城市流动儿童腹泻和咳嗽患病及影响因素分析

目的 了解杭州和北京两城市5岁以下流动儿童过去两周内腹泻和咳嗽的患病率及影响因素.方法 在杭州市下城区和北京市朝阳区、大兴区选取流动人口居住比例较高的地区,由经过严格培训的调查员对所有符合条件的5岁以下流动儿童看护人进行问卷调查.结果 共收集到3 028份5岁以下流动儿童看护人有效问卷.杭州流动儿童过去两周内腹泻和咳嗽的患病率均高于北京,且均具有统计学意义,χ2值分别为5.90和4.68,P＜0.05.在控制了各种可能的危险因素后,3～5岁流动儿童腹泻的患病率是1岁以下儿童组的0.53倍,95% CI:0.42～0.68,但1～2岁和3～5岁儿童咳嗽的患病率分别是1岁以下儿童组的1.40倍,95% CI:1.12～1.75和1.78倍,95% CI:1.46～2.16.结论 两城市流动儿童过去两周内腹泻和咳嗽患病率均较高,且其患病的危险与年龄相关.     

海淀区5岁以下流动儿童营养与健康状况调查

[目的]了解5岁以下流动儿童营养与健康状况. [方法]采用问卷调查和体格检查的方法对通过整群抽样方法获得的海淀区508名5岁以下流动儿童进行营养与健康状况调查. [结果]低出生体重儿和巨大儿各占2.95%和23.03%,均高于北京市城区平均水平.4个月和6个月内纯母乳喂养率分别为75.74%和55.74%,前者高于北京市4月内纯母乳喂养率.6～12个月儿童辅食添加率为95.74%.2～5岁儿童在过去1个月内鱼及水产品、牛羊肉及制品和动物内脏类动物性食物的食用率较低.5岁以下儿童贫血率为20.28%. [结论]流动儿童喂养存在不合理之处,同时流动儿童存在营养不均衡问题和贫血状况.建议相关部门高度重视流动儿童的卫生保健服务,指导婴幼儿合理喂养,最终改善流动儿童营养状况,提高流动儿童健康水平.     

城市流动儿童看护人的儿童保健认知现状调查

[目的]了解杭州和北京两城市5岁以下流动儿童看护人的儿童保健认知现状,从而有利于制定针对性的干预措施。[方法]在杭州市下城区和北京市朝阳区、大兴区选取流动人口居住比例高的地区对所有符合条件的5岁以下流动儿童看护人进行问卷调查。[结果]共收集到3028份5岁以下流动儿童看护人有效问卷。杭州流动儿童看护人的儿童保健认知水平要好于北京流动儿童看护人。但关于孩子6个月应该适时添加辅食的回答正确率在两地分别为27.9%和22.2%,能列举3种及以上儿童疾病或危险信号的比例分别为34.6%和17.0%。[结论]杭州和北京城市流动儿童看护人对某些儿童保健知识,特别是儿童添加辅食月份和儿童危险或疾病信号的知晓率还较低。因此,需要对流动儿童看护人尤其低文化程度看护人进行健康教育和干预以提高其儿童保健知识和态度。     

城市5岁以下流动儿童健康体检状况及影响因素分析

目的:了解杭州和北京两城市5岁以下流动儿童的健康体检现状及其影响因素。方法:选取杭州市和北京市流动人口居住比例高的地区,对符合条件的5岁以下流动儿童看护人进行问卷调查,对流动儿童健康体检的影响因素进行单因素和多因素Logistic回归分析。结果:共收集到3028份5岁以下流动儿童看护人有效问卷,杭州和北京5岁以下流动儿童过去1年内健康体检次数达标率分别为46.4%和29.2%。单因素和多因素分析结果显示看护人低教育程度、低家庭经济收入与流动儿童低水平的健康体检率和体检次数达标率相关,建立儿童健康档案的流动儿童健康体检和体检次数达标的可能性分别是没有建立健康档案流动儿童的14.0倍和5.11倍。结论:两城市流动儿童的健康体检率和体检次数达标率均较低。流动儿童看护人的低教育程度、低家庭经济收入以及没有建立儿童健康档案等均可能是影响流动儿童健康体检状况的重要因素。     

流动人口儿童保健管理模式初探

儿童卫生保健指标是衡量城市经济文化发展水平的重要标志。随着改革开放的深入,大量涌入城市的流动儿童卫生保健问题越来越突出,在一定程度上影响了城市文明进展的步伐。流动儿童保健管理越来越得到各级政府和社会各界的重视,笔者对流动人口儿童保健管理模式进行初步探讨。1流动人口儿童卫生保健管理现状1·1本市2004年5岁以下流动儿童死亡情况。全年本市出生总数39700人,5岁以下儿童死亡总数345人,死亡率8·69‰,其中流动儿童死亡116人,占全市5岁以下儿童死亡总数的33·6%;流动围产儿死亡占全市围产儿死亡的41·9%。2004年市儿保协作组对全…     

5岁以下流动儿童保健现状与干预方法

目的:研究与探讨5岁以下流动儿童的保健现状以及相应的干预方法。方法:选取本市人口密集的社区中5岁以下流动儿童共1032例,对其监护人就儿童的保健情况进行问卷调查,并讨论相应的健康干预方法。结果:根据对1032例问卷的结果研究分析显示,目前5岁以下的儿童的建档率为68.2%,体检次数的达标率为45.5%,2周内腹泻发生率为12.8%,咳嗽发生率为35.1%。结论:流动儿童的保健现状与本地城市户籍的儿童相比,保健状况明显更差。采用有效的干预方法可以提高5岁以下流动儿童的保健现状,保证儿童的健康成长。     

银川市5岁以下流动儿童与常住儿童卫生保健状况比较分析

[目的]了解宁夏银川市5岁以下流动儿童与常住儿童卫生保健状况。[方法]按照整群随机抽样原则在银川市流动人口集居地区随机抽取5个社区为调查现场,利用自制的问卷调查表对580名5岁以下流动儿童和231名常住儿童看护人进行问卷调查。[结果]流动儿童新生儿访视比例为13.3%,健康体检率为54.3%,均明显低于常住儿童(76.7%和93.8%),且差异有统计学意义(χ2=140.50,53.95;P﹤0.05);流动儿童与常住儿童预防接种建卡率均达到97%以上,但流动儿童"五苗"合格接种率(68.5%)低于常住儿童(97.7%)(χ2=40.67,P﹤0.05);[结论]银川市流动儿童卫生保健水平与常住儿童相比还有较大差距,相关卫生部门应采取相应措施提高其卫生保健水平,使其享有与常住儿童相同的卫生保健。     

北京市流动儿童免疫接种率抽样调查

为了解北京市流动儿童免疫接种现状 ,于 1998年开展了流动儿童免疫接种率抽样调查。结果显示 :建卡率 82 6 2 % ,建证率 89 39% ,卡、证符合率 80 2 9% ;1岁以下儿童卡介苗、口服脊髓灰质炎疫苗、百白破混合制剂、麻疹疫苗接种率分别为 71 81%、 79 5 2 %、 78 92 %、 78 84% ,四苗全程合格接种率为 6 5 6 1%。调查发现散居流动儿童的免疫接种现状明显好于集居流动儿童 ,集居儿童中 2～ 6岁儿童建卡率 ,卡、证符合率 ,四种疫苗和四苗全程合格接种率均低于 <1岁和 1岁儿童。此外 ,北京市还存在流动儿童管理水平在地区间的不均衡性。调查提示 ,应采取相应措施以加强流动儿童计划免疫管理     

分析5岁以下流动儿童保健现状与干预方法

目的本文针对城市小于5岁的外来打工者子女保健现状展开研究,并探讨提高保健覆盖范围的方法与措施。方法选取本地人口较为密集社区中的5岁以下属于流动儿童共1000例,并对儿童的监护人进行调查,主要询问儿童保健的情况等,同时讨论关于儿童健康相关的干预方法与措施。结果通过对1000例流动儿童进行问卷调查,结果分析显示,目前本地区的5岁以下儿童健康建档率达到67.3%,接受体检的次数达标率达到44.6%,在2周之内发生腹泻的发生率是13.1%,发生咳嗽达到34.9%。结论对于城市的流动儿童来说,保健的现状较本地的城市户籍儿童更差。通过采取必要有效的措施进行干预可以提高流动儿童,特别是5岁以下儿童的保健现状,可以保证健康成长。     

安徽省颍上县农村地区儿童监护人手足口病相关知识及行为习惯调查

目的了解安徽省颍上县农村5岁以下儿童监护人手足口病(HFMD)知识知晓率及卫生习惯,为干预措施的制订提供参考依据。方法采用多阶段随机抽样的方法,根据地理位置及发病情况在颍上县抽取4个乡镇,采用自行设计的调查问卷,调查农村地区5岁以下儿童监护人手足口病知识知晓率及卫生行为状况。结果本次在颍上县共调查492名5岁以下儿童监护人,手足口病总体知识知晓率为40.93%,儿童父母手足口病知识知晓率高于祖父母(54.72%vs 32.10%;χ2=421.213,P0.001),文化程度高的儿童监护人手足口病知识知晓率高于文化程度低儿童监护人(χ2趋势=493.200,P0.001);知识知晓率最低的项目为手足口病重症的早期识别症状,仅0.81%的人知道持续发热不退、呕吐、肢体抖动是手足口病重症早期易识别的症状;儿童监护人外出回家洗手、使用肥皂洗手比例较低,分别为40.24%、25.81%,儿童父母卫生习惯要好于祖父母。结论农村5岁以下儿童监护人存在手足口病知识知晓率不高、知识知晓不平衡及卫生习惯较差情况,应针对重点人群、重点知识采取有效的干预措施。     

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.