山东省居民对食盐推荐摄入量的知晓情况及影响因素分析

目的调查山东省18～69岁居民对盐推荐摄入量的知晓情况及影响因素。方法采用多阶段分层整群随机抽样方法抽取全省代表性样本15 600人,回收有效问卷15 350份,调查完成率98.40%。山东省疾控系统工作人员在2011年6～7月通过统一问卷收集调查对象盐与高血压相关知识、态度和行为等信息。结果调查的15 350名中,男性占50.1%,女性占49.9%。经过加权调整后,2011年山东省居民中仅29.3%的城市居民和19.2%的农村居民知晓"盐推荐摄入量"。与其他年龄组相比,60～69岁老人中知晓"盐推荐摄入量"的比例最低,仅为13.4%;受教育程度高的居民中有较高的比例知晓"盐推荐摄入量"。高血压患者与非高血压患者均对"盐推荐摄入量"的知晓率较低,仅21.0%的高血压患者知晓"盐推荐摄入量"。结论山东居民对盐推荐摄入量的知晓水平较低,加大对盐推荐摄入量的宣传有利于减少全人群的食盐摄入水平,并控制血压水平。     

Metabolic syndrome and health-related quality of life among U.S. adults

PURPOSE: Little is known about the association between health-related quality of life and the metabolic syndrome. The objective of this study was to compare health-related quality of life in adults with and without the metabolic syndrome. METHODS: We performed a cross-sectional analysis of 1859 men and women aged > or =20 years from the National Health and Nutrition Examination Survey 2001-2002. Health-related quality of life was assessed with the Centers for Disease Control and Prevention HRQOL-4 tool. RESULTS: A larger percentage of participants with the metabolic syndrome had fair or poor health (difference = 11.3%, p = 0.002), > or =14 physically unhealthy days (difference = 5.0%) (p = 0.129), > or =14 mentally unhealthy days (difference = 7.4%) (p = 0.010), and > or =14 activity-limitation days (difference = 5.8%) (p = 0.024) during the past 30 days than participants without the metabolic syndrome. After adjusting for age, sex, ethnicity, educational status, and smoking status, participants with the metabolic syndrome were more likely to have fair or poor health (odds ratio [OR], 1.94; 95% confidence interval [CI], 1.21-3.13), > or =14 mentally unhealthy days (OR, 1.97; 95% CI, 1.28-3.02), and > or =14 activity limitation days (OR, 3.20; 95% CI, 1.46-7.02) than those without the metabolic syndrome. CONCLUSIONS: U.S. adults with the metabolic syndrome experience worse health-related quality of life than adults without this syndrome.     

Epidemiology of maternal morbidity and mortality

Maternal morbidity and mortality remains a significant health care concern in the United States, as the rates continue to rise despite efforts to improve maternal health. In 2013, the United States ranked 60th in maternal mortality worldwide. We review the definitions, rates, trends, and top causes of severe maternal morbidity and mortality, as well as risk factors for adverse maternal outcomes. We describe current local and national initiatives in place to reduce maternal morbidity and mortality and offer suggestions for future research.     

多水平模型在中国人群肥胖的省级社会影响因素分析中的应用

目的 采用多水平模型的方法探索中国人群省级水平社会因素对个体肥胖患病的影响。方法 采用多水平建模的方法,利用2007年慢性病与危险因素监测18~69岁人群数据作为研究结局和个体水平因素,收集国家统计局2007年分省年度数据,通过因子分析方法获得省级社会发展综合指标,分析其与个体体质指数（body mass index,BMI）、肥胖和中心性肥胖的关联关系。结果 2007年,全国范围内18～69岁人群的BMI平均值为（23.27±3.37）kg/m2,肥胖率为8.49%,中心性肥胖率为30.92%。从7个与社会经济、医疗卫生资源、生活环境有关的省级社会因素提取出2个省级水平因子作为各省社会发展综合指标,发现代表居民消费水平和医疗卫生资源充足程度的省级因子与个体BMI、肥胖、中心性肥胖的关联均无统计学意义（均有P>0.05）,而代表社会经济综合发展程度的省级因子与个体BMI（OR=1.09,95% CI:1.04～1.10）、肥胖（OR=1.17,95% CI:1.07～1.28）、中心性肥胖（OR=1.19,95% CI:1.10～1.30）有正向的关联关系。结论 在中国,社会经济综合发展程度较好的地区,个体发生肥胖的风险可能较大。利用多水平模型探索影响个体肥胖等慢性病的地区社会因素,可为卫生政策制定者提供科学证据,引导卫生资源合理分配,具有重要公共卫生意义。     

Quality-adjusted life expectancy (QALE) loss due to smoking in the United States

Purpose

Estimate quality-adjusted life expectancy (QALE) loss due to smoking and examine trends and state differences in smoking-related QALE loss in the U.S.

Methods

Population health-related quality of life (HRQOL) scores were estimated from the Behavioral Risk Factor Surveillance System. This study constructed life tables based on U.S. mortality files and the mortality linked National Health Interview Survey and calculated QALE for smokers, non-smokers, and the total population.

Results

In 2009, an 18-year-old smoker was expected to have 43.5 (SE = 0.2) more years of QALE, and a non-smoker of the same age was expected to have 54.6 (SE = 0.2) more years of QALE. Therefore, smoking contributed 11.0 (SE = 0.2) years of QALE loss for smokers and 4.1 years (37%) of this loss resulted from reductions in HRQOL alone. At the population level, smoking was associated with 1.9 fewer years of QALE for U.S. adults throughout their lifetime, starting at age 18.

Conclusions

This study demonstrates an application of a recently developed QALE estimation methodology. The analyses show good precision and relatively small bias in estimating QALE––especially at the individual level. Although smokers may live longer today than before, they still have a high disease burden due to morbidities associated with poor HRQOL.     

黑龙江省慢性病预防控制能力现状分析

目的了解黑龙江省慢性病预防控制能力现状,为加强该省慢性病防控能力建设、制定慢性病防控相关政策提供依据。方法对2011年黑龙江省1个省级、13个市(地)级和132个县(区)级疾病预防控制中心(疾控中心)慢病防控能力现状进行问卷调查,内容包括机构设置、人员和经费配置、继续教育情况,监测和干预工作开展情况以及科研能力等。采用SPSS 17.0统计软件进行数据分析。结果黑龙江省10个市(地)级和59个县(区)级疾控中心设有专职慢性病科(所)或以慢性病为主的科(所)。各级疾控中心从事慢性病防控人员327人,占所有在岗人员的4.57%(327/7 153),其中本科及以上学历者占42.81%(140/327)、医学类专业者占85.32%(279/327),从事慢性病工作不足5年者占60.25%(197/327)。84.62%(11/13)的市(地)级、87.88%(116/132)的县(区)级疾控中心参加慢病防控相关培训;92.31%(12/13)和65.91%(87/132)开展了死因监测工作;92.31%(12/13)和62.12%(82/132)开展了恶性肿瘤病例报告工作;53.85%(7/13)和68.18%(90/132)开展了高血压干预工作,38.46%(5/13)和67.42%(89/132)开展了糖尿病干预工作。市(地)级和县(区)级疾控中心配置慢性病防控专项经费的单位分别为15.39%(2/13)和14.39%(19/132),承担国内科研课题的单位分别为15.39%(2/13)和2.27%(3/132),发表过国内外期刊论文的单位分别为7.69%(1/13)和0.76%(1/132)。结论与2009年调查数据相比,黑龙江省各级疾控中心慢性病防控人员数量,县(区)级疾控中心设立专职慢性病科(所)或以慢性病为主的科所和配置慢性病专项经费的单位均有所增加,但仍存在机构和人员不足以及工作经费缺乏等问题。     

The Development and Evaluation of an Internet-Based Intervention to Increase Awareness About Food Portion Sizes: A Randomized,Controlled Trial

ObjectiveTo develop a Web-based tool (PortionSize@warenessTool) and to evaluate its effectiveness in increasing awareness of reference serving sizes and factors that may contribute to overeating in response to large portion sizes.MethodsA randomized, controlled trial (intervention, n = 167; control, n = 143) was conducted. The authors measured awareness of reference serving size and overeating triggers from larger portions by an online questionnaire, assessed at baseline and 1 week later. Exposure dose reflected online activity (eg, number of Web pages viewed). Process evaluation data were collected within the intervention group.ResultsThe intervention group demonstrated significantly higher awareness of reference serving sizes (η² = .062; P < .001) and overeating triggers from larger portions (η² = .061; P < .001) at posttest. Also, the authors observed a dose-dependent effect that led to improved awareness.Conclusions and ImplicationsThe PortionSize@warenessTool constitutes a promising tool to improve portion size awareness.     

The association between muscle strengthening activities and atherogenic index of plasma

Atherogenic index of plasma (AIP), calculated as LOG₁₀(triglycerides/high-density lipoprotein-cholesterol), is considered to be a novel indicator of cardiovascular disease (CVD) risk. Muscle strengthening activities (MSA) have been shown to favorably associate with triglycerides and high-density lipoprotein cholesterol (HDL-C). The association between MSA and AIP has yet to be explored in a nationally representative sample of U.S. adults, which was the purpose of this brief report. Data from the 1999–2006 National Health and Nutrition Examination Survey were used (N = 6694 adults 20–85 yrs). AIP was obtained from a blood sample and a 2-item questionnaire was implemented to assess MSA participation over the previous 30-days. Individuals meeting MSA guidelines (vs. not) had reduced odds of having an elevated (> 0.24) AIP (odds ratio = 0.80; 95% confidence interval: 0.65–0.98; P = 0.03). Muscle strengthening activities appear to be inversely associated with AIP. Engaging in MSA may be a strategy to mitigate risk for health outcomes associated with an elevated AIP, such as CVD.