福建省公共场所中央空调冷却塔水嗜肺军团菌污染影响因素分析

目的对福建省2008年公共场所中央空调冷却塔水嗜肺军团菌污染影响因素进行调查,为防控提供依据。方法采集5个设区市114家场所116份空调冷却塔水进行嗜肺军团菌的培养和鉴定,并用PCR检测KatB基因,对影响因素进行分析。结果嗜肺军团菌污染率为40.4%（46/114）,冷却塔水检出率40.5%（47/116）;KatB基因的检出率为33.3%（5/15）;冷却塔水水质处理频率以每月3～4次的检出率最低（16.0%）。结论福建省公共场所嗜肺军团菌污染较严重,冷却塔水水质处理频率和此菌的污染存在关联性,应采取综合措施,降低嗜肺军团菌污染的潜在危险性。     

常州市医务人员吸烟相关行为现况调查

目的了解常州市医务人员吸烟和控烟知识、态度及行为现状,为促进医务人员开展戒烟活动,提高其控烟意识,促使其在日常工作中帮助吸烟者戒烟服务提供科学依据。方法采用分层随机抽样方法,用统一设计的《吸烟现况调查表》对常州市一、二、三级医院的620名医生进行问卷调查。用EpiData3．1录人调查数据形成数据库,用统计软件SPSS13．0进行χ^2检验、趋势检验等统计分析,P〈0．05为差异有统计学意义。结果常州市医务人员总吸烟率为27．58％。其中男性吸烟率为46．03％,女性为1．18％,差异有统计学意义（χ^2=151．2,P〈0．05）。医生在接诊时,有22．74％的医生从不或很少询问患者吸烟情况,33．71％的医生在患者疾病与吸烟相关时才询问;所调查医务人员中,如果知道患者吸烟,57．25％的医生会经常建议患者戒烟;医生吸烟率随着工作年限的增加有所上升（χ^2=18．512,P〈0．05）;不同职称医生的吸烟率差异有统计学意义（χ^2=8．764,P〈0．05）,其中高级职称的医生吸烟率最高为35．48％;不同科室的医生吸烟率间的差异有统计学意义（χ^2=60．928,P〈0．05）,其中以外科医生吸烟率最高达45．73％;在医生的不同学历中以中专及中专以下学历医生的吸烟人数最多,吸烟率分别为37．50％、32．08％。结论应加强医生的健康教育和戒烟知识培训,减少医生的吸烟行为;采取相应的对策使医生有时间也有能力向患者传送控烟知识,提高其在临床提供戒烟服务的能力,进而推进全社会的控烟工作。     

Levels and predictors of urinary nickel concentrations of children in Germany: Results from the German Environmental Survey on children (GerES IV)

Human biomonitoring of nickel has gained interest in environmental medicine due to its wide distribution in the environment and its allergenic potential. There are indications that the prevalence of nickel sensitization in children is increased by nickel exposure and that oral uptake of nickel can exacerbate nickel dermatitis in nickel-sensitive individuals. Urinary nickel measurement is a good indicator of exposure. However, data on nickel levels in urine of children are rare. For the first time, the German Environmental Survey on children (GerES IV) 2003–2006 provided representative data to describe the internal nickel exposure of children aged 3–14 years in Germany. Nickel was measured after enrichment in the organic phase of urine by graphite furnace atomic absorption spectrometry with Zeeman background correction. Nickel levels (n = 1576) ranged from <0.5 to 15 μg/l. Geometric mean was 1.26 μg/l. Multivariate regression analysis showed that gender, age, socio-economic status, being overweighted, consumption of hazelnut spread, nuts, cereals, chocolate and urinary creatinine were significant predictors for urinary nickel excretion of children who do not smoke. 20.2% of the variance could be explained by these variables. With a contribution of 13.8% the urinary creatinine concentration was the most important predictor. No influence of nickel intake via drinking water and second hand smoke exposure was observed.     

The Rise of Electronic Health Record Adoption Among Family Physicians

PURPOSE

Realizing the benefits of adopting electronic health records (EHRs) in large measure depends heavily on clinicians and providers’ uptake and meaningful use of the technology. This study examines EHR adoption among family physicians using 2 different data sources, compares family physicians with other office-based medical specialists, assesses variation in EHR adoption among family physicians across states, and shows the possibility for data sharing among various medical boards and federal agencies in monitoring and guiding EHR adoption.

METHOD

We undertook a secondary analysis of American Board of Family Medicine (ABFM) administrative data (2005–2011) and data from the National Ambulatory Medical Care Survey (NAMCS) (2001–2011).

RESULTS

The EHR adoption rate by family physicians reached 68% nationally in 2011. NAMCS family physician adoption rates and ABFM adoption rates (2005–2011) were similar. Family physicians are adopting EHRs at a higher rate than other office-based physicians as a group; however, significant state-level variation exists, indicating geographical gaps in EHR adoption.

CONCLUSION

Two independent data sets yielded convergent results, showing that adoption of EHRs by family physicians has doubled since 2005, exceeds other office-based physicians as a group, and is likely to surpass 80% by 2013. Adoption varies at a state level. Further monitoring of trends in EHR adoption and characterizing their capacities are important to achieve comprehensive data exchange necessary for better, affordable health care.     

2005年广东省中老年人义齿修复状况抽样调查报告

目的 了解广东省城乡中老年人戴义齿情况,为广东省口腔卫生保健工作提供信息支持.方法 采用多阶段分层等容量随机抽样的方法,抽取广东省35～44岁、 65～74岁城乡常住人口各720人,男女各半.照<第三次全国口腔健康流行病学调查方案>检查义齿修复情况.结果 广东省35～44岁组未发现有戴总义齿, 65～74岁组戴总义齿占9.86%, 35～44岁组无义齿占85.42%, 65～74岁组无义齿占42.22%. 65～74岁2.92%有"非正规固定桥"修复.结论 广东省中老年人都能够根据口腔的状况修复缺失的牙齿,但要避免不良修复体.     

2005年广东省中老年人余留牙和无牙颌抽样调查报告

目的 了解广东省35～44岁、65～74岁城乡人群余留牙和无牙颌的现状,为广东省口腔卫生保健工作提供信息支持.方法 采用多阶段分层等容量随机抽样的方法,抽取广东省城乡35～44岁、65～74岁常住人口各720人,男女各半.按照<第三次全国口腔健康流行病学调查方案>检查余留牙和无牙颌.结果 35～44岁组人均有29.41颗牙,有28颗牙以上的人占81.94%, 99.58%的人有20颗以上的牙,无单颌牙缺失或全口牙缺失. 65～74岁组人均有20.53颗牙,有28颗牙以上的人仅占23.19%, 63.47%的人有20颗以上的牙, 6.25%的人出现单颌牙缺失, 3.47%的人全口牙缺失. 65～74岁组农村失牙高于城市,女性失牙多于男性. 2005年2个年龄组人群均比1995年有更多的余留牙.结论 广东省1/4中年人有失牙,老年人普遍有失牙,比10年前失牙数减少.     

观测器在可摘局部义齿修复中的临床应用调查

目的：探讨在可摘局部义齿修复中应用观测器的重要性。方法：分别用观测法和目测法设计和制作可摘局部义齿，一年半后从支架的缺陷、口腔支持组织的生物学行为和义齿的功能三大方面评价两组义齿的临床疗效。结果：在义齿的固位，稳定，取戴，支持组织的炎症，患者的舒适度等方面，观测法组均优于目测法(P＜0．05)，两组在咀嚼功能方面无显著性差异(P＞0．05)。结论：在修复中应常规采用观测器来设计和制作可摘局部义齿。     

What is the association between income loss during the COVID-19 pandemic and children’s dental care?

BackgroundThe degree to which children experience unmet need for dental care during the COVID-19 pandemic and its association with pandemic-related household job or income loss are unknown.MethodsThe authors performed a cross-sectional household survey of 348 families in Pittsburgh, Pennsylvania, from June 25 through July 2, 2020. Unmet need for child dental care and pandemic-related household job or income loss were assessed using caregiver self-report.ResultsCaregivers reported that the greatest unmet child health care need during the COVID-19 pandemic was dental care (16%), followed by medical care for a well visit or vaccination (5%). Approximately 40% of caregivers reported job loss or a decrease in household income due to the COVID-19 pandemic. The authors found a significant association between the probability of unmet child dental care and pandemic-related household job or income loss (P = .022). Losing a job or experiencing a decrease in income due to the COVID-19 pandemic was associated with unmet child dental care (relative risk, 1.77; 95% confidence interval, 1.08 to 2.88).ConclusionsIn this sample, 3 times as many households reported unmet dental care for a child compared with unmet medical care. Unmet child dental care was more common in households where pandemic-related job or income loss occurred.Practical ImplicationsIf unmet dental care continues as a result of the COVID-19 pandemic, nontraditional strategies for delivering dental care can be considered to improve access to dental care for children, such as teledentistry and oral health prevention services in primary care settings.     

Association between vaping and untreated caries: A cross-sectional study of National Health and Nutrition Examination Survey 2017-2018 data

BackgroundWith the rise in the prevalence of electronic cigarette (e-cigarette) and vaping products and the emergence of evidence indicating their cariogenic potential, it is essential to examine the association between vaping and untreated caries at a population level.MethodsThe authors obtained data from the 2017-2018 National Health and Nutrition Examination Survey and investigated the outcome variable—untreated caries—using oral health examination data. The authors applied multiple logistic regression analyses to assess the association between untreated caries and smoking (cigarette smoking, vaping, and both) while controlling for education, race or ethnicity, income, age, sex, and time since previous dental visit.ResultsA total of 4,618 participants were included in the analyses for this cross-sectional study. Participants who currently smoked e-cigarettes were more likely to have untreated caries (odds ratio, 1.69; 95% CI, 1.24 to 2.29) than those who had never smoked, when adjusted for demographic variables. Similarly, dual smokers (e-cigarette and conventional smokers) were more likely to have untreated caries compared with nondual smokers (odds ratio, 2.43; 95% CI, 1.36 to 4.36).ConclusionBoth vaping and dual smoking are associated with an increased occurrence of untreated caries.Practical ImplicationsVaping status should be included as a part of health history questionnaires for patients. Dental professionals should be informed of the potential oral health implications of vaping and, in turn, impart this knowledge to patients.