宜昌市夷陵区农村山区65岁及以上老年人自评睡眠状况及影响因素分析

目的了解宜昌市夷陵区农村山区≥65岁老年人自评睡眠状况及相关影响因素,为制定干预措施提供依据。方法采取分层整群抽样的方法抽取宜昌市夷陵区山区5个乡镇,每个乡镇随机抽取6个行政村作为样本村,将样本村中所有≥65岁常住居民作为调查对象进行问卷调查,问卷内容包括基本信息、个人生活(含睡眠、身体活动、生活满意度及家庭关系等)和健康状况,对老年人的睡眠质量及其影响因素进行单、多因素分析。结果共调查≥65岁老年人4 002人,男女性别比为0.94∶1,年龄范围为65~96岁,平均年龄(73.34±6.01)岁,年龄以65~74岁(占58.5%)、文化程度以小学及以下为主(占90.7%),婚姻状况以单身(占68.2%)、家庭年收入以10 000元(65.1%)为主。55.4%(2 216/4 002)的老年人自我评价为睡眠质量差。调查对象平均睡眠时间为(7.94±2.08)h/d,睡眠时间7.0 h/d占25.3%(1 013/4 002)。多因素logistic回归分析结果显示,相对于女性、年龄≥75岁、生活满意度为不满意、家庭关系不好及孤独的老年人,男性、年龄为65~74岁、生活满意度为满意、家庭关系好、不孤独的老年人睡眠质量差的可能性更小(OR分别为0.692、0.855、0.550、0.761、0.595)。相对于初中及以上、在婚、未患慢性病的老年人,文化程度为小学及以下、单身和患慢性病的老年人睡眠质量差的可能性更大(OR分别为1.318、1.230、1.453)。结论夷陵区农村山区65岁及以上老年人睡眠存在较大问题,应多措并举予以干预。     

大别山区老年人日常生活活动能力及影响因素

目的 了解安徽省大别山区老年人的日常生活活动能力(ADL)状况及其影响因素,为制定预防和干预措施提供参考依据。方法 采用随机整群抽样方法对安徽省大别山区岳西县来榜镇抽取的1 117名≥60岁老年人进行问卷调查。结果 大别山区1 117名老年人平均年龄为(70.17±6.624)岁,男353人,女764人;ADL量表总分为(19.37±7.101)分,其中躯体生活自理(PADL)量表得分为(6.86±2.726)分,工具性日常生活活动(IADL)量表得分为(12.50±4.956)分;大别山区老年人ADL受损率为73.1%,其中PADL和IADL受损率分别为17.3%和72.5%,轻度和重度ADL受损率分别为54.8%和18.4%;多因素logistic回归分析结果表明,年龄≥70岁和患有慢性病是大别山区老年人ADL受损的危险因素;经常锻炼身体和支配部分经济是大别山区老年人ADL受损的保护因素。结论 大别山区老年人ADL受损情况较重;年龄、经济支配情况、锻炼身体情况和是否患慢性疾病是大别山区老年人ADL的主要影响因素。     

贵阳市居家养老老年人日常生活能力影响因素研究?

目的调查贵阳市居家养老人群日常生活能力,分析其可能的影响因素,为老年人居家养老护理提供参考。方法采用多阶段分层整群随机抽样的方法,随机抽取8个居委会中年龄≥60岁的1 898名居家老年人进行日常生活能力调查;日常生活能力影响因素单因素分析采用t检验、F检验,两两比较采用LSD法,多因素分析采用多元线性回归。结果调查对象平均年龄为(71.4±5.9)岁。贵阳市居家老年人日常生活能力(ADL)总分为(14.91±3.88)分,躯体性日常生活能力(PADL)得分为(6.26±1.27)分,工具性日常生活能力(IADL)得分为(8.65±2.75)分。多元线性回归分析显示:对PADL、IADL和总的ADL有影响的因素及影响大小依次为年龄、是否参加体育锻炼、是否患慢性病和文化程度,差异均有统计学意义(P0.05)。结论贵阳市居家老年人日常生活能力总体水平较好,居家养老护理应重点关注高龄、患有慢性病和文化程度低的老年人。     

农村老年人日常生活活动能力现状及影响因素分析

[目的]调查山东省农村老年人的日常生活活动(ADL)能力状况,分析其影响因素。[方法]采用分层随机抽样方法抽取山东省9个地市的60岁以上老年人600例,应用日常生活活动(ADL)能力量表和自制影响因素问卷对他们进行面对面访谈,测评其ADL现状并对可能影响农村老年人日常生活活动能力的因素进行分析。[结果]山东省农村老年人的日常生活活动能力丧失率为8.8%,影响农村老年人日常生活活动能力的因素包括年龄、躯体健康状况、慢性病、饮食习惯等。[结论]高龄、患有慢性病是农村老年人日常生活活动能力的危险因素,躯体健康、均衡饮食是保护性因素。     

农村老年人日常生活活动能力及影响因素分析

目的了解六安市农村老年人日常生活活动能力(ADL)及影响因素,为制定干预措施提供依据。方法采用方便抽样方法抽取六安市2个乡镇≥60岁的常住老年人为调查对象,采用一般情况调查表、ADL量表和老年抑郁量表(GDS)进行问卷调查,采用多重线性回归模型分析老年人ADL受损的影响因素。结果共发放调查问卷1 217份,回收1 080份,有效995份,问卷有效率为92.13%。调查男性454人,占45.63%;女性541人,占54.37%。ADL受损322例,占32.36%;其中轻度受损303例,占94.10%;中度受损13例,占4.04%;重度受损6例,占1.86%。多重线性回归分析结果显示,农村老年人近1个月需要照顾、对生活不满意、抑郁、≥70岁、健康自我评估不满意、职业为农民是ADL受损的影响因素。结论六安市农村老年人ADL受损率为32.36%,ADL受损与生活满意度低、抑郁、年龄大、健康自我评估差和职业为农民有关。     

2013年宜昌市夷陵农村山区65岁及以上老年人生活满意度及影响因素调查

目的 了解宜昌市夷陵区农村山区65岁及以上老年人生活满意度及其影响因素,为做好农村山区65岁及以上老年人保健工作提供参考依据。 方法 2013年3-12月在参考文献的基础上,自行制定调查问卷,采取分层整群抽样的方式获取样本,对4 002名山区65岁及以上老年人进行面对面调查。调查内容包括人口学资料、生活满意度、生活质量、社会支持相关内容。 结果 调查对象的生活满意度调查结果为:很满意8.45%,满意69.29%,一般20.86%,不满意占1.22%,无法回答0.17%,单因素分析显示,文化程度、居住方式、婚姻、年收入、睡眠质量、是否患慢性病、与家庭成员的关系、就医是否方便、孤独感、遇到困难是否能得到帮助和日常生活能力对山区老年人生活满意度有显著影响(P<0.05); 多因素logistic回归分析,家庭收入低(OR=1.288,P=0.028)、睡眠质量差(OR=1.836,P=0.000)、家庭成员关系不好(OR=4.113,P=0.000)、就医不方便(OR=1.782,P=0.000)、有孤独感(OR=1.351,P=0.002)、遇到困难不能得到帮助(OR=2.089,P=0.000)、日常生活能力差(OR=1.251,P=0.001)是老年人生活满意度下降的危险因素。     

中国老年人日常活动能力的影响因素——基于CHARLS数据的分析

目的了解老年人日常生活能力(Activities of daily living,ADL)现状,分析ADL的影响因素,尤其是医疗保险的作用。方法利用2011年"中国健康与养老追踪调查(China Health and Retirement Longitudinal Study,CHARLS)"数据,对中国健康与养老追踪调查的28个省区150个县级单位449个村级或社区单位7 188名60岁及以上的老年人ADL状况及影响进行分析。结果老年人的ADL受损率为22.38%。Logistic分层回归分析显示,年龄、受教育程度、是否饮酒、睡眠状况、是否患慢性病、抑郁、地域、医疗保险是ADL的影响因素。其中,城市职工医疗保险、公费医疗的老年人,其ADL受损率是无保险老年人的0.612倍,而其他类型保险的老年人(城市居民医疗保险、新型农村合作医疗、商业保险和其他保险),ADL受损率与无保险老年人无显著差异。结论中国老年人ADL受损率较高,个体社会经济因素、躯体健康、抑郁状况、医疗保险是影响ADL功能的重要因素。应采取措施,尽量缩小不同保险制度之间保障水平差异,保障与提高国民健康水平和生活质量。     

重庆市老年人日常生活活动能力影响因素研究

目的了解重庆市老年人日常生活活动能力(ADL)及影响因素,为制定老年人群ADL干预措施提供依据。方法采用多阶段随机抽样方法,选取重庆市11个县(区),每个县(区)抽取2～3个社区≥65岁的老年人为研究对象,采用ADL量表评估躯体生活自理能力(PADL)和工具性日常生活活动能力(IADL),采用多因素Logistic回归模型分析ADL受损的影响因素。结果发放问卷1 400份,回收有效问卷1 341份,回收有效率为95.79%。ADL受损596例,占44.44%;其中轻度受损321例,占53.86%;明显障碍275例,占46.14%。PADL受损385例,占28.71%;IADL受损575例,占42.88%。多因素Logistic回归分析结果显示,年龄≥70岁(OR:2.858～7.507,95%CI:2.119～11.816)、居住在非主城区(OR:2.073～3.709,95%CI:1.434～5.613)、参加商业保险(OR=3.202,95%CI:1.419～7.223)和至少患1种慢性病(OR:2.909～5.629,95%CI:1.562～10.681)是老年人ADL受损的危险因素;大专及以上文化程度(OR=0.236,95%CI:0.090～0.621)、有保姆(OR=0.466,95%CI:0.260～0.835)、月收入1 000～4 000元(OR:0.480～0.664,95%CI:0.274～0.923)是老年人ADL受损的保护因素。结论≥65岁老年人ADL受损率为44.44%,年龄大、居住在非主城区、参加商业保险和至少患1种慢性病是老年人ADL受损的危险因素。     

某社区50岁以上人群日常生活能力与抑郁症状关系

目的：了解社区50岁以上人群日常生活能力与抑郁症状的关系。方法：应用整群随机抽样的方法对合肥市某社区50岁以上人群日常生活活动能力及抑郁情况进行问卷调查，分析老年人日常生活能力与抑郁的关系。结果：ADL受损者有21人，受损率为6．9％；IADL受损者有59人，受损率为19．4％。分别以ADL、IADL受损与未受损进行组间比较，显示SDS得分及抑郁症状检出率均具差异有统计学意义。单因素logistic回归显示ADL、IADL、配偶、生活赡养等4项因素是社区50岁以上人群抑郁的主要危险因素，多因素回归显示仅IADL为抑郁的独立危险因素。结论：社区50岁以上人群日常生活能力受损明显，提高日常生活能力对防治老年人抑郁，改善老年人生存质量有重要意义。     

农村老年人生活活动能力测评及影响因素分析

目的测评农村老年人基本日常生活活动能力（activity of daily living scale,ADL）和工具性日常生活活动能力（instrumental activities of daily living scale,IADL）,探讨老年人日常生活活动能力的影响因素。方法应用Katz日常生活活动量表（Katz-ADL）和Lawton工具性日常生活活动量表（Lawton-IADL）对济宁市农村≥65岁的504位老年人进行多阶段随机抽样问卷调查。结果不同性别、年龄（岁）和有无配偶的老年人在ADL和IADL保存完好的频率上差异均有统计学意义（均有P〈0.05）,过去（65岁前）有健身活动的老年人ADL维持完好率高于无健身活动者（X^2=8.50,P=0.004）。老年人ADL和IADL保持完全独立的频率男性分别为86.67%和44.07%,女性分别为74.36%和20.94%。Logistic回归分析结果提示,年龄、生活状况自评、过去（65岁前）有无健身活动是老年人ADL的影响因素;性别、年龄、生活状况自评和做家务情况是老年人IADL的影响因素。结论社会和家庭在关心和照护老年人同时,应注意心理沟通,让老年人维持力所能及的家务活动和健身活动,使之对生活有较满意的评价,以便有效维护老年人日常生活能力,提升生存质量。     

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.