深圳市公务员先天性白内障现状及发病因素探讨

目的　通过普查深圳市公务员先天性白内障的现状 ,分析影响先天性白内障患病因素 ,探讨有效的防治措施。　方法　在 2 0 0 3年参加深圳市保健中心健康人群体检 ,2 0岁以上的约 3万名公务员中 ,按 3 :1比例随机抽取93 40人调查。按照先天性白内障诊断及分类标准 ,分析年龄、性别、职业的相关性 ,并进行显著性检验。　结果　深圳市公务员先天性白内障总发病率为 0 86% (80 /93 40 ) ,其中男性为 0 87% (4 0 /5 0 40 ) ,女性为 0 84% (3 6/4 3 0 0 ) ,男性高于女性 (P <0 0 5 ) ,职业无明显差异 (P <0 0 5 )与家族史有关。　结论　先天性白内障病发展缓慢 ,发现困难 ,应作为常规体检项目 ,减少遗传病儿出生。     

公职人员的人格与心理健康研究

目的：针对政府公职人员群体的人格和心理健康状况及其相互间的关系进行研究。方法：抽取某市2142名政府机关公务员和985名公安民警，采用艾森克人格量表(EPQ)与症状自评量表(SCL-90)进行测量。结果：全体被试的SCL-90总分和除躯体化之外的各因子得分均显著低于全国常模，其中警察的总分又低于机关公务员。SCL-90分数存在年龄和性别差异。机关公务员与警察的人格无显著差异。被试SCL-90总分和各因子得分与其人格显著相关，其中与神经质的关联性最大。结论：公职人员整体的心理健康水平较好，但男性机关公务员及年长者的心理健康值得关注。神经质与心理健康高度关联。     

Reed B. Bontecou, M.D.—His Role in Civil War Surgery and Medical Photography

This third article on the subject of Civil War injuries and their surgical repair is devoted to Reed B. Bontecou, M.D., a New York surgeon who contributed greatly to the use of photography to document the casualties of the battlefield as seen in the Northern as well as the Southern states. Photographs of the wounded soldiers helped to verify the severity of their injuries, and helped to determine the degree and amount of the post-war pension payments. These photographs were one of the largest sources which were used in the creation of the Otis Archives of the present-day National Museum of Health and Medicine in Washington, D.C. Some of the wounded soldiers' photographs in the Otis Archives demonstrate the use of plastic surgery techniques to repair the wounded face, head and neck, torso, and the extremities by only a handfull of Northern and Confederate surgeons including Gurdon Buck, J.S. Gouley and Henry B. Sands of New York City; H. Culbertson, U.S.V. of Madison, Wisconsin; J. Cooper McKee of Washington, D.C., W.W. Keen, Jr. of Philadelphia; and C.B. Gibson, P.A.C.S. of Richmond; S.H. Stout of Tennessee; and J.B. Bean, a dentist of Chattanooga [4].     

A dilemma for doctors

Community physicians have recently, albeit often reluctantly, been involved in preparations for nuclear war. This paper suggests an alternative: that they should use their skills in epidemiology and in preventive and social medicine in the prevention of nuclear war.     

Adverse selection in the German Health Insurance System – the case of civil servants

At the beginning of their career, civil servants in Germany can choose between the social health insurance (SHI) system and a private plan combined with a direct reimbursement of the government of up to 70 percent. Most civil servants chose the latter, not only but also because they have to cover all contributions in the social system themselves, while regular employees get nearly 50 percent from their employers. The city state of Hamburg decided to change the system by paying half of the contributions if civil servants choose the social plan. We use a stochastic microsimulation model to analyse which socio-economic types of civil servants could benefit from the Hamburg plan and if this changes the mix of insured persons in the SHI system. Our results show that low income and high morbidity types as well as families have a substantially higher incentive to choose SHI. This reform might thereby increase the adverse selection of high risk cases towards SHI.     

2014年成都市中心城区公务员吸烟现状及其影响因素

目的 了解成都市中心城区公务员吸烟现状,探讨吸烟的影响因素,为制定干预策略提供依据.方法 采用问卷调查的方法对成都市403名公务员吸烟状况进行调查,掌握其吸烟现状,采用二分类logistic回归探讨影响公务员吸烟的因素.结果 成都市中心城区403名公务员吸烟率为22.3％,其中男性公务员吸烟率为39.5％,女性为4.5％;47.3％的吸烟者曾经认真地戒过烟.吸烟公务员中仅有22.6％的人员在上班时间吸烟,81.9％在楼内指定吸烟区吸烟;82.9％的公务员认同“公务员应是不吸烟的榜样”,84.9％的公务员支持“应该在政府机构所有范围内禁止吸烟”.影响公务员吸烟的主要因素有性别、年龄、对政府机构禁烟的态度、家庭禁烟规定等等.结论 成都市公务员吸烟率还待进一步降低,吸烟行为受多种因素影响,建议针对影响因素进行吸烟干预,如制定家庭禁烟规定,加强政府机构控烟规章等等切实可行的策略,从而改善公务员的吸烟状况,带动全社会参与戒烟.     

老年痴呆患者遗嘱能力的研究进展

痴呆是一种发展病程不可逆的神经退行性病变,以损害患者的认知功能为核心。轻中度痴呆患者具有一定的认知功能及执行能力。遗嘱能力作为一项高级执行能力,因其跨越医学与法律的范畴引起了国外广大学者的关注。痴呆患者具有立遗嘱的权利,但其所立遗嘱是否有效值得探讨。目前国外对痴呆患者遗嘱能力评定标准、评估工具的研究逐渐增多,而我国对这方面的关注较少。本文通过回顾国内外老年痴呆患者遗嘱能力的相关文献并进行综述,以期为我国引进合理有效的遗嘱能力评定标准和评估工具提供依据,同时为保护我国痴呆患者合法权益、维护患者尊严、减少家庭和法律的纠纷提供借鉴。     

Peer,professional, and public: An analysis of the drugs policy advocacy community in Europe

BackgroundIn recent decades a range of advocacy organisations have emerged on the drugs policy landscape seeking to shape the development of policy at national and international levels. This development has been facilitated by the expansion of ‘democratic spaces’ for civil society participation in governance fora at national and supranational level. However, little is known about these policy actors – their aims, scope, organisational structure, or the purpose of their engagement.MethodsDrug policy advocacy organisations were defined as organisations with a clearly stated aim to influence policy and which were based in Europe. Data on these organisations was collected through a systematic tri-lingual (English, French and Spanish) Internet search, supplemented by information provided by national agencies in the 28 EU member states, Norway and Turkey. In order to differentiate between the diverse range of activities, strategies and standpoints of these groups, information from the websites was used to categorise the organisations by their scope of operation, advocacy tools and policy constituencies; and by three key typologies – the type of advocacy they engaged in, their organisational type, and their advocacy objectives and orientation.ResultsThe study identified over two hundred EU-based advocacy organisations (N = 218) which included civil society associations, NGOs, and large-scale alliances and coalitions, operating at local, national and European levels. Three forms of advocacy emerged from the data analysis – peer, professional and public policy. These groups focused their campaigns on practice development (harm reduction or abstinence) and legislative reform (reducing or strengthening drug controls).ConclusionThe findings from this study provide a nuanced profile of civil society advocacy as a policy community in the drugs field; their legitimacy to represent cases, causes, social values and ideals; and their focus on both insider and outsider strategies to achieve their goals. The level of convergence and divergence in Europe in relation to policy positions on service provision ethos and drug control regulation is indicated.     

Metabolic effects of medium- or long-chain triglycerides and high-protein, carbohydrate-free diets in Zucker rats

The effects of protein levels and types of fat in the diet on the metabolism of lean and obese Zucker rats were studied. For 40 days the rats were fed ad libitum one of four diets: two "usual protein" diets (19% protein by weight) with 19.4% triacylglycerols, either long chain (UP-LCT diet) or medium chain (UP-MCT diet); and two high protein (64% protein), carbohydrate-free diets, again with 19.4% triacylglycerols (HP-LCT and HP-MCT diets, respectively). The energy intakes of the obese rats decreased about equally on the HP-LCT, UP-MCT, and HP-MCT diets. The daily weight gain, which was high in the UP-LCT rats, was lower when carbohydrates were replaced by proteins, or when LCTs were replaced by MCTs; furthermore, when these two changes were made together, their beneficial effects on body weight were additive. The lipid gain, too, was high with the UP-LCT diet and lower both with the high protein diets and with the MCT diets; again combining the two amplified the two individual effects, so much that the final lipid concentration in the body was lowered, whereas the concentration of water increased. Hepatic acetyl CoA carboxylase activity was low when the diet supplied plenty of LCTs, but replacing carbohydrates with proteins in such a diet produced an additional decrease in this enzymatic activity. When either a normal protein or a high protein diet supplied MCTs in place of LCTs, acetyl CoA carboxylase activity was high and similar to that found with a high carbohydrate diet.(ABSTRACT TRUNCATED AT 250 WORDS)     

2 ０１２年温州市公务员体能状况及影响因素分析

摘要：目的　了解温州市公务员体能状况及其影响因素,为制定该人群预防保健措施提供科学依据。方法
　于２０１２年对温州市直机关公务员进行体能测试和健康问卷调查。采用自制调查表对公务员的常见病、运
动习惯、吸烟、饮酒、睡眠等进行现况调查。由温州市体育局国民体质监测中心进行体能素质测试,由温
州市中心医院超声科进行颈动脉内中膜（ｉｎｔｉｍａ ｍｅｄｉａｔｈｉｃｋｎｅｓｓ,ＩＭＴ）厚度测量。结果　以４５６名资料完
整的４０～６０岁公务员为研究对象。结果显示, 该人群患病率相对较高的前５ 种疾病分别为： 颈椎疾病
２８．７３％ （１３１例）、高血脂１７．５４％ （８０例）、高血压１５．１３％ （６９例）、骨关节病１０．５３％ （４８例）、消化
性溃疡６．５８％ （３０ 例）。体力评分及格率为５３．７３％ （２４５／４５６）, 其中女性公务员及格率（８３／１１７,
７０．９４％）显著高于男性公务员（１６２／３３９,４７．７９％）（犘＜０．０１）。颈动脉内中膜（ＩＭＴ） 厚度与年龄呈正
相关（狉＝０．２６８;犘＜０．０１）,与每天的吸烟量呈正相关（狉＝０．０８３;犘＜０．０５）。体力评分与是否规律运动
有相关性（狉＝－０．２１;犘＜０．０１）。结论　温州市直机关公务员健康状况不容乐观,应改变不良生活习惯、
增强体质、科学运动,在医生和体育工作者的指导下定期检查,做到早发现,早预防,早治疗。
关键词：公务员;健康体检;颈动脉粥样硬化;颈动脉内中膜厚度;体质测评
中图分类号：Ｒ８７１　　文献标识码：Ａ　　文章编号：１００９ ６６３９ （２０１４）０１ ００４６ ０３