15～24岁校外未婚青年异/同性间性行为发生状况及影响因素

目的：了解15～24岁校外未婚青年与异性/同性发生性行为的状况及其影响因素,为向该人群提供性与生殖健康教育和服务提供依据。方法：在中国6个省的城市和农村地区,对1 113人校外未婚青年进行计算机辅助的自填匿名问卷调查。结果：15～18岁组和19～24岁组男性异/同性间性行为发生率均高于女性（P＜0.05）。异性间性行为时,15～18岁组7.14%的女性报告首次性行为属被迫发生;15～18岁组和19～24岁组男、女性首次性行为安全措施的使用率为66.67%和40.00%及58.82%和49.11%,男性报告使性伴怀孕和女性报告怀孕的比例接近（30.00%）;19～24岁组性伴个数2名及以上男性报告率高于女性（P＜0.01）。同性间性行为时,15～18岁组男、女性报告平均年龄仅14岁;19～24岁组15.79%的男性报告首次性行为属被迫发生,46.15%的男性和33.33%的女性报告有2名以上性伴。多因素分析显示,男、女性与异性发生性行为共同的危险因素为看黄色制品和年龄较大（OR男分别为3.51和3.81,OR女分别为6.41和3.58）;与赞成婚前性行为相比,本人不能接受婚前性行为（OR=0.18）、父母不能接受婚前性行为（OR=0.37）和朋友持无所谓态度（OR=0.47）是男性的保护因素;与赞成婚前性行为相比,自己认为婚前性行为不好（OR=0.14）和不能接受（OR=0.06）、朋友不能接受婚前性行为（OR=0.16）和不清楚朋友态度（OR=0.21）是女性的保护因素,父母持无所谓态度是女性的危险因素（OR=12.56）。结论：校外未婚青年与异性/同性的性行为及危险性行为发生率较高,并与接触过黄色制品、个人及父母/同伴的开放态度呈正相关。     

海南省乡镇地区校外青年婚前性行为及其与流动经历关系的研究

目的 比较海南省乡镇16 ～ 24岁男女校外青年婚前性行为,并探讨其与流动经历的关系.方法 在海南省A、B县的8个乡镇,按照年龄、性别、是否有流动经历进行等比例配额方便抽样.在A、B县每个镇分别招募160和80名符合条件的研究对象,做面对面问卷调查.结果 获取有效问卷760份(A县322份,B县438份,男女各380份).女性已婚者比例(39.2％)明显高于男性(11.3％,P＜0.01).男女被调查者报告有性行为的比例(56.8％和57.9％)以及有婚前性行为的比例(54.5％和50.0％)相近.在有性行为的调查对象中,男、女初次性行为的平均年龄(18.2岁±1.9岁和19.2岁±1.8岁,P＜0.01)、初次性行为≤18岁者比例(59.3％和35.5％,P＜0.01)和初次外出打工平均年龄(18.0岁±2.3岁和16.5岁±1.9岁,P＜0.01)均有差别;31.2％的男性报告初次性行为在第一次外出打工前,45.9％报告在第一次外出打工后1年内;而女性,78.5％的人报告初次性行为在初次打工一年以后.分析男女被调查者婚前性行为的影响因素,无论男性还是女性,扣除人口学特征因素的影响后,有“3个月以上跨市县/省”流动经历以及报告自己朋友中有很多人有婚前性行为,与有婚前性行为有关;男性有婚前性行为者年龄偏大;女性已婚也是有婚前性行为的独立相关因素.对男性未婚者的多因素分析显示,有流动经历以及年龄偏大与发生婚前性行为独立相关.结论 海南省乡镇地区男、女青年在性行为及流动特征方面存在差异,在开展相关危险性行为研究和干预中应考虑性别差异的影响.     

深圳市坪山新区未婚外来女工性行为状况及影响因素分析

目的:了解深圳市坪山新区未婚外来女工的性行为状况及影响因素。方法:采用整群随机抽样方法确定研究对象,使用统一的问卷调查其基本人口学特征以及性行为状况,利用SPSS19.0软件进行数据分析。结果:722名未婚外来女工中,193人(26.7%)报告有过性行为,初次性行为年龄19.9±2.0岁。有性行为的女工中,23.8%报告有≥2个性伴,32.6%报告有妊娠史,25.4%有人工流产史,9.8%有生育史;多因素分析结果表明年龄≥24岁和月收入≥3000元的女工更有可能发生婚前性行为(OR=2.4和1.9),高中及以上文化程度的女工发生婚前性行为的可能性低于初中及以下文化程度的女工(OR=0.4)。结论:深圳市坪山新区未婚外来女工婚前性行为较普遍,多性伴以及过早发生性行为可能使他们面临未婚妊娠、人工流产等生殖健康问题,对易发生性行为的女工及早进行干预非常有必要。     

不同性别务工青少年生殖健康状况分析

目的 了解15～24岁不同性别进城务工青少年的性与生殖健康知信行状况及影响因素.方法 采用自编结构式匿名问卷对山东省济南市1 075名15～24岁进城务工青少年进行自填式问卷调查.结果 男性与女性进城务工青少年的性与生殖健康知识水平均较低,尤其流产相关知识,男性得分中位数仅25.0分;35.0%的男性认为只要双方愿意就可以发生婚前性行为,高于女性的16.1%;面对恋人性要求,男性坚持不发生性行为的比例(18.1%)远低于女性(53.1%),差异有统计学意义(χ2=141.704,P<0.001);30.7%的调查对象自我报告发生过性行为,其中男性为40.1%,女性为23.7%,差异有统计学意义(χ2=29.385,P<0.001);不同性别进城务工青少年发生婚前性行为的共同影响因素为年龄、文化程度、对避孕的态度;女性还与对婚前性行为的看法、对恋人性要求的处理方式有关.结论 为进城务工青少年提供性与生殖健康教育及服务时应考虑性别差异.     

青少年性与生殖健康研究

目的研究青少年性与生殖健康的现状,了解其观念、知识和行为。方法采用描述流性病学方法,随动抽样调查了5455名15~24岁的未婚青少年。调查采用匿名自填式调查表,数据处理采用MFOXbase,并且采用SPSS统计分析。结果39.73％的调查对象对婚前性行为持赞成或无所谓的态度。54．4％对未婚先孕特可容忍和无所谓的态度。有7．3％已发生婚前性行为,其中,中学生性行为发生率为4．37％,大学生为人43％,非学生为11．81％。对青春期生理知识不懂或略懂的男性占79％,女性占87．2％。对性知识完全不了解或似懂非任的占49．1％。结论目前中国青少年性观念有所转变。婚前性活动发生率有所增加。但是,他们现具有的性知识程度较差,获得性知识渠道也不够理想。这与青少年的意愿有相当大的差距。急待进一步深入开展青少年性与生殖健康方面的研究与工作。     

重庆市农村未婚年轻成人父母对给未婚青年提供生殖健康服务的态度调查

目的：通过向未婚年轻成人的父母了解未婚年轻成人未得到生殖健康需求服务的成因，以确定给未婚年轻成人提供生殖健康服务的最佳途径和可行方法。方法：采用小组访谈法，对重庆市农村地区18-24岁有婚前性行为年轻成人的父母分别访谈，讨论的内容包括父母对未婚年轻成人婚前性行为的态度，父母对婚前性行为和人工流产影响未婚年轻成人健康的认识，父母对给未婚年轻成人提供教育和服务的态度等。结果：农村父母也给子女提一些忠告，但对子女因婚前性行为导致未婚先孕，普遍采取事后补救等被动措施表现出极大忧虑。父母赞成向子女提供有针对性的相关教育和服务，希望政府和社会机构给予重视，结论：农村未婚年轻成人婚前性行为和人工流产的普遍，与其自身文化水平和科学知识不足，家庭观念落后，如父母，教师和社会相关人员生殖健康知识水平不高及社会未重视有关，建议成立青少年生殖健康促进中心，制订相应的媒体法规及将青少年生殖健康教育和生殖健康服务纳入计划生育服务范畴，将有利于保障青少年生殖健康的需求。     

流出地校外青少年婚前性行为及其影响因素分析

目的 了解流出地15～24岁未婚校外青少年性行为特点及影响因素,为该人群开展相关健康教育提供参考.方法 整群随机抽取某县一所职业培训中心在调查期间前来学习、咨询、求职的所有15 ～24岁未婚校外青少年1800名进行间卷调查.结果 流出地校外青少年中发生婚前性行为的比例达18.0％;艾滋病知识平均得分为(9.19±4.28)分,知晓率仅为33.3％;性行为中安全套使用率较低;同伴环境较差的青少年各种危险行为发生的比例较高;多因素分析显示:避孕知识教育、艾滋病性病相关知识得分是性行为发生的保护因素,当前正在打工、朋友中有人发生过性行为、商业性行为、多性伴、吸毒以及和朋友经常一起去喝酒为危险因素.结论 大力加强初中学校和职业培训学校的艾滋病预防教育,营造良好的同伴环境,多部门配合,可能减少校外青少年性行为的发生.     

上海市外来务工青年性与生殖健康知识、态度和行为调查

【目的】了解上海市外来务工青年的性与生殖健康知识、态度和行为现况,为开展针对性的干预措施提供科学依据。【方法】采取整群随机抽样的方法,抽取上海市某区2家工厂24岁以下的外来务工青年,使用自行设计的问卷进行自填式问卷调查。问卷内容包括社会经济学特征、性与生殖健康相关知识、对于安全性行为的态度和行为。实际调查外来务工青年(≤24岁)713人。【结果】男性428名,女性285名;年龄范围为17至24周岁;农村户口占88.9%;79.7%为未婚。性与生殖健康掌握程度较低,对女性的排卵时间回答正确率较低;对于性病艾滋病传播途径等存在误区;不能正确认识安全套与避孕药具的作用与区别,仅有46.5%的男性和31.5%的女性对于避孕药的作用回答正确。性态度较开放,赞同婚前性行为和婚前同居者较多,男性比女性更持宽容态度,男性认为只要双方自愿就可以发生婚前性行为的比例为59.1%,高于女性(P0.01)。婚前性行为发生率较高(男性64.0%,女性56.1%),性安全意识不强,有37.0%的男性和28.9%的女性第一次性行为时没有采取任何避孕措施;每次性行为使用安全套的比率只有20%左右,有12.4%的女性有非意愿妊娠并进行人工流产的经历。【结论】外来务工人员的性与生殖健康状况不容乐观,需加强健康教育和健康促进工作。     

上海未婚青少年性相关行为影响因素结构方程模型分析

目的 在健康促进知信行理论的基础上构建青少年性相关行为影响因素的结构方程模型,探讨其影响因素的直接作用和间接作用.方法 用计算机辅助调查6 299名15～24岁未婚青少年性与生殖健康知识、性相关态度和性相关行为,对调查数据进行结构方程模型拟合,再根据模型参数检验,通过评价修正确定最终模型.结果 青少年生殖避孕知识得分较低,及格率为28.6%.大约75%的男性和55%的女性接受婚前性行为.结构方程模型拟合较好,性与生殖健康知识对性相关行为的直接作用为0.2,间接作用为0.1176,总作用为0.3176.开放的性相关态度对性相关行为起促进作用(0.28).结论 加强对青少年进行正规的、全面的性健康和生殖避孕教育,促使其性态度转变,降低性相关行为风险.     

婚前性行为及妊娠情况调查

目的了解遂昌县婚前检查人群中发生婚前性行为及婚前妊娠的情况。方法对2010-2012年住遂昌县妇幼保健所免费婚前检查的初婚男女进行问卷调查,分析婚前性行为人数、年龄和婚前妊娠等情况。结果婚前性行为发生率男性为74．12％,女性为72．44％,两者比较差异无统计学意义（P〉0．05）;初次发生婚前性行为年龄〈14岁的男性占0．32％,女性占0．49％;女性初次性行为年龄以〉20岁为主,占62．94％;女性婚前妊娠发生率为67．95％,其中年龄〈14岁发生率为0．05％。结论婚前性行为发生普遍,婚前妊娠对青少年的身心健康有长远的不利影响。     

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.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

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.     

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.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.