Dental lead levels in children from two different urban and suburban areas of Turkey

The lead content of shed primary teeth has proved to be a reliable measure of cumulative lead exposure in children as it is an indicator of the degree of exposure over several years, from in utero life to loss of the tooth. Totally 297 shed deciduous teeth were collected from 263 children between ages 4 and 15 to determine the level of lead exposure in Ankara and Balikesir in Turkey. Ankara is the capital of Turkey and characterized by heavy traffic and high air pollution. On the other hand, Balikesir has less traffic. Balikesir-Centre (R) had the highest mean (SD) lead level (1.77+/-1.03microg/g) whereas Ankara-Centre (U) had the lowest level (1.30+/-0.59microg/g). We could not observe a statistically significant difference between urban and suburban regions (Table 1), and in terms of type of tooth, incisors had a statistically significant higher lead level than canines and molars (p<0.05, Table 2). No difference was observed between boys and girls and the accumulation of lead in teeth (p<0.05, ).     

Use of services in old age: data from three surveys of elderly people

It has been suggested that home sharers, particularly spouses, act as substitutes for formal health and social care provision. This hypothesis was investigated in relation to three independent samples of elderly people, using comparable methodology in London (urban area) and Essex (semi-rural area). The uniqueness of the study lies in the ability to make comparisons between younger and older elderly people, in particular with those aged 85 and over. Utilisation of health and social services was found to be higher in the urban area, and it increased with age. Marital status was not associated with service use nor with contact with general practitioners in any age group or area. The social network variables analysed had little or no predictive ability in relation to recency of contact with general practitioners (GPs). Household size was associated with total use of health and social services, and social services in particular. The multivariate analysis confirmed that household size was a strong predictor of use of home help and meals on wheels services; functional status was the best predictor of use of district nursing services.     

陕西省农村6岁以下儿童营养状况两次调查结果比较

儿童营养不良不仅会造成儿童当前身体的发育迟缓,同时还会增加成年时期患许多慢性代谢性疾病的危险。我国0~5岁儿童的营养状况在过去10年中有了很大的改善,但在农村,儿童营养不良率依然很高。为了解陕西省农村儿童的营养状况变化,2002对年陕西省农村6岁以     

Job characteristics and problems related to home care services for the elderly. A comparison among employment categories in Sapporo

OBJECTIVE: The aims of this study were to describe job characteristics for daytime and shift workers in home care services for the elderly and to clarify health care in the work setting, social support, and job satisfaction and possibilities. METHODS: A self-reported questionnaire was given to 433 home care workers, both full time and part time (more than 15 hours), at 35 institutions that provide home care services to residents of Sapporo (return rate; 80.2%). The following issues were investigated: job content (physical care, assistance with housework, and advice), specialty, job satisfaction, possibilities, job training, health care and social support. The results were compared among employed types: full-time and part-time daytime and shift workers using the t-test or the Fisher's test. RESULTS: The participants demonstrated high dissatisfaction with wages, physical uneasiness themselves and limited social support from their supervisors. Especially full-time workers were dissatisfied with the payment, whereas part-time workers complained about insufficient attention to the prevention of lumbago. It was found that part-time daytime workers were given insufficient on-job-training and education for prevention of infection, and that full-time shift workers greatly wished to leave the employment. However, the home care workers were satisfied with their job itself and expected to continue their work. Furthermore, half of the part-time workers hoped to work full time. CONCLUSIONS: Health management and educational training for part-time workers may be necessary to improve the quality of care services and protection of health. Promotion of full time employment and reconsideration of working condition might be necessary to provide sufficient home care services.     

General practitioner's recognition of service cooperation with community pharmacists related to home care in a suburban area

OBJECTIVES: To clarify the factors affecting a general practitioner's demands and the recognition of service cooperation with community pharmacists related to home care in a suburban area. METHODS: A questionnaire on pharmacy services and functions was administered to 215 general practitioners in a suburban area. Gender, age, specialty, length of practice, status of home visiting, requests for community pharmacists, awareness of a home visiting service by community pharmacists, status of issues about home visiting orders to community pharmacists and the criteria for deciding to issue an order, recognition of the necessity of a home visiting service by pharmacists, expectation value to the community of the pharmacists' participation in the home care service and requests, recognition of cooperation with other home care related professions, ease of cooperation with community pharmacists, disincentives for cooperation with community pharmacists, factors necessary to promote cooperation between practitioners and community pharmacists, and factors necessary to promote the home care system were surveyed. Using the results, chi 2 test and principal component analysis were performed. RESULTS: It was found that the general practitioners' main demands were support and management of pharmaceutical therapy. Meanwhile, the practitioners' low cognition of pharmacists' home visiting seemed to be one disincentive to cooperation with pharmacists. Every practitioner who had issued visiting orders to pharmacists practiced home visiting and issued the visiting orders based on patients' condition at home. Practitioners who practiced home visiting were more active in promoting the home care system and had a better cognition and more extensive demands for pharmacists' home visiting compared to practitioners with no home visiting. Practitioners with good recognition of cooperation with community pharmacists had better cognition, realized the necessity of, and expected pharmacist's home visiting compared to practitioners with low awareness. However, practitioners' overall recognition of cooperation with pharmacists was relatively low. As disincentives, practitioners pointed out lack of acquaintance, the unclear function of pharmacists, and no opportunity for cooperation. So, enhancing practitioners' awareness of home care, clarifying the pharmacist's role, establishing a relationship of mutual trust through information feedback and/or exchange based on practice would be effective in promoting service cooperation with community pharmacists.     

上海市城乡小学生睡眠状况调查分析及对策研究

[目的]了解上海市小学生的睡眠状况及其相关因素并进行对策研究.[方法]采用分级整群抽样,于2005年11～12月对上海市城、乡6所小学的一～五年级2 459名小学生进行了问卷凋查,调查内容包括城、乡小学生睡眠状况(采用自制问卷)、影响城乡小学生睡眠时间的因素分析(采用中文版CSHQ).[结果]上海市城、乡小学生周一～周五的平均睡眠时间分别为8.56 h和8.58 h;周末为9.40 h和9.28 h,均明显低于国外同龄儿童及我国颁布的有关学生健康和卫生工作条例中所规定的每天应保证小学生10 h的睡眠时间标准.城、乡小学生平时每天总睡眠时间均随年龄(年级)的增加逐渐减少.影响城、乡小学生睡眠时间的因素略有差异,相同因素有:课业负担重、感到有压力、学习成绩差、完成家庭作业所需时间长、抚养人就寝时间晚等.不同因素包括:城区小学生有喝含咖啡因饮料及看电视时间长的习惯;郊区小学生就晚餐时间晚、卧室有电脑及迷恋上网等. [结论]上海市城、乡小学生睡眠不足普遍存在且与诸多因素有关,社会、学校及家庭多方面需共同努力改善儿童的睡眠状况.     

区域内城乡居民医疗服务需要、需求及其影响因素分析

分析区域内城乡医疗服务需要、需求、潜在需求水平及其影响因素。方法：对12823人进行家庭卫生服务问卷调查，采用单因素分析与非条件Logistic回归分析方法。结果：获得该区域城乡居民2周患病、慢性病患病、门诊2周就诊与住院、未就诊与未住院及其影响因素。结论：区域医疗服务需要水平较低，影响因素主要是人口学特征与经济因素；区域医疗服务需求水平低，门诊影响因素主要为人口学特征与经济因素，住院影响因素为患病种类；潜在需求中住院医疗服务水平高，门诊医疗服务水平低。     

Use of health services and home care before and after conversion of nursing home residences into private flats: Cross sectional consumer health surveys

The aim of this article is to describe the attitude to a changeof nursing home residences into private flats and the use ofservices by elderly persons before and after a major intervention(in 1986) in the service-delivery organization in the DanishMunicipality of Skaevinge. In this intervention, the rooms ofa nursing home were converted into health care centre flats.Former nursing home residents were again living in private flats.Their pensions, which formerly paid for their upkeep in thenursing home, were now paid directly to them. The study is basedon cross-sectional consumer health surveys. A total of 155 elderlypersons participated in ‘before and after’ interviewswhich took place in 1985 and 1987. During the first survey,52% of the elderly persons were positive towards conversionof the nursing home; in the second survey, this figure roseto 76%. There was a significant increase in provision of homehelp from 10 to 37%, home nursing from 11 to 30% and healthadvice in general. Due to the integration of the former nursinghome staff with the home care area, staff now work as interdisciplinaryteams both inside and outside the new health care centre.     

Combining data from primary and ancillary surveys to assess the association between neighborhood-level characteristics and health outcomes: the Multi-Ethnic Study of Artherosclerosis

There is increasing interest in understanding the role of neighborhood-level factors on the health of individuals. Many large-scale epidemiological studies that accurately measure health status of individuals and individual risk factors exist. Sometimes these studies are linked to area-level databases (e.g. census) to assess the association between crude area-level characteristics and health. However, information from such databases may not measure the neighborhood-level constructs of interest. More recently, large-scale epidemiological studies have begun collecting data to measure specific features of neighborhoods using ancillary surveys. The ancillary surveys are composed of a separate, typically larger, set of individuals. The challenge is then to combine information from these two surveys to assess the role of neighborhood-level factors. We propose a method for combining information from the two data sources using a likelihood-based framework. We compare it with currently used ad hoc approaches via a simulation study. The simulation study shows that the proposed approach yields estimates with better sampling properties (less bias and better coverage probabilities) compared with the other approaches. However, there are cases where some ad hoc approaches may provide adequate estimates. We also compare the methods by applying them to the Multi-Ethnic Study of Atherosclerosis and its Neighborhood Ancillary Survey.     

Factors related to frequent usage of the primary healthcare services in old age: findings from The Swedish National Study on Aging and Care

People aged 60 or more are the most frequent users of healthcare services. In this age range, however, both frequent and infrequent users can be found. Frequent users have high rates of illnesses. Previous research has found that the frequency may be influenced also by psychological and social factors. The aim of this study was to investigate to what degree such factors add to the explanation of differences in number of visits to a physician. A cross-sectional study was conducted with a random sample consisting of 1017 individuals, aged 60 to 78 years, from the Blekinge part of the Swedish National Study on Aging and Care database. The data were collected during 2001 to 2003. Hierarchical logistic regression analyses were used with frequent (three visits or more during a year) and infrequent use as a dichotomous dependent variable. The final statistical analyses included 643 individuals (63% of the sample). Independent variables were sense of coherence (SOC), internal locus of control, education level and social anchorage. Control variables were age, gender, functional ability and comorbidity. The results showed that comorbidity was most strongly related to frequent use [adjusted odds ratio (OR) = 8.17, 95% confidence interval (CI) 5.54–12.04]. In addition, SOC and internal locus of control had small, but significant effects on the odds of being a frequent user (adjusted OR = 1.03, 95% CI 1.00–1.06 and adjusted OR = 1.14, 95% CI 1.02–1.27, respectively). The lower the SOC and the internal locus of control were, the higher were the odds of frequent use. Education level and social anchorage were unrelated to frequency of use. The results indicate that frequent healthcare services users are more ill than infrequent users. Psychological factors influence the use only marginally, and social factors as well as age and gender are not by themselves reason for frequent healthcare services use.     

上海市嘉定区望新镇村民脑卒中、高血压相关KAP调查

笔者在上海望新镇开展了以高血压、脑卒中相关知识、态度和行为(KAP)的调查,以进一步开展健康教育,完善以控制高血压为主要干预措施的心脑血管疾病的防治工作.     

基于集中度和圆形分布法的上海市郊区某镇手足口病流行特征分析

目的 分析上海市郊区某镇2012—2018年手足口病流行病学特征和季节性分布规律,为制定有效的防控策略提供科学依据.方法 通过中国疾病预防控制信息系统,收集2012—2018年现住址为上海市郊区某镇的手足口病发病资料,采用描述性流行病学方法进行分析.结果 上海市郊区某镇2012—2018年共报告手足口病病例538例,年...     

Beyond patient dependency: family characteristics and access of elderly patients to home care services following hospital discharge

Access to Skilled Nursing and Home Health Aid services among elderly patients (N = 580) and their family caregivers post hospital discharge was examined using logistic regression. A majority of the sample (65%) were referred for Skilled Nursing services while only 28% were referred for Home Health Aid services. Caregiving situations in which the spouse was the primary caregiver were less than half as likely to be referred for either service when compared to non-spouses. As expected, ADL limitations were a significant predictor of referral for both services. Women patients with the same ADL limitation as men were only about a fourth as likely to be referred for Home Health Aid services as men. Findings are discussed in terms of access to care and the need for policy to consider more than patient limitations in the referral criteria.     

北京城、郊区儿童哮喘及相关过敏疾患的室内环境因素比较

Objective To study the indoor environmental factors associated with the prevalence of asthma and related allergies among school children.Methods A cluster sampling method was used and the ISAAC questionnaire was conducted.A total of 4612 elementary students under Grade Five of 7 schools were enrolled in the survey for the impact of indoor environmental factors on the prevalence of asthma and related allergies in several urban and suburban schools of Beijing.Results A total of 4060 sample were finally analyzed including 1992 urban and 2068 suburban.The prevalence of wheeze, allergic rhinoconjunctivitis and atopic eczema in the past 12 months was 3.1% (61/1992) ,5.3% (106/1992) ,1.1% (22/1992) among urban children while 1.3% (27/2068) ,3.1% (65/2068), 1.0% (22/2068) among suburban children respectively.The prevalence of wheeze and allergic rhinoconjunctivitis of the past 12 months in urban were both significantly higher than that in suburban ( χ2 = 14.77, 11.93, P ＜ 0.01 ).The incidences of having asthma and eczema ever among urban children (5.3% (105/1992) ,29.4% (586/1992))were significantly ( χ2 = 39.03, 147.22, P ＜ 0.01 ) higher than that among suburban ( 1.7% ( 35/2068 ), 13.8%(285/2068)).Atlthough the distributions of indoor environmental factors were similar in both areas, passivesmoking and interior decoration had different influence on the prevalence of asthma and related allergies among school children in the two areas.The significant impact of passive smoking on having asthma ever among suburban children was observed ( OR = 2.70,95% CI = 1.17 - 6.23 ) while no significant result in urban ( OR = 1.06,95% CI = 0.71 - 1.58 ); the percentage of interior decoration was 84.0% ( 1673/1992 )among urban children and 80.0% (1655/2068)among suburban children, there was significant impact of interior decoration on the prevalence of having eczema ever among urban children ( OR = 1.57,95% CI =1.17-2.10) but no significant results were found in suburban sample (OR= 1.06,95% CI =0.76-1.48).Conclusion The prevalence of asthma and related allergies among school children is much higher in urban areas than that in suburban areas and the indoor environmental factors such as passive smoking and interior decoration may differently explain the prevalence of asthma and related allergies in the two areas.     

北京城、郊区儿童哮喘及相关过敏疾患的室内环境因素比较

目的 探讨与儿童哮喘及相关过敏疾患发生相关的室内环境影响因素.方法 采用整群抽样方法,在北京市城区与郊区各选择7所小学的一至四年级学生4612名,使用国际间儿童哮喘及过敏性疾病对比研究标准问卷,调查室内环境因素对儿童哮喘及相关过敏疾患发生的影响.结果 实际分析4060名儿童,其中城区1992名,郊区2068名.城区儿童近12个月喘息、过敏性鼻炎及特应性湿疹的发生率分别为3.1%(61/1992)、5.3%(106/1992)和1.1%(22/1992);郊区为1.3%(27/2068)、3.1%(65/2068)和1.0%(22/2068).城区儿童12个月喘息及过敏性鼻炎的发生率高于郊区,差异有统计学意义(x2值分别为14.77、11.93,P＜0.01).城区儿童既往患有哮喘及湿疹的发生率分别为5.3%(105/1992)、29.4%(586/1992),郊区分别为1.7%(35/2068)、13.8%(285/2068),城区高于郊区,差异有统计学意义(x2值分别为39.03、147.22,P值均＜0.01).尽管两区儿童所处的室内环境因素分布比例比较相近,但被动吸烟及家庭装修对两区儿童哮喘及相关过敏疾患的发生影响不同:被动吸烟对郊区儿童既往哮喘发生的OR=2.70,95%CI=1.17～6.23.而在城区未发现显著影响(OR=1.06,95%CI=0.71～1.58);84.0%(1673/1992)的城区儿童家庭装修过,郊区为80.0%(1655/2068),家庭装修对城区儿童既往湿疹发生的OR=1.57,95%CI=1.17～2.10,在郊区未发现显著影响(OR=1.06,95%CI=0.76～1.48).结论 北京市城区学龄儿童哮喘及相关过敏疾患的发生率显著高于郊区,室内环境因素中被动吸烟、家庭装修对两区儿童哮喘及相关过敏疾患发生的影响可能不同.     

北京城、郊区儿童哮喘及相关过敏疾患的室内环境因素比较

Objective To study the indoor environmental factors associated with the prevalence of asthma and related allergies among school children.Methods A cluster sampling method was used and the ISAAC questionnaire was conducted.A total of 4612 elementary students under Grade Five of 7 schools were enrolled in the survey for the impact of indoor environmental factors on the prevalence of asthma and related allergies in several urban and suburban schools of Beijing.Results A total of 4060 sample were finally analyzed including 1992 urban and 2068 suburban.The prevalence of wheeze, allergic rhinoconjunctivitis and atopic eczema in the past 12 months was 3.1% (61/1992) ,5.3% (106/1992) ,1.1% (22/1992) among urban children while 1.3% (27/2068) ,3.1% (65/2068), 1.0% (22/2068) among suburban children respectively.The prevalence of wheeze and allergic rhinoconjunctivitis of the past 12 months in urban were both significantly higher than that in suburban ( χ2 = 14.77, 11.93, P ＜ 0.01 ).The incidences of having asthma and eczema ever among urban children (5.3% (105/1992) ,29.4% (586/1992))were significantly ( χ2 = 39.03, 147.22, P ＜ 0.01 ) higher than that among suburban ( 1.7% ( 35/2068 ), 13.8%(285/2068)).Atlthough the distributions of indoor environmental factors were similar in both areas, passivesmoking and interior decoration had different influence on the prevalence of asthma and related allergies among school children in the two areas.The significant impact of passive smoking on having asthma ever among suburban children was observed ( OR = 2.70,95% CI = 1.17 - 6.23 ) while no significant result in urban ( OR = 1.06,95% CI = 0.71 - 1.58 ); the percentage of interior decoration was 84.0% ( 1673/1992 )among urban children and 80.0% (1655/2068)among suburban children, there was significant impact of interior decoration on the prevalence of having eczema ever among urban children ( OR = 1.57,95% CI =1.17-2.10) but no significant results were found in suburban sample (OR= 1.06,95% CI =0.76-1.48).Conclusion The prevalence of asthma and related allergies among school children is much higher in urban areas than that in suburban areas and the indoor environmental factors such as passive smoking and interior decoration may differently explain the prevalence of asthma and related allergies in the two areas.