开拓进取 稳步发展——《环境与职业医学》杂志第四届编辑委员会及编辑部工作回顾

《环境与职业医学》杂志第四届编辑委员会组建于2001年12月24日,至今已历时七年八个月。在上海市科委、上海市新闻出版局、上海市卫生局的领导下,在主办单位上海市疾病预防控制中心（以下简称“上海市疾控中心”）、中华预防医学会的指导、管理下,在编委和各方专家的支持下,《环境与职业医学》杂志立足国内学术前沿,汲取国际研究精华,     

Occupational therapists' perception of usage of information and communication technology (ICT) in Western Australia and the association of availability of ICT on recruitment and retention of therapists working in rural areas

Objective:  The purpose of this study was to investigate occupational therapists' usage of information and communication technology (ICT) in Western Australia and the association of availability of ICT on recruitment and retention of rural therapists.
Methods:  One thousand, one hundred and thirty-eight surveys were sent to all occupational therapists registered with the Western Australian Occupational Therapy Registration Board in January 2003. The survey was used to identify ICT access, support and literacy. The attitude of therapists towards using ICT as a communication tool and therapists' usage patterns of ICT in metropolitan and rural localities were analysed by using the Chi-squared test.
Results:  Email and the personal computer were used most frequently. On ICT global competency, 58% of therapists rated their competency level as good or better. Competence was rated lower for web searching (48.5%) and searching for electronic articles (29.8%). Approximately one-third of respondents were dissatisfied with the level of technical support available and only 38.4% of therapists had participated in basic computer training provided by their current employer. Rural therapists had less access to a computer in their work environments in comparison to their metropolitan peers (P  <  0.05). Nevertheless, rural therapists were using email, teleconferencing and videoconferencing more frequently than their metropolitan counterparts.
A proportion of rural therapists (45.5%) felt that ICT influenced their decision to continue working in rural areas.
Discussion and Conclusion:  Professional isolation has been cited as an inhibitor to recruit and retain health-care workers in rural areas. The higher ICT usage by rural therapists may represent the utility of ICT as a means of circumventing professional isolation that is inherent in rural and remote areas.     

人口与健康领域国家"十一五"科技支撑计划招(评)标情况分析报告

通过对“人口与健康领域”国家“十一五”科技支撑计划重大（重点）项目招（评）标过程管理信息的分析，归纳总结了该计划招（评）标阶段的基本特点、存在问题，并提出相应的改进意见。     

Results of evaluability assessments of local wellness policies in 6 US school districts

BACKGROUND: A US federal mandate that school districts devise and implement local wellness policies (LWPs) has potential widespread impact on the nutritional content of foods and beverages available in schools and on the amount of physical activity that students engage in; however, evidence concerning the mandate's effectiveness is limited. This study describes the content of LWPs of 6 US school districts and steps taken toward their implementation and evaluation. METHODS: During visits to 6 school districts, we interviewed 88 school and community representatives about the content of their district's LWPs and how the LWPs were being implemented and evaluated. RESULTS: The 6 LWPs were consistent with the federal mandate, although they varied in content and degree of specificity, and none had been fully implemented. All 6 districts were pursuing strategies to ensure that foods and beverages available at school met nutrition standards but did not offer nutrition education to all K‐12 students. All 6 districts offered students only limited opportunities for physical activity, and all 6 collected data to monitor process and outcomes of their LWPs. CONCLUSIONS: Partial implementation of LWPs in the districts we visited resulted in significant improvement in the nutritional quality of foods available at district schools, but only slight improvement in students' opportunities for school‐based physical activity. We provide recommendations for school districts on implementation and evaluation. Future research is needed to determine the impact of these LWPs on students' health.     

湛江口岸性病监测概况及评价

1984～1996年对湛江口岸性传播疾病(STD)进行了监测。13年来采取(监测体检、检疫查验、监测网点、宣传教育和协作关系等)STD监测措施和手段；对其效果和存在的同题进行了分析与评述；并提出了今后如何改进的合理化建议。     

医院网上招投标系统的建设与应用

介绍了创建以网络平台为基础的招标方法。将网络资源与邀请招标的方式相结合，形成一套完善的招投标系统，以此扩大供应商数量与范围，从中挑选出符合医院实际需要的供应商参加投标，使招投标工作更加行之有效。网上招投标系统的建设有助于提升医院物资集中采购的整体水平和降低医院的采购成本。     

Expression pattern, ethanol-metabolizing activities, and cellular localization of alcohol and aldehyde dehydrogenases in human large bowel: association of the functional polymorphisms of ADH and ALDH genes with hemorrhoids and colorectal cancer

Alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) are principal enzymes responsible for metabolism of ethanol. Functional polymorphisms of ADH1B, ADH1C, and ALDH2 genes occur among racial populations. The goal of this study was to systematically determine the functional expressions and cellular localization of ADHs and ALDHs in human rectal mucosa, the lesions of adenocarcinoma and hemorrhoid, and the genetic association of allelic variations of ADH and ALDH with large bowel disorders. Twenty-one surgical specimens of rectal adenocarcinoma and the adjacent normal mucosa, including 16 paired tissues of rectal tumor, normal mucosae of rectum and sigmoid colon from the same individuals, and 18 surgical mixed hemorrhoid specimens and leukocyte DNA samples from 103 colorectal cancer patients, 67 hemorrhoid patients, and 545 control subjects recruited in previous study, were investigated. The isozyme/allozyme expression patterns of ADH and ALDH were identified by isoelectric focusing and the activities were assayed spectrophotometrically. The protein contents of ADH/ALDH isozymes were determined by immunoblotting using the corresponding purified class-specific antibodies; the cellular activity and protein localizations were detected by immunohistochemistry and histochemistry, respectively. Genotypes of ADH1B, ADH1C, and ALDH2 were determined by polymerase chain reaction-restriction fragment length polymorphisms. At 33 mM ethanol, pH 7.5, the activity of ADH1C*1/1 phenotypes exhibited 87% higher than that of the ADH1C*1/*2 phenotypes in normal rectal mucosa. The activity of ALDH2-active phenotypes of rectal mucosa was 33% greater than ALDH2-inactive phenotypes at 200 μM acetaldehyde. The protein contents in normal rectal mucosa were in the following order: ADH1 > ALDH2 > ADH3 ≈ ALDH1A1, whereas those of ADH2, ADH4, and ALDH3A1 were fairly low. Both activity and content of ADH1 were significantly decreased in rectal tumors, whereas the ALDH activity remained unchanged. The ADH activity was also significantly reduced in hemorrhoids. ADH4 and ALDH3A1 were uniquely expressed in the squamous epithelium of anus at anorectal junctions. The allele frequencies of ADH1C*1 and ALDH2*2 were significantly higher in colorectal cancer and that of ALDH2*2 also significantly greater in hemorrhoids. In conclusion, ADH and ALDH isozymes are differentially expressed in mucosal cells of rectum and anus. The results suggest that acetaldehyde, an immediate metabolite of ethanol, may play an etiological role in pathogenesis of large bowel diseases.     

食品添加剂卫生监督管理探讨

为加强食品添加剂的卫生监督管理，通过对我市食品添加剂生产、经营和使用单位的监督检查情况的分析，探讨在监管过程中应注意的问题及重点要求，保证食品添加剂的卫生安全，切实维护人民群众身体健康。     

医院聘用人员技术职务聘任实践

专业技术职务聘任是医院专业技术人员调职晋级、有效选拔、科学使用的重要举措.文章重点阐述职务聘任的具体实践过程,对实施职务聘任效果进行评价,并对岗位聘任等存在问题进行思考.     

The relationship between sleeping problems and aggression, anger, and impulsivity in a population of juvenile and young offenders

PurposeThe current study examines both the quantity and quality of sleep reported by male adolescents detained in prison, with a focus on exploring the association between the quantity and quality of sleep with aggression, impulsivity, or anger. This represents a novel area of study not yet explored among incarcerated male adolescents.MethodOne hundred eighty-four offenders took part; 104 young (average age 19 years) and 80 juvenile (average age 16 years). All completed a questionnaire exploring sleeping problems, and measures assessing aggression, anger, and impulsivity.ResultsAggression was found to relate both to the quantity and quality of sleep reported, with reduced quantity and quality predicted by increased overall aggression. Across aggression subscales, only increased hostility was predictive of reduced current hours of sleep and increased problems in sleep quality. Apnea risk scores were not predicted by aggression, anger, or impulsivity. Differences in sleep behavior before and during prison were demonstrated, with evidence for increased poor sleeping habits within detention. No differences were observed between young and juvenile offenders.ConclusionsThis study suggests a potential relationship between aggression and sleep among an incarcerated adolescent male sample, highlighting in particular a role for hostility. The findings are discussed in relationship to implications for treatment and directions for future research.     

北京市怀柔区2010年粉尘与高毒企业的危害因素调查

目的了解北京市怀柔区粉尘与高毒危害企业工作场所中职业病危害因素现状,为改善作业场所环境提供技术支持,为监管部门提供科学依据。方法依据国家有关标准、规范,使用气体采样器、大气采样器、粉尘采样仪采集车间空气中的化学物质和粉尘样品,噪声频谱分析仪现场检测噪声。结果对存在粉尘与高毒物品的36家企业工作场所进行了职业病危害因素检测与评价,共采集化学毒物、物理因素、粉尘3大类11项893件样品。其中超标企业14家,超标样品121件,企业超标率38.9%,样品超标率13.5%。结论该区部分企业工作场所中职业病危害因素超标,提示各相关机构应高度重视职业卫生工作,加大监管和宣教力度,提高企业和劳动者的职业病防治意识,促进企业加强职业卫生工作管理,推进作业场所职业健康管理工作规范化、制度化,预防和控制急慢性职业病的发生。     

The crucial role of recess in schools

BACKGROUND: Recess is at the heart of a vigorous debate over the role of schools in promoting optimal child development and well-being. Reallocating time to accentuate academic concerns is a growing trend and has put recess at risk. Conversely, pressure to increase activity in school has come from efforts to combat childhood obesity. The purpose of this review was to examine the value of recess as an integral component of the school day. METHODS: A comprehensive review of recess-specific literature was conducted, beginning with a Google Scholar search, to cull definitions, position statements, and policy recommendations from national/international associations and organizations. A multi-database search followed. Additional articles were selected from reference lists. RESULTS: The search yielded a range of articles, from those focused on specific aspects of recess to those that examined multiple factors, including how to structure and conduct recess. Several themes emerged supporting recess as beneficial for children's cognitive, social, emotional, and physical functioning. Optimal recess was well-supervised and safe. Crucial components were well-maintained playground equipment and well-trained supervisors. CONCLUSION: Recess serves a critical role in school as a necessary break from the rigors of academic challenges. Recess is a complement to, not a replacement for, physical education. Both promote activity and a healthy lifestyle; however, recess—particularly unstructured recess and free play—provides a unique contribution to a child's creative, social, and emotional development. From the perspective of children's health and well-being, recess time should be considered a child's personal time and should not be withheld for academic or punitive reasons.     

常规医疗设备的维修及方法

本文主要叙述了医疗设备的维修及方法和在高等领域的处理办法及管理。     

北京市昌平区儿童青少年超重和肥胖流行状况

目的 阐明北京市昌平区儿童青少年超重肥胖的流行状况。方法 2007年5—10月采取分层整群随机抽样,对北京市昌平区4247名7～18岁中小学生进行调查。测量指标包括身高、体重、收缩压、舒张压等。使用SPSS 11．5进行统计学处理,各组率的比较,采用x^2检验。结果 ①共4247名中小学生参加调查,其中女生2090名,男生2157名,超重肥胖572名;②儿童青少年超重肥胖患病率13．47％;③超重肥胖儿童青少年的高血压与体重正常高血压患病率分别为23．7％和6．3％,患病率差异有统计学意义（x^2=39．89,P〈0．01）。结论 儿童青少年患有超重肥胖率较高,有必要对超重肥胖儿童青少年控制体重,减少高血压的患病率。     

感染科住院患者医院感染的调查分析

目的 探讨感染科住院患者医院感染的临床特征及易感因素,旨在降低感染科医院感染的发生率.方法 回顾性分析2008年1月-2011年12月在感染科住院患者中发生医院感染的资料,观察医院感染发生率、相关基础疾病、感染发生部位及病原学特点等.结果 3447例住院患者中发生医院感染111例,感染率为3.22％,其中发生于结核病54例,占48.65％,其次为肝病45例占40.54％、艾滋病5例占4.50％、败血症4例占3.60％;感染部位以肺部为主,占39.64％,其次为消化系统和上呼吸道,分别占21.62％、15.32％;82份送检标本中,共检出病原体71株,检出率为86.59％,其中革兰阴性菌20株占28.17％,革兰阳性菌5株占7.04％,真菌44株占61.97％,病毒2株占2.82％.结论 感染科住院患者中以结核病患者发生医院感染比例最高,病原体以真菌为主,对感染科住院患者应给予密切关注,控制易感因素,规范抗菌药物的使用,从而降低医院感染发生率.     

《食品卫生法》与《食品安全法》关于食品进货查验的概况及有关规定比较研究

为了2009年6月1日起实施的《中华人民共和国食品安全法》关于食品进货查验索证索票工作的规定和执行起到借鉴作用,并为国家相关部门制定有关细化要求提供参考依据。本文就之前,各监管部门主要是卫生行政部门,执行《中华人民共和国食品卫生法》在食品索证监督管理方面的难点等情况进行了整理、总结、概述,并与《中华人民共和国食品安全法》的规定进行了比较。     

全方位生长发育监测及早期综合干预对婴幼儿发展的影响

目的:研究全方位生长发育监测和早期综合干预对婴幼儿体格及智能发育的影响。方法:随机抽取年龄为48天~5个月的正常婴儿80例为实验组,按1∶1配对原则选取对照组80例。实验组入组后采用全方位生长发育监测及早期综合干预技术对其体格发育及神经精神发展进行定期跟踪监测、评估,同时实施早期干预方案。两组儿童30个月时,对其体格、智能发育指标进行统计分析。结果:实验组总发育商明显高于对照组;实验组在大动作、精细动作、个人社交3个能区发育商数(DQ)高于对照组,同时实验组身高、体重增加值明显大于对照组。结论:婴幼儿全方位生长发育监测技术及早期综合干预技术是一种比较全面的婴幼儿生长发育监测技术,能明显促进婴幼儿体格及智力的全面协调发展,可以面向广大妇幼保健机构推广应用。     

缺铁性贫血对婴幼儿生长发育影响的调查分析

目的 了解缺铁性贫血对婴幼儿生长发育的影响.方法 对1905名6月～3岁小儿缺铁性贫血患病率进行调查,对贫血小儿和非贫血小儿的长速、丹佛智能筛查(DDST)结果、呼吸道感染和腹泻发病率进行比较分析.结果(1)贫血组小儿平均长速低于无贫血组,但差异不明显;(2)贫血组小儿DDST项目及格率明显低于无贫血组,差异有显著性;(3)贫血组小儿呼吸道感染和腹泻发病率明显高于非贫血组,统计学处理有显著性差异.结论 缺铁性贫血对婴幼儿生长发育有严重影响,应予以充分重视.     

我国慢性病挑战与防控对策

慢性病是我国居民的主要死因和主要健康问题,可对家庭和社会带来直接和间接的经济损失,甚至成为影响经济社会可持续发展的重要问题.慢性病病因复杂,主要是不良生活方式的结果,但其背后有复杂的社会决定因素.国内外经验表明,慢性病是可防可控的,必须通过加强政府的政策承诺和领导,将卫生政策融入所有社会政策,建立健康城市等综合干预平台,重构医疗服务体系,普及推广具有成本效益措施以及动员全社会参与,强化规划和监督评价考核等综合措施,才能取得更好的防控效果.     

国际托育质量评估与监测体系

高质量的托育服务能为儿童、家庭和社会带来持续性的收益。建立完备的托育质量评估和监管体系,有助于保障托育服务的高质量发展。目前我国尚未建立托育机构质量监测系统,也缺少专业化和标准化的托育质量评估工具。本研究系统梳理了国际组织、发达国家和地区的托育质量监测和评估体系,包括政府的监管部门、评估内容架构和评估方式等。提示我国应尽快建立完善托育质量管理和评估体系,加强对托育机构的结构质量、过程质量和结局质量的系统评估。从政策保障、制度建设、专业评估工具研发等方面着手,逐步形成由政府主导,多方参与的托育质量监管模式,以保障托育机构健康和高质量发展。