Overweight and all-cause mortality in a Swedish rural population: Skaraborg Hypertension and Diabetes Project

AIMS: To explore the prevalence of overweight in men and women in a Swedish rural community and to examine its associations with all-cause mortality. METHODS: A community-based cohort study. A total of 1,109 men and women aged >or= 40 years participated in a survey of cardiovascular disease (CVD) risk factors in the city of Skara in Skaraborg, Sweden, in 1993-94. Overweight was defined as a BMI >or=25.0 kg m(-2). Vital status was ascertained to 31 December 1999 and sex-specific associations between overweight and mortality were explored. RESULTS: The prevalence of overweight according to the WHO's criteria exceeded 50% in men and 35% in women. In men there was an inverse association between BMI and mortality. Men in the lowest quartile of BMI experienced the highest mortality with 44.1 deaths per 1,000 person-years. The hazard ratio (HR) in the highest quartile was 0.6 (95% CI 0.4-0.9). In women there were no significant differences in mortality between quartiles of BMI. In both men and women with previous CVD the mortality rates decreased with quartiles of increasing BMI. The inverse association between BMI and mortality was confined to elderly men with a history of CVD. CONCLUSION: In both sexes the association between BMI and mortality differed across subgroups of age and of a history of previous CVD. No indication of overweight being negative for longevity was found in this population. Higher age and a history of previous CVD contribute to the excess mortality seen in subjects with low BMI.     

SQA鳌合盐的急性毒性和致突变性研究

目的 检测稀土壳糖胺(SQA)鳌合盐的急性毒性和致突变性。方法 采用霍恩氏法进行急性经口毒性试验，采用小鼠骨髓嗜多染红细胞微核试验、小鼠精子畸形试验和Ames试验对受试物进行致突变性研究。结果 SQA鳌合盐的经口LD50＞10000mg／kg体重；小鼠骨髓嗜多染红细胞微核试验显示无诱发微核作用，小鼠精子畸形试验未见精于畸形率增高，Ames试验在加和不加S9条件下均无致突变性。结论 SQA鳌合盐属实际无毒级物质，在该实验条件下，无致突变作用。     

Major dietary patterns and risk of renal cell carcinoma in a prospective cohort of Swedish women

Links between specific foods and the risk of renal cell carcinoma (RCC) are not well established. Dietary patterns may be a better predictor of RCC risk. Our aim was to identify and examine major dietary patterns and their relation to the risk of RCC in a large prospective cohort study of Swedish women. Complete dietary information was available from a FFQ from 46,572 women aged 40-76 y at baseline. We conducted factor analysis to identify dietary patterns. Cox proportional hazard models were used to estimate rate ratios (RRs) and 95% CIs. During a mean of 14.3 y of follow-up, we identified 93 cases of RCC. We observed 3 major dietary patterns in the cohort: Healthy (vegetables, tomato, fish, fruits, poultry, whole grains), Western (sweets, processed meat, refined grains, margarine/butter, high-fat dairy products, fried potato, soft drinks, meat) and Drinker (wine, hard liquor, beer, snacks) pattern. Higher Healthy pattern scores were not significantly associated with decreased risk of RCC (highest vs. lowest tertile RR = 0.81; 95% CI 0.45-1.48 and RR = 0.54; 95% CI 0.27-1.10 among women < or = 65 y). There was a suggestion of an inverse association between the Drinker pattern and RCC risk (RR comparing the 2nd and 3rd with the first tertile, 0.56; 95% CI, 0.34-0.95; and 0.72; 95% CI, 0.42-1.22, respectively, P = 0.08 by Wald test); the association was clearer among women < or = 65 y (P = 0.02 by Wald test). Our data suggest an inverse association between Drinker pattern and the risk of RCC.     

藏族初中生心理健康状况与应对方式的关系研究

目的 了解应对方式对藏族初中生心理健康状况的影响。方法 采用自编的一般资料,中学生心理健康评定量表、简易应对方式问卷对786名藏族初中生进行问卷调查。结果 分层回归分析显示,第一层人口变量中上学方式、年级、家庭人均月收入、是否留守、学习成绩进入藏族初中生心理健康状况的回归方程(F=8.526,P=0.000),控制人口变量后,应对方式能独立解释心理健康状况21.70%的方差变异。结论 住校、初一、留守、学习成绩差、家庭收入低的藏族初中生心理健康状况差;管理者加强应对技巧的培训,能改善藏族初中生的心理健康状况。     

石油沥青对职业人群健康影响的调查

目的调查长期接触石油沥青对职业人群健康的影响，为制订职业卫生标准提供职业流行病学调查资料。方法对防水材料生产企业和石油沥青暴露人群进行作业场所劳动卫生学和职业流行病学调查。结果对石油沥青暴露组394人，对照组237人调查结果表明，暴露组失眠、胸闷、鼻干等症状出现率高于对照组，其他检查显示，暴露组肺纹理增强、支气管炎出现率虽高于对照组，但无统计学意义。结论作业场所石油沥青烟浓度为0．69—10．46mg／m^3的情况下，石油沥青对职业人群健康没有产生明显的损害作用，也没有发现特异性损害。     

拉萨S0S儿童村家庭膳食的调查与评价

[目的]了解中国拉萨SOS儿童村儿童的膳食结构及营养状况,并根据膳食调查结果和存在的问题,提出合理膳食建议。[方法]2005年12月采用食物称重法,对中国拉萨SOS儿童村负责供养168名4～16岁儿童的17户家庭进行了为期5 d的膳食调查。[结果]17户家庭中绝大部分家庭膳食模式不尽合理,油脂摄入过多,大部分家庭脂肪供热百分比﹥30%;动物性食品摄入量及品种偏少,致使所有家庭的钙摄入量普遍不足,70%左右家庭的核黄素、40%左右家庭的蛋白质摄入量不足;多数家庭维生素A和铁虽然超出供给量标准,但是来源于动物性食品的比例很低。[结论]膳食模式的不合理性,势必影响儿童的正常发育和身心健康。因此,进一步加强营养知识的传授显得极为迫切和必要。     

Differences in adherence and motivation to HIV therapy—two independent assessments in 1998 and 2002

Objective The aim of this study was to compare the level of adherence and motivation in two independent cross-sectional samples of HIV-infected patients conducted in 1998 and 2002, and to investigate the relationship between adherence and motivation.Method Consecutive HIV-infected patients on treatment at a Swedish clinic were asked to complete an anonymous questionnaire. In 1998, 60 patients participated and in 2002, 53 participated. In 2002, the 9-item Morisky Medication Adherence Scale (MMAS) was added to the questionnaire set.Main outcome measure Self-reported adherence and motivation.Results In 1998, 28.1% of the respondents were considered adherent, while the corresponding proportion was 57.4% in 2002 (P = 0.002). The mean summary score for MMAS was 10.7 in 2002 (13 = perfect adherence). The proportion considered motivated were 22.4% in the 1998 survey and 41.3% in 2002 (P = 0.038). Of the respondents considered motivated in the 2002 survey, 46.7% scored the maximum summary score on the MMAS, while 8.7% of the non-motivated respondents did so (P = 0.016).Conclusion The respondents in 2002 were more adherent and motivated than the respondents in 1998 and a relationship between motivation and adherence was found. The difference in adherence and motivation might be due to a new treatment model at the clinic.     

咪唑斯汀治疗慢性荨麻疹临床疗效评价及对血清IL-4水平的影响

目的：评价咪唑斯汀治疗慢性荨麻疹的疗效，探讨IL-4在慢性荨麻疹发病中的作用。方法：对32例慢性荨麻疹患用咪唑斯汀治疗，评价疗效，记录不良反应。同时用ELISA法检测慢性荨麻疹患治疗前后及正常人血清IL-4的水平。结果：治疗1、2wk后总有效率分别为62．5％、84．4％(P＜0．01)，不良反应3例。治疗前血清IL-4水平较正常人明显升高(P＜0．01)；治疗后IL-4水平下降(P＜0．01)，与正常人比较差异不甚明显(P＞0．05)。结论：咪唑斯汀是一种有效、安全的治疗慢性荨麻疹的药物，能降低慢性荨麻疹患血清IL-4的水平。     

Discontinuation of Anticytomegalovirus Therapy in Patients With HIV Infection and Cytomegalovirus Retinitis

Context  Persons with cytomegalovirus (CMV) retinitis and acquired immunodeficiency syndrome (AIDS) have required lifelong anti-CMV therapy to prevent the progression of retinal disease and subsequent loss of vision. Objective  To determine whether patients who were taking highly active antiretroviral therapy (HAART) and who had stable CMV retinitis could safely discontinue anti-CMV therapy without reactivation of their retinitis or increase in human immunodeficiency virus (HIV) viral load. Design  Prospective nonrandomized interventional trial performed from July 1997 to August 1999. Setting  Clinical Center of the National Institutes of Health, Bethesda, Md. Patients  Fourteen patients with stable CMV retinitis and HIV infection and CD4⁺ cell counts higher than 0.15 x 10⁹/L and being treated with systemic anti-CMV medications and HAART. Interventions  Discontinuation of specific anti-CMV therapy. Main Outcome Measures  Reactivation of CMV retinitis, development of extraocular CMV infection, detection of CMV in blood and urine, HIV burden, immunologic function, quality of life, morbidity, and mortality. Results  Twelve (89.7%) of 14 patients had evidence of immune recovery uveitis before anti-CMV drugs were discontinued. No patient had reactivation of CMV retinitis or development of extraocular CMV disease during mean follow-up of 16.4 months (range, 8.3-22.0 months) without anti-CMV therapy. Human immunodeficiency viral load remained stable following cessation of anti-CMV medications. Blood and urine assays for CMV were briefly positive in 9 patients but did not predict reactivation of CMV disease. Worsening immune recovery uveitis was associated with a substantial (>3 lines) vision loss in 3 patients. Conclusions  Maintenance anti-CMV medications were safely stopped in those patients who had stable CMV retinitis and elevated CD4⁺ cell counts and who were taking HAART. The study demonstrates that immune recovery following potent antiretroviral therapy is effective in controlling a major opportunistic infection, even in patients with a history of severe immunosuppression.      

A categorization scheme for assessing pharmacy students' levels of reflection during internships

Objective

To test the reliability, feasibility, and responsiveness of a categorization scheme for assessing pharmacy students'' levels of reflection during internships.

Methods

Pharmacy interns at Uppsala University were asked to write a reflective essay about patient counseling at the start and end of their internships. A modified version of Kember''s categorization scheme for assessing the level of reflection was used to evaluate these essays.

Results

Based on their essay scores, the students'' levels of reflection increased during the internship course (p < 0.001) The mean time for categorization was 3 minutes per essay. The interrater reliability of the 182 essays was κ = 0.63.

Conclusions

The evaluation of the categorization scheme showed that it has good interrater reliability, feasibility, and responsiveness. This scheme might be useful in pharmacy practice educational settings, but needs further validation.