学龄前期肥胖儿童皮褶厚度、体围及血压的对比研究

[目的]比较学龄前期肥胖儿童与正常体重儿童皮褶厚度、体围及血压的差异.[方法]采用随机整群抽样的方法,抽取长沙市18所幼儿园共3 604名儿童进行身高、体重测量,并采用世界卫生组织2006年颁布的身高标准体重值标准进行评价,对单纯性肥胖儿童和与肥胖儿童按照1∶2配对的正常体重儿童进行皮褶厚度、体围及血压的测量.[结果]①肥胖和超重儿童的检出率分别为3.9%和13.0%;②不同性别、不同年龄组的肥胖儿童的皮褶厚度、腰围、臀围、大腿围、收缩压及舒张压均高于正常体重组儿童;③肥胖组儿童的收缩压、舒张压和腰臀比偏高的发生率均明显高于正常体重组儿童.[结论]学龄前期肥胖儿童存在心血管高危状态.     

广州市某社区2~6岁儿童超重肥胖与生命早期因素研究

分析2~6岁儿童超重肥胖与生命早期因素的关系,为预防学龄前儿童超重肥胖提供理论依据.方法 采用随机整群抽样方法,于2018年在广州市抽取1个社区的所有托幼园所922名儿童为研究对象.调查内容包括问卷调查和体格检查.采用Logistic回归分析学龄前儿童超重肥胖与生命早期因素的关系.结果 学龄前儿童超重肥胖检出率为13.4%,男童超重肥胖检出率(16.1%)高于女童(10.1%),差异有统计学意义(Z=2.69,P<0.05).学龄前儿童超重肥胖检出率在大于胎龄儿、剖宫产、出生后6月内人工喂养、母亲孕前体质量指数(BMI)超重或肥胖、母亲孕期体重增重过多组内较高(P值均<0.01).二项式Logistic回归分析显示,大于胎龄儿(OR=2.62,95%CI=1.42~4.82)、剖宫产(OR=1.59,95%CI=1.08~2.36)、出生后6月内人工喂养(OR=2.00,95%CI=1.19~3.37);母亲孕前超重或肥胖(OR=1.97,95%CI=1.08~3.58)和母亲孕期增重过多(OR=2.07,95%CI=1.26~3.39)与学龄前儿童超重肥胖呈正相关(P值均<0.05);母亲孕前消瘦(OR=0.51,95%CI=0.29~0.88)与学龄前儿童超重肥胖呈负相关(P<0.05).结论 该社区2~6岁儿童超重肥胖检出率较高,学龄前儿童超重肥胖与出生体重、分娩方式、出生后6月内喂养方式、母亲孕前BMI和母亲孕期增重等生命早期因素相关,积极有效的早期干预可预防学龄前儿童超重肥胖.     

深圳市0～6岁儿童单纯性肥胖症的流行学研究

[目的]探讨深圳市0～6岁儿童单纯性肥胖症的流行学调查特征. [方法]按照随机整群抽样的方法调查1I 454名0～6岁儿童,以WHO身高标准体重标准为肥胖的判断标准. [结果]总的肥胖检出率为4.2%,男童4.9%,女童3.4%,两者差异有显著性(χ2=14.749,P<0.001),总的超重检出率为10.2%,男童10.6%,女童9.8%.两者差异无显著性(χ2=1.954,P>0.05).0岁组超重及肥胖检出率高于1岁组,1～5岁儿童超重及肥胖检出率呈上升趋势,各年龄组之间的超重及肥胖检出率差异有显著性(χ2超重=65.937,χ2肥胖=121.402,P值均<0.001).特区内、外儿童超重及肥胖检出率差异无显著性(χ2超重=0.74,χ2肥胖=3.045,P值均>0.05).出生体重≥4 kg、父亲低学历、父亲肥胖、母亲肥胖、4个月前人工喂养为主、剖宫产、小儿经常看和食品有关的广告、小儿睡前1 h进食奶类、小儿食欲好、吃饭速度快、父亲鼓励小儿多吃、母亲鼓励小儿多吃、小儿每天运动时间<1 h等是儿童单纯性肥胖症的影响因素. [结论] 深圳市儿童单纯性肥胖症的发生率急剧上升,饮食行为、运动及遗传等是影响儿童肥胖的主要因素,应在全市采取统一的儿童单纯性肥胖症干预措施.     

我国部分城市学龄前儿童超重、肥胖现状及影响因素分析

目的 了解学龄前儿童超重肥胖发生现状及其影响因素,为儿童肥胖干预提供数据支持。方法 采取整群抽样的方法,在9个项目地区抽取56家幼儿园,调查小班和中班学龄前儿童的出生日期、出生体重、父母文化程度、相关因素等内容,测量儿童的身高和体重。采用χ²检验和Logistic回归方法进行统计学分析。结果 11 960名学龄前儿童超重、肥胖的检出率分别为12.22%和10.38%,男童分别为12.67%和13.61%,女童分别为11.72%和6.82%,差异有统计学意义(χ²=157.52,P<0.001);随着年龄的增长,男童超重、肥胖的检出率均呈现增长趋势,差异有统计学意义(χ²=16.10,P=0.041);长江以南地区学龄前儿童超重、肥胖的检出率高于长江流域地区以及长江以北地区,地区间差异有统计学意义(χ²=145.24,P<0.001)。男童、巨大儿和剖宫产出生是儿童发生超重/肥胖的危险因素,危险度分别为1.53(1.40,1.68)、1.92(1.62,2.29)和1.21(1.10,1.34)。结论 调查地区学龄前儿童超重肥胖检出率较高,男童、巨大儿和剖宫产出生的儿童易发生超重/肥胖,预防儿童肥胖需要从孕期开始。     

长春市2007年0～6岁儿童超重及单纯性肥胖的调查

目的 了解长春市0～6岁儿童超重及单纯性肥胖的检出率、城乡差异及其影响因素,为遏制儿童超重及单纯性肥胖进一步流行制定干预措施而提供依据.方法 采取分层整群抽样的方法确定样本量,测量儿童身高、体重,家长问卷调查了解超重及单纯性肥胖儿童的影响因素.结果 4 468名儿童超重及单纯性肥胖检出率为9.33%,城区高于农村(χ2=18.4084,P<0.001),无性别差异(χ2=0.0256,P=0.8730>0.05).各年龄组超重及单纯性肥胖的检出率有显著性差异(χ2=242.7743,P<0.001),23个年龄段中出现5个高峰,分别为1个月、3个月、6个月、12个月、48个月.父亲职业不同(χ2=44.5033,P<0.001)、母亲职业不同(χ2=28.5443,P<0.001)、父亲文化程度不同(χ2=33.6939,P<0.001)、母亲文化程度不同(χ2=27.6952,P<0.001),其子女超重及单纯性肥胖的检出率亦不同,均有显著性差异.结论 2007年长春市0～6岁儿童超重及单纯性肥胖的检出率高于2006年的全国水平,肥胖的防治工作迫在眉睫,重点在4岁年龄段,应加强对儿童家长超重及单纯性肥胖防治知识和科学喂养知识的普及.     

3～6岁儿童单纯性肥胖症相关因素调查

[目的]为探讨3—6岁学龄前儿童单纯性肥胖症相关因素及其防治措施。[方法]采用随机整群抽样方法，抽取福州市16所幼儿园3—6岁学龄前儿童4051名进行身高体重测量，对检出的单纯性肥胖儿童及其对照组正常儿童进行肥胖相关因素问卷调查。[结果]检出单纯性肥胖儿童209人，检出率5．2％，男女比例1．68：1。随着年龄增长肥胖程度及肥胖率上升，6岁年龄组达高峰。肥胖与父母亲体重、身高，出身体重和饮食行为等有关。[结论]幼儿期是肥胖症早期防治年龄。     

马鞍山市城区学龄前儿童肥胖情况调查

目的 了解马鞍山市城区学龄前儿童超重和肥胖的流行现状及主要影响因素,为制定有效的干预措施提供科学依据。方法 采用整群抽样的方法,对马鞍山市城区13所幼儿园3~6岁儿童3 891名进行测量身高、体重,以实测体重超过标准体重120%,并排除继发性肥胖作为诊断标准。结果 马鞍山市城区学龄前儿童超重的发生率为13.6%,单纯性肥胖的发生率为7.86%,其中男童肥胖发生率明显高于女童(χ²=10.546,P=0.001)。各年龄组间儿童肥胖总发生率差异有高度统计学意义(χ²=19.504,P<0.001),学龄前儿童单纯性肥胖的发生率随年龄递增而增高,5岁上升明显。结论 马鞍山市城区学龄前儿童单纯性肥胖症的发生率较高,预防儿童肥胖重点应放在学龄前期。     

学龄前儿童单纯性肥胖发生率及与生活环境相关性的研究

[目的]探讨宁波市区学龄前儿童单纯性肥胖的发生率及其与生活环境的关系. [方法] 采用分层整群随机抽样的方法,选取五个城区60所幼儿园的12 220名中、大班儿童作为研究对象,测量其身高、体重,采用问卷调查儿童的家庭情况、抚养情况、出生情况、喂养情况等生活环境因素,按照WHO的体质指数(body mass index,BMI)>P95判定为肥胖儿童,采用单因素和多因素回归分析影响肥胖的因素. [结果]调查儿童中肥胖的检出率为7.86%,其中男童为8.41%,女童为7.25%;其中父母的文化程度低、出生体重较重、主要抚养人为保姆、抚养人文化程度较低者及大年龄的男童容易发生肥胖. [结论]宁波市学龄前儿童单纯性肥胖的发生率较高,且与儿童生活的家庭环境密切相关,应针对家庭危险因素对儿童肥胖进行有效干预.     

滕州市学龄前儿童单纯性肥胖流行病学研究

目的:了解7岁以下学龄前儿童单纯性肥胖流行现状、影响因素及其危害性,为制定相关的干预措施提供科学依据。方法:选取2002年6月～2004年6月滕州市学龄前儿童9605名,并以“同性别、年龄相近、身高相差≤3cm”为标准选择正常儿童进行1∶1配对。采用χ2检验和多因素条件Logisitic回归方法进行资料分析。结果:检出单纯性肥胖儿童137名,患病率为1.43%,男性明显高于女性;超重儿童136名,超重率1.42%。条件Logisitic回归分析结果,蔬菜、活动方式、喂养方式、家族史、进食速度、夜食习惯与肥胖关系最为密切。结论:滕州市学龄前儿童单纯性肥胖患病率较8年前有较大幅度增加。喜吃蔬菜、活动方式、喂养方式(母乳)是肥胖的保护性因素。家族史、进食速度快,目前食欲好、孕期营养状况,夜食习惯是肥胖的危险因素。     

学龄前儿童肥胖危险因素Logistic模型分析

[目的]分析影响成都市学龄前儿童肥胖的危险因素,为儿童肥胖的预防和控制提供基础资料.[方法]在成都市城区6所幼儿园随机选取50名学龄前肥胖儿童,按1:2的比例与100名同性别、同身高、同年龄的正常儿童配对,通过问卷调查儿童肥胖的影响因素,并采用条件logistic回归模型分析.[结果]多因素条件logistic回归模型分析显示,食量大是学龄前儿童肥胖的第一危险因素(OR=96.93),摄入能量越多发生儿童肥胖的危险性越高;出生巨大儿是学龄前儿童肥胖的第二危险因素(OR=23.77);控制儿童出生体重和能量摄入团素后,父亲肥胖是儿童肥胖的危险因素(OR=5.72).[结论]学龄前儿童肥胖的危险因素多与生活行为方武相关,应采取综合营养干预以预防和控制儿童肥胖.     

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.     

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.     

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.     

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.     

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.     

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.