Child wellbeing and income inequality in rich societies: ecological cross sectional study

Child wellbeing and income inequality in rich societies: ecological cross sectional study .
Pickett K.E. & Wilkinson R.G. ( 2007 ) British Medical Journal , 335 , 1080 – 1085 . DOI: 10.1136/bmj.39377.580162.55.     

Smoking behavior and related lifestyle variables among physicians in Fukuoka,Japan: a cross sectional study

A cross-sectional survey of the entire membership of the Fukuoka Prefecture Medical Association was conducted in 1983 using a self-administered questionnaire. In this investigation the actual prevalence of smoking among physicians and the relationship between their smoking habits and living habits were studied. The study subjects were divided into two groups: those who smoked (1,737 men and 17 women), and those who did not currently smoke (2,267 men and 169 women). It was realized that there were many who were currently non-smokers among women, subjects with a high body mass index, those with heart disease, those without peptic ulcers, those who underwent health check-ups regularly, those accustomed to an early bedtime, those who were not aware of mental stress, those who took regular exercise, those who consumed plenty of fresh vegetables, yellow and green vegetables and fruit, those who did not consume Japanese pickles, coffee.or green tea, and those who drank alcohol only occasionally and only in small amounts. The results of this study suggested the possibility that physicians who were smokers were a group who smoked little and could easily stop smoking. Moreover, non-smoking physicians were found to have a healthier lifestyle than those who smoked. It was considered that, in developing a smoking cessation program for physicians, it is important for them to establish more health-conscious lifestyles.     

Maternal and neonatal health expenditure in mumbai slums (India): A cross sectional study

Background  

The cost of maternity care can be a barrier to access that may increase maternal and neonatal mortality risk. We analyzed spending on maternity care in urban slum communities in Mumbai to better understand the equity of spending and the impact of spending on household poverty.     

Smoking cessation: theory,research and practice

Today experts agree that tobacco smoking shows many of the characteristics of a chronic disease, and that the process of uptake and quitting smoking is long and complicated. Such a perspective should prove to be useful to health educators responsible for planning smoking cessation interventions, epidemiologists conducting tobacco-use surveillance and monitoring, and clinicians treating smoking in their daily practice. This paper discusses smoking cessation from a perspective that is theoretical and practical, describes the importance of both the stages of change model and the different levels of nicotine addiction in the treatment of tobacco use and dependency.     

Initiation to heroin injecting among heroin users in Sydney,Australia: cross sectional survey

Background  

Heroin injection is associated with health and social problems including hepatitis C virus (HCV) transmission. Few studies have examined the circumstances surrounding initiation to heroin injecting, especially current users initiating others. The current study aimed to examine the age of first heroin use and injection; administration route of first heroin use; relationship to initiator; the initiation of others among a group of heroin users; and to examine these factors in relation to HCV status and risk.     

2014年全国医院感染横断面调查报告

目的掌握全国医院感染现患情况,建立医院感染相关指标体系。方法采用横断面调查方法,床旁调查和病历调查相结合,全国医院感染监测网医院及其他自愿参加调查的医院按照统一的调查方案进行调查,调查其医院感染现患情况。结果1 766所医院的资料进入统计,共调查患者1 008 584例,发生医院感染26 972例,医院感染现患率为2.67%,抗菌药物使用率为35.01%。不同床位数医院医院感染现患率、抗菌药物使用率比较,差异均有统计学意义（χ2值分别为1 599.21、3 458.40,均P＜0.01）。医院感染部位主要为下呼吸道（47.53%）、泌尿道（11.56%）和手术部位（10.41%）。共分离病原体13 784株,居前5位的病原体为铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌、金黄色葡萄球菌。Ⅰ类手术患者手术部位感染现患率为1.01%;Ⅰ类切口手术患者预防性抗菌药物使用率为27.99%,不同床位数医院Ⅰ类切口手术患者预防性抗菌药物使用率比较,差异有统计学意义（χ2=400.34,P＜0.01）;治疗使用抗菌药物细菌培养送检率为45.89%,不同床位数医院细菌培养送检率比较,差异有统计学意义（χ2=9 189.90,P＜0.01）。≥900张床位的医院医院感染现患率最高（3.36%）,抗菌药物使用率最低（32.35%）,细菌培养送检率最高（56.03%）。结论此次横断面调查多维度指标显示我国医院感染管理取得显著成效;同时,计算出各指标的百分位数分布,便于各单位进行医院感染相关工作的自我评价。     

General practitioners,revalidation and appraisal: a cross sectional survey of attitudes,beliefs and concerns in Lincolnshire

BACKGROUND: All general practitioners (GPs) are expected to have an appraisal from 2002 and the first cohort will experience revalidation in 2005. Although there is a link between appraisal and revalidation, this has yet to be clarified. OBJECTIVE: To investigate the knowledge, attitudes and beliefs of GPs towards revalidation and appraisal. DESIGN: Cross sectional survey. SETTING: Lincolnshire, UK. PARTICIPANTS: General practitioners. METHOD: In 2000 a self-administered postal questionnaire survey was sent to all 343 GP principals on the list of Lincolnshire Health Authority. The questionnaire consisted of 47 attitudinal statements on appraisal and revalidation. It also included open questions on concerns about appraisal and revalidation and questions on attributes of responders. RESULTS: Of the 343 GPs sent questionnaires, 272 (79%) replied. Lincolnshire GPs had more positive attitudes towards appraisal than towards revalidation. They welcomed appraisal provided that it had local ownership and took into account their views and concerns on the process. Other factors that correlated with a positive attitude towards appraisal included agreement that the purpose of appraisal is educational and that it should result in an agreed development plan. Those who had a positive view of appraisal were more likely to agree set objectives. Previous experience of appraisal either as an appraiser or appraisee was associated with a positive attitude towards appraisal. General practitioners who felt they had more control over the process tended to be more positive. General practitioners who were in favour of appraisal were also more likely to be in favour of revalidation and agree that appraisal formed part of the revalidation process. They were less likely to feel that there was a hidden agenda on the part of government and more likely to agree that revalidation would provide evidence of acceptable care being provided to patients. Time involved and lack of resources were the two main concerns. CONCLUSIONS: A better understanding of knowledge, beliefs and attitudes towards appraisal will ultimately help in setting up a successful appraisal system for GPs. The current emphasis on appraisal as an educational tool will help to foster positive attitudes. The relationship between appraisal and revalidation needs to be clarified. Concerns relating to lack of time and resources for appraisal and revalidation need to be addressed by primary care organisations.     

Smoking cessation and health

This comment questions the conclusion of Jones (1994, 1995) that good health creates an incentive to quit smoking. It is argued that in a cross section, a "stock" of quitters and their present health are observed. Health at the time of cessation is unobserved, and the different time passed since quitting causes an unobserved heterogeneity, masking the true relation between health and smoking cessation. An empirical illustration shows that, at least among the elderly, recent quitters, who provide the most appropriate data on that relation, did so because of poor health.     

Smoking cessation and health: A comment

This comment questions the conclusion of Jones (1994, 1995) that good health creates an incentive to quit smoking. It is argued that in a cross section, a “stock” of quitters and their present health are observed. Health at the time of cessation is unobserved, and the different time passed since quitting causes an unobserved heterogeneity, masking the true relation between health and smoking cessation. An empirical illustration shows that, at least among the elderly, recent quitters, who provide the most appropriate data on that relation, did so because of poor health.     

Smoking cessation and health: A response

Shmueli (1996) highlights the problems raised by the use of measures of current health, and by the omission of past health, in retrospective analysis of cross section data on the prevalence of smoking. In this note the findings in Jones (1994) are augmented by new estimates from the longitudinal follow-up to the Health and Lifestyle Survey (HALS2).     

Formaldehyde vapor in mobile homes: a cross sectional survey of concentrations and irritant effects.

Sixty-five Wisconsin mobile home households volunteered for an assessment of indoor formaldehyde gas. Sixty-one teenage and adult occupants completed health questionnaires. Formaldehyde concentrations ranged from less than 0.10 to 0.80 ppm, with the risk of ocular discomfort showing a positive dose-response relationship.     

天津市戒烟门诊158名就诊吸烟者戒烟状况调查

目的 了解天津市戒烟门诊就诊吸烟者的人群特点、吸烟情况、戒烟情况,为更有效的开展戒烟门诊服务提供科学依据。方法 调查前来三家戒烟门诊就诊的158名吸烟者,并于一个月后进行随访。结果 就诊吸烟者中50%(79/158)是通过医生推荐或转诊至戒烟门诊,47.5%(75/158)决定戒烟的原因是自身患病,59.5%(94/158)的人尝试过戒烟;就诊吸烟者的平均烟龄为19.5年,平均每日吸烟量为16.3支;一个月随访的应答率为86.7%(137/158),一个月随访的时点戒烟率为43.1%(59/137),未戒烟者的一个月时点减烟率为56.4%(44/78);27.0%(37/137)的人认为医生或药物对其戒烟帮助最大。结论 天津市戒烟门诊能提高吸烟者的戒烟率,但目前就诊人数较少,还应继续加大戒烟门诊的宣传力度。     

Primary osteoarthritis and occupations: a national cross sectional survey of 10 412 symptomatic patients

Aims: To describe the age standardised prevalence of symptomatic osteoarthritis (OA) in a nationwide cross sectional survey of 10 412 patients in France, and their functional and work limitations.

Methods: Cases in the survey were compared with their expected counterpart by age, gender, and occupational groupings using data from the 1998 French National Survey on Health Impairment and Disability.

Results: Women represented 66.2% of the sample; mean age was 66.2 years. One third of patients had OA of the knee, 16% of the hip, and 12% of the hand; a third had multiple joint OA. Peak prevalence of symptomatic OA was in the 60–69 year category in women and in the 70–79 year category in men. Agricultural workers showed a significant excess prevalence of OA, with an observed to expected (O/E) ratio of 1.7 in women and 2.3 in men. Linear trends in prevalences between white collar, "mixed" collar, and blue collar workers were also significant, with odds ratios respectively of 1.0, 2.9, and 2.6 in women and 1.0, 1.2, and 1.7 in men. Specific excess prevalence was found in women among housekeepers (O/E 4.4), and in men among unskilled labour workers (O/E 10.3) and truck drivers (O/E 6.7). Total work disability was highest among blue collar workers and partial disability among agricultural workers.

Conclusion: Results contribute to the mounting evidence that OA is potentially aetiologically linked to occupation in a sizeable segment of the population and that OA can no longer be considered an inevitable disease of ageing.

     

Awareness and analysis of a significant event by general practitioners: a cross sectional survey

Objectives: To determine the extent to which general practitioners (GPs) were aware of a recent significant event and whether a structured analysis of this event was undertaken to minimise the perceived risk of recurrence.

Design: Cross sectional survey using a postal questionnaire.

Setting: Greater Glasgow primary care trust.

Participants: 466 principals in general practice from 188 surgeries.

Main outcome measures: GPs' self-reported personal and practice characteristics, awareness of a recent significant event, participation in the structured analysis of the identified significant event, perceived chance of recurrence, forums for discussing and analysing significant events, and levels of primary care team involvement.

Results: Four hundred and sixty six GPs (76%) responded to the survey. GPs from single handed practices were less likely to respond than those in multi-partner training and non-training practices. 401 (86%) reported being aware of a recent significant event; lack of awareness was clearly associated with GPs from non-training practices. 219 (55%) had performed all the necessary stages of a structured analysis (as determined by the authors) of the significant event. GPs from training practices were more likely to report participation in the structured analysis of the recent event, to perceive the chance of this event recurring as "nil" or "very low", and to report significant event discussions taking place.

Conclusions: Most GPs were aware of a recent significant event and participated in the structured analysis of this event. The wider primary care team participated in the analysis process where GPs considered this involvement relevant. There is variation in the depth of and approach to significant event analysis within general practice, which may have implications for the application of the technique as part of the NHS quality agenda.

     

食物不耐受流行现状及其相关因素的横断面调查

目的 探讨居民食物不耐受流行情况及相关影响因素.方法 选取2008年8月至2009年6月某综合医院健康医学中心第一次查体进行食物不耐受项目检测的全部健康体检者(12 766人),应用非条件logistic回归模型进行多因素分析.结果 排名前三位的食物不耐受种类分别为鸡蛋、蟹和牛奶,其阳性率分别为28.5%、24.5%和24.5%.食物不耐受发生率随年龄的增加有增高趋势(P＜0.05),女性发生率(67.3%)显著高于男性(56.2%),P＜0.05.食物不耐受不同分级、不同种类与年龄和性别间存在相关关系(P＜0.05),其中食物不耐受不同分级与年龄分组间x2=19.555(P=0.021),与性别间x2=208.406(P=0.000);食物不耐受种类与年龄分组间x2=81.796(P=0.000),与性别间x2=132.068(P=0.000).logistic回归分析结果显示,与≤40岁组比较,41～50岁组、51～60岁组和＞60岁组OR值(95%CI)分别为1.125(1.027～1.233)、1.307(1.176～1.452)和1.536(1.275～1.849);与男性比较,女性OR值(95%CI)为1.602(1.475～1.741).与正常体重者比较,体重过轻者OR值(95%CI)为1.772(1.207～2.602).结论 食物不耐受与年龄、性别和体重指数相关,健康教育应针对其年龄和性别分布特点进行,保持适宜体重水平可以减少食物不耐受发生的风险.

Abstract：

Objective To study the prevalence of food intolerance among attendants in a general hospital and to learn its related determinants in Beijing,China.Methods An cross sectional survey,from August 1st,2008 to June 30th,2009,was carried out,including 12 766 adults from Health Sciences Center,Chinese PLA General Hospital.Data for epidemiological analysis were entered (double entry) into computer and organized by EpiData 3.0.Non-conditional logistic regression model was used for odd ratio (OR) and 95%CI calculation,with statistic analysis through SPSS 13.0.Results The three leading intolerance food items were egg,crab and milk,and the prevalence rates were 28.5%,24.5% and 24.5% respectively.Prevalence of food intolerance increased along with aging.Levels and the kinds of food intolerance were associated with age,sex and appeared a linear correlation tendency (P＜0.05).Prevalence of food intolerance in females (67.3%) was higher than that in males (56.2%).Data from multiple regression analysis showed that,comparing with age group under 40 and 40 years,the OR(95%CI) of age group 41-50,51-60,and above 60 were 1.125(1.027-1.233),1.307(l.176-1.452)and 1.536(1.275-1.849)respectively.Compared to males,the OR (95% CI) of females was 1.602 (1.475-1.741).When compared with normal weights,the OR (95%CI) of people with low weight was 1.772 (1.207-2.602).Conclusion Food intolerance was associated with age,sex and body mass index.Health education should be carried out according to the related characteristics of age and sex.Suggesting that reducing the risk of food intolerance,keeping the suitable weight was necessary.     

Association of sexual problems with social, psychological, and physical problems in men and women: a cross sectional population survey

STUDY OBJECTIVE: To investigate the association of sexual problems with social, physical, and psychological problems. DESIGN: An anonymous postal questionnaire survey. SETTING: Four general practices in England. PARTICIPANTS: 789 men and 979 women responding to a questionnaire sent to a stratified random sample of the adult general population (n = 4000). MAIN RESULTS: Strong physical, social, and psychological associations were found with sexual problems. In men, erectile problems and premature ejaculation were associated with increasing age. Erectile problems were most strongly associated with prostate trouble, with an age adjusted odds ratio of 2.6 (95% confidence intervals 1.4, 4.7), but hypertension and diabetes were also associated. Premature ejaculation was predominantly associated with anxiety (age adjusted odds ratio 3.1 (95% confidence intervals 1.7, 5.6)). In women, the predominant association with arousal, orgasmic, and enjoyment problems was martial difficulties, all with odds ratios greater than five. All female sexual problems were associated with anxiety and depression. Vaginal dryness was found to increase with age, whereas dyspareunia decreased with age. CONCLUSIONS: This study indicates that sexual problems cluster with self reported physical problems in men, and with psychological and social problems in women. This has potentially important consequences for the planning of treatment for sexual problems, and implies that effective therapy could have a broad impact on health in the adult population.