Trends in the incidence and death from cancer from 1989-2003 in The Netherlands

OBJECTIVE: To provide insight into the changing nature and size of the cancer burden within The Netherlands. DESIGN: Retrospective. METHOD: Data on incidence and death relating to various forms of cancer are calculated on the basis of registered data concerning the incidence (Netherlands Cancer Registration; NCR) of and death (Statistics Netherlands) from cancer in the Netherlands from 1989 until 2003. RESULTS: From the start in 1989 up to 2003, more than one million new cases of cancer were registered with the NCR. The total number of new patients with a primary tumour increased from 56,335 in 1989 to 73,188 in 2003 (30%). The most frequently occurring tumours in 2003 were of the breast, colon, lung and prostate. The age standardized incidence rate for males and females combined, increased from 381 per 100,000 in 1989 to 400 per 100,000 person years in 2003 (+5%). There was an increase in breast, prostate, skin and oesophagus cancer, and also lung cancer in females. Major decreases were seen in lung cancer in males, as well as stomach, ovary and gallbladder cancer. The number of cancer deaths in the Netherlands increased from 35,420 in 1989 to 38,454 in 2003 (+8%). The age and sex standardized mortality rate declined from 234 per 100,000 in 1989 to 201 per 100,000 in 2003 (-14%). CONCLUSION: Despite a slight increase in the incidence of cancer and an increase in mortality from lung cancer (in females), oesophageal cancer and melanomas, the death rate from cancer has dropped considerably. The changes in incidence and mortality may be explained by changes in lifestyle in the 1970s and 80s, in particular use of tobacco and alcohol. Also early detection and screening programmes have resulted in an increase in the incidence of tumours with a better prognosis, which has led to a decrease in mortality. The downward trend in mortality was also influenced by treatment-improving prognoses.     

Teamwork in health care. Lessons from the literature and from good practice around the world

It is becoming more difficult to provide health care that meets the needs of patients within tight budget constraints. This article suggests that one way forward is to channel the energies of people more constructively to work as teams. Some definitions are shown for teams and teamwork, and four benefits suggested of effective teamwork: learning and development, resource management, task performance and communications. In each of these four areas, examples are given from the international world of health care of how teamwork can be achieved. Finally, it is concluded that teamwork can be difficult, but that it is worth pursuing.     

Diet and blood cholesterol in population surveys--lessons from analysis of the data from a major survey in Israel

A careful survey of the diet and serum cholesterol of civil servants in Israel covered 8829 men, aged 40-60 y born in six different areas. The authors were disappointed in their failure to find relationships between the diets and serum cholesterol of the individual men. Their report gives mean values for calories, diet fatty acids, and serum cholesterol for the men grouped by areas of birth. Regression analysis shows highly significant relations of serum cholesterol means to means of diet fatty acids for areas of birth. The relations found conform closely to expectations from dietary experiments in metabolic wards. Failure to consider intraindividual relations in the variables explains the disappointment of the authors of the report on the Israelis. Similar lack of attention to intraindividual variability is frequent in surveys and epidemiological studies and leads to error, controversy, and waste of time and money.     

论预测在疾病预防控制中的应用

<正>在疾病预防控制中,对一个地区乃至全国的疾病发生、发展和流行趋势进行前瞻性的预测,并将预测结果作为制定预防和控制疾病的长远或近期规划的依据,足完全必要的。     

Comparative analysis of the bacterial flora of vegetables collected directly from farms and from supermarkets in Germany

A total of 1,001 vegetables were collected from 13 farms and 11 supermarkets in Bavaria, Germany; 722 samples were positive for coliforms (mostly Enterobacter cloacae; n = 176). Escherichia coli were detected in 34, Pseudomonas spp. in 439, Salmonella spp. in 1, Enterococcus spp. in 682, and Listeria spp. in 11 samples. Prevalence of all investigated genera tended to be lower in samples collected at the supermarket. However, prevalence of Pseudomonas fluorescens was higher in supermarket samples. Cereals/bulbous vegetables were less contaminated than root vegetables/salads. Fruit vegetables seem to be often subsequently contaminated in the retail market. Compared to foods of animal origin, prevalence of pathogenic bacteria is low. Particularly, in 1,001 investigated vegetables, only four L. monocytogenes and one Salmonella enterica have been found. Almost all of the detected microorganisms are reported to be opportunistic pathogens, if only in rare cases. Therefore, fresh produce should be washed or peeled before it is eaten raw.     

天津市1999～2001年急性弛缓性麻痹病例及其密切接触者中非脊髓灰质炎肠道病毒监测分析

天津市 1999～ 2 0 0 1年在急性弛缓性麻痹 (AFP)病例及其密切接触者中共分离到非脊髓灰质炎肠道病毒(NPEV) 4 5株 ,其中柯萨奇B组病毒 (Coxsackie ,Cox .B) 15株 ,占 33 3 %;埃可病毒 (ECHO) 13株 ,占 2 8 9%;不能定型的病毒 17株 ,占 37 8%。从时间分布看 ,Cox .B病毒主要集中在 6～ 8月 ,占 86 7%;ECHO病毒主要集中在 8～ 9月 ,占 92 3%,显示NPEV主要集中在夏秋季。从地区分布看 ,45株NPEV中有 4株分离自市区 ,占 8 9%;41株分离自郊县 (区 ) ,占 91 1%,提示感染肠道病毒与卫生条件有关。     

Nutritional status of indigenous children from the Alto Xingu in 1980 and 1992 and follow-up of weight and height from the first through the fourth years of life

This study focused on the under-five population of the Alto Xingu region in Brazil, with the following objectives: (1) to evaluate height and weight increment from the first through the fourth years of life and (2) to compare nutritional status in 1980 and 1992. Height and weight increases were evaluated in 81 children. Weight and height were measured in 264 children evaluated in 1980 and in 172 in 1992 (< 10 years of age). Median Z-scores in the first and fourth years of life, respectively, showed: (1) a decrease in weight-for-age, (-0.12 in the first year and -0.51 in the fourth year of life; p = 0.002); (2) a decrease in weight-for-height (+1.31 and +0.08; p < 0.001); (3) an increase in height-for-age (-1.50 and -0.94; p < 0.001). Median Z-scores in 1980 and 1992 showed: (1) no change in weight-for-age (-0.61 in 1980 and -0.62 in 1992; p = 0.90); (2) no change in weight-for-height (+0.27 and +0.34; p = 0.10); and (3) a decrease in height-for-age (-1.04 and -1.22; p = 0.02). Height-for-age increased and weight-for-height decreased between the first and fourth years of life. A decrease in height-for-age was observed from 1980 to 1992, demonstrating the importance of nutritional surveillance among the population of the Alto Xingu.     

国防坑道内的氡污染及人员的辐射防护

目的研究坑道内氡浓度及工作人员的氡防护。方法分析坑道内氡的来源，采取降氡措施，限制工作人员坑道内工作时间。结果给出坑道内通风次数及工作人员坑道内年工作时间上限的计算公式。结论通过采取一定的降氡措施和限制工作人员在坑道内工作时间，则可避免氡对人体的危害。