东丽区65岁以上老人流感疫苗接种效果评估

目的评价东丽区65岁以上户籍老年人免费接种流感疫苗的效果。方法选取东丽区2 0 1 4年免费接种过流感疫苗的51 2人65岁以上老年人为接种组,同时选取与接种组性别、年龄、身体状况等相匹配未接种过流感疫苗的3 60名65岁以上老年人为对照组,在流感疫苗接种后半年开展问卷调查,分析两组流感样症状及并发症的发病情况。结果接种流感疫苗对流感样症状的保护率为83.4 7%;对感冒后合并心肺并发症的保护率为81.73%;对普通感冒样症状的保护率为2 8.4 6%;接种流感疫苗发生接种反应的发生率为4.4 9%,均为一般反应。结论老年人接种流感疫苗安全有效。     

北京市老年人群流行性感冒疫苗免疫效果及成本效益评价

目的评价老年人群接种流行性感冒(流感)疫苗的效果和效益。方法选取北京市朝阳区和宣武区590名接种过流感疫苗,且年龄>60岁的老年人群为接种组,在社区中随机选择与接种组年龄、性别、健康状况等相匹配的602名未接种流感疫苗者为对照组。采用流行病学试验方法,在基线调查的基础上,分别于流感疫苗接种(基线调查)后的第1、3和6个月对试验组和对照组进行随访调查。结果接种组流感样疾病的发病率和就诊率均低于对照组,接种后第1、3和6个月内流感疫苗对流感样疾病的保护率分别为52.38%、36.84%和37.89%;接种流感疫苗减少流感样疾病就诊率分别为45.16%、50.54%和50.54%。接种组患感冒、其他呼吸系统疾病和慢性病的发病率和就诊率低于对照组,接种流感疫苗对感冒、其他呼吸道疾病和其他慢性疾病的保护率分别为49.54%、64.54%和38.82%。老年人群接种流感疫苗后第3和6个月内所获得的效益成本比为4.97∶1和4.98∶1。结论老年人群接种流感疫苗能有效地预防流感样疾病的发生,降低流感相关慢性疾病的发病率和复发率,且能够获得较高的成本效益。     

甲型H1N1流感疫苗预防接种效果观察

目的探讨接种甲型H1N1流感疫苗的有效性和安全性。方法选择120例18～60岁在我院接种甲型H1N1流感疫苗人员为接种组,同时按照年龄、性别、疾病匹配的情况选取未接种甲型H1N1流感疫苗者110例为对照组。调查分析甲型H1N1流感疫苗接种后90d内两组甲型H1N1流感发病率和其他流感样疾病发生情况。同时观察接种甲型H1N1流感疫苗后48h内不良反应发生情况。结果接种组甲型H1N1流感发病率和就诊率为0%,对照组甲型H1N1流感发病率和就诊率为7.3%,两组比较有显著统计学差异（P〈0.01）;接种组90d内甲型H1N1流感的保护率为100%,减少就诊率100%。接种组其他流感样疾病发生率（15.0%）和就诊率（8.3%）均明显低于对照组（22.7%和16.3%）,有统计学差异（P〈0.05）;接种组90d内其他流感样疾病的保护率为33.9%,减少就诊率49.4%;接种组共出现不良反应8例,总体不良反应率6.7%,给予适当的处理,症状很快消失。结论接种甲型H1N1流感疫苗是有效和安全的。     

北京市丰台区老年人免费流感疫苗接种效果评价

目的 评价北京市丰台区老年人接种免费流感疫苗的效果。方法 随机抽取丰台区2019年10—11月434名接种免费流感疫苗的60周岁以上的老年人作为接种组,选取2019年未接种流感疫苗的60周岁以上的434名老年人作为对照组。采用统一设计的调查问卷,收集调查对象的基本情况、接种疫苗后一年内流感样病例、呼吸系统疾病和心脑血管疾病的发生及就诊情况。结果 接种免费流感疫苗3个月内,接种组流感样病例的发病率(1.61%)低于对照组的发病率(5.07%),差异有统计学意义(χ²=8.027,P=0.005)。接种免费流感疫苗3个月内、4～6个月、7～12个月流感样病例的保护率分别为68.24%、16.67%、25.00%,流感样病例就医行为的保护率分别为40.00%、25.00%、50.00%;呼吸系统疾病的保护率分别为25.45%、-29.93%、-67.03%,呼吸系统疾病就医行为的保护率分别为19.97%、-8.70%、-57.14%;心脑血管系统疾病的保护率分别为40.00%、16.67%、-25.00%,心脑血管系统疾病就医行为的保护率分别为60.00%、75.00%...     

2008年胶南市部分农村合作医疗人群接种季节性流感疫苗成本效益分析

[目的]评价胶南市参加农村合作医疗人群接种季节性流感疫苗(以下简称流感疫苗)的效果和效益。[方法]2008年10月按年龄段分组选取3个社区共375名流感疫苗接种者为接种组,随机选择年龄、性别、健康状况、经济收入及受教育程度等相匹配的未接种流感疫苗的人群作为对照组,采用流行病学试验研究方法,随访12个月进行调查分析。[结果]疫苗对流感样疾病(ILI)的平均保护率为56.62%,其中60岁以上年龄组为69.23%。[结论]疫苗具有良好的保护性,特别是老年人群效果明显。且流感疫苗接种于60岁以上老年人可产生较高的经济效益,人均每年流感样疾病医疗费用节约约92元,建议农村合作医疗若按照40%的比例报销农村老年人流感疫苗接种费用,将会收到较好的经济效益和社会效益。     

集居人群流感疫苗不同接种覆盖率的保护效果评价

目的研究集体居住生活人群季节性流感疫苗的保护效果。方法按流感疫苗接种覆盖率将7家企业集体居住人群划分为A、B和C组,比较3组的流感发病率及组内接种与未接种人群的发病率,并计算各组疫苗保护率。结果 A、B和C组企业职工流感疫苗接种覆盖率分别为30.60%、64.69%和80.64%,疫苗接种后1年内甲型流感发病率分别为57.28‰、25.37‰和8.60‰,均低于接种前2年发病率;3组免后1年内发病率进行两两比较,差异均有统计学意义(P0.01),甲型流感年发病率随接种覆盖率增高而降低(P0.05)。A、B、C组职工免后1年内的疫苗保护率及95%可信区间分别为61.93%(46.63%~72.85%)、86.51%(78.57%~91.50%)和86.22%(79.18%~90.88%);B组和C组的疫苗保护率均高于A组。结论接种季节性流感疫苗对预防流感效果明显;在集体居住生活人群中,提高疫苗接种覆盖率可提高疫苗保护率。     

某高校离退休人员流感疫苗预防接种效果分析

目的调查某高校离退休人员接种流感疫苗预防流感的效果。方法分析2002～2008年某高校离退休人员(60～85岁)自愿接种流感疫苗的资料。结果作为重点人群的离退休人员,流感疫苗是一种安全有效的疫苗,局部反应在11.6%左右,全身反应在1.0%左右,疫苗对免疫人群有较好的保护性,保护率为46.6%,减少就诊率26.4%。结论接种流感疫苗减少了离退休人员流感样疾病的发生率,对离退休人员具有一定的保护作用。     

北京市城区居民流行性感冒样病例发病情况快速调查

为了解 2 0 0 1年冬季北京市城区居民流行性感冒 (流感 )样病例发病及流感疫苗接种情况 ,使用北京市 8个城区的电话局向号和随机数字相结合产生的电话号码 ,对城区居民进行电话调查 ,同时对部分 3～ 6岁幼儿和≥ 6 0岁老人开展自我管理式问卷调查。结果显示 :2 0 0 1年冬季北京市城区居民流感样疾病罹患率为 10 8% ,≤ 6岁、7～18岁、19～ 5 9岁、≥ 6 0岁人群流感样疾病罹患率分别为 4 0 0 %、16 7%、9 2 %、6 7% ,各年龄组人群罹患率差异有显著的统计学意义。≥ 6 0岁患慢性病老人罹患率为 8 3% ,非慢性病老人罹患率为 4 3% ,差异有显著的统计学意义。城区居民流感疫苗接种率为 10 5 % ,≤ 6岁、7～ 18岁、19～ 5 9岁、≥ 6 0岁人群流感疫苗接种率分别为36 8%、2 8 8%、6 7%、7 9%。接种组和未接种组幼儿流感样病例罹患率和≥ 6 0岁老人的人周发病率差异均无显著的统计学意义。表明 2 0 0 1年冬季北京市城区居民存在流感样病例流行 ,幼儿和患慢性病老人是预防流感样病例的重点人群 ,流感疫苗幼儿接种率较高 ,≥ 6 0岁老人接种率低 ,应积极在老年人群中推广流感疫苗的使用     

老年人接种流感疫苗的效果评价

目的评价老年人接种流感疫苗的效果。方法选取670名离退休教职工为接种组,675名未接种离退休人员为对照组,在接种流感疫苗后的第3个月采取问卷调查。分析两组流感样疾病的发生及治疗情况。结果接种疫苗后3个月,接种组和对照组流感样疾病的发病率分别为11.2%和23.7%,差异有统计学意义(P0.01)。流感疫苗的保护率为52.7%。对照组和接种组患者服用1种药物的比率分别是66.7%和25.0%,服用2种及多种药物的比率为33.3%和75.0%,差异均有统计学意义(P0.01)。结论接种流感疫苗对老年人具有一定的保护作用。     

2007年北京市城区居民流行性感冒样病例发病情况快速调查

目的快速评价北京市2007年元旦前后流行性感冒(流感)样病例发病情况、严重程度、病例就诊和服药行为,以及2006年居民流感疫苗接种情况。方法设计统一调查问卷,随机产生居民家庭电话号码,对抽取的家庭所有成员进行调查。结果共调查300户家庭925人,2006年12月18日～2007年1月14日流感样病例的发病率为4.7%,无并发症及需住院治疗的病例。54.4%的病例患病后到不同级别医院就诊,其中到市级及以上医院的占64.3%,社区医院占4.8%。病人就诊时戴口罩的占10.8%。北京市居民2006年接种流感疫苗的占14.6%,其中0～9岁和10～19岁接种流感疫苗的分别占27.5%和27.6%,≥60岁或有慢性病的人群接种流感疫苗的占17.3%。结论2007年元旦前后,北京市出现季节性流感流行,发病率4.7%,但病情较轻。患者就诊主要集中在大医院,社区医院较少,而且患者防护意识较差。2006年北京市居民流感疫苗接种率偏低,接种疫苗的重点人群,如≥60岁老人或有慢性病的人群流感疫苗接种率也偏低。     

Time trends in smoking in an urban population: a population-based study in Southern Brazil

This study evaluated time trends in smoking prevalence according to gender and family income among individuals 20 years or older in Pelotas, Rio Grande do Sul State, Brazil. Five population-based surveys using census tracts were conducted in the city from 2002 to 2010. Smoking was defined as consumption of one or more cigarettes per day for at least one month. Time trend was assessed using the chi-square test for linear trend. 15,136 individuals were enrolled in these surveys. During this period, overall smoking prevalence decreased from 28% (25.8-30.4) in 2002 to 21% (19.5-23.5) in 2010. This 23% decline was similar in both genders, but differed significantly according to family income (smoking prevalence increased as income dropped). From 2002 to 2010, smoking decreased by 26% in the lowest income quintile and 39% in the highest. Despite such reductions, smoking prevalence is still high, indicating the need to boost control measures, especially among low-income groups.     

Interseasonal variation in blood concentrations of organochlorines in great black-backed gulls (Larus marinus)

In two subsequent breeding seasons (2001 and 2002), we measured 12 organochlorines (OCs), including hexachlorobenzene (HCB), beta-hexachlorocyclohexane (beta-HCH), p,p'-dichlorodiphenyldichloroethylene (DDE), oxychlordane, and eight polychlorinated biphenyl congeners (PCBs), in the blood of the same 25 great black-backed gulls (Larus marinus). The wet-weight concentrations of different OCs in the blood decreased between 45 and 60% from 2001 to 2002. The main reasons for this were lower blood-lipid concentrations and higher body condition in 2002 compared to 2001. The differences in blood lipids and body condition probably resulted from changes in the availability of different prey types between the years. Despite the variation in the blood concentrations of OCs, there was a high predictability of the relative relationship among individuals between the years, especially for the most-persistent compounds (persistent PCBs, oxychlordane, and DDE); that is, individuals with high levels in 2001 still had relatively high levels compared to other individuals in 2002. This suggests that a concentration obtained from a single blood sample is a relatively reliable measurement of OC burdens for individual great black-backed gulls compared to other individuals, independent of changes in mean OC levels within the population. However, by including information about the nutritional status of individuals, more precise interference from samples in different years and locations may be made. Moreover, the great seasonal variation in OC levels within individuals may have implications for how OC monitoring should be conducted in gull populations.     

Characteristics of patients undergoing bariatric surgery in Canada

OBJECTIVE: The increasing prevalence of obesity has led to an increased use of bariatric surgery in the treatment of severely obese individuals. The characteristics of patients undergoing bariatric procedures outside of clinical studies and on a national level have not previously been reported. RESEARCH METHODS AND PROCEDURES: Acute-care hospital discharge data from the Canadian Institute for Health Information were analyzed to determine the demographic and clinical features and in-hospital mortality rates of individuals undergoing bariatric surgery in Canada. Data from individuals undergoing surgery in fiscal year 2002/2003 were compared with data from 1993/1994. RESULTS: Over 1100 bariatric surgeries were performed in Canada in 2002/2003, with the vast majority being performed in middle-aged women. Ten percent of patients had hypertension or diabetes, and only 1% or fewer had dyslipidemia or cardiovascular or cerebrovascular disease. Compared with 1993/1994, patients undergoing surgery in 2002/2003 were older, more likely to have diabetes or hypertension, and had shorter hospital stays. In-hospital mortality rates were <1% in both years. DISCUSSION: In the last decade, there has been a small increase in the average age and the number of patients with concomitant cardiovascular risk factors who are undergoing bariatric procedures in Canada. However, the vast majority of surgeries are being performed in middle-aged women with little cardiovascular comorbidity, and this is likely contributing to very low in-hospital death rates. Such individuals likely represent a highly selected sample of severely obese patients within Canada.     

Regression to the mean: a limited issue in disease management programs for chronic obstructive pulmonary disease.

Our objective was to test for evidence of regression to the mean in chronic obstructive pulmonary disease (COPD)-related health care utilization in a Colorado Medicaid population that met the criteria for, but were not participating in, a COPD disease management (DM) program. National Jewish Medical and Research Center had enrolled individuals who (1) had a diagnosis of COPD for at least 1 year and (2) were active participants in Colorado Medicaid's 1-year DM program called breatheWise; the present study sought a comparator group for that population. In order to test for evidence of regression to the mean (ie, high utilization from the recruitment period reducing without active intervention) in this case management model, we conducted a case-controlled analysis of total spending for a comparator population that would have met the inclusion criteria for the DM program. The present study assessed health care utilization for fiscal years 2002 and 2003 in terms of total rates of emergency room (ER) visits and hospitalizations for all causes in the comparator group of COPD patients. In addition, total costs related to both ER visits and hospitalizations were compiled. In total, 354 individuals met the inclusion criteria and were identified as the comparator group. ER visits and hospitalizations were consistent for 2002 and 2003. ER visits totaled 314 and 315 in 2002 and 2003, respectively, indicating a 0.3% increase that was not significant. Hospitalizations decreased from 0.53 admissions per patient in 2002 to 0.48 in 2003-a 9.4% reduction that was not significant. With comparable rates of ER visits and hospitalizations, total costs for health care utilization remained virtually unchanged between 2002 and 2003. There is minimal evidence of regression to the mean over 2 consecutive years in the Colorado Medicaid patients with moderate to severe COPD.     

Aedes albopictus seasonality in a protected area in the city of São Paulo, Brazil

The study had the objective of assessing the seasonality of Aedes albopictus and the impact of environmental factors on breeding sites in a protected urban area. Immature individuals were collected through fluid aspiration from nine tree holes, in the Ecological Park of Tietê in the city of S?o Paulo, Southern Brazil, from 2001 to 2002. The index of positivity and number of individuals results were as follows: positivity x precipitation (rho=0.69, p<0.001), positivity x temperature (rho=0.35, p<0.001), number of individuals x precipitation (rho=0.29, p<0.001) and number of individuals x temperature (rho=0.13, p<0.05). These correlations suggest rainfalls had greater impact than temperature.     

1992至2002年北京大学社区队列人群体质指数的变化

目的 对比1992年和2002年北京大学社区队列人群体质指数、超重率、肥胖率10年间的变化,进一步探讨个体体质指数的变化特点。方法 1992年采用分层随机抽样的方法抽取北京大学社区35～64岁人群中的1985人进行基线调查,通过体检和问卷调查获得队列人群的个体相关资料,经过长期的心血管疾病随访研究,于2002年对此队列人群进行第2次体检和问卷调查,对2次调查资料均完整的1437人进行分析。结果 (1)10年间男性体重平均增加了4．89kg,女性增加了3．08kg;体质指数(BMI)均值男性由10年前的23．49kg／m^2上升到10年后的25．22kg／m^2,女性由10．年前的23．30kg／m^2上升到10年后的25．02kg／m^2。(2)10年间男性超重率、肥胖率分别增长了47．8％和124．2％,女性则分别增长了29．5％和131．3％。(3)男性10年前超重者中有74．9％的人10年后仍超重,22．9％的人变成肥胖;肥胖者中85．7％的人10年后仍肥胖。女性10年前超重者中58．2％的人10年后仍超重,34．5％的人变成肥胖;肥胖者中93．7％的人10年后仍肥胖。结论北京大学社区队列人群10年间。BMI均值、超重率和肥胖率均有所增加。10年前基线BMI为超重或肥胖者中的大部分人10年后仍为超重或肥胖,恢复为正常者很少,而且BMI超重者比BMI正常者更容易变成肥胖,这说明超重或肥胖一旦形成则很难恢复。因此,控制超重和肥胖的关键在于早期预防。     

Erythropoietin in cancer patients with anemia

OBJECTIVE: The aim of this study is to evaluate the endogenous erythropoietin production in cancer patients with anemia. METHODS: Our prospective study interested 99 cancer patients with anemia from 17 to 80 years old, during the period going from March 2002 to December 2004, and 31 healthy individuals with anemia caused by iron deficiency. A blood sample was collected from each patient, as well as healthy individuals to measure serum erythropoietin, C reactive protein and ferritin. RESULTS: The increase of serum erythropoietin was significantly lower in patients than in healthy individuals (P < 0.05). 25.2% of our cancer patients have inflammatory anemia and 74.7% presented microcytic anemia associated with increase of serum ferririn and CRP. These values were significantly higher than in healthy individuals (p < 0.05). CONCLUSION: Anemia in cancer patients results from activation of inflammatory system, which inhibit erythropoietin production. Apart from etiologic treatments, anemia can be treated with recombinant human erythropoietin.     

Sentinel laboratory surveillance of hepatitis C antibody testing in England: understanding the epidemiology of HCV infection

This paper describes sentinel laboratory surveillance of hepatitis C antibody testing in England. Demographic and test result data were supplemented by follow-up questionnaires sent to the requesting clinician. Between October 2002 and September 2003 almost 75000 anti-HCV tests were performed in eight sentinel centres. More males were tested than females and over half of those tested were aged 25-44 years. Overall 5.7% (3333/58144, range 2.8-7.7%) individuals tested positive. Follow-up questionnaire data showed that 82% (1043/1277) of the positives had injecting drug use reported as the main risk exposure. The majority of negative individuals were undergoing routine screening as recommended for specific patient groups. Most individuals were asymptomatic. Antibody prevalence was estimated to be 34% in current injecting drug users and 42% in former injectors. Comparing positives to routine national surveillance suggests that only 53% (1782/3333) of diagnosed cases were reported. Sentinel laboratory data can provide valuable supplementary data to national surveillance.     

Coverage rates of influenza vaccination in France: a population-based cross-sectional analysis of seasons 2001-2002 and 2002-2003

INTRODUCTION: Influenza is a serious health problem in Europe. Vaccination is the only preventive measure, reducing mortality and morbidity of influenza in all age groups. OBJECTIVES: The authors had for aim to assess influenza vaccination coverage during two seasons in France, to understand the incentives and barriers to vaccination and to determine vaccination intentions for the following winter. METHODS: A random-sampling, mail-based household survey was made among non-institutionalised individuals aged 15 and over. The surveys for 2001-2002 and 2002-2003 used the same questionnaire and were subsequently pooled. Three target groups were determined for analysis: (1) persons aged 65 and over; (2) people working in the medical field and (3) persons aged 65 and over or working in the medical field. RESULTS: Influenza vaccination coverage in France decreased from 23.0% in 2001-2002 to 22.4% in 2002-2003. Most frequent reasons for being vaccinated were advice from the family doctor (50.8%), influenza considered as a serious illness (45.3%) and free vaccine (44.1%). Reasons for not being vaccinated mentioned by people who had never been vaccinated were young age (27.0%), not considering vaccination (18.9%), and not expecting to catch influenza (13.9%). CONCLUSION: Vaccination coverage decreased during the 2002-2003 season in comparison to the 2001-2002 season. The family doctor is the most important source of encouragement for people to be vaccinated against influenza. We therefore suggest that family doctors be better informed on influenza vaccine and the disease itself, so that they can actively inform their patients on these topics.     

Ten years' experience using an integrated workers' compensation management system to control workers' compensation costs

This work presents 10 years of experience using an Integrated Workers' Compensation Claims Management System that allows safety professionals, adjusters, and selected medical and nursing providers to collaborate in a process of preventing accidents and expeditiously assessing, treating, and returning individuals to productive work. The hallmarks of the program involve patient advocacy and customer service, steerage of injured employees to a small network of physicians, close follow-up, and the continuous dialogue between parties regarding claims management. The integrated claims management system was instituted in fiscal year 1992 servicing a population of approximately 21,000 individuals. The system was periodically refined and by the 2002 fiscal year, 39,000 individuals were managed under this paradigm. The frequency of lost-time and medical claims rate decreased 73% (from 22 per 1000 employees to 6) and 61% (from 155 per 1000 employees to 61), respectively, between fiscal year 1992 and fiscal year 2002. The number of temporary/total days paid per 100 insureds decreased from 163 in fiscal year 1992 to 37 in fiscal year 2002, or 77%. Total workers' compensation expenses including all medical, indemnity and administrative, decreased from $0.81 per $100 of payroll in fiscal year 1992 to $0.37 per $100 of payroll in fiscal year 2002, a 54% decrease. More specifically, medical costs per $100 of payroll decreased 44% (from $0.27 to $0.15), temporary/total, 61% (from $0.18 to $0.07), permanent/partial, 63% (from $0.19 to $0.07) and administrative costs, 48% ($0.16 to $0.09). These data suggests that workers' compensation costs can be reduced over a multi-year period by using a small network of clinically skilled health care providers who address an individual workers' psychological, as well as physical needs and where communication between all parties (e.g., medical care providers, supervisors, and injured employees) is constantly maintained. Furthermore, these results can be obtained in an environment in which the employer pays the full cost of medical care and the claimant has free choice of medical provider at all times.