了解深入情况。结果流动青少年对性与生殖健康知识的平均得分为57分,青少年父母的平均得分为70分,1/3的父母得分在60分以下,青少年和父母的知识题得分显著相关(r=0.472,P0.01)。近一半的青少年认为早恋行为"很正常"或"无所谓",46.5%的调查对象认为同龄人中"大多数"或"大约一半"有早恋行为。青少年的生殖健康知识来源选择最多的是学校老师,有62.37%。流动青少年家庭经济收入较低、家庭居住环境较差、居住地经常变化,父母对流动青少年的生殖健康教育重视与认识不够,环境支持力度不足。结论上海市流动青少年生殖健康的知识、态度和行为存在明显的弱质性。为满足流动青少年的生殖健康需要,学校和社会要帮助家庭促进他们的健康成长。     

广州市1292名青少年性态度分析

目的为了解广州市青少年对生殖健康知识以及对生殖健康服务的认知程度；积极配合教育部门开展青春期性教育，让青少年了解青春期的性发育和身体变化趋势，为他们今后一生的健康和幸福打下良好基础。方法本项目以社区为单位进行研究，年龄范围包括10～24岁的青少年共1292人开展问卷调查。结果年龄越大对性态度越开放，男性比女性的性态度相对开放，低年龄组有相当比例对手淫及婚前性行为不了解。结论需要及早开展青少年性与生殖健康教育，有效避免和遏制青少年婚前性行为的发生，促进青少年获得必要的权利和健康成长。     

未婚女性青少年生殖健康治疗服务需求的调查研究

目的:了解未婚女性青少年生殖健康治疗服务的需求现状,为改善健康服务提供科学依据。方法:利用北京大学人口研究所中国青少年生殖健康可及性政策发展研究项目"2009年中国青少年生殖健康全国抽样调查"数据,选取其中关于青少年生殖健康服务需求相关的数据进行卡方检验和logistic分析。结果:共回收未婚女性青少年有效问卷10970份;在最近12个月中,女性青少年的治疗需求率为35.5。回归分析显示,青少年年龄越大、个人可支配收入越高,其生殖健康服务的需求越高;有宗教信仰、初中及以下文化水平的青少年需求较高;农村地区青少年的需求高于城镇青少年;中部地区和西部地区需求高于东部地区。结论:未婚女性青少年的生殖健康服务需求率较高,不同特征者需求不同。应为青少年提供多层次多角度的生殖健康服务保障,重点关注低文化水平、农村和西部地区青少年的服务需求;引导高收入、有性行为的青少年降低高风险行为,促进其生殖健康。     

中西部农村青少年生殖健康观念和行为研究

目的 了解我国中西部农村地区青少年生殖健康相关观念和行为,为有针对性的进行生殖健康干预提供依据.方法 在山西、甘肃、青海和广西各选择1个县,每县选择2个乡的13～19岁在校生约200名,16～19岁校外青少年约100名,男、女各半,共1 230名接受自填式问卷调查.结果 中两部农村约半数青少年明确反对婚前性行为,表示同意的比例低于25%.女青少年在观念上对婚前性行为的开放程度低于男青少年,差异有统计学意义(P<0.05).中西部农村校内青少年"经常"有不利于自我保护行为的比例低于15%,校外青少年为0.7%～30.4%,男性高于女性,部分指标的差异有统计学意义(P值均<0.05).校外男青少年"经常"及"偶尔"去青少年保健门诊咨询的比例最高(31.4%),校内低年龄组女青少年最低(8.5%).结论 中西部农村青少年能认识到生殖健康问题的重要性.在进行生殖健康教育时,不仅要注重观念上的引导,还应针对不利的生殖健康行为给予指导.     

Investigation and Control of Anthrax Outbreak at the Human–Animal Interface,Bhutan, 2010

In 2010, we investigated anthrax outbreak in Bhutan. A total of 43 domestic animals died, and cutaneous anthrax developed in 9 persons, and 1 died. All affected persons had contact with the carcasses of infected animals. Comprehensive preparedness and response guidelines are needed to increase public awareness of anthrax in Bhutan.     

Risk for Travel-associated Legionnaires’ Disease,Europe, 2009

Legionnaires’ disease is underreported in Europe; notification rates differ substantially among countries. Approximately 20% of reported cases are travel-associated. To assess the risk for travel-associated Legionnaires’ disease (TALD) associated with travel patterns in European countries, we retrieved TALD surveillance data for 2009 from the European Surveillance System, and tourism denominator data from the Statistical Office of the European Union. Risk (number cases reported/number nights spent) was calculated by travel country. In 2009, the network reported 607 cases among European travelers, possibly associated with 825 accommodation sites in European Union countries. The overall risk associated with travel abroad was 0.3 cases/million nights. We observed an increasing trend in risk from northwestern to southeastern Europe; Greece had the highest risk (1.7). Our findings underscore the need for countries with high TALD risks to improve prevention and control of legionellosis; and for countries with high TALD risks, but low notification rates of Legionnaires’ disease to improve diagnostics and reporting.     

Travel-associated Diseases,Indian Ocean Islands, 1997–2010

Data collected by the GeoSentinel Surveillance Network for 1,415 ill travelers returning from Indian Ocean islands during 1997–2010 were analyzed. Malaria (from Comoros and Madagascar), acute nonparasitic diarrhea, and parasitoses were the most frequently diagnosed infectious diseases. An increase in arboviral diseases reflected the 2005 outbreak of chikungunya fever.     

Haemophilus ducreyi Associated with Skin Ulcers among Children,Solomon Islands

During a survey of yaws prevalence in the Solomon Islands, we collected samples from skin ulcers of 41 children. Using PCR, we identified Haemophilus ducreyi infection in 13 (32%) children. PCR-positive and PCR-negative ulcers were phenotypically indistinguishable. Emergence of H. ducreyi as a cause of nongenital ulcers may affect the World Health Organization’s yaws eradication program.     

Long-Term Survival Among Histological Subtypes in Advanced Epithelial Ovarian Cancer: Population-Based Study Using the Surveillance,Epidemiology, and End Results Database

BackgroundActual long-term survival rates for advanced epithelial ovarian cancer (EOC) are rarely reported.ObjectiveThis study aimed to assess the role of histological subtypes in predicting the prognosis among long-term survivors (≥5 years) of advanced EOC.MethodsWe performed a retrospective analysis of data among patients with stage III-IV EOC diagnosed from 2000 to 2014 using the Surveillance, Epidemiology, and End Results cancer data of the United States. We used the chi-square test, Kaplan–Meier analysis, and multivariate Cox proportional hazards model for the analyses.ResultsWe included 8050 patients in this study, including 6929 (86.1%), 743 (9.2%), 237 (2.9%), and 141 (1.8%) patients with serous, endometrioid, clear cell, and mucinous tumors, respectively. With a median follow-up of 91 months, the most common cause of death was primary ovarian cancer (80.3%), followed by other cancers (8.1%), other causes of death (7.3%), cardiac-related death (3.2%), and nonmalignant pulmonary disease (3.2%). Patients with the serous subtype were more likely to die from primary ovarian cancer, and patients with the mucinous subtype were more likely to die from other cancers and cardiac-related disease. Multivariate Cox analysis showed that patients with endometrioid (hazard ratio [HR] 0.534, P<.001), mucinous (HR 0.454, P<.001), and clear cell (HR 0.563, P<.001) subtypes showed better ovarian cancer-specific survival than those with the serous subtype. Similar results were found regarding overall survival. However, ovarian cancer–specific survival and overall survival were comparable among those with endometrioid, clear cell, and mucinous tumors.ConclusionsOvarian cancer remains the primary cause of death in long-term ovarian cancer survivors. Moreover, the probability of death was significantly different among those with different histological subtypes. It is important for clinicians to individualize the surveillance program for long-term ovarian cancer survivors.     

Dengue Virus Transmission by Blood Stem Cell Donor after Travel to Sri Lanka; Germany, 2013

Three days after donation of peripheral blood stem cells to a recipient with acute myeloblastic leukemia, dengue virus was detected in the donor, who had recently traveled to Sri Lanka. Transmission to the recipient, who died 9 days after transplant, was confirmed.     

Outbreak of Panton-Valentine Leukocidin–Associated Methicillin-Susceptible Staphylococcus aureus Infection in a Rugby Team,France, 2010–2011

Staphylococcus aureus strains that produce Panton-Valentine leukocidin are known to cause community infections. We describe an outbreak of skin abscesses caused by Panton-Valentine leukocidin–producing methicillin-susceptible S. aureus (clonal complex 121) in a professional rugby team in France during July 2010–February 2011. Eight team members were carriers; 7 had skin abscesses.     

大龄单身女性寻求生育力保存的伦理问题探析

近年来,在肿瘤和卵巢相关疾病发生率逐年增加、不少大龄单身女性渴望为自己购买一份“生殖保险”等社会及个人因素催化下,人类对于生育力保存的需求急剧增加,满足这一需求正在或将成为重大挑战。对于寻求进行生育力保存的大龄单身女性来说,在合适的年龄应用玻璃化冷冻技术将其卵母细胞冻存是目前可采用的最佳生育力保存手段。而单身女性卵子冷冻将面临来自伦理道德、社会乃至法律的巨大挑战。本文概述国内外大龄单身女性卵子冷冻的现状,并对其可能涉及的相关伦理问题及解决途径进行综述,以促进理性正视单身女性卵子冷冻问题。     

Dihydropteroate synthase gene mutations in Pneumocystis and sulfa resistance

Pneumocystis pneumonia (PCP) remains a major cause of illness and death in HIV-infected persons. Sulfa drugs, trimethoprim-sulfamethoxazole (TMP-SMX) and dapsone are mainstays of PCP treatment and prophylaxis. While prophylaxis has reduced the incidence of PCP, its use has raised concerns about development of resistant organisms. The inability to culture human Pneumocystis, Pneumocystis jirovecii, in a standardized culture system prevents routine susceptibility testing and detection of drug resistance. In other microorganisms, sulfa drug resistance has resulted from specific point mutations in the dihydropteroate synthase (DHPS) gene. Similar mutations have been observed in P. jirovecii. Studies have consistently demonstrated a significant association between the use of sulfa drugs for PCP prophylaxis and DHPS gene mutations. Whether these mutations confer resistance to TMP-SMX or dapsone plus trimethoprim for PCP treatment remains unclear. We review studies of DHPS mutations in P. jirovecii and summarize the evidence for resistance to sulfamethoxazole and dapsone.