社区老年人群认知功能与日常生活功能的关系

[目的]了解贵阳市社区60岁及以上老年人认知功能与日常生活功能和一般人口学因素的关系。[方法]采用多级整群抽样,通过问卷询问和体格检查相结合,对贵阳市城区3229名60岁及以上老人进行现况调查,收集相关资料,用简易智能状态检查量表（MMSE）和日常生活能力量表（ADL）进行认知功能及日常生活功能的检查。[结果]MMSE与ADL得分呈显著负相关（r=-0.313,P﹤0.001）。MMSE与PSMS、IADL得分也呈负相关（r值分别为-0.190,-0.341,P﹤0.001）。按不同年龄、性别、教育程度、婚姻状况以及职业分层后差异仍有统计学意义。对MMSE得分影响显著的因素依次为教育、年龄、ADL得分、婚姻状况及性别（P﹤0.05）。[结论]认知功能与日常生活功能关系密切,对影响日常生活功能下降的因素进行有效干预,有助于预防和减缓认知功能及日常生活功能的衰退。     

贵阳市城区老年人认知功能障碍及影响因素分析

目的 探讨贵州省贵阳市老年人认知功能障碍流行状况及影响因素,为预防老年人识知功能下降提供科学依据.方法 采用多级随机整群抽样方法,使用简易智能状态量表(MMSE)对贵阳市2个城区60岁～的社区老年人进行认知功能检查.结果 完成认知评估3 175人,有认知障碍647人(20%),其中轻度认知障碍465人(14.4%),中重度认知障碍182人(5.6%).老年人认知功能障碍程度随年龄增加而增加;不同性别之间老年人认知障碍检出率差异无统计学意义;MMSE分值随受教育程度降低而降低.老年人的认知功能障碍的多领域均存在下降.多元线性回归分析显示,教育程度的高低、日常生活能力(ADL)量表得分、年龄及性别与老年人认知功能障碍之间差异有统计学意义.结论 贵阳市老年人认知功能障碍患病率较高,老人认知功能障碍与教育程度、ADL、性别、年龄等因素相关.应加强对社区老年人认知功能的早期监测,提高社区老年人生活质量.     

南昌市养老机构老年人认知功能现状调查

目的调查南昌市养老机构老年人认知现状,分析其影响因素。方法 2018年6—12月,采用分层整群抽样法从南昌市登记在册的养老机构中选取9所,通过现场发放一般资料问卷、简易精神状态量表(MMSE)及日常生活能力量表(ADL)对268名入住老年人进行调查,并对数据进行分析。结果入住老年人认知功能平均得分为22.59±3.78,处于较低水平;不同年龄、性别、文化程度、婚姻状况、退休前职业、家庭月收入、每周锻炼次数、饮酒及吸烟情况的老年人MMSE得分比较,差异均有统计学意义(均P0.05);多元线性回归分析显示,性别、年龄和文化程度对老年人认知功能有显著影响(均P0.05);MMSE得分与ADL得分呈负相关(r=-0.781,P0.01)。结论养老机构老年人的认知功能水平较低,文化水平低的高龄女性应成为认知功能受损的重点关注人群,应对其定期进行认知评估,及时干预,以促进老年人认知健康。     

贵阳市城区老年人认知功能影响因素通径分析

[目的]探讨贵阳市城区老年人认知功能影响因素,为预防老年人认知功能障碍提供科学依据.[方法]对贵阳市城区老年人进行抽样调查,调查老年人认知功能及相关因素,通过通径分析,探讨其影响因素,并计算各因素的影响作用大小.[结果]影响老年人认知功能下降的因素作用大小依次为:教育程度,年龄,ADL,社会支持,性别,锻炼情况,痴呆家族史,婚姻等.[结论]应加强对老年人认知功能的监测,尤其是高危人群.同时,老年人躯体和社会功能的保持,可延缓认知功能的下降.     

桐乡市老年人认知功能现状调查及影响因素分析

调查桐乡市1 703名老年人认知功能现状及影响因素,为制定适合的干预措施提供基础数据。本研究采用一般情况调查表和简易认智能精神状态检查量表(mini-mental state examination,MMSE)对桐乡市1 703名≥60岁老年人认知功能现状开展调查及其影响因素进行分析。结果显示,1 703名老年人的MMSE得分均值为(25.17±4.38)分,有认知功能障碍者占总人数的11.98%。在单因素分析中,性别(t=7.783,P0.05);年龄(F=188.590,P0.05);文化程度(F=96.354,P0.05);婚姻状况(t=-11.905,P0.05);吸烟(F=37.629,P0.05);饮酒(F=22.501,P0.05)以及饮茶(t=9.514,P0.05)对认知功能的影响差异均有统计学意义。在多元线性回归(逐步法)分析中,年龄、婚姻状况、文化程度、饮茶以及吸烟是MMSE得分的主要影响因素。对老年人认知功能的可干预性影响因素进行干预,可以对老年人认知功能下降起到一级预防、提高生命质量的作用。     

天津市农村60岁及以上人群认知功能下降检出情况和影响因素调查

目的了解天津市农村老年人群认知功能下降的检出情况和影响因素,为预防老年痴呆的发生提供参考。方法于2012年7-9月,采用随机整群抽样的方法,选取天津市蓟县某镇60岁及以上的1 247名老年人进行问卷调查(包括人口学信息和病史)和体格检查(身高、体重和血压),并进行简易精神状态评价量表(MMSE量表)测试。结果调查对象MMSE量表平均得分为(20.74±5.25)分,男性为(22.42±4.48)分,女性为(19.29±5.43)分;认知功能下降检出率为32.5%,女性检出率(38.2%)明显高于男性(25.7%),差异有统计学意义(χ2=22.095,P0.01)。随着年龄的增长,老年人认知功能下降检出率随之升高,差异有统计学意义(χ2=115.712,P0.01);随着受教育程度的升高,老年人认知功能下降的检出率逐渐降低,差异有统计学意义(χ2=58.659,P0.01)。高血压、糖尿病、心绞痛、心肌梗死及肥胖对老年人认知功能下降的影响无统计学意义(P0.05)。根据受教育年限分层,文盲组的认知功能下降检出率为53.6%,不同性别人群的检出率差异无统计学意义(P0.05);受教育年限1~6年组的认知功能下降检出率为23.2%,女性检出率(27.2%)明显高于男性(20.0%),差异有统计学意义(χ2=5.101,P0.05);受教育年限≥7年组的认知功能下降检出率为28.1%,男性检出率(33.3%)高于女性(15.5%),差异有统计学意义(χ2=6.421,P0.05)。结论农村老年人群认知功能下降检出率较高,随着年龄的增长,认知能力逐渐下降,且与教育水平和性别相关。     

社区老年人血糖水平与MMSE得分关系

目的 探讨不同血糖水平对老年人简单智能量表(mini mental state examination,MMSE)得分影响,为预防老年人认知功能下降提供科学依据.方法 于2003年对贵州省贵阳市老年人空腹血糖及MMSE得分进行调查,2008年进行随访;分析基线、随访时不同血糖水平与MMSE得分的关系,以及不同血糖值与随访期间MMSE得分下降的关系.结果 单因素方差分析结果表明,不同性别、年龄、文化程度、血糖不同水平的MMES得分差异有统计学意义;基线时血糖正常者MMSE得分29,空腹血糖受损(IFG)者为28.5,糖尿病者(DM)为28,3组之间差异有统计学意义;随访时血糖正常者MMSE得分27,IFG者为27,糖尿病者(DM)为26,3组之间差异有统计学意义;随访期间不同血糖水平的MMSE得分下降无统计学意义(x2=2.28,P＜0.05);以基线和随访时MMSE得分、MMES得分下降为因变量进行多重线性分析,老年人空腹血糖值有统计学意义.结论 老年人的空腹血糖值异常增高可导致老年人认知功能下降.     

老年人体力活动水平与认知功能的相关性

目的 研究老年人体力活动水平和认知功能的相关性,为预防老年人认知功能减退提供科学依据.方法 对3所养老院的418名60～101岁老年人(男性160名,女性258名)进行体力活动问卷调查和简易精神状态检查量表(MMSE)调查.比较不同性别、年龄段、文化程度老年人的体力活动水平和MMSE得分.采用多元线性回归分析老年人认知状况的影响因素.控制年龄等混杂因素,用偏相关分析老年人体力活动水平与MMSE得分的相关性.比较不同等级活动强度和活动时间老年人的MMSE得分.结果 老年人的体力活动水平和认知状况与性别无关,与文化程度和年龄有关,随文化程度的升高,老年人体力活动水平和认知状况增加,70岁以上老年人体力活动水平和认知状况随年龄的增长而降低,差异均有统计学意义(P＜0.01).认知功能的影响因素按程度大小依次为文化程度(β=0.460)、体力活动水平(β=0.119)、年龄(β=-0.118).控制年龄和文化程度因素的影响,老年人每周体力活动总代谢当量值与MMSE得分呈正相关(P＜0.01).低强度活动水平的老年人MMSE得分明显低于中、高强度活动水平的老年人,差异有统计学意义(P＜0.01).与每周进行中强度及以上体力活动少于90 min者比较,超过90 min的老年人MMSE得分较高,差异有统计学意义(P＜0.01).结论 老年人的体力活动水平与认知功能水平呈正相关.每周从事90 min中强度及以上体力活动对老年人认知功能的改善可能有益.     

太原市城区老年人认知功能及影响因素调查

目的 通过对社区老年人认知功能的横断面调查,探讨老年人认知功能随年龄增加改变的规律.方法 以山西省太原市5个杜区的1065名60岁以上非痴呆老年人作为研究对象,进行认知功能测查及一般情况调查.结果 算术、数字广度、填图、木块图几项测验得分在年龄组间差异均有统计学意义(F值分别为8.31,4.97,3.52,4.50;P均＜0.05).在不同受教育程度者间差异也有统计学意义(F值分别为29.19,36.94,19.39,18.25,P均＜0.05).性别对除数字广度测验(F=1.774,P＞0.05)以外的其他3项测验得分影响差异有统计学意义(F值依次为36.58,15.39,5.54;P均＜0.05).受教育程度与年龄有交互作用.结论 年龄是认知功能下降的危险因素,特别是75岁以后各项认知功能都处在低于65岁之前的水平.受教育水平对认知功能下降的保护作用有限,75岁以后受教育水平高者认知功能的优势减弱.     

太原市城区老年入认知功能及影响因素调查

目的通过对社区老年人认知功能的横断面调查，探讨老年人认知功能随年龄增加改变的规律。方法以山西省太原市5个社区的1065名60岁以上非痴呆老年人作为研究对象，进行认知功能测查及一般情况调查。结果算术、数字广度、填图、木块图几项测验得分在年龄组间差异均有统计学意义（F值分别为8．31,4．97，3．52，4．50；P均〈0．05）。在不同受教育程度者间差异也有统计学意义（F值分别为29．19，36．94，19．39，18．25，P均〈0．05）。性别对除数字广度测验（F=1．774，P〉0．05）以外的其他3项测验得分影响差异有统计学意义（F值依次为36．58，15．39，5．54；P均〈0．05）。受教育程度与年龄有交互作用。结论年龄是认知功能下降的危险因素，特别是75岁以后各项认知功能都处在低于65岁之前的水平。受教育水平对认知功能下降的保护作用有限，75岁以后受教育水平高者认知功能的优势减弱。     

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.     

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.