Under fives mortality in the urban slums of Lucknow

The main objective of this study was to elicit proportional cause specific mortality in the underfives in the urban slums of Lucknow in North India. The families with under five mortality in the 28 randomly selected slums in 1993 were located from the records of the slum health workers and verbal autopsy was conducted to assign a cause of death. There were 71 deaths among 2796 children. The annual under five mortality was 25.4 and the under five mortality rate was 126.7. After the neonatal period, “high fever” that could not be classified into any other disease incorporated in the verbal autopsy instrument, was the most common symptom associated with death, seen in 21.1% cases (95% C.I.: 15.5–34.4%) followed by these diseases: pheumonia in 19.7%, diarrhea in 18.3% and measles in 11.4%. “High fever” as the leading symptom associated with death is being reported for the first time from the urban slums of India. There is an urgent need to identify the underlying etiologies of death due to “high fever” and the policy implications are that children with fever must receive immediate and continued medical attention till the symptom persists.     

2003年济南市城区部分健康体检人群患病情况分析

[目的]了解城市居民患病特点，为有关部门制定健康干预政策提供数据支持。[方法]对2003年下半年到山东省立医院进行体检的济南市城区11161名居民患病情况进行分析。[结果]全部体检者异常率为86．87％。异常率男性为90．09％，女性为80．45％（P〈0．01）；随着年龄的增长，体检异常率呈增加趋势（P〈0．01）。罹患率居前3位的疾病31岁以下男女共患疾病是脂肪肝、单纯性肥胖与慢性胃炎，31～40岁为脂肪肝、慢性胃炎、单纯性肥胖；41～50岁男性脂肪肝、前列腺肥大罹患率均超过40％，女性子宫肌瘤、乳腺增生与慢性子宫颈炎罹患率均超过19％；51～60岁男性前列腺炎、脂肪肝罹患率分别高达62．46％、41．93％，女性脂肪肝与子宫肌瘤罹患率居前2位；61岁以上男性前列腺肥大罹患率高达84．25％，女性脂肪肝与高血压罹患率居前2位。[结论]不同年龄、不同性别居民疾病与异常的罹患率不同，危害健康的主要疾病不同，应有针对性地进行健康干预。     

浙江省城市与农村居民心理卫生知识水平调查

目的了解浙江省城市和农村居民心理卫生知识水平,为健康教育提供依据.方法采用分层随机抽样方法,抽取15岁以上样本2636人采用自编的<心理卫生知识问卷>进行居民心理卫生知识水平的调查.结果城乡居民在精神疾病的发病因素、治疗,常见精神疾病的认识等方面存在一定的差异,在症状识别、预后等方面城乡居民比较接近.结论加强城市和农村居民的心理卫生知识及心理卫生健康教育,以提高居民的心理卫生知识的知晓率,促进居民的心理健康.     

Clean Spaces,Community Building,and Urban Stage: the Coproduction of Health and Parks in Low-Income Neighborhoods

Green zones are potential contributors to health by mitigating disparities between low- and high-income neighborhoods. Against the background of different discourses about city parks—parks as restorative environments, parks as enabling places, and parks as sites for encounters between strangers—we ethnographically studied the coproduction of green spaces and health within low-income neighborhoods. We found three competing notions of urban green, each tied to different notions of neighborhood well-being. Parks as “clean spaces” create expectations of order and peace; parks as places of the community are related to play and activities; and parks as urban stage foster interactions between strangers. By generating experiences that encompass different conceptions of health, citizen-led events can contribute to a shift in the understanding of parks as sites of neighborhood decline to parks as places of hope and new beginnings.     

Participatory Systems Mapping for Municipal Prioritization and Planning

Rapidly growing cities face new and compounding health challenges, leading governments and donors to seek innovative ways to support healthier, more resilient urban growth. One such approach is the systems mapping process developed by Engaging Inquiry (EI) for the USAID-funded Building Healthy Cities project (BHC) in four cities in Asia. This paper provides details on the theory and methods of the process. While systems mapping is not new, the approach detailed in this paper has been uniquely adapted to the purpose of municipal planning. Strategic stakeholder engagement, including participatory workshops with a diverse group of stakeholders, is at the core of this approach and led to deeper insights, greater buy-in, and shared understanding of the city’s unique opportunities and challenges. This innovative mapping process is a powerful tool for defining municipal priorities within growing cities across the globe, where the situation is rapidly evolving. It can be used to provide evidence-based information on where to invest to gain the biggest impact on specific goals. This paper is part of a collection in this issue providing a detailed accounting of BHC’s systems mapping approach across four project cities.     

广西城乡慢性病相关危险因素调查

目的了解广西慢性病相关危险因素的流行现状和分布特征,为广西慢性病防治策略的制定和干预措施的实施提供依据。方法经多阶段随机抽样,对监测点符合条件的18~69岁常住居民共1276人进行问卷调查和体格测量。结果调查人群中慢性病相关危险因素发生率前5位依次是缺乏体力活动、被动吸烟、饮酒、吸烟、高血压,其标化发生率分别为:缺乏体力活动71.79%、饮酒33.75%、吸烟25.92%和高血压13.73%,均高于国内水平(65.28%、20%、25%、11.88%);除超重和中心性肥胖两个危险因素的女性标化率高于男性外,其余因素均是男性标化率高于女性,在危险因素中男性的暴露明显高于女性(P<0.01);城乡地区分布差异中,吸烟、饮酒、缺乏体力活动的标化发生率农村分别为:28.95%、35.92%、90.521%,明显高于城市(19.64%、30.37%、35.02%、),而高血压、超重、肥胖、中心性肥胖的标化发生率则是城市(17.54%、19.94%、2.54%、15.37%)明显高于农村(11.62%、7.97%、0.39%、6.36%)。结论广西部分慢性病相关危险因素处于较高流行水平,慢性病相关危险因素的干预措施应针对不同地区、人群,优先考虑重点干预因素。     

Rural-urban differences in the presentation, management and survival of breast cancer in Western Australia

From all women diagnosed with invasive breast cancer in 1999 in Western Australia, rural and urban women were compared with regard to mode of detection, tumour characteristics at presentation, diagnostic investigations, treatment and survival. Women from rural areas with breast cancer (n=206, 23%) were less likely to have open biopsy with frozen section (P<0.001), breast-conserving surgery (P<0.001), adjuvant radiotherapy (P=0.004) and hormonal therapy (P=0.03), and were less likely to be treated by a high caseload breast cancer surgeon (P<0.001). Adjusting for age and tumour characteristics, rural women had an increased likelihood of death within 5 years of breast cancer diagnosis (HR 1.62, 95% CI 1.10-2.38). This difference was not significant after adjustment for treatment factors (HR 1.36, 95% CI 0.90-2.04).     

城市社区全科医生培训现状及需求调查：专题小组访谈

目的了解我国城市社区全科医生培训现况及需求,为下一步制定相关政策提供参考依据。方法2011年9—12月,对辽宁、福建、宁夏3个省的19名全科医学师资实施了专题小组访谈。访谈在各地培训基地会议室实施。访谈时间平均为2h左右。借助计算机对资料进行编码、归类、精简,总结出访谈主题。结果①集中授课及临床轮转是培训的主要方式;②培训内容多以基本知识和基本技能为主,大纲修订应侧重于这些方面;③作为师资对自身业务水平也有提高和帮助;④工学矛盾、师资水平不高是培训中的主要问题,受访者提出了解决建议。结论培训内容贴近实际需求、多手段解决工学矛盾、加强师资培训l是未来进一步提高全科医学培训质量所需解决的关键问题。     

河北省城乡居民精神健康状况调查

目的了解河北省城乡居民精神健康状况。方法采用多阶段分层抽样的方法确定样本,统一培训调查员,按统一的方法和标准进行面对面的问卷调查。结果66.86%的人自认为精神状况较好或者很好,出现精神状态不佳的为51.36%;感到精神紧张、有压力的为31.26%,感到烦躁不安、无名发火的为38.71%,感到压抑、沮丧、情绪低落的为30.57%,感到伤心、难过的为22.45%,感到做事没价值、没意义的为14.02%,女性明显高于男性,35～54岁年龄组最高,小学和初中文化高于其它文化程度者。从事农、林、牧、渔、水利业生产等重体力劳动的农村人员高于城市人员及其它职业;精神不佳时未采取任何措施的为52.67%。结论河北省城乡居民精神状态不佳的比例超过一半以上,女性、35～岁年龄组、文化程度低、重体力劳动者是精神不佳的高发人群,对此重点人群宜实施有针对性的健康干预。     

城市生活垃圾处理模式选择的影响因素

在总结国内外城市生活垃圾处理影响因素的基础上,提出了城市生活垃圾处理模式选择的6大影响因素,即垃圾基本特征、经济可行性、技术可行性、环境可行性、行业管理及社会环境,并筛选出27项子因素作为评价指标,具有较强的可操作性和适应性,为建立垃圾处理模式选择的定性与定量评价模型奠定了基础。