3～6岁儿童的奶类消费量与生长发育关系

目的探讨我国城乡3—6岁儿童奶类消费量与其生长发育的关系,为国家制定相关政策提供参考依据。方法研究数据来自于2002年中国居民营养与健康状况调查,比较城乡不同饮奶量3～6岁儿童的身高和体重,进行相关指标的统计学分析。结果城乡3—6岁儿童的饮奶率分别为46．9％和8．2％;城乡3～6岁儿童饮奶量平均为23．8g／d,城市儿童高于农村（P〈0．01）;在同一年龄组,城乡儿童饮奶组的身高均高于未饮奶组,4岁、5岁和6岁饮奶组儿童的身高和体重与未饮奶组的差异有统计学意义（P〈0．05）,并且与饮奶量有关。结论需要进一步提高3～6岁儿童的饮奶率和饮奶量,以改善儿童的生长发育状况。     

祖孙三代乳糖不耐受与饮奶情况分析

[目的]了解祖孙三代乳糖不耐受(Lactose intolerance,LI)发生情况并探讨长期、多代饮奶行为对乳糖酶活性的影响。[方法]采用随机整群抽样的方法在乡镇3个幼儿园选取分别来自53个家庭的3～6岁儿童及其父母、祖父母共358人进行饮奶问卷调查,243人进行氢呼气试验并诊断出LI的患者,计算平均每年饮奶量(AMIy),用χ2检验、等级相关等进行统计分析。[结果]成人不饮奶者LI发生率显著高于饮奶者(χ2=5.27,P﹤0.05)。AMIy与LI严重程度呈显著负相关(r=-0.353,P﹤0.05)。祖父母、父母两代均不饮奶的家庭中儿童LI发生率显著高于两代均饮奶的家庭中儿童LI发生率(χ2=4.57,P﹤0.01)。[结论]饮奶与乳糖不耐受有关;饮奶频率越大,饮奶年限越长,能减少不耐受症。乳糖不耐受者能接受的适宜奶量需要进一步的研究,多代的饮奶习惯对后代乳糖酶活性的影响仍需要多个、更大样本的研究支持。     

Conners父母问卷在学龄前儿童心理问题筛查中的应用

目的探讨Conners父母症状问卷在学龄前儿童的临床运用，了解太原市学龄前儿童心理健康状况。方法采用Conners父母症状问卷（Parent Symptom Questionnaire，PSQ），对太原市2448名3-7岁儿童的心理行为问题进行调查。结果应用Conners父母问卷调查太原市学前儿童心理行为问题，其检出率为16．18％（常模为3％～10％）。其中男童17．12％，女童15．09％。经卡方检验，男女之间无显著性差异（x^2=0．17，P〉0．05）；但男女童在品行问题、多动指数因子得分存在显著差异（t=2．38，P〈0．05；t=2．04，P〈0．05），冲动一多动因子得分之间存在非常显著差异（t=3．38，P〈0．01）；小年龄组（3～5岁组）和大年龄组（6-7岁）之间焦虑因子存在显著差异（t=1．69，P〈0．05）。结论学龄前儿童心理行为问题值得重视；Conners父母症状问卷在学龄前儿童的心理筛查中应用方便，值得推广。     

血尿酸、高敏C反应蛋白及同型半胱氨酸与冠心病相关性研究

目的探讨冠心病患者不同临床类型之间血清尿酸、高敏C反应蛋白（high-sensitivitv C—reactiveprotein，hs—CRP）和同型半胱氧酸（homocysteicacid，Hcy）的关系，方法选择年龄≥60岁老年冠心病患者134例分为3组：稳定型心绞痛（SAP）组54例、不稳定型心绞痛（UAP）组42例、急性心肌梗死（AMI）组38例。另选年龄≥60岁未患冠心病者114例作为对照组，分析各组血清尿酸、hs—CRP和Hey含量及三者的关系。结果AMI组及UAP组血清尿酸、hs-CRP和Hcv含量高于对照组和SAP组，差异有统计学意义（P〈0．05）；AMI组血清尿酸、hs—CRP与Hcy含量呈正相关（r=0．73．P〈0．01：r=0．71，P〈0．01），血清尿酸与hs—CRP亦呈正相关（r=0．71，P〈0．01）；UAP组血清尿酸、hs—CRP与Hcv含量呈正相关（r=0．63，P〈0．01；r=0．70，P〈0．01），血清尿酸与hs—CRP亦呈正相关（r=0．48，P〈0．01）。结论在老年冠心病患者中，血尿酸、hs-CRP和Hcv可能联合参与了急性冠状动脉事件的发病过程．     

健康成人牛奶不耐受症的研究

采用问卷调查和氢呼气试验（ＨＢＴ）对健康成人牛奶不耐受及其影响因素进行了研究。调查结果表明：总饮奶率为９０％；饮奶后不耐受症状发生率为３９．０％，症状多为轻度和偶尔出现，不耐受症状发生率与饮奶量、是否同时进食其他食物以及进食食物的种类有关，与饮奶者的年龄、性别和饮奶时间无相关关系；导致不饮奶的原因以非牛奶不耐受因素为主。ＨＢＴ结果显示：牛奶乳糖吸收不良率为７７．８％（饮２５０ｇ牛奶），牛奶乳糖不耐受率为５．６％。     

内蒙古不同浓度砷暴露人群尿砷代谢产物研究

目的 测定内蒙古地区饮用高砷水人群尿砷代谢产物，探讨不同人群砷代谢的特点。方法 采用氢化物发生原子吸收分光光度法检测尿中不同形态的砷代谢产物。结果 2个暴露组人群尿中无机砷（iAs，inorganic arserlic）、甲基砷（MMA，monomethylarsine）、二甲基砷（DMA．dimethylarsine）和总砷（TAs，total arserlic）均高于对照组（P〈0．05）；同样砷暴露水平下，尿中各形态砷含量及其相对比在不同性别问的差异均无统计学意义（P〉0．05），儿童DMA／MMA和DMA％高于成人（P〈0．05），MMA％低于成人（P〈0．05）；2个暴露组儿童、成人分别与对照组比较，暴露组MMA／ias、DMA／MMA、DMA／iAs、DMA％显降低（P〈0．05），而iAs％、MMA％显增高（P〈0．05）；高暴露组与低暴露组相比，儿童DMA／MMA、DMA／iAs、DMA％显增高（P〈0．05），iAs％、MMA％显降低（P〈0．05）。结论 相同砷暴露水平下，男女对砷的甲基化能力无差别，儿童二甲基化能力高于成人。高砷暴露可能降低人群对砷的生物甲基化能力。[编按]     

乌鲁木齐市维吾尔族学龄前儿童行为问题现状及影响因素分析

目的了解乌鲁木齐市维吾尔族学龄前儿童行为问题现况并探讨其影响因素。方法采用Connet＇s量表教师问卷（TRS）和自拟影响因素问卷，对乌鲁木齐市835名学龄前儿童的教师和家长进行问卷调查。结果维吾尔族学龄前儿童行为问题总检出率4．0％，男童为4．4％，女童为3．7％，性别之间无统计学差异（P〉0．01）。男童多动指数得分明显高于女童（P〈0．01），4岁儿童各因子得分均高于其他年龄（P〈0．01）。行为问题发生的影响因素有：带养人、父亲职业、母亲职业、父母工作繁忙否、儿童的分娩情况和发育情况等。结论家庭环境和生物因素对维吾尔族学龄前儿童行为问题的发生有重要影响，应采取综合防治措施。     

儿童与成人烟雾病数字减影血管造影对比分析

目的 探讨儿童型和成人型烟雾病患者脑血管造影的特征及与临床表现的关系。方法 回顾性分析儿童及成人20例烟雾病患者的临床表现及数字减影血管造影（DSA）的影像特点。结果 成人颈内动脉（ICA）、大脑前动脉（ACA）、大脑中动脉（MCA）双侧对称受累较儿童显著多见（P〈0．01）；ICA以狭窄为主，ACA、MCA段闭塞明显增多，成人闭塞比例较儿童更高（P〈0．05）。儿童44．44％，成人72．73％脑底有大量烟雾状血管；大脑后动脉及其分支增粗者儿童77．78％，成人81．82％；颈外动脉向颈内动脉的代偿：儿童组44．44％，成人组36．36％。结论 儿童型和成人型烟雾病患者的DSA表现明显不同，儿童型颈内动脉病变较轻，侧支代偿较差，临床表现以缺血多见；成人型颈内动脉病变较严重，侧支代偿较好，临床表现以出血为主。基底部烟雾状血管的广泛发展、扭曲紊乱与脑出血密切相关。     

某区学龄前儿童单纯性肥胖患病情况调查

目的：了解咸宁市咸安区学龄前儿童单纯性肥胖症的患病率及主要影响因素，为预防儿童肥胖提供依据。方法：采用随机整群抽样法，随机抽取咸安区城区6所幼儿园2～6岁儿童2375名进行肥胖患病情况调查，并对肥胖危险因素进行了分析。结果：该区学龄前儿童单纯性肥胖症患病率为3．58％，其中男童患病率为4．58％，女童患病率为2．56％。男女患病率间差异有统计学意义（x^2=7．01，P〈0．01）。不同年龄组儿童肥胖检出率差异有统计学意义（x^2=14．99，P〈0．01）。Logistic回归分析显示每天看电视时间长（OR=3．5449）、不喜欢体育活动（OR=3．8598）、喜欢吃油腻食物（OR=4．4961）、进食速度快（OR=4．3279）、早餐不正常（OR=1．8815）及父母至少一方肥胖（OR=3．5438）为儿童肥胖的主要危险因素，而父母大专以上文化程度（OR=0．5836）是儿童肥胖的保护因素。结论：学龄前儿童单纯性肥胖患病率较高；儿童肥胖的发生是多因素共同作用的结果。     

2006年重庆市沙坪坝区学龄前儿童肥胖及其影响因素调查

[目的]了解重庆市沙坪坝区儿童肥胖发生状况及其影响因素，为制订预防和控制对策提供依据。[方法]2006年10月，对辖区内7307名3～6岁儿童进行调查，采用1：1配对分析查出的肥胖儿童与非肥胖儿童有关肥胖影响因素的OR值。[结果]调查7307名儿童，肥胖者134名，肥胖率为1．83％。肥胖率，男童为2．12％，女童为1．50％（P〈0．05）；3～6岁分别为1．70％、1．45％、1．38％、3．71％（P〈0．01）。肥胖儿童与非肥胖儿童相比，在喜欢食肉类、喜食甜食、进食量大、进食速度快、人工喂养、出生体重〉4000g、父母一方或双方肥胖者的OR值的95％可信限均大于1；户外活动、父母一方或双方为大专以上文化程度者的OR值的95％可信限均小于1。[结论]沙坪坝区3～6岁儿童肥胖率处于一般水平。不良饮食习惯与遗传是影响儿童肥胖的主要因素。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

Fatigue and health in a seafaring population

Background Occupational fatigue is relatively common withinthe general population and has been linked to reduced performance,injury and longer term ill-health. Despite growing acknowledgementof this problem in the maritime sector, little research hasbeen conducted into the risk factors, prevalence and consequencesof seafarers' fatigue. Aims To examine the prevalence of fatigue among seafarers, identifypotential risk factors and assess possible links with poor performanceand ill-health. Methods Cross-sectional questionnaire survey of seafarers workingin the offshore oil support, short-sea and deep-sea shippingindustries. A number of tools were used including the fatiguesubscale of the profile of fatigue-related symptoms, the CognitiveFailures Questionnaire, the General Health Questionnaire andthe SF36 General Health scale. Results In all, 1855 questionnaires were completed giving anoverall response rate of 20%. Fatigue symptoms were associatedwith a range of occupational and environmental factors, manyunique to seafaring. Reporting a greater number of risk factorswas associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35)for those with three or four risk factors and OR = 9.54 (6.95–13.09)for those with five or more risk factors]. There was also astrong link between fatigue and poorer cognitive and healthoutcomes, with fatigue the most important of a number of riskfactors, accounting for 10–14% of the variance. Conclusions Seafarers' fatigue could impact on safety withinthe industry and may be linked to longer term individual ill-health.It can only be addressed by considering how multiple factorscombine to contribute to fatigue.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.