西藏农村3岁以下儿童营养状况及影响因素分析

目的 了解西藏自治区农村地区3岁以下儿童营养状况.为改善西藏自治区儿童营养状况提出合理化建议.方法 采用人口比例抽样法获得调查对象.自行设计调查问卷,对6个地区15个项目县72个乡镇的1513名儿童母亲进行面对面问卷调查.以年龄别身高Z评分(HAZ)、年龄别体重Z评分(WAZ)和身高别体重Z评分(WHZ)作为儿童营养状况的评价指标.结果 项目地区儿童生长迟缓(HAZ＜-2)、低体重(WAZ＜-2)和消瘦(WHZ＜-2)的患病率分别为33.9%,16.5%和3.4%.不同地区及性别儿童营养不良患病率不同.男童低体重患病率明显高于女童.差异有统计学意义(P＜0.01).在海拔4500m以上,生长迟缓和低体重的患病率分别达36.5%和19.1%.结论 西藏农村地区3岁以下儿童营养状况不容乐观,应根据影响儿童营养状况的相关因素采取干预措施.改善儿童营养状况,降低各种营养不良患病率.     

贵州省农村<7岁儿童体格发育水平分析

目的 了解贵州省农村儿童体格发育水平及营养不良患病情况.方法 采用分层随机整群抽样方法调查贵州省农村儿童8 680人,以中国<7岁儿童生长标准为参数计算儿童年龄别身高Z值(HAZ)、年龄别体重Z值(WAZ)和身高别体重Z值(WHZ)与生长迟缓、低体重和消瘦发病率.结果 各年龄组儿童体格发育均落后于参考标准,6月龄内儿童Z值主要分布0～1和0～-1两个区间;6月龄后逐渐向左移,WAZ、WHZ值主要分布于0～-1和-1～-2两个区间,HAZ左移较前二者更明显.18月龄后各Z值主要分布于-1～-2和<-2两个区间.营养不良发生率在6个月以内较低,6月龄后随年龄增长患病率增高,在36～48月龄时达到高峰;8 680名<7岁儿童中生长迟缓3 292例,低体重1 523例,消瘦388例,发病率分别为37.9%,17.5%和4.5%.结论 贵州省农村儿童体格发育与中国同龄儿童生长标准存在较大差距,长期慢性营养不良是其主要因素,改善农村儿童营养状况是今后贵州省儿童保健工作重点.     

7岁以下农村儿童体格发育调查

目的:了解江西省农村儿童体格发育水平及营养不良的患病率。方法:通过整群抽样调查江西省农村9238例儿童,所有儿童均由统一培训人员测量身高、体重,以WHO/NCHS标准为参数评价儿童体格发育水平,计算年龄别身高Z值(HAZ)、年龄别体重Z值(WAZ)和身高别体重Z值(WHZ)。分别计算儿童生长迟缓、低体重、消瘦的患病率。结果:我省农村儿童体格发育水平6月以内可达甚至超过WHO标准,6月龄后开始滞后。6月龄内儿童Z值主要分布在0～1和-1～0两个区间;6月龄后逐渐向左移,Z值主要分布于-1～0和-1～-2两个区间。儿童HAZ和WAZ主要分布在-1～0和-1～-2两个区间;而WHZ则以0～1和-1～0两个区间为主。生长迟缓、低体重和消瘦的患病率分别是13.2%、13.0%和2.9%,出生后6月内营养不良检出率最低,以后随年龄增长检出率逐渐增加,生长迟缓率在18～24月龄时达高峰。结论:我省农村儿童体格发育水平与WHO标准仍有一定差距,提示应进一步提高农村卫生水平和加强健康教育,有效改善农村儿童营养状况。     

应用人体测量法评估湖南省宜章县0～7岁农村儿童的营养状况

目的应用人体测量法评估宜章县0～7岁农村儿童营养状况。方法采用横断调查设计，随机抽样，获得2969名0～7岁儿童，以身长和体重作为衡量儿童营养状况的指标，采用Z值法以WHO参考人群为标准评估该儿童群体的营养状况。结果年龄别身高（HA）Z值的标准差波动在1．13～1．33，年龄别体重（WA）Z值的标准差波动范围较大在1．02～1．43，特别是1岁以内的儿童。与WHO参考分布相比，该儿童群体的HAZ值和WAZ值显著左移约1个单位，身高别体重（WH）Z值左移0．4个单位，生长迟缓、低体重和消瘦的患病率分别为20．1％、21．6％和6．8％。营养不良患病情况在出生后3个月龄内较低，6月龄后患病率迅速上升，在15月龄左右达到20％～30％，此后有所下降但维持在较高水平上。低体重与生长迟缓和消瘦问有显著的相关关系，Pearson相关系数分别为0．815和0．636（P〈0．01），发育迟缓与消瘦间没有发现显著的相关关系。结论该县农村儿童的整体营养状况受到不良影响，相对于WHO参考人群营养不良患病率较高，低的HA和WA可能是该地区农村儿童的主要问题。     

云南省贫困地区2~6岁儿童膳食多样化与生长发育的相关性研究

目的分析云南贫困地区儿童营养状况,探索膳食多样化评分(dietary diversity score,DDS)与生长发育指标的相关性。方法计算2006-2009年云南省4个贫困县儿童营养监测项目中膳食调查对象最近24h内9类食物的膳食多样化评分(DDS9),同时计算其年龄别身高、年龄别体重和身高别体重Z评分(HAZ、WAZ、WHZ)及营养不良率,分析食物消费状况和生长发育指标的相关性。结果共1 686名2~6岁儿童进入分析。儿童低体重率、生长迟缓率和消瘦率分别为24.3%、24.7%和7.5%。DDS9平均为6.0±1.38,DDS9与HAZ及WAZ呈显著性正相关(r=0.11,P=0.00;r=0.063,P=0.01),而与WHZ未见显著性相关(r=-0.02,P=0.327)。各类食物消费与生长发育指标的单因素Logistic回归分析显示:缺乏乳类、肉类和水产品消费分别为生长迟缓、低体重和消瘦的危险因素。结论云南贫困地区2~6岁儿童膳食多样化程度低,营养不良率高。DDS9与儿童生长发育指标呈一定相关性,在儿童膳食质量评价、营养不良预测方面有一定的应用价值。     

贵州省贫困农村<3岁儿童营养状况分析

目的评价贵州省4个贫困农村3岁儿童营养状况,为改善该地区儿童营养状况提供依据。方法采用人口比例抽样法,于2005年对贵州省4县1256户有3岁儿童的家庭进行问卷调查,以儿童身高和体重作为儿童营养状况的评价指标。结果该地区3岁以下儿童生长迟缓[年龄别身高Z值(HAZ)-2],低体重[年龄别体重Z值(WAZ)-2]和消瘦[身高别体重Z值(WHZ)-2]的患病率分别为29.9%,19.6%和9.0%,男童生长迟缓率(32.2%)高于女童(26.0%);在月龄上,18～24月龄生长迟缓率最高(39.5%),低体重率以15～18月龄最高(26.8%),消瘦率以12～15月龄最高(12.8%);不同民族间患病率差异有统计学意义(P0.01),各县间患病率差异有统计学意义(P0.05)。结论3岁儿童营养状况存在问题,普及科学喂养知识,增加高蛋白摄入,有助于改善儿童营养状况。     

江西省农村留守儿童营养状况分析

目的:了解江西省农村留守儿童营养状况。方法:整群抽样调查0～7岁留守儿童和非留守儿童各1 157名。由专业人员测量身高和体重,并检测血红蛋白。以WHO2006标准为参数评价儿童体格发育水平,计算年龄别身高Z值(HAZ)、年龄别体重Z值(WAZ)和身高别体重Z值(WHZ)。配对资料使用配对t检验方法,率的比较使用χ2检验。结果:留守儿童的HAZ均值为-1.13,非留守儿童为-1.00,两者差异有统计学意义(P<0.05);留守儿童和非留守儿童的WAZ和血红蛋白(Hb)均值较接近,差异无统计学意义(P>0.05);留守儿童低体重、生长迟缓和消瘦的发生率分别为5.95%、19.42%和2.79%,贫血发生率为17.96%,留守儿童和非留守儿童差异无统计学意义(P>0.05)。结论:江西省农村留守儿童营养状况可达非留守儿童水平,但江西省农村儿童整体营养状况仍不容乐观,应进一步提高农村卫生水平和加强科学喂养知识等健康教育,以期有效改善农村儿童营养状况。     

补充含有蛋白质、微量营养素的辅助食品对6～24个月婴幼儿营养干预的效果研究

目的对6~24个月婴幼儿补充含有蛋白质、微量营养素的辅助食品的干预效果进行分析和评价。方法从我社区随机选取150名6~24个月婴幼儿作为研究对象,均开展营养干预,在常规饮食基础上每日补充含有蛋白质、微量营养素的辅助食品,持续1年,对比分析不同月龄段营养干预前后年龄别体重(WAZ)、年龄别身长(HAZ)、身长别体重(WHZ)以及低体重、生长迟缓、消瘦、贫血等情况。结果通过干预后,不同月龄婴幼儿的WAZ、HAZ及WHZ均有改善,且低体重率、生长迟缓率、消瘦率、贫血检出率均明显降低,与干预前比较均存在差异,有统计意义(P0.05)。结论对6~24个月婴幼儿补充含有蛋白质、微量营养素的辅助食品,可有效提升营养水平,减少营养不良发生,降低贫血率,有助于婴幼儿良好发育和成长。     

宁夏六县农村3岁以下儿童营养状况分析

目的：为了解宁夏农村3岁以下儿童的营养状况,对宁夏6县进行了随机抽样横断面调查。方法：以身高和体重作为衡量儿童营养状况的指标,并同时调查有关社会环境因素。结果：该地区生长迟缓（HAZ＜－2）、低体重（WAZ＜－2）和消瘦（WHZ＜－2）的总患病率分别为：15．0％、11．7％、2．7％。回族高于汉族,经济好的县高于经济差的县。与NCHS／WHO标准分布比较,提示宁夏6县3岁以下儿童整体的营养状况较差。进行因素,分析发现腹泻,母亲文化程度,儿童数,喂养及辅食添加为营养不良的影响因素。结论：应积极开展营养健康教育,加强 儿童常见病的防治,提高孕妇和乳母的保健知识,在重点干预的同时,还要注意改善整体儿童的营养状况。     

中国9地区3～12岁儿童生长发育Z评分分析

目的了解并分析中国9地区3~12岁儿童生长发育和营养状况,为促进儿童保健和营养管理提供依据。方法对9地区(7城市,2农村)1 722名儿童进行身高、体重等体格测量和问卷调查,计算相应Z评分,综合评价被调查儿童的生长发育和营养状况。结果 9地区被调查儿童的身高和体重均值及超重率较高,而低体重率、生长发育迟缓率、消瘦率较低,年龄别体重(weight for age Z-score,WAZ)、年龄别身高(height for age Z-score,HAZ)和年龄别BMI(BMI for age Z-score,BAZ)达中等以上发育水平者分别为89.04%、89.19%和83.22%,城市儿童和农村儿童消瘦率、超重率以及WAZ、BAZ发育较差者所占比例的差异有统计学意义(P0.05)。结论 9地区被调查儿童生长发育总体状况较好,但仍然存在低体重和超重、肥胖的情况,应重视儿童的健康教育和营养管理工作。     

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.     

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.     

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.     

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.