上海市虹口区1951～2003年婴儿死亡率动态分析

[目的]监测上海市虹口区婴儿死亡的变化趋势,观察婴儿死亡率对平均期望寿命的影响,并采取相应措施降低婴儿死亡率。[方法]对虹口区1951~2003年出生的623855名活产婴儿以及同期死亡的16559名婴儿的死亡资料以动态数列的方法进行分析。[结果]婴儿死亡率从1951~1953年的54.41‰降至2000~2003年的4.82‰,下降速度为91.1%;新生儿死亡率从12.07‰降至2.53‰,下降速度为79.0%,受之影响平均期望寿命逐年上升。婴儿的主要死因已由1951年的传染病与寄生虫病改变为近年的新生儿病及先天畸形。[结论]随着我区医疗事业的发展,婴儿死亡率显著降低。为降低婴儿死亡率,提高平均期望寿命,现阶段应以加强出生缺陷监测工作和提倡围产期保健作为重点。     

1988-2003年林州市食管癌、胃癌死亡率时间趋势描述

目的 利用林州市肿瘤登记处的食管癌、胃癌死亡登记报告资料,描述性分析林州市居民的食管癌、胃癌死亡水平及变化趋势.方法 从林州市肿瘤登记处抽取1988-2003年期间死亡原因为食管癌、胃癌的全部记录,共获得记录18240例,其中食管癌10138例,胃癌8102例.分别按性别、年龄、年份分组后与相应的人口数据连接.计算食管癌、胃癌各个年份死亡率及世界人口年龄调整率.采用Jionpoint模型估计年龄调整死亡率的年度变化百分率,评价林州市食管癌及胃癌死亡率的时间变化趋势.结果 2003年林州市人群食管癌、胃癌年龄调整死亡率分别为68.47/10万和57.01/10万;自1988-2003年期间2种癌症的年龄调整死亡率均呈下降趋势;死亡率的EAPC分别为-3.82(-4.81～-2.82,P＜0.001)和-2.95(-4.16～-1.73,P＜0.001).同时分性别、胃癌分解剖部位(贲门、胃其他部位)以及食管合并贲门癌的年龄调整死亡率也均呈有统计学意义的下降趋势.结论 伴随着社会经济的发展、居民生活水平提高、居住环境条件改善及医疗资源的有效配置,林州市人群食管癌、胃癌的死亡率呈现下降趋势.     

Trends in infant and child mortality in Mozambique during and after a period of conflict

This study describes urban and rural trends of infant, child and under-five mortality in Mozambique (1973-1997) by mother's place of residence. A direct method of estimation was applied to the 1997 Mozambican Demographic and Health Survey data. The levels of infant, child and under-five mortality were considerably higher in rural than in urban areas. The difference in mortality between urban and rural areas increased over time until 1988-1992 and thereafter diminished. Possible causes of the different trends (e.g. the impact of civil war, drought, migration, adjustment programme and HIV/AIDS) are discussed. The increase in mortality in urban areas during the last few years before the survey may have been related to the immigration to urban areas of mothers whose children had high levels of mortality. Higher levels of infant, child and under-five mortality still prevail, particularly in rural areas. Further studies are needed to investigate the differentials of infant and child mortality by mother's place of residence.     

中国2003-2007年喉癌发病率和死亡率分析

目的 研究中国喉癌发病与死亡的流行状况.方法 2003-2007年喉癌发病与死亡数据来源于全国32个肿瘤登记地区,并经全国肿瘤登记中心审核、整理和统计分析,计算粗率、中国和世界标化率及变化趋势.结果 2003-2007年中国喉癌粗发病率为2.04/10万,粗死亡率为1.06/10万,均为男性高于女性,城市高于农村;在32个登记地区中发病中标率最高是广东省中山市(2.08/10万),死亡中标率最高是河北省涉县(1.58/10万);2003-2007年全国喉癌发病率和死亡率变动不大.结论 中国喉癌发病率、死亡率处于较低水平,但应采取综合措施,防止喉癌发病率和死亡率上升.     

Occupational exposure to crystalline silica dust in the United States, 1988-2003

The purposes of this study were a) to summarize measurements of airborne (respirable) crystalline silica dust exposure levels among U.S. workers, b) to provide an update of the 1990 Stewart and Rice report on airborne silica exposure levels in high-risk industries and occupations with data for the time period 1988-2003, c) to estimate the number of workers potentially exposed to silica in industries that the Occupational Safety and Health Administration (OSHA) inspected for high exposure levels, and d) to conduct time trend analyses on airborne silica dust exposure levels for time-weighted average (TWA) measurements. Compliance inspection data that were taken from the OSHA Integrated Management Information System (IMIS) for 1988-2003 (n = 7,209) were used to measure the airborne crystalline silica dust exposure levels among U.S. workers. A second-order autoregressive model was applied to assess the change in the mean silica exposure measurements over time. The overall geometric mean of silica exposure levels for 8-hr personal TWA samples collected during programmed inspections was 0.077 mg/m3, well above the applicable American Conference of Governmental Industrial Hygienists threshold limit value of 0.05 mg/m3. Surgical appliances supplies industry [Standard Industrial Classification (SIC) 3842] had the lowest geometric mean silica exposure level of 0.017 mg/m3, compared with the highest level, 0.166 mg/m3, for the metal valves and pipe fitting industry (SIC 3494), for an 8-hr TWA measurement. Although a downward trend in the airborne silica exposure levels was observed during 1988-2003, the results showed that 3.6% of the sampled workers were exposed above the OSHA-calculated permissible exposure limit.     

Avoidable infant mortality and associated factors in Porto Alegre, Southern Brazil, 2000-2003

A case-control study was performed to investigate the association between the categories avoidable and non-avoidable death and socio-demographic, maternal reproductive, and neonatal status. The study used multivariate logistic regression according to a hierarchical model to analyze 1,139 infant deaths from 2000 to 2003. The variables sex, maternal age, number of live born infants, type of pregnancy, place of birth, and 5-minute Apgar were not associated with avoidable deaths. However, maternal schooling 相似文献   

Publication output in telemedicine during the period January 1964 to July 2003

The MEDLINE database was used to survey the period January 1964 to July 2003 for the number of publications relating to telemedicine (n = 5911), as well as their distribution by country (n = 42). Publications per million inhabitants were then correlated with each country's population density, gross national product, human development index (HDI) and number of PCs per 1000 inhabitants. Telemedicine publications made up 0.05% of all medical publications cited in MEDLINE. American and European countries along with others classified as industrialized produced 97% of all telemedicine publications. In terms of publications per million inhabitants, Norway and Finland took the lead. There were significant correlations between telemedicine publications per capita and HDI (r = -0.60), number of PCs per 1000 inhabitants (r = 0.73) and gross national product per capita (r = 0.69), but not population density (r = -0.12).     

贵州省2003至2007年婴儿死因结构及相关因素探讨

目的 了解贵州省婴儿死因结构的现状,探讨相关因素,寻求相应的干预措施.方法 对2003年1月至2007年9月在贵州省监测点出生的活产婴儿42 644例及同期死亡婴儿1 127例的监测资料进行分析.结果 贵州省2003至2007年婴儿死亡率呈下降趋势,(趋势χ2=34.186,P<0.001).5年间贵州省婴儿死因结构构成比依次为:肺炎(27.99%)、出生窒息(24.79%)、早产低出生体重(14.45%)、腹泻(10.61%)、意外窒息(5.04%);5年间贵州省婴儿死亡顺位未发生根本性变化,肺炎占婴儿死因首位.结论 贵州省2003至2007年婴儿死亡率虽呈下降趋势,但仍高于全国同期水平.加强基层初级卫生保健和围产期保健,提高基层卫生服务质量,扩大保健服务的覆盖面是降低婴儿死亡率的重要策略.     

中国2003--2007年甲状腺癌发病死亡现状及流行趋势分析

目的分析中国甲状腺癌发病和死亡现状及流行趋势。方法2003-2007年甲状腺癌发病和死亡数据来源于全国32个肿瘤登记处,分别计算粗率、年龄别发病率和死亡率、中国人口标化率(中标率)和世界人口标化率(世标率)及变化趋势;采用Jionpoint模型对部分登记地区的20年发病和死f数据进行趋势分析。结果2003-2007年中国甲状腺癌发病率为4.44／10万,市标率为2.89／10万,世标率为3.31／10万;甲状腺癌死亡率为0.44／10万,中标率0.21／10万,世标率o 29／10万,分别占恶性肿瘤发病死亡构成的1.67％和0.26％;女性发病率和死亡率明显高于男性,分别为男性的3.38倍和1.75倍;城市人群发病率和死亡率高于农村;2003--2007年中国甲状腺癌发病率和死亡率呈上升趋势,每年分别以14.51％和1.42％的速度上升。结论中国甲状腺癌发病率和死亡率均呈上升趋势,应有效控制其高发现状。     

International variation in pancreatic cancer mortality for the period 1955-1998

Background: Pancreatic cancer is an important cause of cancer mortality in developed countries. This article examines time trends for pancreatic cancer mortality rates in 38 countries on five continents between 1955 and 1998. Methods: We used the World Health Organization database on Age-Standardized World Population pancreatic cancer mortality rates by gender and fitted these data with linear regression models. This allowed us to (1) investigate the statistical significance of temporal trends; and (2) consider differences in trends among countries; and (3) predict future pancreatic cancer mortality rates. Results: Over 44 years, pancreatic cancer mortality rates increased for females worldwide. Pancreatic cancer mortality rates for men increased in Southern Europe. In contrast, pancreatic cancer mortality rates for men in North America and Oceania increased until about 1975 and then decreased or remained stable. Ourpredictive models suggest that by 2005 the relative burden of pancreatic cancer mortality will have shifted away from Northern Europe and North America toward Southern Europe and Asia. Conclusions: Future research on pancreatic cancer should concentrate separately on the assessment of risk attributable to exposure to environmental factors, lifestyle factors, genetic determinates of pancreatic cancer, and the interactive influences of these factors on pancreatic cancer.     

Distribution and trend of deaths within the hospital environment in Spain during the 1997-2003 period

BACKGROUND: Where a person's death occurs depends upon situations of a demographic, socioeconomic, cultural and healthcare-related nature. The objective of this study was that of describing the variations in the percentages of deaths in hospitals among the Autonomous Communities of Spain, distinguishing between those which occurred in emergency care and during hospitalization and delving into their relation with variables possibly providing an explanation thereto. METHODS: The study was an ecological one, the trend in the percentage of deaths in hospitals within the 1997-2003 period having been studied. The percentages of deaths in hospitals from each Autonomous Communities during the 2000-2002 period were calculated based on the Natural Population Movement and the Survey of In-Patient Healthcare Establishments which includes information from all of the public and private hospitals. The relationship thereof to demographic, socioeconomic and healthcare-related variables was analyzed by single linear regression. RESULTS: A total of 53% of the deaths occurred in hospitals (ranging from 37.3% to 68.4% in the different Autonomous Communities). A total of 10.7% of the deaths occurred in emergency care (ranging from 6% to 14.5%) and all others during hospitalization. CONCLUSIONS: The percentage of deaths having occurred in hospitals was greater in the Autonomous Communities having a smaller elderly rural population, a larger foreign population and a higher degree of frequenting of emergency care. The percentage of hospital deaths in emergency care was greater in those Autonomous Communities having poorer socioeconomic indicators. The trend over the seven years studied was toward a rise in the percentage of deaths in hospitals.     

Social determinants for infant mortality in the Nordic countries, 1980-2001

AIM: Social equity in health is an important goal of public health policies in the Nordic countries. Infant mortality is often used as an indicator of the health of societies, and has decreased substantially in the Nordic welfare states over the past 20 years. To identify social patterns in infant mortality in this context the authors set out to review the existing epidemiological literature on associations between social indicators and infant mortality in Denmark, Finland, Norway, and Sweden during the period 1980-2000. METHODS: Nordic epidemiological studies in the databases ISI Web of Science, PubMed, and OVID, published between 1980 and 2000 focusing on social indicators of infant, neonatal, and postneonatal mortality, were identified. The selected keywords on social indicators were: education, income, occupation, social factors, socioeconomic status, social position, and social class. RESULTS: Social inequality in infant mortality was reported from Denmark, Finland, Norway, and Sweden, and it was found that these increased during the study period. Post-neonatal mortality showed a stronger association with social indicators than neonatal mortality. Some studies showed that neonatal mortality was associated with social indicators in a non-linear fashion, with high rates of mortality in both the lowest and highest social strata. The pattern differed, however, between countries with Finland and Sweden showing consistently less social inequalities than Denmark and Norway. While the increased inequality shown in most studies was an increase in relative risk, a single study from Denmark demonstrated an absolute increase in infant mortality among children born to less educated women. CONCLUSIONS: Social inequalities in infant mortality are observed in all four countries, irrespective of social indicators used in the studies. It is, however, difficult to draw inferences from the comparisons between countries, since different measures of social position and different inclusion criteria are used in the studies. Nordic collaborative analyses of social gradients in infant death are needed, taking advantage of the population-covering registers in longitudinal designs, to explore the mechanisms behind the social patterns in infant mortality.     

The effect of poverty, social inequity, and maternal education on infant mortality in Nicaragua, 1988-1993

OBJECTIVES: This study assessed the effect of poverty and social inequity on infant mortality risks in Nicaragua from 1988 to 1993 and the preventive role of maternal education. METHODS: A cohort analysis of infant survival, based on reproductive histories of a representative sample of 10,867 women aged 15 to 49 years in León, Nicaragua, was conducted. A total of 7073 infants were studied; 342 deaths occurred during 6394 infant-years of follow-up. Outcome measures were infant mortality rate (IMR) and relative mortality risks for different groups. RESULTS: IMR was 50 per 1000 live births. Poverty, expressed as unsatisfied basic needs (UBN) of the household, increased the risk of infant death (adjusted relative risk [RR] = 1.49; 95% confidence interval [CI] = 1.15, 1.92). Social inequity, expressed as the contrast between the household UBN and the predominant UBN of the neighborhood, further increased the risk (adjusted RR = 1.74; 95% CI = 1.12, 2.71). A protective effect of the mother's educational level was seen only in poor households. CONCLUSIONS: Apart from absolute level of poverty, social inequity may be an independent risk factor for infant mortality in a low-income country. In poor households, female education may contribute to preventing infant mortality.