北京市怀柔区社区居民高血压患者知信行分析

目的了解北京市怀柔区社区居民高血压患者知识、信念与行为现状,为开展高血压患者健康教育提供理论依据。方法抽取怀柔区两个乡镇35岁及以上人群中筛检出高血压患者及高危人群共计491人,使用北京市疾病预防控制中心慢性病防治所编制的调查问卷。结果高血压患者与高危人群相关知识知晓率较高;高血压高危人群在知识知晓率、信念形成率和健康行为形成率均低于高血压患者;高血压患者在患高血压后控制血压正确行为率较低。结论开展健康教育工作应关口前移,拓宽到高血压高危人群及全社会,并加强高血压患者的规范化管理工作。     

上海市某社区高血压高危人群综合干预效果评价

【目的】评价上海市社区高血压高危人群综合干预实施效果,为在社区推广、开展干预提供依据。【方法】于2015年10至2017年2月,对上海市青浦区徐泾社区招募200名高血压高危人群实施综合干预。对干预前后高血压健康知识、不良生活行为进行问卷调查,进行体检和实验室检测。【结果】经过15个月干预,高血压高危人群对高血压知识知晓状况明显提高,血压、血糖、血脂、血尿素氮以及血肌酐水平明显改善,体质指数(BMI)均值及肥胖、每日食盐摄入量、高盐膳食以及缺乏有氧运动的比例均明显下降,降幅分别为0.45、5.5%、0.45 g、10.5%和22.0%(P0.05);吸烟、过量饮酒干预前后无明显变化;超重比例干预后较干预前上升5.5%(P0.05)。【结论】综合干预可以提高高危人群高血压知识的知晓率,改善健康水平,控制高血压行为危险因素。     

社区高血压患者综合干预效果评价

目的评价在社区中开展高血压患者综合干预的效果。方法选取北京市朝阳区673名高血压患者,在社区中进行为期4年的综合干预,并进行效果评价。采用χ2检验。结果经过4年的综合干预,研究对象的血压控制率达到84.0%,较干预前提高46.1%(P<0.01);高血压相关知识、遵医嘱服药率均显著提高(P<0.01);生活方式方面,除高脂饮食无明显改变外,其他健康行为生活方式采纳率均有所提高(P<0.05);血脂控制率较干预前有提高(P<0.01)但血糖控制率变化差异无统计学意义(P>0.05)。结论综合干预能有效提高社区高血压患者的知识知晓率和血压控制率,降低危险因素水平。     

社区人群综合干预对预防和控制高血压效果评价

目的评价社区人群综合干预对预防和控制高血压的效果。方法按照类实验设计,于1996年在北京市选取干预、对照社区各5万人群,对干预社区开展为期3.5 a的高血压一、二级预防,期间对确诊高血压患者进行随访管理,并分别于1997年和2000年先后对干预、对照社区各整群随机抽取800人左右进行基线和干预后血压水平及相关知识、态度、行为（KAB）调查。结果干预社区的2 478名确诊高血压患者的随访管理过程中,1998、1999和2000年确诊高血压患者管理率分别为64.15%,73.82%和82.56%,血压控制率分别为54.28%,62.04%和62.42%,管理率和血压控制率逐年提高。经过干预活动后,与对照社区比较,干预社区人群KAB水平及人群关心保健知识、受知识影响和规律性锻炼率变化更明显（P〈0.05）。干预社区高血压人群收缩压、舒张压水平降低幅度和高血压知晓率、治疗率、控制率提高程度均大于对照社区,但差别无统计学意义。结论社区综合干预措施能有效地规范人群的健康相关行为,对控制人群高血压具有重要意义。     

2010年中国成年人高血压患病情况

目的评价上海市社区高血压高危人群综合干预实施效果,为在社区推广、开展干预提供依据。方法于2015年10至2017年2月,对上海市青浦区徐泾社区招募200名高血压高危人群实施综合干预。对干预前后高血压健康知识、不良生活行为进行问卷调查,进行体检和实验室检测。结果经过15个月干预,高血压高危人群对高血压知识知晓状况明显提高,血压、血糖、血脂、血尿素氮以及血肌酐水平明显改善,体质指数(BMI)均值及肥胖、每日食盐摄入量、高盐膳食以及缺乏有氧运动的比例均明显下降,降幅分别为0.45、5.5%、0.45 g、10.5%和22.0%(P < 0.05);吸烟、过量饮酒干预前后无明显变化;超重比例干预后较干预前上升5.5%(P < 0.05)。结论综合干预可以提高高危人群高血压知识的知晓率,改善健康水平,控制高血压行为危险因素。     

广东省韶关市两社区居民高血压知信行调查分析

目的了解韶关市社区居民对高血压相关知识的知晓情况和不良行为及生活方式发生率,为制定社区居民高血压防治对策提供依据。方法抽取本市两个社区,从35岁及以上人群中筛检出高血压患者及高危人群共690人进行访谈式问卷调查。结果社区居民高血压相关知识知晓率均在70%以下,高血压患者与高危人群相关知识、态度、行为比较,除了自己的血压水平知晓率、经常测量血压率、总吸烟率、总饮酒率、成功戒酒率、有规律运动率两组存在显著性差异外,其他均无统计学意义。结论社区人群的高血压相关知识知晓率较低,相关知信行高血压患者高于高危人群。     

青海省慢性病综合干预控制项目实施效果评价

目的通过慢病综合干预控制项目的实施,开展以"维持健康体重"和"控制血压"为核心内容的人群干预,探索人群超重、肥胖和血压控制模式,促进社区慢性病的综合防治,并进行效果评价。方法以卫生部"维持健康体重和血压管理关键技术"社区试行项目的工作内容和实施方案为指导,对参加项目的社区居民采用"高危人群和慢病患者管理信息表"收集相关信息,并录入管理系统进行人群分类,按照人群分类结果,以体重和血压为核心指标对超重且中心性肥胖及高血压病人进行管理。结果经过1年时间的干预,管理人群的吸烟率由干预前(2008年)的20.8%下降为干预后(2009年)的12.2%;高血压患者的知晓率、治疗率、控制率分别由干预前的68.2%、60.8%及14.6%上升为干预后的71.4%、63.0%及39.9%。超重且中心性肥胖人群的腰围均值由干预前的95.9 cm下降为干预后的91.1 cm。结论在社区开展以"维持健康体重"和"控制高血压"为核心目标的慢病管理关键技术对控制体重和提高高血压患者的血压控制率是有效地。     

石油职工高血压高危人群健康行为干预效果评估

目的探讨石油职工高血压高危人群实施生活方式干预效果。方法对克拉玛依石油职工体检人员中选取400名高血压高危人群对象(血压为120~139 mmHg/80~90 mmHg),存在2种及以上高血压危险因素的体检者。随机分为干预组与对照组各200例,对干预组进行为期2年的生活方式干预,对实施前后血压、血脂、血糖、体重等危险因素及缺血性心血管10年发病危险度进行对比。结果干预组疾病认知率明显提高,血压、体重下降明显,疾病危险因素明显减少;而对照组虽然疾病认知率有所提高,疾病危险因素也有所下降,但血压,体重有不同程度上升,缺血性心血管10年发病危险度下降。结论对石油职工高血压高危人群实施生活方式干预,能有效降低血压及血脂,并能随新的生活方式的逐步形成而减少高血压的新增及心血管事件发生。值得社区大力推广。     

健康教育和膳食干预对高血压社区综合防治的效果分析

目的探索健康教育和膳食干预在社区综合防治高血压的效果。方法在深圳市南山区大冲社区中,由社区卫生健康服务中心工作人员按照《深圳市高血压、糖尿病社区综合防治项目手册》,分别对450名非高血压人群、高血压高危人群及高血压患者进行综合健康教育,比较干预前、后社区居民高血压相关知识知晓率、高血压危险因素及高血压患者血压控制情况。结果调查居民在干预前后高血压相关知识知晓率差异均有统计学意义(P0.05)。99例高血压高危人群干预前、后摄入高脂饮食和少运动的检出率间差异均有统计学意义(P0.05),而高盐饮食、过量饮酒、肥胖和吸烟检出率差异无统计学意义(P0.05),110例高血压患者干预前、后血压控制情况差异有统计学意义(P0.05)。结论以《深圳市高血压、糖尿病社区综合防治项目手册》为依据,通过社区卫生健康促进网络,对居民进行高血压社区综合防治是可行的、有效的。     

苏南农村居民高血压高危人群的综合干预效果评价

目的 评价综合干预措施对农村社区高血压高危人群预防高血压的效果.方法 在苏州吴江市松陵镇开展社区干预实验,在实验社区及对照社区各随机抽取高血压高危人群80例,对照社区进行常规管理,实验社区在常规管理的基础上,开展强化式健康教育、知己量化管理、镇村一体化综合干预,对照组常规管理,干预前和1年后,分别调查两社区高危人群的高血压健康知识、不良行为生活方式和体检.结果 经1年干预,实验组高血压健康知识知晓率高于干预前和对照组;不良行为流行率低于干预前和对照组;除总胆固醇(total cholesterol,TC),其余体检项目均低于干预前,差异均有统计学意义(均有P ＜0.05).结论 针对农村实际情况和居民知识水平,开展有针对性的综合干预对于提高农村社区居民高血压高危人群的知、信、行水平,具有减低发病率、预防高血压、提高农村社区居民的健康水平的作用.     

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.