慢性病知识测量工具应用研究

健康教育是慢性病干预措施的一个重要组成部分，历来得到各级有关部门的重视。然而长期以来由于缺乏用于效果评估的测量工具，导致无法对目标进行评估。为此，于2007年～2008年进行了慢性病大众知识测量工具的研究，同时为苏州市慢性病中期健康教育目标效果评估奠定了基础，现将该项研究情况报告如下。     

追踪随访式健康教育在城市社区常见慢性非传染性疾病防治中的应用研究

目的研究追踪随访式健康教育在城市社区慢性非传染性疾病(慢性病)管理中的应用效果。方法以某社区已确诊的慢性病患者650例为研究对象,对其进行追踪随访式健康教育,并对教育前后的效果指标进行分析。结果研究对象在干预前后的慢性病防治、健康行为改变均有显著改善(P<0.05)。结论追踪随访式健康教育在城市社区常见慢性病防治中的应用成效显著,较目前普遍应用的健康宣教更容易达到增加患者慢性病防治知识知晓率、健康行为改变率的目的 ,值得推广应用。     

我国慢性病防治健康教育研究及开展现状

近些年,医疗卫生机构纷纷开展一系列研究揭示健康教育对慢性病防治的重要性,慢性病健康教育受到卫生行政部门和医疗卫生机构的重视.把握慢性病健康教育开展现状,及时发现并解决问题,有助于我们把慢性病的健康教育做好做精,降低慢性病发病率、致残率和死亡率.本文从健康教育对慢性病防治的意义、慢性病防治健康教育主要内容和模式、慢性病防...     

西北边远地区基层官兵慢性病健康教育需求调查

目的了解西北边远地区官兵慢性病健康教育需求，探讨开展慢性病防治健康教育长效机制。方法采取健康体检及问卷调查的方法，了解西北边远艰苦地区基层连队慢性病患病情况。结果西北边远艰苦地区官兵吸烟率72．94％，饮酒率58．11％。慢性病患病率和知晓率分别为：超重与肥胖37．71％和7．16％，高血压9．28％和4．08％，脂肪肝15．2％和11．44％，高尿酸血症13．96％和0％。看病难、知识来源少是官兵认为在维护个人健康方面存在的主要难题，部队提供的慢性病防治专项健康教育相对不足，官兵希望获得保健、营养、慢性病防治等健康知识，对专题讲座、发放健康教育书籍及提供远程教育和咨询等健康教育形式比较欢迎。结论加强边远地区连队慢性病预防健康教育符合官兵需求，是特殊环境下增强官兵身体素质、提高部队战斗力的有力措施。     

中山市某镇农村社区慢性病实施健康教育效果评价

目的：探索适合农村社区慢性病患者的健康教育方式，并评价健康教育的干预效果，以提升农村慢性病综合防治水平。方法：选择148例慢性病患者定期开展健康教育活动和行为方式调查问卷。结果：健康教育12个月后，患者知识、态度和行为得分较干预前有明显提高，患者收缩压、糖化血红蛋白等与干预前有显著性变化。结论：健康教育在慢性病的综合防治中有重要的作用。     

“健康中国”背景下我国慢性病管理模式发展的价值意蕴、现实困境与优化路径*

“健康中国”战略对我国慢性病管理模式的发展提出了更高要求。通过文献资料及逻辑分析等研究方法,对我国慢性病管理模式的价值意蕴、慢性病管理的典型模式及慢性病管理存在的问题等方面进行审视,探索“健康中国”背景下我国慢性病管理模式发展的优化路径。研究认为,我国慢性病管理存在慢性病防治健康教育力度不足、专业医务人员数量紧缺、慢性病管理信息平台建设不平衡及慢性病管理体系不健全等突出问题。基于此,结合“健康中国”战略的发展要求,提出优化路径：行稳致远——提高居民健康教育的力度,强基固本——推进基层医疗卫生队伍的建设,互联互通——加快慢性病管理信息平台的开发,统筹兼顾——搭建慢性病管理的分级诊疗体系。     

基于经济学的农村慢性病健康教育思考与建议

作为预防和控制慢性病的基础性工作，慢性病健康教育工作的重要性得到了广泛的认同，但实践中，这项工作的开展却不尽人意。通过分析慢性病健康教育服务的公共产品性质、成本一效益分析困难、具有消费品和投资品双重特点等经济学特征，结合农村卫生工作实际，提出加强和改进农村健康教育工作的政策建议。     

双塔区人群传染病和慢性病防治知识知晓率调查

健康教育是健康促进的基础。为进一步了解双塔区城乡人群传染病、慢性病防治知识知晓情况，为今后有针对性的开展健康教育工作以及为制定健康教育干预策略和措施提供科学依据。于2007—07-09／13对辖区内部分城乡人群进行“传染病、慢性病防治知识”知晓情况问卷调查，现将调查结果报告如下。     

听障人群慢性病知识水平及健康教育意愿调查分析

目的了解听障人群慢性病知识水平及健康教育意愿,为提高听障人群健康素养提供科学依据。方法选择上海市黄浦区五里桥社区的听障人群,使用"中国居民健康素养调查问卷"中慢性病相关问题,由经过统一培训的社区医生和手语翻译面对面进行问卷调查。结果 152名研究对象中,慢性病知识得分最高12分(满分20分),平均得分4.67分。多因素有序logistic回归分析结果显示经常主动了解慢性病相关知识的研究对象得分较高(β=1.472,P=0.004)。87.50%的研究对象表示愿意参加慢性病健康教育,而期望度排名前三的健康知识获取途径为手机微信(73.34%),电脑网络(53.29%)和报刊杂志(50.66%)。结论听障人群慢性病相关知识缺乏但健康教育参与意愿较高,研究者及相关部门在制定教育方案时应优先考虑听障人群喜爱的教育形式。     

社区居民慢性病综合干预效果分析

本研究通过对实施健康教育与促进前（2006年）和之后（2010年）居民健康体检结果及调查资料对比分析，探讨健康教育与健康促进对居民慢性病的干预效果。结果显示，两组不同年份人群的健康知识知晓程度、不良行为改善程度等均有明显提高，前后差异有统计学意义（P〈0．05）。由此可见，社区健康教育与健康促进可以作为一条改善居民健康状况、预防控制慢性病的有效途径。     

鼻咽癌药物经济学研究进展

目的:了解国内外鼻咽癌药物经济学研究进展。方法:检索专业学术期刊,根据相关纳排标准筛选文献,提取关键信息。结果:共纳入5篇中文、5篇英文文献,中文文献多采用成本-效果分析,而英文文献多采用-成本效用分析;各研究多以直接医疗成本作为成本指标;中文文献多未进行敏感性分析,而英文文献纳入考虑的敏感性指标较为全面。结论:我国鼻咽癌药物经济学研究在成本界定、效果指标选择和敏感性分析方面存在优化空间。     

2001-2010年我国伤害预防病例对照研究及队列研究文献质量评价

目的评价2001-2010年我国公开发表的伤害预防病例对照研究和队列研究文献的质量。方法文献来源于四个主要的中文数据库和两个英文数据库。采用Newcastle-Ottawa-Scale（NOS）工具分别对纳入的伤害预防病例对照研究和队列研究文献进行方法学质量评价。结果 2001-2010年我国伤害预防病例对照研究和队列研究文献分别有84篇和13篇。病例对照研究中,职业人员和儿童青少年分别占45.2%和36.9%,伤害类型中,多种伤害占71.4%。队列研究中,儿童青少年占46.2%,伤害类型中,多种伤害占92.3%。病例对照研究的方法学质量得分均在5分及以上,平均（6.1±0.7）分;但研究在＂暴露因素的确定＂、＂无应答率＂以及＂病例的确定是否恰当＂条目上得分较低。队列研究的方法学质量得分以6分和7分为主,平均（6.3±0.9）分;但研究在＂结局指标的评价＂条目上得分较低。结论我国的伤害病例对照研究和队列研究数量较少,研究人群以儿童青少年和职业人员为主,伤害类型以多种伤害为主,质量相对较高。     

Post-coital contraception: an overview of published studies

Information from published studies testing the effect of hormonal and mechanical interceptive methods in post-coital contraception was pooled with the aim of assessing the efficacy of various regimens. The pooled failure rates were 0.6% (19/3168 based on four studies) for high-dosage ethinylestradiol, 1.1% (11/975, based on two studies) for other high-dose estrogens, 1.8% (69/3802 based on 11 studies) for combined estro-progestin preparations, 2.0% (20/998 based on three studies) for danazol and 0.1% (1/879 based on nine studies) for intra-uterine devices (IUD). Although this overview has several limitations in terms of over-representation of optimistic results in the literature or absence of direct comparison between treatments in several studies, it suggests that IUD and high-dose ethinylestradiol are more efficacious forms of post-coital contraception than danazol or combined contraceptives.     

Pooled analysis of epidemiological studies involving biological markers.

Pooled analysis is a method frequently used in epidemiology when individual studies are too small to allow any definite conclusion. Several guidelines have been published on pooling of classical epidemiological studies, but no information is available on pooling of studies involving biological markers. We have used information of two recently started pooled analyses, one on cytogenetic damage, the other on genetic susceptibility to environmental carcinogens, in order to make inferences on the applicability of a pooled analysis to molecular epidemiological studies. Issues in pooling data from epidemiological studies involving molecular markers are described here, including the choice of study design, planning and conducting of the study, data request, collection and storage, and costs. Some practical indications on the conduct of a pooled analysis in molecular epidemiology is given.     

Dietary Fibre Intake in Relation to Asthma,Rhinitis and Lung Function Impairment—A Systematic Review of Observational Studies

A high intake of dietary fibre has been associated with a reduced risk of several chronic diseases. This study aimed to review the current evidence on dietary fibre in relation to asthma, rhinitis and lung function impairment. Electronic databases were searched in June 2021 for studies on the association between dietary fibre and asthma, rhinitis, chronic obstructive pulmonary disease (COPD) and lung function. Observational studies with cross-sectional, case–control or prospective designs were included. Studies on animals, case studies and intervention studies were excluded. The quality of the evidence from individual studies was evaluated using the RoB-NObs tool. The World Cancer Research Fund criteria were used to grade the strength of the evidence. Twenty studies were included in this systematic review, of which ten were cohort studies, eight cross-sectional and two case–control studies. Fibre intake during pregnancy or childhood was examined in three studies, while seventeen studies examined the intake during adulthood. There was probable evidence for an inverse association between dietary fibre and COPD and suggestive evidence for a positive association with lung function. However, the evidence regarding asthma and rhinitis was limited and inconsistent. Further research is needed on dietary fibre intake and asthma, rhinitis and lung function among adults and children.     

Effect of conjugated linoleic acid on body composition and plasma lipids in humans: an overview of the literature

Studies in mice have indicated that feeding diets containing 0.5-1% conjugated linoleic acid (CLA) considerably reduces body fat. These findings have attracted much interest because of the potential use of CLA as a tool to promote weight loss in humans. Several CLA studies in humans have now been published, and the objective of the present review was to give an overview of these experiments. Most of the studies were done in free-living subjects and were not strictly controlled for nutrient and energy intakes. None of the studies found a significant reduction in body weight, and only 2 studies showed a significant but relatively small body fat-lowering effect. Some studies suggested that CLA may have a tendency to increase lean body mass. Furthermore, there are indications from animal studies that CLA may have effects on plasma lipids. However, only one study in humans showed a significant HDL-cholesterol-lowering effect of CLA; in all the other studies, there were no significant effects on plasma total, LDL-, and HDL-cholesterol concentrations or on plasma triacylglycerol concentrations. Thus, the results of the studies in humans indicate that the effect of CLA on body fat is considerably less than that anticipated from mice studies and that CLA has no major effect on plasma lipids.     

Chart review. A need for reappraisal

Imperfections of chart review as a data collection method are detailed, with particular emphasis on the issue of reliability. The authors identify 125 journal articles published between 1991 and 1992 in which the authors' conclusions were based principally on chart review findings and were either clinical or health care epidemiology studies, or quality assessment studies. Eight percent of epidemiology studies and 56% of quality assessment studies presented data on interrater reliability. Forty-four percent of epidemiology studies and 20% of quality assessment studies did not describe the number of chart reviewers involved. Forty-three percent of epidemiology studies and 28% of quality assessment studies used supplementary data sources. The authors conclude that the validity and utility of studies based on chart review would be enhanced by attention to interrater reliability and the use of supplementary data sources.     

Economic Evaluations Relating to Diabetes: A Descriptive Review and Their Compliance with Guidance

From a search of the Health Economics Evaluations Database (HEED), 301 studies relating to diabetes-related interventions were identified. Of these, 223 studies contained some original data, i.e., were applied studies. Over the 1990s, the number of studies undertaken in this area appears to be increasing year on year, and more of the studies are applicable to the USA than to all other countries combined. Most studies are peer reviewed, the main type of analysis is cost-consequence, and the interventions most often assessed are pharmaceutical and care services. Both the public and the private sectors sponsor many of these studies. However, only a fraction of these studies appear to accord with guidance for good economic evaluation. For example, when the search criteria were tightened to capture only those studies that consider both outcomes and costs, 173 studies were identified. Narrowing the search criteria to capture only those studies that were based on randomized controlled trial (RCT) or modeling data—the methods recommended by the US Panel and the National Institute of Clinical Excellence (NICE)—reduced the sample to 56 studies. With specific focus on those studies that evaluated pharmaceuticals, only the modeling approach appeared to show any compliance at all with another key recommendation of the existing guidance on methods; that of using outcome measures that are applicable to a long-term time horizon.
Though modeling does offer certain advantages over RCTs (for example, a larger range of comparators can be more readily incorporated, long-term outcome measures can be more easily and inexpensively estimated), modeling results have less internal validity. Also, modeling in itself relies on good RCT data. Therefore, the results of economic evaluations should be interpreted with care, irrespective of whether they are principally based on RCT or model-based methods.     

Impact of Sizes of Servings,Glasses and Bottles on Alcohol Consumption: A Narrative Review

This review summarises the evidence on the impact of serving and container size on how much people drink, interventions that have the potential to reduce alcohol consumption across populations, thereby improving health. A rapid search identified 10 published reports of 15 studies and 1 review. Four studies focused on serving size, eight studies and the review on glass size, two studies on bottle size and one on both glass and bottle size. Twelve studies and the review focused on wine, one study on beer and two on both. All were conducted in England, by just two research groups. Removing the largest serving size of wine decreased wine sales by 7.6% (95% CI −12.3%, −2.9%) in a study in 21 licenced premises, reflecting findings from two prior studies in semi-naturalistic settings. Adding a serving size for beer that was a size smaller than the largest was assessed in one study in 13 licenced premises, with no evident effect. Reducing the size of wine glasses in restaurants decreased wine sales by 7.3% (95% CI −13.5%, −1.5%) in a mega-analysis of eight datasets from studies in five licensed premises. Using smaller wine glasses at home may also reduce consumption, but the evidence from just one study is less certain. No studies have assessed the impact of glass size for drinking beer. The effect of bottles smaller than the standard 750 mL on wine consumed at home was assessed in two studies: 500 mL bottles reduced consumption by 4.5% (95% CI −7.9%, −1.0%) in one study, but in another, using 375 mL bottles there was no evident effect. No studies assessed the impact of bottle or other container size for drinking beer. Reducing the size of servings, glasses and bottles could reduce wine consumption across populations. The impact of similar interventions for reducing consumption of other alcoholic drinks awaits evaluation. Further studies are also warranted to assess the generalisability of existing evidence.     

电子烟生殖发育毒性的研究进展

在世界范围内,电子烟的使用人数急剧增加,其中,妊娠期妇女与处于发育阶段的青少年是电子烟的主要使用群体之一。已有研究表明电子烟暴露可对神经系统、心血管系统、呼吸系统的发育造成不良影响,并且,电子烟成分对生殖系统也会造成损害。因此,对于电子烟生殖和发育毒性的研究亟需完善。本文从人群流行病学调查、动物实验和体外实验研究出发,总结近年来有关电子烟对生殖和发育毒性的研究,阐述电子烟生殖发育毒性的研究现状及进展,为进一步探讨电子烟的毒性效应提供参考依据,并对电子烟市场的管理提出一定的参考意见。