安徽省长丰县农村留守儿童伤害分布及危险因素研究

目的 了解安徽省农村地区留守儿童伤害的分布及危险因素.方法 采用分层整群抽样方法抽取安徽省长丰县农村3617名中小学生进行问卷调查,了解留守儿童最近1年伤害的发生情况,并对其伤害发生的相关因素进行单因素和多因素logistic回归分析.结果 调查留守儿童1614名,占学生总数的45.83%.主要监护类型为单亲监护(55.82%).中小学生伤害发生率为32.25%,男生伤害发生率为45.22%,女生为35.28%,差异有统计学意义(χ2=16.245,P=0.000);其中留守儿童伤害发生率为40.90%,高于非留守儿童(24.95%),差异有统计学意义(χ2=101.730,P=0.000).留守儿童在跌伤、交通伤、动物咬伤等7种伤害类型上发生率高于非留守儿童,差异有统计学意义.多因素分析显示:非独生子女(OR=1.445)、性格外向(OR=1.062)、矛盾性(OR=1.150)、独立性(OR=1.110)、娱乐性(OR=1.096)可能是留守儿童伤害的危险因素,而女生(OR=0.598)、亲密度(OR=0.933)、控制性(OR=0.917)可能是留守儿童的保护性因素.结论 该地区留守儿童伤害由多种因素共同作用导致,家庭环境和个人性格起主要作用,应针对危险因素采取有效的预防措施,减少留守儿童伤害的发生.     

连平县部分中小学生交通伤害现状分析

目的了解农村中小学生交通伤害发生率和交通安全知识、行为特征,为制定干预措施提供科学依据。方法对广东省连平县元善镇在校中小学生,采用自填式问卷调查方法,调查其交通伤害、交通安全知识、危险行为和暴露危险因素等情况。结果共调查农村9726名中小学生,其交通伤害发生率为7.94%,男生高于女生,与学生的教育程度有一定关系,小学三～五年级较高（8.71%～11.96%）,六年级最低（4.73%）;认知正确率在52.04%～82.11%之间,有危险行为的学生占21.44%～23.67%;57.90%～85.23%的学生暴露在交通危险因素中。结论农村中小学生交通安全知识贫乏,大部分学生暴露在危险因素中。农村学生交通伤害干预急待开展。     

农村中小学生溺水危险因素分析

目的 探讨广东省农村中小学生发生溺水的危险因素,为制定切实可行的溺水干预对策和措施提供科学依据.方法 选取1个农村地区乡镇的中小学生为调查对象,采用统一问卷及学生集中填写方式.结果 农村中小学生溺水发生率为5.65%,小学、初中、高中发生率分别为7.69%.5.80%,2.39%,有逐步下降趋势(P＜0.01);男生溺水发生率为7.14%,高于女生的4.03%(P＜0.01).多因素Logistic回归分析显示,家庭成员常有矛盾(OR=1.179)、经常无人陪护去非游泳区游泳(OR=1.409)、经常单独去野外开放性水域捕鱼(捉鱼)(OR=1.180)、经常在野外水域或池塘里.周围与同伴打闹(OR=1.377)、经常在不知深浅的开放性水域跳水或潜水(OR=1.373)为溺水危险因素,高年级为保护因索(OR=0.864).结论 农村中小学生溺水的危险因素具有多元性. -     

清远市清新区农村中小学生伤害认知现状及影响因素分析

目的通过对清远市清新区农村中小学生伤害认知情况的调查,为开展有效的健康教育和干预措施提供依据。方法采用整群随机抽样的方法,对清远市清新区禾云镇和浸潭镇的5 504名中小学生进行自填式问卷调查,调查内容包括个人基本情况、家庭情况、学校安全教育情况及伤害知识认知情况。并对伤害知识达标水平的影响因素进行单因素和多因素非条件Logistic回归分析。结果调查5 504名学生,回收5 250份有效问卷,有效率95.37%。伤害知识达标率为87.33%,男、女生的达标率分别为85.40%、90.05%,中、小学生的达标率分别为91.63%、83.25%,差异均有统计学意义(P0.05)。多因素结果显示,个人因素、家庭因素、学校因素对伤害知识水平的影响均有统计学意义(P0.05,95%CI不含1)。女性(OR=1.43)、中学(OR=1.87)、身体一般(OR=1.88)及健康(OR=1.83)、非独生(OR=1.48)、非留守(OR=1.17)的学生伤害知识达标水平较高;老师很少(OR=0.43)及从不(OR=0.49)强调安全问题、学校无开展安全演习(OR=0.36)的学生伤害知识达标水平较低。结论清新区农村中小学生的伤害知识水平较高,个人因素、家庭因素、学校因素分别对清新区农村中小学生的伤害知识水平存在不同程度的影响,相关部门应根据不同特征的中小学生,有针对性地开展健康教育,提高其对伤害的认知水平,规范中小学生的日常行为习惯,降低伤害发生率。     

深圳市中小学生运动伤害现况及影响因素分析

目的了解广东省深圳市中小学生运动伤害现况及影响因素,以减少运动伤害的发生。方法分层整群抽取3 540名深圳市中小学生,回顾性调查1年间运动伤害情况。结果中小学运动伤害发生率为21.61%,3年级(9.62%)低于其他年级,男生(23.93%)高于女生(18.40%),独生子女(26.43%)高于非独生子女(18.24%),暂住户籍(24.07%)高于本地户籍(18.53%);导致伤害的运动主要是跑步(31.76%)和篮球(26.93%);不同运动导致伤害的部位和伤害后果不同,伤害后累计缺课1 536节,活动受限4 994.5 d,医疗费用66 460元;分类树分析显示,打闹是运动伤害发生主要危险因素,打闹同时模仿或恶作剧的男生运动伤害发生率最高。结论中小学生运动伤害发生率较高,应加强相关健康教育,预防运动伤害的发生。     

广州市中小学生运动伤害危险因素的配对病例对照分析

目的 探讨中小学生运动伤害的危险因素.方法 按性别、年龄、班级1:1配对原则,通过样本量计算选择349对运动伤害病例和对照,采用单因素和多因素条件logistic回归分析.结果中小学生发生运动伤害的危险因素是:鞋底磨损大(OR=7.20,95%CI:2.37～21.84)、疲倦(OR=14.34,95%CI:2.29～89.66)、带病时参加运动的频率高(OR=1.96,95%CI:1.29～3.06)和既往伤害史(OR=2.11,95%CI:1.41～3.96).运动伤害的保护因素:体育训练时有老师指导动作(OR=0.46,95%CI:0.26～0.79)、运动时做防护措施(OR=0.36,95%CI:0.20～0.64)和运动前热身运动的频率高(OR=0.31,95%CI:0.14～0.67).结论 中小学生运动伤害与个人因素、家庭因素和社会因素有关;应提高学生和老师的安全运动意识,减少运动伤害危险行为的发生.     

深圳市南山区中小学生伤害发生情况及其影响因素分析

目的 了解深圳市南山区中小学生伤害发生情况及其影响因素,为预防中小学生伤害提供依据。 方法 采用随机整群抽样方法,以深圳市南山区8所小学、8所初中和4所高中的所有学生为研究对象,调查过去12个月内伤害的发生情况,共收回合格问卷为3 169份,采用 SPSS 22.0 进行统计分析。 结果 深圳市南山区中小学生伤害发生率为7.79%,男生伤害发生率(8.54%)高于女生(6.95%),但差异无统计学意义(χ²=2.795,P=0.054)。初中生伤害发生率14.50%,高于高中(5.29%)及小学生(5.37%)(χ²=72.554,P＜0.01)。伤害发生地点主要为学校(36.44%),其次是学校及家里以外的其他地方占33.60%,发生在家里的伤害占29.96%。伤害发生的前三位原因为跌倒/坠落(58.30%),刀/锐器伤(11.34%),钝器伤(10.53%)。多因素 logistic 回归分析结果显示,“高年级”(OR=1.499,95%CI:1.195～1.881)、“走读”(OR=3.206,95%CI:1.975～5.203)、外地户籍(OR=1.416,95%CI:1.074～1.992)是伤害发生的危险因素,“母亲为照料者”(OR=0.702,95%CI:0.541～0.912)是伤害发生的保护因素。 结论 南山区中小学生伤害发生率呈现不同特点,应针对不同学龄段的学生采取不同干预措施,减少伤害的发生。     

商洛市中小学生生活方式与超重肥胖的相关性分析

目的调查商洛市中小学生生活方式及肥胖发生率并分析两者之间的相关关系,为中小学生肥胖预防提供参考依据。方法随机抽取本市8所小学和中学的6 932名学生作为调查对象,测定BMI指数,采用生活方式调查问卷调查中小学生生活方式,分析超重肥胖与生活方式的相关性。结果本市中小学生超重发病率为14.37%,肥胖率为10.69%。城市地区中小学生超重发病率为16.20%,肥胖率为12.71%,农村地区中小学生超重发病率为12.24%,肥胖率为8.34%,经卡方检验,差异有统计学意义(P0.05)。经多因素非条件Logistic回归分析,喜食甜食、西餐(OR=2.431,95%CI=1.171~5.846)、不爱运动(OR=1.106,95%CI=1.011~2.937)、熬夜(OR=1.347,95%CI=1.102~4.073)和不吃早餐(OR=1.122,95%CI=1.004~1.980)为中小学生超重肥胖的主要危险因素;运动锻炼(OR=0.819,95%CI=0.011~0.979)为中小学生超重肥胖的保护因素。经相关分析,中小学生超重肥胖与西餐食用次数、碳酸饮料食用量呈明显正相关(r=0.736、0.693,P0.05),与运动锻炼次数呈明显负相关(r=-0.814,P0.05)。结论商洛市中小学生超重肥胖发病率较高,特别是城区学生发病率最高,与喜食甜食、西餐、不爱运动等不良生活方式明显相关,应该加强体育锻炼,养成健康的生活方式预防超重肥胖。     

深圳市中小学生道路交通伤害及其影响因素分析

了解深圳市中小学生道路交通伤害发生情况及相关影响因素,为减少青少年道路交通伤害的发生提供参考.方法 采用分层整群抽样的方法,抽取深圳市18所学校共4 871名学生进行道路交通伤害发生情况问卷调查,运用多因素Logistic逐步回归分析筛选影响因素.结果 近1年内中小学生交通伤害发生率为5.75%(280/4 871).小学生交通伤害发生率最高(8.88%),其次为初中生(5.09%),高中生交通伤害发生率最低(3.22%),差异有统计学意义(P<0.01).多因素Logistic回归分析结果显示,小学(初中与之比较:OR=0.534,95% CI=0.380 ~0.749;高中与之比较:OR=0.314,95%CI=0.213~0.464)、肥胖(OR=1.855,95%CI=1.225~2.809)、大家庭(OR=1.463,95%CI=1.103~ 1.941)、步行(OR=1.750,95%CI=1.116~2.746)、骑自行车上学(OR=3.636,95%CI=2.015 ~ 6.560)、违反交通规则次数多(OR=1.343,95%CI=1.167~ 1.546)、校内人车道不分开(OR=1.433,95%CI=1.110~ 1.850)学校学生更倾向于发生交通伤害,学校有专人维护校周交通秩序(OR=0.818,95%CI=0.698~0.958)、所乘校车无超载情况(OR=0.483,95%CI=0.330~0.706)是交通伤害的保护因素.结论 深圳市中小学生道路交通伤害发生情况不容忽视,多种因素影响交通伤害发生.应采取针对性的干预措施,以减少学生交通伤害的发生.     

深圳市中小学生骨折现状及其影响因素分析

了解深圳市中小学生骨折的流行特征及其影响因素,为制定针对中小学生的骨折防控干预措施和策略提供科学依据.方法 采用方便抽样的方法,抽取深圳市10个区18所学校的5 116名中小学生为调查对象.通过自制的调查问卷开展调查,采用x2检验、Logistic回归分析法分析骨折的危险因素.结果 在过去1 a内,中小学生骨折的发生率为2.4%,男生骨折发生率(3.3%)高于女生(1.3%)(x2=20.380,P<0.05);不同年龄组学生骨折发生率差异有统计学意义(x2 =7.324,P<0.05).单因素分析显示,性别、年龄、年级、家庭经济情况、打篮球、踢足球、运动时穿鞋的种类、溜冰或玩滑板、运动场地与骨折发生相关均有统计学意义(P值均<0.05);多因素Logistic回归分析结果显示,外地户籍、篮球场地是中小学生骨折的危险因素(OR值分别为1.523,1.955,P值均<0.05);女生、中等家庭经济收入、运动时穿运动鞋是中小学生骨折的保护因素(OR值分别为0.515,0.611,3.389,P值均<0.05).结论 应根据危险因素予以积极干预,开展中小学生骨折相关的安全意识教育,最大限度地减少中小学生骨折的发生.     

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.