上海市浦东新区食源性疾病社区干预效果评估

[目的]对浦东新区部分居民进行预防食源性疾病干预效果评价,为居民的食源性疾病预防、干预提供科学依据。[方法]以浦东新区30个社区为研究现场,采用随机抽样方法,将地域相邻的2个社区分为干预组和对照组,干预组接受为期3年的干预。于2008年12月—2009年6月,采用问卷对干预组和对照组进行调查,为期3年。[结果]干预组社区居民知识水平和饮食习惯相对于对照组得到明显改善;年内腹泻发生率显著降低(P0.05)。[结论]采取有效可行的社区干预措施可改善居民的知识水平和行为生活方式,控制食源性疾病的发生。     

浦东新区小学生零食知信行营养教育效果评价

目的评价营养教育对浦东新区小学生零食知信行的影响效果,为改善小学生零食行为提供依据。方法在浦东新区每街镇抽取2所小学,分别分为干预组和对照组,对干预组开展为期3个月的营养教育,并对干预效果进行评估。结果共调查小学生7 276名,营养教育后,城乡地区干预组营养知识知晓率及态度提高差异均有统计学意义(P值均<0.05);干预组零食行为较干预前提高,且整体优于对照组,但城区干预组常吃新鲜蔬果或坚果的比例不到9%;常吃含糖饮料及糕点的比例仍高于10%;在饮料行为方面,城乡干预组常喝果蔬饮料的比例不到20%,而常喝碳酸饮料的比例超过20%。结论营养教育能提高小学生对零食的认知及态度,对零食行为有一定改善作用。     

社区高血压及营养KAP健康教育效果分析

目的 评价高血压及营养健教对社区高血压人群的干预效果。方法 在上海某社区随机抽取370名年龄为35-75岁高血压病人作为高血压及营养知识。态度及行为（KAP）调查的基线人群,其中干预组176人,对照组194人。结果 经一年的社区干预后,对两组人群进行高血压及营养知识,态度及行为复查,干预组对营养知识的掌握优于对照组;干预组对中国居民膳食指南的知晓率在干预后也明显提高;在改善不良膳食行为方面,干预组行为改善率高于对照组,两组相比有显著性差异。结论 社区高血压及营养知识健康教育对高血压人群提高高血压及营养知识水平是有效的和可行的。     

上海市闵行区社区居民食品营养标签健康教育项目干预效果分析

目的评价对社区居民开展食品营养标签健康教育的效果,为探讨改善居民营养标签KAP的方法提供依据。方法采取分层随机抽样方法。从上海市闵行区所辖13社区,随机抽取6个社区为干预社区,7个社区为对照社区,对干预社区开展营养标签健康教育,并对干预效果进行评估。结果干预后,干预组对食品营养标签知-信-行水平与对照组及干预前相比较均有显著提高(P0.05)。干预后,干预组对食品营养标签的知晓率从干预前的73.1%上升到95.6%;了解营养标签的比例从干预前的22.1%上升到57.7%;认为营养标签有必要标示的比例从干预前的78.1%上升到95.6%;购物时经常阅读和参考营养标签的比例从干预前的43.1%、32.7%分别上升到68.8%、57.5%。结论采用集中式宣教和个体化指导相结合的营养标签健康教育方式效果明显。进一步提高社区居民对营养标签的认知和应用水平,还需要更加细致深入和持之以恒的营养标签健康教育。     

宝山区吴淞社区居民合理营养健康教育效果评价

目的评价社区居民合理营养综合干预效果,为进一步开展合理营养干预工作提供依据。方法选择两个居委的居民作为干预组,实施为期15个月的综合干预,对干预组和对照组居民干预前后的合理营养知、信、行状况进行评价。结果干预组居民合理营养总知晓率干预后有显著提高(P<0.05),对照组没有变化。干预组居民的饮食以及烹调习惯大都也有了显著改善(P<0.05),而对照组则除个别外没有改善。结论在社区居民中开展合理营养健康教育,有助于提高社区居民合理营养知、信、行水平。     

营养教育扑克牌在城市社区中年居民营养教育中的应用研究

目的探讨以营养教育扑克牌作为营养宣传载体开展城市社区中年人群营养教育的可行性及效果.方法采用对照试验研究设计,将成都市玉林社区237名45～59岁居民分成营养教育扑克牌组、普通营养教育组、对照组3个组,进行营养教育干预研究.结果营养教育扑克牌组营养知识优秀率的提高明显高于普通教育组和对照组(x2=17.082,P＜0.01),与干预前比较,普通教育组和对照组营养知识优秀率的改变差异均无统计学意义(x2分别为0.033、0.069,P＞0.05),但干预前后3组的营养态度和行为变化差异均无统计学意义(态度的t分别为0.680、0.841、1.199,行为的t分别为0.018、0.380、0.162,P＞0.05).结论应用营养教育扑克牌作为营养宣传载体开展城市社区中年人群营养教育具有一定的效果和优势.     

上海浦东某社区健康行为干预效果评价

目的:评价健康促进活动对社区居民健康相关行为的形成及改变的影响.方法:分层随机抽取浦东新区某街道500户居民进行健康生活方式的基线调查,通过多种形式对居民的生活方式进行干预,持续干预10个月后比较其健康生活方式知识、信念、行为的改变情况.结果:干预前后居民的每天吃蔬菜、每天吃早餐、饮食口味等合理营养行为,及保持心情愉快和熬夜、锻炼身体等个人心理健康、运动行为差异有统计学意义;而戒烟限酒等行为变化不大.结论:健康生活方式的行为干预,可改变人群的合理营养等行为,但对戒烟限酒等行为的改变,需要长期坚持不断的行为干预和干预方法的改善.     

上海市某社区人群相关重点传染病健康教育干预效果评价

[目的]了解上海市阂行区社区人群中菌痢、病毒性肝炎等重点传染病的知晓水平和行为状况,探讨综合性健康教育干预内容,评价干预效果. [方法]采用PPS抽样方法,在上海市阔行区颛桥镇抽取2个社区,对社区居民实施半年的相关传染病综合性健康教育.分别于干预前后对所有干预的居民进行相关知识的问卷调查,通过比较干预前后居民的相关传染病知识知晓率和相关行为正确率的变化,评价健康教育效果. [结果]干预后居民相关重点传染病相关知识的知晓率及相关正确的行为意向认知率均有显著提高(P<0.05),但对经常吃熟食、隔夜菜的行为意向仍保持较高比率,分别为41.98%(本地居民)和51.26%(外来人群);安全套使用的行为认知率仍很低.分别为26.72%(本地居民)和42.02%(外来人群). [结论]传染病综合性健康教育效果明显.但要真正改变人们行为,实现由知识的获得、态度的转变到行为实践的飞跃,仍需要进行长期广泛而持续的健康教育工作.     

昆明市社区居民糖尿病防治健康教育干预效果评估

目的探讨社区健康教育干预措施对人群糖尿病防治知识及行为的影响,为有效开展社区糖尿病干预提供科学依据。方法采用社区干预试验研究方法,选择干预社区和对照社区,对干预社区居民实施以健康教育和健康促进为主的干预活动;通过比较2个社区基线及1年半后糖尿病防治知识和行为变化情况,评估干预效果。结果 1年半后,干预社区居民糖尿病防治知识知晓率比干预前明显提高,糖尿病相关健康行为形成率也有所提高;而在对照社区,社区居民糖尿病防治知识知晓率和健康行为形成率均没有明显变化。结论糖尿病社区健康教育与干预项目对社区居民糖尿病知识认知水平的提高和健康行为的形成有较好的促进作用,应加强社区糖尿病健康教育与行为干预工作。     

上海市浦东新区某企业员工营养知信行的干预效果

目的了解对浦东新区某造船企业员工营养知识、态度、行为干预效果,为对企业员工进一步开展营养干预提供依据。方法根据进餐食堂不同,抽取2个工作组共843人,随机分为干预组和对照组,对干预组开展为期6个月的营养干预,通过干预前后营养问卷调查对干预效果进行评价。结果营养干预后,干预组营养知识、态度、行为较干预前及与对照组的比较,多数指标改善,且差异有统计学意义。结论通过营养干预的开展,提高了企业员工营养知识水平,强化了积极的营养态度,改善了营养行为。     

"产业化"与"市场化"的错位

医疗改革之弊,也许在于过度的“市场化”而非产业化。如果不对这两个概念加以区别,将棒子打在“产业化”上,其结果有可能贻害相关领域的改革深化     

The use of "impotence" and "frigidity": why has "impotence" survived

The negative connotations and decreased utility of the terms "impotence" and "frigidity" prompted an investigation of their use in the literature. Psychological Abstracts were reviewed from 1940 to 1983 for titles containing these terms. It was found that both impotence and frigidity titles fluctuated at low levels from 1940 to 1969. Frigidity titles then increased slightly, but dropped to zero after 1979. Impotence titles, however, have continued to increase at a significant rate. Classic sexual behavior and therapy works are reviewed to explain this discrepancy since both terms are equally inappropriate.     

The "lessons" of the Australian "heroin shortage"

Heroin use causes considerable harm to individual users including dependence, fatal and nonfatal overdose, mental health problems, and blood borne virus transmission. It also adversely affects the community through drug dealing, property crime and reduced public amenity. During the mid to late 1990s in Australia the prevalence of heroin use increased as reflected in steeply rising overdose deaths. In January 2001, there were reports of an unpredicted and unprecedented reduction in heroin supply with an abrupt onset in all Australian jurisdictions. The shortage was most marked in New South Wales, the State with the largest heroin market, which saw increases in price, dramatic decreases in purity at the street level, and reductions in the ease with which injecting drug users reported being able to obtain the drug. The abrupt onset of the shortage and a subsequent dramatic reduction in overdose deaths prompted national debate about the causes of the shortage and later international debate about the policy significance of what has come to be called the "Australian heroin shortage". In this paper we summarise insights from four years' research into the causes, consequences and policy implications of the "heroin shortage".     

耐多药结核病患者"知""信""行"护理干预模式研究

目的评价耐多药结核病患者“知、信、行”护理干预模式的效果。方法将60例耐多药结核病患者随机分成研究组和对照组各30例,对照组采用规则抗结核治疗和常规护理,研究组实施“知、信、行”护理干预。结果研究组知识、信念、行为明显高于对照组;12个月痰菌阴转率为83．3％、患者病灶吸收率81．3％、空洞闭合率55．6％,明显高于对照组;二者与对照组比较差异有显著意义。结论采用“知、信、行”护理干预模式,能有效地提高耐多药结核病患者的治疗疗效,改善其生活质量。     

Diagnosing "dayans" and "demons"

The new ?Witch Craft Prevention Bill? prohibiting witch hunting was passed in Bihar, India, in reaction to the branding and subsequent killing of more than 500 helpless women as "dayans" (witches) in the past 7 years. Most of them were single, widows, or deserted women victimized by the pathological greed of some of the male members of their families or by some powerful persons in the village community interested in claiming their property. Even with the passage of the bill, though, most of these crimes will remain unpunished because the community is an accomplice in them, and they tend not to be reported. What is needed overall is socioeconomic and political development that will lead to the empowerment of women to ensure that there will be an end to the cruel and inhuman activities (such as witch hunting) instigated by traditional healers or "Ojhas".     

Cultural characteristics of "high" and "low" performing hospitals

PURPOSE: To compare and contrast the cultural characteristics of "high" and "low" performing hospitals in the UK National Health Service (NHS). DESIGN/METHODOLOGY/APPROACH: A multiple case study design incorporating a purposeful sample of "low" and "high" performing acute hospital Trusts, as assessed by the star performance rating system. FINDINGS: These case studies suggest that "high" and "low" performing acute hospital organisations may be very different environments in which to work. Although each case possessed its own unique character, significant patternings were observed within cases grouped by performance to suggest considerable cultural divergence. The key points of divergence can be grouped under four main headings: leadership and management orientation; accountability and information systems; human resources policies; and relationships within the local health economy. PRACTICAL IMPLICATIONS: As with any study, interpretation of findings should be tempered with a degree of caution because of methodological considerations. First, there are the limitations of case study which proceeds on the basis of theoretical rather than quantitative generalisation. Second, organisational culture was assessed by exploring the views of middle and senior managers. While one should in no way suggest that such an approach can capture all important cultural characteristics of organisations, it is believed that it may be at least partially justified, given the agenda-setting powers and influence of the senior management team. Finally "star" performance measures are far from a perfect measure of organisational performance. Despite such reservations, the findings indicate that organisational culture is associated in a variety of non-trivial ways with the measured performance of hospital organisations. ORIGINALITY/VALUE: Highlights considerable cultural divergence within UK NHS hospitals.