海淀区2004年碘缺乏病干预项目综合评估分析

[目的]通过碘缺乏病综合干预，使2004年底全区居民碘盐覆盖率达到95％；居民合格碘盐食用率达到90％；居民对食用碘盐可预防碘缺乏病的知晓率达到80％的3项指标。[方法]执行北京市2004年度消除碘缺乏病综合干预项目，进行目标动员、知识业务培训、摸底调查、专项检查、执法检查、工作检查、健康教育、健康促进、自我评估，最后市评估组根据评估方案对全区综合干预进行项目评估。[结果]摸底调查医院、学校、宾馆饭店、餐厅94家。合格碘盐35家，合格碘盐食用率37．23％。执法检查超市便利店28家出售合格碘盐单位占96。57％，集贸市场25家出售合格碘盐单位占20％，查出仿冒、伪劣私盐、非碘盐1kg包装袋共1873袋，散装盐65kg。工作检查1299户居民，居民合格碘盐食用率89．84％，非碘盐占10．16％，个体路边零售店227家，出售合格碘盐164家，占72．25％，出售私盐非碘盐63家，占27．75％。市检查组评估检查居民合格碘盐覆盖率98．75％，居民合格碘盐食用率98．75％，商场出售合格碘盐100％，碘缺乏病知识知晓率98．33％和99．17％，3项指标均达到项目标准。[结论]碘缺乏病防治工作是一项社会化的系统工程，需要全社会各部门密切配合，政府应强化各部门职责，完善可持续发展，建立长效消除碘缺乏病的运作工作机制，将打击私盐、非碘盐工作列入工商、卫生监督所长期工作议事日程，确保碘缺乏病防治工作长期可持续开展。     

肇庆市鼎湖区消除碘缺乏病防治效果分析

目的了解近年来肇庆市鼎湖区碘缺乏病防治工作情况,评估防治效果,为下一步的防治工作提供参考依据。方法收集肇庆市鼎湖区2007-2011年的碘缺乏病防治监测数据,分析居民食用碘盐合格率、碘盐覆盖率、非碘盐率以及8～10岁儿童甲状腺肿大率、尿碘中位数等指标;对学生和家庭主妇进行碘缺乏病防治知识问卷调查。结果5年共检测1074份盐样,合格1034份,食用碘盐合格率为96．28％,盐碘中位数为37．60mg／kg,碘盐覆盖率为100％;8—10岁儿童甲状腺肿大率为0（0／400）,尿碘中位数为180．70μg／L;学生碘缺乏病防治知识知晓率为95．33％（715／750）,家庭主妇碘缺乏病防治知识知晓率93．33％（350／375）。结论肇庆市鼎湖区食盐加碘消除碘缺乏病防治工作取得了较好成效,所有技术指标均已达到持续消除碘缺乏病标准。     

杭州市居民食盐加碘策略知识态度行为调查分析

目的：了解杭州市民对食盐加碘策略的认知程度和碘相关知识的知晓情况，为有针对性地开展碘缺乏病防治健康教育提供依据。方法：采用调查问卷，通过随机抽样方法对337名市民进行调查。结果：市民对碘盐可预防碘缺乏病的认识程度较好，对碘缺乏及碘过量造成的危害也有较高认知，大多数的市民（65．88％）认为国家食盐加碘策略基本正确，食盐加碘应该“因地制宜、分类指导”。但也认为目前甲状腺肿瘤发病率确实升高和可能升高的占65．87％，而且有54．89％的市民认为是吃碘盐造成的；27．0％市民认为补碘超过适宜量或碘过量，这也是市民选择无碘盐（16．62％）或交替购买碘盐和无碘盐（35．91％）的主要原因。居民自愿购买碘盐比例偏低（42．73％），不少市民（26．41％）认为，沿海和发达地区应该自主选择碘盐和无碘盐，或农村地区食用加碘盐而城市人群食用无碘盐。结论：应进一步加大健康教育的力度，尤其要重视沿海城市居民碘缺乏病健康教育，探讨因地制宜的健康教育方法及模式。     

2002年烟台市碘缺乏病目标人群健康教育现状评估

[目的]掌握烟台市碘缺乏病目标人群健康教育现状,为下一步开展健康干预活动提供科学依据。[方法]2002年,在烟台市13个县(市、区)以多阶段随机抽样方法,抽取五年级小学生4 840名、学校周围20~60岁的家庭主妇1 300名、有非碘盐村的11家食盐零售店店主,进行消除碘缺乏病健康教育知识问卷考评。[结果]健康教育知识及格率家庭主妇、学生、零售店主分别为95 9%、87 6%、89 6%;家庭主妇和学生行为正确率分别为98 0%和88 9%;防治知识来源家庭主妇81 1%为学生讲述,学生77 9%为教师授课,零售店店主54 5%为宣传单。[结论]烟台市碘缺乏病相关知识知晓率家庭主妇比较高,学生和食盐零售店店主有待进一步提高。     

豫西小学生碘缺乏病状况及防治对策

目的 为促进消除碘缺乏病（IDD）项目的深入开展，建立消除碘缺乏病健康教育干预模式。方法对1102名小学二～四年级的学生进行IDD知识调查、甲状腺触诊检查，并整群抽取124名小学生的尿样及家中食盐，进行尿碘和盐碘碘含量测定。结果23．96％的小学生听说过碘缺乏病，其知识知晓率为26．53％，54．08％的小学生不知道碘盐与非碘盐的识别特征；17．42％的家庭食用碘盐方法错误；触诊甲状腺肿大率为14．88％；44．65％的小学生认为家长会听自己的宣传；94．48％的家庭听了孩子的宣传后会照宣传内容去做。结论提高缺碘地区小学生预防碘缺乏病的自觉性和主动性，加强家庭碘盐的正确食用，是提高居民对IDD防治效果的重要方法与手段。     

2008~2012年天津市西青区居民食用碘盐监测结果

目的了解天津市西青区2008--2012年居民食用碘盐情况,为制定消除碘缺乏病防治策略提供科学依据。方法按照东、西、南、北、中片区随机抽取1个乡（镇、街）,每乡（镇、街）中随机抽取4个行政村（居委会）,每行政村（居委会）中随机抽检15户居民盐样,根据《全国碘盐监测方案（修订）》采用直接滴定法测定碘盐。结果2008--2012年共检测居民户碘盐1488份,碘盐中位数为30．1mg／kg,碘盐覆盖率、碘盐合格率、合格碘盐食用率、非碘盐率分别为93．8％、99．4％、93．1％、6．3％。2008年碘盐覆盖率、合格碘盐食用率、碘盐合格率分别仅为87．2％、85．4％和98．0％,2010--2012年碘盐覆盖率、合格碘盐食用率、碘盐合格率均明显高于2008年（P〈0．05）。结论西青区碘盐合格率和合格碘盐食用率呈逐年上升趋势并且已达到国家要求,但仍存在不合格碘盐现象,须加强食用碘盐的监督监测工作和居民碘缺乏病防治知识的宣传、教育工作。     

2008-2013年北京市延庆县农村居民食用碘盐监测结果

目的对延庆县2008--2013年农村居民食用碘盐监测结果进行分析,掌握延庆县居民食用碘盐状况,为防治碘缺乏病及正确实施食盐加碘干预措施提供科学依据。方法按照《全国碘缺乏病监测方案》的要求在延庆县农村地区抽取9个乡镇进行居民食盐碘含量监测,对抽取到的1740份食盐样品按照GB／T13025．7—1999的要求使用直接滴定法测定碘含量。结果2008--2013年,碘盐覆盖率分别为：95．83％、95．49％、92．01％、96．88％、97．22％、97．67％,9个乡镇碘盐覆盖率的差异无统计学意义（fisher检验P=0．1143）。6年间碘盐合格率差异无统计学意义（x^2=5．739,v=5,P〉0．0．5）;6年间碘盐覆盖率差异有统计学意义（x^2=15．406,v=5,P〈0．05）;在进行两两比较之后得,9个乡镇2010与2013年的碘盐覆盖率之间差异具有统计学意义（x^22=9．697,P〈0．01）。结论延庆县农村地区居民食用碘盐的合格率已达到国家标准,但仍有部分居民食用不合格碘盐,应加强健康教育,普及居民科学补碘知识;同时应严厉打击私盐对盐业市场的冲击,加强食用碘盐的监督监测工作。     

沿海居民碘盐选择意愿及碘缺乏病防治知识知晓情况调查

目的了解北海市居民对碘盐的选择意愿及对碘缺乏病防治知识的知晓情况,进一步推动碘缺乏病防治工作。方法 2010年4月,对北海市3个主城区6个街道办事处（镇）有固定电话的家庭成员进行电话问卷抽样调查,调查内容包括碘盐选择意愿及碘缺乏病防治知识知晓情况。结果拨打电话1 290个,有效应答234人;主动选择购买碘盐的155人,占66.2%（155/234）,选择购买不加碘食盐或对是否选择碘盐持无所谓看法的73人,占31.2%（73/234）;海城区、银海区、铁山港区自主选择碘盐率分别为76.3%（100/131）、70.1%（24/34）、45.0%（31/69）,海城区高于铁山港区（P〈0.01）。听说过碘缺乏病的108人,占46.2%（108/234）,未听说过碘缺乏病的126人,占53.8%（126/234）,了解碘缺乏病危害的79人,占调查总数的33.8%（79/234）;了解碘缺乏病预防方法的51人,占调查总数的21.8%（51/234）;海城区、银海区和铁山港区居民碘缺乏病相关知识知晓率在8.8%～61.1%之间,海城区居民碘缺乏病各项相关知识知晓率高于铁山港区（均P〈0.05）。结论北海市居民食用碘盐和碘缺乏病知识认识不足,提示应进一步加强碘缺乏病健康教育工作,普及碘缺乏病知识,提高自觉食用碘盐的意识。     

漳州市2007年小学生尿碘、碘盐检测结果与防治策略

目的了解漳州市碘缺乏病（IDD）防治效果，为防治决策提供依据。方法采用抽样法（PPS）进行抽样；用砷铈催化分光光度法检测8～10岁小学生尿碘；同时按照国标GB／T13025．7—1999中直接滴定法测定，监测其食用碘盐合格率。结果尿碘合格率为86．67％，食用碘盐合格率为82．89％。食用碘盐的学生尿碘中位数明显高于食用非碘盐的学生尿碘中位数。结论漳州市8～10岁儿童尿碘合格率保持在消除碘缺乏病（IDD）阶段目标，其碘盐食用率基本达到消除碘缺乏病标准。但是非碘盐冲击市场问题还非常严重，应加强部门协作严厉打击私盐市场的不法行为。     

采用LQAS进行碘盐监测结果分析

全民食用碘盐是消除缺碘缺乏病（ＩＤＤ）的主要防治措施，新制订的《全国碘缺乏病防治监测方案》要求对食用碘盐监测采用批质量保障抽样法（ＬＱＡＳ）以便地整批碘盐的整体质量作出快速有效的定性判断，１９９５年我市采用ＬＱＡＳ进行碘盐监测，分别对碘盐加工厂，零售店，居民户检测２４９批，合格２４１批，合格率为９６．７８％，不合格８批，占检测批数３．２１％，碘盐质量亟提高。     

企业职工高尿酸血症与血压、血脂、血糖的相关性研究

目的探讨企业职工高尿酸血症（HUA）与血压、血脂、血糖的相关性,为企业进行健康管理提供依据。方法以中国石油长庆油田公司各下属企业为抽样单位,整群随机抽取2个单位,每个单位中所有的HUA者作为HUA组,共720人;同时在尿酸水平正常者中随机选取620人为正常组。通过Logistic回归分析HUA与年龄、性别、血压、血脂、血糖的关系。结果HUA合并高血压、高血脂、空腹m糖受损任意一项、两项、三项的比例均远高于正常组（OR值分别为：4．036,2．562,4．174）。多因素Logistic回归发现：男性、收缩压、总胆固醇、三酰甘油、低密度脂蛋白胆固醇是HUA的危险因素（OR值分别为7．736,2．309,1．721,2．761,1．411）;高密度脂蛋白胆固醇为HUA的保护因素（OR值为0．211）。结论HUA存在性别差异,且与血压、血脂密切相关。企业对职工的健康管理应充分考虑多危险因素的综合作用,全面的进行健康教育及干预。     

癌缺氧病因及预防和治疗

目的 探讨癌及安阳林州市食管癌高发原因及癌病因预防和治疗措施.方法 对林州市食管癌等疾病现场进行调查,在进行10余年统计分析基础上,综合分析了全国156篇文献成果.结果 提出癌缺氧病因学说,使用制氧机、按摩器、饮用纯净水治疗恶性肿瘤,取得良好效果,改水能够大幅降低林州市居民食管癌发病率、死亡率.结论 癌可能是由于机体长...     

Recruitment and retention challenges and successes

Objective: Addressing health disparities requires well designed, culturally adapted research. However, recruiting/retaining minority participants has often been challenging. We present strategies used to successfully recruit and retain rural Hispanic women during a breastfeeding education intervention.

Design: This study involved a two-group repeated measures quasi-experimental design with assessments at seven intervals between enrollment and 6 months postpartum. Participants (Hispanic women?≥?15 years old) were recruited through a regional hospital.

Results: We successfully met our recruitment goals, most women contacted were enrolled (46 of 58), and 100% completed the study.

Discussion: Research staff with ties within the community helped establish trust. Using bilingual study materials, simple language, and an interpreter addressed language/literacy concerns. Phone assessments facilitated participation as transportation was an issue. Accommodating requests to deliver or mail study materials and providing incentives were important. Extra effort was needed to maintain contact when phone service was disrupted or participants moved. Keys to success were persistence, flexibility, and alleviating barriers to participation.     

初产妇与经产妇焦虑抑郁状态分析及干预

目的：分析初产妇、经产妇心理状态特点,以便采取更有效的干预措施。方法筛选2014年6月至2015年1月在咸阳市旬邑县妇幼保健院产科门诊产前检查的健康初产和经产妇各60名,孕周为28~40周。入组时用焦虑自评量表( SAS)、抑郁自评量表(SDS)对两组孕妇进行心理评定,并给1次支持性心理干预(40~60分钟),1周后再次用SAS、SDS对两组孕妇进行评定分析。结果经产妇干预前SAS(50.73±3.45)、SDS(49.13±3.86)评分明显高于初产妇SAS(42.45±2.08)、SDS(41.77±2.21),差异均有统计学意义(t值分别为-15.921、-12.817,均P<0.01);干预后两组SAS、SDS评分均比干预前明显降低,差异均有统计学意义(t值分别为14.999、15.413;15.724、15.832,均P<0.01);干预后经产妇 SAS(38.61±5.02)、SDS(39.10±3.03)评分明显高于初产妇SAS(34.88±3.31)、SDS(32.01±4.27),差异均有统计学意义(t值分别为-4.805、-10.489,均P<0.01)。结论初产妇和经产妇均伴有焦虑、抑郁情绪,干预前后经产妇抑郁、焦虑情绪均较初产妇明显,支持性心理干预能有效改善孕妇的不良情绪。     

Continuity and change in neighborhood disadvantage and adolescent depression and anxiety

We used data from the Fragile Families and Child Wellbeing Study which includes a sample of adolescents of age 15 at the most recent wave (between 2014 and 2017) from mainly low-income urban families in the United States, to examine the association between neighborhood poverty entries and exits and adolescent depression and anxiety. In addition, we examined whether these associations differed by gender. Adolescents who consistently lived in disadvantaged neighborhoods had the highest level of depression and anxiety. Those who entered poor neighborhoods were more depressed than those who never lived in poor neighborhoods. Those who exited poor neighborhoods showed no significant difference in depression and anxiety compared to those never lived in poor neighborhoods. Furthermore, these associations applied to adolescent girls only and were not statistically significant for boys. The results suggest that neighborhood poverty has cumulative negative impacts on adolescent mental health and disproportionally affects adolescent girls. Reducing neighborhood poverty would substantially improve the health of adolescents, especially girls, which would reduce health disparities.     

Enabling positive change: Progress and setbacks in HIV and sexual and reproductive health and rights

At a point in history when the future of sexual and reproductive health including HIV looks particularly uncertain, it is helpful to recognise that many of the challenges currently faced are neither new nor insurmountable. Reflecting on past achievements and lessons learned helps us to have confidence that positive change is feasible. This paper reflects on some of the changes observed in countries like India and Mozambique and identifies a range of factors which need to coalesce to enable these developments, along with specific contextual factors. It is the combination of these influences rather than any one of them alone that brought about the change in the three instances described – fostering a positive political response to HIV in its early years in India; bringing about policy reform on abortion in Mozambique; and increasing contraceptive prevalence and age at marriage in some districts in Bihar, India. Change is always fragile and susceptible to setbacks, but change-seekers can learn in the process and gain renewed hope that progress can and often does take place if they persevere.     

儿童青少年超重肥胖评价方法及SPSS和SAS实现

超重肥胖已成为世界各国儿童青少年面临的重大公共卫生问题之一。现行的儿童青少年超重肥胖筛查标准不统一,逐条评价或自行编写程序容易出错且效率较低。本研究以中国学龄儿童青少年超重与肥胖筛查标准为例,详细介绍了国际和中国共四种评价儿童青少年超重肥胖的方法和步骤,结合具体案例详细介绍其应用方法,同时编制SPSS和SAS程序包和解...     

Car ownership and the association between fruit and vegetable availability and diet

Objective

Nearly all research on the food environment and diet has not accounted for car ownership — a potential key modifying factor. This study examined the modifying effect of car ownership on the relationship between neighborhood fruit and vegetable availability and intake.

Methods

Data on respondents' (n = 760) fruit and vegetable intake, car ownership, and demographics came from the 2008 New Orleans Behavioral Risk Factor Surveillance System. Shelf space data on fresh, frozen, and canned fruits and vegetables were collected in 2008 from a random sample of New Orleans stores (n = 114). Availability measures were constructed by summing the amount of fruit and vegetable shelf space in all stores within defined distances from respondent households. Regression analyses controlled for demographics and were run separately for respondents with and without a car.

Results

Fruit and vegetable availability was positively associated with intake among non-car owners. An additional 100 m of shelf space within 2 km of a residence was predictive of a half-serving/day increase in fruit and vegetable intake. Availability was not associated with intake among car owners.

Conclusions

Future research and interventions to increase neighborhood healthy food options should consider car ownership rates in their target areas as an important modifying factor.