广西农村暗娼安全套坚持使用情况及影响因素分析

目的 了解广西农村地区暗娼人群商业性行为时安全套使用情况及影响因素, 为制定暗娼艾滋病综合干预措施提供参考依据。 方法 采用多级抽样的方法,2019年4—6月在国家和省级暗娼哨点招募农村暗娼进行横断面问卷调查,调查内容包括场所位置、一般人口学信息、艾滋病知识、性行为特征及安全套使用等。用多因素非条件logistic 回归方法分析最近一个月坚持使用安全套的相关因素。 结果 2019年共调查农村暗娼1 350人,平均年龄(42.71±8.62)岁,艾滋病知识知晓率为95.63%(1 291/1 530),最近一次商业性性行为使用安全套比例为94.72%(1 274/1 345),最近一个月商业性性行为每次均使用安全套的比例为87.85%(1 186/1 350)。多因素非条件logistic 回归显示,知晓艾滋病知识(OR=14.857,95%CI:8.196～26.932)是安全套坚持使用的促进因素;交易场所为村屯(OR=0.180,95%CI:0.106～0.304)、30岁及以上年龄(30～岁组,OR=0.275,95%CI:0.090～0.841;50～岁组,OR=0.131,95%CI:0.042～0.407)是安全套坚持使用的障碍因素。 结论 应进一步加强对农村地区、大年龄暗娼人群安全套推广使用等综合干预力度。     

Risk for SARS-CoV-2 Infection in Healthcare Workers,Turin, Italy

We measured severe acute respiratory syndrome coronavirus 2 spike protein subunits S1/S2 antibodies by using capillary electrophoresis and a chemiluminescence immunoassay for 5,444 active healthcare workers in Italy. Seroprevalence was 6.9% and higher among participants having contact with patients. Seroconversion was not observed in 37/213 previously infected participants.     

Thermal discomfort in healthcare workers during the COVID-19 pandemic

Introduction:Due to the COVID-19 pandemic, healthcare workers are now required to use additional personal protective equipment (PPEs) to protect themselves against the virus. That led to an increased clothing insulation which is negatively affecting the perceived healthcare workers’ thermal sensation.Objectives:While demonstrating through software simulations the potential level of thermal discomfort healthcare workers involved in the COVID-19 emergency can be subjected to, this work aims at identifying measures to improve thermal sensation perception and acceptable thermal conditions for medical personnel.Methods:After having obtained the insulation values of individual clothing used by staff during COVID-19 emergency through the use of a thermal well-being evaluation software, the Fanger indexes (PMV - Predicted Mean Vote and PPD - Predicted Percentage of Dissatisfied) were calculated in order to estimate staff satisfaction to microclimatic conditions.Results:The use of COVID-19 additional PPEs with an air temperature equal to 22 °C (normally considered optimal) brings the PMV index equal to 0.6, which corresponds to 11.8 % being unsatisfied (PPD) due to perceived heat.Discussion:The use of additional protective devices significantly increases the clothing insulation level, facilitating the onset of conditions of thermal discomfort in the health workers. Workers engaged in the execution of nasopharyngeal swabs were most affected by the summer weather conditions and certainly represent the most critical category, for which it would be recommended to implement a higher turnover of service to reduce individual exposure time and consequent discomfort.     

我国女性性工作者领域社会组织参与艾滋病防治项目管理能力建设需求研究

目的 了解为女性性工作者（FSW）提供艾滋病防治服务的社会组织项目管理能力建设需求。方法 向2017-2018年参与国家艾滋病防治基金项目的社会组织负责人开展问卷调查及访谈,结合基金项目管理信息系统相关数据,利用Excel 2016软件和SPSS 25.0软件整理分析社会组织的分布与基金获得情况,以及社会组织对项目管理能力的需求。结果 2017-2018年参与执行基金FSW项目的社会组织共184个,完成问卷调查的社会组织156个,主要集中在西部地区（44.0%,81/184）,以四川省、广西壮族自治区和云南省居多;东部地区获得的基金支持最多;社会组织对项目数据收集及分析利用的需求最高,占68.6%（107/156）,其次是项目风险分析应对及质控,占64.1%（100/156）;社会组织负责人学历对项目计划管理和项目财务管理能力建设需求的差异有统计学意义（χ²=5.78,P=0.016;χ²=8.99,P=0.003）。结论 当前我国FSW领域的社会组织数量和基金获得比例的分布,与异性性传播的艾滋病疫情分布不一致。仍需继续鼓励、引导扶持社会组织的发展资金;结合社会组织对能力建设的需求针对性的制定项目能力建设计划。     

Associations and community health workers: analysis and time trends over ten years of training-action

ObjectiveTo analyse the profile of the persons and associations that participated in the course, quantify peer education activities and analyse their evolution.MethodA quantitative study using an analysis of the course records from 2009 to 2018 was designed for this purpose inside mihsalud program designed to promote health amongst persons in vulnerable situations in the city of Valencia (Spain). It offers a yearly training-action course of community health workers (CHW) that is attended by persons who have been proposed by associations. The associations were defined according to their population (immigrant, local or intercultural) and the CHWs according to gender, country of birth, year of course, association and continuity after training. Means and confidence intervals were calculated at 95% and a bivariate analysis was conducted in order to compare the activities that took place in 2009 to 2013 with those of 2014 to 2018. The time trends were analysed by applying linear regression models that included the different years studied as the dependent variable.Results201 CHW of 31 nationalities were trained, 81.6% (95% confidence interval [95% CI]: 75.5-86.7] were women. Eighty-two associations participated, 51.2% (95% CI: 39.9-62.4] worked with culturally diverse populations. Participation by associations (p = .017) and CHWs (p = .377) increased in a statistically significant manner over the years. After the course, 35.3% (95% CI: 28.7-42.4] of the CHWs continued to collaborate voluntarily in the associations.ConclusionsThe results of the CHW training-action course improve over time given that a significant increase in participation by associations and women can be seen, along with a greater number of activities completed during the training. One effect of this is that CHWs are contracted or carry out voluntary activities in the associations.     

新冠疫情下基层医务工作者心理状况的调查与研究

目的:评估在疫情期间,基层医务人员的个人心理状况并对基层医务人员心理状况进行分析。方法:2020年2—4月以上海市浦东新区上钢社区卫生服务中心为调查点,选取30名参与疫情防控工作的医务人员为调查组,并以1∶2的比例选择未参加疫情防控的医务人员为对照组,以焦虑自评量表,斯坦福急性应激反应量表及匹兹堡睡眠量表为调查工具,调查比较医务人员的相关心理状况及心理状况产生的影响。结果:研究组在焦虑评分上高于对照组,且具有统计学意义。在应激反应上,无论是单方面还是总得分,研究组得分都高于对照组,且具有统计学意义;在睡眠质量上,研究组总得分也高于对照组,其中在睡眠障碍和日间功能障碍方面具有统计学意义,而其他方面无统计学意义。结论:通过本次调查,我们发现在疫情情况下,参与疫情防控的基层医务人员更易产生焦虑,且更易产生应激反应,同时其睡眠状况较差。     

养老机构养老护理员职业认同现状及影响因素分析

目的 探讨养老机构养老护理员职业认同现状及其影响因素,为提升养老护理员职业认同水平提供参考依据。方法 采用整群随机抽样法,于2020年9—12月在遵义市城区内的95所养老机构中随机抽取24所,对24所养老机构中符合纳入标准的所有养老护理员采用一般情况调查表、养老护理员职业认同量表、人文关怀能力评价量表进行调查,本次调查共发放问卷351份;应用SPSS 21.0进行数据分析,其中一般情况采用描述性统计分析,职业认同的影响因素采用单因素分析、多元线性逐步回归等方法进行分析。结果 养老护理员职业认同平均得分为（104.95±18.39）分,多元线性回归分析结果显示:养老护理员职业认同影响因素有年龄（t=-2.398,P=0.017）、月收入（t=3.695,P＜0.001）、文化程度（t=2.544,P=0.011）、职业技能证书（t=2.072,P=0.039）、培训机会（t=4.704,P＜0.001）、工作时长（t=-4.254,P＜0.001）、照护老人数量（t=-3.336,P=0.025）、家庭支持情况（t=4.608,P＜0.001）、人文关怀能力（t=9.576,P＜0.001）。结论 养老护理员职业认同处于中等水平,建议有关部门针对以上影响因素提出整改措施,提高养老护理员职业认同水平,促进养老机构护理队伍的建设。     

Barriers and facilitators to uptake and promotion of influenza vaccination among health care workers in the community in Beijing,China: A qualitative study

BackgroundIn the prevention and control of influenza, it is important for healthcare workers (HCWs) to be vaccinated and recommend influenza vaccines to their patients. However, there is limited evidence on the factors influencing uptake and promotion of influenza vaccination to patients among HCWs in China.MethodsWe conducted in-depth interviews among HCWs in community health centers, including general practitioners (GPs) and preventive health workers (PHWs), during January to February 2017. A total of 21 individuals, purposively selected from six community health centers covering central districts and remote suburbs in Beijing, were interviewed using semi-structured topic guides. Thematic analysis was used to analyze the interviews and coding framework was developed both inductively and deductively.ResultsIdentified factors influencing influenza vaccine uptake included knowledge, perception and recognition, and prior experience of vaccine uptake. All PHWs conservatively recommended influenza vaccine because of concerns about potential patient–doctor disputes. GPs rarely recommended vaccination under their own initiative because vaccine promotion was not their duties. Notably, we found that the division of work was an underlying reason for the different behaviors regarding vaccine uptake and promotion between GPs and PHWs.ConclusionsOur findings highlighted a combination of misconceptions and cognitive biases limiting influenza vaccine uptake among HCWs in China. Our findings indicate that promotion of health education regarding influenza vaccination should be implemented among HCWs. Importantly, the division of work greatly affects the behaviors of HCWs. GPs, who are at the front line in the doctor–patient relationship, have a critical role in influenza vaccination programs.     

COVID-19 vaccine uptake and its associated factors among Palestinian healthcare workers: Expectations beaten by reality

BackgroundIn response to this extraordinary outbreak, many countries and companies rush to develop an effective vaccine, authorize, and deliver it to all people across the world. Despite these extensive efforts, curbing this pandemic relies highly upon vaccination coverage. This study aimed to determine SARS-COV-2 vaccine uptake among Palestinian healthcare workers, the factors that influence vaccination uptake, and the motivators and barriers to vaccination.MethodsA cross-sectional study was conducted using an online anonymous self-administered questionnaire during April and May 2021, after the Palestinian Ministry of Health launched the COVID-19 vaccination campaign.The questionnaire collected socio-demographic characteristics, vaccination attitude and vaccination uptake status, and motivators and barriers towards vaccination. In addition, multivariate logistic regression was performed to identify the influencing factors of vaccination uptake.ResultsThe study included 1018 participants from different professions, including 560 (55.0%) females. Of the participants, 677 (66.5%; 95% CI: 63.5–69.4%) received the vaccine. Higher uptake was observed among males (aOR = 1.5; 95 %CI: 1.1–2.1), single HCWs (aOR = 1.3; 95 %CI: 1.1–1.8), HCWs working in the non-governmental sector (aOR = 1.6; 95 %CI: 1.2–2.4), higher monthly income (aOR = 1.9; 95 %CI: 1.4–2.8) and smoking (aOR = 1.5; 95 %CI: 1.1–3.5). The lower level of negative vaccination attitudes predicted higher intake; mistrust of vaccine belief (aOR = 1.6; 95 %CI: 1.4–1.7) and worries over unforeseen future effects (aOR = 1.2; 95 %CI: 1.1–1.3).ConclusionIn conclusion, the COVID-19 vaccination uptake was comparable to other studies worldwide but still needs to be improved, especially in the context of this ongoing global pandemic. It is imperative to invest resources to promote vaccination uptake and target all the vaccine misconceptions and fears.     

Influenza cases in nine aged care facilities in Sydney,Australia over a three-year surveillance period, 2018—2020

BackgroundInfluenza outbreaks in aged care facilities are a major public health concern. In response to the severe 2017 influenza season in Australia, enhanced influenza vaccines were introduced from 2018 onwards for those over 65 and more emphasis was placed on improving vaccination rates among aged care staff. During the COVID-19 pandemic, these efforts were then further escalated to reduce the additional burden that influenza could pose to facilities.MethodsAn observational epidemiological study was conducted from 2018 to 2020 in nine Sydney (Australia) aged care facilities of the same provider. De-identified vaccination data and physical layout data were collected from participating facility managers from 2018 to 2020. Active surveillance of influenza-like illness was carried out from 2018 to 2020 influenza seasons. Correlation and Poisson regression analyses were carried out to explore the relationship between physical layout variables to occurrence of influenza cases.ResultsInfluenza cases were low in 2018 and 2019, and there were no confirmed influenza cases identified in 2020. Vaccination rates increased among staff by 50.5% and residents by 16.8% over the three-year period of surveillance from 2018 to 2020. For each unit increase in total number of beds, common areas, single rooms, all types of rooms (including double occupancy rooms), the influenza cases increased by 1.02 (95% confidence interval:1.018–1.025), 1.04 (95% confidence interval: 1.019–1.073), 1.03 (95% confidence interval: 1.016–1 0.038) and 1.02 (95% confidence interval:1.005–1.026) times which were found to be statistically significant. For each unit increase in the proportion of shared rooms, influenza cases increased by 1.004 (95% confidence interval:1.0001–1.207) which was found to be statistically significant.ConclusionsThere is a relationship between influenza case counts and aspects of the physical layout such as facility size, and this should be considered in assessing risk of outbreaks in aged care facilities. Increased vaccination rates in staff and COVID-19 prevention and control measures may have eliminated influenza in the studied facilities in 2020.