饮食因素对绝经期妇女骨质疏松影响

目的 了解饮食因素对绝经期妇女骨质疏松的影响,为指导绝经期妇女通过合理饮食预防骨质疏松的发生提供参考依据.方法 采用两阶段抽样方法对在黑龙江省哈尔滨市电力小区随机抽取的281名绝经期妇女进行问卷调查和骨密度测量.结果 调查的281名绝经期妇女中,检出骨质疏松患者115例,骨质疏松检出率为40.9%;其中50岁～、56岁～和61～65岁分别检出骨质疏松患者40,47和28例,骨质疏松检出率分别为31.5%,43.1%和62.2%;多因素非条件Logistic回归分析结果表明,食用粗粮≥100 g/d和饮用可乐是绝经期妇女骨质疏松的危险因素;食用五花肉、食用瓜类蔬菜≥75 g/d和食用芥兰类蔬菜≥10 g/d是绝经期妇女骨质疏松的保护因素.结论 多吃瓜类和芥兰类蔬菜、不饮用可乐、适量摄入粗粮和五花肉可以预防绝经期妇女骨质疏松的发生.     

莱芜市756例围绝经期妇女健康状况分析

围绝经期妇女由于卵巢功能的衰退,导致围绝经期综合症状,影响了个人生活质量。本研究对莱芜市756名围绝经期妇女的健康现状,进行问卷调查。现报告如下。1对象与方法1.1对象随机抽取莱芜市2个社区、1个乡镇,年龄在     

杭州市围绝经期妇女骨质疏松情况分析

目的:了解杭州市围绝经期妇女骨质疏松的发生情况。方法:对门诊或住院的围绝经期妇女进行骨质疏松情况调查。结果:杭州市围绝经期妇女骨质疏松的患病率为27.98%,患病率居中等偏下。围绝经期妇女的骨密度随着Kupperman评分的增加而降低,而骨密度越低骨质疏松的患病率越高。结论:通过调查围绝经期妇女骨质疏松情况有利于采取合理饮食,纠正不良生活习惯,加强运动等措施预防骨质疏松的发生。     

青岛市围绝经期妇女保健需求情况调查

目的 了解青岛市围绝经期妇女对围绝经期认识程度和保健需求,为制定保健措施提供依据.方法 采用整群随机抽样方法,选取青岛市区及城郊的1 600名35～59岁妇女作为调查对象,进行围绝经期妇女保健需求调查.结果 保健需求排在前5位的有:定期全面查体(54.56%)、围绝经期咨询(50.88%)、预防骨质疏松(42.56%)、预防老年痴呆症(39.19%)、保护关节功能(38.25%).只有16.56%的妇女了解围绝经期保健知识,知识主要来源于媒体(38.60%)、同事朋友(35.92%)、医疗机构(26.48%).围绝经期妇女性激素治疗(HT)率为4.13%,市区妇女性激素治疗(HT)率明显高于城郊妇女(χ2=15.36,P<0.01).结论 围绝经期妇女对保健需求迫切,保健知识贫乏,应深入开展健康教育,普及推广性激素治疗的相关知识.     

健康教育对社区绝经期妇女骨质疏松症知信行的影响

目的探讨健康教育对社区绝经期妇女骨质疏松症知信行的影响。方法选取218例围绝经期的妇女,随机分为对照组及观察组:观察组108例,进行健康教育干预,干预一年后通过调查问卷分析干预效果;对照组110例,不采取干预措施。结果两组研究对象干预前在骨质疏松知识、健康信念及预防保健差异无统计学意义(t=1.87、0.24、1.56,均P0.05)。干预后与对照组相比,观察组骨质疏松知识、健康信念及预防保健的分值更高且差异有统计学意义(t=8.46、6.02、22.79,均P0.01)。结论健康教育可纠正社区围绝经期妇女对骨质疏松的错误认知,树立健康理念,改善预防保健行为,可预防骨质疏松症的发生。     

基于logistic模型对影响绝经期妇女骨质疏松症的动物性饮食因素研究

目的描述绝经期妇女动物性食品摄入情况,探讨摄入动物类食品对骨质疏松的影响。方法随机抽取哈尔滨市区281名年龄在50岁至65岁之间的绝经期妇女。采用CRF健康问卷表进行调查;并使用双能X线骨密度仪(NorlandXR-36型)测量腰椎骨的骨密度。利用SAS9.1统计软件对绝经期妇女动物性食品摄入情况进行描述;控制混杂因素后,使用logistic回归分析骨质疏松与摄入动物性食品之间的关系。结果绝经期妇女平均每日肉类摄入量为82.25g,海产品为44.51g,蛋类为56.70g,奶制品为205.59g;单因素分析显示:年龄、肥胖、学历、收入、生育个数、蔬菜类及牛肉类食物与骨质疏松的患病有关(P<0.05)。多因素分析显示,动物性食物中的牛肉为骨质疏松发生的保护因素、蛋类为骨质疏松发生的危险因素(P<0.05)。结论绝经期妇女肉类、蛋类平均每日摄入量高于推荐摄入量,水产品、奶类平均每日摄入量低于推荐摄入量;食用动物性食品中的牛肉可能预防骨质疏松的发生,但过多的摄入蛋类可能增加骨质疏松的患病风险,未发现饮用牛奶与骨质疏松的患病存在关联。     

广州市社区中年妇女围绝经期保健的现状和影响因素

激素补充疗法 (ｈｏｒｍｏｎｅｒｅｐｌａｃｅｍｅｎｔｔｈｅｒａｐｙ ,ＨＲＴ)在我国绝经妇女中应用起步较晚 ,有关绝经和ＨＲＴ的知识和态度对绝经期妇女的健康行为影响较大。我们对广州市社区中年妇女围绝经期保健知识、态度和行为的现况进行了调查 ,为开展社区防治提供依据。一、对象与方法1.调查对象 :经多阶段抽样 ,在广州市随机抽取 2个居委会 ,按户籍本的身份证号调查所有≥ 45岁～ <5 5岁的妇女 ,共 2 2 0名。2 .方法 :(1)问卷设计与调查内容 :设计结构型围绝经期保健问卷 ,并经预调查修订。主要调查内容 :① 31个知识题 ,共 8个方…     

调节方式对围绝经期综合征影响的研究

[目的]了解不同调节方式对城乡女性围绝经期症状、抑郁发生及其程度的影响,指导临床选取更合理的干预方法.[方法]选取河北省7个地区,按照城乡分层在每地区随机抽取100名(城乡各50名)45～55岁妇女,共计700名作为研究对象,采用一般闻卷、Kupperman评分表和抑郁自评量表(CES-D)对研究对象进行调查.[结果]调查对象中有围绝经期综合症者占95.22%,抑郁发生率31.26%,围绝经期综合症及抑郁的发生与药物调节、运动调节相关,差异有显著性(P＜0.05),与保健品调节无关.[结论]运动调节对围绝经期综合征的效果好.     

围绝经期妇女骨质疏松干预的相关研究

目的:探讨教育干预对围绝经期妇女骨质疏松症的预防效果。方法:从增城地区选取400名符合要求的围绝经期妇女,平均分为A、B两组,A组为非干预组,B组为干预组,对A组只进行一般指导,对B组进行健康教育指导干预。记录两组妇女身高和体重,计算体重指数(BMI)。结果:两组妇女3个月、6个月时的骨密度检测结果无统计学差异,9个月和1年时骨密度检测结果有明显统计学差异。结论:加强围绝经期妇女骨质疏松的干预,能明显的改善围绝经期妇女的身体状况,为今后探索更加积极的防治措施,制定更加有效的干预模式提供有力的科学依据。     

老年绝经期妇女骨质疏松脊椎压缩骨折的防治

目的 :探讨老年绝经期妇女骨质疏松脊椎压缩骨折的综合防治方法。方法 :利用不同的抗骨质疏松药物对 113例绝经期妇女骨质疏松压缩骨折的患者进行了保守治疗 ,并辅以补充维生素、钙剂和物理疗法。结果 :雌激素、降钙素和二膦酸盐药物均有良好的缓解骨质疏松压缩骨折造成的骨痛症状 ,骨密度得到不同程度的提高。结论 :抗骨质疏松药物可明显缓解绝经期妇女骨质疏松椎体压缩骨折造成的骨痛症状 ,但不同的药物对症状的缓解速度不同。     

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.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.     

Psychopathological features of a patient population of targets of workplace bullying

BACKGROUND: A strong association between workplace bullying and subsequent anxiety and depression, indicated by empirical research, suggests that bullying is an aetiological factor for mental health problems. AIMS: To evaluate levels of stress and anxiety-depression disorder developed by targets of workplace bullying together with outcome at 12 months and to characterize this population in terms of psychopathology and sociodemographic features. METHODS: Forty-eight patients (36 women and 12 men) meeting Leymann Inventory of Psychological Terror criteria for bullying were included in a prospective study. Evaluations were performed at first consultation and at 12 months using a standard clinical interview, a visual analogue scale of stress, the Hospital Anxiety and Depression (HAD) scale, the Beech scale of stress in the workplace and a projective test (Picture-Frustration Study). RESULTS: At first consultation, 81% of patients showed high levels of perceived stress at work and 83 and 52% presented with anxiety or depression, respectively. At 12 months, only 19% of working patients expressed a feeling of stress at work. There was a significant change in symptoms of anxiety while there was no change in symptoms of depression. Stress at work and depression influenced significatively capacity to go back to work. At 12-month assessments, workers showed a significantly better score on the HAD scale than non-workers. Over half the targets presented a neuroticism-related predominant personality trait. CONCLUSION: Workplace bullying can have severe mental health repercussions, triggering serious and persistent underlying disorders.     

The rise and fall in incidence of malignant mesothelioma from a British Naval Dockyard, 1979-1999

BACKGROUND: The incidence of malignant mesothelioma in Britain is predicted to rise over the next 15-25 years because of past failure to protect the workforce against inhalation of asbestos. In British Naval dockyards, alternative insulation materials and respiratory protection were introduced from the mid-1960s. Aims This study was carried out to investigate the effects of these control measures on mesothelioma deaths in dockyard workers. METHODS: Cases of mesothelioma of the pleura and peritoneum between 1979 and 1999 in workers from the Devonport Naval Dockyard, south-west England, were sought from coroners' and medico-legal records. RESULTS: Three hundred and one cases were identified, 7% peritoneal. The peak incidence occurred in 1991 with 25 cases per annum (quadratic model fit R(2) = 74.2%, P < 0.001) and we predict that by 2003 the incidence will fall to fewer than five cases per annum. The mean time between first exposure and presentation was 48.5 years [95% confidence interval (CI) = 47.3-49.8], but this was significantly shorter in the more heavily exposed trades, when compared with the less heavily exposed (42 years, 95% CI = 39.0-45.0, versus 49.5 years, 95% CI = 48.2-50.9). Those with higher exposure were also at significantly greater risk of peritoneal disease (P < 0.023, Fisher's exact test). CONCLUSION: The reduction in incidence of mesothelioma is greater than can be accounted for by reduction in numbers of dockyard workers over the last 50 years. Changes in insulation materials and improved industrial hygiene measures introduced into the Devonport Dockyard from the mid-1960s have resulted in an earlier decline in the incidence of malignant mesothelioma than that predicted for the British workforce as a whole.     

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.     

Organophosphate toxicity and occupational exposure

The ubiquitous organophosphates present a continuing health hazard in agriculture, public health eradication programmes and as chemical warfare agents. Despite significant progress in understanding the potential mechanisms of toxicity far beyond the commonly accepted mechanism of cholinesterase inhibition in intentional exposures, the precise health effects following occupational exposures are yet to be completely defined. A much greater understanding exists of the clinical features of organophosphate poisoning. These are characterized by a triphasic response involving an initial acute cholinergic phase, an intermediate syndrome (both associated with high mortality) and a disabling but non-lethal delayed polyneuropathy. The delayed polyneuropathy may occur in the absence of the cholinergic or intermediate phases. However, progress is still required in order to improve the quantification and assessment of occupational exposures and the implementation of appropriate preventive measures. Finally, evidence-based guidelines for appropriate or optimal therapeutic interventions following poisoning are required urgently and collaborative work with colleagues in developing countries, where the occurrence of organophosphate exposures is more frequent, may provide the answers.     

Miliaria rubra of the lower limbs in underground miners

This report documents a case series of miliaria rubra of the lower limbs in miners at a deep underground metalliferous mine in tropical arid Australia. During the summer months of February and March 1999, all cases of miliaria rubra of the lower limbs in underground miners seen at the mine's medical centre were clinically examined and administered a questionnaire. Twenty-five patients were seen, an incidence of 56.4 cases per million man-hours. Miliaria rubra was most often located between the ankle and knee (88% of cases). Twenty-four percent had concurrent folliculitis and 20% had concurrent tinea. Thirty-two percent had a personal history of asthma. Walking through ground-water and splashing of the legs was common. Three to 4 weeks of sedentary duties in air conditioning was generally required to achieve resolution of miliaria rubra. The incidence of miliaria rubra of the lower limbs is 38% of the incidence of heat exhaustion at the same mine. The length of disablement is greater, however. Atopics may be at increased risk of miliaria rubra. Control measures are discussed.     

Die sogenannte Vinylchlorid-Krankheit—eine berufsbedingte Systemsklerose?

Zusammenfassung Es wurden 13 Arbeiter untersucht, die zwischen 1 3/4 und 18 Jahren in einem PVC-herstellenden Betrieb beschäftigt waren. 8 von ihnen wiesen sklerodermieartige Hautveränderungen (Abb. 2) auf, die histologisch charakterisiert sind durch Verbreiterung und Homogenisierung der kollagenen Faserbündel (Abb. 3 u. 4) sowie Fragmentation und Rarefizierung der elastischen Fasern (Abb. 5). Bei 7 Patienten bestanden trommelschlegelartige Auftreibungen einzelner Fingerendphalangen (Abb. 1). 11 Patienten zeigten Durchblutungsstörungen der Extremitäten (4 von diesen ein Raynaud-Syndrom) und 6 Patienten Acroosteolysen einzelner Fingerendphalangen (Abb. 6, Tabellen 1–3).Darüber hinaus bestand bei allen Patienten eine Thrombocytopenie, bei 12 Patienten eine Splenomegalie, bei 11 Patienten eine Einschränkung der Leberfunktion (erhöhte BSP-Retention). An der Leber ließ sich histologisch bei den 5 laparoskopierten Patienten eine deutliche Fibrosierung der Portalfelder nachweisen. Bei 4 Patienten bestanden Oesophagusvaricen (Tabellen 4 u. 5). 8 Patienten zeigten eine Partialinsuffizienz mit Hinweisen für vorwiegend restriktive Veränderungen.Die hier beschriebenen Veränderungen gehen weit über das bisher bekannte Acroosteolysesyndrom hinaus. Es wird der dringende Verdacht geäußert, daß langfristige Vinylchlorid-Exposition dieses komplexe Krankheitsbild verursacht. Daher wird für diese systemische Krankheit die Bezeichnung Vinylchlorid-Krankheit vorgeschlagen.Wir danken Frau E. Voigtländer für die Herstellung der klinischen und histologischen Abbildungen.