农村低档暗娼艾滋病性病感染及安全套使用影响因素分析

目的了解农村地区低档性服务场所的暗娼性行为特征,性病艾滋病感染情况,安全套使用情况及影响因素。方法采用横断面研究设计,整群抽样方法抽取南宁市某镇低档性服务场所的暗娼进行面对面问卷调查及血清学检测。结果 388名调查对象中,年龄大于30岁占56.45%,HIV、梅毒、丙肝感染率分别为3.09%,15.76%,4.38%,合并感染率3.36%。与客人性行为最近一个月安全套每次使用率为61.92%,其影响因素为年龄、艾滋病知识知晓、最近一次商业性行为安全套使用情况、最近一年接受同伴教育情况(P0.05)。结论南宁市农村地区低档暗娼呈大龄化,文化程度低,流动性大,艾滋病知识知晓率低,艾滋病性病感染率高,安全套使用率低特点,根据当地暗娼分布特征和高危行为影响因素因地制宜探索农村地区低档暗娼有效干预方法尤为必要。     

2005～2006年百色市暗娼艾滋病和梅毒相关危险行为调查

目的 了解百色市暗娼艾滋病和梅毒相关危险行为现状,评估暗娼感染艾滋病风险,为在暗娼中开展行为干预提供相关信息和依据.方法 采用随机抽样方法,对暗娼经营的不同档次场所的女性性服务工作者(FSW)进行而对面健康问卷及采血检测HIV、RPR c,结果 调查253名暗娼,血检HIV阳性2例,HIV阳性率为0.79%,均为低档场所,该场所的HIV阳性率为5.71%;RPR平均阳性率为4.35%,其中,高档场所0.96%,中档场所3.51%,低档场所17.14%;艾滋病防护知识平均知晓率61.26%,低档场所为34.29%;最近一次与客人发生性关系使用安全套比例为88.93%(225/253);最近一个月与客人发生性关系使用安全套比例56.52%(143/253),低档场所仅占28.57%;最近半年出现性病相关症状的比例47.83%.结论 百色市FSW中存在HIV感染者;艾滋病和梅毒相关危险行为在低档的暗娼场所中普遍存在.     

2008年柳州市不同层次场所暗娼艾滋病知识行为与感染状况调查

[目的]了解柳州市暗娼艾滋病知识、高危行为与艾滋病病毒（HIV）、梅毒感染状况,为在暗娼中开展进一步行为干预提供相关信息和依据。[方法]2008年47月,对柳州市城区及柳城县、柳江县部分场所的暗娼进行问卷调查和血清学检测。[结果]调查1 047名暗娼,艾滋病相关知识知晓率为89.77%（低档场所为82.41%）,最近1次与客人发生性关系时安全套使用率为80.32%,最近1个月每次性交易都使用安全套者占57.31%（低档场所为37.72%）;最近1年出现性病相关症状的占41.17%。抗-HIV阳性率为0.38%,梅毒感染率为2.67%（低档场所为9.58%）。[结论]柳州市暗娼艾滋病知识知晓率不高,安全套使用率较低,低档场所暗娼是行为干预的重点。     

彝汉两民族暗娼艾滋病相关知识行为及感染状况的监测

目的 了解凉山彝族自治州彝汉两民族暗娼社会人口学、艾滋病相关知识行为及HIV、梅毒和HCV感染状况.方法 按照国家级HIV哨点监测方案对凉山州的暗娼人群进行艾滋病行为学监测和血清学监测.结果 在调查的964名暗娼中,汉族和彝族分别占68.8％和31.2％.与汉族暗娼相比,彝族暗娼年龄偏小,文化程度较低,无固定性伴者较多,流动性大,主要分布在街头、路边小店等低档场所.暗娼艾滋病知识总体知晓率为90.9％,彝族(83.7％)低于汉族(94.1％),其影响因素有年龄、文化程度和干预服务.暗娼安全套坚持使用率为80.4％,彝族(68.2％)低于汉族(85.9％),其影响因素有年龄、民族、干预服务和HIV检测.HIV、梅毒、HCV的感染率分别为2.39％、3.42％和1.66％.结论 彝族暗娼感染HIV的风险远远超过汉族,应加强对该人群的综合干预工作.     

2011年合江县暗娼艾滋病知识及性病感染状况分析

目的 了解合江县暗娼人群的艾滋病、丙型肝炎、梅毒(HIV/HCV/TP)的感染情况,以及艾滋病相关知识知晓现状,为卫生行政部门制定艾滋病的防治策略和干预措施及效果评价提供依据.方法 于2011 - 04/06对全县范围内的暗娼场所和暗娼人群进行一对一问卷调查和采血.结果 共调查400人,采血400份.艾滋病相关知识知晓率为78％,其中高档场所为100％,中档场所为82.00％,低档场所为57.00％.最近1次商业性行为时安全套使用率为81.00％,高档场所为95.00％,中档场所为89.00％,低档场所为55.00％.HIV检出率为0.25％ (1/400),年龄为27岁,来自低档场所;HCV的检出率为0.75％(3/400),2人年龄在20～29岁,1人在40 ～49岁,均来自低档场所;TP的检出率为2.75％(11/400),年龄为20岁以下的3人,20 ～29岁8人,均来自低档场所.结论 合江县暗娼人群艾滋病知识知晓总体较高,性病感染率较高,存在商业行为中不使用安全套等高危行为.对暗娼持续开展艾滋病防治综合干预是一项长期工作,尤其是低年龄、低档场所的暗娼是监测和干预工作的重点人群.     

高中低档场所暗娼艾滋病知识行为与感染状况调查分析

目的了解柳州市不同层次场所暗娼艾滋病知识、高危行为与艾滋病病毒、梅毒感染状况,为开展进一步针对性行为干预提供依据。方法 2008年4～7月,对柳州市市区及柳城县、柳江县部分场所的暗娼进行问卷调查和血清学检测。结果共调查1 047名暗娼,艾滋病相关知识知晓率为89.8%,高中档场所暗娼知识知晓率均高于低档场所暗娼;中高档场所暗娼最近1次与客人发生性关系时安全套使用率、最近1个月每次性交易都使用安全套率、最近1次与配偶或同居男友发生性关系时安全套使用率均高于低档场所暗娼。结论柳州市暗娼艾滋病知识知晓率较低,安全套使用率也较低,不同层次场所暗娼应采用针对性的干预措施。     

2011年钟山县农村地区低档场所暗娼人群监测情况分析

目的了解钟山县农村地区低档场所暗娼人群中艾滋病、梅毒、丙肝感染状况和行为特征,为制定艾滋病、性病防治策略和干预措施提供参考依据。方法对钟山县农村地区低档场所进行摸底调查,选取每次性交易收费在50元以下的低档场所的暗娼进行问卷调查和HIV、丙肝、梅毒检测,分析其感染情况和行为特征。结果共调查55家低档场所的211名暗娼,其艾滋病知识知晓率(正确回答8道知识题的比例)为22.75%(48/211)。HIV抗体检测阳性率为3.79%(8/211),梅毒阳性率为26.07%(55/211),丙肝阳性率为1.42%(3/211)。最近1个月每次与客人发生性行为时都使用安全套的比例为42.18%(89/211)。结论钟山县农村地区低档场所暗娼人群艾滋病知识知晓率低,存在不安全性行为,今后应针对农村地区采取各种不同的方式开展防治艾滋病宣传教育和干预工作。     

广西钟山县不同档次场所暗娼人群HIV感染及高危行为调查

目的了解广西钟山县不同档次场所暗娼人群的行为特征及人类免疫缺陷病毒(HIV)与梅毒感染情况及其变化趋势,为分析艾滋病流行趋势及防治措施提供科学依据。方法按照《国家级HIV综合监测点监测方案》的要求,进行问卷调查并采血检测。全部结果录入国家哨点监测客户端软件后,采用Excel 2003和SAS 9.1软件进行资料分析。结果共监测1 337名暗娼,低档场所607人,占44.08%;中档场所770人,占55.92%。低中档场所暗娼在最近1次商业性行为时使用安全套比例、接受艾滋病干预服务及最近1 a内接受艾滋病检测比例均存在提高趋势(P0.05)。中档场所暗娼在艾滋病知识知晓率及最近1个月内商业性行为每次都使用安全套比例均存在提高趋势(P0.05),低档场所暗娼不存在提高趋势(P0.05)。HIV抗体阳性率为1.96%,8例为既往确认阳性,占29.63%;梅毒阳性率为15.03%。梅毒阳性率逐年升高,均存在升高趋势(P0.05)。结论钟山县低档暗娼对艾滋病知识的知晓率、坚持使用安全套比例低,HIV、梅毒感染率高,是干预的重点人群;HIV抗体阳性患者在该地继续从事性服务比例大,是艾滋病传播的重要桥梁人群,应进行有效管理;梅毒感染率居高不下,应引导并加强性病的规范化治疗。     

桂林低档暗娼艾滋病知识、安全套使用情况及危险因素分析

目的 分析桂林低档暗娼的艾滋病相关知识、安全套使用情况、高危行为及艾滋病、丙肝和梅毒感染情况.方法 选择路边店、洗头房、浴足屋等低档场所或街边,或者是她们每提供一次性服务(例如阴道交、肛交或口交)收取少于50元钱的861名低档暗娼进行问卷和血清学调查.结果 调查对象平均年龄为31.2岁,艾滋病相关知识知晓率为65.27％,最近1月发生性关系平均客人数为54.2人,最近1个月每次性行为均使用安全套的率为40.19％,存在吸毒现象,HIV阳性14人,丙肝阳性24人,梅毒阳性62人.结论 低档暗娼年龄偏大,自我保护意识差,客人数多,安全套的使用率低,是艾滋病感染和传播的高危人群,应深入开展宣传教育和干预工作,并同时开展嫖客干预.     

芜湖市镜湖区2011年暗娼人群艾滋病知识及相关行为调查报告

目的了解芜湖市镜湖区暗娼人群艾滋病相关知识的知晓情况、行为特征及其在商业性性行为中的安全套使用情况,为在公共娱乐场所性服务工作者中全面推广正确使用安全套、加强艾滋病的健康教育以及预防控制提供参考依据。方法采用暗娼人群哨点监测统一的调查问卷,对芜湖市镜湖区不同档次娱乐场所中暗娼人群进行行为学调查和血清学调查。结果共调查暗娼405人,HIV抗体检测均为阴性,梅毒感染率为9.63%,丙肝感染率为0.74%;中高档与低档暗娼艾滋病知晓率差异无统计学意义(P>0.05);中高档场所和低档场所暗娼最近一次安全套使用率和最近一个月安全套使用率差异有统计学意义(P<0.01);低档场所暗娼的梅毒感染率和中高档场暗娼梅毒感染率差异有统计学意义(P<0.01);多因素logisitic回归分析显示:娱乐场所的档次(P<0.01,OR=4.19)、文化程度(P<0.01,OR=1.82)、艾滋病知识知晓程度(P<0.01,OR=2.09)和接受同伴教育(P=0.01,OR=1.94)是安全套使用的影响因素。结论不同档次娱乐场所的暗娼艾滋病相关知识知晓率均较高,但每次性行为均使用安全套的比率仍然较低,低档场暗娼的安全套使用率更低,需要探索更有实效行为干预模式,提高安全套的全程正确使用率,以减少艾滋病经性行为传播。     

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.     

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.     

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.     

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.     

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.     

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.