上海市长宁区老年人接种肺炎疫苗的影响因素调查

[目的]研究影响老年人接种肺炎疫苗的因素,提出促进老年人疫苗接种的策略和政策性建议。[方法]将500名老年人分为肺炎疫苗接种组和未接种组,自拟《老年人群肺炎疫苗知晓及接种情况调查表》,采用多因素回归分析方法,分析接种肺炎疫苗的影响因素及相关情况。[结果]老年人接种肺炎疫苗与其是否接种过流感疫苗、是否患过肺炎或老慢支等呼吸系统疾病、家庭人均月收入、对肺炎疫苗认知和是否患有其他慢性病有关;老年人文化程度、目前或退休前职业和家庭类型与其接种肺炎疫苗无关。[结论]加强广泛且有针对性的宣传对促进肺炎疫苗的接种具有重要作用。另外降低价格、纳入医保这些措施对肺炎疫苗的接种也具有促进作用。     

成都市户籍老年人肺炎疫苗接种率及影响因素调查

目的了解成都市对老年人实行接种肺炎疫苗优惠政策后,成都市户籍老年人肺炎疫苗的接种率及其影响因素。方法采用多阶段整群随机抽样方法,抽取5个区(市)县30个社区,每个社区随机抽取40名60岁及以上成都市户籍老年人,共1 200人为调查对象。采用自制问卷调查老年人人口学特征、健康状况及行为,疫苗接种率、政策知晓率等情况,利用χ2检验、非条件Logistic回归分析对肺炎疫苗接种率及影响因素进行单因素、多因素分析。结果成都市户籍老年人的肺炎疫苗接种率为42.1%,经多因素Logistic回归分析,自身接种疫苗需求、收到接种疫苗预约、优惠政策知晓、近两年参加体检、参加肺炎防治宣传意愿及患慢性心血管疾病情况是肺炎疫苗接种率的主要影响因素(P0.05)。结论成都市老年人肺炎疫苗的接种率较高,但以后的工作中应注意宣传肺炎及其疫苗的相关知识,提高老年人对肺炎的预防意识,对肺炎疫苗的认识度和接受度;接种过程中应适当放宽对接种禁忌症的把握度,提高高龄、患慢性病的老年人等高危人群的接种率。     

海曙区老年人群肺炎疫苗接种意愿及影响因素分析

目的了解海曙区家庭医生签约门诊老年人群肺炎疫苗接种意愿及影响因素。方法采用分层随机抽样方法对宁波市海曙区两个社区卫生服务中心和两个镇卫生院签约门诊管理的65岁以上老年人进行肺炎疫苗接种意愿调查,对数据进行χ~2检验、二分类多因素Logistic回归分析。结果在568名调查对象中,32.92%签约门诊老年人表示愿意接种肺炎疫苗,5.99%签约门诊老年人表示曾经接种了肺炎疫苗。多因素Logistic回归分析结果显示,65～74年龄组、有医保历年余额、有肺炎疫苗免疫史、有流感疫苗免疫史、两种以上慢性病患病史、签约门诊医务人员推荐接种是老年人群肺炎疫苗接种意愿的影响因素。结论海曙区家庭医生签约门诊老年人群肺炎疫苗接种意愿较低,应开展肺炎疫苗接种知识宣传、签约门诊肺炎疫苗接种健康处方等干预措施提高老年人群的肺炎疫苗接种意愿,从而提高老年人群的肺炎疫苗接种率。     

上海市老年人肺炎疫苗接种意愿及影响因素分析

目的了解上海市老年人肺炎疫苗接种的意愿,分析影响接种的因素,为制定相关的干预措施,提高老年人肺炎疫苗接种率,降低社区老年人肺炎球菌相关疾病的发生提供依据。方法通过分层随机抽样的方法,选取年龄≥60岁上海市户籍老年人,自拟《老年人群肺炎疫苗知晓情况及接种意愿调查表》进行问卷调查,采用多元Logistic回归分析方法,分析接种肺炎疫苗意愿的影响因素。结果共有3 569名调查对象完成问卷调查(合格率96.41%);36.0%(n=1 283)老年人表示愿意接种肺炎疫苗。多因素Logistic回归分析显示,高年龄组接种意愿低(OR=0.37,95%CI:0.28~0.51),不认为肺炎是一种严重疾病组接种意愿低(OR=0.81,95%CI:0.66~0.99),不认为肺炎可以被预防组接种意愿低(OR=0.61,95%CI:0.47~0.80)。结论老年人对肺炎疫苗的认知是影响其是否愿意接种的重要因素,对肺炎疫苗加强针对性的宣传对提高肺炎疫苗接种率具有重要作用。     

长沙市老年人肺炎疫苗接种率及影响因素研究

目的了解长沙市老年人肺炎疫苗的接种率及其影响因素。方法 2017年11～12月从长沙市9个县市区中随机抽取2个县市区,每个县市区再分别随机抽取2个乡镇/街道,每个乡镇/街道各调查106名60岁以上老年人(共424人),开展问卷调查,对肺炎疫苗接种率及影响因素进行分析。结果长沙市老年人肺炎疫苗接种率为5.77%;居住地区类型、退休前职业、文化程度、个人月收入、是否知道老年人易得肺炎、是否知道肺炎疫苗、是否知晓山东疫苗事件、是否患有其他慢性病差异有统计学意义(χ~2=9.251、45.080、54.309、48.669、33.883、82.348、31.762、11.010,P0.05)。多因素logistic回归分析显示,是否知道肺炎疫苗(OR=22.24, 95%CI:8.60～57.56)和是否患有其他慢性病(OR=0.15,95%CI:0.03～0.70)是影响肺炎疫苗接种率的主要因素(P0.05)。结论长沙市老年人肺炎疫苗接种率低,应开展多种途经、形式多样的宣传方式,加强对肺炎及肺炎疫苗相关知识的宣传,提高肺炎疫苗认知度和接受度,接种过程中适度放宽接种禁忌证的把握,提高慢性病老年人接种率。     

常州市武进区慢性病患者流感和肺炎疫苗接种意愿及影响因素

目的了解武进区慢性病患者对流感和肺炎疫苗的认识,探讨接种意愿及其影响因素,为促进慢性病患者接种流感和肺炎疫苗工作提出建议。方法采用自主设计的调查问卷,调查慢性病患者对流感和肺炎相关知识认知情况,并采用描述流行病学方法进行分析。结果共计1 354名慢性病患者纳入研究,平均年龄(64.18±6.76)岁,女性居多为759人(占56.06%)。流感、肺炎疫苗的知晓率分别为55.4%、45.4%;愿意接种2种疫苗的分别为138人(占10.19%)、117人(占8.64%);不愿意接种的主要原因依次为:不清楚疫苗可预防疾病(48.85%);患病及时治疗,未考虑预防(36.44%);身体健康,患病的概率很小(19.93%);疫苗非医保,价格难以承受(5.65%);疫苗预防作用不大(4.70%);其他原因(4.11%)。多因素logistic回归结果显示,年龄、平均月收入、职业、对健康关注情况与流感疫苗和肺炎疫苗接种意愿有关(P值均0.05)。结论武进区慢性病患者对流感和肺炎疫苗的接种意愿较低。应积极开展针对性宣教,提高他们对流感和肺炎疫苗的认知水平,引导慢性病患者主动接种疫苗。     

宝山社区老年人肺炎疫苗接种行为影响因素分析及家庭医生健康干预效果

目的通过调查分析宝山社区老年人肺炎疫苗接种意愿及行为的影响因素,探索建立基于家庭医生服务模式为基础的健康干预方案,以提高宝山社区肺炎疫苗接种意愿和接种率。方法随机选取宝山社区两个居委会,合计500名60岁及以上常住老年人进行肺炎疫苗内容的相关问卷调查,在调查的基础上,从不愿意接种疫苗的287名老年人中再随机抽取100名作为研究对象,分为干预组和对照组,各50名。由家庭医生对干预组制定和实施干预方案,比较干预前后两组肺炎疫苗接种意愿及行为改变的情况。结果 500名调查对象完成调查问卷(合格率100%),宝山社区老年人对肺炎疫苗知识的知晓率较低,仅占21%;老年人不愿意接种肺炎疫苗原因主要有担心疫苗有不良反应(31.01%)、身体不好不愿意接种(28.92%)和身体好不要接种(24.04%);主动获取肺炎知识、曾患肺炎、老慢支等呼吸系统疾病以及医生曾建议接种肺炎疫苗这些因素是影响老年人接种肺炎疫苗意愿的影响因素;家庭医生实施健康干预后,干预组肺炎知识、肺炎疫苗知识知晓率高于对照组(均P0.05),干预组肺炎疫苗的接种率高于对照组(P0.05)。结论加强对肺炎疫苗接种项目的社区宣传,并通过家庭医生实施发放宣传资料、开展知识讲座、知识竞赛等多种形式的健康干预,对提高老年人群肺炎和肺炎疫苗知识的知晓率、提高肺炎疫苗接受度和接种意愿、改变接种行为具有一定意义。     

家庭医生基于健康信念模式在老年人肺炎疫苗接种行为中的干预研究

目的通过分析上海某社区老年人肺炎疫苗接种行为影响因素,由家庭医生基于健康信念模式进行针对性干预,探索提高老年人接种肺炎疫苗意愿的干预策略,以提高肺炎疫苗在老年人中接种的覆盖率。方法随机选取辖区内1200名60岁及以上常住、未接种肺炎疫苗的老年人进行疫苗接种相关的问卷调查;并从不愿意接种疫苗的老年人中随机选取干预组和对照组各150名调查对象,由家庭医生进行基于健康信念模式的干预研究。结果共有1168名调查对象完成问卷调查(合格率为97.3%),30.99%的老年人表示有意愿接种肺炎疫苗;老年人患有慢性呼吸系统疾病及家人患有慢性呼吸系统疾病的、担心自己罹患肺炎、知道肺炎可以预防、知道肺炎疫苗及知道免费接种疫苗的调查对象肺炎接种意愿较高;不愿意接种的原因主要是担心不良反应(38.71%)、自认为没有必要(19.73%)和缺少医生建议(15.63%);家庭医生进行基于健康信念模式的干预,对老年人接种肺炎疫苗的意愿改变有明显效果(P0.001)。结论通过家庭医生进行基于健康信念模式的干预,加大宣传肺炎及其疫苗的相关知识,提高老年人对肺炎的预防意识,帮助老年人接受肺炎疫苗接种的益处、克服行为改变过程中的障碍,对提高老年人肺炎疫苗接受度和接种意愿具有重要作用。     

上海市嘉定区老年人肺炎疫苗接种意愿及影响因素调查

目的探索影响老年人肺炎疫苗接种意愿的因素,为制定老年人肺炎链球菌性疾病免疫策略及政策提供依据。方法以居委为单位进行随机整群抽样,抽取493名60岁以上的户籍老年人,采用自行设计的《老年人群肺炎疫苗接种情况调查表》进行调查。结果愿意免费接种肺炎疫苗的为264人,占53.5%。不愿意接种的原因主要是:担心发生不良反应(39.0%)、觉得没必要(31.8%)、接种禁忌证(12.1%)。Logistic回归模型显示老年人接种肺炎疫苗的意愿与其年龄有关。结论应通过有针对性的宣传等干预措施增加老年人肺炎疫苗接种意愿,从而降低老年人肺炎发病率。     

上海市静安区老年人免费肺炎疫苗接种意愿及其影响因素研究

目的研究老年人接种23价肺炎球菌疫苗的影响因素,促进老年人接种肺炎疫苗,为更好地落实老年人肺炎疫苗接种项目提出政策建议。方法采用按年龄段分层抽样方法在静安区每个街道各选取100名60岁以上的常住老年人,进行面对面问卷调查收集一般情况,健康状况,肺炎疫苗的知晓情况及接种意愿等信息。采用单因素和多因素logistic回归分析方法,分析影响老年人免费肺炎疫苗接种意愿的因素及相关情况。结果 47.60%的老年人知晓肺炎疫苗,53.80%的老年人愿意接种免费肺炎疫苗。老年人对免费肺炎疫苗的接种意愿与文化程度和对"上海市60岁以上老年人免费接种肺炎疫苗"项目的知晓有关,文化程度为大专以上的老年人(OR=0.27,95%CI:0.09~0.77)比文盲半文盲的更不愿意接种免费肺炎疫苗,听说过肺炎疫苗项目的老年人(OR=1.68,95%CI:1.07~2.64)比没听说过的更愿意接种免费肺炎疫苗。结论加强对肺炎疫苗接种项目的宣传,提高人群知晓率,针对各层次的人群开展知识讲座,避免认识的误区,可以促进老年人接种肺炎疫苗。     

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.     

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.     

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.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.