社区早孕妇女预防出生缺陷相关知识调查与对策

目的了解社区早孕妇女预防出生缺陷相关知识知晓情况，以更好地做好社区出生缺陷的一级预防工作。方法对早孕门诊中234名早孕妇女进行预防出生缺陷相关知识的问卷调查。结果本组调查对象中，28．2％（66／234）的早孕妇女知晓出生缺陷相关知识。其中，本市户籍知晓率为31．6％，显著高于非本市户籍的13．6％（P〈0．05）。大专及以上文化程度知晓率为38．2％，显著大于大专以下的9．8％（P〈0．01）。各年龄组间，出生缺陷知识知晓率的差异无统计学意义（P〉0．05）。所有孕妇对神经管畸形（NTDS）的预防知晓率最低，为53．0％。结论社区应宣传、普及孕前、孕期保健知识，做好出生缺陷的一级预防。     

城市化初期居民出生缺陷知识需求及宣传教育模式

目的探讨开展预防出生缺陷宣传教育的最佳有效方式。方法以深圳市龙岗区龙岗街道常住人口中的新婚及待孕夫妇为干预对象，采用集中教育方式，利用宣传展版、小册子、讲座和VCD等形式进行优生知识宣传教育，通过调查问卷对比教育前后干预对象对出生缺陷知识、态度变化以及参与优生筛查的行为改变，评估不同宣传教育效果。结果该人群文化层次以高中及以下者为主（83％）；受欢迎的宣传教育形式由高到低依次为VCD（86％）、宣传展版（79％）、讲座（57％）、宣传册（48％）；综合教育有效地提高了群众对出生缺陷干预工作的认识，对出生缺陷高危因素的认知显著提高（P〈0．001）；对优生知识学习的必要性认识由干预前的（12％）提高到（100％）；主动参加优生筛查率由干预前的14％提高到100％。结论针对城市化初期居民优生意识、生殖保健知识相对匮乏，保留有旧的传统婚育观和不良生活习性等特点，采用多元化的宣传教育模式，可有效提高科普宣传效果，强化群众对出生缺陷危害性的认识，积极主动参与出生缺陷干预活动。     

出生缺陷知识与文化和经济的关系

目的:了解孕妇对预防出生缺陷的知识、态度、行为情况,为进一步完善婚前保健、孕前保健及围产期保健服务提出合理化建议,提高出生人口素质。方法:采用分层抽样和随机抽样的方法,抽取深圳市龙岗区三个街道的90例孕期妇女作为调查对象,利用自行设计的调查表,进行面对面问卷调查,了解孕期妇女出生缺陷的知信行(KAP)情况。结果:文化层次高的孕妇,夫妇双方婚前医学检查率明显高于文化水平低者,差异有统计学意义(χ2=6.771 7,P<0.05);文化程度越高的孕妇对孕期保健、预防出生缺陷知识掌握得越多。对孕期"保持良好心情"的知晓率以月收入4 000～7 000元组最高(95.00%),月收入7 000元以上组的知晓率最低(61.54%);在孕期"注意少接触农药/油漆"及"注意少接触猫狗等"行为方面也有不同,家庭人均月收入越高的孕妇对上述行为的重视程度越高。结论:文化程度与家庭经济状况是孕期妇女掌握出生缺陷相关知识的影响因素。     

南京市社区预防出生缺陷健康教育的效果评价

目的 评价南京市鼓楼区预防出生缺陷健康教育的效果,为以社区为基础的出生缺陷一级预防提供科学依据.方法 选择2008年3月～2009年7月在南京市鼓楼区建围产期保健小卡的孕妇作为调查对象并进行出生缺陷相关知识宣传教育,采用问卷调查早孕人群干预前后出生缺陷知识、态度和行为的变化,分析其影响因素.结果 干预后早孕人群对预防出生缺陷相关知识的总得分(34.43±3.10)高于干预前(29.56±4.77) (t=58.50,P＜0.001).干预后21道题目回答正确率均高于干预前,其中仅1道题干预前后正确率的差异无统计学意义(P=0.458).年龄、文化程度、职业和家庭人均月收入对干预效果都有明显的影响(均有P＜0.05).年龄大者比年龄小者,本科及以上文化程度比初中及以下者,医护人员比工人,家庭人均月收入1 001 ～元、2 001～元、3 001～元、4 001～元、≥5 001元比≤1 000元者对知识的掌握明显增多.结论 利用健康教育的模式对早孕人群进行干预,能提高其预防出生缺陷的能力.应对文化程度偏低、家庭收入较少的育龄妇女进行预防出生缺陷知识的普及.     

贵州省农村育龄夫妇预防出生缺陷知识、态度、行为的现状及需求调查

目的:了解贵州省农村育龄夫妇预防出生缺陷知识、态度、行为的现状及需求,为建立出生缺陷干预模式提供依据。方法:采用多阶段随机与整群相结合抽样方法,抽取贵州省内8个县中2360个家庭为对象进行问卷调查,问卷分为妻子回答部分和丈夫回答部分。结果:收回有效问卷2318份,出生缺陷知识总分及格率仅为46.15%;70%以上的育龄妇女对预防出生缺陷持有积极态度;在预防出生缺陷行为调查项目中,仅有56.38%的妇女及66.65%的丈夫得分及格。结论:调查地区育龄妇女对出生缺陷知识的知晓率低,知识的匮乏直接影响到育龄夫妇对预防出生缺陷的态度,不能主动形成有益于预防出生缺陷的行为,提示农村地区预防出生缺陷知识普及宣传不到位,育龄人群预防出生缺陷的意识和行为亟待提高。     

山东省某医院职业中毒病人健康教育的效果分析

目的评价对职业中毒病人实施跟踪连续性健康教育效果,以探讨完善教育模式。方法对山东省泰安市中心医院分院106例职业中毒病人实施住院健康教育的基础上,出院后采用医院一社区联动教育模式进行跟踪连续干预,并在干预前后采用同一问卷进行测评,比较病人在教育前后健康知识、态度和行为得分变化。结果病人知识平均得分由干预前的65．82分上升到88．71分,态度平均得分由61．10分上升到81．97分,行为平均得分由59．55分提高到77．88分,干预前后得分差异均有统计学意义（P〈0．05）。女性的态度和行为干预效果好于男性（P〈0．05）;不同年龄和文化程度病人知识、态度和行为得分均显著高于教育前（P〈0．05）,且高年龄组干预后行为得分好于低年龄组（P〈0．05）。不同文化程度病人干预后得分差异无统计学意义（P〉0．05）。结论对职业中毒病人采用医院一社区联动模式实施跟踪连续性健康教育,能够有效提高职业中毒病人防治知识水平,显著改善病人对疾病防治的态度和行为,值得推广借鉴。     

汕头市金平区育龄妇女社区预防出生缺陷健康教育效果评估

目的了解金平区开展出生缺陷健康教育干预效果,探讨适合社区推广的综合干预方法。方法实施出生缺陷社区干预前、后,分别抽取300名育龄妇女,采用自行设计的问卷对其出生缺陷预防知识、态度、行为(KAP)进行调查。结果干预前、后,育龄妇女出生缺陷预防知识平均知晓率分别为60.8%、79.9%,有婚检意愿的占比分别为72.7%、85.7%,有产前筛查意愿的占比分别占75.0%、87.7%,进行婚检对象占比分别为63.0%、82.9%,进行产前筛查对象占比分别为67.0%、82.3%,差异均有统计学意义(P值均0.05)。获取预防出生缺陷相关知识的主要途径干预前、后分别为通过亲朋好友(37.3%)和阅读知识卡片等宣传材料(78.7%)。结论在联合计划生育三级服务网络基础上,开展全社区预防出生缺陷的健康教育和健康促进活动是一种可行、有效的社区干预模式。     

惠州市孕末期妇女营养知识态度行为的现况研究

目的了解惠州市孕末期妇女营养知识、态度及行为状况,分析影响孕期饮食行为的因素,促进优生优育政策的推广。方法随机抽取2007年6月-2008年6月在医院产科门诊接受围产期检查的1316名孕末期妇女,以面访形式进行问卷调查。结果孕妇营养知识得分（K分,x=70．68,S=21．32）和饮食行为得分（P分,x=81．15,S=14．81）相对较低,饮食态度较好（A分,x=118．40,S=14．66）;98．48％的孕妇愿意改变不良饮食习惯,51．30％有挑食习惯;孕妇的职业、文化程度、丈夫文化程度、家庭月收入与KAP得分均为正相关且有统计学意义（P〈0．05）;孕妇营养KAP3者均为正相关且有统计学意义（P〈0．05）。结论孕妇的饮食态度较好,但饮食行为仍不合理,建议加大孕期营养知识的宣传力度,使改善孕期营养的问题得到全社会的重视,通过指导孕妇合理饮食、均衡膳食,改变孕妇错误的饮食观念．以此促进优生优育政策的推广。     

孕妇艾滋病知识、态度、行为调查及干预研究

目的 评价健康教育对孕妇艾滋病知识、态度及行为的影响。方法 随机选择固定在产科门诊检查、年龄在18～40岁之间的孕妇1000例进行艾滋病知识、态度、行为问卷调查。结果 干预前，72．1％的人认为可以接种疫苗预防艾滋病，69．9％的人认为患性病易感染艾滋病，经过干预后，知晓率有所提高，有显著差异（P〈0．05）。而对输血、性接触、母婴传播知识的掌握，干预前后差异无显著意义（P〉0．05）。结论 在孕妇中应继续加大力度，广泛宣传当前我国艾滋病流行形势及严重危害，宣传预防艾滋病的基本知识，消除人们对艾滋病的恐惧心理。     

哈尔滨市社区居民应对气候变化知识、态度、行为干预效果分析

目的了解气候变化健康干预前后社区居民对热浪等气候变化的知识、态度、行为(KAP)变化情况,评估干预效果。方法采用多层次单纯随机抽样的方法,分别于气候变化健康干预工作前后,抽取600余名18岁及以上社区居民进行问卷调查,对比干预前后社区居民对热浪知识、态度、行为等改变。应用多元线性回归分析知识、态度、行为的影响因素。结果干预前、后在知识知晓率、态度转变率、行为形成率方面差异均有统计学意义(均P0.05);年龄、文化程度、锻炼、干预对知识、态度、行为的影响差异均有统计学意义(均P0.05)。结论年龄、文化程度、是否注重自身健康、干预是知识、态度、行为的影响因素,开展有针对性的气候变化健康干预工作可有效提升高居民对于热浪的正确认知、改善其态度和相关行为。     

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.     

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.