湖北省农村地区社会支持与老年人虐待关系的研究

目的 研究湖北省麻城市农村地区老年人虐待发生情况,探讨社会支持与老年人虐待间的关系.方法 采用横断面调查研究方法,整群抽取麻城市农村地区3个办事处17个行政村≥60岁的老年人,调查过去一年内虐待发生情况及相关因素.调查内容包括一般情况、社会支持以及老年人虐待情况等.结果 麻城市农村地区老年人总虐待、身体虐待、情感虐待、疏于照顾和经济剥削的发生率分别为36.2％、4.9％、27.3％、15.8％和2.0％.控制性别、年龄等混杂因素后,需要家人生活或经济上的支持和帮助是总虐待的危险因素(OR=1.28,95％CI:1.01～1.63),而需要时得到家人生活或经济(OR=0.76,95％CI:0.58～0.98)、精神(OR=0.63,95％CI:0.49～ 0.82)和朋友在精神(OR=0.73,95％CI:0.59～ 0.90)上的支持和帮助是虐待的保护因素.身体虐待、情感虐待、疏于照顾和经济剥削的保护因素分别是需要时得到家人生活或经济上的支持和帮助(OR=0.59,95％CI:0.35～0.99)、需要时得到家人(OR=0.67,95％CI:0.51～0.89)及朋友(OR=0.67,95％ CI:0.54～0.84)精神上的支持和关心、需要时得到家人生活或经济上的支持和帮助(OR=0.63,95％CI:0.45～0.88)、需要时得到家人生活或经济(OR=0.38,95％CI:0.14～0.98)上以及朋友或其他人精神( OR=0.42,95％CI:0.20～0.87)上的支持和帮助.结论 麻城农村地区老年人受虐待现状不容乐观,社会支持是老年人虐待发生的一个重要影响因素.     

北京市社区老年人跌倒发生现况及危险因素分析

目的 了解北京市社区老年人跌倒的发生特点与规律,并对造成跌倒发生的危险因素进行分析,为进一步开展老年人跌倒的预防工作提供依据.方法 本次调查覆盖北京市某街道所辖的12个社区,在每个社区内符合条件的60岁及以上老年人中,采用系统抽样方法分别抽取100名老年人进行人户调查.结果 在被调查的老年人中,1年内共有169位老年人发生过258次跌倒,跌倒发生率为15.6％,其中男性跌倒发生率为14.7％ (96人次),女性跌倒发生率为16.4％(162人次);老年人跌倒大多发生在室内.不同性别的老年人跌倒发生地点的构成差异有统计学意义(x2=8.05,P=0.045);社区老年人跌倒损伤部位以四肢最多见,其次为躯干和头面部,导致内脏损伤较少见,只有5人,不同性别的老年人跌伤部位的构成差异有统计学意义(x2=7.99,P=0.046);年龄高(OR=2.395,95％ CI:1.902～3.001)、担心跌伤(OR=1.433,95％ CI:1.120～1.833)、家庭不和睦(OR=1.238,95％ CI:1.047～2.049)为社区老年人跌倒的危险因素.结论 北京市社区老年人跌倒发生率较高,严重威胁着老年人的身心健康.     

曲靖市中小学生伤害发生现状和危险因素分析

目的 了解曲靖市中小学生伤害发生现状和危险因素,为制定相应的干预措施预防和控制学生伤害事件的发生提供科学依据.方法 于2010年4月采用分层整群随机抽样的方法,抽取曲靖市2所小学、2所中学共10 561名中小学生为调查对象,进行问卷调查,回顾性调查过去1年的伤害情况.采用非条件logistic回归分析影响伤害发生的危险因素.结果 曲靖市中小学生伤害发生率为23.97％.男生伤害发生率（27.31％）高于女生（20.39％）,差异有统计学意义（x2=69.26,P＜0.01）.小学、初中和高中学生伤害发生率差异有统计学意义（X^2=126.434,P＜0.01）,初中生为伤害高发人群（31.06％）.居于前5位的伤害类型依次为跌落伤（22.59％）、碰撞伤（11.44％）、刀割伤（9.84％）、动物咬伤（4.52％）和烧烫伤（4.38％）.多因素非条件logistic回归分析结果显示,初中生（OR=1.44,95％CI：1.26～1.64）、与母亲生活的学生（OR=1.47,95％CI：1.15～1.87）、母亲的民族为苗族的学生（OR=2.78,95％CI：1.20～6.43）更容易发生伤害事件;而女生（OR=0.67,95％CI：0.60～0.74）、父亲职业为工人（OR =0.83,95％CI：0.70～0.99）或农民（OR =0.82,95％CI：0.71～0.94）的学生、在家排行较小的学生（OR=0.84,95％CI：0.73～0.96）、年龄小的学生（OR=1.05,95％CI：1.03～1.07）相对不容易发生伤害事件.结论 中小学生伤害发生率较高,伤害由多因素作用导致,与个人、家庭及学校环境危险因素有关.     

农村地区中学生自行车伤害危险因素病例对照研究

目的 探讨农村地区中学生自行车伤害发生的危险因素,为农村地区中学生自行车伤害的预防控制工作提供科学依据.方法 采用分层整群抽样方法,应用自填式问卷调查方式,对潮汕两英镇地区6所中学的3 708名中学生的自行车伤害发生情况进行调查.对筛选出的502例伤害病例,根据同学校、同年级、同性别的原则,在骑乘自行车上下学而未发生自行车伤害的学生中,按照1∶3匹配,采用病例对照研究方法进行相关因素的Logistic回归分析.结果 骑车者搭扶其他车辆(OR=1.603,95％ CI=1.174～2.189)、骑车者骑车带人(OR=1.395,95％ CI=1.119～1.746)、乘坐自行车时搭扶其他车辆(OR=1.776,95％ CI=1.356～2.327)、乘坐自行车时与骑车者打闹( OR=1.594,95％ CI=1.202～2.117)、父亲在外工作或经商(OR=1.500,95％ CI=1.194～1.885)、家庭人均年收入低于5 000元(OR=3.320,95％ CI=1.979～5.570)为农村地区中学生自行车伤害发生的危险因素.而家庭人均年收入高于5 000元(OR =0.257,95％ CI=0.076～0.719)为保护因素.结论 中学生自身不良的骑车行为、父亲在外和家庭经济水平低是影响农村地区中学生自行车伤害的危险因素.     

低出生体重儿发生的相关危险因素分析

目的 研究低出生体重儿发生的相关危险因素,探讨降低低出生体重儿的相关措施.方法 应用病例对照研究方法,对100例低出生体重儿和300例正常新生儿的相关资料进行单因素分析及非条件多因素Logistic回归分析.结果 母亲年龄(OR=3.232;95％ CI:0.453～ 3.348)、孕周(OR=2.454;95％CI:0.975 ～ 2.349)、双胎及多胎妊娠(OR=2.642;95％ CI:0.723 ～ 2.348)、妊娠期高血压疾病(OR=2.236;95％ CI:0.455～ 2.445)是低出生体重儿发生的相关危险因素,母亲文化程度(OR=3.642;95％ CI:1.347 ～ 3.425)、家庭月收入(OR=3.532;95％ CI:1.436～2.335)是低出生体重儿发生的保护性因素.结论 针对母亲年龄、孕周、双胎及多胎妊娠、妊娠期高血压疾病等危险因素开展针对性的防治工作是降低低出生体重儿发生率的有效措施.     

成年抗中性粒细胞胞质抗体相关性血管炎患者贫血发生率及其危险因素分析

目的 探讨成年抗中性粒细胞胞质抗体(ANCA)相关性血管炎患者贫血发生率及其危险因素.方法 回顾性分析72例成年ANCA相关性血管炎患者临床资料,患者根据年龄分成中青年(＜ 65岁)组(43例)及老年(≥65岁)组(29例)；应用Logistic分析探讨发生贫血的危险因素.结果 在72例成年ANCA相关性血管炎患者中,47例(65.3％)出现贫血,中青年组贫血发生率为55.8％(24/43),老年组贫血发生率为79.3％(23/29),老年组贫血发生率明显高于中青年组,差异有统计学意义(P＜0.01).校正其他混杂因素后,年龄(每增加10年,OR=1.23,95％ CI 1.12～ 1.95,P=0.001)、糖尿病(OR=1.34,95％CI 1.14～ 1.89,P=0.013)及大量蛋白尿(OR=1.11,95％ CI 1.05～1.76,P=0.011)是总体ANCA相关性血管炎患者发生贫血的独立危险因素.结论 老年ANCA相关性血管炎贫血发生率要明显高于中青年患者；治疗前年龄(每增加10年)、糖尿病及大量蛋白尿是成年ANCA相关性血管炎患者发生贫血的独立危险因素.     

北京市某社区老年人多次跌倒发生率 及相关因素的随访研究

目的调查北京市某社区老年人多次跌倒的发生情况,并探讨跌倒相关因素。方法 以北京市某社区为调查现场,2009年抽取472名老年人采用面对面询问方式进行人户调查,通过 单因素及多因素logistic回归分析多次跌倒的影响因素。结果472名老年人中,跌倒>---2次共29 名,多次跌倒发生率为6．1％。多因素logistic回归分析显示,家庭月收入高(OR----1．39,95％CI： 0．67～2．16)、担心跌倒(OR=2．23,95％CI：1．47。3．85)、静态平衡异常(OR=2．48,95％CI：1．84～ 4．05)是老年人多次跌倒的危险因素,楼梯台阶宽度合适(OR=0．49,95％CI：0．21．1．12)、日常用品 易于取放(OR=0．41,95％CI：0．14—1．16)是多次跌倒的保护因素。结论北京市某社区老年人多 次跌倒发生率高,跌倒发生与多种因素有关,应采取综合性措施预防老年人跌倒。     

湖北省0～14岁儿童伤害状况及危险因素分析

目的 了解湖北省儿童伤害发生的流行病学特征和相关危险因素,为制定儿童伤害干预措施提供科学依据.方法 多阶段分层整群抽取湖北省10个市、县的0～14岁儿童家长进行回顾性问卷调查.结果 共调查儿童10 688名,城市5 894名,农村4 794名.儿童非致死性伤害发生率为19.0％,发生率男性高于女性(OR=1.28),农村高于城市(OR=2.58).6～11岁组的伤害率最高(23.7％),0～2岁组的伤害率最低(5.5％).前3位伤害类型依次为跌倒/坠落(45.2％)、烧烫伤(9.5％)和动物伤(9.5％).79.6％为轻度损伤,40.1％的伤害发生在家里/宿舍.男性、家庭人口数多、居室热水等摆放不合理、母亲无工作的儿童更易发生伤害.结论 湖北省0～14岁儿童伤害情况较为严重,儿童自身的因素和家庭环境的因素对儿童伤害的影响不容忽视.     

急性前列腺炎患者肺部感染的危险因素分析

目的 分析急性前列腺炎患者肺部感染状况及其危险因素,为临床治疗提供科学依据.方法 选择2007年1月-2012年1月住院治疗的急性前列腺炎患者152例,根据其是否发生肺部感染分为感染组21例和未感染组131例,应用单因素和多因素分析方法研究导致患者发生肺部感染的危险因素.结果 急性前列腺炎患者的肺部感染发生率为13.82％;年龄＞60岁、糖尿病史、心脏病史、原发呼吸系统慢性疾病、吸烟、住院时间≥7d者的肺部感染发生率分别为27.3％、34.6％、31.2％、32.0％、24.4％、47.6％;年龄＞60岁(OR=1.673,95％CI=1.215～2.303)、糖尿病史(OR=2.896,95％CI=1.416～5.922)、心脏病史(OR=1.819,95％ CI=1.127～2.935)、原发呼吸系统慢性疾病(OR=1.315,95％CI=1.102～1.569)、吸烟(OR=1.674,95％CI=1.216～2.304)、住院时间≥7 d(OR=l.562,95％CI=1.118～2.182)是患者发生肺部感染的危险因素.结论 急性前列腺炎患者应尽早入院治疗,积极治疗其慢性病和并发症,以降低肺部感染的发生.     

金属制造业职业伤害危险因素的病例交叉研究

目的 探讨金属制造业职业伤害的瞬时危险因素.方法 采用配对病例交叉研究的方法,研究对象为广东省中山市4个职业伤害定点医院收治的来自金属制造业的由机械压力导致的职业意外伤害患者208人,采集伤害发生前30 min内危险因素的暴露情况,伤害发生前一天同一时段12种急性危险因素的暴露情况.结果 采用条件logistic回归分析,结果显示,更换工作岗位(OR =20.76,95％ CI=2.04～210.53),突然加班(OR =10.11,95％ CI=2.57～39.75)是职业伤害的危险因素(P＜0.01),而其他危险因素没有统计学意义.结论 更换工作岗位和突然加班是职业伤害的危险因素.     

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.