柳州市城区7~17岁儿童少年睡眠时间及其与高血压的关系

目的 了解柳州市城区中小学生高血压及睡眠不足的发生情况,分析睡眠时间与儿童少年血压的关系。方法 采用分层随机整群抽样法,于2019年3-4月在柳州市城区抽取2 354名7~17岁中小学生进行睡眠相关问卷调查,并测量血压以及身高、体重等生长发育指标。结果 柳州市城区中小学生高血压检出率为19.83%,男生高于女生(21.68% vs 18.17%),平均睡眠时长为(7.85±1.14)h,睡眠不足发生率为74.21%。回归结果显示,男生夜间睡眠时间与其收缩压以及舒张压之间均呈显著负相关关系(β分别为-0.101,-1.097);睡眠不足组发生高血压的风险是睡眠充足组的1.93倍(95%CI:1.24~3.01,P=0.004),女生中未见上述联系。结论 柳州市中小学生睡眠不足发生率及高血压检出率均处于一个较高水平,且睡眠不足对血压的影响存在性别差异。     

柳州市城区7~17岁儿童少年睡眠时间及其与高血压的关系

目的 了解柳州市城区中小学生高血压及睡眠不足的发生情况,分析睡眠时间与儿童少年血压的关系。方法 采用分层随机整群抽样法,于2019年3-4月在柳州市城区抽取2 354名7~17岁中小学生进行睡眠相关问卷调查,并测量血压以及身高、体重等生长发育指标。结果 柳州市城区中小学生高血压检出率为19.83%,男生高于女生(21.68% vs 18.17%),平均睡眠时长为(7.85±1.14)h,睡眠不足发生率为74.21%。回归结果显示,男生夜间睡眠时间与其收缩压以及舒张压之间均呈显著负相关关系(β分别为-0.101,-1.097);睡眠不足组发生高血压的风险是睡眠充足组的1.93倍(95%CI:1.24~3.01,P=0.004),女生中未见上述联系。结论 柳州市中小学生睡眠不足发生率及高血压检出率均处于一个较高水平,且睡眠不足对血压的影响存在性别差异。     

2015年甘肃省15~69岁居民健康素养水平及影响因素研究

目的 分析甘肃省居民健康素养水平及其影响因素。方法 2015年11月~2016年2月,采用多阶段抽样方法抽取23 250名15~69岁常住居民进行面对面问卷调查,采用Rao-Scott调整χ²检验不同人口学特征居民健康素养水平的差别,复杂抽样非条件Logistic回归进行影响因素分析。结果 收回有效问卷22 048份,有效回收率为94.8%。甘肃省居民健康素养水平为4.7%,多因素Logistic回归分析显示,汉族具备健康素养的几率高于少数民族（OR=2.217,95%CI：1.392~3.532,P=0.001）;25~岁、35~岁的具备健康素养的几率高于65~69岁（均有P<0.05）;高中/职高/中专、大专及以上的具备健康素养的几率高于不识字或识字少（均有P<0.05）;月收入2 000~元、≥ 5 000元的具备健康素养的几率高于月收入<500元的（均有P<0.05）;医务人员具备健康素养的几率高于农民（OR=3.837,95%CI：1.653~8.909,P<0.001）;家庭人口数为4~人的具备健康素养的几率高于家庭人口数≥ 7人的（OR=1.910,95%CI：1.072~3.406,P=0.029）。结论 甘肃省居民健康素养水平较低,在制定干预策略和措施时,需关注民族、年龄、经济收入、文化程度、职业、家庭人口数等因素。     

唐山市40岁以上人群脑卒中危险因素现况调查

目的 了解和掌握河北省唐山市40岁以上人群脑卒中危险因素暴露水平及其人群分布特征.方法 在唐山市整群抽取年龄≥40岁的人群作为目标人群.设计统一的卒中危险因素调查表,对符合入选标准者进行一般项目及脑卒中常见危险因素现况调查;采用现况研究方法,按年龄和性别分组,对危险因素暴露率及其人群分布特征进行分析和描述.结果 符合纳入标准且最终纳入数据统计分析的人数为5 267人,高血压、心脏病、糖尿病、卒中家族史、肥胖、吸烟、饮酒等因素的暴露率分别为30.70%,21.80%,5.45%,29.07%,20.24%,22.78%和11.24%.除男性肥胖和女性饮酒外,各年龄组及性别间危险因素暴露率差异均有统计学意义(P＜0.05).除男性体质指数(BMI)外,不同年龄组及性别间收缩压、舒张压和体质指数(BMI)等差异有统计学意义(P＜0.01).高血压病、心脏病、糖尿病等危险因素暴露水平随年龄增加而上升.结论 唐山市≥40岁人群中脑卒中危险因素整体暴露水平较高,各因素暴露水平与年龄、性别密切相关.     

Changes in cardiovascular risk factors and health behaviours from 1992 to 1997 in the Republic of Karelia, Russia

BACKGROUND: In Russia rapid changes have taken place both in total and chronic disease mortality during recent years. Little reliable information is available on the trends in conventional risk factors in Russia. METHODS: Chronic disease risk factors and health behaviours were studied in the Republic of Karelia, Russia in 1992 and 1997, in population surveys connected with the National FINRISK Study in Finland. Independent random population samples (n = 1000) of people aged between 25 and 64 years were drawn in both survey years. Surveys included a self-administered questionnaire, physical measurements and laboratory analyses. RESULTS: The levels of systolic blood pressure, total serum cholesterol, and high-density lipoprotein cholesterol decreased among both genders from 1992 to 1997, but the difference between the survey years was statistically significant only among women. Both self-reported alcohol consumption and serum gamma-glutamyl transferase levels increased significantly in both men and women. There was a significant shift in the type of fat used on bread and in cooking, from butter use to use of margarine and vegetable oil, among both genders. CONCLUSIONS: As a whole the risk factor levels in the Republic of Karelia are high. However, some slight improvement in risk profile was seen. Positive changes in dietary habits, such as change in the quality of fat and associated reduction in serum cholesterol levels may have contributed to the decline in cardiovascular disease mortality seen in Russia since 1995. However, since smoking and elevated blood pressure levels as well as alcohol consumption are still highly prevalent, there is a great need for effective interventions.     

中国四省7～17岁儿童青少年心血管代谢性危险因素的流行特征

目的探讨中国河北省、浙江省、陕西省和湖南省(四省)7～17岁儿童青少年心血管代谢性危险因素的流行特征以及人口经济特征对其的影响。方法选取"神经系统疾病专病社区队列研究"2018年的1 747名7～17岁儿童青少年作为研究对象, 对高腰围、中心性肥胖、TG升高、TC升高、LDL-C升高、HDL-C降低、血压升高、血糖升高和危险因素聚集进行分析。应用χ2检验进行单因素分析、多因素logistic回归分析人口经济学因素与危险因素的相关性、Cochran-Armitage趋势检验进行分析。结果中国四省7～17岁儿童青少年高腰围、HDL-C降低、血压升高、TG升高、血糖升高、中心性肥胖、TC升高、LDL-C升高检出率分别为29.08%、15.28%、13.17%、13.05%、11.79%、7.33%、6.53%、5.15%。18.37%的儿童青少年中存在危险因素聚集。多因素logistic回归分析结果显示, 女性高腰围发生的风险高于男性(OR=1.67, 95%CI:1.26～2.22), 血糖升高和危险因素聚集的风险低于男性(OR=0.69, 95%CI:0.49～0.99;OR=0.72,...     

Physical health,mental health,and behaviour problems among early adolescents in foster care

Background Adolescents with chronic illness in the general population are at increased risk of mental health and behaviour problems. Depression is also associated with delinquency. Adolescents in foster care are more at risk for chronic illness and mental health issues. We investigated whether adolescents in long‐term foster care with chronic illness have associated higher rates of internalizing and externalizing problems and delinquency. We also investigated if depression mediates the relationship between physical health and externalizing behaviours. Methods Data are from the National Survey of Child and Adolescent Well‐Being; adolescents age 11 and older residing in long‐term foster care (n= 188). Children whose caregivers reported on the occurrence of a chronic illness were compared using anova on internalizing and externalizing subscale scores and total scores of the Youth Self Report (YSR) and Child Behavior Checklist (CBCL), and modified Self‐Report of Delinquency (MSRD) scores of delinquency and total number of delinquent acts. Bootstrapping analyses were used to test our hypothesis that depressive symptoms (Children's Depression Inventory) function as a mediator. Results Adolescents with a chronic illness reported greater internalizing (YSR: F= 7.069, P= 0.009; CBCL: F= 4.660, P= 0.032) and externalizing (YSR: F= 5.878, P= 0.016; CBCL: F= 3.546, P= 0.061) problems, a greater number of delinquent acts (6.66, F= 5.049, P= 0.026) and heightened overall delinquency (F= 5.049, P= 0.026). Depression significantly mediated the effects of overall health on delinquency (95% CI, 0.03–1.76). Conclusions It is important to consider the complex interrelationships between physical health, mental health, and behaviour for adolescents in foster care. These findings support the need for comprehensive services for these youths, including specialized assessments and collaboration between protective services and healthcare systems.     

Health behaviours and socio-economic status in Ontario, Canada

Data from the 1990 Ontario Health Survey were used to investigate the association of socio-economic status with the likelihood of meeting current recommendations for four health behaviours (smoking, fat intake, alcohol consumption, and physical activity level) in adults living in Ontario (Canada). Health behaviours were categorised as unhealthy if they did not meet current recommendations in Ontario (smoking, fat intake < 30% of dietary energy, alcohol intake < 14 units per week, low level of leisure-time physical activity). Two summary variables based on the number ofÔ unhealthyÕ behaviours were also examined: the crude number of unhealthy behaviours reported and the likelihood of reporting 3 or 4 unhealthy behaviours. Four measures of socio-economic status were used: educational achievement, household income status, source of household income, and occupational prestige. Multiple logistic and linear regression analyses were performed to explore the association of each unhealthy behaviour and of the summary variables with socio-economic status indicators (taken independently or simultaneously), controlling for demographic characteristics. Except for the positive relationship between income status and high alcohol intake, measures of unhealthy behaviours were inversely associated with the socio-economic indices, suggesting that individuals in lower socio-economic groups are at an increased risk for health problems.     

Socioeconomic status, psychosocial health and health behaviours among Hungarian adolescents

BACKGROUND: While socioeconomic differences in health, morbidity, and disability are highest among middle-aged persons, there is a certain level of 'equalization' during adolescence and young adulthood. Despite this equalization, however, there still are differences in psychosocial variables or health-related behaviours, often very subtle and sometimes difficult to measure. METHODS: Using data (n = 1114) on high school students (aged between 14 and 21 years) from the Southern Plain Region, Hungary, the present study looks at the role of multiple SES indicators (objective and subjective; occupation and education; family structure) in adolescents' psychosocial health (self-perceived health, psychosomatic, and depressive symptomatology) and health behaviour (substance use and sports activity). RESULTS: Based on the results of multivariate logistic regression analyses, findings suggest the following: (i) SES self-assessment proved to be a significant predictor of adolescents' psychosocial health and health behaviours; (ii) family structure (that is, living in a non-intact family) also significantly influenced adolescents' psychosocial health and health behaviours; (iii) parents' employment status and schooling had a limited influence on their children's health outcomes; (iv) in a word, SES gradients in adolescents' psychosocial health and health behaviour were inconsistent and sometimes irregular (that is, inverse). The subjective SES measurement plays an important role (positive association), whereas certain types of parents' inactive status (in terms of labour market, that is, unemployment or retirement) seem to act in a predictable way (negative association). CONCLUSIONS: Our results indicate that despite certain level of equalization during adolescence, some important relationships between SES variables and health outcomes may occur.     

温州地区7～16岁中小学生抽动障碍的现况调查

目的 了解温州地区中小学生抽动障碍(TD)的流行病学特征。方法 采用分层整群抽样方法,对温州地区9742名7～16岁的中小学生进行TD横断面调查。结果 TD总患病率为104/万;短暂性抽动障碍、慢性运动或发声抽动障碍、发声与多种运动联合抽动障碍的患病率分别为34/万、27/万、43/万;男性TD患病率为166/万,女性为29/万,男性高于女性(X~2=43.96,P<0.001,患病率比为5.7,95％CI:3.20～10.30),TD三种临床亚类型的患病率均表现为男性高于女性;平均发病年龄为(8.5±2.8)岁,发病高峰在6～10岁,各年龄组患病率以9～10岁组为最高(X~2=15.51,P<0.01).小学生TD患病率显著高于初中生(X~2=11.33,P<0.01,患病率比为2.2,95％CI:1.37～3.43);延迟诊断率69.3％,延迟诊断时间(中位数)为1.0年。结论 TD在温州地区儿童少年中较多见,疾病早期漏诊现象严重,应提高临床医生及社会公民对该病的认识,做到早发现早治疗。     

Determinants of selected unhealthy eating behaviours among male and female adults

In this exploratory study we have examined determinants of unhealthyeating behaviours in a sample of 500 middle aged adults froma city community in Scotland. Effects of sociodemographic characteristicsand behavioural factors on the number of unhealthy eating habitswere estimated. Findings from regression analyses show strongeffects of male gender, lower occupational status, and smokingstatus on poor eating habits. A significant interaction effectbetween gender and alcohol consumption indicates a considerablegender difference in links between nutrition and drinking habits.The present findings indicate the complicated nature of determinantsof unhealthy eating behaviours and call for more complex methodsin studying patterns of eating behaviour.     

Antecedents and Correlates of Deviant Activity in Urban Youth Manifesting Behavioral Problems

This study examines both risk and protective factors preceding and associated with the origin and extent of deviant activity reported by 375 inner-city, primarily African-American, youth admitted to youth bureaus designed to address early problematic behavior in the community. This report focuses on the findings and key underlying issues for the development and evaluation of primary prevention strategies targeting high-risk youth. Study participants varied considerably in terms of their self-reported exposure to risk and protective factors and in the nature and extent of their previous engagements in deviant activity. The principal antecedents and correlates of deviant behavior were found to be age, gender, school behavior problems, and the deviance of peers. For youth reporting ever having engaged in delinquent activity, the most prominent predictors of the extent and severity of activity, besides chronological age, were age at first deviance, the deviance of peers and the manifestation of school behavior problems. Family deviance was an additional predictor of engagement in multiple forms of deviance. In addition to reaffirming the utility of self-reported measures of early development in the prediction of deviant behavior, results of the study point to the need for a finer differentiation of the predispositional characteristics and circumstances of targeted youth than is ordinarily undertaken in primary prevention efforts.     

上海市社区中老年居民慢性病患病调查

目的 了解上海市长宁区社区中老年居民慢性病患病情况和分布特征.方法 采用横断面现况调查,研究对象为上海市长宁区某街道40～74岁男性和40～70岁女性,分别于2003年和1998年完成了6 488名男性和8 511名女性的健康调查,根据上海市人口普查资料的年龄构成计算慢性病标化患病率,并采用χ²检验比较不同特征人群的慢性病患病率差异.结果 男、女性慢性病中高血压患病率最高,标化患病率分别为28.0%、22.6%;分别有40.9%男性和36.5%女性患有高血压、冠心病、糖尿病、慢性阻塞性肺病和脑卒中5种主要慢性病中的一种;体质指数(BMI)≥24者,高血压和冠心病的患病率较高;经常吸烟、饮酒的男性,脑卒中、高血压和慢性阻塞性肺病的患病率较高,而吸烟、饮酒对女性慢性病的影响较小.结论 不同特征人群慢性病患病率有一定差异,控制肥胖和戒烟是重要的干预措施.     

Socioeconomic differences in use of medical care and antibiotics among schoolchildren in Sweden

BACKGROUND: Studies of mortality among children and adults in Sweden have demonstrated considerable socioeconomic differences. This paper describes socioeconomic patterns of physical morbidity and use of medical care and antibiotics in schoolchildren in Sweden. METHODS: A cross-sectional study based on parent interviews from the Swedish Survey of Living Conditions in 1996-1997 was used. The study population consisted of 3,557 children aged 6-15 years. RESULTS: Forty-five percent of the schoolchildren in the study were reported to have been absent from school because of illness at least once during the previous three months, 8% were taking regular medication and 10% had ever suffered from a chronic disorder. There were no indications of socioeconomic differences according to the education of the responding parent in morbidity or use of consultations with a physician. However, children in families where the responding parents had primary education only consumed antibiotics less often (OR 0.7 and CI: 0.5-0.9) when compared to children in families with post-secondary education. Children in rural areas used consultations with a physician less often and consumed less antibiotics (adjusted OR 0.7 and CI: 0.4-0.9 and 0.7 and CI: 0.5-0.9 respectively). CONCLUSION: No obvious patterns of socioeconomic inequality in physical morbidity or use of medical care were identified among schoolchildren in Sweden. Further studies are needed in order to explain the social inequality in consumption of antibiotics among schoolchildren in Sweden and to describe social and regional patterns of psychiatric, behavioural and psychosomatic morbidity.     

Community Variation in Risk and Protective Factors and Substance Use Outcomes

Communities are the context in which many prevention activities take place. One approach to community prevention is to identify the most elevated risk factors and most depressed protective factors for substance use in a community and then to select and implement preventive interventions to address the most elevated risk factors and most depressed protective factors in the community. This approach presumes that there are reliable differences between communities in risk and protection and that these differences relate to differences in substance use across communities. This paper addresses these issues using data from 28,091 students in 41 communities across the U.S. Intraclass correlation coefficients are used to assess the degree to which there are reliable and meaningful differences between communities in levels of risk and protective factors. The community means of the risk and protective factors are then correlated with levels of substance use. Findings indicate that there are meaningful differences between communities in levels of specific risk and protective factors, and that those differences are related to different levels of substance use in these communities. These results provide an empirical foundation for tailoring community-wide efforts to prevent substance abuse to the specific profiles of risk and protective factors experienced by youths in different communities.     

无锡市不同吸烟行为人群健康素养水平比较

目的分析不同吸烟行为人群的健康素养水平, 为控烟干预工作提供科学依据。方法采取多阶段分层随机抽样方法, 对江苏省无锡市辖区内4 321名15~69周岁常住居民进行问卷调查, 调查所得数据使用全国第六次人口普查江苏省人口构成加权后再进行分析。结果不同吸烟行为人群的健康素养水平不同, 已戒烟人群的综合健康素养水平最高(21.55%), 其次是从不吸烟人群(20.36%)和每天吸烟人群(19.67%), 最低的是偶尔吸烟人群(13.37%);“健康技能”维度和“基本医疗”健康问题的健康素养水平最高均为每天吸烟人群(22.32%, 8.49%), 最低均为偶尔吸烟人群(11.06%, 2.27%)。结论较高的健康素养水平能够促进和维持人群远离烟草, 应继续开展居民健康素养促进工作, 针对吸烟人群的干预重点应放在科学健康观的树立和慢性病预防相关健康素养的提高上。     

北京市0～6岁儿童五类残疾危险因素分析

【目的】探讨与儿童5类残疾（视力、听力、智力、肢体和精神残疾）相关的生物和环境方而的危险因素。【方法】按照1：2配比的原则选择北京市2004年“0～6岁儿童残疾抽样调查”中的残疾儿章和部分正常儿童作为研究对象．采用问卷涮雀形式进行病例对照的研究。【结果】选取312名病例．624名对照进行研究。多因素分析显示与儿童残疾发生相关的主要危险因索强度由大到小依次为：出生窒息、残疾家族史、母亲饮酒、早产、儿童期患病、出生时哭声不响亮、母亲文化程度低、家庭人均月收入低。【结论】预防儿童残疾发生的重点仍应足产前和产时因素，比如孕前做好遗传咨询、母亲避免孕期前后饮酒、预防早产的发生、减少出生窒息的发生等。应对不良的家庭社会经济状况儿童的家长（特别是母亲）进行有针对性地指导．及时发现发育巾的问题，及早进行干预性训练．从而减少残疾的发生。     

The undisciplined patient in neoliberal society: conscious,informed and intuitive health behaviours

Applying Foucault’s theoretical concept of discipline, the present article uses the term undisciplined patients to describe those who resist medical authority, defy conventional medical interpretations concerning health risks and adopt non-normative health behaviours. There is considerable scholarly literature available on non-normative health behaviours, such as out-of-hospital birth, refusal to vaccinate or homoeopathy. While differentiating each such issue from the others has its merits, we argue that these health behaviours have much in common and ought to be perceived as a social phenomenon characteristic of Western neoliberal societies, in which health consumers are expected to assume responsibility for their own health behaviours and to avoid health risks. The objective of the research on which this article is based was to explore the common attitudes underlying the health behaviours of undisciplined patients, or, using Foucault’s terminology, determining which technologies of the self they implemented. We conducted in-depth interviews with 10 Jewish Israeli undisciplined patients during 2016. We identified four different practices that undisciplined patients implement: critical awareness of the medical hegemony; willingness to challenge by asking questions, collecting information and involvement in a continuous process of inquiry; using intuition in making health-related decisions and possessing a powerful internal locus of control; and willingness to control their fear and anxiety. Their health behaviours varied widely, including non-normative and normative practises alike, rendering it impossible to address them as one coherent discipline. Situating the social phenomenon of undisciplined patients is of importance to researchers who study risk, as well as to health policy experts. It will also benefit those who study specific non-normative health attitudes and behaviours.     

南京中学生健康危险行为与抑郁症状关系

目的 了解江苏省南京市中学生健康危险行为和抑郁症状分布情况,并探讨两者之间的关联。方法 采用青少年心理健康状况调查表,于2010年9-10月随机抽取南京市5所学校2 118名中学生进行问卷调查。结果 调查的2 118名中学生中,具有1、2、3项及以上健康危险行为的中学生分别为21.6%、6.0%、4.4%;抑郁症状检出率为46.0%,其中轻度、中度、重度抑郁症状检出率分别为29.4%、13.4%、3.3%;高中生、有健康危险行为的学生抑郁症状检出率均高于初中生、无健康危险行为的学生,差异均有统计学意义(P<0.05);多因素logistic回归分析显示,随着健康危险行为项数的增加,抑郁症状检出率呈上升趋势(χ_趋势²=58.9,P<0.05),调整人群归因危险度百分比(PARc%)为14.8%。结论 健康危险行为是罹患抑郁症状的危险因素,应引起学校、家庭和社会的重视。