健康指导员对社区健康教育管理模式创新的研究

目的 科学验证将健康指导员策略应用于社区健康教育中所取得的实际效果,探索社区健康教育管理新模式,为有效开展社区健康教育提供科学依据.方法 选取两个社区作为研究现场,其中干预社区接受健康指导员与单纯健康教育干预相结合的综合干预,对照社区仅接受单纯的健康教育干预,对干预一年后两个社区相关指标进行分析比较.结果 干预社区居民的健康知识知晓率、健康行为形成率在干预后均明显提高,差异有统计学意义;而对照社区上述指标在干预前后差异无统计学意义.结论 健康指导员策略能成功地促使社区内各方面人员以主人翁精神参与其中,帮助建立起自治型社区健康教育管理新模式,在获取更好健康教育效果的同时,促进社区健康教育工作的可持续性发展.     

广州市社区人群结核病健康教育效果评价

目的评价在广州市社区人群中实施结核病健康教育的效果。方法采用整群抽样的方法，在广州市越秀区抽取2个居委会，对社区居民实施1年的结核病健康教育。干预前后分别随机抽取700人进行问卷调查，通过比较干预前后居民的结核病知识知晓率和相关行为正确率，评价健康教育的效果。结果干预前后分别收回有效问卷627份和618份。干预后，居民结核病防治知识知晓率和相关行为正确率均有明显提高（P〈0．01），知识总知晓率和相关行为总正确率，分别由干预前的49．8％和74．7％，上升到干预后的69．7％和82．3％（P〈0．01）。结论开展社区居民结核病健康教育对提高居民结核病防治知识水平、促进其形成健康行为具有重要作用。     

昆明市社区居民糖尿病防治健康教育干预效果评估

目的探讨社区健康教育干预措施对人群糖尿病防治知识及行为的影响,为有效开展社区糖尿病干预提供科学依据。方法采用社区干预试验研究方法,选择干预社区和对照社区,对干预社区居民实施以健康教育和健康促进为主的干预活动;通过比较2个社区基线及1年半后糖尿病防治知识和行为变化情况,评估干预效果。结果 1年半后,干预社区居民糖尿病防治知识知晓率比干预前明显提高,糖尿病相关健康行为形成率也有所提高;而在对照社区,社区居民糖尿病防治知识知晓率和健康行为形成率均没有明显变化。结论糖尿病社区健康教育与干预项目对社区居民糖尿病知识认知水平的提高和健康行为的形成有较好的促进作用,应加强社区糖尿病健康教育与行为干预工作。     

柳州市社区居民慢性病健康教育干预效果评价

目的通过对社区居民开展慢性病及健康生活方式为内容的一系列健康教育活动并进行效果评价,探讨社区健康教育的有效工作模式。方法以随机整群抽样方法抽取柳州市某社区作为干预活动社区试点,开展健康教育干预活动,并随机抽取360名40~60岁居民在干预前后开展健康知识与行为的问卷调查。结果通过在社区开展一系列的健康教育干预活动,干预前后居民健康知识总知晓率分别为43.4%和69.3%,总的健康行为形成率干预前后分别为45.3%和62.7%,差异均有统计学意义。结论在社区开展健康教育干预活动是普及健康知识促进健康行为形成的有效措施。     

上海市某社区人群相关重点传染病健康教育干预效果评价

[目的]了解上海市阂行区社区人群中菌痢、病毒性肝炎等重点传染病的知晓水平和行为状况,探讨综合性健康教育干预内容,评价干预效果. [方法]采用PPS抽样方法,在上海市阔行区颛桥镇抽取2个社区,对社区居民实施半年的相关传染病综合性健康教育.分别于干预前后对所有干预的居民进行相关知识的问卷调查,通过比较干预前后居民的相关传染病知识知晓率和相关行为正确率的变化,评价健康教育效果. [结果]干预后居民相关重点传染病相关知识的知晓率及相关正确的行为意向认知率均有显著提高(P<0.05),但对经常吃熟食、隔夜菜的行为意向仍保持较高比率,分别为41.98%(本地居民)和51.26%(外来人群);安全套使用的行为认知率仍很低.分别为26.72%(本地居民)和42.02%(外来人群). [结论]传染病综合性健康教育效果明显.但要真正改变人们行为,实现由知识的获得、态度的转变到行为实践的飞跃,仍需要进行长期广泛而持续的健康教育工作.     

社会动员策略在四川农村社区健康促进中的应用研究

近年来我国在多个领域实施健康促进项目,但这些项目普遍存在过分依赖外部投入、可持续性较差等问题.针对这些问题,我们将联合国儿童基金会(UNICEF)所积极倡导的社会动员策略(Social Mobilization Strategy)系统地应用于四川省农村一个腹泻病控制健康促进项目中,并对其应用效果进行深入的研究,以期为上述问题的解决提供一些答案.课题选择了三个社区作为实验现场.其中一个社区接受社会动员、健康信息传播与行为矫正措施相结合的综合干预;另一个社区进行健康信息传播与行为矫正等常规的健康教育干预;第三个社区为空白对照社区,不进行上述这些干预.研究结果表明,"社会动员+健康教育”社区对象的相关健康认知和行为改善情况、腹泻病控制效果等均优于"健康教育”社区和空白对照社区;社会动员等综合干预策略的系统运用,使干预社区内部潜力和资源得以合理开发,社区群众和干部参与项目的积极性得以充分调动,可持续的健康促进网络和机制得以及时形成.本研究基本上取得了预期的效果,同时证明了社会动员策略在四川农村社区是行之有效的健康促进新策略,具有较好的推广价值.     

城市社区健康教育与健康促进工作管理机制试运行效果评价

目的验证"自贡市城市社区健康教育与健康促进工作管理机制"实施过程中的可行性和有效性,为建立社区健康教育长效工作机制提供依据。方法设立试点社区及对照社区,新旧工作机制分别实施于试点社区与对照社区。干预前后对居民健康知识和健康行为进行同题问卷调查,数据应用SPSS13.0统计软件进行t检验、卡方检验和方差作统计分析。结果试点社区干预前后居民健康知识的知晓率和健康行为形成率都有明显提高(P0.05);试点社区与对照社区干预后比较,试点社区居民健康知识的知晓率和健康行为形成率高于对照社区(P0.05)。结论新的社区健康教育工作管理机制的运行对群众健康教育的效果明显优于现行社区健康教育工作管理机制。     

福州市社区糖尿病健康教育干预效果评价

目的 探讨福州市社区糖尿病健康教育的干预效果,为有效开展社区糖尿病干预提供科学依据.方法 采用分层整群随机抽样的方法,选取福州市1个城区的2个社区分别作为干预社区和对照社区,于2009年1月至2011年1月,对干预社区35岁以上居民进行全面系统的糖尿病健康教育,对照社区不作干预.干预2年后,测量2个社区居民的腰围,血压,计算体质指数( BMI),测定空腹血糖值,对生活质量、糖尿病患病率、知晓率、服药率和控制率进行比较.结果 干预2年后,干预社区居民空腹血糖值、BMI、腰围、收缩压低于对照社区,生活质量好于对照社区,差异均有统计学意义(P＜0.01).干预社区居民糖尿病患病率(18.3％)低于对照社区(27.3％),糖尿病知晓率(63.2％)、服药率(64.4％)和控制率(10.7％)均高于对照社区(分别为41.7％、35.8％、6.7％),差异均有统计学意义(P＜0.01).结论 社区健康教育能降低糖尿病的患病率,减少糖尿病的危险因素,提高糖尿病的防治效果.     

限盐减油膳食行为干预在社区居民中应用效果研究

目的：研究限盐减油膳食行为干预在社区居民中的应用效果。方法：随机抽取当地常住居民中在家做饭的家庭成员150人,年龄18-65岁,通过问卷调查、健康教育和主动干预的方式对其进行干预前后效果调查。结果：干预后有97．34％居民愿意继续使用控盐勺、控油壶,干预前后的限盐减油膳食行为比较差异有统计学意义（P〈0．05）。结论：限盐减油干预在社区居民应用中效果显著,但合理健康膳食行为模式并非短期能够完全形成,需要坚持不懈的健康教育和健康促进行动予以强化和巩固。     

浙北地区城乡社区健康教育效果评价

目的评价浙北地区城乡社区健康教育效果,探讨城乡社区健康教育的有效方法。方法在浙北地区各选择1个城市社区和1个农村社区实施综合性健康教育干预活动,同时选择条件相似的2个社区作为对照。干预前后,在城市和农村干预、对照社区均随机抽取600人进行问卷调查,比较调查对象健康核心信息知晓率和健康相关行为形成率。结果干预后,农村干预社区居民对核心知识的知晓率明显提高（P〈0.05）;而城市干预社区居民则无明显提高。城市干预社区居民饮酒率下降,测量血压的比例升高（P〈0.05）;农村干预社区居民形成了定期更换牙刷以及刀和菜板生熟分开的行为习惯（P〈0.05）。结论充分发挥社区卫生服务中心的作用,通过责任医师实施综合性干预,是城乡健康教育的一种有效方法。     

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.     

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.     

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.