广西农村饮用水与环境卫生现状调查

目的了解广西农村饮用水卫生、改厕和粪便处理以及农村生活垃圾、污水治理等现状,为制定和实施广西农村爱国卫生相关规划和策略提供依据。方法于2006年7—12月,按照《中国农村饮用水与环境卫生现状调查方案》规定的内容和方法进行调查。于2006年丰水期(8月),进行水样的采集、保存、检验和评价。结果本次共调查23个县、241个村、2414户、11393723人。广西农村集中式和分散式供水人口分别占31.66%和68.34%;以地面水、地下水为饮用水源的人口分别占22.22%和77.78%。共采集水样241件,水质合格率为21.58%。以地面水、地下水为水源的水质合格率分别为32.76%和18.03%,集中式和分散式供水水质合格率分别为24.06%和18.52%,国债与非国债项目供水工程水质合格率分别为21.67%和26.04%。除细菌总数(62.24%)和总大肠菌群(29.88%)外,色度等15个指标合格率均在90%以上,其中,总硬度、砷、硫酸盐、臭和味合格率为100%。农村使用卫生厕所户数占43.79%,使用非卫生厕所户数占50.95%,无厕户占5.26%。非卫生厕所粪便无害化处理率仅占13.74%。241个村月产...     

四川省农村改水改厕对腹泻病影响的效果研究

目的了解四川省农村改水改厕对控制腹泻病发病的效果,为腹泻病的预治提供科学依据。方法于2006年12月—2007年3、6、9月的15—30日,对四川省罗江县和丹陵县的12个行政村(每个县抽取3个乡镇,每个乡镇抽取2个行政村)改水、改厕情况和腹泻病发病情况进行调查和分析。结果抽查的1659户的供水方式均以分散式供水为主,占92.65%,集中式供水水源以地下水为主,占83.6%。卫生厕所仅有716户,占43.16%,厕所类型以沼气池厕所为主,占96.79%,非卫生厕所中以不渗漏旱厕为主,占92.79%。磨子村、龙滩村、石河村和梅湾村为改水改厕村,余家庵和明慧村为改厕未改水村,韩坝村、雄义村和田坝村为改水未改厕村,明月村、五营村和三堰村为未改水改厕村。4次共调查了20551人,有192人发生腹泻,年发病率为0.93%。改水改厕村、改水或改厕村、未改水改厕村腹泻病发病率分别为0.70%(48/6872),0.91%(77/8506)和1.30%(67/5173),3者间比较,差异有统计学意义(χ2=11.486,P<0.01)。改水村与未改水村的腹泻病发病率[0.87%(104/12000)和1.03%(88/8551...     

Non-remission of depression in the general population as assessed by the HAMD-7 scale

Remission from the symptoms of depression is the optimal outcome for depression treatment. Many studies have assessed the frequency of treatment, but there are none that have estimated the frequency of treated remission in the general population. We addressed this issue in the population of Alberta using a brief Hamilton Depression Rating Scale (HAMD)-7 scale (recently validated against the HAMD-17 scale in a clinical setting) that has been proposed as a suitable indicator for remission in primary care. We used data from a survey conducted within the Alberta Depression Initiative in 2005 (n=3,345 adults), to produce a population-based estimate of the number of respondents taking antidepressant medication for depression. From this group we selected a subpopulation that did not screen positive when the MINI module for major depression was administered (i.e., who did not have an active episode). Non-remission in this subpopulation was assessed with a version of the HAMD-7 scale adapted for telephone administration by a nonclinician. Of the survey respondents, 189 reported taking antidepressant medication for depression. Of these, 115 were found not to have an active episode. However, 49.0% of this subpopulation was not in remission as evaluated by the HAMD-7. We estimate that 1.3% (95% confidence interval, 0.9-2.0%) of the population is in treated non-remission for depression. Our study indicates a substantial degree of non-remission from depression in individuals taking antidepressants in the general population. This suggests that, in addition to increasing the frequency of treatment, increasing the effectiveness of treatment can have an impact on population health.     

The Japanese Centenarian Study: autonomy was associated with health practices as well as physical status

OBJECTIVES: To investigate the prevalence of centenarians who have preserved activities of daily living (ADLs) and good cognitive and psychosocial status in Japan. DESIGN: Census-based survey. SETTING: Cross-Sectional Investigation of Half of All Japanese Centenarians Study, 2000. PARTICIPANTS: A nationwide census-based study was conducted of all of the male centenarians and a random sample of half of all the female centenarians who were included in the National Census of Japan. After excluding those who had died and whose addresses could not be identified, 1,907 centenarians (53.0%) participated in the present visitation interview survey. MEASUREMENTS: ADLs, cognitive status, and psychosocial status. Centenarians who have preserved ADLs and good cognitive and psychosocial status were defined as autonomous centenarians. RESULTS: Of the study subjects, 10.4% were judged to be autonomous centenarians. Multiple logistic regression analyses revealed that autonomy in centenarians was associated with better visual acuity, getting regular exercise, spontaneous awakening regularly in the morning, preserved masticatory ability, having no history of drinking, having no history of severe falls after the age of 95, more frequent intake of protein, living at home, and being male. It was also demonstrated that autonomous centenarians were not associated with appetite, vegetable or seaweed intake, smoking habits, auditory capacity, body mass index, or present illness. CONCLUSION: These findings suggest that health practices play an important role in preserving ADLs and good cognitive and psychosocial status after reaching the age of 100 and should be useful for establishing an educational program for the ever-increasing "super elderly" population in Japan.     

National adoption of sentinel node biopsy for breast cancer: lessons learned from the Canadian experience

Sentinel lymph node biopsy (SLNB) in breast cancer has not been readily adopted into Canadian surgical practice in comparison with the United States. We sought to evaluate current national practice patterns and explore barriers to direct efforts to improve the adoption of SLNB in Canada. All active (n = 1413) general surgeons in Canada were surveyed by mail. Surgeon demographics, practice patterns, skill acquisition and attitudes towards SLNB were assessed. The response rate was 63% (n = 889). Of the 506 (57%) surgeons who treated breast cancer, half were community based with breast surgery comprising <25% of their practices. Most (70%) performed 相似文献   

Does the Italian pediatric anesthesia training program adequately prepare residents for future clinical practice? What should be done?

BACKGROUND: Pediatric anesthesia should be considered a subspecialty addressing the complete pediatric population (from preterm to teenager) and requiring particular anatomical, pathophysiological, pharmacological and anesthesiological knowledge. A survey was conducted to evaluate the training in pediatric anesthesia performed by Medical Schools of Anesthesia in Italy and to assess if the European Federation of Associations of Pediatric Anesthesia (FEAPA) guidelines for training in pediatric anesthesia had been adopted. METHODS: The survey was addressed to the Directors of the Departments of Anesthesia and Intensive Care of the Medical Schools throughout Italy using a questionnaire. RESULTS: We contacted all 37 Schools of Anesthesia, but only 26 of these (70 %) answered all the questions. A specific training program exists in 24 (92%). The duration of the training is variable: in 40% of the schools it lasts 2 months, in 27% 3 months and in 33% more than 3 months (3-6 months). Only 29% of the Schools required a minimum number of procedures to be performed during the training period. A final test is performed in 46% of the Schools. A dedicated staff for pediatric anesthesia exists in 70% of the Italian Schools. CONCLUSIONS: In Italy, the FEAPA guidelines have not yet been completely adopted. The experience of a dedicated unit for pediatric anesthesia will be invaluable to define operative guidelines, courses and to establish the minimum equipment necessary for pediatric management in nonspecialist hospitals.     

Factors associated with use of psychotherapy

CONTEXT: Psychotherapies are recommended in manuals of good practice. There is however little epidemiological data assessing access to this type of treatment, and in particular the combined role of the offer and socio-demographic characteristics. The present research aims to contribute data on the profiles of a sample of individuals who underwent psychotherapy in France, and on the respective impact of various factors such as mental health status, socio-demographic characteristics, life events and the care offer, focusing on a specific population for whom the mode of financial cover for this type of care is governed by a complementary health insurance (MGEN). METHODS: Between June 1999 and March 2000 a survey using a self-administered questionnaire was conducted on a sample of MGEN-insured individuals. Ten thousand individuals aged between 20 and 60 were selected randomly, received a questionnaire, and up to three recalls in case of non-response. The overall response rate was 66.5%. The questionnaire comprised 261 questions enabling data collection concerning the main socio-demographic, professional and mental health variables. RESULTS: In this population aged from 20 to 60, lifetime prevalence of recourse to psychotherapy was 11.8%. The main factor associated with use of psychotherapy is the severity of the clinical condition (assessed in terms of comorbidity). Certain traumatic events experienced in childhood are also related. The effect of socio-demographic variables varies according to severity, although it was noted that being female, having high educational status, and being single were consistently related to wider use of psychotherapy. The analysis also evidenced the importance of the density of the care offer. CONCLUSION: Our results suggest that the use of psychotherapy, within a well-informed population with high quality insurance cover, is related primarily to clinical condition rather than to socio-demographic status, especially in people with high levels of comorbidity, although the effect of educational status remains. However, this study only looked at mere use of psychotherapy, without determining the suitability of the treatment provided. It is indeed possible, and even probable, that variables such as educational status, income, or care offer may have a link with resorting to the right type of care, in terms of both relevance and adequate duration.     

Status inconsistency and common mental disorders in the Israel-based world mental health survey

Objective  Research on status inconsistency (SI) and its impact on mental health has been dormant for many years. This study tested the association between SI and emotional distress, anxiety and mood disorders. Methods  Data were gathered from the Israel-based component of the World Mental Health Survey (n = 4,859). SI was defined by the combination of high education (13+ years) with low income (1st decile). Mood and anxiety disorders were diagnosed with the composite international diagnostic instrument (CIDI), and emotional distress was measured with the 12-item general health questionnaire (GHQ-12). Results  Multivariate analysis showed increased risk for mood or anxiety disorders among SI subjects (n = 231), odds ratio (OR) = 1.75, 95% confidence interval (95% CI) 1.13–2.63. The estimate was slightly attenuated when marital status was added to the model (OR = 1.55, 95% CI 1.0–2.39). SI subjects showed higher GHQ-12 scores. Conclusion  SI, which can disrupt an individual’s sense of coherence, is associated, although not causally, with increased 12 month prevalence rates for mood or anxiety disorders and with higher psychological distress.