2009—2011年烟台市男男性行为人群艾滋病高危行为变化及影响因素研究

目的探讨烟台市男男性行为人群（men who have sex with men,MSM）艾滋病传播相关的行为变化趋势及其影响因素。方法采用流行病学与血清学相结合的方法,于2009-2011年对该人群进行问卷调查,并采集血液进行HIV、梅毒抗体检测。使用Epi Data 3.0建立数据库,应用SPSS 13.0软件对数据进行统计分析。结果2009-2011年共调查1 169名MSM,艾滋病相关知识知晓率、最近6个月每次都能坚持使用安全套率有逐年增加趋势;多因素Logistic回归分析显示,促使MSM最近6个月坚持安全套使用的影响因素有：艾滋病知识得分（OR=0.60,95%CI：0.37～0.97）,最近1年曾被诊断为性病（OR=2.18,95%CI：1.51～3.16）,最近1年接受过干预服务（OR=0.47,95%CI：0.35～0.64）。结论烟台市MSM人群艾滋病防治知识及安全套使用率近3年呈升高趋势,但不安全性行为的普遍存在,不能100%坚持安全套的使用等行为还需引起高度重视。     

烟台市男男性行为者安全套使用现状及影响因素分析

目的 了解烟台市男男性行为者（men who have sex with men ,MSM）安全套使用现状及影响因素,为艾滋病防治提供理论依据。方法 采用方便抽样,样本来源于网络招募和现场招募的烟台市MSM。采用问卷调查,共调查113人。单因素分析采用检验,多因素分析采用二分类logistic回归分析。结果 共回收有效问卷110份,艾滋病知识平均得分（81.18±12.46）分,最近半年有过同性、商业同性和异性性行为者分别占100.00%、6.36%和16.36%,最近半年同性和异性性行为安全套坚持使用率分别为42.73%和44.44%。RUSH(rush poppers ,RUSH)使用率为36.36%。焦虑和抑郁检出率分别为47.27%和39.09%。多因素分析显示,同性性行为安全套坚持使用的促进因素为知识得分≥80分（OR = 0.323 ,95%CI:0.185～0.916）、知晓“感染其他性病会增加感染HIV的风险”（OR = 0.619,95%CI:0.467～0.820）和接受过同伴教育（OR = 0.425,95%CI:0.183～0.837）,危险因素为使用RUSH（OR = 2.891,95%CI:1.442～6.174）。结论 烟台市MSM安全套坚持使用率较低,应进一步加强艾滋病知识宣传、同伴教育和新型毒品危害性宣传,提高安全套使用率。     

柳州市男男性行为队列人群HIV感染影响因素分析

目的 利用队列人群数据探讨影响柳州市男男性行为人群（men who have sex with men,MSM）感染艾滋病的影响因素,为制定柳州市艾滋病预防控制策略和措施提供依据。方法 2014年6月在柳州市区采用雪球抽样方法招募MSM并建立队列,每半年随访一次,每次随访时进行问卷调查、采集静脉血进行艾滋病病毒（human immune deficiency virus,HIV）抗体检测。结果 基线和三次随访共招募MSM 1 369人次,成功完成一次、二次、三次随访的人数分别为158例、126例、74例。随着随访次数增加,MSM队列人群对艾滋病相关知识的知晓率升高（χ_趋势2=7.698,P=0.006）;最近一次肛交性行为（χ_趋势2=7.510,P=0.006）和商业同性肛交性行为（χ_趋势2=5.005,P=0.025）中安全套使用情况均有上升的趋势。多因素Cox回归分析显示:艾滋病相关知识得分较高（OR=0.119,95%CI:0.021~0.686,P=0.017）及最近6个月未使用过毒品（OR=0.036,95%CI:0.006~0.212,P<0.001）者,其感染艾滋病的风险低。结论 应进一步加强MSM人群艾滋病知识宣传,提高艾滋病相关知识知晓率和安全套使用频率,降低毒品使用,以遏制艾滋病在该人群的蔓延。     

男男性行为人群艾滋病流行趋势及安全套使用影响因素分析

目的 了解男男性行为人群（MSM）艾滋病知识知晓率、行为、干预服务和艾滋病感染率的变化趋势及使用安全套的影响因素,初步评价综合干预的效果.方法 利用2010-2012年杭州市MSM人群监测数据,分析MSM人群艾滋病的知识、行为、干预服务和艾滋病感染率的变化趋势;采用多因素非条件Logistic回归分析安全套使用的影响因素.结果 2010-2012年艾滋病感染率分别为8.45%、8.17%和8.07%;接受过宣传咨询和同伴教育者的比例逐年递减;艾滋病防治知识知晓率、同性性行为时每次使用和最近一次使用安全套比例以及吸毒者所占比例均无明显变化.来自酒吧/歌舞厅/茶室/会所（OR=1.745,95%CI：1.099～2.771）、未婚（OR=1.514,95%CI：1.113～2.059）以及曾经检测过HIV（OR=1.553,95%CI：1.205～2.000）的男男性行为人群更容易坚持每次使用安全套.结论 近三年杭州市男男性行为人群艾滋病感染率变化不大,进一步降低感染率还需加强同伴教育和宣传咨询等干预服务工作;扩大人群检测既能及早发现感染者,又可以促进安全套使用.     

广州市海珠区男男性行为人群安全套使用影响因素分析

目的了解广州市男男性行为者(men who have sex with men,MSM)的安全套使用情况及相关影响因素,为针对性开展MSM人群干预工作提供依据。方法 2015—2016年对目标人群进行面对面问卷调查、艾滋病和梅毒血清学检测。结果1 036名MSM的HIV抗体和梅毒阳性检出率分别为7.24%、4.83%。80.60%的MSM最近六个月发生过肛交性行为,8.78%的MSM与异性发生过性行为。最近一次发生同性肛交性行为时安全套使用率从2015年的71.75%上升到2016年的81.49%(P0.05);最近六个月发生同性肛交性行为时每次均用安全套比例从2015年的53.81%上升到2016年的65.04%(P0.05);最近一次发生异性性行为时安全套使用率从2015年的47.83%上升到2016年的66.67%(P0.05);最近六个月发生异性性行为时每次均用安全套比例从2015年的26.09%上升到2016年的60.00%(P0.05)。多因素分析结果显示,文化程度高(OR=1.594,95%CI:1.100～2.308)、最近一年接受过干预服务(OR=1.521,95%CI:1.105～2.093)的MSM更容易坚持使用安全套,最近一年曾被诊断患过性病(OR=0.334,95%CI:0.149～0.745)的MSM坚持每次使用安全套比例低。结论广州市MSM人群安全套使用率低、知行分离,艾滋病、梅毒感染率高,应采取更为有效的综合干预手段,促使MSM人群减少不安全性行为,提高安全套使用率,遏制艾滋病的进一步传播蔓延。     

烟台市MSM人群性行为特征及安全套使用影响因素研究

目的了解烟台市男男性行为者(men who have sex with men,MSM)性行为特征及安全套使用影响因素,为艾滋病防治工作提供理论依据。方法采用网络和现场招募相结合的方法,招募研究对象进行问卷调查,调查内容主要包括社会人口学特征、性取向、同性交友方式、性行为及安全套使用情况等。应用Epidata 3.0软件进行数据录入,应用SPSS 13.0软件进行统计学分析,单因素分析采用χ2检验,多因素分析采用二分类logistic回归。结果共调查531人,其中网络招募431人、现场招募100人。调查对象最近1年同性肛交性伴数以1~3个为主,同性性行为坚持每次使用安全套的比例为49.9%;接受过艾滋病咨询检测、同伴教育、安全套宣传与发放的比例分别为54.4%、27.1%和28.6%。多因素分析结果显示,文化水平高(OR=0.67,95%CI:0.50-0.90)和最近一次同性肛交性行为距离调查时点较长(OR=0.84,95%CI:0.72-0.97)是同性肛交性行为安全套坚持使用的促进因素。与离异或丧偶人群相比,与同性同居为安全套坚持使用的危险因素(OR=2.87,95%CI:1.11-7.47)。结论烟台市MSM人群高危行为普遍,安全套使用率较低,接受艾滋病相关干预服务的比例相对较低,应进一步探索适合MSM人群特点的艾滋病干预措施。     

男男性行为人群性角色状况及其与安全套使用和HIV检测的关系

目的了解成都市男男性行为人群（men who have sex with men,MSM）中性角色状况及其与安全套使用和HIV检测的关系,为发展适合MSM不同亚群特点的HIV预防干预策略提供依据。方法采用分类滚雪球抽样法招募MSM,由统一培训的调查员进行面对面的问卷调查。结果共招募MSM 191人,其中29.8%只作为或多数情况下作为插入方（1号）、31.4%只作为或多数情况下作为被插入方（0号）、38.7%作为插入方和被插入方的情况相差不多（0.5号）;过去半年内与男性固定性伴肛交时,49.7%坚持使用安全套,0号与1号相较于0.5号更倾向于坚持使用安全套（0号：OR=5.43,95%CI：2.26～13.07;1号OR=3.40,95%CI：1.42～8.12）;过去半年内与男性偶然性伴肛交时,58.7%坚持使用安全套,0号与1号相较于0.5号更倾向于坚持使用安全套（0号：OR=2.63,95%CI：1.01～6.83;1号OR=4.08,95%CI：1.52～10.96）;最近1年内,77.0%接受过HIV检测,0.5号、1号接受HIV检测率高于0号（0.5号：OR=2.26,95%CI：1.01～5.05;1号：OR=3.42,95%CI：1.27～9.21）。结论不同肛交性角色的MSM在安全套使用和HIV检测上存在差异,可根据性角色针对性开展艾滋病防治工作。     

芜湖市男男同性性行为人群男男社交软件使用状况及影响因素分析

目的了解芜湖市男男同性性行为人群(men who have sex with men, MSM)男男社交软件(MSM-APP)的使用情况及其对艾滋病相关行为因素的影响。方法 2019年4—7月,利用自制的MSM-APP使用情况调查表,通过分类滚雪球法、MSM活动场所招募等方式开展横断面调查。了解其基本人口学特征、交友方式以及艾滋病相关行为。采集血液进行人类免疫缺陷病毒(human immunodeficiency virus, HIV)和梅毒检测。采用logistic回归分析MSM-APP使用的相关因素。结果本研究调查400名MSM,最近6个月与同性发生过肛交性行为318人(79.50%),坚持安全套使用196人(61.64%),感染HIV 44人(11.00%),使用过MSM-APP 341人(85.25%),使用过MSM群组(MSM-GROUP)258人(64.50%)。使用MSM-APP与MSM-GROUP的调查对象艾滋病知晓率、最近6个月坚持使用安全套、接受安全套宣传发放/自愿咨询检测(voluntary counseling testing, VCT)服务和接受同伴教育服务比例均高于未使用者,差异有统计学意义(P0.05)。Logistic回归分析结果显示调查对象的年龄(OR=0.92,95%CI=0.88～0.95)、文化程度(OR=2.88,95%CI=1.32～6.30)、艾滋病知识知晓(OR=4.51,95%CI=2.16～9.42)和是否接受安全套宣传发放/VCT服务(OR=0.92,95%CI=0.88～0.95)与是否使用MSM-APP相关联。Logistic回归分析结果显示,调查对象是否在校学生(OR=0.26,95%CI=0.12～0.53)、年龄(OR=0.94,95%CI=0.91～0.97)、户籍(OR=0.47,95%CI=0.23～0.94)、艾滋病知识知晓情况(OR=2.74,95%CI=1.32～5.68)和是否接受安全套宣传发放/VCT服务(OR=2.13,95%CI=1.24～3.68)与是否使用MSM-GROUP相关联。结论使用MSM-APP的MSM艾滋病知识知晓率、安全套使用和接受艾滋病相关服务的比例相对较高,可以借助MSM-APP开展MSM艾滋病防控工作。     

白银市男男性行为人群行为特征及艾滋病流行趋势分析

目的 了解2009-2013年白银市男男性行为人群(men who have sex with men,MSM)知识、行为变化趋势,分析艾滋病(acquired immunodeficiency syndrome,AIDS)和梅毒流行趋势,为干预策略和措施制定提供科学依据.方法 采用滚雪球的方法招募调查对象,并进行问卷调查和血清学检测.结果 白银市MSM艾滋病知识知晓率呈上升趋势(X2trnd=25.51,P＜0.001).最近6个月同性肛交性行为发生率为76.27％,最近1次安全套使用率为63.79％,最近6个月安全套坚持使用率为30.33％;最近6个月同性商业性行为发生率为12.94％,最近6个月安全套坚持使用率为41.41％,最近1次安全套使用率为65.66％;最近6个月异性性行为发生率29.11％,最近6个月安全套坚持使用率为27.05％,最近1次安全套使用率为51.71％;近年来,AIDS和梅毒感染率无明显变化趋势.结论 白银市MSM人群艾滋病AIDS知识知晓率上升趋势明显,性行为及安全套使用率无明显变化,AIDS、梅毒感染率保持在较高水平.     

郑州市2014-2018年男男性行为人群同性安全性行为影响因素

目的了解郑州市男男性行为(MSM)人群艾滋病哨点监测结果及同性安全性行为影响因素,为降低MSM人群不安全性行为,制定针对性措施提供依据。方法整理郑州市2014-2018年MSM艾滋病哨点监测数据,采用SPSS 20.0进行统计学分析。结果2014-2018年共监测1 357例,人类免疫缺陷病毒(HIV)抗体阳性率、梅毒阳性率分别为16.51%、11.72%,各年差异均有统计学意义(P值均<0.05),2016-2018年梅毒抗体阳性率呈逐年降低趋势(χ2趋势=8.37,P=0.004);2014-2018年MSM人群艾滋病知识知晓率分别为91.45%、84.40%、63.46%、69.64%、74.83%,同性性行为坚持使用安全套和异性性行为坚持使用安全套比例分别为46.51%、27.81%;二元logistic回归分析显示:文化程度高(高中或中专:OR=1.803,95%CI:1.245～2.609、大专及以上:OR=2.103,95%CI:1.491～2.965)、过往接受过艾滋病检测(OR=2.204,95%CI:1.718～2.828)是同性安全性行为的促进因素。结论郑州市MSM人群HIV检出率较高,该人群发生性行为时安全套使用率不高,应采取有效防治措施进行干预。     

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.