2008年与2012年全国健康素养调查方案对比分析

  目的  了解江苏省南京市女性居民健康素养水平,为制定健康素养干预规划提供科学依据。  方法  于2016年10 — 12月采取多阶段分层随机整群抽样方法,抽取南京市4 694名15～69岁城乡常住居民,采用全国居民健康素养监测调查问卷进行调查。  结果  南京市女性居民健康素养水平为19.45 %,城市居民健康素养得分高于农村;随年龄增长,健康素养得分降低,25～34 岁组健康素养得分最高,为（46.08 ± 10.75）分,65～69 岁组健康素养得分最低,为（37.61 ± 11.91）分;受教育程度越高,健康素养得分也越高,大专/本科及以上者得分最高,为（47.29 ± 10.54）分,小学及以下文化健康素养得分最低,为（34.50 ± 12.19）分;医务人员健康素养得分高于非医务人员;慢性病患者健康素养得分低于无慢性病者;家庭收入越高,健康素养得分越高。单因素分析显示,不同地域、年龄、文化程度、是否医务人员、是否患慢性病、家庭年收入的女性居民健康素养水平差异均有统计学意义 （均P < 0.05）。多元线性回归分析显示,文化程度、家庭收入水平、城乡、年龄、是否医务人员对健康素养得分有显著的预测力（R² = 0.19, β = 0.26、0.14、– 0.08、– 0.07、0.05,P = 0.00）,其中文化程度为最具预测力的变量。  结论  南京市女性居民健康素养水平仍需进一步提高。     

The Dutch Health Council report on haemopoietic stem cells

The Dutch Health Council advised the government on the use of haemopoietic stem cells in clinical medicine in September 2003. Most stem cell transplantations (SCTs) are performed in closely co-operating centres for haematological intensive care, and these centres are required to have a license from the government. The introduction of non-myeloablative SCT, exploiting the immunological effects of donor T cells, extends the variety of diseases for which SCT is a useful treatment option, as well as extending the age limits. The capacity of the centres appears to be sufficient, but their finances are not. This, together with strict adherence to accepted indications, is probably one of the main reasons why the number of SCTs performed in the Netherlands is rather low as compared to other European countries. The Council stresses that the harvesting and handling of umbilical cord stem cells is a public rather than a private matter, with the purpose of creating a bank for these preparations from which patients may benefit if the need so dictates. The Council pleads for support to advance the basic research on stem cells and the immunological aspects of stem cell transplantation.     

National colorectal carcinoma screening program deserves further study; a report from the Dutch Health Council

Each year there are about 8400 new colorectal carcinoma (CRC) cases in the Netherlands. Despite improved treatment possibilities the mortality rate has not shown a decline. A reduction in the mortality rate can be achieved by screening for CRC by means of faecal occult-blood testing. Endoscopic screening (flexible sigmoidoscopy or colonoscopy) could reduce not only the mortality but also the incidence of CRC, but this has yet to be conclusively demonstrated. The introduction of a national screening programme deserves serious consideration, although various questions need to be answered before a final decision can be taken. These concern the optimal screening strategy, the expected degree of participation, the follow-up under persons in whom polyps are found, the demand on human resources and other resources, and the cost-effectiveness.     

Health Council report on health claims for foods and food supplements

The Health Council of the Netherlands has issued a report on the health claims often made for foods and food supplements. It is concluded that the boundary between medical claims and health claims is not clear: there is no scientific or practical distinction between the 'prevention of disease' and the 'promotion and maintenance of health'. Only explicit, specific and evidence-based claims regarding the prevention, and possibly the treatment, of diseases or conditions are of any value to public health. If the impression is correct that the nutrient content of a product, a change in bodily function or a reduction of a disease risk factor reduces the likelihood of developing a certain disease, this effect should be stated explicitly. If the impression is not correct, then the claim is irrelevant and therefore misleading. A claim must always be supported by research involving human subjects and generally accepted scientific criteria must be adhered to.     

Overweight and obesity; recommendations from the National Health Council

The Health Council of the Netherlands has issued a report on overweight and obesity. These are considered major threats to personal health, the public health care services and economic welfare. Overweight and obesity are no longer considered variations of the norm, but as a disease. As genetically predisposing factors cannot be influenced, major initiatives to contain further deterioration of the problem must be on environmental factors i.e. on macronutrient intake and physical exercise. Special target groups (young people, people of low socioeconomic status and immigrants) need to be defined. Government, health care organisations, industry and the general public should work together to combat overweight and obesity. The chances of success are not predictable but are certainly big enough to justify action.     

Report of the Health Council on the use of benzodiazepines. The Netherlands Health Council]

The Netherlands Health Council has issued a report on the appropriate use of benzodiazepines, detailing current knowledge on mode of action, indications for use, adverse effects and the prescribed volume in the Netherlands. About 3% of the adult population are chronic users of benzodiazepines. Chronic use is complicated by the risk of falling; the relative risk of hip fractures in chronic benzodiazepine users in about 1.7. Chronic use should be discouraged. However, most chronic users are fragile elderly people for whom a good night's sleep implies temporary escape from a sorry existence with somatic or psychic symptoms. Such circumstances should be kept in mind when treating individual patients.     

Health Council of the Netherlands' report on contraception in intellectually disabled people

Recently the Health Council of the Netherlands published a comprehensive report which incorporates juridical, ethical, medical and social aspects directing the judgement and decision-making regarding contraception in people with an intellectual disability. Although professional responsibility is in the hands of medical practitioners, medical guidelines to manage consent issues and to indicate contraception in this population are missing. There are no ethical and legal grounds for enforcing contraception and it comes down to professional accountability in trying to prevent irresponsible parenthood by a convincing dialogue. People with intellectual disabilities are intellectually, physically, socially and economically prone to be vulnerable parents, who need assistance in making deliberate choices to have children and in raising them. There is an urgent need for advanced sexual education and a comprehensive social discussion on contraception for this population. Physicians for intellectually disabled people embrace the committee's recommendations to stimulate public debate, enhance research, develop guidelines and build professional networks to call on.     

The Dutch Health Council report on screening for Chlamydia: too reserved

The prevalence of sexually transmitted diseases (STDs) increased in the Netherlands in the years 2000-2003. A recent population-based study showed that Chlamydia infections were a problem in urbanised areas; prevalence in rural areas was low. In 2004, the Dutch Health Council advised against a national screening programme for Chlamydia. However, the newest figures on the distribution of Chlamydia infections suggest that screening in large cities might be cost-effective. Much can be learned from the screening programme in the United Kingdom.