青岛市社区卫生服务现状及发展对策

目的：了解青岛市区居民医疗需求及卫生服务的利用现状。方法：采用整群随机抽样法,调查市区居民3057名,结果：居民的两周患病率为108．28‰,慢性病的患病率为24．58‰,居民的失能率为45．79‰,居民的两周就诊率为73．60‰,住院率为46．78‰。结论：青岛市区居民的慢性病的患病率较高,应加强社区卫生服务以满足居民的需求。     

青岛市区居民慢性非传染性疾病调查

目的：了解青岛市市区居民慢性非传染性疾病（慢病）的患病现状及影响因素。方法：采取整群随机抽样法，对青岛市市区15个居委会的3057名居民进行问卷调查。结果：青岛市市区居民慢病患病率为24．58％（女性为26．50％，男性为22．77％），居民慢性病的患病率随年龄增加而增高（γs=0.5629,P=0.0001）。按病种排在前5位的疾病为高血压、冠心病、关节炎／风湿病、胆囊及胃肠炎和糖尿病。慢性病的患病率与化程度呈负相关；吸烟、饮酒等不良生活行为可使居民患慢性病的危险性增加。结论：青岛市市区居民慢病患病率较高，应在居民中采取干预措施以预防和减少慢病的发生。     

洛阳市某社区居民慢性病患病情况调查分析

本文采用横断面调查的方法，对知识分子相对集中的社区居民进行了慢性病患病情况调查，结果表明，该社区居民１９９４年慢性病患病率为２４４．１７‰（标化率为１６０．３４‰）男性慢性病患病率为２４１．９１‰。（标化率为１５８．８８‰）；女性为２４６．６２％（标化率为１６４．３１‰）。慢性病患病率随年龄增长而升高，而患病年龄多在４０～５９岁，即中年期，主要慢性病前五位依次为高血压、冠心病、病毒性肝炎、低血压、慢性胃炎。慢性病患病率与文化水平、精神状态，体育锻炼密切相关。     

安徽省肥西农村地区卫生服务需求调查分析

目的 了解安徽省农村卫生服务需求及卫生服务利用情况。方法 采用整群随机抽样方法，抽取3077人进行问卷调查；用两周患病率和慢性病患病率两项指标评价卫生服务需求情况。结果 总两周患病率为94．37‰，男性两周患病率为91．13‰．女性两周患病率为98．00‰，男、女间差异无显性．其趋势与全国趋势相一致。两周患病率前5位依次为呼吸系统、消化系统、循环系统、血液系统及肌肉骨骼系统和结缔组织疾病，5大系统合计占疾病总数的90．52％。慢性病患病前5位依次是：慢性胃肠炎、类风湿性关节炎、慢性支气管炎、高血压、贫血。在性别上慢性病患病率女性高于男性，但差异无显性。随着年龄的增加慢性病患病率明显增加，由0～4a组的l0．02‰增加到65a以上组的343．82‰。本次调查发现盲或半盲慢性病患病率最高，不同化程度慢性病患病率差异有显性，大专及以上患病率较低。结论 政府和卫生主管部门应根据本地具体情况采取相应的卫生政策和办医形式，以满足农民高的卫生服务需求量。     

安徽省涡阳县农村社区卫生服务需求

目的 了解涡阳县农村社区卫生服务需求与利用状况。方法 采用分层整群随机抽样方法抽取样本后入户调查。结果 居民两周患病率为114．52‰，其中男性两周患病率为112．66‰；女性两周患病率为116．28‰，男、女性别差异无显性，其趋势与全国的趋势相一致。两周患病率前五位疾病依次为呼吸系统疾病、消化系统疾病、运动系统疾病、循环系统疾病及传染病，占疾病总数的86．3％。调查慢性病患病中前五位的疾病依次是：慢性胃肠炎、胆结石和胆囊炎、类风湿性关节炎、慢性支气管炎、消化性溃疡，与肥西和全国农村1998年调查结果存在差异。在性别上慢性病患病率女性高于男性，但差异无显性。本次调查发现农民就医观念淡漠，在有病不就医中认为病轻而不就医占50％。经常就诊的场所以附近的乡村级卫生室为主。结论 当地政府和卫生主管部门应结合本地区疾病谱的特点选择适宜的卫生政策以满足农民更高的卫生需求。     

广州市白云区“城中村”人群健康及卫生服务现况调查

目的：了解广州市城中村人群健康和卫生服务现况，为构建和谐社会，发展城市社区卫生服务提供依据。方法：多阶段分层整群随机抽样，在辖区城中村内抽取3个社区的部分居民进行问卷调查。结果：被调查人群两周患病率为117．2‰，慢性病患病率为107．2‰、两周就诊率为71．8‰、两周未就诊率为45．4‰、住院率为4．2‰，卫生服务需求和利用水平下降。结论：城中村人群卫生服务需要量隐性增加，对医疗服务需求和利用呈下降趋势，有效需求呈多极化。     

昆明市农村地区人群糖尿病流行现状

目的了解昆明农村地区居民糖尿病患病现状及其特征，探讨制订糖尿病预防控制对策。方法采用多阶段随机抽样方法，随机抽取20～74岁常住居民3440人进行糖尿病流行病学调查，包括问卷调查和体格检查。结果昆明农村居民糖尿病患病率为4．01％，标化患病率为2．90%；其中，男性患病率为4．54％，标化率为3．55％；女性患病率为3．76％，标化率为2．61％。不同年龄、不同职业居民糖尿病患病率差别有统计学意义（P〈0．01）。一类农村居民糖尿病患病率高于二类农村居民，差别有统计学意义（X2=8．849，P=0．003）。结论昆明农村居民糖尿病患病率已处于较高水平，尤其是在经济相对发达的地区．应加强农村居民糖尿病健康教育和预防控制工作。     

浙江省城乡居民两周患病情况分析

目的了解浙江省城乡居民患病情况,为卫生服务决策提供客观依据。方法采用多阶段分层整群抽样方法,使用第三次卫生服务调查问卷入户调查。结果浙江省居民两周患病率为113.22‰,城市103.98‰;农村114.94‰,农村高于城市,患病的严重程度农村大于城市。男性、女性的两周患病率分别为104.72‰和121.87‰,女性高于男性。城乡居民的两周患病率在年龄、文化程度、职业、医保类型方面差异有显著性。居民两周患病位于前5位的依次为呼吸系统疾病、消化系统疾病、循环系统疾病、肌肉骨骼结缔组织疾病、损伤和中毒。结论农村居民的卫生服务需要量高于城市居民,女性、儿童、老人、低文化程度、下岗、失业人群是卫生服务重点人群,慢性病是城市居民重点疾病,农村居民卫生服务面临感染性疾病、慢性病、伤害的影响。     

安徽省岳西县新型合作医疗对健康及卫生服务公平性影响的研究

目的 探讨新型农村合作医疗试点地区农村居民卫生服务公平性的现状。方法 采用分层整群抽样的方法，于2005年7月1—15日对安徽省新型农村合作医疗试点县岳西县2112名农村居民的卫生服务公平性现状进行入户问卷调查。用率、比、Gini系数、集中指数（CI）和χ^2检验进行统计分析。结果 试点地区5组收入状况居民中，从最低收入组到最高收入组的2周门诊就诊率分别为48．14‰、82．90‰、65．88‰、48．72‰和50．66‰，CI值为-0．026，各组居民就诊率差异无统计学意义（χ^2=5．52，P〉0．05）；近一年内住院率分别为59．08‰、67．36‰、51．76‰、58．97‰和52．86‰，CI值为-0．017；半年内慢性病患病率分别为295．40‰、243．52‰、230．59‰、225．64‰和176．21‰，CI值为-0．055，不同收入组居民慢性病患病率存在差异（χ^2=18．42，P〈0．01），随收入降低慢性病患病率呈增高趋势。5组收入居民中，年人均医药费用占人均家庭支出比例分别为36．12％、26．18％、22．47％、23．26％和15．65％。在新型农村合作医疗补偿措施前后，住院患者的Gini系数分别为0．445和0．448。结论试点地区农村居民卫生服务利用趋于公平性，但农村居民在卫生筹资、新型农村合作医疗补偿方面存在不公平性，低收入居民有较高的卫生服务需要。     

浙江省农村居民两周患病率及影响因素分析

目的：了解浙江省农村地区15岁以上居民的两周患病率及影响因素。方法：采用多阶段整群随机抽样方法于2003年对浙江省农村居民进行家庭健康询问调查。结果：浙江省农村地区15岁以上居民两周患病为11．4％。采用logistic回归，筛选出影响两周患病率的主要因素为慢性病、年龄、文化程度、职业。结论：浙江农村居民的卫生服务需求仍处于较高水平，应建立健全新型农村合作医疗，以满足居民的医疗需求。     

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.