预防艾滋病母婴传播影响因素研究进展

艾滋病母婴传播是指HIV感染孕产妇通过妊娠、分娩或哺乳将艾滋病毒传播给子女,根据三级预防原则,预防艾滋病母婴传播策略可分为避免危险(预防育龄妇女感染,避免HIV感染妇女非意愿妊娠)、减少危险(尽早发现HIV感染孕妇,采用UNAIDS推荐的"抗逆转录病毒治疗+产科干预+人工喂养"模式进行干预以减少胎儿或婴儿暴露危险)和HIV感染母亲及其婴儿和家庭的关爱与支持三方面.     

云南省预防控制母婴垂直传播艾滋病病毒的研究

目的：了解云南省HIV母婴垂直传播的流行趋势,探讨如何减少或阻断HIV母婴垂直传播,为预防和控制母婴垂直传播HIV提供一些依据。方法：对云南省8年HIV孕妇监测哨点中艾滋病病毒（HIV）感染者检出情况进行调查分析。结果：孕妇监测哨点中的艾滋病病毒（HIV）感染者检出数均逐年增加。结论：云南省艾滋病的母婴垂直传播问题日趋严重,应引起高度重视并加强防范,以达到减少或阻断HIV母婴垂直传播。     

云南省消除艾滋病病毒母婴传播工作机制及效果评价

目的分析评估云南省消除艾滋病病毒(HIV)母婴传播工作措施的效果,总结云南省消除HIV母婴传播工作机制,为其他地区实现消除HIV母婴传播目标提供科学依据。方法使用文献回顾法,收集云南省自2006年起实施的预防及消除HIV母婴传播工作措施与预防策略,通过全国预防HIV母婴传播信息管理系统,收集云南省2006—2019年全省HIV感染孕产妇及所生儿童的个案卡与随访登记卡,云南省2006—2019年预防HIV母婴传播工作月报表,计算评价指标以分析各项工作措施的实施效果。结果云南省建立了保障孕产妇HIV抗体检测、HIV感染孕产妇及所生儿童抗病毒治疗、保健、随访检测措施落实的"逢孕必检"、"转介制度"、"专人管理"、"感染个案评审"、"信息监测与管理"等工作制度与运转机制,孕产妇HIV抗体检测率从79.09%提高至99.97%,孕期HIV抗体检测率从44.56%提高到99.89%,HIV感染产妇抗病毒治疗比例从75.92%提高至99.72%,HIV感染产妇所生儿童抗病毒治疗比例从86.90%提高至99.91%,艾滋病母婴传播率(校正)从项目实施初期的8.78%下降到1.93%。结论云南省消除艾滋病母婴传播工作机制可保障预防艾滋病母婴传播干预措施有效落实,保障与促进云南省消除艾滋病母婴传播工作达到世界卫生组织艾滋病母婴传播消除认证中的基本指标要求,可供其他省份和周边国家借鉴。     

山东省2008-2009年预防艾滋病母婴传播监测结果分析

目的监测山东省预防艾滋病母婴传播咨询与检测服务情况,了解孕产妇艾滋病病毒（HIV）感染情况及流行特征,为制定预防艾滋病母婴传播干预措施提供依据。方法 2008-2009年以连续横断面调查方法对山东省部分县（市、区）的孕产妇进行HIV感染自愿咨询与检测,HIV初筛阳性者做确认试验;使用Excel和SPSS软件进行数据整理和统计分析。结果孕产妇在孕晚期接受HIV抗体检测咨询服务的比例仍然较高,在孕早期接受HIV抗体检测咨询服务的比例比较低;性传播是山东省孕产妇感染HIV的主要途径;艾滋病病毒感染孕产妇年龄主要在25～35岁之间、多为从外省嫁入的少数民族妇女、受教育程度普遍较低、家庭生活困难、多为农民或无业人员。结论从外省嫁入的少数民族妇女是艾滋病母婴传播的高发人群;育龄妇女感染HIV的初级预防是预防艾滋病母婴传播的工作重点之一;采取综合的干预措施能有效减少艾滋病母婴传播的危险,可最大程度地减少儿童感染艾滋病,降低艾滋病对妇女、儿童的影响。     

HIV抗体快速检测技术在母婴阻断传播中的应用

艾滋病母婴传播是指感染艾滋病病毒的妇女在怀孕、分娩或产后哺乳过程中将艾滋病病毒传染给胎儿或婴儿,导致胎儿或婴儿感染艾滋病。艾滋病母婴传播可以发生在妊娠的任何时期。研究资料显示,25%~38%的HIV垂直传播为子宫内传播[1]。妊娠、分娩至产后2年,艾滋病病毒的母婴传播率并     

农村外省籍嫁入妇女HIV和梅毒感染状况分析

目的 了解山东省邹城市农村外籍嫁入妇女的人类免疫缺陷病毒(HIV)和梅毒感染状况,为制定艾滋病防治措施提供科学依据.方法 对1995年以来由外省迁入邹城市与当地农民婚配的妇女进行问卷调查,并采集静脉血4 ml,检测HIV抗体和梅毒抗体.结果 邹城市外来妇女HIV感染8例,感染率为0.30%;梅毒感染38例,感染率为1.41%; HIV和梅毒双重感染者4例.HIV感染者原籍均为云南省,HIV感染者迁入时间最早为2003年.同时发现3例通过性接触将HIV传染给配偶,1例经母婴传播将HIV传染给子女.梅毒感染者中云南籍占81.58%.结论 邹城市农村外来妇女存在HIV和梅毒的感染流行,并已有HIV二代传播;外来妇女成为当地传播HIV/AIDS的危险因素之一.     

开远市阻断母婴传播HIV/AIDS研究

目的　探讨艾滋病病毒 (HIV)母婴垂直传播的规律 ,为预防和阻断HIV的母婴传播提供依据。方法　采用流行病学研究方法进行研究。结果　 (1)开展阻断HIV/AIDS母婴传播项目 ,必须建立完整的组织机构和管理措施 ,多个部门参与工作与管理 ,互相协调与配合 ,才能保证项目的顺利实施与管理。 (2 )流行病学监测表明 ,开远市孕妇人群中HIV感染率约为 6 4 3‰ ,传播途径以性传播为主 ,其次是静脉吸毒。 (3)在健康教育评价中 ,对艾滋病知识、传播途径和预防方法的知晓率 ,在健康教育后明显高于健康教育前 (P <0 0 0 1)。 (4 )病例对照研究表明 ,孕妇感染HIV的危险因素为职业、文化程度、静脉吸毒、卖淫、多性伴、配偶HIV阳性和配偶或性伴吸毒等。结论　在开展阻断孕妇HIV/AIDS母婴传播项目时 ,同时进行项目系统管理研究、流行病学监测、健康教育及其评估、流行病学病例对照研究等是必需的 ,可有效降低和防止孕妇的HIV感染率和HIV母婴传播的发生率。     

2015-2019年温州市HIV感染孕产妇特征分析

目的了解2015-2019年温州市HIV感染孕产妇特征,为进一步改进预防艾滋病母婴传播工作的管理模式,降低艾滋病母婴传播率,提供科学依据。方法采用回顾性调查分析法,通过国家妇幼卫生综合信息平台预防艾滋病、梅毒和乙肝母婴传播管理信息系统,对2015年1月1日-2019年12月31日在温州医疗机构建册、产前检查及确诊的HIV感染孕产妇个案资料进行分析,比较本市户籍和非本市户籍(流动人口)孕产妇感染HIV阳性率的差别,分析HIV感染孕产妇特征及母婴传播率,并采用Logistic回归模型分析母婴传播影响因素。结果 2015-2019年温州市累计检测孕产妇507 014人,其中检出HIV感染孕产妇137例,感染率为27.02/10万。流动人口孕产妇HIV感染率高于户籍孕产妇,差异有统计学意义(P0.05),2015-2019年温州HIV孕产妇感染率呈逐年上升趋势,但以2018年感染率最高。多因素Logistic回归分析结果显示,在校正HIV感染孕产妇的年龄、文化程度、职业、孕产次等因素后发现,择期剖宫产、孕产妇孕期开始接受抗病毒治疗时间早为母婴传播的保护因素,急诊剖宫产为母婴传播的危险因素(均P0.05)。结论 2015-2019年温州市孕产妇HIV感染以25～35岁、初中文化程度、已婚家庭主妇/无业为主,且以流动人群比例高,确诊时间以孕期保健时发现为主。择期剖宫产、孕产妇孕期开始接受抗病毒治疗时间早为母婴传播的保护因素,急诊剖宫产为母婴传播的危险因素。因此,普及人群艾滋病母婴阻断宣传,加强性活跃年龄段、低学历、无业、流动人群孕产妇管理,早诊断、抗病毒治疗是控制艾滋病母婴传播的工作重点。     

艾滋病病毒母婴传播阻断效果分析

目的分析艾滋病患病率较高的河南省某县婚龄妇女及孕妇、产妇的人类免疫缺陷病毒（HIV）感染状况;探讨实行多种干预措施后的效果及科学、简单、经济的阻断HIV经母婴传播的评价方法.方法采取整群抽样方法,对该县婚龄妇女及孕产妇进行连续4年HIV的监测,采取实验流行病学研究方法对不同目标人群采取不同干预措施（提供咨询、暂缓结婚、自愿终止妊娠、母婴抗病毒药物服用）;并对HIV阳性人群进行描述性研究.对HIV感染产妇所分娩的婴儿分别进行0、9和18个月时随访与检测;初步对产妇和婴儿的药物阻断效果进行评价.结果 4年来,共对婚龄妇女13693人、孕妇32155人、产妇11367人进行HIV抗体检测;其中确认HIV阳性的婚龄妇女39人、孕妇112人、产妇81人;81名产妇所分娩的婴儿85人中,19名满18月龄婴儿HIV抗体检测阴性,其余仍在随访中.结论采用多种阻断艾滋病经母婴途径传播的干预模式,取得一定效果.     

2005～2008年云南省某边境县预防艾滋病母婴传播综合干预情况分析

目的:评估近年某边境县预防艾滋病母婴传播综合干预情况,为下一步预防艾滋病母婴传播工作提供依据。方法:对从云南省妇幼卫生信息网络直报系统导出2005～2008年某边境县上报的反映预防艾滋病母婴传播综合干预情况的相关数据进行回顾分析。结果:2008年某边境县HIV抗体检测基本覆盖孕产妇,其中孕期检测率为86.65%,两率均高于云南省平均水平(P<0.001)。HIV阳性检出率为0.95%,远高于全省平均水平(P<0.001),4年间无变化(P=0.372)。56.21%HIV感染孕产妇选择终止妊娠,43.79%选择继续妊娠。HIV感染孕产妇住院分娩率为89.55%,2008年达100.00%。HIV感染产妇和所生婴儿抗病毒药物均服用率79.10%,其中2008年孕产妇服药率达100.00%。抗病毒药物使用逐渐以AZT+3TC+NVP三联用药方案为主,高于全省平均水平(P=0.002)。人工喂养率高达94.12%。HIV感染孕产妇所娩儿童77.78%在访,其中满18月龄儿童HIV抗体检测(1例拒检)仅有1例检出阳性。结论:某边境县预防艾滋病母婴传播综合干预措施逐步到位,预防艾滋病母婴传播效果明显。预防H1V感染妇女非意愿妊娠、降低儿童失访率等应成为某边境县今后预防艾滋病母婴传播工作的重点。     

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 occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

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.     

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.     

Fatigue and health in a seafaring population

Background Occupational fatigue is relatively common withinthe general population and has been linked to reduced performance,injury and longer term ill-health. Despite growing acknowledgementof this problem in the maritime sector, little research hasbeen conducted into the risk factors, prevalence and consequencesof seafarers' fatigue. Aims To examine the prevalence of fatigue among seafarers, identifypotential risk factors and assess possible links with poor performanceand ill-health. Methods Cross-sectional questionnaire survey of seafarers workingin the offshore oil support, short-sea and deep-sea shippingindustries. A number of tools were used including the fatiguesubscale of the profile of fatigue-related symptoms, the CognitiveFailures Questionnaire, the General Health Questionnaire andthe SF36 General Health scale. Results In all, 1855 questionnaires were completed giving anoverall response rate of 20%. Fatigue symptoms were associatedwith a range of occupational and environmental factors, manyunique to seafaring. Reporting a greater number of risk factorswas associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35)for those with three or four risk factors and OR = 9.54 (6.95–13.09)for those with five or more risk factors]. There was also astrong link between fatigue and poorer cognitive and healthoutcomes, with fatigue the most important of a number of riskfactors, accounting for 10–14% of the variance. Conclusions Seafarers' fatigue could impact on safety withinthe industry and may be linked to longer term individual ill-health.It can only be addressed by considering how multiple factorscombine to contribute to fatigue.     

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.