子女收入、家庭支持与老年人健康

目的：分析子女收入对老年人健康状况的影响及群体性差异,并探究家庭支持在其中的中介效果。方法：使用2011—2018年四期中国健康与养老追踪调查(CHARLS)数据构建非平衡面板,以60岁及以上老年人作为研究对象,基于时间固定效应模型分析子女收入对老年人健康的效应水平,使用倾向得分匹配法对内生性问题进行讨论,并采用Karlson-Holm-Breen(KHB)方法对子女经济转移、时间转移以及二者组合路径的家庭支持方式进行机制检验。结果：子女收入提高分别在0.049和0.033水平上显著改善老年人自评健康和生活满意度,在修正选择性偏差后结论依旧稳健;子女提供经济支持、照料与情感支持在改善老年人健康中发挥重要的中介作用。结论：子女收入对老年人存在健康溢出效应,但在不同年龄、性别和户籍状况老年群体中存在差异;提高青年收入水平,倡导子女提供兼顾经济和时间转移的家庭支持方式有利于改善老年人健康状况,有助于实现健康老龄化战略目标。     

居住安排对我国老年人生活满意度的影响效应分析

目的 探讨居住安排对老年人生活满意度的影响，为实施积极老龄化国家战略，提升广大老年人的幸福感提供实证依据。方法 运用2011—2012年、2014年和2018年中国老年健康影响因素跟踪调查(CLHLS)三期面板数据，采用个体固定效应模型进行分析。结果 描述分析发现，当前我国的养老模式以居家养老为主，老年人与子女同住占比较高，但呈下降的趋势；回归分析显示，在控制老年人社会经济状况和健康状况等情况下，与子女同住最有利于提升老年人生活满意度水平，与其他家人同住次之(β=0.206,95%CI:0.054～0.358),入住养老机构的老年人生活满意度最低(β=-1.021,95%CI:-1.703～-0.339);居住安排对生活满意度的影响效应存在城乡、性别的异质性。经济地位的调节效应显示，相较于经济状况较差，自评经济状况较好的老年人，居住在养老机构有利于其生活满意度的提升，而对“与其他家人同住”的老年人，自评经济状况较好则不利于其生活满意度的提升。结论 在居家养老为主导的养老模式下，应鼓励老年人与家人同住，最理想的状态是与子女同住；在社会政策上应鼓励“普惠型”养老机构服务模式，“兜底”老年弱...     

甘肃省积极老龄化现况及影响因素分析

目的 分析甘肃省老年人积极老龄化现状及影响因素,为推进欠发达地区积极老龄化提供依据。方法 依据世界卫生组织定义的积极老龄化“健康、参与、保障”测量框架自行设计定量问卷,本研究于2021年12月—2022年9月多阶段分层随机抽取甘肃省东、中、西部60～80岁老年人进行面对面问卷调查,测评积极老龄化现状并分析个体因素与社会因素对积极老龄化的交互影响。结果 2 458例调查对象在积极老龄化“健康、参与、保障”三个维度的百分制得分分别为（79.12±11.19）分、（63.43±16.23）分、（71.82±12.52）分。甘肃省东部区域老年人积极老龄化总得分（77.49±7.61）分,高于中部区域（69.44±10.51）分和西部区域（71.22±10.76）分,差异有统计学意义（F=155.320,P<0.001）。个体因素性别、既往职业、婚姻、居住状态分别与社会因素所在区域对积极老龄化影响有交互效应;个体因素中年龄60～<70岁（OR=0.53, 95%CI:0.36～0.77）、收入>2 000元（OR=1.93, 95%CI:1.34～2.78）是积极老龄化的独立保...     

社会参与对老年人抑郁轨迹的影响——基于生活质量的中介效应

目的 研究社会参与和抑郁轨迹之间的关系并探索生活质量的中介效应。方法 基于中国健康与养老追踪调查2011—2018年四期数据,采用组基轨迹模型识别老年人抑郁症状的异质性轨迹,运用多分类logistic回归研究社会参与和抑郁轨迹之间的关联,利用KHB方法分析生活质量对社会参与和老年人抑郁轨迹影响的中介效应。结果 共纳入了4 931名年龄在60～105岁且至少有2期抑郁症状调查数据的老人,确定了4个抑郁轨迹组：长期无抑郁组(61.69%)、抑郁升高组(16.69%)、抑郁缓解组(13.83%)、长期高抑郁组(7.79%)。与长期无抑郁组的受试者相比,社会参与数量越多,抑郁轨迹归属于抑郁缓解组、抑郁升高组和长期高抑郁组的可能性越小(RRR=0.899,95%CI:0.812～0.994;RRR=0.885,95%CI:0.786～0.995;RRR=0.747,95%CI:0.630～0.885);另外,生活质量在两者的关系中发挥了显著的中介效应,且抑郁升高组中自评健康的中介效应贡献占比最大,为30.33%,抑郁缓解组和长期高抑郁组中身体疼痛情况的中介效应贡献占比最大,分别是27.94%和2...     

我国不同地区老年人成功老龄化现状及影响因素分析-基于CHARLS数据的实证研究

目的 了解我国不同地区老年人成功老龄化的现状及其影响因素的差异,为促进我国老年人健康老龄化和探讨预防措施提供依据。方法 数据来源为2015年中国健康与养老全国追踪调查（China Health and Retirement Longitudinal Study,CHARLS）数据,利用二分类logistic回归模型进行危险因素的分析。结果 本次研究发现我国老年人成功老龄化率为14.41%,城市(31.35%)高于农村(10.70%);城市老年人群慢性病患病率、抑郁率、功能损失率、低认知功能占比和低社会参与率均低于农村老年人;年龄、婚姻状况、受教育程度、饮酒情况、中心性肥胖是成功老龄化的影响因素(P均<0.05)。结论 我国老年人成功老龄化率较低,城乡健康不公平显著,老年人心理和生理健康相关问题可能增多,应积极采取预防控制措施,促进我国健康老龄化的发展。     

退休后工作参与和老年人自评健康状况的关联效应分析

目的 探讨退休后工作参与和老年人自评健康状况的关联效应,为老年人退休后再就业的合理性提供参考依据。方法 基于中国健康与养老追踪调查(CHARLS)2018年的截面数据,以Stata14.0软件为工具,运用倾向值得分匹配法进行统计分析。结果 本研究发现,年龄、是否参加社会活动、退休金、养老保险、性别对退休后老年人工作参与的影响具有统计学意义;工作参与和退休老年人自评健康状况关联效应的平均处理效应分别为0.062、0.065、0.068,即退休后进行工作参与能使老年人自评健康水平提高6.2%～6.8%(P＜0.05)。65～79岁年龄组的退休老年人工作参与后,其自评健康水平提升7.6%～7.9%(P＜0.05);退休后进行工作参与的男性老年人,其自评健康水平提升6.4%～8.3%(P＜0.05)。结论 退休后工作参与和老年自评健康具有正向关联效应;退休后工作参与和老年自评健康的关联效应存在性别、年龄差异。     

海岛老年人代谢综合征的现况研究

随着我国城乡居民生活及医疗卫生水平的不断改善,老龄化速度明显加快,代谢综合征(MS)患病率呈现明显上升趋势[1-4]。因此,老年人代谢综合征患者需要引起我们的高度关注。对2010年5月—2011年11月参加新型农村合作医疗,并参     

关注慢性病 助力健康老龄化

正世界人口正在快速老龄化。2015—2050年,全球60岁及以上人口数将从9亿增加到20亿。预计到2050年,80%的老年人将生活在低收入和中等收入国家~([1])。我国从1999年进入老龄化社会,截至2018年,我国60岁及以上人口达2.5亿,占17.9%,而65岁及以上人口达1.7亿,占11.9%~([2])。人口的城乡流动造成了农村地区人口迅速老龄化,预计到2030年,中国农村和城市地区60岁及以上人口的比例将分别达到21.8%和14.8%~([3])。中国老龄人口基数庞大、增长迅速,如何保障老年人健康,对实现健康中国战略目标至关重要。     

城市老年人睡眠时长和体力活动关系的交叉滞后分析

目的 探讨老年人睡眠时长和体力活动之间的相关关系和预测作用，为促进城市老年人身心健康提供理论基础，为建立健康生活方式提供参考依据。方法 数据来源于2011—2015年中国健康与养老追踪调查数据(China Health and Retirement Longitudinal Study,CHARLS)，以作答体力活动问题城市老年人作为研究对象，采用交叉滞后路径分析模型分析睡眠时长和体力活动之间的因果时序关系及作用方向。结果 最终对281名≥60岁城市老年人3次施测的体力活动参与水平之间相关性分析r_{2011年与2013年}=0.030、r_{2011年与2015年}=0.214、r_{2013年与2015年}=0.213，且呈正相关(P<0.01);3次施测的睡眠时长之间相关系数分别为r_{2011年与2013年}=0.423、r_{2011年与2015年}=0.397、r_{2013年与2015年}=0.403，且呈正相关(P<0.01)。通过交叉滞后路径分析结果显示，...     

2015—2018年广东省基本公共卫生服务项目绩效评价结果分析

目的对广东省2015—2018年度省级组织的基本公共卫生服务项目绩效评价结果进行分析,为提升工作能力提供决策依据。方法采用重复测量方差分析方法,分别对2015—2018年度综合成绩、组织管理、资金管理、项目执行、项目效果按照单变量单组重复测量方差分析和单变量两组重复测量方差分析进行统计分析。结果除综合成绩、资金管理存在地理区域与时间之间的交互效应外,组织管理、项目执行、项目效果成绩均未见交互效应。组织管理、资金管理、项目执行、项目效果的时点效应差异均有统计学意义(P<0.05),均呈上升趋势;珠三角各年度资金管理、项目执行评价成绩均显著高于非珠三角地区(P<0.05);无论珠三角地区还是非珠三角地区,2017年度、2018年度组织管理评价成绩均数均显著高于2015年度(P<0.01);4年间不同地理区域项目效果的差异无统计学意义(F=2.772,P=0.112)。结论我省基本公共卫生服务工作处于成长上升期,但地区发展不平衡仍然非常显著,一定程度上影响了我省基本公共卫生服务项目开展的总体效果。     

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.