中学生吸烟行为社会心理因素及预测的研究

本文对天津市区３７３４名中学生进行了吸烟行为及其社会心理因素调查，结果显示，中学生吸烟行为主要与下列社会心理因素有显著联系：吸烟者赞同吸烟的情绪作用（ＯＲ＝２．５６）和社交功能（ＯＲ＝２．７３），对吸烟的即时危害了解较多（ＯＲ＝２．８３），心理压力较大（ＯＲ＝１．２４），独立性较强（ＯＲ＝１．４８）。持反烟态度的中学生吸烟的较少（ＯＲ＝０．４２）。对吸烟情绪功能的认识（ＲＲ＝１．７４），对反烟宣传的态度（ＲＲ＝０．７４）对预测中学生吸烟有显著作用。     

吸烟与脑卒中关系的病例对照研究

调查１８８例脑卒中病人及１８８例正常对照的吸烟情况后发现，吸烟与脑卒中有关，其ＯＲ＝２．１３，Ｐ＜０．００１，随着吸烟年限的延长、吸烟量的增加，患脑卒中的危险性也在增加（ＯＲ分别为１．０２、Ｐ＜０．００１和１．２１、Ｐ＜０．ＯＯ１）；开始吸烟年龄越大越容易患病，ＯＲ＝１．０２，Ｐ＜０．０５。被动吸烟也与脑卒中密切相关（ＯＲ＝６．５６，Ｐ＜０．００１）。经高血压病史调整后，吸烟、被动吸烟仍与脑卒中密切相关。通过病例组与对照组血脂分析发现：病例组中吸烟者ＴＣ及ＨＤＬ－Ｃ明显低于非吸烟者；对照组吸烟者与非吸烟者血脂水平无明显差异。     

女性吸烟与脑卒中的病例对照研究

本文采用病例对照的方法分析了１２８例女性脑卒中病例及正常对照组的吸烟情况及血脂水平，结果发现：吸烟者患脑卒中的ＯＲ＝１．８５，被动吸烟的ＯＲ＝４．２５，Ｐ均＜０．０５。而且开始吸烟年龄越大、吸烟量越多、越容易患脑卒中（Ｐ＜０．０５）。经高血压病史调整后，吸烟的作用消失，被动吸烟的作用也减弱了（ＯＲ＝２．７２）；还分析了血清总胆固醇、甘油三酯、高低密度脂蛋白胆固醇与女性脑卒中的关系，未发现有明显差异。     

吸烟者慢性阻塞性肺疾病外环境因素的病例对照研究

目的：提供除吸烟以外的外环境因素与吸烟发生慢性阻塞性肺疾病（ＣＯＰＤ）关系的信息。方法：在北京房山区２３个自然村筛查出１５４例吸烟无慢性呼吸道疾病症状的ＣＯＰＤ患者（ＦＥＶ１／ＦＶＣ＜７０％）,在同年龄（±３岁）、同性别、同居住地吸烟的正常人群中（无慢性呼吸道疾病症状且ＦＥＶ１／ＦＶＣ≥７５％）,按１∶１配对作为对照。其中男性１３７对,女性１７对。问卷包括个人一般情况、居室环境、职业暴露史、吸烟史、饮酒史、过敏史、个人史、家族史。肺功能测定,包括用力肺活量（ＦＶＣ）,第一秒用力肺活量（ＦＥＶ１）及ＦＥＶ１／ＦＶＣ等。结果：病例组与对照组年龄、受教育程度、吸烟量无显著差异。单因素分析：冬季热炉取暖方式（ＯＲ＝１．７５）、厨房没有安装抽油烟机（ＯＲ＝２．０３）及居住土坯房屋类型（ＯＲ＝１．８２）等居室环境与ＣＯＰＤ发生有关联（Ｐ＜０．０５）;接触谷尘（ＯＲ＝１．６３）、化学品（ＯＲ＝１１．７７）等职业暴露;吸烟深吸（ＯＲ＝１．６８）、有无过滤嘴（ＯＲ＝２．５５）、家族慢性支气管炎史（ＯＲ＝１．７４）等与ＣＯＰＤ发生有关联,统计学上有显著性意义。多因素Ｌｏｇｉｓｔｉｃ分析结果表明,接触化学品（ＯＲ＝３．２７）、吸     

云南省陇川县男性青年吸毒危险因素分析

目的　探索边境地区男性青年吸毒的危险因素。方法　断面调查基础上建立回顾性队列,观察期为１９９１ 年１ 月１ 日至１９９４ 年８ 月１ 日。被调查对象人口学和行为方面资料采用匿名方法收集。危险因素的确定采用单因素和多因素分析方法。结果　每年新吸毒者发生率在１９９１ ～１９９３ 年间逐年上升。根据多因素分析,吸毒的危险因素包括：未婚、离婚或分居或丧偶（ Ｏ Ｒ＝ ８ ．９） 、被朋友或他人鼓励尝试毒品（ Ｏ Ｒ＝ ８ ．８） ,吸烟（ Ｏ Ｒ＝ ２ ．４） ,属景颇族（ Ｏ Ｒ＝ １ ．８） 以及１９９１ 年家庭成员中有人吸毒（ Ｏ Ｒ＝ １ ．５） 。至少上学７ 年是吸毒的保护因素（ Ｏ Ｒ＝ ０ ．６） 。几个主要危险因素的人群归因危险度分别是：被朋友或他人鼓励尝试吸毒为７０ ．８ ％ ,吸烟５０ ％ ,属景颇族为２４ ％ 。结论　采取社区干预来改变人们对吸烟及吸毒的看法,可能会大幅度降低新吸毒者发生率。为此,建议尽快开展社区干预项目。     

膀胱癌危险因素交叉配比病例对照研究

对１１２例膀胱癌病例进行与非肿瘤对照和胃癌对照交叉配比病例对照研究，结果相对于胃癌、膀胱癌的特异危险因素为危险职业作业史（ＯＲ＝２．０７）、泌尿道病史（ＯＲ＝２．８３）、憋尿（ＯＲ＝２．８７）、常服解热镇痛药（ＯＲ＝２．６７）；较特异危险因素为吸烟（ＯＲ＝２．７５）和食用糖精（≥１５次／年，ＯＲ＝４．００）；一般因素为精神创伤（ＯＲ＝２．１１）。遗传易感性似乎不明显。     

女怀非吸烟者中被动吸烟与肺癌关系的探讨

为了探索非吸烟中肺癌发病原因，采用病例对照的方法对北京市ＳＩＮＯ＿ＭＯＮＩＣＡ则人群中的肺癌病例进行了调查，分析结果显示动吸吸烟与非吸烟女性患肺癌有一定的阳性关联（ＯＲ＝２．５２，Ｐ〈０．０５），并随被动吸烟年支的增中而上升，当达２００年支以上时有显统计学意义（Ｐ〈０．０５）。环境香烟烟雾（ＥＴＳ）诱发肺腺癌的可能性较大（ＯＲ＝２．３２，Ｐ〈０．０５），而与肺鳞似无关系（ＯＲ＝１．０４，Ｐ〈０     

生活,饮食等因素与消化性溃疡患病危险的病例—对照研究

对消化性溃疡（ＰＵ）患病危险因素的配比研究结果表明，单因素分析筛选出ＰＵ家族史、慢性萎缩性胃炎（ＣＡＧ）家族史、进餐无定时，晚睡前饮食、偏咸口味、吸烟、Ａ型性格、偏硬饮食８个变量与ＰＵ有显著性联系，其中吸烟与ＰＵ患病危险呈剂量反应关系。同时将筛选出的８个变量引入Ｌｏｇｉｓｔｉｃ回归模型分析，提示５个变量为ＰＵ患病的主要危险因素：ＰＵ家族史（ＯＲ＝５．５５）、进餐无定时（ＯＲ＝２．５９７）、偏咸口味（ＯＲ＝１．８５）、睡前饮食（ＯＲ＝１．６６）、吸烟（ＯＲ＝１．３６）。     

女性非吸烟者中被动吸烟与肺癌关系的探讨

为了探索非吸烟者中肺癌发病原因，采用病例对照的方法对北京市ＳＩＮＯ－ＭＯＮＩＣＡ项目监测人群中的肺癌病例进行了调查，分析结果显示被动吸烟与非吸烟女性患肺癌有一定阳性关联（ＯＲ＝２．５２，Ｐ＜０．０５），并随被动吸烟年支的增加而上升，当达２００年支以上时有显著统计学意义（Ｐ＜０．０５）。环境香烟烟雾（ＥＴＳ）诱发肺腺癌的可能性较大（ＯＲ＝２．３２，Ｐ＜０．０５），而与肺鳞癌似无关系（ＯＲ＝１．０４，Ｐ＜０．０５）。     

鞍钢工人的肿瘤危险度——肺癌病例-对照研究

对鞍钢男工中６１０例肺癌新发病例及９５９例对照进行了访问调查。经吸烟、其他肺疾患、家族肿瘤史、食用水果等非职业因素调整后，岗位工龄等于或超过１５年的下列工人的肺癌危险度显著增高：冶炼工和轧钢工（ＱＲ＝１．５，９５％ＣＩ＝１．１～２．２），耐火砖厂工（ＯＲ＝２．９，９５％ＣＩ＝１．４～５．９），装卸工（ＯＲ＝２．５，９５％ＣＩ＝１．０～６．１），焦炉工（ＯＲ＝３．４，９５％ＣＩ＝１．４～８．５）。各种粉尘和Ｂ［ａ］Ｐ暴露与肺癌危险性呈显著的剂量－反应关系，但与粉尘的特殊成分未见此种关联。长期暴露于污染物的钢铁工人的肺癌的危险度增加４０％。     

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.