Socioeconomic status and health status: A study of males in the Canada health survey

The relationships between education/occupation/income and health status have been well documented in the international epidemiological and sociological literature for many years, however, specific studies on the subject are scarce in Canada. Even when relationships have been demonstrated, the reasons for these relationships are much debated. This study presents an analysis of the relationship between socioeconomic status (SES) and health status. The study is based on analysis of data from a sample of nearly 2000 male principal income earners from the 1978 Canada Health Survey. Firstly, is there a relationship between an individual's SES and health status in Canada? Secondly, what aspects of SES--education, occupational status, and/or income--are most important? Thirdly, what are the possible explanations of the observed relationship? That is, is it possible to disaggregate the relationship and thereby infer possible causal mechanisms? The findings indicated a direct positive relationship between SES and health status, i.e. the higher an individual's SES, the better that person's health. The major exception to this was the SES/fitness relationship. In this instance, the higher the SES, the lower the level of fitness. Though age was an important control variable as SES, fitness and illness are age related, the findings relating SES to the health measures remained even when age was controlled for. Of the three SES measures, income was consistently the best correlate of health status. Occupational status showed the most inconsistent relationships with health status. The findings supported both the social causation and social selection hypotheses. That is, social position can have an effect on health status (social causation), while health status can affect one's social position (social selection).     

早期肠内营养对患者免疫与营养状态及术后感染的影响观察

目的 观察胃肠道术后早期给予肠内营养对患者免疫和营养状态及术后感染的影响,以降低术后感染率.方法 选取在医院行手术治疗的186例胃肠道疾病患者为研究对象,根据入院顺序随机分为观察组和对照组各93例,观察组患者在手术后早期给予肠内营养支持治疗,对照组患者术后常规给予补液支持治疗,比较两组患者术后机体免疫和营养状态及术后感染率.结果 观察组患者术后10d前白蛋白为(285.2±17.1)mg/L,白蛋白为(36.7±1.3)g/L,体重为(59.7±5.4)kg; IgG、IgM和IgA分别为(14.47±1.92) g/L、(1.47±0.15) g/L和(2.62±0.14) g/L;CD3+、CD4+和CD4+/CD8+比值分别为(54.06±5.31)％、(43.29±3.06)％和(2.49±0.47),均明显高于术前和对照组,比较差异有统计学意义(P＜0.05);观察组患者术后感染发生率为1.08％,低于对照组的7.53％,差异有统计学意义(P＜0.05).结论 对胃肠道手术患者术后给予早期肠内营养有利于改善患者营养和免疫状况,降低术后感染率.     

永宁县婴幼儿营养状况及喂养状况的调查研究

目的:通过对永宁县婴幼儿营养状况的调查,了解永宁县婴幼儿的营养状况以及喂养状况,为婴幼儿合理喂养、改善婴幼儿营养状况、减少营养不良的患病率提出科学依据。方法:选择永宁县1个社区和1个乡镇0～3岁婴幼儿为研究对象,自行设计调查问卷对婴幼儿一般喂养状况进行调查,并测量身高(身长)、体重,采用WHO推荐使用的Z评分方法来评价婴幼儿的营养状况。结果:城镇婴幼儿的母乳喂养率为27.3%,农村婴幼儿的母乳喂养率为34.7%,母乳喂养率较低。城乡婴幼儿各类辅食添加率差异较显著,城镇≤6月婴幼儿主要添加蛋类、乳类和水果,农村谷类和乳类添加较多,6月龄婴幼儿各类辅食添加率明显提高,但仍存在城乡差异,除谷类、蔬菜、豆类添加率农村高于城镇外,其他辅食添加率均为城镇高于农村。婴幼儿营养不良和营养过剩同时存在,低体重率为3.55%,消瘦率为2.03%,发育迟缓率为15.48%,超重率为9.64%,且农村高于城镇。因为农村婴幼儿发育迟缓率较高,实际属于生长迟缓型肥胖。结论:大力宣传提倡母乳喂养,全面加强婴幼儿喂养的宣传与指导,尤其是在农村地区,婴幼儿抚养人应作为宣传教育的重点人群。     

维持性血液透析病人的营养状况

目的 :评价维持性血液透析 (MHD)病人的营养状况。　方法 :对 4 6例MHD病人进行膳食调查、人体测量及生化指标包括体重、肱三头肌皮皱厚度 (TSF)、上臂肌围 (AMC)、血清总蛋白 (TP)、白蛋白 (Alb)、前白蛋白 (PA)、转铁蛋白 (TF)检测 ,计算实际体重占理想体重百分比 (IBW % ) ,并作营养评价。　结果 :①MHD病人能量摄入普遍低于 12 5 .4kJ/ (kg·d) ,蛋白质摄入基本达到 1.0g/ (kg·d) ;②不同指标评估营养不良的发生率分别为IBW 9.13% ,TSF 71.74 % ,AMC 5 8.70 % ,Alb 30 .4 3% ,TF 82 .6 1%。各项指标均属正常者仅占 6 .5 2 %。　结论 :综合指标评价结果表明 ,本组病人有 93.4 8%存在不同表现和不同程度的营养不良。MHD病人进行常规的营养评价及合理的营养指导对预后有积极意义     

人感染猪链球菌病流行态势

猪链球菌病是由多种不同菌群的链球菌感染引起的人兽共患传染病,在北欧和东南亚的畜间广泛流行。人感染猪链菌病以散发为主,我国于1998年和2005年发生了人感染猪链球菌病暴发疫情,发病人数占全世界病例总数的半数以上。文章主要对猪链球菌病病原学特性和人感染猪链球菌病的临床表现特征、流行情况、流行病学特征以及流行环节、流行因素等方面的最新研究进展进行介绍,为今后该病的有效诊断、防治及研究提供参考。     

Subjective social status and health in young people

Health inequalities according to objective socioeconomic position (SEP), have been well-documented. Yet, in young people the associations are negligible. Recently, research on the association of subjective social status (SSS), and adult health has begun to accumulate. Studies on young people are rare and describe societies with large income inequalities. Here, we investigated the association between SSS and health, while controlling for own and familial SEP. The study population consisted of 15-year-olds (N = 2369) who have grown up in a context of low social inequalities. Data were derived from surveys carried out in 2004 in 29 secondary schools in Helsinki. The SSS was measured with an indicator specific to and validated for adolescents (a societal ladder). Outcome measures were self-rated health, health complaints, presence of limiting longstanding illness (LLI) and GHQ-12 caseness (indicating psychiatric morbidity). The SSS associated strongly with all health measures. Adjusting for objective socioeconomic measures attenuated the associations; although they all remained statistically significant apart from LLI among girls. The subjective assessment contributes to health inequalities in young people largely independent of objective SEP. Subjective ratings most probably capture aspects of social hierarchy that are more subtle and less well represented than in conventional measures.     

2010年吉林市学龄前儿童营养状况调查

目的:了解吉林市3～6岁儿童的营养状况及不良的饮食习惯,为制定干预措施提供依据。方法:选取吉林市不同城区内7所幼儿园3～6岁儿童进行饮食行为调查,调查均通过抚养人同意,采用自拟调查问卷;根据儿童体格检查结果,按照Kaup指数标准对儿童的营养状况进行评价。结果:各年龄段的儿童均存在一定比例的营养不良和超重肥胖;不同营养状态的儿童均有挑食、偏食的习惯,女童挑食偏食情况比男童严重(P<0.01);而且吃零食对正餐也造成一定程度的影响,二者之间存在统计学差异(P<0.01)。结论:为促进吉林市学龄前儿童的健康成长,培养儿童良好的饮食行为习惯是改善儿童营养状况的根本性措施。     

家庭社会经济状况与3岁以内儿童生长发育及营养状况的关系

目的 探究家庭社会经济状况(SES)与3岁以内儿童生长发育及营养状况的关系,为我国儿童预防保健提供科学依据。方法 数据源于2015年中国九市7岁以下儿童体格发育调查的西安地区数据。研究共纳入父/母亲文化程度、父/母亲职业和家庭年收入5项指标因子,构建了SES综合指标作为自变量。结局变量为身长、体重和评估的营养状况结局。调整儿童性别和月龄后,分别建立线性回归和Logistic回归模型,分析SES与身长体重和营养结局的关系。结果 研究共纳入3岁以内儿童12 017人,经评估营养不良者281人(2.3%),营养过剩者531人(4.4%)。调整儿童性别和月龄后,与低水平SES儿童相比,中等水平SES儿童身长增加0.32 cm(95%CI:0.16~0.47),发生营养过剩的风险降低20%(OR =0.80, 95%CI:0.65~0.98);高水平儿童身长增加0.77 cm(95%CI:0.61~0.92),体重增加0.06 kg(95%CI:0.006~0.12),发生营养过剩的风险降低33%(OR=0.67, 95%CI:0.53~0.83)。结论 较好的社会经济状况可能降低营养过剩的风险,有助于儿童的发育与营养健康。应改善家庭育儿环境,加强对低SES家庭的儿保宣教,提高儿童的健康水平。     

Maternal perceptions of children's weight status

Background Several studies have addressed mothers' perceptions of their children's weight status; however, there is no investigation on Portuguese children (a country with one of the highest levels of children's overweight and obesity in Europe). The aim of this study was to quantify maternal misclassification of child weight status in a sample of Portuguese children aged 9 to 12 years, according to gender, family income, and maternal weight status, education level and age. Methods Data were collected in a school‐based study (school year 2009/2010) in northern Portugal with 499 urban children (236 girls; 47.3%). Body mass index was calculated from measurements of height and weight [body mass (kg)/height (m²)]. Mothers' perceptions of child's weight status, age, height and weight were accessed by a questionnaire. Children's age, gender and socio‐economic status were extracted from the schools' administrative record systems. Cohen's Kappa was used to analyse the misperceptions and the agreement between children's objectively measured weight status and mothers' perception of their child's weight status. Results The prevalence of underweight, overweight and obesity in children was 4.6%, 25.5% and 6.4%, respectively. A proportion of 65.2% of underweight and 61.6% of overweight/obese children were misclassified by their mothers. For the majority of variables presented, the values of agreement were fair (k ranged from 0.257 to 0.486), but were statistically significant. Significant differences in the percentages of mothers who correctly classified their children's weight status were only found among the most educated in the overweight/obese group and among the normal‐weight mothers in the underweight group. Conclusions Many mothers do not properly recognize their children's weight status and frequently underestimate their children's body size.     

Marital status and suicide in the National Longitudinal Mortality Study

OBJECTIVES: The purpose of the study was to examine the effect of marital status on the risk of suicide, using a large nationally representative sample. A related objective was to investigate the association between marital status and suicide by sex. METHODS: Cox proportional hazards regression models were applied to data from the National Longitudinal Mortality Study, based on the 1979-1989 follow up. In estimating the effect of marital status, adjustments were made for age, sex, race, education, family income, and region of residence. RESULTS: For the entire sample, higher risks of suicide were found in divorced than in married persons. Divorced and separated persons were over twice as likely to commit suicide as married persons (RR = 2.08, 95% confidence intervals (95% CI) 1.58, 2.72). Being single or widowed had no significant effect on suicide risk. When data were stratified by sex, it was observed that the risk of suicide among divorced men was over twice that of married men (RR = 2.38, CI 1.77, 3.20). Among women, however, there were no statistically significant differentials in the risk of suicide by marital status categories. CONCLUSIONS: Marital status, especially divorce, has strong net effect on mortality from suicide, but only among men. The study showed that in epidemiological research on suicide, more accurate results would be obtained if samples are stratified on the basis of key demographic or social characteristics. The study further observed that failure to control for relevant socioeconomic variables or combining men and women in the same models could produce misleading results.     

家庭社会经济地位和主观社会经济地位对精准扶贫家庭学生抑郁症状的影响

目的 探讨家庭社会经济地位和主观社会经济地位对精准扶贫家庭学生抑郁症状的影响。方法 采用家庭社会经济地位问卷、青少年主观社会地位量表和流调用抑郁自评量表对450名精准扶贫家庭学生进行调查。结果 （1）可能有抑郁症状的占17.4%,有抑郁症状的占57.3%;（2）家庭社会经济地位对主观社会经济地位有正向预测作用（B = 0.19,P＜0.001）,对抑郁症状的预测作用无统计学意义（B = 0.04,P＞0.05）,主观社会经济地位对抑郁症状有负向预测作用（B = - 0.28,P＜0.001）;（3）主观社会经济地位在家庭社会经济地位和抑郁症状之间起完全中介作用,中介效应值为0. 05(95%CI:- 0.09～- 0.02)。结论 精准扶贫家庭学生抑郁症状的检出率较高,家庭社会经济地位主要通过主观社会经济地位影响抑郁症状。     

社会心理咨询的现状研究

目的:探讨目前社会心理咨询存在的问题.方法:调查某个咨询机构的156名来访者的基本资料和咨询情况进行频数统计和类属分析.结果:咨询机构经营处于亏损状态,咨询人流量少,而且以一次咨询居多,咨询脱落率高,咨询技术单一.结论:我国心理咨询行业总体来说还是处于缓慢发展阶段,应增强人们维护心理健康的意识,同时提高咨询师的专业技能和职业素质.     

Nutritional status of preoperative colorectal cancer patients

Background: The present study aimed to determine the extent of malnutrition in preoperative colorectal cancer patients. Malnutrition has been shown to affect post‐operative outcome, so it would be beneficial to identify those who are malnourished or who are at risk of becoming so preoperatively. We examine whether weight loss is related to the length of stay or changes in fat free mass. Methods: Patients were enrolled consecutively from outpatients 2–4 weeks prior to surgery. Assessments included body mass index, percentage weight loss, dynamometry, Malnutrition Universal Screening Tool, Subjective Global Assessment and bioelectrical impedance. Cancer staging and hospital length of stay were recorded. Results: One hundred and thirty‐two patients were eligible and 87 enrolled. Sixty‐seven patients were weight losing and 20% had lost >10% of their usual body weight. Handgrip strength was lower in malnourished patients compared to those who had not lost weight (mean 19.4 and 27.3 kg, respectively, P = 0.013). Mean (SD) fat free mass in patients with a weight loss >10% was 39.7 (13.5) kg and, in those with <10% weight loss, was 51.9 (12.0) kg (P = 0.001). This difference was not demonstrated for fat. Conclusions: Over half of these patients had lost weight prior to surgery and one in five were malnourished. Body composition measurements demonstrated that malnourished patients had significantly less fat free mass compared to patients who were not clinically malnourished. Nutritional screening would be beneficial in this group preoperatively to identify weight‐losing patients at an early stage in the care pathway when they initially enter the secondary care system.     

我国HIS的发展情况及未来趋势

医院信息系统 (HospitalInformationSystem ,HIS)的开发与应用是医院信息化建设的基础。本文详细的介绍了医院信息管理系统在国内外的发展情况 ,并预测其的发展趋势     

合并甲状腺功能减退脑卒中患者的营养状况

目的评估合并甲状腺功能减退脑卒中患者在治疗期间的营养状况及其与预后的关系。方法回顾性分析比较了28例合并甲状腺功能减退（研究组）和28例甲状腺功能正常急性脑卒中患者（对照组）的临床资料。结果住院（104-4）d时，研究组患者的血红蛋白和血清白蛋白水平明显低于住院前（P〈0．05），其住院天数、肺部感染、消化道出血和腹泻发生率及对营养支持治疗的热量和蛋白质量均明显高于对照组（P〈0．05）。结论合并甲状腺功能减退脑卒中患者的营养状况较差，易出现临床并发症且预后不佳，应及时和足量给予营养支持。     

临床病理尸体解剖检验的现状及思考

近10年来，临床病理尸体解剖检验率明显下降，而因医疗纠纷的法医病理学尸检则大幅上升。针对上述情况，作者分析了主要原因，并提出了相应的对策。首先要加强有关医疗管理部门的重视，加强法制建设。其次要重视病理学科的发展及病理专业人员的培养，改善尸检条件，充分发挥病理医师的积极性。第三，要加强宣传教育，耐心细致地做好家属工作。     

Anosmia and nutritional status

The present study quantified the food perception, food behavior and possible nutritional risk of anosmic patients. Anosmics were divided into three groups according to the duration of their olfactory symptoms: a) lifelong anosmics (n=9), b) mid-term anosmics (anosmics for five years or more but not lifelong) (n=22), and c) recent-onset anosmics (anosmics for less than five years) (n=22). Patients were compared to controls with no smell problem (n=33). We measured standard anthropometric, biochemical and nutritional parameters (24-hour recall and 3-day food record).Anosmics and controls did not differ in a number of anthropometric measures including body weight and body mass index. Mid-term anosmics showed significantly lower serum albumin levels but not serum total protein. Both recent onset and mid-term anosmics had significantly lower hemoglobin values than the controls but not the lifelong anosmics. A similar pattern was noted with measures of food enjoyment. Nevertheless, the anosmics did not differ in nutrient intake or eat less frequently.     

Changes in nutritional status in adults over Christmas 1998

Background: Anecdotal evidence suggests that Christmas often leads to positive energy balance and a deterioration in nutritional status but there have been few studies. Methods: Twenty-six adults completed anthropometric, blood pressure and total blood cholesterol measurements before and after the Christmas holiday. Results: An increase in mean weight occurred (0.93 kg) despite five subjects being ill. Diastolic blood pressure increased most (8%) with six subjects being classified as mildly hypertensive after Christmas, but only two before. This might be explained by alcohol intake and/or changes in insulin secretion/resistance. Conclusion: Changes consequent upon Christmas and their correction deserve further attention.     

东莞市居民健康和社会保障现状调查

目的为客观了解我市居民健康状况、卫生服务需求与利用和社会保障情况。方法采取分层整群随机抽样的方法,以入户询问调查的方式,调查600户,共调查1937名居民,包括询问家庭成员基本情况、两周患病和住院情况以及社会保险情况。结果我市医疗点覆盖面广,平均距离最近医疗点为2公里,11min便可到达,看病花费的时间在1h内;居民养老保险和医疗保险覆盖面广,分别达83．1％和93．7％,卫生服务在距离、时间和经济上可及性好,“看病难”的现象得到缓解。病人对医生的信任度较高（在78％～80％之间）。存在问题：仅17．3％的调查人口知晓社会保险缴纳金额,商业保险投保率低;33．8％和62．4％的患者认为门诊和住院费用贵,“看病贵”在住院尤为显著。结论为满足不同层次的医疗服务需求,缓解“看病难、看病贵”的社会问题,政府应该加大卫生投入、提高医疗保险的报销比例、扩大社会保障范围;医疗机构应当提高医疗服务质量、控制医疗费用的不合理增长、优化诊疗流程、加强与患者的沟通,做到服务好、质量好、医德好,让群众满意;从而引导居民建立理性的就医行为。     

复印机操作人员健康状况调查

[目的]了解复印机操作人员的健康状况。[方法]对石家庄市120名复印机操作人员进行调查。调查采用访问式。选择河北医科大学行政人员及学生100名为对照组。[结果]复印人员可出现神经衰弱症状、呼吸系统损害症状、皮肤粘膜刺激症状及肌肉骨骼损害症状,调查组症状总检出率为52.5％,与对照组相比差异有显著性(P<0.05)。[结论]复印人员存在职业健康问题,应采取措施进行预防。