2000～2004年深圳市龙岗区5岁以下儿童死亡监测结果分析

[目的]分析5岁以下儿童死亡的主要原因,为降低5岁以下儿童死亡率提供干预措施.[方法]对2000～2004年深圳市龙岗区5岁以下儿童的死亡监测资料进行统计分析.[结果]深圳市龙岗区婴儿以及5岁以下儿童死亡率呈逐年下降趋势;5岁以下儿童死因主要是早产和低出生体重、出生窒息、溺水和意外窒息;非户籍人口的婴儿及5岁以下儿童死亡率高于常住人口的死亡率.[结论]加强围生期保健、特别是流动人口保健服务,控制意外死亡,是降低5岁以下儿童死亡率的关键.     

南京市5岁以下儿童死亡情况分析及预防措施

[目的]掌握南京市5岁以下儿童死亡现状及死因分布状况,为制定预防措施以及政府部门决策提供依据.[方法]对2007年南京市5岁以下儿童死亡资料进行统计分析.[结果]2007年南京市5岁以下儿童死亡率为7.78‰,男8.01‰,女7.49‰,婴儿死亡前5位死因分别为先天性心脏病、早产低出生体重、其他先天异常、出生窒息、意外窒息;5岁以下儿童前5位死因分别为先天性心脏病、早产低出生体重、其他先天异常、出生窒息、溺水.[结论]针对各年龄段儿童的具体死因建立相关预防措施,强化健康教育,以进一步降低5岁以下儿童死亡率.     

宜昌市西陵区5岁以下儿童死亡资料分析

[目的]了解宜昌市城区监测点西陵区5岁以下儿童死亡原因及预防措施.[方法]对1998～2004年宜昌市西陵区5岁以下儿童死亡资料进行描述性分析.[结果]5岁以下儿童死亡率11.5‰;新生儿死亡率7.01‰;婴儿死亡率8.697‰.早产和出生低体重、其他先天性异常、出生窒息是前3位死因顺位.意外是1～4岁儿童死亡的主要原因.[结论]宜昌市西陵区5岁以下儿童死亡率和婴儿死亡率处于较低水平;加强高危儿的管理、防止意外伤害是降低婴儿死亡和5岁以下儿童死亡的主要举措.     

1997～1998年省级监测点5岁以下儿童生命监测结果分析

[目的] 探讨福建省5岁以下儿童死亡的动态变化及各年龄组的主要死因.[方法] 在12个监测区抽样调查.[结果] 1997、1998年儿童死亡率分别为34.83‰和30.87‰.山区儿童死亡率最高,城市最低;死亡年龄主要分布在新生儿、婴儿阶段,不同年龄主要死因也不相同.集中反映了加强孕产妇系统管理,提高产科质量及出生窒息抢救,对降低早产、低出生体重、出生窒息的发生起着积极作用.加强儿童系统管理,强化健康教育,提高家长对科学育儿、安全教育方法的认识,采取早期干预,是降低5岁以下儿童死亡率的有效措施.     

东川区2001年-2005年新生儿死亡情况分析

[目的]了解新生儿死亡率及动态变化趋势,并提出相应干预措施.[方法]对昆明市东川区2001年～2005年5岁以下儿童死亡监测中的新生儿死亡情况进行分析.[结果]新生儿死亡率呈逐年下降趋势;五年间出生窒息、肺炎、早产和低出生体重、意外和先天异常是我区新生儿死亡的前四位死因,只是死因顺位有变化.[结论]加强围产期保健及对各级医务人员的技术培训,是降低新生儿死亡率的有效措施.     

抚顺市1999～2003年5岁以下儿童死因分析

[目的]了解抚顺市5岁以下儿童死亡率及影响因素,为政府部门制定妇幼保健决策提供依据.[方法]采用流行病学前瞻性调查方法,以妇幼三级保健网为依托,对1999～2003年抚顺市出生的64 277例活产儿及5岁以下儿童死亡情况进行全面监测.[结果]5年间婴儿死亡率为11.06‰,5岁以下儿童死亡率12.71‰,新生儿及婴儿死亡占5岁以下儿童死亡的比例分别70.38%、87.03%.婴儿及5岁以下儿童死因顺位均为先天畸形、早产儿及低出生体重、出生窒息.[结论]抚顺市三个死亡率虽然低于全省水平,但有波动,2001～2003年有上升趋势.提示我们应重点加强先天畸形、早产及低出生体重、出生窒息的保健管理.意外伤害、肿瘤导致5岁以下儿童死亡呈上升均势,应引起足够重视.提出应建立抚顺市新生儿急重症急救网络,强化健康教育,提高妇幼保健质量和产儿科人员适宜技术水平等措施,以便进一步降低死亡率.     

2000～2004年山东省5岁以下儿童意外死亡监测结果分析

[目的]了解山东省5岁以下儿童意外死亡的现状与特点,探讨预防措施.[方法]采用全省5岁以下儿童死亡监测网收集的2000～2004年以人群为基础的监测资料,计算不同地区的婴儿、1～4岁儿童和5岁以下儿童意外死亡率及死因顺位.[结果]5年间,山东省5岁以下儿童意外死亡由第四位分类死因上升到第三位,并且是1～4岁儿童的第一位分类死因.在各种意外死亡中,意外窒息多见于婴儿组,交通意外、溺水多见于1～4岁组.[结论]意外死亡上升为危害儿童健康的主要卫生问题.重视儿童意外死亡,加大宣传力度,提高防范意识,最大限度地降低5岁以下儿童意外死亡率.     

2002～2005年封丘县5岁以下儿童死亡资料分析

[目的]探讨5岁以下儿童死亡的原因,提出相关措施干预.[方法]对2002～2005年封丘县5岁以下儿童死亡相关资料进行统计分析.[结果]2002～2005年封丘县5岁以下儿童死亡率21.4‰,婴儿死亡率19.54‰,新生儿死亡率16.9‰.各年间死亡率的差异无统计学意义(P>0.05).死因依次为早产及低出生体重、出生窒息、肺炎、路途死亡原因不明、先天性心脏病.[结论]提高产科质量,掌握新生儿复苏和新生儿喉镜插管等措施,可降低5岁儿童死亡率.     

宁德市婴儿意外窒息死亡分析

[目的]了解宁德市婴儿意外窒息死亡的状况和特点,以降低婴儿期意外窒息伤害发生率和死亡率.[方法]利用宁德市5岁以下儿童死亡监测网,对监测区内2000～2005年的婴儿意外窒息死亡74例死亡,采用SPSS软件进行分析.[结果]婴儿期意外窒息主要死因为蒙被窒息、夜间哺乳姿势不正确、溢乳等,多发生于3月内小婴儿,以10月至次年2月为高发季节,各年龄组间主要死因差异有显著性.[结论]从孕期开始进行安全知识宣传,宣传如何避免婴儿意外伤害知识,及正确的哺乳方法和紧急救助措施.     

2003年宁德市5岁以下儿童死亡监测分析

[目的]分析我市5岁以下儿童死亡死因及保健服务状况,为降低死亡率提出有效干预措施。[方法]按监测方案,在监测区对常住人口以5岁以下儿童村级出生、死亡季报表为基础逐级上报,乡、县于第4季度对年度资料进行审核,查漏报情况,由专业人员入户调查,市妇幼所于年终抽查,进行漏报调查,并将年度资料汇总分析。[结果]2003年宁德市监测区5岁以下儿童死亡率15．9‰,婴儿死亡率13．5‰,新生儿死亡率9．8‰,婴儿死亡占5岁以下死亡85．2％,新生儿死亡占婴儿死亡72．5％,年龄越小所占比例越重。5岁以下儿童死因前5位顺位为先天畸形、意外、早产及低出生体重、肺炎和出生窒息。[结论]加强围产保健,提高产前诊断及筛查能力,降低缺陷儿出生率;侧重新生儿期保健;改善农村地区儿童生存水平。     

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.