学龄儿童营养不良的危险因素分析

[目的]探讨儿童营养不良的危险因素,为预防儿童营养不良提供科学依据。[方法]按1︰1配对的原则对121例营养不良儿童和对照组进行调查,用SPSS13.0软件对调查因素进行单因素和多因素的Logistic回归分析。[结果]单因素分析表明母亲文化程度、家庭经济收入、家庭成员关系、单亲家庭、母亲不知道合理营养、经常吃水果蔬菜、常吃鱼肉蛋奶及豆制品、偏食挑食、常吃零食、食量小、经常患病、近两个月内患严重疾病、经常户外运动等13项因素与儿童营养不良有关。多因素Logistic回归分析发现家庭经济收入低(OR=3.0419)、家庭成员关系紧张(OR=2.6347)、母亲不知道合理营养(OR=3.2851)、偏食挑食(OR=4.5821)、经常患病(OR=2.1632)是儿童营养不良的危险因素,而母亲文化程度高(OR=0.5162)、常吃蔬菜水果(OR=0.4794)、常吃鱼肉蛋奶及豆制品(OR=0.2319)、经常户外运动(OR=0.3168)是儿童营养不良的保护因素。[结论]儿童营养不良是多因素综合作用的结果,应采取综合措施来预防儿童营养不良的发生。     

学习障碍儿童家庭影响因素的Logistic回归分析

目的分析学习障碍儿童的家庭影响因素,为儿童学习障碍的防治提供参考依据。方法采用自拟家庭情况调查问卷对2364名学生家长进行调查,并进行单因素及多因素非条件Logistic回归分析。结果单因素Logistic回归分析显示,亲子交流(OR=0.803)、孩子在家中的学习环境(OR=0.626)、家庭经济收入(OR=0.775)、父亲文化程度(OR=0.590)、母亲文化程度(OR=0.582)是儿童学习障碍的保护因素;娇宠型教育方式(OR=3.710)是儿童学习障碍的危险因素。多因素Logistic回归显示,父亲文化程度(OR=0.721)、母亲文化程度(OR=0.753)和娇宠型教育方式(OR=4.007)是家庭因素中儿童学习障碍的主要影响因素。结论家庭因素对儿童学习障碍的影响不可忽视,提高父母文化素质、改善教育方式对防治儿童学习障碍具有重要的意义。     

贵港农村地区儿童毒鼠强意外中毒危险因素的病例对照研究

目的分析农村地区儿童毒鼠强意外中毒的危险因素,为儿童毒鼠强意外中毒的预防和干预提供科学依据。方法采用1∶2病例对照方法,对广西贵港市农村地区1～14岁毒鼠强中毒的92例病例和未发生中毒的对照组184例进行调查。调查内容包括健康教育、家庭因素、儿童自身危险行为和鼠药管理等。采用条件Logistic回归模型分析儿童毒鼠强中毒发生的危险因素。结果多因素条件Logistic回归分析发现常外出玩耍(OR=2.683,95%CI=1.595～4.515)、经常吮手(OR=2.556,95%CI=1.468～4.449)、随意放置鼠药(OR=3.765,95%CI=1.823～7.652)等3个因素是危险因素,而监护频率高(OR=0.344,95%CI=0.182～0.605)、知道中毒预防知识(OR=0.180,95%CI=0.075～0.432)2个因素是保护因素。结论应针对儿童毒鼠强中毒的危险因素制定有效的综合预防干预措施。     

贵港市农村1～14岁儿童意外中毒危险因素的病例对照研究

目的:探讨农村地区儿童发生意外中毒的危险因素,为儿童意外中毒的预防和干预提供科学依据。方法:采用1∶1匹配的病例对照研究方法,对广西贵港市237例因意外中毒而住院或急诊的1～14岁农村儿童和居住于同一地区、性别、年龄匹配的237例对照儿童进行问卷调查。采用单因素和多因素条件Logistic回归模型分析危险因素。结果:单因素条件Logistic回归分析发现父母非第一监护人、母亲低学历、常外出玩耍、经常吃零食、经常吮手、随意放置鼠药或农药、监护频率高、学校有健康教育课程、知晓中毒预防知识、教育儿童卫生饮食10个因素与发生意外中毒有关。多因素条件Logistic回归分析发现母亲低学历(OR=2.134,P=0.003)、父母非第一监护人(OR=3.219,P=0.000)、常外出玩耍(OR=2.172,P=0.000)、经常吮手(OR=2.367,P=0.001)、随意放置鼠药或农药(OR=2.184,P=0.007)5个因素是危险因素;监护频率高(OR=0.570,P=0.007)、学校有健康教育课程(OR=0.327,P=0.011)、知晓中毒预防知识(OR=0.247,P=0.000)3个因素是保护因素。结论:农村地区儿童意外中毒的发生与健康教育、家庭因素、儿童监护、儿童自身危险行为、毒物管理等因素有关。应针对儿童中毒的危险因素制定综合的预防干预措施。     

学龄期儿童6 098名单纯性肥胖及其影响因素分析

[目的]了解咸宁市咸安区7～12岁儿童单纯性肥胖症的发病率及主要影响因素,为预防儿童肥胖提供理论依据.[方法]采用随机整群抽样法,随机抽取咸安城区8所小学7～12岁儿童6 098名进行调查分析.[结果]儿童单纯性肥胖症检出率为7.46%,男童检出率(9.28%)高于女童(5.61%),两者间差异有非常显著性(X2=29.76,P＜0.01).不同年龄组儿童肥胖检出率差异无显著性(X2=1.23,P＞0.05).Logistic回归分析显示看书写作业时间长(0R＝9.653)、不喜欢体育活动(OR＝7.635)、喜欢吃油腻食物(OR＝4.423)、进食速度快(OR=4.462)及父母至少一方肥胖(OR=3.085)为儿童肥胖的主要危险因素,而父母大专以上文化程度(OR＝0.561)是儿童肥胖的保护因素.[结论]儿童单纯性肥胖率较高,家庭、学校、社会应采取合适的综合干预措施控制儿童肥胖的发生.     

弱视患病危险因素的1∶1配比病例对照研究

目的:探讨儿童弱视患病的主要危险因素。方法:采用1∶1配比的病例对照研究方法,对新诊断的60例弱视儿童及与病例同性别、同居住地区、年龄相差±0.5岁以内的60名健康儿童进行调查。应用条件Logistic回归分析方法分析先天因素、后天环境状况及营养因素等对弱视患病的影响。结果:单因素分析结果显示,父亲生育年龄高(OR=1.113)、孕次多(OR=1.542)、儿童常居环境采光差(OR=6.500)、儿童发钙水平高(OR=1.005)、儿童发镁含量高(OR=1.041)和儿童BMI大(OR=1.961)均可增加儿童患弱视的危险性;而父母亲学历高(OR=0.507;OR=0.624)、母亲孕期少食甜食(OR=0.560)和儿童身高高(OR=0.904)则可降低患弱视危险。进一步的多因素回归分析显示,母亲孕次多(OR=1.987)、儿童常居环境采光差(OR=15.80)、儿童发钙含量高(OR=1.010)和儿童BMI高(OR=2.170)是弱视患病的主要危险因素。结论:儿童弱视患病受多因素影响,母亲孕次多、儿童的常居环境采光差、发钙高及BMI高可增加儿童弱视患视的危险,即先天发育环境、后天光视觉环境和儿童营养状况共同影响弱视发生。     

北京、上海3～5岁儿童饮食行为现状及影响因素分析

目的了解北京、上海3～5岁儿童的饮食行为现状,分析其影响因素,为制定干预措施提供依据。方法在北京、上海各选国家一级一类幼儿园3所,用分层抽样方法选择3～5岁儿童1620人,对其家长进行问卷调查;对影响因素进行Logistic回归分析。结果所有调查儿童中约44.5%偏食,50.1%挑食,87.5%吃零食,70.3%喜欢喝含糖饮料。Logistic回归分析显示,母亲文化程度(OR=2.11,95%CI:1.55-2.87)、就餐时提示孩子吃某种食物(OR=2.25,95%CI:1.65-3.05),就餐时强迫孩子吃某种食物(OR=1.73,95%CI:1.21-2.48)与儿童挑食、偏食行为均相关;母亲文化程度(OR=2.11,95%CI:1.55-2.87)与儿童喝含糖饮料相关。结论偏食、挑食及喜欢喝含糖饮料是学龄前儿童存在的主要饮食行为问题,在宣传科学喂养的同时,要培植家长正确的育儿理念。     

广东地区前列腺癌与饮食因素的病例对照研究

[目的]探讨广东地区前列腺癌与饮食因素的病因学关联。[方法]在中山大学四所附属医院开展一项病例对照研究(1︰2配对),匹配条件为年龄组(±5岁)、性别、民族和居住地类型相同。调查以面谈为主,辅以病历记录,采用条件Logistic回归法分析数据。[结果]以前列腺增生为对照,每月至少吃1次鸡肉可以增加患前列腺癌的危险,OR=2.74(0.67-11.16);常吃玉米和叶类蔬菜有助于预防前列腺癌,OR玉米1～4次/月=0.31(0.13-0.76),OR蔬菜每天=0.42(0.13-1.40)。以其他疾病为对照,每月吃鸡肉者患前列腺癌的危险是偶尔/从未食用者的2.70(0.66-11.00)倍;常喝牛奶和常吃动物内脏也增加患前列腺癌的危险,OR牛奶1～6次/周=2.56(0.80-8.16),OR动物内脏1～6次/周=9.07(1.10-74.64);常吃玉米、块茎类蔬菜和水果有助于降低患前列腺癌的危险,OR玉米1～4次/月=0.54(0.23-1.22),OR块茎类蔬菜1～4次/月=0.38(0.12-1.28),OR水果1～4次/月=0.15(0.023-0.96)。[结论]本研究提示摄入过多的鸡肉、牛奶和动物内脏是前列腺癌的危险因素,多吃玉米、蔬菜和水果有利于降低前列腺癌的危险。     

中国贫困地区母亲外出打工儿童的营养不良状况及影响因素研究

目的分析和研究在中国十三省(市)贫困地区中,母亲外出打工的儿童营养不良状况及其影响因素。方法数据来自中国疾病预防控制中心2009年公共卫生突发应急反应机制运行项目——建立贫困地区6岁以下儿童营养健康状况相关危险因素的监测及数据信息系统。调查采用多阶段分层整群随机抽样方法,内容包括询问调查、体格测量、血红蛋白检测和膳食调查。提取18月龄以下的儿童作为分析对象。以2006年WHO生长发育标准计算Z评分;多因素分析采用非条件logistic回归模型;数据清理和分析均采用SAS 9.12统计软件。结果在研究样本中,9.3%的儿童其母亲在外打工。母亲在外打工儿童的生长迟缓率为15.5%,低体重率为6.0%。排除了其他变量的影响后显示,低出生体重(OR=2.543,95%CI 1.481～4.365)、少数民族(OR=1.661,95%CI 1.274～2.165)、母亲在外打工(母亲不在家)(OR=1.602,95%CI 1.085～2.367)、最近的医疗机构为1公里及以上(OR=1.308,95%CI 1.008～1.696)、家庭拥有不卫生厕所(OR=1.311,95%CI 1.017～1.689)是18个月以下儿童发生营养不良的独立危险因素。结论在贫困地区,母亲在外打工的婴幼儿营养不良状况堪忧,加强留守儿童营养与健康监测、采取有效的综合改善措施有利于留守儿童的生长发育。     

学龄前儿童出生状况和日常饮食习惯对视力发育的影响

目的了解学龄前儿童出生状况和日常饮食习惯对其视力发育的影响。方法选择2014年10月-2015年6月在六安市金安区托幼机构、儿保门诊进行视力筛查且资料完整的2 082名儿童为研究对象,所有对象均≤7岁。采用χ~2检验、多因素Logistic回归分析日常饮食状况对儿童视力发育的影响。结果接受调查的儿童视力异常发生率为48.6%。多因素Logistic回归表明,与学龄前儿童视力发育有关的因素包括:月龄为0~23个月(OR=3.854,95%CI:2.137~6.950)、父亲学历为大专及以上(OR=1.338,95%CI:1.031~1.738)、很少吃坚果(OR=0.641,95%CI:0.454~0.906)、经常吃坚果(OR=0.637,95%CI:0.424~0.957)、很少吃深色蔬菜(OR=0.612,95%CI:0.428~0.875)、经常吃深色蔬菜(OR=0.629,95%CI:0.425~0.930)。结论食用坚果、深色蔬菜是儿童视力发育的保护因素。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.