综合医院门诊病人艾滋病知识调查分析

[目的]了解门诊病人艾滋病认知情况.[方法]用问卷法对山东省潍坊市1所三级综合医院的275名病人进行调查.[结果]艾滋病相关知识知晓率62.84%,认为多性伴、血液传播的正确率在80%以上,而对蚊虫叮咬、握手拥抱、共用办公用具、共用游泳池等不传播的正确率为30.35%～52.73%.对HIV感染者和艾滋病人存在明显的恐惧心理和歧视行为.[结论]医院就诊病人艾滋病知识缺乏,应加强培训教育,消除恐惧心理和歧视行为.     

2010年山东省男男性行为者艾滋病知识知晓情况及其影响因素分析

[目的]了解山东省男男性行为者(MSM)人群艾滋病知识知晓情况,探讨其相关影响因素,并为针对MSM人群开展的艾滋病的防治、健康教育及行为干预提供依据。[方法]2010年4～7月,在山东省济南、青岛、淄博、烟台、济宁、聊城、滨州、菏泽8市,抽取半年内有过插入性口交或肛交同性性行为的3 086名MSM人群进行调查。[结果]调查3 086人,艾滋病知识总体知晓率为83.31%,其中8题基本知识均知晓的占45.79%,知道蚊虫叮咬不会传播艾滋病的占73.01%,知道与HIV感染者或艾滋病病人一起吃饭不会感染HIV的占80.88%,知道与HIV感染者共用注射器有可能得艾滋病的占91.22%,正确使用安全套可以减少艾滋病的传播的占90.99%。多因素非条件Logistic回归分析结果,MSM艾滋病知识总知晓率,与来自酒吧/歌舞厅/茶室/会所者相比,来自浴池/桑拿/足疗/按摩场所者较低,来自艾滋病自愿免费咨询检测者较高;与≤20岁者相比,21～29岁较高,≥40岁者较低;与初中及以下文化程度者相比,高中/中专文化者和大专及以上者较高;本省户籍、最近1年接受过同伴教育和最近1年做过HIV抗体检测者较高。[结论]山东省MSM人群艾滋病知识知晓率一般;文化程度高、最近1年做过HIV抗体检测者艾滋病知识知晓率较高。     

菏泽市部分HIV/AIDS患者资料调查

[目的]了解HIV/AIDS患者的心理,分析减少歧视对预防和控制艾滋病的作用。[方法]对已确认的HIV/AIDS患者,在知情、保密的情况下进行个人访谈;选择存在HIV/AIDS患者的村庄或附近村庄的村民,调查这部分村民对HIV/AIDS患者存在的相关歧视及原因。[结果]124例HIV/AIDS患者中,108人（87.0%）为有偿献血者,46人（37.1%）有过报复社会的想法。48.4%的感染者表示生活中的主要压力为经济困难,43.8%的感染者感受到村民对他们的歧视,79.2%（305/385）的人认为可以通过宣传教育来降低歧视。[结论]应有计划、有步骤地扩大全民健康教育,宣传歧视和不尊重HIV/AIDS病人权利的危害性,从而通过减少歧视来预防和控制艾滋病。     

医疗领域内艾滋病病人被歧视现状的定性研究

[目的]了解艾滋病病人/感染者艾滋病相关知识掌握情况、在医疗领域内遭受歧视的态度,以发现歧视的产生原因及探索消除歧视的方法。[方法]利用个人访谈、角色扮演、现场观察等方法,对48名HIV感染者/AIDS患者进行调查。[结果]HIV感染者/AIDS患者存在自我歧视,医疗领域内普遍遭受歧视。[结论]应对艾滋病病人进行心理干预以减少歧视现象。     

MSM中HIV/AIDS患者心理抑郁焦虑状况调查分析

<正>自从1981年首次发现艾滋病以来,艾滋病的流行在全世界一直呈上升趋势。艾滋病病毒(human immunodeficiency virus,HIV)感染者和艾滋病(acquired immunodeficiency syndrome,AIDS)患者(简称HIV/AIDS)普遍存在较严重的心理压力以及抑郁、人际关系敏感等负面情绪[1];调查发现,300例艾滋病患者中有抑郁症者占41.3%、有焦虑症者占31.4%、有报复心理者占20.0%、有麻木者占8.3%[2]。男男性行为人群(men who have sex with men,MSM)的心理问题     

2011年商丘市48例农村艾滋病病毒感染者/艾滋病病人膳食调查

[目的]了解商丘市艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人的营养素摄入情况,为制定相关干预措施提供依据。[方法]2011年10月,选择柘城县3个艾滋病疫情高发村的48例HIV感染者/AIDS病人,采用3d24h膳食回顾法调查食物摄入情况。[结果]调查HIV感染者/AIDS病人48例,各种营养素平均摄入量除维生素E和铁外均存在不足,能量和蛋白质摄入量分别为1 666.70±20.00Kcal和49.70±5.11g,占推荐摄入量(RNI)的74.10%和71.00%;维生素中,维生素A、维生素C、硫胺素和核黄素的摄入量较低,占RNI的49.60%～86.50%;矿物质中,硒和锌的摄入量不足,分别为45.81±5.04μg和6.94±0.16mg,占RNI的91.67%和52.40%。[结论]HIV感染者/AIDS病人能量和营养素摄入低,应采取措施改善他们的食物摄入情况。     

准医护人员艾滋病职业暴露认知及羞辱与歧视

目的 了解准医护人员对艾滋病相关职业暴露的认知与恐惧心理以及羞辱和歧视现象,为进一步在准医护人员中开展艾滋病宣传教育提供科学依据.方法 采用自行设计调查问卷,随机抽取湖南省湘南学院343名准医护人员进行问卷调查.结果 343名准医护人员对艾滋病职业暴露相关知识的总知晓率为72.5%,其中男生为71.0%,女生为73.2%,不同性别知晓率差异无统计学意义(P>0.05);仅6.4%的准医护人员对与艾滋病感染者日常接触各项假设均不惧怕,女生恐惧心理高于男生(t=3.77,P<0.01);男女生对艾滋病感染者相关羞辱感差异无统计学意义(P>0.05);准医护人员中愿意为艾滋病感染者进行手外伤包扎者占35.6%,视情况而定者占60.3%,拒绝处理者占4.1%;认为艾滋病感染者或患者只能到传染病院就医者占83.4%,不愿意为HIV阳性患者做体格检查者占6.9%,会将患者感染HIV的情况告诉其他与治疗无关的同事者占22.2%,在接诊艾滋病感染者或患者时感到紧张与恐惧者占60.1%,认为不应向艾滋病感染者或患者提供就业机会者占23.6%.结论 准医护人员对日常接触艾滋病职业暴露相关知识知晓率不高,对艾滋病职业暴露存在恐惧心理,艾滋病相关羞辱感与歧视感较为严重.     

2010年广州市部分社区居民艾滋病歧视状况及影响因素分析

[目的]了解广州市社区居民艾滋病歧视状况及其影响因素,为消除对艾滋病的歧视提供科学依据。[方法]2010年9～12月,随机抽取广州市越秀区3个社区居民2 546人进行调查,并对性别、年龄、婚姻、文化程度以及艾滋病12个知识点的知晓情况与艾滋病相关歧视进行分析。[结果]调查2 463人,不愿意与HIV感染者/艾滋病病人交往的比例,婚姻状况、不同文化程度、不同年龄差异有统计学意义(P<0.01);共用坐厕、蚊虫叮咬、一起吃饭不会传染艾滋病,共用注射器吸毒会传染艾滋病知晓者与不知晓者对HIV感染者/艾滋病病人态度差异有统计学意义(P<0.01)。多因素Logistic回归方程分析结果,已婚(包括丧偶和离婚者)、共用坐厕、蚊虫叮咬不会传染HIV、一起吃饭和感染了艾滋病病毒的人不能从外表上看出来不知晓者更不愿意与HIV感染者/艾滋病病人交往。OR值分别为0.71、1.37、1.60、1.37、1.27。[结论]广州市社区艾滋病歧视普遍存在,特别是在已婚及丧偶和离婚居民中较严重,在艾滋病的反歧视宣传中应重点加强对非传播途径的宣传。     

娱乐场所女性服务人员艾滋歧视及其对艾滋病防治服务依从性的影响

[目的]了解娱乐场所女性服务人员对艾滋病感染者的歧视状况及其对艾滋病防治服务依从性的影响。[方法]随机抽取嘉定菊园新区126名娱乐场所女性服务人员为调查对象,采用项目统一设计的问卷进行社会人口学、行为学、艾滋病相关知识认知和艾滋歧视状况的调查,并采集静脉血、尿液进行艾滋病病毒（HIV）、单纯疱疹病毒Ⅱ型（HSV-2）、梅毒、淋球菌和沙眼衣原体检测。[结果]126名被调查者中,来自较大型歌厅（KTV）者占31.75%、小发廊者占62.70%、小足浴店者占2.38%、小浴室者占3.17%。未发现HIV抗体阳性者;性病感染率为22.22%。艾滋歧视平均得分（4.19±1.61）分,最低1分,最高7.5分。艾滋病知识知晓程度低,则艾滋歧视水平高（χ2=5.184,P=0.023）。曾经做过HIV抗体检测者仅占23.81%,由于不相信会感染或不知道去哪里检测是未检测的主要原因;在过去一个月中曾出现过性病相关症状者占61.90%,其中,去医院就诊者占70.51%;50.00%在过去一年中参加性病常规检查,平均（1.79±0.99）次;最后一次发生商业性行为时安全套使用率为96.83%,与固定性伴的安全套使用率为45.74%;曾经自然流产者占11.11%,曾经人工流产者占65.87%,其人工流产次数为1~7次（中位数为1.00次）;采取避孕措施者占97.62%,其中采用安全套避孕者占66.67%。艾滋歧视水平高,HIV抗体检测比例低（χ2=5.936,P=0.015）,性病感染率高（χ2=4.829,P=0.028）。[结论]娱乐场所女性服务人员艾滋歧视普遍存在,艾滋病防治服务依从性不容乐观,歧视对艾滋病防治服务依从性有一定影响。     

医学大专生艾滋病相关知识和态度现况调查

[目的]了解医学大专生艾滋病知识的现状、AIDS知识来源及其对AIDS/HIV感染者的态度,为有效开展艾滋病的健康教育提供科学依据。[方法]通过问卷调查方式对学生进行AIDS相关问题的现况调查,并运用Excel,SAS9.13软件进行统计分析。[结果]目前大学生艾滋病知识的来源主要是报刊杂志和电视广播等媒体,在学校中接受艾滋病知识的所占比例偏低。调查发现学生对艾滋病传播途径掌握较好,但相关知识了解不足;大学生虽然对通过吸毒及性行为感染HIV者普遍存在歧视态度,但赞成婚前性行为的大学生在50%以上。[结论]大专生对艾滋病知识的认知水平仍需提高,部分学生的态度有待改进,该校应加大力度对大专生进行预防艾滋病知识的健康教育。     

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.     

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.