健康危险行为对武警军官自评健康状况影响

目的 探讨吸烟、饮酒等健康危险行为对武警军官自我评价健康状况的影响.方法 采用横断面调查的方式,对2068名武警军官进行健康危险行为调查,分析具有不同健康危险行为军官的自评健康状况的差异.结果 自评健康为很好、好、一般、差的军官分别占调查人群的28.296,43.1%,25.3%,3.4%.年龄、职别、文化程度、婚姻状况等影响军官的自评健康状况,差异均有统计学意义(均P＜0.01).在9类健康危险行为中,重度饮酒、体重异常、体力活动缺乏、睡眠不足和心理压力过大等5个危险因素明显降低军官的自评健康状况(P＜0.01).多分类Logistic回归分析表明,具有1,2,3个和3个以上健康危险行为者的自评健康状况为差的风险分别是无危险行为者的1.12,1.25,1.32,1.39倍(P＜0.01).结论 特定危险因素和军官自评健康状况显著相关,且危险因素的聚集可明显降低军官的自评健康.     

职业人群健康对生产力影响的定量研究

摘要：[目的]探讨职业人群健康对生产力的影响。[方法]选择上海市某区自愿参加健康单位建设的8家企事业单位的全部在职员工进行问卷调查,定量分析进行职业人群健康状况（评价指标包括健康自评、心理健康和慢性病患病否）对生产力的影响。[结果]在职业人群健康状况方面,调查对象健康自评为很好、较好、一般、差或很差的比例分别为14．62％、31．72％、48．69％、4．97％;心理健康不佳者（WHO-5总评分低于13分）比例占52．83％,调查对象中无慢性病、有一种慢性病、有两种及以上慢性病者所占比例分别为51．66％、27．87％、17．87％。在健康状况对生产力受损的影响方面,健康自评每下降一级,生产力受损指标[健康问题所致工作时间损耗百分比（ percentage of work time misseddue to health, PWH ）除外,健康问题所致工作损伤百分比 （ percentage of impairment while working due to health, PIH ）、总体工作损伤百分比（ percentage of over all work impairment due to health, POH ）、活动损伤百分比（ percentage of activityimpairment due to health, PAH ） ]增加20个百分点（P〈0．01）;心理健康不佳者生产力受损指标（PWH除外,PIH、POH、PAH）较心理健康较好者增加10个百分点（P〈0．01）,达到30％;患1种以上慢性病者生产力受损指标（PIH、POH）达到30％。[结论]职业人群健康状况不佳（健康自评一般和差或很差、心理健康不佳的比例均超过53％）和健康状况（评价指标包括健康自评、心理健康和慢性病患病否）对员工生产力有影响,健康状况越差,对生产力影响程度越大。建议加强职业人群健康促进,以减少生产力损失。     

我国成人健康自评的影响因素追踪研究

目的 家庭是社会的缩影和侧面,从家庭、个体两方面分析我国成人健康自评状况,探讨健康自评影响因素,提高健康问题的预见性和主动性,为促进我国成人健康提供参考。方法 本研究提取多阶段分层整群随机抽样的2010年、2012年、2014年、2016年中国家庭追踪调查（CFPS）16岁及以上成人研究对象有效数据41764例,每期数据10441例。描述我国成人健康自评现状,构建广义估计方程模型,将人口学变量、家庭变量、个体变量先后纳入模型进行检验,从家庭和个体两方面探讨我国成人健康自评的影响因素。结果 2010年,自评健康者占86.15%,自评不健康者占13.85%;2016年,自评健康者占85.64%,自评不健康者占14.36%。随着控制变量、自变量的依次纳入,模型QIC从32399.292降至27221.571,说明模型的拟合优度不断提升。本研究中,政府补助（P＜0.001）、做饭最主要用水为井水（P=0.005）、做饭最主要用水为窖水（P＜0.001）、做饭最主要燃料为罐装煤气/液化气/天然气/管道煤气（P＜0.001）、做饭最主要燃料为电（P＜0.001）、两周患病情况（P＜0.001）、半年患慢性病（P＜0.001）、住院（P＜0.001）、喝酒频率（P＜0.001）、是否午休（P=0.001）、公费医疗（P=0.018）、新型农村合作医疗（P=0.001）对成人健康自评影响的差异有统计学意义。结论 应重点关注年龄较大、受教育程度较低、乡村、家庭生活条件较差这部分人群,合理配置公共卫生资源,提高我国成人健康生命质量。     

贵州贫困农村地区老年人健康自评情况及影响因素分析

目的 了解贵州省贫困农村地区老年人健康自评情况及影响因素.方法 采用多阶段分层整群随机抽样方法,在贵州省50个国家级贫困县中抽取6个县3 600户调查对象中农村户籍、年龄大于或等于60岁的常住老年人共1400名作为研究对象.研究内容包括一般人口社会经济学特征,健康自评情况、健康状况、自我保健行为、吸烟、饮酒情况、社会支持等,结果分析采用x2检验及有序变量累积比数模型.结果 在1400名研究对象中,健康自评“好”的老年人565人,占40.4％; “一般”的为635人,占45.4％; “差”的200人,占14.3％;文化程度高、收入高的、有经常性社会交往的老年人健康自评好,年龄越大、患有慢性病、两周患病、ADL、IADL有损害、做过健康体检及生活照料依赖家人/亲友的老年人健康自评差.结论 贵州贫困农村地区老年人文化程度低、经济条件差,健康自评水平低,提高农村老年人的生活水平,加强农村地区医疗卫生保健,缩小城乡差距,应成为改善农村老年人健康状况的关键.     

济南市≥65岁老人身体健康状况及影响因素分析

目的 了解山东省济南市老年人身体健康状况并比较城乡区别.方法 采用分层随机抽样方法 选取样本,采用问卷调查方法,对济南市1 071名≥165岁老年人进行了入户调查,并拟合广义线性模型进行统计分析.结果 1071人中,自评身体健康状况很好者143人,占13.40%;自评一般者729人,占68.10%;自评较差者198人,占18.50%;与同龄人比较,自评身体健康状况很好者106人,占9.90%;自评较好者313人,占29.20%;自评一般者522人,占48.70%;自评较差者128人,占12.00%;城市好于农村,差异有统计学意义(u=-4.544,P=0.000);患有慢性病老年人675人,患病率为63.02%,城市老年人慢性病患病率高于农村,差异有统计学意义(u=134.65,P=0.000);常见慢性病患病率前6位为高血压、心脏病、糖尿病、慢性支气管炎、颈椎病、脑血管疾病.结论 济南市老年人群健康状况不容乐观,年龄、对所居住社区(村)评价、精神/心理得分、居住地和个人平均月收入对身体健康状况的影响具有统计学意义.     

开封地区农村老年人健康自评状况及影响因素分析

目的探究开封地区农村老年人健康自评状况及其影响因素,为健康老龄化政策的制定提供依据。方法抽取2017年5月调查区域(禹王台区、顺河区、祥符区、杞县、通许县、尉氏县)的开封地区农村户籍的901名老年人。采用问卷调查的方式对调查对象的一般情况、健康自评状况及相关影响因素进行调查和分析。结果901名调查对象,男女比为1∶0.98,受教育程度:未上过学占49.17%,留守老人占比70.48%。健康自评为"差"者360例(39.96%),健康自评为"一般"者379例(42.06%),健康自评为"好"者162例(17.98%);Logistic回归分析结果显示,开封市农村老年人健康自评状况的相关影响因素有是否为留守老人、是否患有慢性病、是否年内住院、BMI指数(P0.05)。结论开封地区农村老年人健康自评状况较为积极,健康自评状况的相关影响因素有是否为留守老人、是否患有慢性病、是否年内住院、BMI指数。     

基于健康素养监测的居民自评健康状况研究

目的:分析辽宁省居民自评健康状况与健康素养的关系,为健康教育干预措施和策略的制定提供依据.方法:采用分层多阶段与人口规模成比例抽样(PPS)方法,抽取辽宁省[15,69)岁常住居民进行问卷调查,应用多因素logistic回归分析自评健康状况与健康素养的关系.结果:回收有效问卷2916份,男性占46.33％,女性占53....     

空腹血糖受损切点下调后糖调节受损状况调查

目的了解空腹血糖受损（IFG）切点下调后对糖调节受损（IGR）状况的影响。方法收集1896例完整的健康体检资料并分别按年龄和不同空腹血糖水平进行分组,采用卡方检验进行统计学分析。结果IFG诊断标准下调后IFG患病例数增加271例,IFG患病率由13．1％增至27．4％,两者比较差异有统计学意义（X^2=62．68,P〈0．05）,正常糖耐量由60．3％降至47．5％,两者比较差异有统计学意义（×。=120．03,P〈0．05）。空腹血糖5．6—6．0mmol／L组与〈5．6mmoL／L组及与6．1—6．9mmol／L组比较,在超重或肥胖、高血压、高血脂、脂肪肝及心电图异常方面比较,差异均有统计学意义（P〈0．05）。结论IFG切点下调后对武汉该地区IGR分布有显著影响,新增单纯IFG人群已出现糖、脂代谢异常,应引起重视并及早进行干预治疗。     

空腹血糖受损切点下调后糖调节受损状况调查

目的了解空腹血糖受损（IFG）切点下调后对糖调节受损（IGR）状况的影响。方法收集1896例完整的健康体检资料并分别按年龄和不同空腹血糖水平进行分组,采用卡方检验进行统计学分析。结果IFG诊断标准下调后IFG患病例数增加271例,IFG患病率由13．1％增至27．4％,两者比较差异有统计学意义（Х^2=62．68,P〈0．05）,正常糖耐量由60．3％降至47．5％,两者比较差异有统计学意义（Х^2=120．03,P〈0．05）。空腹血糖5．6～6．0mmol／L组与〈5．6mmol／L组及与6．1～6．9mmol／L组比较,在超重或肥胖、高血压、高血脂、脂肪肝及心电图异常方面比较,差异均有统计学意义（P〈0．05）。结论IFG切点下调后对武汉该地区IGR分布有显著影响,新增单纯IFG人群已出现糖、脂代谢异常,应引起重视并及早进行干预治疗。     

儿童期父母社会经济地位对子女成年健康的影响：中国居民健康的代际不公平效应

目的:分析儿童期父母的社会经济地位对子女成年后健康的独立影响,评价我国居民健康的代际不公平效应.方法:应用中国综合社会调查2005年的数据,通过多分类有序Logistic回归分析,测量儿童期父母的社会经济地位对子女成年后自评健康的影响.结果:儿时父亲接受过正式教育、父亲职业为领导干部或专业技术人员的、或母亲接受过正式教育的子女,成年后拥有更高的健康水平.结论:儿童期父母的社会经济地位对子女成年期的自评健康有影响,这种影响在控制子女成年期社会经济地位和人口学变量后依然存在,即存在由社会经济地位导致的健康代际不公平效应.各社会经济地位变量中,母亲的受教育程度对子女成年后自评健康影响最为显著.     

上海市人群自报健康水平的综合测量(一)

人群自报健康资料是进行非死亡性健康测量的重要工具该测量基于上海市嘉定、宝山、金山和崇明4区(县)的家庭卫生服务调查中的自报健康资料进行人群自报健康水平的综合测量研究。结果表明，由于“顶效应”和“切点位移偏倚”的存在，不宜直接应用自报健康资料进行跨人群比较或进一步作为卫生系统决策和管理的依据；结合健康情景的HOPIT模型能显著弱化自报健康资料的“顶效应”，并改善其跨人群可比性。     

基于TBL教学的《健康教育学》课程教学效果初探

目的为了提高学生的健康教育实践能力,评价TBL教学方式在健康教育学课程中的作用及教学效果,以期改进教学方法、完善教学内容,为课程教学质量的评估提供可依数据。方法选择2014级(五年级)与2016级(三年级)预防医学专业本科生共57名进行问卷调查。结果学生对《健康教育学》课程教学效果总体满意,其中很满意和比较满意合计占73.7%。超过70%的学生认为课程中的“实践能力培养”对本科学习有作用,超过60%的学生认为该课程能提升自我全面发展能力,且两个年级的学生评价结果差异无统计学意义(P>0.05)。结论本研究采用TBL教学法对预防医学本科生的课程教学评估效果和方式均优良,且课程前置(高年授课提前至低年级授课)达到了课程计划的要求和预期的教学效果。     

健康情景问卷方法在自报健康水平校正中的应用

介绍健康情景问卷方法在自报健康中的应用.以杭州市健康调查为例,首先利用健康情景问题确定被调查者的健康评判标准,发现性别、年龄、文化程度和收入水平等因素对自报健康资料的切点均有不同程度的影响(即切点位移);通过HOPIT模型的统计调整和计算,使每个被调查者的自报健康结果基于相同的标准,从而实现不同人群自报健康的校正,使结果适于比较.结果 发现杭州市居民女性的健康水平低于男性,收入水平越高的人群,健康水平越高.因此在健康调查中有必要利用健康情景技术.

Abstract：

To introduce the application of vignettes in the survey on health condition,we took the Hangzhou health survey as an example. We tried to find the respondents' health judgment standard by using vignettes first and discovered the population' s demographic characteristics as sex,age, years of schooling and income etc. could influence the self-reported health condition on the response category cut-points. Then the cut-points were corrected through hierarchical ordered probit model in order to reflect the respondents' self-reported health condition based on the same standard,making the result suitable for comparison. Data from our research discovered that the level of health condition of females was lower than that of males among the residents living in Hangzhou and the higher income they received, the better health condition they had. Thus, the health vignettes seemed very essential in the survey on health condition.     

公共卫生硕士专业学位研究生培养质量的调查研究

目的了解我国公共卫生硕士专业学位研究生的培养现状,探究培养质量影响因素,发现问题提出对策,为我国公共卫生硕士专业学位研究生培养提供依据。方法采用自编问卷对28所开设公共卫生硕士专业学位研究生教育院校的研究生进行问卷调查,采用描述性统计、探索性因子分析和多元线性回归分析对问卷结果进行分析。结果 53.68%的研究生认为课程教学中"重理论,与实践联系太少",9.81%的研究生表示没有专业实践机会,71.78%的研究生是单一导师制,44.79%的研究生在课题研究阶段进行基础类的实验研究。探索性因子分析降维提取"平台条件"、"专业实践"、"课程设置"、"导师队伍"、"奖惩机制"5个因子;多元线性回归分析发现"专业实践"、"导师队伍"和"平台条件"对研究生的自身培养质量评价呈正向影响。结论高校应该优化公共卫生硕士专业学位研究生的导师指导制度和导师队伍,规范专业实践培养过程,健全科研基础设备和完善专业实践基地建设,提高专业学位研究生的培养质量。     

拉萨地区藏族人群生活行为方式与自评健康状况的关联研究

目的 探讨拉萨地区藏族人群自评健康状况与常见生活行为方式暴露的关联,以期为该人群的健康促进工作提供依据。方法 选取国家重点研发计划“西南区域自然人群队列”中拉萨地区藏族人群作为研究对象,以面对面电子问卷调查方式收集自评健康状况,采用全环境关联研究（EWAS）方法,全面探讨生活行为方式因素与自评健康状况的关联。结果 6 212名藏族人群中自评健康状况非常好占9.1%,较好占55.9%,一般占28.0%,较差或很差占6.9%。EWAS框架下的有序Logistic回归分析显示偶尔饮酒（OR=0.79）、经常饮酒（OR=0.66）、膳食评分（OR=0.97）、每周业余平均锻炼时长2~3 h（OR=0.72）、每周业余平均锻炼时长>3 h（OR=0.84）人群更易有好的自评健康状况。而重度环境烟雾暴露（OR=1.52）人群自评健康状况更差。结论 藏族人群的自评健康状况总体较为乐观,多种生活行为因素与自评健康状况相关,为后续健康教育、促进方向提供理论依据。     

Do major life events influence physical activity among older adults: the Longitudinal Aging Study Amsterdam

Background

Accelerometers have been used to determine the amount of time that children spend sedentary. However, as time spent sitting may be detrimental to health, research is needed to examine whether accelerometer sedentary cut-points reflect the amount of time children spend sitting. The aim of this study was to: a) examine agreement between ActiGraph (AG) cut-points for sedentary time and objectively-assessed periods of free-living sitting and sitting plus standing time using the activPAL (aP); and b) identify cut-points to determine time spent sitting and sitting plus standing.

Methods

Forty-eight children (54% boys) aged 8-12 years wore a waist-mounted AG and thigh-mounted aP for two consecutive school days (9-3:30 pm). AG data were analyzed using 17 cut-points between 50-850 counts·min^-1 in 50 counts·min^-1 increments to determine sedentary time during class-time, break time and school hours. Sitting and sitting plus standing time were obtained from the aP for these periods. Limits of agreement were computed to evaluate bias between AG50 to AG850 sedentary time and sitting and sitting plus standing time. Receiver Operator Characteristic (ROC) analyses identified AG cut-points that maximized sensitivity and specificity for sitting and sitting plus standing time.

Results

The smallest mean bias between aP sitting time and AG sedentary time was AG150 for class time (3.8 minutes), AG50 for break time (-0.8 minutes), and AG100 for school hours (-5.2 minutes). For sitting plus standing time, the smallest bias was observed for AG850. ROC analyses revealed an optimal cut-point of 96 counts·min^-1 (AUC = 0.75) for sitting time, which had acceptable sensitivity (71.7%) and specificity (67.8%). No optimal cut-point was obtained for sitting plus standing (AUC = 0.51).

Conclusions

Estimates of free-living sitting time in children during school hours can be obtained using an AG cut-point of 100 counts·min^-1. Higher sedentary cut-points may capture both sitting and standing time.     

Poor self-rated mastication and associated factors in Brazilian adults

This study estimated the prevalence of bad/very bad self-rated mastication and investigated associated factors among Brazilian adults. The sample included 13,431 adults examined and interviewed in the SBBrazil project. Self-rated mastication was combined in three categories: good/ very good (the reference), fair, and bad/very bad. Multinomial logistic regression was performed to measure the association between fair and bad/very bad self-rated mastication and all independent variables included in the analysis, with significance set at p < 0.05. 55.6% of participants rated their mastication as good/very good, 24.9% as fair, and 19.5% as bad/very bad. In the final multivariate analysis, factors associated with bad or fair self-rated mastication were: receiving no information on how to avoid oral problems; presenting fewer than 23 remaining teeth; requiring total or partial prosthesis; bad/very bad self-rated oral health; gingival pain and/or toothache in the previous year; and need of dental treatment. In conclusion, various factors were associated with self-rated mastication, especially subjective conditions, thus emphasizing its importance as an oral health indicator.     

Self-rated Health in Middle-aged Women: Associations with Sense of Coherence and Socioeconomic and Health-related Factors

This study aimed to describe and analyse self-rated health in relation to sense of coherence and socioeconomic and health-related factors and to explore the associations between self-rated health and these factors in order to identify health resources and health limitations in a group of healthy middle-aged women. Healthy middle-aged women from a defined geographical area in Southern Sweden ( n =577) answered a postal survey with the sense of coherence scale and questions about socioeconomic and health-related conditions. The results showed that very good/rather good self-rated health was associated with high sense of coherence and good economic situation, and these factors can be seen as a health resource. Poor self-rated health was most strongly associated with perceived symptoms of tension, weak sense of coherence, treatment for depression, treatment for chronic disease, and difficult economic situation, and these factors can be seen as health limitations. In conclusion, only 29% of the women rated their health as very good and 41% of the women had symptoms of tension but they were not sick-listed. It is of major public health interest to improve the understanding of self-rated health and to develop health promotion for women and methods to prevent symptoms of tension and sick-listing.     

Self-rated oral health among Brazilian adults and older adults in Southeast Brazil: results from the SB-Brasil Project, 2003

The aim of this study was to determine which characteristics (predisposing and enabling, oral health, perceived need for dental treatment, and behavior) are independently associated with self-rated oral health among adults and older adults in Southeast Brazil. The study was based on 3,240 participants in the SB-Brasil Project/ Southeast. The characteristics of those who rated their oral health as good/very good were compared to those who rated it as fair, poor, or very poor. The following characteristics were significantly and independently associated with better self-rated oral health among adults: monthly household income > US 60.00 dollars, no current perceived need for dental treatment, place of residence in cities with > 50,000 inhabitants, and visit to the dentist > 3 years previously. Among older adults the factors were: monthly household income > US 60.00 dollars, no current perceived need for dental treatment, and 1-19 permanent teeth. Our results confirm those observed in other countries, showing associations between self-rated oral health and predisposing and enabling factors, oral health, perceived need for dental treatment, and behavior.     

Self-rated Health in Middle-aged Women: Associations with Sense of Coherence and Socioeconomic and Health-related Factors

This study aimed to describe and analyse self-rated health in relation to sense of coherence and socioeconomic and health-related factors and to explore the associations between self-rated health and these factors in order to identify health resources and health limitations in a group of healthy middle-aged women. Healthy middle-aged women from a defined geographical area in Southern Sweden ( n =577) answered a postal survey with the sense of coherence scale and questions about socioeconomic and health-related conditions. The results showed that very good/rather good self-rated health was associated with high sense of coherence and good economic situation, and these factors can be seen as a health resource. Poor self-rated health was most strongly associated with perceived symptoms of tension, weak sense of coherence, treatment for depression, treatment for chronic disease, and difficult economic situation, and these factors can be seen as health limitations. In conclusion, only 29% of the women rated their health as very good and 41% of the women had symptoms of tension but they were not sick-listed. It is of major public health interest to improve the understanding of self-rated health and to develop health promotion for women and methods to prevent symptoms of tension and sick-listing.