中学生吸烟影响因素及控制对策

目的探讨中学生吸烟行为及相关影响因素，为制定中学生控烟对策提供依据。方法对沈阳市21所中学，1855名中学生进行问卷调查，收集到有效问卷为1831，统计分析采用SPSS11．5软件。结果中学生尝试吸烟率为26．7％（男生35．6％，女生18．2％）。调查前1个月吸烟率6．3％（男生10．7％，女生2．0％）。开始吸第1支烟的平均年龄（13．4±2．9）岁，其中男生（13．3±2．9）岁，女生（13．5±3．1）岁。吸烟的相关因素，男生为周围人吸烟、好朋友吸烟、学校类别、认为拒绝别人递的烟不礼貌等因素。女生为家庭收入、好朋友吸烟等因素。结论沈阳市中学生吸烟率较高，开始吸烟年龄也较低，应引起社会各界的高度重视，通过动员社会、学校力量，采取加大禁烟力度，城市立法，严禁向未满18岁青少年售烟等综合措施降低中学生吸烟率。     

某煤矿职业病危害控制效果评价

目的对某煤矿职业病危害因素的控制效果进行评价。方法采用现场职业卫生学调查法、工作场所职业病危害因素现场检测与实验室分析法、检在表对照法相结合进行综合评价。结果生产过程中产生的主要职业病危害因素：粉尘、化学毒物、噪声。26个监测点中21个点粉尘合格，总粉尘合格率为80．7％，呼吸性粉尘合格率为84．6％。14个监测点的化学毒物测定值均小于接触限值，合格率100％。12个噪声监测点中有3个点超标。最大值98dB（A），合格率为75．0％。气象条件符合卫生要求。该建设项目的选址与总体布置、生产设备布局、职业病防护设施、个人使用的防护用品、职业卫生管理等符合国家有关法规要求。结论该建设项目职业病危害控制效果基本合格，但仍需进一步完善防尘、降噪声设施。     

太湖县一起菌痢暴发疫情流行病学调查及控制措施分析

目的了解太湖县发生突发公共卫生事件后所采取的应急处置工作，为类似事件的应急处置提供经验。方法分析太湖县某初级中学菌痢疫情暴发后所采取的控制措施和控制效果以及对社会的影响，总结经验教训。结果本次菌痢疫情暴发为一次集中暴露，无续发病例出现，本次菌痢疫情调查处理非常及时、有效。结论反应迅速是根本，领导重视是关键，措施有效是保证，未病先防是治本之道。     

流程化进阶管理在病案质量监控中的应用

病案质量是医院医疗质量考核的重要内容之一,有效的监控病案质量将有助于提高医院的医疗、教学、科研和管理水平。按照流程化进阶管理模式,在制定流程、实施流程、改进流程和总结流程的过程中,不断进行持续改进,实现流程的优化运作,逐步达到病案质量监控效果的最大化。     

桂西北地区某高校5届新生HBV感染状况分析

目的了解民族地区高校新生HBV感染状况,为乙肝的防治工作提供依据。方法用酶标法(ELISA)测定近5届9485名新生的HBsAg,对HBsAg阳性者进一步检测其他4项乙肝血清指标,对结果进行统计分析。结果HBsAg平均阳性率为10.34%,且以HBsAg、HBeAg、HBcAb阳性(大三阳)和HBsAg、HBeAb、HBcAb阳性(小三阳)2种感染模式为主,占HBV所有感染模式的83.18%。结论该校HBV感染检出率高于全国平均水平,并未见下降趋势,应引起高度重视。对未感染HBV的同学入学后应进行乙肝疫苗接种。     

吸烟与性别对氯氮平及去甲氯氮平药动学的影响

目的：研究３０例精神分裂症患者服用固定剂量（６ｍｇ·ｋｇ－１）的氯氮平达稳态后的药动学，以及吸烟与性别对药动学的影响。方法：血药浓度采用ＲＰＨＰＬＣ测定，药动学程序进行参数模拟，并用Ｅｐｉｓｔａｔ统计软件包进行ｔ检验。结果：吸烟者氯氮平及其代谢物去甲氯氮平的消除半衰期（ｔ１／２）分别为（９．２２±２．０）ｈ和（８．４±２．７４）ｈ，明显低于非吸烟者［分别为（１３．８９±３．１５）ｈ和（１３．６８±２．３５）ｈ］，峰浓度（ｃｍａｘ）在吸烟者也明显低于非吸烟者［氯氮平：（３０３．９８±１１８．６５）ｎｇ·ｍｌ－１与（５５２．４５±１８６．４１）ｎｇ·ｍｌ－１，去甲氯氮平：（１３３．８５±６２．４２）ｎｇ·ｍｌ－１与（２３０．２±８６．１８）ｎｇ·ｍｌ－１］，女性非吸烟患者的ｃｍａｘ较男性非吸烟患者高，但统计学上差异无显著性。结论：吸烟可加快氯氮平及去甲氯氮平的代谢。     

Health status and health care use of Massachusetts women reporting partner abuse

BACKGROUND: Studies indicate that women abused by their intimate partners are at increased risk for a number of health problems and have increased rates of health care utilization. However, these findings are based mainly on studies using clinic or health plan populations. In this study, we examined the association between intimate partner abuse (IPA) and health concerns and health care utilization in a population-based sample of adult women. METHODS: We analyzed data on 2043 women aged 18 to 59 who participated in the 1998 Massachusetts Behavioral Risk Factor Surveillance System (BRFSS), a population-based health survey that included questions on IPA. IPA was defined as experiencing physical violence by, fear of, or control by an intimate partner. Consequences of IPA and self-rated health status and health care utilization of women experiencing IPA were examined. RESULTS: A total of 6.3% of Massachusetts women aged 18 to 59 reported IPA during the past year. Women experiencing IPA were more likely than other women to report depression, anxiety, sleep problems, suicidal ideation, disabilities, smoking, unwanted pregnancy, HIV testing, and condom use. Women experiencing IPA were less likely to have health insurance, but received routine health care at similar rates as other women. CONCLUSIONS: These results indicate that women in the general population experiencing IPA are at increased risk for several serious emotional and physical health concerns. Most of these women are in routine contact with health care providers. These findings also suggest that the BRFSS may provide a valuable mechanism for tracking state-based IPA prevalence rates over time.     

Is there an association between passive smoking and breast cancer?

Recent epidemiological studies have suggested passive smoking as possible risk factors in breast cancer etiology. However, the evidence is not conclusive. We conducted a meta-analysis of the risk of breast cancer associated with passive smoking. Eleven studies were identified through Medline, Cancer Abstracts and abstract presented at related scientific meetings. Combined estimates of relative risks (RR) were calculated using fixed and random effect models. Significant heterogeneity was detected among the studies (² = 34.6, p < 0.01). The combined estimate of RR for ever exposure to passive smoking was 1.41 (95% confidence interval (CI): 1.14–1.75). The combined estimate for published studies was 1.43 (95% CI: 1.10–1.85). Only two studies reported significant dose-response relation between level of passive smoking and premenopausal breast cancer. Our analysis suggests a possible weak association between passive smoking and breast cancer. More studies are needed to establish whether the observed association is causal.     

Tobacco,alcohol intake,and diet in relation to adenocarcinoma of the esophagus and gastric cardia

Little is known about the etiology of adenocarcinoma of the distal esophagus/cardia, a cancer which has increased in incidence in the United States over the last two decades. We analyzed data on smoking, alcohol use, dietary intake, and other factors obtained from 173 hospitalized males with adenocarcinoma of the distal esophagus/cardia (cases) and 4,544 hospitalized males with diseases not related to smoking and of other organ systems than the gastrointestinal tract (controls). Cases of squamous cell carcinoma of the esophagus (n=136) and adenocarcinoma of the distal stomach (n=122) were included as separate case groups. All subjects were interviewed in 28 hospitals in eight cities in the US between 1981 and 1990. After adjustment for covariates, the odds ratio (OR) for adenocarcinoma of the distal esophagus/cardia for current smokers was 2.3 (95 percent confidence interval [CI]=1.4–3.9) and that for ex-smokers was 1.9 (CI=1.2–3.0) relative to never-smokers. The OR for drinkers of four or more ounces of whiskey-equivalents of alcohol per day (relative to those consuming less than one drink per week) was 2.3 (CI=1.3–4.3). Intakes of total fat and vitamin A from animal sources were significant risk factors and fiber intake was associated inversely with adenocarcinoma of the distal esophagus/cardia. Although the number of female cases of adenocarcinoma of the distal esophagus/cardia was small (n=21), significant associations were observed for smoking and alcohol.Dr Kabat is in the Department of Epidemiology and Social Medicine, Albert Einstein College of Medicine, Bronx, NY, USA. At the time of this work be was with the Division of Epidemiology, American Health Foundation, New York, NY. Drs Ng and Wynder are with the Division of Epidemiology, American Health Foundation. Address correspondence to Dr Kabat, Department of Epidemiology and Social Medicine, Albert Einstein College of Medicine, Belfer Bldg, Rm 1302, 1300 Morris Park Avenue, Bronx, NY 10461, USA. Supported by National Cancer Institute Program Project grant CA32617 and Center grant CA17613.     

Tobacco Use Characteristics Among Rural Ohio Appalachians

Appalachians remain at high risk for cancer, heart and lung disease, in part because of their high prevalence of tobacco use; yet, information about their tobacco consumption patterns is limited. The purpose of this study was to describe tobacco consumption variables among rural adult Appalachian tobacco users. Subjects, aged 18 and older (N = 249), participated in a face-to-face interview about tobacco consumption variables and knowledge regarding the health effects of tobacco at fairs in two rural Ohio Appalachian counties. The majority of participants were categorized as precontemplators, although 21 percent were classified in preparation stage of change. Mean age of initiation was 16.6 years and number of cigarettes smoked per day (cpd) was significantly higher for men, as compared to women. One-third of males reported the use of smokeless tobacco. The majority had not tried to quit for more than a year and the average number of previous quit attempts was low. One-half of the sample had been advised in the past to quit by their physician. Few had used nicotine replacement with past quit attempts but greater than half would consider this approach with future attempts. Knowledge about the health effects of smoking indicated that most were aware of the relationship between smoking and cancer but less than one-half recognized its association with heart disease. Those with less education were less informed about the health effects to self and non-smokers. While a sizeable portion expressed interest in quitting, knowledge about the health effects of smoking is lacking, especially with regard to heart disease and among those with less education.