Randomized controlled community trial of the efficacy of a multicomponent stage-matched intervention to increase sun protection among beachgoers

BACKGROUND: Skin cancer is about as common as all other cancers combined and is preventable by sun protection. The most intense sun exposures often occur on the beach, so we chose this setting to test an intervention to affect sun protection behaviors. METHODS: We developed a multicomponent stage-matched intervention for beachgoers and evaluated its efficacy in a randomized trial for influencing stage of change and self-reported behavior. RESULTS: We randomized 2,324 persons ages 16 to 65 on the beach (83% of those approached). The intervention was effective in increasing self-reported sun protective behaviors. Effects were similar across gender and age groups. CONCLUSIONS; The beach is a good site for recruitment and intervention to prevent skin cancer in high-risk populations. Our stage-matched intervention package was effective for increasing sun protective behaviors.     

The prevalence of major depression or dysthymia among aged Medicare Fee-for-Service beneficiaries

RESEARCH OBJECTIVE: Estimates of the prevalence of major depression vary widely. Current estimates range from 2 to 14 % depending upon the definition and procedure for diagnosis. Further, most estimates are for special populations, either living in selected geographic areas or receiving specific types of medical care. A national survey of Medicare Fee-for-Service (FFS) beneficiaries provides an opportunity to assess the current level of major depression or dysthymia among a diverse population of older Americans. STUDY DESIGN: The Health Outcomes Survey (HOS) was administered to a national random sample of 1,000 Medicare FFS beneficiaries. We used the Mental Component Summary (MCS) measure of the SF-36 to estimate the prevalence of major depression or dysthymia. Logistic regression was used to examine associated factors. RESULTS: The response rate was 61.7%. Using an MCS score of 42 or lower, prevalence of major depression or dysthymia was estimated to be 25% for respondents age 65 years and older. Logistic regression analysis revealed that the likelihood of major depression or dysthymia was associated with years of education (Odds Ratio (OR) = 0.87), difficulties performing activities of daily living (OR = 1.72), and Medicaid enrollment (OR = 2.67). CONCLUSIONS: The results revealed that one-quarter of the respondents reported mental health problems consistent with major depression or dysthymia. This is higher than previously reported. Like previous studies, years of education, physical impairment, and poverty are strong predictors of major depression or dysthymia. The high rate of major depression or dysthymia implies there may be considerable unmet need among elderly Medicare FFS beneficiaries for diagnosing and treating mental illness.     

广东省汕尾市区健康成人血清尿酸浓度检测分析

目的分析汕尾市区健康成人血清尿酸浓度与年龄、性别之间的关系,建立血清尿酸参考值范围。方法采用尿酸酶-过氧化物酶偶联法对789例健康成人血标本进行检测。结果血尿酸浓度男性为(341±70)μmol/L,女性为(282±61)μmol/L,已接近欧美国家水平。同年龄段男女相比较,差异均有统计学意义(P<0.001)。结论血清尿酸浓度男女之间差异有统计学意义,各年龄段也有差别,建议各地实验室建立自己的血清尿酸参考值范围,以便能够更好诊断引起尿酸浓度改变的各种疾病。     

Meeting the Need for State-Level Estimates of Health Insurance Coverage: Use of State and Federal Survey Data

Objective. Critically review estimates of health insurance coverage available from different sources, including the federal government, state survey initiatives, and foundation-sponsored surveys for use in state policy research.
Study Setting and Design. We review the surveys in an attempt to flesh out the current weaknesses of survey data for state policy uses. The main data sources assessed in this analysis are federal government surveys (such as the Current Population Survey's Annual Social and Economic Supplement, and the National Health Interview Survey), foundation-supported surveys (National Survey of America's Families, and the Community Tracking Survey), and state-sponsored surveys.
Principal Findings. Despite information on estimates of health insurance coverage from six federal surveys, states find the data lacking for state policy purposes. We document the need for state representative data on the uninsured and the recent history of state data collection efforts spurred in part by the Health Resources Services Administration State Planning Grant program. We assess the state estimates of uninsurance from the Current Population Survey and make recommendations for a new consolidated federal survey with better state representative data.
Conclusions. We think there are several options to consider for coordinating a federal and state data collection strategy to inform state and national policy on coverage and access.     

北京市房山区中小学校食堂建设与学生营养教育调查

目的 了解北京市中小学校食堂现状及其在学生营养健康教育中所起的作用，为加强学校食堂建设和学生营养健康教育提供科学依据。方法 采用随机抽样的方法，对房山区9所中小学校食堂及366名在校就餐的学生进行膳食及营养教育相关情况的问卷调查。结果 食堂硬件设备较好，但饮食服务人员文化程度较低，初中及以下文化程度者占86．0％，极少接受营养知识培训。在食堂就餐的学生较多，但食堂几乎从未结合学生饮食开展过任何形式的营养健康宣教。学生营养知识普遍欠缺，并且通过学校获得营养相关知识的机会少，只占18．0％；83．3％的学生希望食堂能够增加饮食营养宣传和指导服务。结论 学校食堂建设应与学生营养健康教育相结合。     

Spermatogenesis after unilateral orchiectomy for testicular cancer in patients following surveillance policy

PURPOSE: Only limited information is available on the natural course of spermatogenesis in patients with testicular cancer who underwent unilateral orchiectomy and surveillance. We analyze long-term exocrine function of the remaining testicle in patients following surveillance policy. MATERIALS AND METHODS: Sperm counts and serum follicle-stimulating hormone (FSH) levels were available in 60 nonrelapsing cases approximately 3 weeks (baseline), 1 year and 2 years or greater after orchiectomy. Contralateral testicular cancer subsequently developed in 2 men. RESULTS: At baseline 36 patients were normospermic (10 or greater x 106/ml.), 7 were azoospermic and 17 were oligospermic. After 1 year 45 patients were normospermic. Mean sperm concentrations increased significantly from 26 to 39 x 106/ml. during year 1 after orchiectomy. Elevated serum FSH at baseline was associated with incomplete recovery of spermatogenesis, although sperm counts improved in 3 of 7 patients. Furthermore, in the 2 initially oligospermic patients with subsequent contralateral testicle cancer transient normospermia was observed after 1 year. After orchiectomy fatherhood was recorded in 28 men and was assisted by fertilization using fresh semen in 2. CONCLUSIONS: In nonrelapsing testicular cancer cases on surveillance, initially reduced spermatogenesis recovers during year 1 after orchiectomy especially if baseline serum FSH is normal. Transient recovery also occurs in patients in whom contralateral testicular cancer subsequently develops. In high risk patients and in initially oligospermic patients with plans for future fatherhood, the period of improved spermatogenesis may be used for multiple semen cryopreservations enabling subsequent assisted fertilization.     

宁夏农村乳母膳食营养与乳汁中营养素含量调查研究

１９９１年４～５月对宁夏农村产后０～６月健康乳母进行了满月前后膳食调查及部分３～１２月乳母乳汁主要营养素含量测定。结果产后一个月内乳母的动物性食物、油及糖摄入量明显高于一个月以后，而蔬菜、豆类等则正好相反。月子中乳母蛋白质、脂肪、能量、铁及尼克酸摄入量均达到或超过ＲＤＡ（推荐的每日膳食营养索供给量标准）。满月后乳母膳食各种营养素摄入量均达不到ＲＤＡ；满月后乳母乳汁营养素测定结果偏低。以上结果提示：应加强对乳母的营养指导，改变哺乳期不均衡的膳食习惯，以利母婴健康。     

Effect of sampling frames on response rates in the WHO MONICA risk factor surveys

Sample surveys are used to investigate occurrence and determinants of diseases in populations. Their reliability is influenced by quality of sampling frame and response rate. We investigated relationship between sampling frame type and response rates and assessed their impact on non-response bias, using data from the WHO MONICA Project, where 37 centres in 20 countries conducted sample surveys, employing the best locally available sampling frame. Sampling frames fell into three categories: Population registers (PR), electoral registers (ER), and health care registers (HR). Response rate (rrs) was factored into components reflecting quality of sampling frame (contact rate cr) and characterizing willingness of sample members to participate (enrolment rate er). The mean quality score for the sampling frames was 92 for PR, 87 for HR and 85 for ER; they contributed on average 23, 20, and 26 to the respective non-response rates. For all frame types and both sexes the lowest quality score occurred in the age group 35–44, suggesting a reduced ability to track migration of a highly mobile population group. The patterns in the age/sex distribution of er indicate at least for males in PR and females in HR a potential for non-response bias. Estimation of non-response bias through an abbreviated questionnaire failed because of low item response. We found that contact rate characterizes sampling frame quality. For all frame types it had a major influence on response rate. It is likely that low er and low cr cause different kind of bias, requiring different measures to minimize their effects.for the WHO MONICA Project** Sites and key personnel of the WHO MONICA Project are found at http://www.ktl.fi/publications/monica/rr_sframe/appendix.htm     

重庆市某中学初中生营养不良及肥胖影响因素分析

目的 了解中学生营养不良和肥胖的状况及其影响因素,为采取合理的干预措施提供依据.方法 采用问卷调查和查阅学生近期健康档案的方法,根据《中国学生7～22岁身高标准体重值》对学生营养状况进行评价,并对相关影响因素进行非条件Logistic逐步回归分析.结果中学生营养不良率为9.4%,肥胖率为24.2%.营养不良的发生与性别、是否偏食挑食、睡眠时间、早餐情况、是否吃动物内脏等5个因素密切相关.肥胖的发生与性别、父亲的体重指数、进食速度、是否宵夜、是否偏食挑食等5个因素密切相关.结论纠正中学生的营养不良和肥？关键要加强营养知识教育,帮助他们建立良好的饮食生活模式.