浙江省结核病不同干预措施的疾病经济负担评价

目的；研究结核病不同干预措施对结核病疾病经济负担的影响。方法：运用卫生经济学和失能调整生命年(DALY)方法计算疾病经济负担。结果：非项目地区结核病人的社会例均间接痰病经济负担初治1574．38元，复治5796.26元．比项目地区初治多846．92元，复浩多507．14元；倒均直接疾病经济负担初治7357．60元，复治19312.50元，比项目地区初治多5828．20元．复治多15888．30元；社会例均疾病经济负担12395．00元．比项目地区病人多9263．00元。结论：需加强非项目地区结核病人的管理，减轻病人社会的疾病经济负担。     

结核病控制项目对疾病负担影响研究

目的 研究结核病控制三类不同干预措施对结核病病人疾病负担的影响。方法 采用WHO推荐的失能调整寿命年（DALY）测算方法评价结核病病人的疾病负担。结果 例均初治TB病人,ITP地区为最轻,损失0.31个DALY;NTP地区居中,损失0.42个DALY;CTT地区为最重,损失0.61个DALY;例均复治TB病人,NTP为最轻,损失0.59个DALY;ITP居中,损失0.62个DALY;CTT为最重,损失0.91个DALY。从社会角度看,ITP地区每千人TB的DALY损失值年均为16.42,NTP年均DALY损失值是33.6,CTT年均DALY损失值是37.36,NTP是ITP地区的2.05倍,CTT是ITP的2.28倍。结论 ITP在降低TB病人的疾病负担方面远胜于NTP与CTT,不管从病人角度还是从社会角度 （社会发现率）,其效果均较好。     

耐药与敏感肺结核病人疾病经济负担对照研究

目的研究耐药与敏感肺结核病人的疾病经济负担.方法调查了15个"WHO结核病耐药监测"县(市)耐药与敏感病人207例,利用经济学评价方法,探讨其疾病经济负担.结果例均家庭疾病经济负担:初治耐药组为3061.5元、敏感组为2103.7元;复治耐药组为8414.0元、敏感组为6798.1元.例均社会疾病经济总负担,耐药患者为14655.30元,敏感患者为5740.68元.耐药是敏感的2.6倍.结论耐药肺结核病患者无论是家庭疾病经济负担,还是社会疾病经济负担都要比药物敏感肺结核患者要高.     

三门峡结核病疾病经济负担调查报告

目的研究三门峡市结核病人的疾病经济负担。方法调查三门峡市结防所2004年治管的结核病人112例,其中初治病人90例,复治病人22例,利用经济学评价方法,探讨其疾病经济负担。结果例均家庭疾病经济负担为2731元。例均结核病人社会疾病经济负担为3486元。结论复治结核病人的疾病经济负担高于初治结核病人。     

初复治肺结核病人家庭及社会疾病经济负担比较分析

目的：比较分析肺结核初复治病人的家庭及社会疾病经济负担.方法：采用失能调整上（DALY）方法计算疾病经济负担.结果：复治结核病人的家庭和社会的疾病经济负担明显高于初治病人.结论：急需减轻结核病人的疾病经济负担,尤其是复治病人的疾病经济负担,减少复治结核病例的发生.     

三门峡市结核病疾病经济负担调查

[目的]研究三门峡市结核病人的疾病经济负担。[方法]调查三门峡市结防所2004年治管的结核病人112例,其中初治病人90例,复治病人22例,利用经济学评价方法,探讨其疾病经济负担。[结果]例均家庭疾病经济负担为2 731元。例均结核病人社会疾病经济负担为3 486元。[结论]复治结核病人的疾病经济负担高于初治结核病人。     

结核病控制项目地区耐药结核病病人经济负担研究

目的:研究结核病(以下简称TB)控制项目地区耐药TB病人疾病经济负担。方法:运用卫生经济学调查方法和失能调整生命年(DALY)指标计算疾病经济负担。结果:耐药TB病人的例均间接疾病负担为8808.78元,比不耐药TB病人多5121.37元;例均直接疾病经济负担为6000.95元,比不耐药TB病人多1397.28元;社会例均疾病经济负担为14809.69元,比不耐药TB病人多6518.65元。结论:重视初治TB病人的管理,减少耐药TB病人的产生,减轻病人与社会的疾病经济负担。     

应用DALY结合人力资本法研究某三甲专科医院医院获得性重症肺炎的间接经济负担

目的应用伤残调整寿命年(DALY)结合人力资本法初步研究某三甲专科医院医院获得性重症肺炎(SHAP)患者的间接经济负担。方法按照全球疾病负担研究中计算DALY的方法,分别计算出某三甲医院2016年1月1日—2017年12月31日SHAP各年龄组患者DALY,再利用DALY与人力资本法结合估计SHAP患者的间接经济负担,并根据SHAP致病菌是否是多重耐药菌进行分组,比较两组患者间接经济负担。结果 71例SHAP患者,损失DALY 172. 35年,平均疾病负担为2. 43 DALY,平均间接经济负担51 428. 37元。SHAP患者多重耐药菌感染组(46例)、非多重耐药菌感染组(25例)平均疾病负担分别为3. 36、0. 71 DALY,平均间接经济负担分别为77 235.32、3 957. 18元;两组SHAP患者平均间接经济负担比较,差异有统计学意义(P 0. 05)。结论 SHAP患者平均疾病负担及间接经济负担均不低,其中SHAP患者多重耐药菌感染的间接经济负担高于非多重耐药菌感染。     

初治涂阳肺结核病人及其传染性所致疾病负担的评价方法研究

以失能调整寿命年 (DALY)为指标探讨初治的肺结核菌涂片阳性病人及其传染性所致疾病负担的评价方法。以北京市 1994年 794例初治涂阳肺结核病人的性别、年龄发病资料为基础 ,构成了 2 0 0 0人的研究队列。依据大量流行病学数据建立了在不干预 (自然史 )状况下以及在医生直接观察下对结核病短程督导化疗 (DOTS)干预的转归及传染模型。结果表明 ,若不考虑结核传染性所致的潜在疾病负担 ,将有 2 9 6%的DALY损失被忽略。DOTS可减少 92 9%的DALY损失 ,同时降低 99 9%由于传染所致的DALY损失     

浙江省结核病干预措施对家庭疾病经济负担的影响

结核病在我省仍是严重危害人民健康的传染病 ,它不仅影响患者及周围群众的身体健康 ,而且使家庭承受疾病的经济负担。为此 ,我们从卫生经济学的角度 ,分析不同的结核病干预措施 (项目县与非项目县 )对家庭疾病经济负担的影响 ,为制定结核病控制策略提供科学依据。材料与方法1　对象　随机抽取 8个项目县和 7个非项目县 2 0 0 0年结束疗程的新发肺结核病人 4 99例 ,其中初治 4 0 7例 ,复治 92例 (项目县的病人选例不属减免范围 )。2　内容　病人基本情况 ,结核病就诊治疗情况 ,家庭经济情况 ,疾病经济负担 (包括治疗费、就诊费、交通费、营养…     

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.