青岛市市南区高血压高危人群生活方式相关危险因素现况调查

[目的]了解青岛市市南区高血压高危人群生活方式危险因素分布现状,为进一步制定社区高血压高危人群干预措施提供科学依据。[方法]采取多中心调查的方法,对35岁以上社区居民进行高血压高危人群筛查,并对筛查出的人群进行问卷调查。[结果]青岛市市南区高血压高危人群危险因素发生率男性从高到低依次为腹型肥胖(77.3%)、超重或肥胖(74.0%)、缺乏体育锻炼(51.0%)、饮酒(45.4%)、吸烟(40.7%)、口味偏咸(30.4%)、以荤食为主(28.4%);女性依次为腹型肥胖(65.6%)、超重或肥胖(65.2%)、缺乏体育锻炼(53.1%)、口味偏咸(21.7%)、以荤食为主(8.8%)、饮酒(5.1%)、吸烟(0.3%)。除缺乏体育锻炼以外,男性各危险因素发生率均高于女性(P0.05)。[结论]青岛市市南区高血压高危人群危险因素以腹型肥胖、超重或肥胖和缺乏体育锻炼为主,建议社区卫生服务中心应该从控制体重、加强锻炼和低盐饮食方面制定干预措施。     

中国居民慢性非传染性疾病现状及危险因素

目前慢性病及相关危险因素呈快速上升趋势,对人民健康和社会经济发展带来严重影响。慢性病发生主要与行为危险因素是吸烟、不合理膳食、过量饮酒、超重或肥胖、缺少体育锻炼等相关。不同人群其危险因素不同,应当个体化采取干预措施,预防慢性病的主要行为干预措施是戒烟、限酒、低盐饮食和适当的运动。     

上海市南汇区35～69岁农村居民高血压患病及相关危险因素分布现况研究

[目的]了解南汇区35～69岁农村居民高血压患病现状及相关危险因素的分布情况,为政府制定农村高血压防治策略提供科学依据。[方法]采用分阶段整群随机抽样的方法,抽取年龄在35～69岁的农村居民707人,研究内容包括饮酒、吸烟等行为危险因素的问卷调查以及测量身高、体重、血压、腰围等。[结果]农村居民高血压患病率为27.86%,男女性高血压患病率差异无统计学意义(P﹥0.05),高血压患病率随年龄增高而上升的趋势(P﹤0.001);高血压知晓率和服药率分别为33.5%和25.7%。农村居民肥胖、腹部肥胖、规律锻炼、饮酒、精神压力、高油膳食、高盐膳食所占比例分别为9.40%、35.54%、70.68%、18.95%、10.33%、51.90%和54.60%。[结论]高血压已成为影响35～69岁农村居民身体健康的重要公共卫生问题,其主要的危险因素如肥胖、高油膳食、高盐膳食、饮酒等在南汇区农村居民中广泛分布;应建立以政府为领导,多部门和社区广泛参与的高血压防治体系,加强危险行为因素干预工作,以遏制农村高血压流行的快速增长趋势。     

新乡铁路地区职工血压水平及其影响因素研究

[目的]探索影响铁路职工血压水平的主要危险因素。[方法]以Korotkoff音确定血压值并进行问卷调查。[结果]血压随年龄增大而升高(P﹤0.05);父母均有高压史的职工,其男性收缩压和女性舒张压高于父母均无高压史者(P﹤0.05);超重和肥胖者,其收缩压和舒张压均高于正常体重者(P﹤0.01);平均每日饮酒量大于150g者,其收缩压和舒张压高于不饮酒者(P﹤0.05);每日吸烟量与血压之间无明显规律,但吸烟年限长者,其收缩压和舒张压高于不吸烟者(P﹤0.05)。[结论]年龄,高血压家族史,肥胖和超重,饮酒和吸烟可能是引起血压水平升高的主要危险因素。     

某儿科医院职工健康危险评估及比较

[目的]调查某儿科医院职工与几种慢性病发生有关的危险因素,进行健康危险度评估,以采取相应措施,提高健康水平.[方法]职工填写“健康生活方式综合评估问卷”,利用健康危险度软件进行分析,计算每一职工发生几种慢性病的危险分数,并比较不同职别之间差异.[结果]35.71%的人被动吸烟;59.82%从不参加体育锻炼.因体育锻炼、超重、家族性高血压病史、食用油炸或腌制食品、少食蔬菜、摄盐过多等导致的危险分数均高于该因素在一般人群的危险分数;胃癌的危险分数在不同职别间差异有统计学意义.[结论]应根据不同类型危险因素的特点和各疾病的危险分数,对相关人群采取相应的健康促进手段.     

社区持续性复合式粗杂粮干预对慢性病的作用

[目的]评价复合式粗杂粮干预对控制社区慢性病的效果,为防治慢性病提供新措施。[方法]把筛查出的超重/肥胖、高血压、血脂异常、高血糖人群,分为复合式粗杂粮干预组与对照组,干预组给予粗杂粮干预、健康教育和定期体检,对照组只给予健康教育,干预时间为1年。[结果]干预组超重/肥胖、高血压、血脂异常、高血糖的患病率比对照组显著下降,自身比较也明显下降(P﹤0.01或﹤0.05)。[结论]社区持续性复合式粗杂粮干预是降低慢性病的有效方法。     

健康教育和膳食干预对高血压社区综合防治的效果分析

目的探索健康教育和膳食干预在社区综合防治高血压的效果。方法在深圳市南山区大冲社区中,由社区卫生健康服务中心工作人员按照《深圳市高血压、糖尿病社区综合防治项目手册》,分别对450名非高血压人群、高血压高危人群及高血压患者进行综合健康教育,比较干预前、后社区居民高血压相关知识知晓率、高血压危险因素及高血压患者血压控制情况。结果调查居民在干预前后高血压相关知识知晓率差异均有统计学意义(P0.05)。99例高血压高危人群干预前、后摄入高脂饮食和少运动的检出率间差异均有统计学意义(P0.05),而高盐饮食、过量饮酒、肥胖和吸烟检出率差异无统计学意义(P0.05),110例高血压患者干预前、后血压控制情况差异有统计学意义(P0.05)。结论以《深圳市高血压、糖尿病社区综合防治项目手册》为依据,通过社区卫生健康促进网络,对居民进行高血压社区综合防治是可行的、有效的。     

东湖区高血压社区管理效果评估研究

[目的]探讨社区综合干预措施对血压认知和行为改变以及高血压控制的影响。[方法]对东湖区565名社区高血压患者进行综合干预,比较干预前后血压控制、血压、知晓率及行为的改变率。[结果]综合干预措施后,高血压知晓率明显提高,规律服药人数增加(P﹤0.001),血压平均水平明显下降(P﹤0.01),高血压控制率显著提高,由18.23%到48.85%(P﹤0.01),有不良行为和危险因素如过量饮食、缺乏体力活动体重指数和盐摄入量的患者比例下降(P﹤0.01)。[结论]在社区实施高血压综合干预防治,对高血压患者的血压控制是一种比较有效的管理模式。     

高校教职工慢性病现患研究及干预措施探讨

[目的]了解高校教职工慢性病患病情况及影响因素,为采取干预措施提供科学依据. [方法]对该高校的教职工进行健康体检,并对结果进行统计分析. [结果]超重及肥胖患病率38.68%,高脂血症患病率37.98%,脂肪肝患病率17.54%,高血压患病率14.99%,糖尿病患病率4.31%,均随年龄增长而有增高趋势,男性高于女性,差异有统计学意义(P＜0.05-0.01).超重及肥胖人群高脂血症、脂肪肝、高血压、糖尿病的患病率均高于体质量正常人群.差异有统计学意义(P＜0.01).教师人群高血压的患病率高于普通人群,差异有统计学意义(P＜0.01),而普通人群在超重及肥胖、高脂血症、脂肪肝患病率高于教师人群,差异有统计学意义(P＜0.01). [结论]高校教职工慢性病患病率较高,应采取多种干预措施,有效控制和降低慢性病的患病率. 17.54%,高血压患病率14.99%,糖尿病患病率4.31%,均随年龄增长而有增高趋势,男性高于女性,差异有统计学意义(P＜0.05～0.01).超重及肥胖人群高脂血症、脂肪肝、高血压、糖尿病的患病率均高于体质量正常人群.差异有统计学意义(P＜0.01).教师人群高血压的患病率高于普通人群, 异有统计学意义(P＜0.01),而普通人群在超重及肥胖、高脂血症、脂肪肝患病率高于教师人群,差异有统计学意义(P＜0.01). [结论]高校教职工慢性病患病率较高,应采取多种干预措施,有效控制和降低慢性病的患病率. 17.54%,高血压患病率     

成都地区非酒精性脂肪肝患病率及危险因素分析

[目的]探讨健康体检人群中非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)的患病率以及其危险因素,为非酒精性脂肪性肝病防治提供依据。[方法]以参与健康体检的3079例人群为研究对象,收集相关体检资料进行统计学分析。[结果]非酒精性脂肪性肝病总检出率为12.18%,男性患病率明显高于女性,且有明显的年龄差异(P﹤0.001);NAFLD组体重指数、血压、空腹血糖、肝功、血脂和低密度脂蛋白水平均高于对照组,高密度脂蛋白低于对照组;除冠心病外,NAFLD组吸烟、肥胖、高血压、高血糖、高脂血症和胆结石的患病率均高于对照组;多因素非条件Logistic回归分析示高血压、高低密度脂蛋白、高甘油三酯、血糖异常、男性和肥胖是NAFLD的独立危险因子,且其相对危险度依次升高,以血糖异常、男性和肥胖最高。[结论]NAFLD的发生与肥胖、男性和高脂血症密切相关,且非酒精性脂肪性肝病患者的高血压、高血糖、胆结石的患病率也高于健康人,须重视防治非酒精性脂肪性肝病。     

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.