北京市朝阳区社区居民健康行为及社区卫生服务需求调查

目的 了解朝阳区居民健康行为及社区卫生服务需求,为社区卫生服务规划提供参考.方法 调查对象中,以家庭为抽样单位实施整群抽样法,对朝阳区18岁以上户籍人口实施问卷调查,最终抽取83 475名调查对象.结果 高中以下学历者52.4%,离退休人员37.0%,无业人员9.6%;调查对象吸烟率20.5%、缺乏体育锻炼率34.7%、轻体力劳动者86.1%;对社区医生水平不放心（40.3%）、药品种类不齐全（33.8%）是居民不愿意到社区卫生服务机构看病的主要原因;取药（72.2%）、打针输液（71.9%）是居民到社区卫生服务机构的主要需求.结论 政府应进一步加强社区老年保健、提高社区医生专业水平、增加基本药物种类,促进居民社区卫生服务利用率;居民生活行为危险因素众多,加强健康教育等措施势在必行.     

"非典"对广州市社区居民健康意识影响的调查

为了解广州市社区居民在突发公共卫生事件时个人和家庭防病意识,卫生行为状况,为有针对性地开展社区健康教育提供依据,广州市健康教育所于2 0 0 3年以问卷的方式对本市部分社区居民进行相关知识、行为调查,结果如下。对象与方法1 对象　广州市1 3个行政区中的42个街道和社区共计447人。其中男性1 96人,女性2 5 1人;年龄在1 0～92岁。2 方法　问卷以健康防病知识、个人健康行为为主要内容并了解接受信息来源等问题1 0条,满分1 0 0分。问卷无记名随机对447例社区居民进行调查。结　　果1 社区居民接受健康教育信息来源(见表1 )。2 社区居…     

社区妇幼健康教育需求分析

为使妇幼卫生服务进一步走入家庭,满足不同层次妇女儿童的保健需求,开展以家庭为基础的社区妇女儿童健康保护、健康促进及社区生殖保健服务,确定服务的优先领域,北京市朝阳区妇幼保健院于1998年进行了“社区母乳喂养情况”和“社区妇幼健康服务”抽样调查,其中内容之一是社区妇幼健康教育的需求。对象和方法1对象　居住在本社区1年以上的人口,包括常住人口和暂住人口;以有学龄前儿童的家庭为调查单位,包括儿童的母亲和45岁以上的妇女。2方法　采取随机抽样法,抽取4个街道办事处(朝外大街、双井、潘家园、八里庄)中22个保健地段。调查员统一…     

深圳居民膳食结构与膳食营养素摄入状况研究

目的 了解深圳居民的膳食结构、营养素摄入现状,为制定卫生政策和指导居民合理饮食提供科学依据.方法 2009年6-7月,运用多阶段整群随机抽样法,抽取深圳市8个行政区中73个社区,每个社区抽取120户居民中15岁以上常住居民(每户随机抽1人,共8 782人).再从中抽取50%对象进行膳食调查.采用食物频率法获取调查对象过...     

桂林市社区已婚育龄妇女健康知识认知、态度和行为状况及其影响因素分析

目的:了解桂林市社区已婚育龄妇女健康知识的认知、态度与行为状况,并分析其影响因素,为不断提高社区已婚育龄妇女的健康状况、制定科学有效的健康教育干预策略提供参考依据.方法:采用分层整群抽样的方法随机抽取600名已婚育龄妇女,应用《社区卫生诊断调查问卷》对其进行现场问卷调查,运用Epidata 3.1和SPSS 13.0软件进行资料的整理与统计学分析.结果:桂林市社区已婚育龄妇女对健康知识的总知晓率为56.9％,健康相关行为的正确持有率为70.3％.Logistic回归分析结果显示,家庭人口数、文化程度和年龄是影响社区已婚育龄妇女健康知识知晓率的主要因素;文化程度、户口性质、健康知识知晓情况是影响健康相关行为正确持有率的主要因素.结论:桂林市社区已婚育龄妇女健康知识的知晓率和健康相关行为的正确持有率普遍较低,应加强已婚育龄妇女的健康教育,重点加强生殖健康方面的健康教育,健康教育的重点目标人群为文化教育程度低、流动人口、家庭规模大及年龄低的已婚育龄妇女.     

我国中西部4省(自治区)农村居民生殖健康知识知晓现状及其影响因素分析

目的了解我国中西部4省(自治区)农村居民生殖健康知识知晓情况及分析影响因素。方法采用多阶段整群抽样方法对在甘肃、青海、山西和新疆4个省(自治区)16个项目县抽取的84个行政村共5443名农村社区居民进行问卷调查。结果有2570名(47.2%)调查对象知道至少1种生殖道感染症状,男性的知晓率(34.2%)低于女性(56.2%),差异有统计学意义(χ2=253.540,P<0.01)。在8种生殖道感染症状中,调查对象对外阴瘙痒的知晓率较高(37.6%)。有64.2%的未婚女性、56.3%的已婚女性、69.8%的未婚男性和71.7%的已婚男性不知道生殖道感染途径。多因素分析表明,民族(OR=0.591,95%CI:0.473～0.737)、性别(OR=2.572,95%CI:2.289～2.889)、婚姻状况(OR=1.573,95%CI:1.192～2.075)和文化程度(OR=1.491,95%CI:1.398～1.590)与生殖道感染症状知晓情况有关联,民族(OR=0.751,95%CI:0.592～0.953)、性别(OR=1.985,95%CI:1.760～2.239)和文化程度(OR=1.465,95%CI:1.372～1.564)与生殖道感染途径知晓情况有关联。结论我国中西部农村地区居民生殖健康知识比较匮乏,在今后的农村健康教育工作中,应采取因地制宜的方法,提高农村人口的生殖健康知识水平。     

农村已婚育龄妇女生殖保健状况调查

目的: 了解农村已婚育龄妇女生殖保健状况, 为更好地开展妇幼卫生保健工作提供依据。方法: 采用分层整群抽样法抽取咸宁市 3个县的 26个村共 3 612名已婚育龄妇女进行有关生育、保健等生殖健康状况及需求的调查。结果: 农村已婚育龄妇女初婚年龄平均为 21. 6岁、平均孕次 2. 03次, 平均活产子女数 0 .89。已婚育龄妇女接受新婚教育的比例为 12 10%,夫妇双方婚检的参与率为 32. 00%, 文化程度越高, 参与婚前检查和产前检查的比例越高。45. 76%的已婚育龄妇女接受过生殖健康服务, 接受服务的主要地点集中在乡镇计生所 (72. 29% ), 相关信息的获取途径主要为电视 (75. 94% )。已婚育龄妇女对生殖健康服务的需求高, 其中以提供产前检查服务为最高 (93 .80% )。结论: 农村已婚育龄妇女生殖健康服务基础薄弱, 文化程度与个人生殖保健水平呈正相关, 农村已婚育龄妇女生殖保健存在问题较多, 对生殖健康服务的需求迫切。     

广州市社区育龄妇女生殖健康情况调查

目的:了解广州市社区育龄妇女生殖健康状况,以便更有针对性地开展生殖健康服务。方法:采用多阶段抽样的方法在荔湾区22个街道按比例随机抽取15～49岁的已婚(或有性生活史)的育龄妇女共450例,进行生殖健康状况问卷调查。结果:被调查妇女中异常孕产者占59.78%,其中有人工流产史占58.00%;导致意外妊娠的原因57.47%是由于避孕失败,42.53%是没有采取避孕措施而致。采取的避孕方式前3位是:宫内节育器(48.89%)、避孕套(42.20%)和口服避孕药(3.78%)。34.44%的妇女在妇科疾病普查中发现有异常。结论:荔湾区妇女人工流产发生率较高,应在社区育龄妇女中广泛开展生殖健康教育,改善妇女生殖健康状况,提高计划生育/生殖健康服务管理水平。     

农村社区开展家庭医生签约服务及建立固定诊疗关系的探索

家庭医生责任制是建立在全科医生与居民签约并建立固定诊疗关系的基础之上.上海市浦东新区农村社区开展广泛宣传发动、组建包括乡村医生在内的全科团队、上门开展签约和采集电子健康档案,并建立社区首诊、在联合体内梯度就诊的新型家庭医生服务模式,根据社区居民与社区卫生服务中心联系的紧密程度,将服务对象分为健康管理、健康服务和健康关怀三大类,针对不同服务需求提供不同的签约服务内容,服务质量好坏与家庭医生的报酬相关.经过第三方测评,群众和社会各界知晓率达到75.0％,户籍人口签约率达到了84.6％,群众满意度达到91.4％,做法和经验对其他地区开展工作有参者意义.     

宝安区社区居民参与社区健康服务中心慢性病管理情况分析

目的了解宝安区社区居民慢性病知晓率和参与社区健康服务中心随访管理的情况,为有效提高慢性病的社区管理率提供参考依据。方法于2015年6-11月,以调查前在深圳市居住6个月以上,年龄为18~69岁的社区常住人口为研究对象,采用多阶段随机抽样的方法共抽取1 283名居民,开展问卷调查、体格检查和实验室检查。用SPSS 20.0统计软件包进行χ~2检验,秩和检验。结果调查人群中,高血压和糖尿病的患病率分别为27.0%和7.8%,知晓自身患高血压和糖尿病比例分别为57.2%(95%CI:52.0%~62.4%)和65.0%(95%CI:55.7%~74.3%),其中,参与随访管理的比例分别为55.1%(95%CI:48.1%~62.0%)和60.0%(95%CI:48.1%~71.9%),表示不知道"社区健康服务中心能够提供慢性病的随访管理"的功能占8.7%和9.7%。参加高血压社区健康服务中心管理者的年龄(中位数为49岁,P_(25)~P_(75)为42~59岁)小于未参加者(中位数为55岁,P_(25)~P_(75)为44~63岁),差异有统计学意义(P0.05),而参加者与未参加者的性别、户籍情况、文化程度和经济状况差异均无统计学意义(P0.05)。参加糖尿病随访管理者与未参加随访管理者比较,年龄、性别、户籍、文化程度和家庭人均月收入差异均无统计学意义(P0.05)。结论知晓自身患病是患者参与社区健康服务中心随访管理的重要因素,应采取措施提高社区居民对自身慢性病的知晓率,同时进一步增加居民对社区键康服务功能的了解。     

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.     

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.     

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.     

Planning research

The starting point for any research project should be a question.Once this has been defined and the relevant scientific literaturereviewed, a protocol should be drawn up. This will be used notonly as a guide to the conduct of the study and in the preparationof the final report, but also in seeking any financial supportand approvals that are required for the investigation. A protocolis normally arranged in sections covering the background tothe study, the question(s) that it will address, the methodsthat will be used for the collection and analysis of data, thestatistical power of the investigation (where relevant), anyethical considerations, and the financial input that will beneeded. A pilot study is often helpful where aspects of thestudy method are untried or of uncertainvalidity.