基于一所医院产后抑郁症的患病情况及其危险因素调查

目的:调查产后抑郁(PPD)的患病情况,分析PPD的危险因素,为PPD的预防和干预提供依据。方法:利用自制问卷和爱丁堡产后抑郁量表(EPDS),对2012年7～10月在北京市朝阳区一所医院分娩的300例产妇的基本情况和PPD情况进行调查。EPDS共包括l0个项目,得分范围为0～30分。本研究定义EPDS总分≥10分者为产后抑郁症。采用SPSS18.0软件对PPD的发生情况及危险因素进行分析。结果:本次调查时点内调查对象PPD发生率为24.33%。多因素logistic回归分析发现,"与婆家关系差"(OR=2.47,95%CI=1.120-5.44)、"孕前健康状况差"(OR=4.99,95%CI=1.561-15.93)、"怀孕影响目前工作或收入"(OR=1.79,95%CI=1.02-3.12)的产妇,PPD患病率较高。结论:当前PPD的发生率较高,心理原因是主要危险因素,产后良好的家庭支持和心理支持可降低PPD症的发生率。     

上海市某区基层卫生工作者慢病状况调查及相关因素研究

目的 了解上海市某区社区卫生服务中心卫生工作者慢性疾病现状及相关影响因素,为开展早期防治提供建议。 方法 采用方便抽样方法,以该区全体基层卫生工作者为调查对象,对慢性非传染性疾病的影响因素进行logistic回归分析。 结果 共发放问卷1 816份,独立完成知情同意的人数为1 515人,应答率83.43%。平均年龄(38.77±8.07)岁,研究对象慢性疾病检出率为53.07%。按国际疾病分类患病率前三位依次为肌肉骨骼系统疾病47.79%、消化系统疾病46.73%、泌尿生殖系统疾病22.77%。患病率在10%以上的病种共13种,前三位分别是颈椎病34.72%、龋齿21.72%、视疲劳18.68%。基层卫生工作者的职业紧张发生率为11.55%,在卫生技术人员中为12.26%。多因素回归分析结果显示影响基层卫生工作者慢性疾病患病率的危险因素包括女性(OR=1.506, 95%CI:1.079～2.102),35～44岁(OR=2.568, 95%CI:1.752～3.766),45～65岁(OR=3.766, 95%CI:1.965～7.026),收入7～11万(OR=1.812, 95%CI:1.214～2.706),收入＞11万(OR=1.649,95%CI:1.064～2.555),工龄≥21年(OR=2.077, 95%CI:1.156～3.732),业务培训＞1次/周(OR=1.829, 95%CI:1.329～2.517),职业紧张(OR=2.533, 95%CI:1.469～4.368)。已婚(OR=0.596, 95%CI:0.426～0.835)为其保护因素。 结论 基层卫生工作者慢性疾病患病率较高,相关部门需针对危险因素进行有效干预,促进卫生工作者健康。     

Occupation and risk of esophageal and gastric cardia adenocarcinoma

BACKGROUND: Adenocarcinomas of the esophagus and gastric cardia have risen dramatically in incidence over the past few decades, however, little research has been conducted on the occupational risk factors for these cancers. METHODS: In this population-based case-control study, lifetime job histories were compared between cases of esophageal adenocarcinoma (n = 283), gastric cardia adenocarcinoma (n = 259), and population controls (n = 689). Odds ratios (OR) and 95% confidence intervals (CI) for ever employment and by duration in various occupational and industrial categories were calculated using unconditional logistic regression. RESULTS: The risk of esophageal adenocarcinoma was elevated for persons ever employed in administrative support (OR = 1.5; 95%CI = 1.0-2.1); financial, insurance, and real estate (OR = 1.6; 95%CI = 1.0-2.4); and health services (OR = 2.2; 95%CI = 1.2-3.9). The risk of gastric cardia adenocarcinoma was increased among transportation workers (OR = 1.7; 95%CI = 1.1-2.6), as well as among carpenters (OR = 1.8; 95%CI = 0.9-3.9) and workers in the furniture manufacturing industry (OR = 2.4; 95%CI = 0.9-6.3). However, we observed few duration-response relations between length of employment in any category and cancer risk. CONCLUSIONS: This study revealed associations of esophageal adenocarcinoma with employment in administrative support, health services, and a category of financial, insurance, and real estate industries, and of gastric cardia adenocarcinoma with transportation and certain woodworking occupations. Some of these findings may be due to the play of chance associated with the multiple comparisons made in this study. Our results suggest that, overall, workplace exposures play a minor role in the etiology and upward trend of esophageal and gastric cardia adenocarcinomas.     

Carpal tunnel syndrome in repetitive work: a follow-up study

BACKGROUND: The Project on Research and Intervention in Monotonous work (PRIM) studied Danish workers for 3-4 years to determine the effects of monotonous work. The present study is a subset of that cohort and compares prevalence and incidence differences of carpal tunnel syndrome (CTS) between workers with highly repetitive work tasks and workers with varied work tasks. METHODS: The baseline study included 731 participants. Follow-up examinations were performed after 6 and 18 months. The CTS diagnosis was based on symptom interviews and nerve conduction tests. The repetitiveness levels were determined with electrogoniometers and observation of cycle times. RESULTS: The overall prevalence of CTS was 1.6% on the working hand and 0.7% on the other hand. There was a significantly increased risk of CTS for every 10-hr increase of repetitive non-forceful work (OR = 1.84; 95% CI = 1.06-3.19) on the working hand. This result, however, was based on few cases and a low prevalence in the control group. The overall annual CTS incidence was 0.62% on the working hand and 0.44% on the other hand. For the repetitive work tasks, the mean power frequencies ranged from 0.53 to 0.79 Hz. CONCLUSIONS: In the baseline study, highly repetitive work was associated with CTS. The CTS incidence was too low to perform any analyses of exposure differences.     

泰安市儿童青少年近视流行现状及影响因素

目的 分析泰安市儿童青少年近视流行现状及其可能的影响因素,为近视防控提供科学依据。方法 2019年10月采用多阶段整群随机抽样方法,在泰安市25所学校(幼儿园)抽取4～19岁儿童青少年,进行远视力检查和非睫状肌麻痹条件下的屈光检测,并对四年级及以上的中小学生开展近视影响因素问卷调查。结果 泰安市7 524名儿童青少年总体近视患病率为60.2%,5岁组、6岁组、小学、初中、高中和职高学生近视患病率分别为11.7%、14.0%、38.3%、82.3%、91.4%和74.4%。多因素分析显示,性别为女(OR=1.583,95%CI:1.374～1.825,P＜0.001)、年级增加(OR=1.062,95%CI:1.052～1.072,P＜0.001)、每天作业时长达2～3小时(OR=1.320,95%CI:1.067～1.633,P=0.010)、经常躺着或趴着看书或电子屏幕(OR=1.354,95%CI:1.094～1.676,P=0.005)是本地学生近视患病的危险因素,而在校能够每天做2～3次眼保健操(OR=0.776,95%CI:0.663～0.909,P=0.002)、2周调换1次座位(OR=0.631,95%CI:0.467～0.853,P=0.003)、每周能上2次体育课(OR=0.639,95%CI:0.423～0.967,P=0.034)、课间休息到户外活动(OR=0.699,95%CI:0.584～0.837,P＜0.001)则是近视的保护因素。结论 泰安市儿童青少年近视患病率呈现低龄、高发、进展迅速的特点,期望通过切实减轻课业负担、改变不良用眼习惯、加强校内眼保护措施来实现近视控制。     

Intestinal parasite carriage in workers exposed to sewage

The presence of protozoan cysts and helminth eggs in sewage and the very low minimal infective doses of parasites suggest an occupational risk for workers exposed to sewage. The objective of this study was to assess this risk in a group of raw sewage–exposed workers. The relationship between sewage exposure and intestinal parasite carriage was estimated by a multiple cross-sectional survey comparing yearly prevalence rates in 126 employees working in sewers in Paris, France, with the prevalence rate in 363 food-handlers employed between 1988 and 1993. The incidence of intestinal parasitic infestation was estimated among sewage-exposed workers. Four parasite species were identified among sewage-exposed workers: whipworm, Giardia lamblia, Entamoeba coli and Endolimax nanus. The prevalence mean of intestinal parasite carriage was 11.8% (57/480), related to the presence of protozoa in 91% of samples. G. lamblia was present in 3.5% (17/480) of samples. The incidence of positive parasitological stool examination was 5.9/100 person-years. The incidence of G. lamblia in stool examinations was 1.7/100 person-years. Age-adjusted odds ratios were significantly higher in exposed workers in 1988 (OR: 6.5; 95%CI: 2.0–14.5), 1990 (OR: 4.4; 95%CI: 1.2–10.1) and 1991 (OR: 3.4; 95%CI: 1.0–8.2), but not during the other three years. The results of this study emphasize an occupational risk of intestinal protozoan infestation in workers exposed to sewage. The decrease of adjusted OR with time reflects the efficacy of compliance with rules of hygiene.     

中国女性乳腺癌危险因素的Meta分析

目的:评价中国女性乳腺癌部分危险因素的作用,探索乳腺癌的病因。方法:运用Meta分析方法对我国1996～2006年间公开发表的有关乳腺癌危险因素病例对照研究的12篇文献资料进行定量综合分析。结果:各因素合并OR值分别为:初潮年龄(年)OR=1.54(95%CI:1.3437～1.7654);哺乳OR=0.68(95%CI:0.4779～0.9782);口服避孕药OR=1.33(95%CI:1.0627～1.6589);良性乳腺疾病史OR=2.62(95%CI:2.0275～3.3804);吸烟OR=1.86(95%CI:1.5394～2.2415);饮酒OR=0.81(95%CI:0.6196～1.0686);饮茶OR=0.86(95%CI:0.7646～0.9728)。结论:初潮年龄、口服避孕药、良性乳腺疾病史及吸烟是乳腺癌发生的危险因素,哺乳及饮茶则是乳腺癌的保护因素。     

Psychological Distress in Hospitalized Patients with Chronic Obstructive Pulmonary Disease

OBJECTIVES: To investigate the prevalence of psychological distress in hospitalized patients with chronic obstructive pulmonary disease (COPD), and to examine possible associations between psychological distress and several sociodemographic variables. METHODS: The Hopkins Symptom Checklist was used to gather data from 92 hospitalized COPD patients. These data were compared with 3,319 respondents aged 45 or over drawn from the 1998 Norwegian Statistics Health Survey. The latter were divided into four groups: respondents with COPD, respondents with other respiratory diseases, respondents with mixed chronic diseases, and a healthy group. RESULTS: The prevalence of psychological distress was found to be 58.7% in the hospitalized COPD patients and 42.9% in the community-based COPD sample. After controlling for sociodemographic variables and current smoking, the results showed a higher risk of psychological distress among hospitalized COPD patients (OR = 23.69; 95% CI: 13.37-41.98) and the community-based COPD sample (OR = 18.16; 95% CI: 8.31-39.68), and with sub-samples with other respiratory diseases (OR = 5.87; 95% CI: 3.82-9.02), and mixed chronic diseases (OR = 3.51; 95% CI: 2.39-5.18). CONCLUSIONS: COPD is associated with a high prevalence of psychological distress in both hospital and community settings. Furthermore, it appears that age, gender, education, marital status, and current smoking status do not substantially mediate the association between the severity of psychological distress and COPD status. The results provide additional evidence of the importance of screening for psychological distress symptoms in both hospitalized and community-based patients with COPD.     

Predictive factors for incident musculoskeletal disorders in an in-plant surveillance program

OBJECTIVES: A surveillance program for upper-limb work-related musculoskeletal disorders (UWMSD) based on assessment of health and risk factors was implemented between 1996 and 2000 in a large shoe factory with overall high levels for biomechanical exposure. The study aimed to identify workers with an increased risk of UWMSD incidence. METHODS: In 1996, 1997 and 2000, 166 workers filled out a questionnaire and underwent a standardized physical examination. Factors from the 1996 questionnaire (general, personal and occupational factors) associated with UWMSD incidence in 1997 were selected. The predictive role of these variables was studied with a logistic model, taking into account also gender and age. The performance of a risk score based on this model was studied in 2000, using the Wilcoxon test and ROC curves. RESULTS: In 1997, 28 incident cases of UWMSD were observed (N = 107, 26.2%). Work pace and prior history of UWMSD were the only factors significantly associated with UWMSD incidence in 1997 (respectively 33% versus 13%, P = 0.02 and 58% versus 22%, P = 0.01). Psychological distress (36% versus 21%, P = 0.10), physical fatigue (35% versus 22%, P = 0.14), repetitiveness (30% versus 18%, P = 0.17) and task precision (33% versus 21%, P = 0.16) were also included in the logistic model for 1997 UWMSD incidence. Controlling for these variables, prior history of UWMSD remained associated with incidence in 1997 (OR = 5.5, 95% CI = 1.4-21.8). In the period from 1997 to 2000, 24 incident cases were observed (N = 102, 23.5%). The risk score, based on variables from the 1997 model, was significantly higher for incident cases (median = 6 in incident cases versus 4.5 for healthy subjects, P = 0.02). ROC curves indicated that the highest agreement reached 67% for sensitivity and 59% for specificity. Among subjects who did not change their task (N = 71, 18 incident cases), performance reached 66% for specificity with the same sensitivity. CONCLUSION: These results suggest that surveillance programs of UWMSD at a company level are possible even with overall high levels for biomechanical exposure and should take into account occupational and personal factors, including prior history of UWMSD.     

Prevalence and incidence of HIV-1 infection among employees of a large textile business and their wives in Kinshasa, 1991-1996

BACKGROUND: The Democratic Republic of Congo has been experiencing a critical economic situation for several years, resulting in a favorable context for the spread of HIV-infection. A study was performed in a large textile factory in Kinshasa, to determine prevalence and incidence of HIV-infection among employees and their wives. METHODS: From February to November 1996, a cross-sectional study was conducted among 2010 employees (1859 males, 151 females) of the factory and their 1198 female partners. Participants responded to a structured questionnaire and HIV testing was performed after an informed consent was obtained in a pre-test counselling session. Using a reconstituted population of 1580 employees (1502 males, 78 females) and their 806 female partners (all HIV-seronegative in 1990), we determined the HIV incidence between 1990 and 1996. Employees included manual workers, middle managers and senior managers. RESULTS: Overall prevalence and incidence rates were 2.1% (95% CI=1.6%-2.6%) and 0.16/100 persons-years (95% CI=0.09-0.22) respectively. Reported condom use was associated with HIV infection in men (OR=2.5; 95% CI=1.2-5.3) and their spouces (OR=1; 95% CI=0.02-10.7) and with a history of urethral discharge in men (OR=4.1; 95% CI=1-30.1). The HIV incidence between 1990 and 1996 was 0,2/100 person-years (95% CI=0.1-0.2). The seroconversion risk increased from manual workers to senior managers (chi-square for linear trend=12.9; p<0.001). CONCLUSIONS: Despite the deterioration of health services and the economical instability in Kinshasa, HIV prevalence and incidence rates in this factory were much lower than rates observed in factories in same East and Southern African countries. Comparative prospective studies using a similar methodology are needed to better understand the reasons for these differences.     

社区老年人运动认知风险综合征患病率及相关因素的系统评价和Meta分析

目的 对社区老年人运动认知风险综合征的患病率和相关因素进行系统评价和meta分析。方法 计算机检索Pub Med、Embase、Web of Science、CINAHL、Sino Med、Cochrane Library、Psyc Info、知网、万方和维普等数据库,检索时限为建库至2022年5月。纳入有关社区老年人运动认知风险综合征患病率及其相关因素的研究。横断面研究采用美国卫生保健质量和研究机构推荐的质量评价标准进行评价。队列研究和病例对照研究使用纽卡斯尔-渥太华量表进行质量评价。使用Stata 15.0软件对提取的数据进行meta分析。结果 共纳入16篇文献,涉及51 364例社区老年人。结果显示,社区老年人运动认知风险综合征总患病率为8.0%(95%CI:7.0%～10.0%)。亚组分析结果显示,美洲、亚洲和欧洲患病率分别为8.9%(95%CI:6.9%～10.8%)、9.0%(95%CI:7.2%～10.7%)和5.1%(95%CI:0.1%～10.0%)。中国社区老年人运动认知风险综合征患病率为10.2%(95%CI:7.5%～12.9%)。社区老年人运动认知风险综合征的...     

青春早中期心理应激对青少年健康危险行为的预测作用

  目的  探讨青春早中期心理应激对青少年健康危险行为的预测作用,为早期识别青少年健康危险行为发生风险提供依据。  方法  于2018年4月从重庆市4所中小学通过立意抽样招募1 046名五至八年级中小学生,采用问卷调查和体格检查的方法收集调查对象基本情况和心理应激水平;于2018年10月收集健康危险行为自我报告情况,采用多因素Logistic回归分析青春早中期心理应激与青少年健康危险行为的关系。  结果  青少年健康危险行为报告率由高到低分别为不合理运动(62.05%)、偏食行为(24.76%)、打架(21.03%)、自杀意念(17.02%)、离家出走意念(9.85%)、情绪不良(8.80%)、吸烟(4.21%)、喝酒(3.73%)、赌博(3.63%)、网络成瘾(3.06%)。多因素Logistic回归分析结果显示,高水平心理应激与打架(OR=1.02,95%CI=1.01~1.03)、自杀意念(OR=1.02,95%CI=1.01~1.03)、情绪不良(OR=1.02,95%CI=1.01~1.03)、离家出走意念(OR=1.02,95%CI=1.01~1.03)、不合理运动(OR=1.01,95%CI=1.00~1.02)、吸烟(OR=1.02,95%CI=1.00~1.03)、网络成瘾(OR=1.02,95%CI=1.00~1.03)、偏食(OR=1.01,95%CI=1.01~1.02)和赌博行为(OR=1.02,95%CI=1.01~1.04)呈正相关(P值均 < 0.05)。  结论  青少年健康危险行为以不合理运动和偏食行为报告率相对较高,青春早中期心理应激状况对青少年健康危险行为报告风险具有正向预测作用。     

Prevalence and Work-Relatedness of Self-Reported Carpal Tunnel Syndrome Among U.S. Workers: Analysis of the Occupational Health Supplement Data of 1988 National Health Interview Survey

To estimate the prevalence and work-relatedness of self-reported carpal tunnel syndrome (CTS) among U.S. workers, data from the Occupational Health Supplement of 1988 National Health Interview Survey (NHIS) were analyzed. Among 127 million “recent workers” who worked during the 12 months prior to the survey, 1.47% (95% CI: 1.30; 1.65), or 1.87 million self-reported CTS, and 0.53% (95% CI: 0.42; 0.65), or 675,000, stated that their prolonged hand discomfort was called CTS by a medical person. Occupations with the highest prevalence of self-reported CTS were mail service, health care, construction, and assembly and fabrication. Industries with the highest prevalence were food products, repair services, transportation, and construction. The risk factor most strongly associated with medically called CTS was exposure to repetitive bending/ twisting of the hands/wrists at work (OR = 5.2), followed by race (OR = 4.2; whites higher than nonwhites), gender (OR = 2.2; females higher than males), use of vibrating hand tools (OR = 1.8), and age (OR = 1.03; risk increasing per year). This result is consistent with previous reports in that repeated bending/twisting of the hands and wrists during manual work is etiologically related to occupational carpal tunnel syndrome.     

HIV阳性男男性行为者抑郁现状及相关因素研究

目的 了解HIV阳性男男性行为者（men who have sex with men, MSM）抑郁现状及相关因素,为提高其心理健康水平提供依据。方法 采用方便抽样的方法,于2016年7-8月在南京市某医院对参加抗病毒治疗的 HIV阳性MSM进行问卷调查。采用logistic回归分析抑郁的相关因素。结果 抑郁症状发生率为38.6%（134/347）。多因素logistic回归分析显示,高社会支持（OR=0.955,95%CI:0.914~0.998）和高自尊（OR=0.788,95%CI:0.731~0.849）的HIV阳性MSM发生抑郁的可能性较小。 确诊时间＜12 月（OR=1.943,95%CI:1.080~3.493）和高感知歧视者（OR=1.049,95%CI:1.021~1.078）更有可能出现抑郁症状。结论 HIV阳性MSM抑郁症状的发生率较高,尤其是新发感染者。需要制定心理干预、咨询、治疗相结合的综合服务模式,以减少歧视,提高社会支持水平,缓解他们的负性情绪,从而改善其生存质量。     

潍坊市成人居民主要慢性病患病现状及其影响因素分析

目的 了解潍坊市成人居民慢性病患病现状及其影响因素,为慢性病预防与控制提供理论依据。方法 采用分层随机抽样方法在潍坊市抽取5 156名≥18岁成人居民进行问卷调查,利用logistic回归分析主要慢性病患病影响因素。结果 潍坊市成人居民高血压、血脂异常及糖尿病患病率分别为35.16%、34.60%、9.39%;对其影响因素进行logistic回归分析,多因素结果显示男性（OR = 1.391,95%CI:1.164～1.661）、年龄大（OR = 13.568,95%CI:8.215～22.408）、饮酒（OR = 1.270,95%CI:1.060～1.520）、肥胖（OR = 9.644,95%CI:5.203～17.878）、高盐（OR = 1.020,95%CI:1.000～1.041）、自评健康状况差（OR = 3.006,95%CI:1.694～5.335）、锻炼（OR = 0.834,95%CI: 0.725～0.959）是高血压的影响因素;男性（OR = 1.268,95%CI:1.032～1.558）、年龄大（OR = 6.049,95%CI:2.420～15.117）、肥胖（OR = 18.227,95%CI:2.471～134.480）、自评健康状况差（OR = 3.664,95%CI:1.093～12.277）、锻炼（OR = 0.719,95%CI:0.587～0.880）是糖尿病的影响因素;年龄大（OR = 2.209,95%CI:1.522～3.206）、自评健康状况好（OR = 0.859,95%CI:0.743～0.993）、已婚（OR = 0.599,95%CI:0.402～0.893）、肥胖（OR = 6.239,95%CI:3.868～10.062）、吸烟（OR = 1.281,95%CI:1.076～1.526）、高盐（OR = 1.024,95%CI:1.006～1.043）、高油（OR = 1.208,95%CI:1.007～1.014）是血脂异常的影响因素。结论 高血压、血脂异常和糖尿病是潍坊市成人居民的主要健康问题,其患病率随年龄呈上升趋势,应加强对老年人、超重和肥胖居民的健康管理,同时大力倡导低盐饮食,戒烟限酒,适度锻炼,提高居民生存质量。     

The incidence rates and risk factor of mild injury for two weeks: using Korea national health and nutrition examination survey 2001

OBJECTIVES: This study was performed to provide the basic data for establishing countermeasures for preventing injury by analyzing the incidence rates, the risk factors, the characteristics of the injury and the utilization of medical care for mild injury that lasted for two weeks. METHODS: We examined the injury survey data among the National Health and Nutrition Survey data. The definition of mild injury that lasted for two weeks was that the injury that caused pain at least once a day for two weeks or the injury for which the usual daily activity of the injured person was severely affected. We used statistical analysis methods such as chi-square test and multiple logistic regression analysis. RESULTS: The incidence rate of injury that lasted for two weeks was 4.7 per 1,000 persons. On the multiple logistic regression, the children and adolescents (OR=3.80, 95%CI=1.63-8.84) had higher rates of injuries than the adults, and the middle and high school (OR=0.51, 95%CI=0.31-0.85) and college(OR=0.34, 95%CI=0.17-0.68) students had lower rates of injuries than the elementary school students. The unemployed (OR=0.39, 95%CI=0.20-0.73) and others (OR=0.38, 95%CI=0.21-0.70) had lower rates of injuries than the blue collar workers. The major causes of injuries were found to be falling and slipping, and the most prevalent place of occurrence was near or at home. CONCLUSIONS: A prevention program needs to be developed and continuous education must be offered to the children, adolescents and blue collar workers.     

中国慢性乙型肝炎住院患者戊型肝炎重叠感染的转归:系统综述与Meta分析

  目的   评估中国慢性乙型肝炎(chronic hepatitis B, CHB)患者中戊型肝炎病毒(hepatitis E virus, HEV)重叠感染的发生和转归情况。   方法   检索PubMed、中国知网(CNKI)以及万方数据资源库, 收集2008-2019年中国关于CHB患者中HEV重叠感染的文献和相关文献的参考文献, 按照纳入排除标准进行文献筛选, 对纳入的文献进行数据提取、质量评价和统计分析, 使用R 3.5.2和Revman 5.3软件进行异质性检验(统计量I2)、合并率和比值比(odds ratio, OR)的计算。   结果   共纳入28篇文献。在CHB住院患者中HEV重叠感染率为13.6%(95% CI:12.5%~14.9%)。重叠感染HEV的CHB住院患者(CHB-HEV住院患者)中肝衰竭发生率为34.7%(95% CI:29.6%~40.1%), 发生风险均高于单纯CHB患者(OR=10.9, 95% CI:6.8~17.4)、重叠感染甲型肝炎病毒(hepatitis A virus, HAV)的CHB住院患者(CHB-HAV住院患者)(OR=3.8, 95% CI:2.4~6.2)以及单纯戊型肝炎患者(OR=5.1, 95% CI:3.8~6.8)。CHB-HEV住院患者病死率为13.8%(95% CI:10.3~17.8), 病死风险均高于单纯CHB患者(OR=8.5, 95% CI:4.0~18.3)、CHB-HAV住院患者(OR=14.4, 95% CI:4.8~42.9)以及单纯戊型肝炎患者(OR=4.4, 95% CI:3.0~6.4)。   结论   我国CHB住院患者中重叠感染HEV较常见, 是肝衰竭和死亡的重要诱因。     

Prevalence and incidence of carpal tunnel syndrome in a meat packing plant

OBJECTIVES: To determine prevalence and incidence of carpal tunnel syndrome (CTS) in a modern meat packing plant. The secondary objective was to explore the relation between ethnicity and CTS. METHODS: Six hundred and sixty five workers were interviewed and examined to find the prevalence of CTS. Subsequently, 421 workers without CTS were followed up and examined at a median interval of 253 days; of those, 333 remained without CTS and were again examined at a median interval of 148 days. RESULTS: The prevalence and incidence of CTS was 21% and 11/100 person-years, respectively. The incidence for Asian mixed, white, and other ethnicities was 12.0, 12.2, and 7.2 cases/100 person- years, respectively. The observed incidence for men and women was 9.7 and 18.4 cases/100 person-years, respectively. This difference was not quite significant (p = 0.068) with an estimated relative risk (women v men) of 1.9 (95% confidence interval (95% CI) 0.9 to 3.8). The interaction between sex and use of tools was significant (p = 0.04), however, although the relative risk for CTS in women who used tools was 4.2 the numbers were small and not significant. The relative risk for men who used tools was 0.64 and not significant. The percentage of incident cases with comorbid disease was only 6.3% (3/47). CONCLUSIONS: The prevalence and incidence of CTS in this workforce were higher than in the general population. However, the prevalence of CTS in this modern, mechanised plant was not significantly different from that reported in older plants. No relation was found between ethnicity, age, body mass index, and CTS for either prevalence or incidence. Comorbid disease among the cases of CTS is significantly less than that found in other industry.     

中国农村中老年人社会隔离的影响因素分析

目的 调查我国农村中老年人社会隔离的影响因素。方法 采用2015年中国健康与养老追踪数据,筛选出符合研究纳入标准的农村中老年人样本7 427例,根据Berkman社会网络指数判断是否存在社会隔离,采用多因素logistic逐步回归分析,对社会隔离的影响因素进行探讨。结果 中国农村中老年人社会隔离发生率为28.84%,其主要影响因素有:性别(OR = 1.55,95%CI:1.38～1.73)、年龄(OR = 1.69,95%CI:1.58～1.80)、地域(OR = 1.21,95%CI:1.13～1.29)、教育水平(OR = 0.83,95%CI:0.74～0.94)、金融机构存款金额(OR = 0.86,95%CI:0.80～0.93)、出入阶梯数(OR = 1.06,95%CI:1.01～1.13)、听力(OR = 1.25, 95%CI:1.11～1.41)、认知情况(OR = 0.91,95%CI:0.89～0.93)、生活满意度(OR = 1.07, 95%CI:1.01～1.15)、抑郁(OR = 1.17,95%CI:1.04～1.31)。结论 我国农村中老年人社会隔离发生率较高,应结合农村中老年人群体的特殊性,加强农村基础设施建设,重视中老年人身心健康管理,增加其社会网络和社会参与,以减少社会隔离的发生。     

Individual and ecological factors related to the geographical variability of psychological distress among small areas: a multilevel analysis in Catalonia, Spain

BACKGROUND: To know the geographic distribution of the prevalence of psychological distress is important for mental health services planning. This study is aimed at identifying the individual factors and those related to the area of residence which may explain the geographic variability of psychological distress (by healthcare districts) in Catalonia. METHODS: The data was taken from the 1994 Catalonian Health Survey and from the 1996 Catalonia population statistics. The prevalence of psychological distress is estimated by age and sex and by healthcare district. In a two-level logic regression model, a study is made of the relationship between the individual variables (first level: health survey n = 12,455) and those of the area of residence (second level: the healthcare district, n = 46) to the geographic distribution of the prevalence of psychological distress. RESULTS: The significant variables at individual level are in men: age (45-64 years OR: 0.63 y > 64 years OR: 0.22), working status (no work OR: 1.60), number of chronic diseases (CD) (CD = 1 OR: 1.75 CD = 2 OR: 2.06 CD = 3-5 OR: 3.36 and CD > 5 OR: 8.9). In women: age (25-44 years OR: 0.63 45-64 years OR: 0.45 and > 64 years OR: 0.32), working status (no work OR: 1.30), number of chronic diseases (CD = 1 OR: 1.75 CD = 2 OR: 2.44 CD = 3-5 OR: 4.09 and CD > 5 OR: 11.14), and also the kind of parental household in women (single-parental OR: 1.42). The variables at the level of the area of residence are in migration (men OR: 1.55 and women OR: 1.68) and unemployment (men OR: 1.07 and women OR: 1.06). CONCLUSIONS: The individual factors do not suffice to explain the geographical variability of the prevalence of psychological distress, but the characteristics of the area of residence are also important.