Burns in young children: a retrospective matched cohort study of health and developmental outcomes

Background Unintentional injuries are a major cause of death and disability in childhood. Most burns are unintentional, the majority occurring in pre‐school children. Little is known about the outcomes of young children following burns. The purpose of this study was to examine the presenting features of burned children and compare their health and developmental outcomes with controls. Methods Children under 3 years admitted to the Welsh Regional Burns Centre between September 1994 and August 1997 were studied up to their sixth birthday (final data collection 2003) to ascertain the nature, course and cause of their burn. One hundred and forty‐five burned children were matched with 145 controls. Their physical, psychosocial and educational health status was compared. Retrospective data were gathered from hospital notes, social services, emergency department databases, child health surveillance records and schools. Results Burns peaked at age 13–18 months were typically sustained by scalding, drink spillage and contact with hot objects. They occurred most frequently at mealtimes and 89.7% were judged to be unintentional. There was a high rate of non‐attendance for follow‐up – 24%. The families of children admitted with burns were more likely to have moved home than those of controls (P = 0.001). By age 6 significantly more cases were admitted to hospital with an unrelated condition (P = 0.018). There were no differences between the cases and controls in immunization status, development, school attendance and educational progress up to the age of 6 years (P > 0.05). Conclusions We found important findings in relation to unintentional injury prevention and also noted markers that may indicate inequalities in health service utilization between cases and controls. There were no major differences between developmental and educational outcomes in the two groups.     

An historical prospective study of mortality within a cohort of gas distribution workers

An historical prospective study of mortality within a cohort of 1,410 gas distribution workers was conducted. This cohort was followed for ten years (1971-1980) and data on 118 deaths were obtained. Five-year (1973-1977) averages of both St. Louis and United States age-specific mortality figures were used to create "expected" mortality rates for comparison with the observed deaths in the cohort. Analyses of the cohort were done according to: 1) person-years contributed during the study period (the "age-attained" method) and 2) the number of years from commencement of work in the company until the end of the study period (1980) or death (the "latency" methods of analysis, Standardized Mortality Ratios (SMRs) were calculated for all causes of death, all malignant neoplasms, and for cardiovascular disease and malignant neoplasms of the respiratory and digestive systems. In no case was the SMR found to be beyond the range of what would be expected in the "standard" populations. While the present study does not contradict the negative findings of the one previous investigation of mortality of gas distribution workers, the limitations of small cohort size, reliance on death certificates and non-industrial comparison populations make any conclusions at best provisional.     

Housing tenure as a focus for reducing inequalities in the home safety environment: evidence from Growing Up in New Zealand

Objectives: To determine whether specific demographic characteristics are associated with the presence or absence of household safety strategies. Methods : This study was conducted within Growing Up in New Zealand, a contemporary longitudinal study of New Zealand (NZ) children. Multivariable analyses were used to examine the maternal (self‐prioritised ethnicity, education, age, self‐reported health) and household (area‐level deprivation, tenure, crowding, residential mobility, dwelling type) determinants of household safety strategies being present in the homes of young children. Results : In comparison to family‐owned homes, privately owned rental homes were less likely (OR=0.78; 95%CI 0.65–0.92), and government‐owned rental homes were more likely (OR=1.74, 95%CI 1.25–2.41) to have eight or more household safety strategies present. Conclusions : Living in a privately owned rental home in NZ exposes children to an environment where there are fewer household safety strategies in place. Implications for public health : Housing tenure provides a clear target focus for improving the household safety environment for NZ children.     

A historical cohort mortality study among shipyard workers in Genoa, Italy

BACKGROUND: A historical cohort mortality study was conducted among 3984 shipyard workers assigned to ship repair, refitting, and construction in the harbor of Genoa, Italy, between 1960 and 1981. These workers were exposed to asbestos fibers, welding fumes and gases, silica dust, polycyclic aromatic hydrocarbons, and solvents. METHODS: Workers were classified in 20 different job-titles depending upon the type of activity. Standardized mortality ratios (SMRs) were computed using male residents of the Province of Genoa as the referent population. RESULTS AND CONCLUSIONS: For the whole cohort significantly increased SMRs were detected for all causes, all cancers, liver, larynx, lung, pleural and bladder cancers, respiratory tract diseases, and cirrhosis of the liver. The analysis by job-title showed increased SMRs not only for pleural cancer, but also for lung, laryngeal cancers and respiratory tract diseases in occupations entailing heavy asbestos exposure. Bladder and liver cancers and liver cirrhosis mortality also appeared to be related to occupational exposure.     

An engineer's perspective of the intervention research workshop

As an engineer practicing in the area of engineering controls for the reduction of occupational exposures to hazardous agents, the Intervention Research Workshop studies appeared to be effective for the studied situations, yet the models may not be applicable across a wide range of intervention possibilities. A more generic model might be more appropriate, perhaps a business model. Dr. W. Edwards Deming has proposed a model for the production of goods and services. If we can view interventions as products which need to be sold to potential customers, perhaps this type of model would be more effective across a wide range of intervention strategies. © 1996 Wiley-Liss, Inc.

1 This article is a US Government work and, as such, is in the public domain in the United States of America.

     

Overweight and obesity in Irish primary schools: retrospective cohort study

BACKGROUND: This retrospective cohort study investigates the feasibility of using established methods and routinely generated data from the statutory primary school health-screening programme to estimate prevalence rates for childhood overweight and obesity in children from a rural area in the Republic of Ireland (ROI). METHOD: Paper-based records in the primary school health service for County Leitrim and parts of County Cavan in north-west of ROI were hand searched to identify children attending senior infant classes during academic year 2001/2002. Electronic calculation of body mass index (BMI) and age at examination was carried out. Application of age- and sex-specific cut-off points from International Obesity Task Force (IOTF) and United Kingdom (UK) standard definitions for childhood overweight and obesity was used to determine age- and sex-specific prevalence rates for childhood overweight and obesity. RESULTS: The eligible cohort was almost completely identified and consisted of 361 children. Weight and height measurements were available on 328 (91%) children aged between 4.22 and 7.92 years. IOTF standard application gave prevalence rates of 25% for obesity and overweight in boys and 26% in girls. With the UK growth standard, this increased to 34% in boys and reduced to 23% in girls. CONCLUSION: It is feasible to generate prevalence rates for childhood overweight and obesity from data routinely obtained through the statutory school health-screening programme in ROI. This study suggests levels of childhood overweight and obesity comparable to other Western societies. Further research on developing a universally accepted standard definition of childhood overweight and obesity is required.     

河南省林州市食管癌发病率、死亡率与饮用水污染和改水的关系

林州市1964年通过红旗渠引浊漳河水，全市79％的居民饮用渠水，随着渠水水量减少和污染，80年代开始分批大规模改水改厕，为了检验改水降低食管癌发病率、死亡率效果，进行了改水前后对比研究。     

职业健康监护评价与死亡相关的队列研究

目的 探讨广州市职业健康监护评价结果与死亡的相关性。方法 利用１９８９～１９９２年广州市实施职业健康监护（ＯＨＳ）系统中建立的３９９家工厂中≥３５岁的７８７８５名职工的个体健康档案为基础资料,皖前瞻性队列研究方法,随访至１９９８年１２月３１日,了解队列中职工的生存状态和死亡情况,并进行χ＾２检验和Ｃｏｘ模型分析。结果 （１）队列中７８７８５名职工随访８年,共６２７６３５人年（男性３８９２４０人年）,总死亡人数为１５２５人,总死亡率为２４０．０／１０万人年（男３３０．４／１０万人年、女１００．３／１０万人年）。（２）队列中男女职工有职业接触史者分别为４６．１％和３４．４％,建档时有吸烟史男女职工分别占７０．３％和１．５％。（３）无论男性或女性,总死亡率与ＯＨＳ评价结果均有明显相关,调整年龄、文化程度、吸烟与职业接     

噪声作业所致工人职业性听力损失风险回顾性队列研究

目的 探讨噪声接触时间和噪声强度对噪声作业工人听力损失的风险程度。方法 采用回顾性队列研究分析广东省中山市1411名噪声作业工人连续3年纯音气导听阈和噪声监测数据。结果 1411名中山市噪声作业工人2012-2014年双耳高频听阈存在时间主效应和噪声强度主效应(P<0.05)。噪声作业工人2012、2013、2014年的双耳高频听阈分别为(30.88±7.21)、(30.57±6.91)、(30.37±7.21)dBHL,2013年与2012年相比,噪声作业工人双耳高频听阈升高(P<0.05),2014年与2013年相比,双耳高频听阈无差异(P>0.05);不同噪声强度双耳高频听阈不同(P<0.05),≥88 dB(A)噪声强度的工人双耳高频听阈最高,2012-2014年分别为(32.83±9.45)、(32.20±9.11)、(32.22±9.52)(dBHL)。结论 噪声接触时间和噪声强度与噪声接触工人双耳高频听阈损失存在剂量-反应关系。     

Anorexia nervosa in young men: A cohort study

OBJECTIVE: The current study investigates the background and outcome of anorexia nervosa (AN) in young men. METHOD: All (N = 61) men, born in 1968-1977 with hospital care in Sweden between 1987 and 1992 due to AN, were compared with the general population. Information about socioeconomic background, health-related outcome (hospital care for AN, other psychiatric diagnoses, abuse of alcohol/drugs and/or suicide attempt), and social outcome (major income from sick leave/sick pension or > or = 6 months social welfare, living with birth parents, and living with child and partner; education level) was taken from national registers. RESULTS: On a group level, the findings suggest some differences between male patients with AN and the male population without AN concerning social background, capacity to support oneself, and living with partner and child. Mental ill-health outcome was almost the same for men with AN as for the general population. CONCLUSION: Male gender in AN--on a group level--suggests a good psychiatric prognosis.     

Personal status of general health checkups and medical expenditure: A large-scale community-based retrospective cohort study

Background

We sought to clarify the association between the personal utilization of general health checkups (GHCs) and medical expenditures (MEs) in a middle-aged Japanese population.

Probiotics: immunomodulation and evaluation of safety and efficacy

The intake of probiotics has been associated with beneficial effects on the immune system, such as improved disease resistance and diminished risk of allergies. This review gives an overview of the immunomodulatory effects of probiotics investigated with in vitro assays, experimental animal models, and clinical trials, and explores possible mechanisms underlying the immunomodulatory effects. Immunomodulation, however, is not always beneficial and might induce detrimental effects; therefore, a scheme is proposed for benefit-risk assessment of immunomodulation by probiotics. Within this scheme, expert judgment based on data derived from a panel of in vitro assays, animal models, and clinical trials should lead to conclusions on efficacy and safety aspects of probiotics.     

Challenges in comparing the methods and findings of cohort studies of oral health: the Dunedin (New Zealand) and Pelotas (Brazil) studies

Objective: to systematically compare methods and some findings from two prospective cohort studies of oral health. Methods : This paper describes and compares two such population‐based birth cohort studies of younger adults: the Dunedin Multidisciplinary Health and Development Study (conducted in New Zealand); and the 1982 Pelotas Birth Cohort Study (conducted in Brazil). Results: The two cohorts showed socio‐demographic similarities and differences, with their gender mixes being similar, but their ethnic compositions differing markedly. There were some important similarities and differences in methods. Overall dental caries experience was higher among the Dunedin cohort. Each of the studies has examined the association between childhood‐adulthood changes in socio‐economic status and oral health in the mid‐20s. Both studies observed the greatest disease experience among those who were of low SES in both childhood and adulthood, and the least among those who were of high SES in both childhood and adulthood. In each cohort, disease experience in the upwardly mobile and downwardly mobile groups lay between those two extremes. Conclusions and implications: There are important similarities and differences in both methods and findings. While the need for a degree of methodological convergence in future is noted, the two studies are able to use each other as replicate samples for research into chronic oral conditions.     

胃癌前病变转归影响因素回顾性队列研究

目的研究胃癌前病变的转归情况及其影响因素,为胃癌前病变或胃癌的预防提供基础资料。方法采用回顾性队列研究方法对江苏省溧阳市2004年前经病理确诊为胃癌前病变的患者进行随访,通过胃镜检查、病理诊断及问卷调查获取病理结局及相关影响因素。结果122 例胃癌前病变患者有41 例转归为非胃癌前病变,转归率为33.61%;Cox回归模型分析显示,在调整年龄、性别、职业、吸烟、饮茶、饮酒等因素后,与不采取治疗措施的对象比较,采取治疗措施对象发生转归的RR值为3.24(95%CI=1.22~8.57),常规服药对象发生转归的RR值为3.92(95%CI=1.45~10.64),西药治疗对象发生转归的RR值为2.84(95%CI=1.08~7.46),中药治疗对象发生转归的为RR值为5.13(95%CI=1.22~21.74)。结论采取治疗措施和常规服药是促使胃癌前病变患者发生良性转归的重要因素。     

大学生膳食中铅摄入量及食用安全性评价

目的了解辽宁省锦州市在校大学生膳食中铅污染状况及食用安全性,为合理膳食提供依据。方法采用双份饭法收集489名大学生连续3 d食物,经湿法消化后,用石墨炉原子吸收光谱法测定12类膳食中铅的含量,并估算其每天实际摄入量,与世界卫生组织(WHO)/联合国粮农组织(FAO) 食品添加剂联合专家委员会(JECFA)推荐的暂定每周可耐受摄入量(PTWI)相比较,评价大学生膳食中铅摄入量的安全性。结果在12类膳食中铅平均含量较高的是蛋类、蔬菜类、水产类,分别为0.321、0.116和0.097 mg/kg;大学生膳食中铅的主要摄入来源为蔬菜、蛋类和谷类,分别占每日总铅摄入量的39.12%、17.58%和16.29%;铅摄入量的平均值、中位数值和P_97.5值均低于PTWI值,但P_97.5极端值超过了PTWI值1.39倍。结论大学生膳食中铅的摄入量相对安全,但存在铅摄入量较高的个体,并且大量摄入含铅量较高的食物仍存在潜在危害,因此有必要降低高铅食物摄入量。