Effects of Dietary Exposure to Zearalenone (ZEN) on Carp (Cyprinus carpio L.)

The mycotoxin zearalenone (ZEN) is frequently contaminating animal feeds including feed used in aquaculture. In the present study, the effects of dietary exposure to ZEN on carp (Cyprinus carpio L.) were investigated. ZEN at three different concentrations (low dose: 332 µg kg⁻¹, medium dose: 621 µg kg⁻¹ and high dose: 797 µg kg⁻¹ final feed, respectively) was administered to juvenile carp for four weeks. Additional groups received the mycotoxin for the same time period but were fed with the uncontaminated diet for two more weeks to examine the reversibility of the ZEN effects. No effects on growth were observed during the feeding trial, but effects on haematological parameters occurred. In addition, an influence on white blood cell counts was noted whereby granulocytes and monocytes were affected in fish treated with the medium and high dose ZEN diet. In muscle samples, marginal ZEN and α-zearalenol (α-ZEL) concentrations were detected. Furthermore, the genotoxic potential of ZEN was confirmed by analysing formation of micronuclei in erythrocytes. In contrast to previous reports on other fish species, estrogenic effects measured as vitellogenin concentrations in serum samples were not increased by dietary exposure to ZEN. This is probably due to the fact that ZEN is rapidly metabolized in carp.     

性病门诊外来人员就诊者性行为情况调查

目的了解性病门诊求医的外来人员的性行为及性病患病情况。方法对在性病门诊求医的外来人员进行问卷调查。结果未婚性行为率60.0%,第一次性行为发生在婚前率为47.6%,有2人以上性伴占46.8%,安全套使用率<50%。被调查者中性病患病率为37.1%。感染≥2次性病率为12.2%,占性病患病数的32.8%。结论应推广性病门诊规范化服务,采用各种宣传方式。提供健康信息,提高高危人群性病预防知识,转变态度并提倡安全性行为。     

Accessibility and utilization patterns of a mobile medical clinic among vulnerable populations

We mapped mobile medical clinic (MMC) clients for spatial distribution of their self-reported locations and travel behaviors to better understand health-seeking and utilization patterns of medically vulnerable populations in Connecticut. Contrary to distance decay literature, we found that a small but significant proportion of clients was traveling substantial distances to receive repeat care at the MMC. Of 8404 total clients, 90.2% lived within 5 miles of a MMC site, yet mean utilization was highest (5.3 visits per client) among those living 11–20 miles of MMCs, primarily for those with substance use disorders. Of clients making >20 visits, 15.0% traveled >10 miles, suggesting that a significant minority of clients traveled to MMC sites because of their need-specific healthcare services, which are not only free but available at an acceptable and accommodating environment. The findings of this study contribute to the important research on healthcare utilization among vulnerable population by focusing on broader dimensions of accessibility in a setting where both mobile and fixed healthcare services coexist.     

妇女孕产期保健服务利用状况及影响因素调查

目的探讨妇女孕产期保健服务的利用状况,对其影响因素进行分析和调查。方法选取2014年3月在我市工作的流动人口育龄妇女为研究对象,其中470人有分娩经历。对这些妇女的产前检查、产后访视服务的利用状况及其影响因素进行分析。结果470例流动人口育龄妇女做过产前检查的共有356例．产前检查率为75．74％;得到产后访视的妇女有342例,产后访视率为72．77％。大专及以上文化程度的妇女产前检查次数为8．72±3．19,产后访视次数为1．12±1．25,明显高于初、高中文化程度妇女的5．86±3．23、0．65±1．12和小学以下文化程度妇女的3．70±2．69、0．29±0．68．差异均具有统计学意义（P＜0．05）。家庭月收入4ooo元以上的妇女产前检查次数为7．78±3．64．产后访视次数为0．98±1．26,明显高于家庭月收入2ooo～3999元妇女的6．22±3．14、0．71±1．23和家庭月收入2000元以下妇女的4．98±3．06、0．49±0．97,差异均具有统计学意义（P＜0．05）。结论文化程度、家庭收入、年龄和是否参加生育保险是影响妇女孕产期保健服务利用状况的重要因素．应加强针对流动人口育龄妇女的孕产期保健管理力度,开展孕产期健康教育,充分发挥计生网络的作用,努力改善流动妇女的孕产期保健状况。     

信阳市不同户籍产妇产后抑郁症现况及影响因素分析

目的:了解河南省信阳市不同户籍产妇产后抑郁症的患病现状,对比分析本市户籍与外市户籍产妇产后抑郁症的危险因素,提出建议和对策。方法:随机抽样选择400例产妇,其中本市户籍产妇220例,外市户籍产妇180例,采用自行设计的孕产期调查表和爱丁堡产后抑郁量表(EPDS),在产后42 d进行问卷调查和评定,EPDS总分≥13分者初步诊断为产后抑郁症,应用SPSS16.0统计软件分析不同户籍产妇产后抑郁症的危险因素。结果:2013年信阳市产后抑郁症患病率为8%。外市户籍产妇的患病率明显高于本市户籍产妇(P0.05)。本市户籍产妇产后抑郁症与产妇的文化程度和家庭月收入有关(P0.05),与年龄、职业、分娩方式、丈夫及家人对婴儿性别在意程度、住院付费方式无关;外市户籍产妇产后抑郁症与产妇的年龄和文化程度有关(P0.05),与家庭月收入、职业、分娩方式、丈夫及家人对婴儿性别在意程度、住院付费方式无关。本市户籍产妇随着文化程度及家庭月收入的降低,产后抑郁症患病率呈增高趋势;外市户籍产妇随着年龄及文化程度的降低,产后抑郁症患病率呈增高趋势。结论:社会心理因素是产后抑郁症发生的高危因素,流动产妇对于这一因素较长期居住产妇更为敏感,其孕产期心理健康保健应得到妇幼保健及相关部门的重视。     

2008～2012年保山市疟疾防治成效评价

目的总结保山市疟疾防治经验,分析成效,为今后的疟疾防治服务提供科学依据。方法对保山市2008～2012年疟疾疫情资料进行描述性研究,运用SPSS11．5统计分析软件进行相关的统计分析。结果保山市2008-2012年共有确诊的疟疾病例共计3600例,占总报告传染病的37．08％。其中间日疟2718例,占发病总数的75．50％,恶性疟696例,占19．33％,未分型186例,占5．17％。死亡1例,病死率为2．78／万。发病率从2008年的46．3／10万,下降到2012年的9．18／10万,下降80．17％。其中外源性疟疾下降80．45％,内源性下降42．31％。结论实施全球基金疟疾项目后防治力度加大,规范程度提高,保山市2008-2012年疟疾发病人数逐年下降,保护了人民群众的身体健康,产生了较大的社会效益和经济效益。     

Methods for the analysis of multiple endpoints in small populations: A review

While current guidelines generally recommend single endpoints for primary analyses of confirmatory clinical trials, it is recognized that certain settings require inference on multiple endpoints for comprehensive conclusions on treatment effects. Furthermore, combining treatment effect estimates from several outcome measures can increase the statistical power of tests. Such an efficient use of resources is of special relevance for trials in small populations. This paper reviews approaches based on a combination of test statistics or measurements across endpoints as well as multiple testing procedures that allow for confirmatory conclusions on individual endpoints. We especially focus on feasibility in trials with small sample sizes and do not solely rely on asymptotic considerations. A systematic literature search in the Scopus database, supplemented by a manual search, was performed to identify research papers on analysis methods for multiple endpoints with relevance to small populations. The identified methods were grouped into approaches that combine endpoints into a single measure to increase the power of statistical tests and methods to investigate differential treatment effects in several individual endpoints by multiple testing.     

Constructing and identifying predictors of frailty among homeless adults—A latent variable structural equations model approach

Homeless urbanites are a heterogeneous population with unique health and social service needs. The study examined situational, behavioral, health-related and resource indicators in terms of their direct impact on frailty, hypothesized as a latent variable. Using structural equation modeling (SEM), a model was tested with 150 homeless men and women, ages 40–73, from three homeless day center drop-in sites on Skid Row and one residential drug treatment (RDT) facility that works with homeless parolees and probationers. In bivariate analyses with the latent construct frailty, months homeless (p < 0.01), female gender (p < 0.05), education (p < 0.05), comorbid conditions (p < 0.001), nutrition (p < 0.001), resilience (p < 0.001), health care utilization (p < 0.01), and falls (p < 0.001) were significantly associated with frailty. In the final path model, significant predictors of frailty included educational attainment (p < 0.01), comorbid conditions (p < 0.001), nutrition (p < 0.001), resilience (p < 0.001), and falls (p < 0.01). These findings will serve as a foundation for future nurse-led, community-based initiatives that focus on key predictors of frailty among the homeless and the development of interventions.