我国12～17岁儿童营养及膳食认知现状调查

目的:了解我国12～17岁儿童的膳食知识现况,探讨学龄期儿童对膳食知识的掌握程度与其健康状况的关联性,为提高农村儿童健康水平、制定相应的干预措施提供依据.方法:采用2006年中国健康和营养调查(CHNS)项目的儿童调查部分资料,利用分层整群随机抽样方法随机抽取我国九个省市共1954名儿童,其中,12～17岁儿童663例,进行现况调查.结果:12～17岁的超重检出率男童高于女童(x<'2>=5.493,P<0.05),差异具有统计学意义;城市儿童对中国膳食宝塔的知晓率高于农村(x<'2>=18.275,P<0.01);城市和农村儿童相比(x<'2>=21.577,P<0.01),城市儿童更喜欢吃快餐(肯德基、比萨饼、汉堡包等);男女童比较(x<'2>=5.308,P<0.05),男童喜欢吃蔬菜的比例明显多于女童.结论:我国12～17岁儿童的超重和肥胖检出率偏高,对膳食知识的了解比较片面,我们仍要加强对儿童青少年的营养健康知识教育,以促进青少年健康成长.     

13所私立幼儿园儿童膳食及健康状况调查

目的了解深圳市龙岗区布吉各私立幼儿园的儿童膳食及健康状况,进一步有针对性地做好私立幼儿园儿童膳食的指导工作。方法对辖区内13所私立幼儿园共3 264名儿童作膳食及健康状况调查。膳食调查采用称重法,园外采用整群随机抽样调查。结果这些幼儿园膳食结构不合理,营养摄入不达标。检查结果显示,3 264名儿童的体格发育健康水平良好,体重达标者3 096名(占94.9%),单纯性肥胖症者88名(占2.7%),发育迟缓者38名(占1.2%),消廋者4名(占0.1%),低体重者38名(占1.2%)。582名儿童园外零食消费调查显示,园外每天在家进晚餐的有511名(占87.8%),吃零食者492名(占84.5%)。结论膳食调查结果显示,这些幼儿园儿童的摄入总能量偏低;糖、脂肪、蛋白质摄入不达标;视黄醇、VB1、VC摄入量不足;钙、锌的摄入量严重不足;营养不良和营养过剩仍是学龄前儿童较为突出的问题。亟待建立和完善卫生保健制度,加强膳食营养管理,提高专业人员的知识水平,同时要加强对私立幼儿园的宣传教育和监管力度。     

天津市0～6岁儿童二类疫苗接种现状及影响因素

目的了解天津市儿童二类疫苗接种率及儿童家长对二类疫苗的认知情况,分析二类疫苗接种影响因素,为制定相关疫苗接种策略提供科学依据。方法采用分层随机抽样的方式抽取3个区针对6岁以下儿童家长开展问卷调查,问卷调查内容包括儿童家庭一般情况、家长对二类疫苗认知情况以及儿童二类疫苗接种情况等相关内容。结果共调查450名儿童家长,其中344名儿童(76.44%)接种过二类疫苗,水痘疫苗接种率最高(56.00%),七价肺炎疫苗接种率最低(4.89%)。经多因素Logistic回归分析表明,儿童年龄、家庭收入、母亲健康情况及家长对疫苗接种信息知晓程度是影响儿童二类疫苗接种的相关因素(P0.05)。家庭收入越高、母亲越健康、家长对疫苗接种信息了解越多,相应的儿童二类疫苗接种水平越高。结论目前天津市儿童二类疫苗接种水平有待进一步提高,需采取多种措施宣传引导儿童家长增强疫苗认知,规范疫苗接种服务管理,提高儿童二类疫苗接种水平,有效防控相关传染病发生。     

山西省保德县流动儿童计划免疫健康教育效果分析

目的了解流动儿童监护人计划免疫健康教育效果。方法采用随机抽样的方法抽取240名流动儿童监护人作为干预组,对干预组实施计划免疫健康教育,采用自行设计的问卷对干预组干预前后进行问卷调查。选择同一类地区中年龄、性别、职业、文化程度及家庭经济状况相似的常住儿童监护人作为对照组,采用同一问卷进行调查,对结果进行比较。结果干预组在干预前有关儿童计划免疫的知识、态度和行为意向均处于较低水平,低于对照组(P0.05)。干预组在干预后对计划免疫、关键信息的知晓率明显提高(P0.01),计划免疫态度及行为意向明显改善,接近或高于对照组(P0.01)。干预组在实施干预后及时建卡率和"四苗"接种率均有了明显的提高(P0.01)。结论对保德县流动儿童监护人进行计划免疫健康教育能提高该人群计划免疫相关知识,改善相关态度和行为意向。     

常州市武进区居民健康素养干预效果评价

目的评价常州市武进区居民健康素养干预效果。方法武进区于2017年实施了为期10个月的有针对性的健康素养干预活动,并干预前(2016年)、干预后(2017年)分别采用分层多阶段随机抽样方法抽取15～69岁常住居民,采用全国居民健康素养监测调查问卷进行调查,并对干预前后调查结果进行对比分析。结果干预前后分别有效调查432、390人,健康素养水平由干预前的19.4%提高到干预后的35.9%(P0.05)。logistic回归分析结果显示,文化程度是健康素养水平的影响因素(OR=1.815,95%CI:1.454～2.266)。干预前后,健康技能及健康生活方式与行为素养水平差异均有统计学意义(P值均0.05);科学健康观、传染病防治、慢性病防治、基本医疗、健康信息等素养水平差异均有统计学意义(P值均0.05)。结论本次居民健康素养水平干预效果较好,今后应针对居民需求和健康素养薄弱点,加强对健康素养干预方式的研究。     

西部4省(区)民族地区留守儿童健康素养与意外伤害的关系

目的了解西部民族地区留守儿童健康素养与意外伤害的关系,为针对性开展民族地区留守儿童健康教育提供参考。方法采用多阶段分层整群随机抽样方法,抽取广西、云南、四川、贵州等西部4个省(区)的4个少数民族自治县留守儿童2822名进行调查。结果西部4省(区)民族地区留守儿童健康素养水平为7.90%,基本知识和理念、健康生活方式与行为、基本技能水平分别为9.82%、7.94%和8.10%。不同年级、监护类型、父亲文化程度、母亲文化程度的留守儿童健康素养水平差异均有统计学意义(P0.01)。西部4省(区)民族地区留守儿童意外伤害发生率为48.90%,不同性别、年级、监护类型、父亲文化程度、母亲文化程度的留守儿童意外伤害发生率差异均有统计学意义(P0.01)。不具备健康素养留守儿童意外伤害发生率高于具备健康素养留守儿童,差异具有统计学意义(P0.01)。多因素Logistic回归分析结果显示,不具备健康素养是西部民族地区留守儿童发生意外伤害的危险因素(OR=1.120,95%CI:1.054～1.185)。结论西部民族地区留守儿童健康素养水平较低,而其意外伤害发生率较高。提高民族地区留守儿童健康素养水平有助于降低其意外伤害的发生风险。     

贵州省北部农村儿童家长烧烫伤知信行调查及影响因素分析

目的了解贵州省北部农村地区儿童烧烫伤现状及其家长关于儿童烧烫伤知识、信念、行为水平,分析影响KAP得分的因素。方法采用多阶段整群随机抽样方法抽取585户农村家庭进行调查;利用访谈提纲,分别对40名中学生和40名小学生进行小组深度访谈。结果中小学生烧烫伤发生率为5.88%,留守儿童烧烫伤发生率(9.18%)高于非留守儿童(4.19%);家长烧烫伤的行为总正确率为61.82%;单因分析显示,不同文化程度的监护人儿童烧烫伤知识得分为:小学及以下(6.07±1.57),初中(6.19±1.39),高中(6.31±1.67),大专及以上(7.79±0.80);初中组的学生知识得分(6.27±1.50)高于小学组(5.99±1.47);留守儿童关于烧烫伤的知识得分(5.97±1.46)低于非留守儿童(6.29±1.50)。多元线性回归分析显示,家长关于儿童烧烫伤KAP得分的影响因素主要是监护人文化程度、学生年级和儿童留守与否(标准化β值分别为0.126,0.099,-0.088,P均0.05)。定性访谈反映儿童从家长方面学到的烧烫伤预防知识及急救技能不足。结论预防儿童非故意烧烫伤的发生,需加强对儿童和家长的健康教育和培训力度,普及伤害相关知识,提高儿童和家长的伤害认知水平。     

四川省理县居民健康素养水平及影响因素分析

目的 分析四川省理县居民健康素养水平状况,并探讨其影响因素。 方法 采用多阶段整群随机抽样的方法,主要分为四个阶段,阶段一采用单纯随机抽样方法,随机抽取3个乡镇;阶段二在每个抽中的乡镇内,采用单纯随机抽样方法,随机抽取3个行政村(居委会);阶段三在每个抽中的行政村(居委会)内,采用单纯随机抽样方法抽取居民户;阶段四按照“生日法”方法,抽取居民。问卷采用《四川省2018年健康促进县(区)建设项目方案》中人群调查问卷对理县选取15～69岁居民进行调查。采用logistics回归模型分析健康素养影响因素。 结果 理县居民总体健康素养具备率为24.38%。从6类问题健康素养的具备率来看,从高到低依次为科学健康观(40.25%)、基本医疗(37.19%)、健康信息(27.90%)、传染病防治(25.62%)、安全与急救(25.50%)和慢性病防治(22.69%)。经logistics分析,理县居民健康水平的影响因素是:民族(OR_羌族=2.463, 95%CI:1.133~5.352)和文化程度(OR_初中=4.997, 95%CI:1.093~3.884;OR_{大专及以上}=6.138, 95%CI: 1.249~6.747)。 结论 四川省理县居民健康水平已达到《“健康中国2030”规划纲要》要求,但健康素养各维度模块水平存在较大差异。可从年龄、民族、文化程度、本地户籍和是否患慢性病等方面,采取针对性防控措施。     

合肥市蜀山区居民健康素养调查

目的了解蜀山区居民健康素养现状,为提高社区居民健康素养水平工作的开展提供参考依据。方法采取随机抽样的方法,抽取某社区15～69周岁居民150人,采用卫生部统一制定的健康素养调查问卷进行调查。结果调查对象具备健康素养的比例为11.3%,具备基本知识和理念、健康生活方式与行为、基本健康技能的比例分别为14.7%、12.0%和55.3%;从事医疗工作,文化程度越高者,其健康素养越高(P0.05)。结论蜀山区居民健康素养水平较低,应进一步加强健康教育工作,提高居民健康水平。     

北京市大兴区接种卡介苗儿童家长健康教育知识及信息需求分析

目的了解北京市大兴区接种卡介苗儿童家长健康教育信息需求,为探索适合接种卡介苗儿童监护人的预防接种知识健康教育方式提供依据。方法采用分阶段随机抽样的方法,随机抽取大兴区5个街道办事处和14个镇,采用无记名选择型问卷对1000名预防接种卡介苗的儿童(1~2岁)家长进行健康教育知识及信息需求调查,由负责查验的专业人员当场做好记录,采用SPSS 18.0软件行数据的分析和统计。结果家长知晓对卡介苗接种后可能出现的不良反应[90.3%(903/1000)]和接种前后的注意事项需求率[85.7%(857/1000)]较高。高中及以上文化程度者预防接种健康教育知识需求(90.3%)明显高于高中以下者(69.47%),差异有统计学意义(P0.05);来自城市的家长预防接种健康教育知识需求(93.48%)明显高于来自农村家长(78.20%),差异有统计学意义(P0.05);儿童家长希望获得的预防接种健康教育的途径(62.6%)明显高于实际获得途径(43.46%),差异有统计学意义(P0.05)。结论卡介苗接种后可能出现的不良反应及常见处理办法、卡介苗接种的禁忌证及接种前后的注意事项等是接种卡介苗儿童家长健康教育信息重点需求内容;文化程度较低及流动儿童家长应作为健康教育的重点人群。     

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.     

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.     

Stress in the Norwegian police service

BACKGROUND: High levels of stress have been attributed to the conditions of police work, but there is little empirical evidence for this. AIMS: To develop a new instrument to measure job stress in the police; to assess the most severe and frequent police stressors; to compare levels of stress according to the demographic and organizational factors; and to study stress in relation to personality traits, work locus of control and coping strategies. METHODS: A comprehensive nationwide questionnaire survey of 3272 Norwegian police at all hierarchical levels, including the Norwegian Police Stress Survey (NPSS), the Job Stress Survey, the Basic Character Inventory, the Work Locus of Control Scale, and the Coping Strategies Scale. RESULTS: Work injuries were appraised as the most stressful but least frequent stressor and job pressure was reported the least severe but most frequent stressor. Females experienced job stressors less frequently, but appraised them as more severe than men did. Older police officers reported more job pressure severity and fewer work injuries. The police in districts where peer support was planned but not implemented, and who worked in districts with more than 50,000 inhabitants, perceived the lack of support more severely than others. The correlations between stress and personality traits, work locus of control, and coping were moderate. CONCLUSIONS: The NPSS captures police-specific stressors that are not adequately measured by global stress instruments. The study of stress in police work should preferably involve a nationwide use of police-specific stress instruments.