成渝两地社区居民乙型肝炎歧视现状的流行病学调查

目的 了解成渝两地社区居民对肝炎歧视的现状及其影响因素,为防治策略调整提供理论依据。方法 选取重庆市和成都市的社区居民作为调查对象,共939名。采用自行设计的结构式调查问卷分析居民的乙肝歧视现状,并通过Logistic回归模型分析肝炎歧视的影响因素。结果 将歧视程度分为无或轻、中、重3种类型,仅有13.27%的调查对象完全无歧视,75.19%的调查对象存在中度及重度乙肝歧视,12.41%的居民乙肝歧视得分达到最高分6分。多因素分析显示,与56岁以上的人群相比,年龄在16～25岁的人群乙肝歧视程度低的概率较大,OR(95%CI)值为0.285(0.114,0.710);与年收入56 000元以上的调查对象相比,年收入水平在14 000元以下的人群乙肝歧视程度高的概率较大,OR(95%CI)值为7.325(3.898,13.765)。结论 成渝两地社区居民乙型肝炎歧视现象严重,开展消除乙肝歧视的工作中应重点关注老年人、低收入的人群,健康教育应注意消除大众对乙肝传播途径的错误认知方面。     

成都市某城乡结合社区居民乙肝知识认知情况调查分析

目的了解成都市某城乡结合社区居民对乙肝相关知识的认知状况,分析造成认知差异的影响因素,为城乡结合社区开展乙肝健康教育活动的方式方法提供科学依据。方法采用自设问卷于2010-08/2011-08在成都市某城乡结合社区的居民开展乙肝相关知识调查。结果调查对象242人中从未做过乙肝血清学检测的占41.03%,其中农村户口者占77.39%,城镇户口占22.61%,差异有统计学意义（P〈0.05）;对乙肝的3大传播途径（血液、母婴传播和性传播）能正确认识率约50%,对不传播乙肝的途径如咳嗽、喷嚏、共餐等知晓率不高,初中以下文化程度者选择率达85.16%,高中及以上文化程度者选择率为14.84%,差异有统计学意义（P〈0.05）;约36.6%居民对乙肝感染者存在不同程度的歧视态度,服务行业类居民愿意与乙肝患者就餐的人数占36.91%,非服务行业类居民占63.09%。结论成都市某社区不同户籍、不同文化层次、不同职业居民对乙肝的重视程度、相关知识了解情况及对感染者歧视度上存在偏差,应针对性的进行社区健康教育,以减少社区居民的乙肝感染率。     

江西省乙肝防治现场居民知识、态度、行为基线调查

目的了解江西省乙肝防治现场居民乙肝知识、态度和行为的现况,为在当地开展有针对性的乙肝防治健康教育提供依据。方法采用自制统一的调查问卷,在4个乙肝防治现场对3815名18～59岁人群进行乙肝知识、态度、行为(KAP)的流行病学调查。结果居民的乙肝防治知识知晓率平均为47.02%,对感染乙肝病毒的可能结局,乙肝的治疗转归,日常感染途径等了解得不太全面,且不同学历、年龄段、职业间知识得分、态度、行为的差异均有统计学意义。结论江西省乙肝防治现场居民的乙肝防治知识掌握程度较低,对乙肝患者/携带者接受程度较差,提示应加大对乙肝防治知识尤其是传播途径的宣传力度,且特别要注重对农村地区、年长人群、低学历人群、农民和工人等职业人群的健康教育。     

山东农村地区成年人对乙肝患者歧视状况分析

目的分析山东省农村地区成年人对乙肝患者歧视状况及相关影响因素。方法于2011—2012年采用概率比例规模(PPS)抽样方法,抽取山东省4县共14个村,共2 894名≥18岁居民进行问卷调查。分析对乙肝患者歧视程度及对乙肝歧视的影响因素。结果 23.67%(683人)对乙肝的相关症状、10.19%(295人)对乙肝患者未经治疗的后果、7.64%(211人)对乙肝有效治疗方式和7.84%(227人)对乙肝的传播途径一无所知。53.84%(1 558人)在与乙肝患者或病毒携带者接触的过程中感到恐惧、担心自身被传染;仅有3.14%(91人)完全无歧视,而高达71.73%(2 076人)有严重的乙肝歧视。对乙肝患者及病毒携带者的歧视程度主要受收入状况、恐惧态度和对乙肝传播途径认知的影响。调查对象获取乙肝认知的途径以新闻传媒为主,占61.47%(1 779人),仅有3.42%(99人)通过与肝炎患者交谈相处获得乙肝认知。结论山东省农村成年乙肝歧视现象仍普遍存在,消除乙肝歧视迫在眉睫。     

深圳市社区居民病毒性肝炎知识、态度和行为的流行病学调查

目的了解深圳社区居民对病毒性肝炎,尤其是乙肝传播、危害等相关知识的知晓率及对待乙肝感染者的态度和行为,为当地制定相关健康教育策略提供依据。方法采用流行病学现况调查方法,随机抽取深圳市15～59岁的社区居民1 544名,采用自填式问卷调查获取居民病毒性肝炎知识、态度、行为信息进行分析。结果绝大多数调查对象表示听说过甲肝(71.9%)和乙肝(91.5%),而听说过丙肝(36.6%)、丁肝(20.7%)和戊肝(18.0%)的则相对较少;仅有不到一半调查对象了解乙肝的传播途径(45.0%),但一半以上的调查对象知道可以通过疫苗接种来预防甲肝(56.9%)和乙肝(75.6%);大部分的调查对象害怕与乙肝感染者近距离接触,有30.0%和27.1%的乙肝感染者遭遇过被人远离或升学就业的困难。结论应以社区为单位,长期、持续开展形式多样的健康教育活动,提高社区人群,尤其是流动人群对病毒性肝炎的传播、预防等相关知识的认知水平,从根本上消除"乙肝恐惧"和"乙肝歧视"现象。     

苍南县居民防灾意识及认知水平调查分析

目的了解苍南县居民防灾意识及灾害认知水平,为开展有效的减灾教育,提高公众灾害风险意识和抗灾技能提供依据。方法采用自制调查问卷,对578名居民进行调查。结果居民防灾意识平均得分率为68.40%,防灾意识农村高于城镇,已婚者高于未婚者;文化程度越高,防灾意识越强;不同经济收入居民以平均月收入2000～4999元组防灾意识最强,5000元以上组最低。居民灾害认知水平平均总得分率为76.74%,其中农村高于城镇;年龄小者、文化程度和平均月收入高者,灾害认知水平也高;不同职业居民以医务人员灾害认知水平最高,国家机关、企事业人员次之,商业和服务业人员最低。结论苍南县居民防灾意识和认知水平较低,存在着城乡、年龄、文化程度、婚姻状况、职业状态和不同经济收入水平的差异,应针对不同人群,采取不同的教育方法和重点教育内容,进一步加强灾害风险意识和防灾知识教育。     

福建省居民乙肝知识知晓率调查研究

目的 了解福建省各地市居民乙肝基本知识及行为、态度现状,探讨开展乙肝健康教育的策略.方法 采用问卷法对9地市随机抽取的699名居民进行现场调查.结果 乙肝基本知识知晓率为72.9％,文化程度越高,乙肝基本知识知晓率、行为正向率、态度正向率越高;乙肝基本知识、行为和态度间存在正向相关性.结论 应针对不同人群设计或选择不同...     

天津不同人群乙肝知识知晓及疫苗接种率分析

目的 了解天津市不同人群乙肝防治知识知晓率和乙肝疫苗接种率,为更好的制定成人乙肝疫苗接种和健康教育策略提供科学依据.方法 按经济和地理特点分层,抽取天津市5个区(县),采用整群抽样方法 抽取乙肝重点人群;采用方便抽样方法,以商场超市等公共场所普通人群作为对照;使用《天津市防治乙肝知识知晓率调查表》,调查乙肝疫苗接种情况,乙肝相关知识知晓率以及对乙肝病毒健康携带者的歧视状况.结果 学生、教师、医务人员、保育员、饮食服务人员、银行职员、HBV家庭密切接触者和静脉吸毒人群乙肝疫苗接种率依次为41.33%、33.88%、70.23%、62.50%、38.16%、41.53%、39.84%和3.57%;乙肝知识知晓率分别为54.51%、73.47%、89.95%、77.36%、53.61%、64.72%、67.15%和28.72%;对乙肝携带者歧视率分别为52.54%、28.78%、5.85%、20.83%、54.08%、40.68%、22.71%和37.50%;普通人群乙肝疫苗接种率为32.82%,知晓率为58.30%,歧视率为31.07%.结论 乙肝重点人群的乙肝疫苗接种率高于普通人群,但总体接种率仍不高;防治知识知晓状况参差不齐;存在乙肝歧视.     

浙江省居民对结核病患者歧视态度及行为分析

目的通过调查居民对结核患者的相关态度与行为,分析结核病歧视现状与相关因素,为结核病健康教育及行为干预提供建议。方法对浙江省10个县6 000名常住居民进行入户问卷调查,调查其结核病核心知识及信息的知晓情况,对结核患者相关态度与行为等。结果在4 932名知晓肺结核的居民中,3 233人表现出对周围发生的结核病人的歧视倾向,占65.6%;在390名周围曾有结核病的居民中,104人与这些病人有"减少来往"行为,占26.7%;高年龄段、农民、文化水平较低、已婚、收入较低人群更易产生歧视态度;知晓结核病能传染的居民歧视态度更明显,而知晓结核病诊断和预后的居民歧视态度却相对不明显。结论居民对于结核病的歧视态度与行为广泛存在,对结核病相关知识表面理解更易导致歧视。     

江西省乙肝高发地区育龄妇女KAP调查与分析

目的:了解江西省育龄妇女对乙肝的认知水平、态度及行为,分析其影响因素,为今后有针对性地开展宣传教育提供科学依据。方法:对江西省乙肝高发地区18～49岁育龄妇女进行乙肝防治知识-态度-行为问卷调查并对结果进行统计分析。结果:1 161名育龄妇女乙肝防治知识知晓率为45.76%,对乙肝的传播途径有一定的了解,但仍存在误区。被调查妇女乙肝防治知识平均得分(11.44±5.10)分,妇女年龄、文化程度、职业得分组间差别有统计学意义(P<0.01);只有不到1/3的调查对象愿意与乙肝患者/携带者交往;文化程度和是否注射疫苗是影响乙肝防治知识、态度、行为的主要因素。乙肝防治知识、态度及行为三者之间存在相关性。结论:江西省育龄妇女乙肝防治知识知晓率较低,对乙肝患者/携带者有一定的歧视现象,今后应针对低文化、高年龄、农民加强健康教育,提高乙肝防治基本知识和自我防护意识,最终控制乙肝传播。     

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.