2018年中国老年居民蔬菜和水果摄入状况及影响因素研究

目的 了解中国≥60岁居民蔬菜和水果摄入现况及影响因素，为老年人均衡营养膳食的宣传教育提供参考。方法 数据来源于2018年中国慢性病及危险因素监测，在全国31个省(自治区、直辖市)的298个县(区)，采用分层多阶段整群随机抽样方法抽取≥18岁常住居民194 749人。问卷收集人口统计学等信息，采用食物频率表采集调查对象过去12个月内新鲜蔬菜和水果摄入频次和摄入量等信息，该研究将其中完成调查的≥60岁且蔬菜和水果摄入相关信息完整的69 246人作为研究对象。采用SAS 9.4软件进行基于复杂抽样的方差分析、logistic回归、Rao-Scottχ²检验，并采用多因素logistic回归进行影响因素分析。结果 2018年中国≥60岁居民蔬菜摄入量为361.5 g/d(95%CI:351.1～371.9 g/d)，水果摄入量为74.8 g/d(95%CI:69.0～80.6 g/d)；蔬菜摄入量未达推荐量的比例为41.0%(95%CI:39.0%～43.0%)，水果摄入量未达推荐量的比例为87.0%(95%CI:85.6%～88.5%)。多因素logistic回归分析...     

2010年中国老年人业余锻炼及静态行为调查

目的了解中国≥60岁老年人业余锻炼及静态行为。方法采用多阶段分层随机抽样方法在全国疾病监测点系统及新疆生产建没兵团农二师,利用包含全球身体活动问卷(GPAQ)的调查问卷,通过面对面调查收集≥18岁成年人慢性非传染性疾病(慢病)相关危险因素及业余时间中、高强度休闲性身体活动的频率和持续时间等身体活动信息。本研究利用其中15193名>60岁调鱼对象的信息,对老年人业余锻炼及静态行为进行分析。对样本进行复杂加权后,计算从不锻炼率、每周参与至少3 d且每天至少30 min中等强度或相当量活动比例(经常锻炼率)和每周参与至少5 d且每天至少30 min中等强度或相当量活动比例(积极锻炼率)以及总静态行为时间等指标。结果中国≥60岁老年人从不锻炼率为85.4%(95%CI：83.5%～87.3%),经常锻炼率为12.o%(95%CI：10.o%～1 3.1%),积极锻炼率为9.9%(95%CI：8.5%~11.3%)。其中城市人群经常锻炼率(23.8%,95%ci：20.7%.26.9%)和积极锻炼率(20.5%,95%ci：17.9%一23.1%)均明显高于农村。随教育水平、家庭经济收入增加,老年人经常锻炼率和积极锻炼率均上升,各组间差异有统计学意义。老年入平均每日总静态行为时间为42(95%Cl：4.1～4.4)h,平均每日看电视时间为105.1(95%CI：100.6~109.6)min。城市地区、教育水平及家庭经济收入均较高的老年人,每日总静态行为和电视时间均更长.差异有统计学意义。结论中国老年人业余时间参与锻炼的水平较低,尤其是农村地区老年人的锻炼情况更值得关注。     

2010-2018年中国成年居民健康体检率变化趋势及影响因素分析

目的了解2010-2018年中国成年居民健康体检现状及变化趋势, 探讨健康体检率的主要影响因素, 为制定健康干预政策提供数据支持和理论依据。方法利用2010、2013、2015和2018年中国慢性病及危险因素监测横断面调查数据, 对数据进行复杂加权后, 分析中国成年居民健康体检率、变化趋势及健康体检原因构成比, 采用年均变化百分比(AAPC)描述变化趋势。以Anderson模型为分析框架, 采用多因素logistic回归模型分析健康体检率的影响因素。结果 2010-2018年中国成年居民健康体检率从28.2%(95%CI:24.8%～31.6%)上升至41.0%(95%CI:38.9%～43.1%, 趋势P<0.001), AAPC为5.47%, 文化程度较低、人均年收入较低、农村和西部地区的居民年均增长幅度较大。2018年居民参与健康体检的原因以社区免费提供(36.7%)和单位免费提供(28.5%)为主。多因素分析结果显示, 女性、年龄≥45岁、初中及以上文化程度、城市、参加医疗保险、人均年收入≥24 000元、患慢性病数≥1个、不吸烟、饮酒、身体活动充足人群的健康体检率较高。...     

浙江省15～69岁居民不同慢性病患病状况下的健康素养水平及其影响因素分析

目的分析浙江省15～69岁居民不同慢性病患病状况下的健康素养水平及其影响因素。方法本研究为横断面研究, 采用分层多阶段整群随机抽样方法, 于2022年6—11月在浙江省30个监测点抽取19 200名15～69岁常住居民, 使用《全国居民健康素养监测调查问卷》展开入户问卷调查。调查内容包括社会人口学特征、健康相关因素及健康素养水平等。共发放问卷19 200份, 收回问卷19 051份, 其中有效问卷18 857份(98.98%)。采用χ2检验比较居民不同慢性病患病状况下的健康素养水平, 采用logistic回归分析其影响因素。结果 2022年浙江省15～69岁居民健康素养具备率为38.36%, 其中多重慢性病患者的健康素养具备率显著低于单一慢性病患者及未患慢性病者(14.70%比25.37%、42.21%)(χ2=483.05, P<0.001)。患有多重慢性病与健康素养不足呈正相关(OR=1.26, 95%CI:1.01～1.58), 多重慢性病患者在基本知识和理念(OR=1.29, 95%CI:1.03～1.63)、健康生活方式与行为(OR=1.24, 95%CI:1.01～1...     

中国中老年居民高血压、糖尿病和血脂异常共病现状及影响因素研究

目的分析我国中老年居民高血压、糖尿病及血脂异常(三高)的共病现状及影响因素, 为"三高共管"提供数据支撑。方法利用2018年中国慢性病及危险因素监测收集的相关信息, 以134 950名≥45岁的常住居民作为研究对象。对样本进行复杂加权后, 分析不同特征居民三高患病及共病状况;采用多因素logistic回归模型探讨三高共病的影响因素。结果我国中老年居民高血压、糖尿病和血脂异常的患病率分别为46.0%(95%CI:45.1%～47.0%)、19.5%(95%CI:18.7%～20.2%)、43.3%(95%CI:42.3%～44.4%);高血压和糖尿病、高血压和血脂异常、糖尿病和血脂异常的共病率分别为12.3%(95%CI:11.7%～12.8%)、22.8%(95%CI:22.1%～23.4%)、11.6%(95%CI:11.1%～12.0%);三高共病率为7.6%(95%CI:7.2%～8.0%)。这些共病率均随年龄、BMI的增长呈上升趋势, 城市高于农村, 东北及华北地区较高(P<0.05)。高血压、糖尿病和高TC血症的共病率为1.9%(95%CI:1.7%～2.1%), 高血...     

基于“生命八要素”评分的中国成年居民心血管健康状况分析

目的以"生命八要素"评分法评估我国成年居民心血管健康状况, 为制定和完善心脑血管疾病防控政策和措施提供参考。方法 2015年中国成人慢性病与营养监测在全国31个省(自治区、直辖市)298个监测县(区), 采用多阶段分层整群随机抽样方法, 在每个行政村/居委会抽取45户, 并从中选取20户, 对所有户中居民进行膳食调查。本研究将完成膳食调查、年龄≥20岁且相关信息完整的70 093人作为研究对象, 采用美国心脏协会2022版心血管健康评分标准—"生命八要素"评估我国成年居民心血管健康状况。所有结果采用基于设计的复杂抽样加权调整。结果 2015年我国≥20岁居民心血管健康得分为73.3±12.6, 女性(77.9±11.6)显著高于男性(68.7±11.8), 城市(74.5±12.8)高于农村(71.9±12.2), 组间差异均有统计学意义(P<0.001)。我国有0.25%(95%CI:0.16%～0.33%)成年居民的心血管健康评分为100分, 较高、中等和较低心血管健康评分的居民分别占33.0%(95%CI:31.6%～34.3%)、63.2%(95%CI:62.1%～64....     

郑州市中老年居民超重和肥胖流行特征及影响因素分析

目的了解郑州市中老年居民超重和肥胖流行特征及影响因素,为制定肥胖防制策略和措施提供依据。方法于2018年采用多阶段分层抽样方法抽取郑州市40～79岁常住居民作为调查对象,采用自行设计的调查问卷对基本信息和主要行为危险因素进行调查,并进行身高和体重测量。结果共调查中老年居民4 079人,超重1 772例,超重率为43.44%;肥胖852例,肥胖率为20.89%;超重和肥胖共计2 624例,超重和肥胖率为64.33%。多因素Logistic回归分析结果显示,男性(OR=1.253,95%CI:1.079～1.456)、饮酒(OR=1.411,95%CI:1.186～1.679)是中老年居民超重和肥胖的危险因素;高中及以上文化程度(OR=0.835,95%CI:0.713～0.978)、经常锻炼(OR=0.754,95%CI:0.627～0.907)是中老年居民超重和肥胖的保护因素。结论郑州市中老年居民超重和(或)肥胖处于较高水平,主要与性别、文化程度、是否饮酒及是否经常锻炼有关。     

河北省成年居民慢性病流行特征及其相关因素分析

目的了解河北省成年居民慢性病及相关危险因素的流行水平。方法采用多阶段随机抽样,通过问卷、体格测量及血样检测等方法,调查分析河北20个区(县)4200名成人慢性病及相关危险因素与流行水平。结果人群超重率、肥胖率、向心性肥胖率、高血压患病率、血脂异常率、糖尿病患病率分别为35.19%,16.38%,52.98%,38.50%,39.62%,5.81%;标化率分别为30.28%,14.05%,44.32%,27.86%,32.71%,4.00%。以上几种慢性病患病率随年龄增长而升高,55岁以下组男性高于女性,55岁以上组女性高于男性,城市高于农村。河北省男性吸烟率、饮酒率高于女性(P<0.01)。居民参加体育锻炼率为22.86%。多因素Logistic回归分析显示,超重是向心性肥胖、高血压、血脂异常和糖尿病的危险因素(OR值和95%CI分别为10.69,6.62～17.26;1.95,1.58～2.40;1.38,1.13～1.69;1.72,1.05～2.81);高血压是超重、向心性肥胖、血脂异常的危险因素(OR值和95%CI分别为1.99,1.60～2.46;1.60,1.33～1.92;1.57,1.35～1.82);血脂异常是超重、向心性肥胖、高血压和糖尿病的危险因素(OR值和95%CI分别为1.40,1.14～1.72;1.56,1.31～1.86;1.58,1.36～1.83;1.66,1.22～2.26)。结论河北省成人慢性病患病率处于全国较高水平,防治处于较低水平。超重、向心性肥胖、高血压、血脂异常是河北省成年居民应重点防治的慢性病,中老年人群是慢性病防治的重点。     

云南省40岁及以上居民肺功能检查率及影响因素分析

目的了解云南省≥40岁居民肺功能检查率及影响因素,为云南省制定、完善及评价慢性呼吸系统疾病的政策及干预措施提供基础数据,同时也为全国其他省份横向比较提供参考依据。方法于2015年8月至2016年2月,采用多阶段分层随机抽样的方法,在云南省5个慢性阻塞性肺疾病(COPD)监测点抽取3 000名≥40岁常住居民进行调查,通过面对面询问调查的方式获取调查对象的基本信息、个人疾病史、危险因素、肺功能检查情况等。应用SPSS 22.0软件,采用复杂抽样加权统计方法对居民肺功能检查率进行χ2检验,肺功能检查情况的影响因素采用多因素logistic回归分析。结果云南省≥40岁居民肺功能检查率为1.8%(95%CI:1.2%～2.6%)。多因素logistic回归分析结果显示,不知晓呼吸道疾病者(OR=0.415,95%CI:0.199～0.864),目前不存在呼吸道症状者(OR=0.472,95%CI:0.246～0.906),无呼吸系统疾病史者(OR=0.452,95%CI:0.214～0.954)肺功能检查率较低,均有统计学意义(P0.05)。结论云南省≥40岁居民肺功能检查率较低,绝大多数的居民未接受过肺功能检查,是云南省慢性病防控当中突出的问题,应通过多种途径、采取有效措施提高肺功能检查率。     

云南省40岁及以上居民慢性阻塞性肺疾病流行情况及影响因素分析

目的 了解云南省40岁及以上居民的慢性阻塞性肺疾病（COPD）患病情况及影响因素。方法 2014 - 2016年,采取多阶段分层整群随机抽样的方法,在云南省5个监测点抽取40岁及以上常住居民3 000名进行调查,通过问卷、体测和肺功能检测获取调查对象的基本信息、个人及家族史、危险因素、COPD患病情况等,分析调查对象COPD的患病率及相关影响因素。结果 共获取有效样本3 000例,云南省40岁及以上居民COPD患病率为11.3%,其中男性患病率为16.7%,女性为5.1%;40～49岁、50～59岁、60～69岁、70岁及以上居民的患病率分别为4.4%、10.6%、19.1%、34.3%。多因素Logistic回归分析结果显示,女性患病风险较低（OR = 0.276, OR95%CI = 0.203～0.375）,而年龄较大（OR = 2.017, OR95%CI = 1.755～2.320）、有呼吸系统疾病家族史（OR = 1.760, OR95%CI = 1.292～2.397）是居民罹患COPD的危险因素。结论 云南省40岁及以上居民的COPD患病率高于全国平均水平,男性、年龄较大及有呼吸系统疾病家族史是患病的危险因素。     

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.