云南省陇川县男性静脉吸毒青年共用注射器具危险因素分析

以１９９４年８～１０月在云南省陇川县１８～２９岁男性青年断面调查中发现的静脉吸毒者为研究对象,运用回顾性队列研究设计,观察期为１９９１年１月１日至１９９４年８月１日,采用单因素及多因素分析方法,研究了静脉吸毒者共用注射器具行为的决定因素。在回顾性队列研究期间,静脉吸毒者中共用注射器具的年新发生率平均为１９．６％。多因素分析结果显示,除民族以外的其它人口学特征、吸烟、饮酒及婚前（婚外）性行为,对静脉吸毒者中共用注射器具的发生无预测作用,而景颇民族则是合用注射器具的主要危险因素（ＯＲ＝５．８,９５％Ｃ．Ｉ．２．５～１３．８）,其人群归因危险度为５８．５％。我们认为,对于景颇族静脉吸毒者中很高的合用注射器具行为需要进一步研究。针对合用注射器具行为的ＨＩＶ预防性干预工作,应以景颇族静脉吸毒者为主要目标人群     

四川省抽样人群中高血压危险因素研究

根据四川省１９９１年度高血压抽样调查资料，采用病例－对照的研究方法，结合条件Ｌｏｇｉｓｔｉｃ回归模型，分析了高血压的危险因素。结果表明，影响高血压的主要危险因素是：体重指数（ＯＲ＝１．６６１，９５％ＣＩ：１．５２９～１．８０４）、高血压家族史（ＯＲ＝１．２５８，９５％ＣＩ：１．１６４～１．３６０）、脉率（ＯＲ＝１．５３９，９５％ＣＩ：１．２４９～１．８９８）、卫生知识水平（ＯＲ＝１．０５８，９５％ＣＩ：１．０２９～１．０８８）和每日酒精摄入量（ＯＲ＝１．１９０，９５％ＣＩ：１．０４２～１．３５９）。从本次调查资料，我们未发现吸烟与高血压有关联。     

生活,饮食等因素与消化性溃疡患病危险的病例—对照研究

对消化性溃疡（ＰＵ）患病危险因素的配比研究结果表明，单因素分析筛选出ＰＵ家族史、慢性萎缩性胃炎（ＣＡＧ）家族史、进餐无定时，晚睡前饮食、偏咸口味、吸烟、Ａ型性格、偏硬饮食８个变量与ＰＵ有显著性联系，其中吸烟与ＰＵ患病危险呈剂量反应关系。同时将筛选出的８个变量引入Ｌｏｇｉｓｔｉｃ回归模型分析，提示５个变量为ＰＵ患病的主要危险因素：ＰＵ家族史（ＯＲ＝５．５５）、进餐无定时（ＯＲ＝２．５９７）、偏咸口味（ＯＲ＝１．８５）、睡前饮食（ＯＲ＝１．６６）、吸烟（ＯＲ＝１．３６）。     

云南省某县男性青年吸毒现象调查

为了解吸毒现象，于１９９４年８～１０月对云南省某县８２个自然村或生产队的１８～２９岁男性青年进行了调查。共调查１５４８人，发现吸毒者４３３人，吸毒率２８％。绝大多数吸毒者是在８０年代中期以后开始吸毒，且新吸毒人数逐年上升。景颇族的吸毒率显著高于汉族和傣族；文化程度与吸毒率呈反向剂量反应关系；吸烟、饮酒和有婚前／婚外性行为男青年的吸毒率显著高于没有这些因素的青年；而且，吸毒率与累计吸烟量和累计饮酒量呈正向剂量反应关系，与开始吸烟年龄、开始饮酒年龄及第一次性生活年龄呈反向剂量反应关系；被朋友、他人鼓励尝试毒品和家庭成员中有人吸毒的青年，吸毒率显著高于没有这些因素的青年。提示，吸毒现象在该县的男青年中比较严重，预防青少年吸毒的工作必须尽快开展起来     

孕产妇死亡病例对照研究

本文对山西省阳城县１９８９～１９９１年５５例死亡孕产妇按１：２配比进行了病例对照研究。经单因素、多因素条件Ｌｏｇｉｓｔｉｃ回归分析，从１８个研究因素中筛选出４个危险因素，它们是妊娠合并症（ＯＲ＝８．９９）、异常孕产史（ＯＲ＝３．７６）、计划外生育（ＯＲ＝３．２０）和非足月分娩（ＯＲ＝１６．０７）。     

中学生腰背痛的流行病学调查

用统一的调查表及体检资料，对成都市某中学１５５８名学生进行腰背痛流行病学调查。结果：５５．１％的学生有腰背痛病史，现患率为４２．８％，患病率随年级增大而增高。腰背痛学生中，１７．２％因腰背疼痛影响上学或活动，６．６％因腰背痛就医。腰背痛的相关危险因素有腰伤史（ＯＲ＝２．７５）、坐位时间≥１０ｈ（ＯＲ＝１．６０）、坐姿不正确（ＯＲ＝１．５６）、体质指数≥２２（ＯＲ＝１．４５）以及睡眠用枕头≥２个（ＯＲ＝１．３２）。     

巢式病例对照研究在通气相关肺炎危险因素调查中的应用

目的研究通气相关肺炎（ＶＡＰ）的致病危险因素。方法采用巢式病例对照研究的方法,对５８例确诊为通气相关肺炎（ＶＡＰ）的病例,按同科室、同性别、年龄相同或相近（±５岁）,入院时间相同或相近（＜１周）,病情相似,１∶１配以５８例对照探讨ＶＡＰ的危险因素。结果对２０多种可能的危险因素进行单因素分析。有１６种呈显著性差异。对这１６种主变量进一步进行多因素条件性Ｌｏｇｉｓｔｉｃ回归分析表明：基础病情重（ＯＲ＝９．４０）、留置胃管（ＯＲ＝８．８６）、患者意识状态差（ＯＲ＝８．３９）、气管切开（或插管）时间长（＞２周）（ＯＲ＝６．８９）、有颅脑外伤（ＯＲ＝６．６０）、频繁更换呼吸机接头插管（ＯＲ＝６．４４）、应激性溃疡预防用药（ＯＲ＝５．５２）、住院时间长（＞１月）（ＯＲ＝４．３１）为ＶＡＰ发生的独立危险因素。结论ＶＡＰ的发生是多因素综合作用的结果,且证明存在胃→咽→下呼吸道的逆行感染途径     

吸毒人群丙型肝炎病毒感染危险因素的研究

采用病例对照的研究方法,对广州市５３１名吸毒人员进行丙型肝炎病毒（ＨＣＶ）感染危险因素的调查,资料采用Ｌｏ－ｇｉｓｔｉｃ回归方法分析。结果表明：静脉吸毒（ＯＲ＝６．６８,Ｐ＜０．００１）,非固定婚外性伴侣（ＯＲ＝３．７１,Ｐ＜０．００１）,输液史（ＯＲ＝２．６４,Ｐ＜０．０１）和抗－ＨＢｃ阳性（ＯＲ＝１．７４,Ｐ＜０．０５）是ＨＣＶ感染独立的危险因素,而在性生活中使用避孕套（ＯＲ＝０．３７,Ｐ＜０．００５）是保护因素。提示广州市吸毒人群ＨＣＶ感染的主要途径是血液传播,同时性传播途径也起着重要的作用。     

儿童脑瘤危险因素研究

采用１：３配比的病例对照研究方法，对１９９１年３月至１９９４年１２月期间，在哈尔滨市六大医院诊断的儿童脑瘤患儿（共５６例），进行危险因素研究。经单Ｂ素和多Ｂ素条件Ｌｏｇｉｓｔｉｃ回归分析，结果表明：既往头部外伤史（ＯＲ＝４．３３），父亲职业性接触农药或汽油（ＯＲ＝４．２６）和父亲饮白酒史（ＯＲ＝１．３５）三因素为儿童脑瘤发病的重要危险因素。     

饮食与胃癌关系的病例对照研究

目的探讨鱼露摄入及饮食、生活习惯与胃癌发生的关系。方法１９９４年５月～１９９５年７月，在胃癌高发区福建省长乐、福清两市，进行以人群为基础１２配对的病例对照研究。共调查２７２对。结果危险状态的单因素检验提示，过量摄入鱼露（ＯＲ＝２．５７）、腌制蔬菜（ＯＲ＝１．４１）、腌制海产品（ＯＲ＝１．５７），少吃新鲜蔬菜（ＯＲ＝１．９５）、柑桔类水果（ＯＲ＝１．４１）、其他水平（ＯＲ＝１．３１）、绿茶（ＯＲ＝１．７２），以及暴露于霉粮（ＯＲ＝２．３２）、三餐不定时（ＯＲ＝５．４７）、家族肿瘤史（ＯＲ＝３．２７）等与胃癌的发生存在显著性正关联。未发现吸烟、饮酒、盐摄入量、使用冰箱等与胃癌间的联系。危险状态的条件Ｌｏｇｉｓｔｉｃ回归分析，入选最佳子集的因素为鱼露、腌制海产品、三餐不定时和家族肿瘤史。４个因素的综合归因危险度为７５．４９％。结论过量摄入鱼露、腌制食品、霉粮，及三餐不定时、家族肿瘤史等可能是当地胃癌高发的危险因素。而新鲜蔬菜、水果，绿茶等可能具有保护作用。     

Tobacco smoking among Portuguese high-school students.

The aim of this study was to evaluate the prevalence, behavioural patterns, and determinants of smoking among a large sample of high-school students from Porto, the second largest city in Portugal, information on sociodemographic characteristics and personal history of tobacco, alcohol, coffee, and illicit drug use was obtained from 2974 students, aged 12-19 years (48.7% female, 51.3% male), using an anonymous self-administered questionnaire. Crude and adjusted odds ratios (OR) were calculated by logistic regression analysis to estimate the association between smoking and the characteristics evaluated. Overall, 35.8% students had never smoked, 39.4% had tried it ("experimental" smokers) but were not smokers, 3.3% were former smokers, 6.6% occasional smokers, and 14.9% regular smokers. The mean age for starting smoking was 13.4 +/- 2.1 years for males and 13.4 +/- 1.6 years for females. The prevalence of current smoking was higher among males than females, but the difference was not significant. Male students were significantly more likely to smoke more cigarettes per day than were females. The prevalence of smoking was significantly associated with the following variables: being aged > 12 years; having parents who had attended school for < 4 years; having a mother (OR = 1.88), siblings (OR = 1.96) or friends (OR = 1.75) who smoked; low academic performance (OR = 1.74 for one or two failures and OR = 2.27 for more than two failures at school); and consumption of coffee (OR = 2.90), alcohol (OR = 3.53), or illicit drugs (OR = 6.69). The prevalence of smoking among adolescents increased with age. There is therefore a need for school-based tobacco prevention programmes which also deal with family influences on smoking.     

Prevalence and Sociobehavioral Correlates of Tobacco Use Among Hispanic Children: The Tobacco Resistance Activity Program

ABSTRACT: To examine tobacco use patterns and its sociobehavioral correlates among Hispanic in-school youth, a tobacco use and knowledge survey was administered to 660 children from fourth through sixth grade classes, of which 69% (n = 453) were of Hispanic origin. Male Hispanics were more exposed to previous tobacco use (38% vs. 20%, p < .01), reported more current smoking, had more smoking friends, received more cigarette offers, and wanted to try a cigarette compared to females (all p < .05). Also, more previous alcohol use was noted in the previous tobacco users, indicating its potential as a "gateway drug." From multivariate analyses, being offered cigarettes was the strongest environmental indicator of previous tobacco usage, followed by having adult smokers in the house, smoking friends, (all p < .01), and being around other smoking youth (p < .05). This study offers additional knowledge about factors that may cause Hispanic youth to initiate smoking, and suggests the need to address peer and social influences in school-based substance abuse programs. (J Sch Health. 1993;63(9):391–396)     

云南省德宏州不同民族吸烟行为及对烟草危害认识的对比分析

目的 对比分析德宏州汉族、傣族、景颇族的吸烟现状和对吸烟危害相关知识的认识情况。方法 采用多阶段分层抽样的方法,随机抽取7 052名15岁及以上常住居民进行问卷调查,包括吸烟及相关知识情况。结果 汉族、傣族、景颇族居民的吸烟率分别为33.4%、35.9%、48.1%;被动吸烟率分别为44.5%、47.5%、46.4%。3种民族的男性吸烟率均远高于女性（χ2=1425.837,χ2=895.092,χ2=435.822,P<0.001）。3种民族中,男性吸烟者的初次吸烟年龄均以在15~24岁组所占比例最高（χ2=27.645,χ2=23.752,χ2=139.740,P<0.001）。景颇族吸烟者每日吸烟量少于汉族和傣族吸烟者,而汉族吸烟者每日吸烟量高于傣族和景颇族吸烟者（χ2=123.190,P<0.001）。汉族和傣族的女性居民对吸烟会导致胃肠道疾病、糖尿病、流产的正确回答率高于男性居民（χ2=13.014,χ2=11.114,P<0.01;χ2=12.721,P<0.01,χ2=6.747,P<0.05;χ2=35.559,χ2=19.932,P<0.001）;汉族女性居民对吸烟会导致脑卒中的正确回答率高于汉族男性居民（χ2=12.585,P<0.01）。结论 云南省德宏州的傣族、景颇族居民具有吸烟率高,但对烟草危害知识的知晓率低的特点。因此应加强健康教育,提高该人群对烟草危害的认识,减少烟草对少数民族的健康危害。     

Predictors of the onset of tobacco consumption among secondary school students of Barcelona and Lleida

BACKGROUND: Knowing the factors predisposing the smoking onset of smoking at school age may help to improve the preventive strategies and make the starting age later. This study is set out to describe the natural history of smoking throughout the teen-age years and the main factors which may predict teenagers developing the smoking habit. METHODS: This is a longitudinal study of a survey type, using the school room as the sampling unit at six schools in Barcelona and Lleida. A total of 1,460 students within the 12-19 age range took part. Two surveys were conducted, an initial survey in the spring of 1992 and a follow-up survey one year later. A total of 1,236 questionnaires (84.3%) were paired by means of a personal code used for the longitudinal study. RESULTS: A total of 25% of the students were regular smokers at the start of the study, 17.1% smoking occasionally or having experimented with smoking, there being no differences between sexes for both of these categories. Among those who were non-smokers at the starting survey, 12.7% stated that they smoked occasionally and 6.2% regularly one year later. The females started smoking at an earlier age, the differences as compared to males being statistically significant at 14 years of age. The predictors of the smoking onset include favorable attitudes toward cigarettes (OR = 3.1; CI5% (1.6-5.6), drinking alcoholic beverages (OR = 2.2; CI95% (1.4-3.3), being younger than age 15 (OR = 2.0; CI95% (1.2-3.4), having friends who smoke (OR = 1.9, CI95% (1.2-3.0) and the stated intention of smoking in the future (OR = 1.6; CI95% (1.0-2.5). CONCLUSIONS: The students showing a higher degree of tolerance toward cigarette smoking, entailing favorable attitudes or friends who smoke or who intend to smoke in the future at the start of the study are at a much higher risk of Smoking onset than their classmates who are not of these characteristics. The cigarette smoking prevention programs must focus special attention on the teenagers most highly vulnerable to these factors.     

Prevalence of youth access to alcohol, guns, illegal drugs, or cigarettes in the home and association with health-risk behaviors

PURPOSE: To describe the prevalence of access to alcohol, guns, drugs, or cigarettes in the home and its association with related health-risk behaviors among adolescents.METHODS: We analyzed cross-sectional data from the 1995 in-home survey of the National Longitudinal Study on Adolescent Health which used a nationally representative school-based sample (N = 6,504) of adolescents in grades 7-12. We used logistic regression analysis, adjusted for gender, race/ethnicity and age, to examine the associations between access to alcohol, guns, drugs, and cigarettes in the home and the practice of risk behaviors involving those variables.RESULTS: Overall, 1,817 (28%) adolescents reported having easy access to alcohol in the home, 1,616 (25%) had access to a gun, 189 (3%) had access to drugs, and 2,067 (32%) had access to cigarettes. Associations were found between easy home access to alcohol and drinking during the past 12 months (Adj. OR = 2.16, 95% CI = 1.89-2.47), ever being drunk at school (Adj. OR = 2.33, 95% CI = 1.85-2.95, and ever driving drunk (Adj. OR = 1.64, 95% CI = 1.29-2.09). Access to a gun at home was associated with carrying a gun to school (Adj. OR = 2.54, 95% CI = 1.40-4.64). Associations were also found between access to drugs and cigarettes in the home and ever using drugs and smoking regularly.CONCLUSIONS: Easy access to alcohol, guns, and cigarettes in the home is prevalent among adolescents and may increase involvement in risky behaviors. Limiting access therefore is important in order to reduce the occurrence of health-risk behaviors associated with substance use, deliquency and injury among adolescents.     

Change in the drugs administration pattern in the Basque Country Community. The 1991-1996 trend

BACKGROUND: A reduction of intravenous route as a method of consuming drugs and a change towards to the use of less morbid routes has taken place in the last years in national and international contexts. Our objective was to examine change trends in the drugs administration route in the Basque Country Community and to explore factors associated with the injected route (IR) use. METHODS: A time-based series of cross-sectional studies using data provided by the Information System on Drug Abuse (SIT) of the Basque Government was used. A total of 12,382 admissions to treatment produced between the years 1991 to 1996 was analyzed. For the analysis of trends linearity test was play and for the estimation of the association between explanatory variables and outcome variable logistic regression model was carried out. RESULTS: A significative change in the route of drugs administration (chi 2 = 621.3; p < 0.001) is evidence, having decreased the prevalence of IR use from 83% 1991 to 52.3% in 1996. The adjusted regression model (-2LL = 10,766.7) reveals the age of the drugs users as a protective variable (OR = 0.94; IC95% = 0.93 to 0.95). On the contrary, being man (OR = 1.25; IC95% = 1.11 to 1.39), having received previous treatments (OR = 2.63; IC95% = 2.38 to 2.90), being heroine the drug that motivates the demand for treatment (OR = 9.41; IC95% = 7.24 to 12.2), and the greater number of consumption years (OR = 1.14; IC95% = 1.13 to 1.16), are presented as factors associated with a greater utilization of the Injected Route. CONCLUSIONS: Even though it has been observed a reduction of the use of the injected route over the years, a prevalence of the 52.3% in 1996 continues being too high. It is discussed the need of persisting in the application of harm reduction and risks prevention strategies.     

陇川县2007-2009年暗娼人群艾滋病综合监测分析

目的:对云南省陇川县暗娼人群艾滋病综合监测结果进行分析。方法:于2007年至2009年间连续3年在知情同意的情况下采用面对面的问卷调查和采血样监测对陇川县城内的暗娼进行普查。建立数据库并进行统计学分析。结果:陇川县暗娼人群的中位年龄为24～25岁,以汉族为主、景颇族次之,初中文化程度为主。3年间,暗娼人群艾滋病知识知晓率逐年显著升高;最近一次商业性行为以及最近一个月商业性行为中安全套使用率也显著提高;吸毒者所占比例下降。2007年至2009年历年梅毒检测阳性率分别为:3.65%、1.65%和0,HIV的检测阳性率分别为:6.57%、4.13%和1.56%。结论:2007-2009年陇川县暗娼艾滋病综合监测取得了一定的效果,但仍需加大相关工作力度。     

Evaluation of a Health Promoting Schools program to reduce smoking in Australian secondary schools

This randomized controlled trial evaluated the effectiveness of a multicomponent Health Promoting Schools (HPS) intervention program in improving self-reported smoking outcomes among a cohort of adolescents in 22 public secondary schools in the Hunter Region of New South Wales, Australia. Pre-test surveys were completed by students in the first 2 years of secondary school, with a 2-year post-test survey. Multivariate analyses examined intervention effect for the main outcome, post-test smoking behavior, controlling for pre-test smoking status, school and other confounders. The sample comprised the cohort of 1852 students who completed both surveys. The results demonstrated that the HPS program failed to improve smoking behavior over the 2 years (equal increase of 10% in both groups). The program was successful in improving smoking knowledge, but not attitudes, in intervention versus control group (P < 0.001). Independent predictors of post-test smoking included: pre-test smoking [odds ratio (OR) = 5.44; 95% confidence interval (CI) = 3.20-9.28], being female (OR = 0.55; CI = 0.35-0.87), having more close friends who smoked (OR = 1.42; CI = 1.33-1.52), peer group having no clear opinion about smoking (OR = 3.23; CI = 1.27-8.27), having more positive and less negative attitudes towards smoking, and being less involved in school activities. We discuss methodological issues in multicomponent community-based interventions, and highlight the strengths and limitations of this study.     

Alcohol, cigarette, and marijuana use among fourth-grade urban schoolchildren in 1988/89 and 1990/91.

A public-school-based epidemiological survey of fourth-grade students in Washington, DC, was performed in 1988/89 (n = 4675) and 1990/91 (n = 4678). Comparisons of data for the two periods revealed that the lifetime prevalence of self-reported alcohol use, alcohol use without parental knowledge, and smoking more than a puff of cigarettes declined; marijuana use and cigarette experimentation did not. Seven variables were associated with use. Declines were observed in perceived peer pressure to use; seeing a family member/friend selling drugs; and being offered alcohol, cigarettes, or marijuana by peers. No declines were observed in family use, perceived friends' use, being bothered a lot if best friends use, or seeing someone else selling drugs.     

Electronic Cigarette Use and Attempts to Quit Smoking Cigarettes Among Adolescents in Taiwan

Purpose

This study assessed the relationship between electronic cigarette (e-cigarette) use and attempts to quit smoking cigarettes by adolescent smokers in Taiwan.