鞍山市城市居民情感、焦虑、酒精使用障碍流行病学调查

目的 了解鞍山市18～65岁居民情感、焦虑、酒精使用障碍患病率和分布特点.方法 采用多阶段分层整群随机抽样方法,以美国<精神障碍诊断与统计手册第三版修正版)(DSM Ⅲ-R)为诊断标准,以复合性国际诊断交谈检查量表(CIDI1.0)对鞍山市1 955名18～65岁城市居民进行入户调查.结果 调查的应答率为81.49%.三类精神障碍总的2周、12个月和终生标化患病率分别为4.95%,7.36%和10.54%.情感障碍、焦虑障碍和酒精使用障碍的终生患病率分别为2.60%,2.25%和3.10%,终生患病率居前3位的依次是场所恐怖(2.70%)、重性抑郁(2.64%)和酒精依赖(2.35%).男性焦虑障碍患病率低于女性(OR=0.591,95%CI:0.392～0.893),酒精使用障碍患病率高于女性(0R=23.395,95%CI:8.516-64.270).结论 情感、焦虑、酒精使用障碍等精神疾病已成为鞍山市重大公共卫生问题,亟待解决.     

辽宁省城市地区≥40岁居民脑卒中患病现状及其相关危险因素分析

目的分析城市≥40岁居民脑卒中患病特征及其相关危险因素,为制定综合有效的脑卒中防控策略提供参考依据。方法于2018年3月—2019年2月对辽宁省辽阳市弓长岭区和刘二堡以及丹东市振安区5 424例≥40岁的常驻居民进行问卷调查、体格检查和实验室检查,采集脑卒中患病特征及其相关危险因素资料。结果辽宁省城市≥40岁居民脑卒中患病人数为292例,脑卒中患病粗率为5.4%,男性高于女性(7.2%vs 4.4%,P 0.001)。脑卒中标化患病率为3.8%,男性和女性分别为4.8%和3.4%。多因素logistic回归分析结果显示,男性(OR=2.25,95%CI=1.75～2.97)、超重或肥胖(OR=1.35,95%CI=1.03～1.77)、缺乏锻炼(OR=1.86,95%CI=1.31～12.65)、高血压(OR=2.84,95%CI=2.08～3.89)、糖尿病(OR=1.93,95%CI=1.49～2.50)、脑卒中家族史(OR=2.13,95%CI=1.64～2.78)等是脑卒中患病的主要危险因素。结论辽宁省城市地区≥40岁居民脑卒中患病率较高,疾病负担较重,亟待开展积极有效的脑卒中相关危险因素综合干预。     

呼伦贝尔蒙古族地区居民高血压及相关危险因素

目的 调查呼伦贝尔蒙古族地区居民高血压患病率与相关影响因素.方法 采用多阶段抽样方法,按性别、年龄分层,抽取呼伦贝尔市新右旗阿镇18岁以上居民453人进行问卷调查,测量血压、身高、体重、腰围,并计算体质指数,统计分析高血压患病率与相关危险因素.结果 被调查人群高血压患病率为34.5%,标化率为45.4%,其中男性为48.9%,女性为25.4%,男性高血压患病率高于女性(P<0.05);超重肥胖者的高血压患病率高于非超重肥胖者(P<0.001);腹型肥胖者高血压患病率高于腰围正常者(P<0.001);饮酒者高血压患病率高于非饮酒者(P<0.01).非条件Logistic回归分析表明,体质指数(OR=2.255,95%CI:1.180～4.311)、性别(OR=2.788,95%CI:1.461～5.323)、饮酒(OR=2.306,95%CI:1.287～4.134)和年龄大于50岁(OR=11.312,95%CI:4.309～22.132)是高血压的危险因素.结论 呼伦贝尔蒙古族地区高血压标准化患病率较高,高龄、超重与肥胖、男性和饮酒为高血压的主要危险因素.政府和卫生部门应针对危险因素加强健康教育和健康促进,预防和控制高血压.     

辽宁省农村地区出血性卒中患病情况及影响因素分析

目的分析辽宁省农村地区出血性卒中患病率及其相关危险因素,为出血性卒中的防控提供理论依据。方法2017年9月至2018年5月按照分层整群随机抽样方法在辽宁农村地区随机选取4个县(市)19个村庄,对年龄≥40岁的10 926名常住居民进行脑卒中相关危险因素调查,包括问卷调查、体格检查(身高、体重和血压等)和生化检测。采用SPSS 21.0软件进行χ~2检验、单因素和多因素logistic回归分析。结果出血性卒中粗患病率为1.38%,男性(1.73%)高于女性(1.15%),患病率随年龄增长而升高,有统计学意义(趋势χ~2=25.222,P0.05),标化患病率为0.99%,男性和女性分别为1.27%和0.84%。男性(OR=2.26,95%CI:1.58～3.24)、高血压病史(OR=5.43,95%CI:2.99～9.87)、房颤(OR=2.68,95%CI:1.12～6.43)、脑卒中家族史(OR=1.78,95%CI:1.28～2.48)、缺乏运动(OR=3.18,95%CI:2.24～4.52)和老龄化(50～59岁OR=17.60,95%CI:2.41～128.49;60～69岁OR=15.38,95%CI:2.11～112.00;70～79岁OR=10.23,95%CI:1.37～76.53;≥80岁OR=11.51,95%CI:1.40～94.59)与出血性卒中高风险相关。结论辽宁农村地区40岁以上人群出血性卒中患病率高,亟待通过控制血压、加强锻炼等措施降低和预防出血性卒中的发生。     

辽宁省居民情感、焦虑和酒精使用障碍共病影响因素分析

目的分析辽宁省居民情感障碍、焦虑障碍及酒精使用障碍的共病率及主要危险因素。方法辽宁省居民精神疾病调查以DSM-III-R为诊断标准,共诊断1 214例精神障碍患者,以单纯情感障碍、单纯焦虑障碍和单纯酒精使用障碍患者为对照,采用Logistic回归模型分析情感与焦虑共病、焦虑与情感共病、酒精与情感或焦虑共病的各主要危险因素的OR值及95%CI。结果情感与焦虑障碍是最常见的共病,离异者情感共病焦虑、焦虑共病情感、酒精共病情感或焦虑的危险度增加3～5倍,女性酒精使用障碍共病情感或焦虑障碍的危险性明显高于男性(OR=5.28,95%CI=1.84～15.15),农村居民焦虑共病情感障碍的危险性明显低于城市居民(OR=0.57,95%CI=0.36～0.92)。结论辽宁省居民精神障碍患者中情感障碍、焦虑障碍和酒精使用障碍共病普遍存在,精神疾病共病的预防、诊断和治疗水平亟待提高。     

辽宁省城乡居民精神疾病流行病学调查

目的了解辽宁省18岁以上人群各类精神疾病患病率和分布特点。方法采用多阶段分层整群随机抽样方法，以复合性国际诊断交谈检查量表（CIDI 1．0）对全省6个市／县13358名18～65岁城乡居民进行了入户调查。结果调查的应答率为86．1％。各类精神疾病的2周、12个月和终生患病率分别为5．03％，8．09％和11．26％。情感障碍、焦虑障碍和酒精使用障碍的12月患病率分别为2．01％、3．97％和3．27％。男性情感障碍（OR=0．59，95％0=0．48～0．72）和焦虑障碍（OR=0．46，95％CI=0．39～0．53）患病率明显低于女性，酒精使用障碍显著高于女性（OR=23．67，95％CI=15．71～35．67）。离婚者3类障碍的患病率均明显增高。城市居民的情感障碍患病率显著高于农村（OR=1．54，95％CI=1．21～1．95）。14．60％和1．40％患者一生中曾患有2类或3类疾病，情感障碍与焦虑及酒精使用障碍的终生共病率分别为41．96％和10．87％。结论辽宁省每11个居民中约有1人患有精神疾病，精神疾病已经成为常见病和迫切需要解决的重大公共卫生问题。     

辽宁省城市40岁及以上居民血脂异常流行现况及其危险因素分析

目的了解辽宁省城市≥40岁居民血脂异常的患病、知晓、治疗和控制现况,分析患病危险因素,为血脂异常的精准防控提供理论依据。方法 2018年3月至2019年2月,采用多阶段分层整群随机抽样的方法对辽宁省城市5 424例≥40岁的常住居民进行横断面研究,调查血脂异常流行现况,利用logistic回归分析相关危险因素。结果辽宁省城市≥40岁居民血脂异常的粗患病率为49.53%,男性高于女性(51.64%vs 48.42%,P0.05)。标化患病率为47.86%,男性和女性分别为56.52%、43.49%。50～59岁(OR=1.239)、家庭年收入低(10 000～19 999元,OR=1.366;5 000～9 999元,OR=1.514)、现饮酒(OR=1.174)、高血压(OR=1.349)、糖尿病(OR=1.717)、超重或肥胖(OR=1.527)是血脂异常的危险因素。血脂异常的知晓率、治疗率和控制率分别为14.88%、5.93%和2.20%。结论辽宁省城市≥40岁居民血脂异常患病率较高,但知晓、治疗和控制水平较低,亟待针对主要患病危险因素开展综合防控。     

辽宁省城乡居民社交恐怖症流行病学调查

目的了解辽宁省城乡居民社交恐怖症患病率、分布特点和治疗现状。方法采用多阶段分层整群随机抽样方法,以复合性国际诊断交谈检查量表1.0版(CIDI 1.0)对辽宁省6个市县13 358名18～65岁城乡居民进行面访调查;使用WHO-CIDI 1.0软件进行分析,按精神障碍诊断和分类(DSMⅢ-R)标准分别判定终生、12月和2周患病诊断。结果社交恐怖症的终生、12月和2周调整患病率分别为1.29%,0.81%和0.46%。女性终生患病率高于男性(OR=1.43,95%CI=1.05～1.95);患病率随年龄升高明显升高(P0.01);随学历升高明显降低(P0.01);仅10.6%的患者曾服药治疗。结论社交恐怖症是一种普遍存在的心理疾病,需采取综合措施提高社交恐怖症的认识和诊疗水平。     

神池县城乡居民高血压及其危险因素现况调查

目的 了解山西省神池县城乡居民高血压患病现况及危险因素,为制定相应的干预措施提供科学依据.方法 采取分层整群抽样方法,抽取神池县的4个乡镇,每个乡镇随机抽取2个居委会(村)作为调查点,对每个调查点20～74岁常住居民进行高血压患病现况及相关危险因素问卷调查.结果 共调查2231人,其中男性871人,女性1360人.高血压患病率为28.0%(标化率为23.6%),其中男性为32.0%(标化率为28.5%),女性为25.4%(标化率为20.7%),男女性差别有统计学意义(X2=11.437,P＜0.01).知晓率为49.4%,治疗率为41.6%,控制率为20.8%.经非条件Logistic回归分析,高龄(OR=1.674,95%CI为1.508～1.858)、文化程度低(OR=1.240,95%CI为1.078～1.427)、饮酒(OR=1.474,95%CI为1.082～2.009)、缺少锻炼(OR=1.347,95%CI为1.059～1.714)、不注意饮食控制(OR=1.082,95%CI为1.000～1.171)、有高血压家族史(OR=1.993,95%CI为1.566～2.538)以及肥胖(OR=2.291,95%CI为1.974～2.660)是高血压的危险因素.结论 神池县居民高血压患病率较高,应针对高血压现状及危险因素采取综合性防治措施.     

天津市某社区50岁以上居民高血压患病情况及相关因素

目的 了解50岁以上居民高血压患病情况及相关危险因素,为制定高血压防治策略提供科学依据.方法 采用现况调查的方法,对某社区50岁以上全部居民3 763人进行调查,内容包括人口统计学特征、生活方式、睡眠情况、疾病史及疾病家族史等相关因素以及测量身高、体重、腰围、臀围、血压等.结果 高血压患病率为43%,男性患病率41.2%,女性患病率为44.5%,男女性高血压患病率差别有统计学意义(P＜0.05).单因素Logistic回归分析结果显示,年龄(OR=1.029,95%CI:1.021～1.037)、女性(OR=1.145,95%CI:1.005～1.305)、体质指数(OR=1.118,95%CI:1.097～1.140)、腰围(OR=1.025,95%CI:1.019～1.032)、腰臀比(OR=5.809,95%CI:2.047～16.489)、糖尿病(OR=2.186,95%CI:1.840～2.598)、高脂血症(OR=2.460,95%CI:1.558～3.885)、高血压家族史(OR=2.692,95%C/:2.307～3.142)及睡眠障碍(OR=1.354,95%CI:1.159～1.582)与高血压高危险有关.多因素Logistic回归分析与高血压有关的因素是:高血压家族史(OR=3.253,95%CI:2.611～4.052)、年龄(OR=1.053,95%CI:1.041～1.065)、BMI(OR=1.098,95%CI:1.071～1.126)、糖尿病(OR=2.248,95%C/:1.769～2.858)、高脂血症(OR=2.234,95%CI:1.378～3.623)及睡眠障碍(OR=1.370,95%CI:1.113～1.686).结论 高血压已成为影响50岁以上居民身体健康的重要公共卫生问题,年龄、体质指数、高血压家族史、糖尿病、高脂血症及睡眠障碍与高血压有关.     

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.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

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.