艾滋病病毒感染者／艾滋病病人配偶／固定性伴HIV感染现状调查

[目的]了解艾滋病病毒(HIV)感染者和艾滋病(AIDS)病人配偶/固定性伴HIV感染现状,探索艾滋病病毒感染者及艾滋病病人(PLWHA)配偶/固定性伴降低胜接触传播的有效预防措施.[方法]对已确认的PLWHA的配偶/固定性伴采血进行HIV抗体检测.[结果]对全县可随访到的PLWHA的配偶/固定性伴73例进行了艾滋病毒抗体(抗-HIV)筛查,检出阳性23例,占31.51%.[结论]对PLWHA及其配偶/固定性伴进行健康教育、行为干预,是今后澄江县艾滋病控制工作的重点和难点.定期随访,指导PLWHA做到每次性交时正确使用安全套是减少配偶、性伴间传播HIV的有效方法.     

HIV检测阳性结果性伴告知意愿及影响因素调查

[目的]了解我国部分地区HIV检测阳性结果性伴告知意愿及影响因素,为探讨性伴告知策略提供参考依据。[方法]采用非概率抽样方法对大冶市和凉山州HIV感染者和艾滋病病人进行一对一匿名问卷病例调查。定量调查结果采用SAS软件进行统计分析。[结果]HIV感染者和艾滋病病人中,愿意将HIV检测阳性结果告知配偶占78.57%,不愿意告知占21.43%,愿意告知的主要原因为怕传染给配偶、希望得到配偶的关爱或安慰;不愿意告知的主要原因是担心配偶接受不了现实、担心受到歧视。多因素Logistic回归分析表明,不同地区(OR=59.99;P﹤0.01)、咨询检测中是否探讨性伴告知(OR=76.16;P﹤0.01)、客观社会支持程度不同(OR=59.29;P﹤0.01)的患者在性伴告知意愿上的差异有统计学意义。[结论]为有效实施性伴告知,应强化艾滋病知识宣传、提高VCT服务质量、提高社会支持程度和加强心理健康干预等。     

艾滋病病毒感染者和病人生存质量调查及相关因素分析

目的调查与评价艾滋病病毒感染者和病人的生存质量,分析影响其生存质量的因素。方法采用世界卫生组织生存质量简表（WHOQOL—BREF中文版）加上艾滋病相关条目。对300例艾滋病病毒感染者和病人与112例健康的配偶／固定性伴及吸毒同伴进行调查。结果艾滋病病毒感染者和病人各方面得分均显著低于健康的配偶／固定性伴及吸毒同伴（P〈0．01）,健康的配偶,固定性伴及吸毒同伴的生存质量的心理领域和社会关系领域显著得分低于全国其他城市常模人群（P〈0．01）。文化程度、CD4细胞计数及家庭年收入与艾滋病病毒感染者和病人生存质量呈正相关,吸毒及HIV检测前及与配偶,固定性伴发生性关系的频次与艾滋病病毒感染者和病人的生存质量呈负相关。结论艾滋病病毒感染者和病人总体生存质量较差,其性伴或吸毒同伴的生存质量的心理领域和社会关系领域得分也低于全国其他城市常模人群。     

结核病与HIV／AIDS

艾滋病（acquired immuno—deficiency syndrome，AIDS）是由人类免疫缺陷病毒（human immunodeficiency virus，HIV）感染引起的一种获得性免疫缺陷疾病。截至2007年底我国现存艾滋病病毒感染者和病人约70万，全人群感染率为0．05％，其中艾滋病病人8．5万人，2007年新发艾滋病病毒感染者5万，因艾滋病死亡2万人。     

新疆HIV阳性者性伴告知现况及影响因素分析

目的 为了解新疆HIV感染者及患者性伴告知情况及相关影响因素,为当地的性伴告知工作提供工作建议.方法 对新疆10个县市(区)内所有能够随访到的HIV感染者和病人3 071例进行问卷调查.结果 新疆HIV阳性者性伴告知率为81.5％ (2 010/2 467),其中男性为82.2％(1 229/1 495),女性为80.3％ (781/972);62.2％(1251/2 010)选择在1周内告知;52.1％(1 047/2 010)选择本人告知;59.3％(1 776/2 994)期望告知对象为配偶或性伴;多因素Logistic回归结果表明,性伴告知的影响因素为感染者家庭收入≤500元/月(OR=1.65,95％ CI=1.23 ～2.20)、感染者确认时限(OR=1.08,95％ CI=1.02～1.15)、感染者婚姻状况为已婚(OR =4.46,95％ CI =2.91～6.82)、感染者有子女(OR=1.50,95％ CI=1.12 ～2.00)及调查地区为新疆北部和南部地区(OR =4.10,95％ CI=2.72 ～6.19;OR =2.34,95％ CI=1.53 ～3.57).结论 新疆的HIV感染者和病人性伴告知率较高,影响因素包括当地持续深入的支持活动、感染者婚姻状况及子女状况等.     

云南、广西两省四县（区）人类免疫缺陷病毒感染者检测结果告知意愿及影响因素分析

目的了解云南、广西两省四县（区）人类免疫缺陷病毒（HIV）感染者检测结果的告知意愿及影响因素。方法采用方便抽样,对云南和广西两省四县（区）于2008年1～12月期间检出的HIV感染者采用自行编制的匿名问卷进行一对一调查,调查HIV阳性人群HIV检测阳性结果的告知对象、告知意愿及相关影响因素。结果361名调查对象中,愿意将HIV检测阳性结果告知固定性伴、非固定性伴、亲人和朋友的比例分别占72．6％,22．0％,63．2％和6．2％。单因素和多因素Logistic回归分析结果显示,年龄（OR=3．73,95％CI：1．22—11．38）,艾滋病知识知晓（OR=63．13,95％CI：20．76～191．97）与探讨性伴告知（OR=2．32,95％CI：1．01～5．79）在固定性伴告知意愿上的差别有统计学意义。结论部分HIV感染者不愿意将HIV阳性状态告知他人,应进一步开展艾滋病健康教育,不断提高HIV检测阳性结果的告知意愿,减少家庭或同伴感染概率,防止HIV二代传播。     

河北省4县（市）HIV／AIDS并发结核的调查分析

目的了解艾滋病病毒感染者和艾滋病病人中肺结核病的感染情况。方法随访已确诊的艾滋病病毒感染者和艾滋病病人，为HIV／AIDS者拍摄X线胸片和痰抗酸杆菌染色涂片检查。结果2007年1—10月，共筛查HIV／AIDS病例397例，确诊肺结核病人10例，TB／HIV双重感染检出率为2．5％。结论应建立结核病与艾滋病防治机构间的合作机制，在结核病人和HIV／AIDS中开展结核病与艾滋病双重感染双向监测，提高TB／HIV双重感染病人发现率，防止传播和蔓延。     

我国预防艾滋病高危人群行为干预的方法及现况

自1981年世界第1例艾滋病病毒感染者发现至今，短短20多年间，艾滋病已经在全球肆虐流行。而我国自1985年出现首例艾滋病患者以来，截至2007年10月31日，现存艾滋病病毒感染者和病人约70万（55～85万）人，全人群感染率为0．05％（0．04％～0．07％），其中艾滋病病人8．5万（8～9万）；2007年新发艾滋病病毒感染者5万（4～6万）人，因艾滋病死亡2万（1．5～2．5万）人。我国目前法定报告传染病中，虽然艾滋病的发病率和死亡率并不高，但其病死率紧随狂犬病而位列第二。     

遵义市50周岁及以上艾滋病病毒感染者/病人感染途径高危因素分析

目的 了解遵义市中老年艾滋病病毒感染者/病人(people living with HIV/AIDS,PLWHA)的流行病学特征,为下一步采取控制措施提供科学依据.方法 采取病例个案流行病学调查、随访记录和电话回访相结合的方式,对1995 - 2010年遵义市50周岁及以上PLWHA病例进行调查,回顾分析其最有可能的感染途径.结果 共调查PLWHA 55例,自我报告感染途径从高到低前3位是非婚异性性接触(50.91％)、其他(18.18％)、男男性行为(12.73％),经过溯源性调查和回顾分析,最有可能的感染途径前3位的是非婚异性性接触(61.82％)、男男性行为(14.55％),配偶/固定性伴传播(12.73％).结论 性接触是遵义市中老年艾滋病主要的感染途径,要积极开展中老年人的HIV监测检测,并采取针对性的干预措施.     

农村既往有偿献血社区居民艾滋病病毒检测意愿调查

目的 了解农村既往有偿献血社区居民艾滋病病毒(human immunodeficiency virus，HIV)检测意愿。方法 选择10个存在既往有偿献血事件的村庄，采用入户调查和村中拦截行人的方式对18～59a村民进行问卷调查。结果 调查有效问卷共477份，大部分人愿意接受艾滋病病毒检测，随机抽样、普查和只查献血员进行艾滋病病毒检测的接受率分别为85．95％、93．08％和60．17％，经统计学检验三者之间差异有显著性，人们进行艾滋病病毒检测的意愿与调查方式有关。不愿意接受检测的主要原因是认为自己没有感染的可能和担心别人怀疑自己感染了艾滋病；愿意将HIV阳性检测结果告知配偶、家庭其他成员和家庭以外的人的比例分别为86．37％、53．67％和21．59％。结论 在农村既往有偿献血社区，大部分人愿意接受艾滋病病毒检测，人们较易接受对全体村民进行HIV检测；其检测结果告知范围人们更倾向于局限在家庭范围内。     

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.