离退休干部187例生活质量及慢性疾病调查

目的：了解离退休干部生活、心理、健康等现状。方法：对187例离退休干部进行健康体检及生活质量问卷调查。结果：自评生活满意度分别为：23．7％良好，74．2％中等，2．1％差；96．7％离退休干部有中等以上的经济收入；91．6％离退休干部生活能自理；12．9％离退休干部对自己的身体健康不满意；100％有慢性疾病，影响其生活质量主要是慢性疾病，患3种以上慢性病者占76．8％；部分老人存在不同心理障碍；医疗保健满意度为63．8％。结论：各种慢性疾病是影响离退休生活质量的主要原因。     

上海市闸北区高龄老人慢性疾病现况调查

目的提高社区高龄老人生活质量，为社区高龄老人的疾病预报，健康促进及制定社区高龄老人卫生政策提供科学依据。方法在上海市闸北区≥80岁老年人中，采用分层整群抽样方法确定调查对象，采用问卷访谈与临床检查相结合的回顾性调查取得资料。结果高龄老人慢性病总患病率为72．4％，其中男性为33．7％、女性为38．7％。高龄老人一般患有2～3种慢性病，高血压患病率居首位。其后依此为心脏病、慢性阻塞性肺疾病、骨及关节病、糖尿病、脑梗死。结论社区高龄老人中，女性慢性病患病率高于男性。表明女性虽有生存优势，但并无健康优势。在治疗和预防老年人慢性疾病中，对老年女性应给予更多的关注。心、脑血管疾病已成为影响老年人健康的主要疾病，各种老年性慢性病对高龄老人日常生活妨碍程度最大的前几位疾病依次是：心、脑血管疾病、白内障、糖尿病、骨及关节疾病。高龄老人的健康医疗问题值得进一步的关注。     

上海市奉贤区农村高龄老人综合健康状况调查

目的了解高龄老人身体健康、经济状况、家庭和社会保障、日常生活能力及医疗服务的需求,以便对社区高龄老人的综合健康质量作出正确评估.方法采用整群抽样方法对奉贤区按东、南、西、北、中5个区域中各抽查1个镇共1 634名80岁以上老人入户调查.结果高龄老人慢性病患病率为68.05%,以高血压、慢性阻塞性肺病、心脏病为主,有17.20%的高龄老人生活能力处于半自理和完全不能自理的状态,享有医保或初级合作医疗待遇的老人占69.98%,有77.41%的老人月经济收入低于100元,对生活和健康总体满意或较满意的占90.33%.结论奉贤区高龄老人经济收入偏低,总体生活满意度较高.有必要针对不同情况采取不同的社区干预措施,以提高老年人综合健康水平.     

高龄老人社区卫生服务需求及影响因素的调查

目的 通过对成都市高龄老人社区卫生服务需求及影响因素进行调查，了解高龄老人的社区卫生服务情况，为今后更好地开展社区卫生服务提供有益的参考资料。方法 采用入户问卷调查方式，就小天竺辖区204位80岁以上高龄老人的一般情况、健康及医疗保健情况和社区卫生服务需求意愿进行调查。结果 被调查高龄老人有46．10％的老人愿意建立社区健康档案；37．30％的老人愿意医务人员上门提供医疗服务；31．90％的老人愿意在生病出院后，在家中继续接受医疗康复服务；49．50％的老人愿意在社区接受健康教育；26．00％的老人选择热线电话健康咨询服务；29．90％的老人愿意在社区定期进行体检；21．60％的老人愿意接受居家护理服务；40．10％的老人愿意在家中接受康复服务；92．20％的老人选择在家中养老；7．80％的老人选择在养老院养老。结论 高龄老人社区卫生服务出现“高需要，低利用”的原因之一是社会经济因素，原因之二是因为对社区卫生服务宣传力度不够。     

高龄老干部280例健康检查结果分析及保健策略

目的调查80岁以上高龄老干部主要疾病及防治措施。方法为280例高龄老干部进行全面体格检查,包括专科查体、血液生化和肿瘤标记物,心电图、腹部B超、CT、胃肠镜等。结果检查出疾病16种,总患病数1764例,平均每人患病6．3种。检出最高的前8位疾病依次为白内障[（视觉障碍）89．3％]、排泄障碍（81．8％）、冠心病（66．8％）、高血压（65．4％）、睡眠障碍（55．7％）、脂肪肝（42．1％）、高血脂（34．3％）和糖尿病（30．7％）。结论对高龄老人患的主要疾病,要有针对性的健康指导,加强自我保护意识,是提高高龄老人生活质量的关键。     

高龄老人生活质量调查分析

目的：了解高龄老人生活质量。方法：采用中华医学会老年分会流行病学组推荐统一调查表,问卷式调查并进行查体。结果：１ ７３５ 名高龄老人中生活完全自理占８７．９％ ,８１．１％ 尚能参加部分劳动。心理健康状况较好占４８．１％ 。４３．３％ 患慢性病,主要为慢性支气管炎、脑卒中、高血压病、冠心病、关节炎。结论：调查结果为了解河北省高龄老人生活质量现状提供依据,指出重视物质赡养、精神赡养与加强老年卫生保健工作必要性,以及积极发挥社会、家庭在提高高龄老人生活质量中的作用     

187名农村老年人生活状况调查和分析

目的：了解农村老人的生活质量。方法：用问卷调查法，获取农村老人的身体、心理、经济状况、社会支持的状况。结果：44．3％老人未能确定是否患有慢性病，59．4％老人生活自理有不同程度下降，17．1％活动受限。月经济收入在50～200元内的占64．17％，43.32％自认经济状况较差，77．54％老人表示医疗费用承担有困难。就医困难的首位原因是经济困难。老年人大部分有负性情绪，主要是孤独感、衰老感、忧郁感。绝大部分老人健康保健意识差。结论：应提高老年人对疾病的预防和治疗意识，重视提高老年人的心理健康水平和基本生活条件。     

龙游县新型农村合作医疗基金两年运行状况分析

目的：分析龙游县新型农村合作医疗基金两年运行状况，为后续的新型农村合作医疗工作持续改进提供依据。方法：对2004、2005两年度“龙游县新型农村合作医疗基金年度报表”的数据作统计分析。结果：农村居民参保率分别为77．92％、80．17％；基金收支节余分别为25．8％、6．5％；受益者人均补助金额1247元、1328元，补助金额每人〈500元者占51．7％、51．6％，500～1000元者占20．8％、21．1％，1001～5000元者占22、3％、21．4％，〉5000元者占5、2％、5．9%；费用补助率21．16％、19．81％；人受益率2．92％、3．24％；人均医疗费用2005年度比2004年度增长14．13％，以县内（14．16％）、二级乙以下（19．77％）医疗单位增长为著。有效费用率在下降，以县内（-7．26％）、二级甲等（-10．32％）医疗单位为著。结论：龙游县农村居民参加新型农村合作医疗积极性高，基金运作基本正常，但仍存在医疗费用增长过快、费用补助率及人均受益率较低、有效费用率下降的问题。     

高龄股骨颈骨折患者的手术治疗(附132例报告)

目的：观察3种不同手术方法治疗高龄股骨颈骨折患者的效果。方法：对〉60岁高龄股骨颈骨折患者132例实施手术治疗。结果：120例平均随访1年以上，疼痛消失，功能满意，恢复生活自理能力者93例，占78％；恢复部分生活能力者18例，占15％；仍有疼痛，不能下地活动与生活自理者9例，占7．5％。结论：手术治疗高龄股骨颈骨折的效果满意，能提高老年人的生活质量和降低死亡率。     

青岛市居民接触各类大众传播渠道及健康传播可及情况调查

目的了解青岛市城市和农村居民接触各类大众传播渠道及健康传播可及情况。方法多阶段整群随机抽样、入户问卷调查≥15岁符合条件的居民，城市300人，农村304人。结果看电视：城市为97．2％，农村为96．7％；听广播：城市为加．2％．农村为6．7％；读报：城市为89．2％，农村为51．7％；留意宣传栏：城市为34．9％，农村为58．9％；留意广告或流动数字媒体：城市为43．0％，农村为33．9％；接受短信：城市为64．4％，农村为43．9％；上网：城市为38．6％，农村为6.0％；愿意参加宣传活动：城市为57．2％．农村为83．8％。定期收看电视健康节目：城市为11．8％，农村为5．2％；定期收听广播健康节目：城市为3．2％．农村为0．6％。居民主动获得健康信息来自卫生专业人员：城市为69．7％，农村为78．9％。“电视新闻＋报纸新闻＋宣传活动＋短信”组合可及性：城市为98．6％，农村为94．0％。农村55岁以上的居民接触各类传播渠道比例低于其他年龄的居民。结论电视是青岛城乡居民可及性最高的传播渠道；在健康传播中联合应用多种传播渠道会更好的实现传播目标。     

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.     

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.     

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.     

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.     

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.