儿童感染乙肝表面抗原的影响因素病例对照研究

[目的]探讨福建省15岁以下儿童感染乙肝表面抗原(HBsAg)的影响因素,为进一步控制乙肝流行提供依据。[方法]根据分层整群随机抽样,对儿童HBsAg携带率进行调查,抽取其中6个县(市、区),采用1:2病例对照研究设计,以HBsAg阳性儿童为病例,同性别、同自然村或街道和年龄上下相差不超过2岁的HBsAg阴性的儿童为对照。用SPSS 13.0软件包进行条件logistic单因素和多因素统计分析。[结果]儿童乙肝疫苗首针是否及时接种回归系数(β)=1.554,预防接种史β=-2.744,拔牙史β=2.974,家庭内乙肝病人或病毒携带者β=3.153。[结论]儿童有拔牙史、家庭内有乙肝病人或病毒携带者,是儿童感染HBsAg的危险因素;儿童乙肝疫苗首针及时接种、儿童有预防接种史是保护因素。     

广东省急性乙型病毒性肝炎影响因素的病例对照研究

目的了解广东省急性乙型病毒性肝炎(乙肝)感染的可能影响因素,为预防控制新发乙肝提供科学依据。方法采用1∶1配对的病例对照研究。选取广东省6个乙肝监测点确诊的新发乙肝患者作为病例,选取同性别、年龄±1岁、HBs Ag和抗-HBs 2项指标同时阴性者作为对照,进行既往肝病史、6个月内输/献血史、医源性接触史、免疫史、生活接触史等问卷调查,对调查结果进行单因素和多因素logistic回归分析。结果 2013年1月至2015年8月广东省6个乙肝监测点共报告确诊急性乙肝病例213例,完成病例对照配对123对,其中男性90对,女性33对;病例组平均年龄为(42.02±18.11)岁,对照组为(42.46±17.98)岁,2组的年龄构成一致(P0.05)。多因素logistic回归分析显示,乙肝疫苗接种史是急性乙肝感染的保护因素,OR=0.013(95%CI:0.001~0.169);既往肝病史、家庭(宿舍)内有乙肝患者或乙肝病毒携带者、肌肉或静脉注射是急性乙肝感染的危险因素,OR值分别为152.144(95%CI:11.473~2 017.590)、5.182(95%CI:1.073~25.033)和21.097(95%CI:3.407~130.656)。结论接种乙肝疫苗是急性乙肝感染的保护因素,而既往肝病史、家庭(宿舍)内有乙肝患者或乙肝病毒携带者、肌肉或静脉注射是急性乙肝感染的危险因素。建议高危人群尽早接种乙肝疫苗。     

608名军队干部HBsAg携带状况及危险因素调查

为了解军队干部HBsAg携带状况及有关的危险因素。采用酶联免疫技术和病例 -对照研究的方法进行研究。结果表明 ,军队干部HBsAg的阳性率为5 .6 % ,明显低于地方同年龄组人群。单因素及多因素分析 ,肝病史、注射及针刺治疗史与HBsAg阳性相关显著 ;乙肝接触史、医院工作史有一定的影响 ;乙肝疫苗接种史是保护因素。     

某部乙型病毒性肝炎病例调查及感染危险因素

目的 了解某部官兵乙型病毒性肝炎发病情况及其发病危险因素,为制定干预措施提供指导。方法 对2013年1月至2014年6月期间某部队上报的新发乙肝病例进行个案调查,并对可能的危险因素进行Logistic统计分析。结果在上报的48名病例中,误诊率为6.2%(3/48)、旧病例重复报告率为4.2%(2/48),共收集新发乙肝病例43例。病例在各单位散发,没有集中流行或暴发的时间分布特征;发病年龄以20岁到30岁居多,病例平均年龄为34.8岁;以乏力、尿黄、纳差、黄染为主要症状;一周内确诊率为55.8%(24/43);半年以上确诊率为16.3%(7/43);单因素分析表明,乙肝疫苗接种史(P0.05)和外出就餐史(P0.01)与乙肝发病的相关性具有统计学意义;多因素Logistic分析表明,经常外出就餐者患乙肝的危险性是不外出就餐者的16.310倍(95%CI:3.916~67.928);没有乙肝疫苗接种史者患乙肝的危险性是有乙肝疫苗接种史者的3.891倍(95%CI:1.021~14.925)。结论 某部乙肝呈散发趋势,20~30岁官兵是乙肝防控的重点人群,其主要感染因素为外出就餐和没有乙肝疫苗接种史。     

社区人群乙肝感染流行因素分析

[目的]了解铁路社区乙肝感染流行因素。[方法]采用病例对照研究的方法,对乙肝病毒感染的流行因素进行分析。[结果]单因素分析:家庭成员乙肝史、注射史、输液史、牙科手术史、外出旅行史、外餐习惯可能是乙肝流行因素。多因素分析:家庭乙肝史、牙科手术史、乙肝疫苗接种入选方程。家庭成员乙肝史可能是乙肝的高危因素(OR=6.77),母婴和家庭密切接触传播可能是目前传播乙肝的主要途径。牙科手术所使用的探针、钻头消毒不彻底在医源性感染中可能显示越来越重要(OR=6.67)。乙肝疫苗接种是唯一的保护因素(OR=0.16)。[结论]母婴和家庭密切接触传播可能是目前社区传播乙肝的主要途径。     

戊型病毒性肝炎危险因素病例对照研究

目的 探讨戊型病毒性肝炎(戊肝)的危险因素.方法 以112例戊型病毒性肝炎患者为病例组,以其同事(学)、配偶或邻居作为对照,应用病例对照研究方法收集流行病学史、相关卫生行为等,采用单因素、多因素Logistic回归等分析戊肝发病的危险因素.结果 单因素分析表明,与戊肝发病相关的危险因素有外餐史、不洁饮食史、不良卫生习惯、抽烟习惯、有特殊业余嗜好、慢性乙肝或HBsAg携带史等;多因素Logistic回归分析,差异有统计学意义的有外餐史(OR=2.42,95%CI=1.27～4.59)、不良卫生习惯(OR=2.18,95% CI=1.19～3.99)和慢性乙肝或HBsAg携带史(OR=5.54,95%CI=2.24～13.70).结论 外餐史、不良卫生习惯是戊型病毒性肝炎的危险因素,既往有乙肝病史或HBsAg携带史的人群是戊肝发病高危人群,应加强保护.     

河北省0～14岁急性新发乙型肝炎病例监测分析

[目的]了解河北省0～14岁急性新发乙型肝炎(乙肝)监测系统运转情况。[方法]对河北省所辖市、县2005年报告的乙肝病例进行统计分析。[结果]2005年河北省报告0～14岁急性新发乙肝1015例,7～14岁病例占总病例数的81.9%。男女性别比1.84︰1;全年均有病例报告;乙肝疫苗三针全程免疫儿童占29.6%;69.4%的病例在发病前半年曾接受过注射;14.9%的病例家庭内有乙肝病人或乙肝表面抗原(HBsAg)携带者。[结论]今后要加强乙肝监测,提高乙肝疫苗接种率,特别是新生乙肝疫苗首针及时接种率和三针全程接种率,重视安全注射,在青少年人群中开展健康宣传教育,有效控制乙肝流行和传播。     

2007-2009年天津市塘沽区新发乙型病毒性肝炎病例对照研究

目的了解天津市塘沽区新发乙型病毒性肝炎感染现状及影响因素（个体因素、生活习惯和家族因素）。方法以该区2007--2009年新发乙型病毒性肝炎为研究对象,采用1：2病例对照研究。结果单因素方差分析结果表明,乙肝家族史、静脉注射史、美容创伤史、拔牙史、输血史和手术史的OR值分别为100．00,33．79,24．09,13．44,4．00和2．25,多因素条件logistic回归分析结果表明,进入回归方程的变量为乙肝家族史、静脉注射史和美容创伤史。结论乙肝家族史、静脉注射史、美容创伤史、拔牙史、输血史和手术史是新发乙型肝炎的主要危险因素。     

常州市8月龄~14岁儿童麻疹传播影响因素分析

目的探讨8月龄~14岁儿童中麻疹传播影响因素,评价现行免疫措施实施效果,探索可能对其采取的保护措施。方法选取常州市范围内在2009-2013年发病的8月龄~14岁儿童,采用病例对照研究的方法,就病例和对照的发病与就诊情况、可能的暴露史、居住地和旅行史、既往麻疹患病史、卫生服务情况、社会人口学和经济学信息等内容进行入户个案访谈调查。结果单因素及多因素分析结果显示:家长对预防接种的态度积极(OR=0.041,OR95%CI=0.004~0.404)、有麻疹疫苗接种史(OR=0.013,OR95%CI=0.003~0.051)是8月龄~14岁儿童麻疹发病的保护因素,外来流动人口(OR=6.016,OR95%CI=2.341~15.462)、发病前7~21 d医院暴露史(OR=7.015,OR95%CI=2.846~17.290)、接种次数较少(OR=5.865,OR95%CI=1.679~20.485)是8月龄~14岁儿童麻疹发病的危险因素,疫苗接种次数越少危险性越大。结论高质量的麻疹疫苗常规免疫和强化免疫可以减少8月龄以上儿童发病,并应重视加强流动儿童和院内感染的管理。     

2009年泰山区产妇HBsAg筛检及新生儿首针乙肝疫苗接种情况分析

乙型病毒性肝炎是我国重点控制的传染病。儿童感染乙型肝炎病毒主要是通过母婴传播,年龄越小感染后变为持续携带者的危险越高。对新生儿出生24h内实行乙肝疫苗接种,不仅可降低HBsAg携带率,也是预防乙型肝炎的有效策略。我们对2009年泰山区辖区的住院分娩产妇HBsAg检测情况,产科医院出生新生儿首针乙肝疫苗接种情况进行汇总分析。     

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 human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

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.     

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.     

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.     

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.     

The risk of heat exhaustion at a deep underground metalliferous mine in relation to surface temperatures

The risk of heat exhaustion at a deep underground metalliferous mine was assessed in relation to thermal conditions prevailing on the surface. For each day of a 1-year prospective case series of heat exhaustion, surface 24-h mean wet and dry bulb temperatures were recorded. From this data, 24-h mean wet bulb globe temperatures were derived using certain assumptions. The three surface temperature variables were significantly higher on those days on which heat exhaustion occurred, compared to those days on which it did not occur (P < 0.001). The relative risk of heat exhaustion on days when the 24-h mean wet bulb globe temperature was in the range 26.0-28.0 degrees C was 4.82 (95% confidence interval 2.12-10.96). Surface temperature data could be used at this mine to warn miners about the risk of heat exhaustion.