Prevalence of smoking in a diabetic population: the need for action

Smoking habits in insulin-treated diabetics in Nottinghamshire (UK) and clinic-attending diabetics in Nottingham have been analysed. Compared with the general population, the prevalence of current cigarette smoking is significantly less (p less than 0.001) in both diabetic men and women older than 50 years. Fewer diabetic men over 60 years have ever smoked than in the general population (p less than 0.001) but this finding does not apply to diabetic women. While intervention probably plays some part in this lower prevalence, the most likely explanation is the multiplicative effect of both smoking and diabetes to produce high mortality risks. Actuarial analysis of insulin-treated clinic attenders diagnosed after 1970 showed that at most 14% (95% confidence interval [Cl] 9-18%) of the 183 who smoked at diagnosis had given up 5 years later while a minimum of 8% (95% Cl, 6-11%) of the 313 who were non-smokers had started smoking. Information about the patterns of smoking in patients with chronic disease is incomplete and it appears that too little is being done in clinical services which provide long-term management for these patients to either discourage smoking or determine why some patients give up smoking but others do not.     

鼻咽癌高危人群微核特征研究

目的 观察鼻咽癌高危人群的主要细胞遗传学特征。方法 常规培养外周血淋巴细胞，检测鼻咽癌高危人群、鼻咽癌患者、鼻咽炎患者及正常人的微核率。结果 鼻咽癌高危人群及鼻咽癌患者的微核率明显增加，且随病情进展而继续增高。结论 鼻咽癌高危人群存在比较明确的细胞遗传不稳定性。     

Back pain from the epidemiological point of view

Summary In the last decades back pain has reached dramatic proportions in industrialized countries. Disorders of the back are nowadays the leading cause of direct and indirect health care costs. Accurate prevalence estimates are needed to serve as a basis for health care evaluations. A review of epidemiologic studies in the general population reveals that back pain has reached a prevalence of 40 % for current pain. 7 to 18 % are “frequently”, “often”, “daily” or “constantly” affected. 75 % of the adult population suffers from back pain during the last year. 80 to 90 % of the adult population in industrialized countries experience back pain ever. Gender specific differences are only present in severe, chronic forms which are more often experienced by women. Back pain has a prevalence maximum at 50 to 64 years. Older persons display lower prevalence estimates. The prevalence maximum in men is one decade earlier than in women. There are several potential explanations for this prevalence pattern that are discussed in the article. Back pain can be classified by location, temporal characteristics, pain intensity and pain history. Currently, for none of these dimensions generally accepted, uniformly employed and validated definitions are available. In most of the industrialized countries back pain is one of the most expensive symptoms. 75–90 % of the direct and indirect health care costs were caused by those 5–10 % of patients who are disabled. As predictors of back pain a history of back pain and job satisfaction play by far a more important role than the extensively studied mechanical factors. For a first episode of back pain the prognosis is favorable. If the pain persist for more than three months the prognosis is unfavorable. After six months of absenteeism because of back pain more than half of the afflicted never return to work. Rarely back pain is present as a single symptom. In more than 80 % back pain is associated with pain in at least one joint. It remains to be studied if back pain may be viewed as an entity or as part of a more complex pain syndrome.      

上海市闵行区流动人口中的孕产妇保健状况

通过对上海市闵行区580名外来孕产妇及580名作为对照的本地孕产妇的孕产期保健现况调查分析,表明外来孕产妇缺乏必要的孕产期保健措施,有47.6％的外来孕产妇从未做产前检查,产后保健则完全没有,并由此而造成外来产妇在急产、死产、甚至孕产妇死亡等方面令人忧虑的现状。为适应和促进当前经济发展的新形势,改善流动人口的孕产妇保健状况,应对流动人口中孕产妇保健状况深入研究,并采取相应的措施。     

Population toxicokinetics of tetrachloroethylene

 In assessing the distribution and metabolism of toxic compounds in the body, measurements are not always feasible for ethical or technical reasons. Computer modeling offers a reasonable alternative, but the variability and complexity of biological systems pose unique challenges in model building and adjustment. Recent tools from population pharmacokinetics, Bayesian statistical inference, and physiological modeling can be brought together to solve these problems. As an example, we modeled the distribution and metabolism of tetrachloroethylene (PERC) in humans. We derive statistical distributions for the parameters of a physiological model of PERC, on the basis of data from Monster et al. (1979). The model adequately fits both prior physiological information and experimental data. An estimate of the relationship between PERC exposure and fraction metabolized is obtained. Our median population estimate for the fraction of inhaled tetrachloroethylene that is metabolized, at exposure levels exceeding current occupational standards, is 1.5% [95% confidence interval (0.52%, 4.1%)]. At levels approaching ambient inhalation exposure (0.001 ppm), the median estimate of the fraction metabolized is much higher, at 36% [95% confidence interval (15%, 58%)]. This disproportionality should be taken into account when deriving safe exposure limits for tetrachloroethylene and deserves to be verified by further experiments. Received: 20 April 1995/Accepted: 24 August 1995     

Creating a place for population health: Interpreting the spaces of a new School in Auckland,New Zealand

Although the reconfiguring of health care within the hospital sector has gained considerable attention by social scientists, the tertiary education sector's response to new health philosophies and practices has proceeded largely unexamined. This paper considers the new School of Population Health at the University of Auckland, accounts for its origins and considers the synergies between its design and workplace organisation. The results of a thematic analysis of narratives offered by 24 employees collected in 2004 are then presented. Findings suggest that the amassing of academics from a range of health-related backgrounds is advancing interdisciplinary dialogue even if the nature and purpose of population health remains unclear to some. A key concern of respondents was the openness of the workplace which encourages a collaborative atmosphere but also generates distraction. The degree to which conduct within the new building is perceived as regulated was also of concern. Place clearly matters in the story of the new School: the form of the building (featuring an architecture of openness) complements its function (generating new collaborations and creative thinking about health). However, the question of how ‘salutogenic’ a setting it is remains contested.     

鄂尔多斯沙地草场小毛足鼠种群数量动态分析

目的 了解小毛足鼠种群数量变动因素。方法 1991-1998年4-10月在中国农业科学院草原研究所鄂尔多斯沙地草场改良试验站，利用直线夹日法调查。结果 小毛足鼠为该地区优势种，该鼠数量变化季节性明显，年间变化差异较大。经过8年调查，小毛足鼠数量变化经历了低谷(1991—1992年)、高峰(1993年)、下降(1994年)和低谷(1995—1998年)4个时期。结论 影响种群数量变动的主要因素有种群年龄组成中幼年组的百分比、怀孕率、鳖殖指数以及该地区子午沙鼠、三趾跳鼠和黑线仓鼠的数量。     

Cystitis as a correlate of female urinary incontinence

The objectives of the research were to study the association between prevalent urge and stress urinary incontinence (UI) and a history of cystitis in adult females. A cross-section of the adult female population, aged 30–59 years, in the Municipality of Aarhus, Denmark, was studied, using self-reported data based on postal questionnaires. The sample consisted of 3114 women, out of whom 2613 (84%) delivered the information requested. The main outcome measures were period prevalence in 1987 of episodes of UI provoked by physical stress and UI associated with a feeling of urge, prevalence of experience of episodes of cystitis and UI related to cystitis in adult life, and prevalence of relative risks, as indicated by odds ratio (OR), of UI conditional on cystitis experience. Results indicated that the 1987 period prevalences of UI provoked by physical stress and UI associated with a feeling of urge were 15% and 9%, respectively. Forty-five per cent reported a history of cystitis and 10% of UI during episodes of cystitis. Both UI provoked by stress and UI associated with a feeling of urge were significantly correlated to cystitis (OR 2.1, P<0.0001, and 1.8, P<0.0001, respectively) and to UI during episodes of cystitis (OR 7.1, P<0.0001, and 5.7, P<0.0001, respectively). When corrected for the stress aspect, UI being associated with a feeling of urge showed no association of its own to a history of cystitis. However, stress and urge aspects were both correlated to the experience of UI during episodes of cystitis. The prevalence of experience of cystitis increased with increasing number of urologic (per operation OR 2.1, P<0.0001) and gynecologic operations (per operation OR 1.5, P<0.0001), e.g. curretage (per operation OR 1.2, P<0.001), but not with the number of abdominal operations or the number of childbirths. It was concluded that cystitis may be an important component of UI etiology. Stress and not urge UI seems to be the key type related to a history of cystitis in general. The experience of UI during cystitis is connected to both stress and urge UI. A history of cystitis may possibly itself by initiated by surgery.     

Inter-cohort differences in coronary heart disease mortality in the 25-year follow-up of the seven countries study

Sixteen cohorts of men aged 40–59 years at entry were examined with the measurement of some risk factors and then followed-up for mortality and causes of death for 25 years. These cohorts were located in the USA (1 cohort), Finland (2), the Netherlands (1), Italy (3), the former Yugoslavia (5), Greece (2), and Japan (2), and included a total of 12,763 subjects.Large differences in age-adjusted coronary heart disease (CHD) death rates were found, with extremes of 45 per 1000 in 25 years in Tanushimaru, Japan, to 288 per 1000 in 25 years in East Finland. In general, higher rates were found in the US and Northern European cohorts as compared to the Southern European and Japanese cohorts. However, during the last 10 years of follow-up large increases of CHD death rates were found in some Yugoslavian areas. Out of 5 measured entry characteristics treated as age-adjusted levels (serum cholesterol, systolic blood pressure, cigarette smoking, body mass index and physical activity at work), only serum cholesterol was significant in explaining cohort differences in CHD death rates.Over 50% of the variance in CHD death rates in 25 years was accounted for by the difference in mean serum cholesterol. This association tended to decline with increasing length of follow-up, but this was due to the great changes in mean serum cholesterol in the two Jugoslavian cohorts of Velika Krsna and Zrenjanin. When these two cohorts were excluded the association increased with time.Changes in mean serum cholesterol between year 0 and 10 helped in explaining differences in CHD death rates from year 10 onward.It can be concluded that this study suggests that mean serum cholesterol is the major risk factor in explaining cross-cultural differences in CHD.     

达乌尔黄鼠种群繁殖特征的研究

本文根据1983～1986年在松辽平原区通辽地区的调查,研究了达乌尔黄鼠种群繁殖特征。结果表明:在松辽平原地区,各年份达乌尔黄鼠的怀孕率多在90％以上,平均胚胎数多在8.0以上,胚胎分布呈正态分布。黄鼠在怀孕过程中,有5.48—16.26％的雌体发生胚胎吸收,平均吸收胚胎2.0个左右,吸收胚胎分布呈poisson分布。1984年观察,平均每只雌鼠实际产仔鼠7.622±0.154只,其分布仍为正态分布。