青海省部分地区成年居民主要慢性病患病率及知晓、治疗和控制情况

目的了解青海省部分地区成年居民主要慢性病患病及知晓、治疗和控制状况,为制定相应防治措施提供政策和科学依据。方法根据青海省地域、经济特点,采用多阶段分层随机抽样方法,于2010年10月抽取1 792名18岁及以上居民为调查对象,进行问卷调查、身体测量和实验室检测,对高血压、糖尿病和血脂异常患病及知晓、治疗和控制情况进行调查和分析。结果调查对象高血压、糖尿病和血脂异常患病率分别为29.6%、4.9%和47.6%(全国标化率分别为29.0%、4.8%和47.4%,全省标化率分别为26.2%、4.3%和47.5%)。血脂异常以低高密度脂蛋白胆固醇血症和高甘油三酯血症为主,其患病率分别为41.5%和14.5%;高血压患者的知晓率、治疗率和控制率分别为39.4%、24.0%和8.7%,糖尿病患者的知晓率、治疗率和控制率分别为64.6%、56.1%和28.0%,血脂异常患者的知晓率和治疗率分别为8.4%和5.3%。调查对象的高血压和糖尿病的患病率均随年龄增加而升高(χ2值分别为261.60和43.35,P0.01)。结论青海省部分地区成年居民主要慢性病患病率水平较高,而知晓率、治疗率和控制率较低,应加强慢性病综合防治工作,以降低慢性病的发病和死亡。     

贵州省成年居民血脂异常患病现状及危险因素分析

目的了解贵州省成年居民血脂异常患病现状及其危险因素,为血脂异常的预防控制提供参考依据。方法于2011年8—12月采用多阶段分层整群随机抽样方法对在贵州省抽取的9 280名≥18周岁成年居民进行问卷调查、体格检查和实验室检测。结果贵州省成年居民血脂异常者患病率为58.1%,高总胆固醇血症、高甘油三酯血症、高低密度脂蛋白胆固醇血症和低高密度脂蛋白胆固醇血症患病率分别为11.9%、18.9%、9.6%和37.4%;贵州省成年居民对血脂异常诊断的知晓率为3.9%,男性和女性居民知晓率分别为3.7%和4.1%,城市和农村居民知晓率分别为4.2%和3.8%,18~44、45~59和≥60岁居民知晓率分别为1.9%、5.7%和6.3%,居民血脂异常诊断知晓率随着年龄增长呈增高趋势(χ2=58.253,P0.001);多因素非条件logistic回归分析结果显示,居住在农村、吸烟、饮酒、红肉摄入过多、谷薯类摄入不足、高血压、糖尿病和超重/肥胖是贵州省成年血脂异常患病的危险因素。结论贵州省成年居民血脂异常患病率较高,且对血脂异常诊断的知晓率较低;居住地及是否吸烟、饮酒、红肉摄入过多、谷薯类摄入不足、高血压、糖尿病、超重/肥胖为该地区成年居民血脂异常患病的主要危险因素。     

中老年社区居民血脂、体质指数与慢性病的相关性分析

目的 探讨中老年社区居民血脂、体重与慢性病的相关性,为社区居民健康管理提供参考依据.方法 检查900名中老年社区居民的血脂,测量计算体质指数,并进行问卷调查.结果 被调查的社区居民甘油三酯、总胆固醇、体质指数合格率分别为65.4％、72.4％和30.7％;高血压、糖尿病患病率分别为40.6％和10.8％.logistic回归分析结果显示,年龄、糖尿病、总胆固醇水平是中老年社区居民高血压患病的影响因素;高血压、体质指数是中老年社区居民糖尿病患病的影响因素(均P ＜0.05).结论 杭州市中老年社区居民血脂合格情况尚可,体质指数合格情况偏低.高年龄、糖尿病、总胆固醇水平是中老年社区居民高血压患病的显著影响因素,高血压、体质指数是中老年社区居民糖尿病患病的显著影响因素.     

湖南省35-75岁居民高血压患病、知晓、治疗和控制情况分析

目的描述湖南省35~75岁居民高血压患病、知晓、治疗和控制现状,探究患者个体特点与高血压知晓、治疗和控制的关联。方法利用湖南省心血管病高危人群早期筛查与综合干预项目所采集的数据进行分析。描述该地区高血压患病率、知晓率、治疗率和控制率,并利用多水平混合模型探究高血压知晓、治疗和控制与个体特点的关系。结果共纳入77531名调查对象,平均年龄(56.79±9.75)岁,62.25%为女性。调查人群高血压患病率为47.42%,标化高血压患病率为35.92%。55.04%知晓其患有高血压,46.56%接受降压药物治疗,13.32%血压得到控制。多水平混合模型显示年龄大、受教育程度高、肥胖、既往发生过心肌梗死、既往发生过卒中、糖尿病患者具有较高的高血压知晓率、治疗率和控制率(均P<0.001)。结论湖南省35~75岁居民高血压患病率高,知晓、治疗和控制情况有待提高,应继续全面开展高血压防治及宣教工作。     

城市社区居民对高血压和糖尿病危险因素知晓情况的分析

目的 了解城市社区居民对高血压和糖尿病危险因素的知晓情况及其影响因素,为进一步开展健康教育及健康促进、研发社区健康教育相关的适宜技术和资料提供依据和参考.方法 按照方便抽样的方法,选择全国12省市的14家社区卫生服务中心,在知情同意的原则下,对来社区卫生服务中心就诊的社区居民进行问卷调查.结果 在调查的6 620名社区居民中,随着年龄的增大,社区居民对高血压和糖尿病危险因素的知晓率下降(x2 =131.382,P＜0.001);患有高血压或糖尿病的社区居民较未患的知晓率高,差异有统计学意义(x2=8.962,P=0.003);多因素非条件Logistic回归分析显示家庭月收入、工作状态和是否患有高血压或糖尿病这3个变量进入回归方程.结论 社区老年人群对高血压和糖尿病危险因素的知晓率较低,应该加强社区老年居民的健康教育,研发社区健康教育相关的适宜技术尤为重要.     

北海城市居民慢性病患病及影响因素现况调查研究

目的 了解北海市城区居民慢性病流行特征及影响因素,为制定当地慢性病防控策略、评估防控措施与政策的综合效果提供基线数据。方法 采用概率比例规模抽样法,抽取北海市海城区6个街道办、行政村/居委会共1 428人。采用问卷调查的方式收集调查对象的社会人口学特征、生活方式等信息,同时进行身体测量并采集血液样本进行实验室检测。结果 调查对象高血压、糖尿病患病率分别为22.48%和11.27%;血脂与尿酸异常检出率分别为33.29%和11.91%;居民肥胖率为10.57%,久坐率为15.13%,52.66%的调查对象红肉摄入过量;慢性病核心知识知晓率与高血压核心知识知晓率分别为67.96%和45.24%。高血压、糖尿病患者对自身罹患慢性病的知晓率分别为55.14%和62.73%,血压、血糖监测率为64.17%和54.66%。结论 海城区居民高血压和糖尿病患病率低于国内其他城市,血脂异常、高胆固醇血症、高低密度脂蛋白胆固醇血症、低高密度脂蛋白胆固醇血症检出率均低于以往当地水平,吸烟、饮酒、蔬菜水果摄入不足等风险行为有所控制,经常锻炼率、糖尿病核心知识知晓率有所提高,慢性病防控工作取得一定成效。今后要逐...     

重庆市35～75岁居民高血压知晓率、治疗率与控制率及相关因素分析

目的分析重庆市35～75岁居民高血压知晓率、治疗率和控制率及相关因素,为开展高血压综合防治提供建议。方法 2016—2018年在重庆市8个中国心血管病高危人群早期筛查与干预项目点招募35～75岁常住居民进行问卷调查、体格检查和血糖、血脂检测,数据采用SPSS 25.0进行统计分析,不同人群高血压知晓率、治疗率和控制率的比较采用χ~2检验,高血压知晓率、治疗率和控制率相关因素分析采用二分类逐步后退的Logistic回归分析。结果共计调查101 036人,血脂异常、高血压、糖尿病患病率分别为31.48%、40.80%与17.16%,标化患病率分别为30.81%、33.91%、14.35%,高血压知晓率、治疗率、控制率分别为45.65%、 36.03%、11.60%。多因素logistic回归分析结果提示,年龄、户籍、职业、是否饮酒、是否戒烟、体重、中心性肥胖、糖尿病、血脂异常与高血压知晓率相关。户籍、民族、年龄、家庭年收入、是否饮酒、体重、中心性肥胖、血脂异常、糖尿病与高血压治疗率相关。户籍、年龄、家庭年收入、是否饮酒、中心性肥胖、糖尿病与血压控制率相关。结论重庆市高血压患病率较高,知晓率、治疗率和控制率较低,应针对重点人群、危险因素开展高血压综合防治,提高高血压知晓率、治疗率与控制率。     

社区中老年糖尿病与高脂血症相关性分析

目的了解上海市临汾社区居民糖尿病、高脂血症的流行病学特征,为糖尿病与高脂血症的防治提供依据。方法采用整群随机抽样的方法抽取社区≥45岁的600名中老年居民,进行健康筛查问卷调查。结果临汾社区中老年糖尿病、高脂血症的患病率分别为10.5%、76.2%,其中高胆固醇血症、高甘油三酯血症、低高密度脂蛋白血症的患病率分别为12.8%、37.8%、25.5%,男性低高密度脂蛋白血症的患病率显著高于女性(P<0.01),男女高胆固醇血症有统计学意义(P<0.05),高甘油三酯血症无统计学意义(P>0.05)。文化程度越低,糖尿病的患病率越高,而高脂血症患病率不明显。不同饮食、运动的人,糖尿病和高脂血症患病率有统计学意义(P<0.05)。饮酒与糖尿病、高脂血症无统计学差异(P>0.05)。糖尿病与非糖尿病人群的高脂血症患病率、血脂水平差异有统计学意义(P<0.05)。结论糖尿病与高脂血症患病率高,应加强社区中老年糖尿病防治,强调在控制血糖的同时应控制好血脂。     

辽宁省≥40岁农村糖尿病患者知晓率与治疗率和控制率现状及影响因素调查研究

目的分析辽宁省农村地区≥40岁2型糖尿病人群的知晓、治疗和控制情况以及相关影响因素,为糖尿病防控策略制定和调整提供科学依据。方法 2017年9月至2018年5月,本研究按照分层整群随机抽样方法在辽宁省农村地区随机选取4个县的19个村庄,对年龄≥40岁的10 926名常住居民进行问卷调查、体格检查和实验室检测,对其中1 768例糖尿病患者的知晓率、治疗率和控制率及其影响因素进行分析。结果 1 768例糖尿病患者知晓率、治疗率和控制率分别为42.14%、34.11%和38.47%,女性知晓率和治疗率高于男性(P0.05)。多因素logistic回归分析发现,有高血压、低高密度脂蛋白胆固醇血症、糖尿病家族史的糖尿病患者知晓率和治疗率较高,年龄较大的糖尿病患者治疗率亦较高,家庭年收入较高、缺乏运动的糖尿病患者控制率较高。高总胆固醇血症、现在饮酒的糖尿病患者知晓率和治疗率较低,高低密度脂蛋白胆固醇血症、低高密度脂蛋白胆固醇血症的糖尿病患者控制率较低。结论辽宁省农村地区≥40岁糖尿病人群知晓率和治疗率均处于较低水平,控制率有待提高,应加强糖尿病高危人群的筛查和健康教育工作,针对重点人群采取干预措施来防控糖尿病的发生和发展。     

2013年南京市溧水区成年人糖尿病防治意识调查

目的了解南京市溧水区居民糖尿病防治意识,为进一步开展糖尿病健康教育提供基线数据。方法随机抽取南京市溧水区8个社区18岁及以上8 153名居民,进行面对面问卷调查,对其糖尿病防治意识进行统计分析。结果调查人群对糖尿病常见症状的知晓率为57.2%;糖尿病可以引起高血压、冠心病、肾病及眼病的知晓率分别为33.3%、31.2%、38.6%及42.7%;父母患有糖尿病,子女就易患糖尿病的知晓率为62.0%,以上知晓率随年龄增长均呈下降趋势,调查人群对血糖知晓率为28.3%。有86.5%的糖尿病患者采取控制措施,采取口服降糖药、注射胰岛素、运动、控制饮食、血糖监测的比例分别为67.6%、9.9%、27.6%、43.6%、25.6%。结论南京市溧水区居民的糖尿病防治意识较差,应加强该区居民糖尿病健康教育,在糖尿病患者健康教育方面应当加强饮食治疗、运动治疗以及血糖监测方面的宣传。     

High prevalence of vasectomy in New Zealand.

The aim of this study was to examine the prevalence of vasectomy and associated factors in New Zealand, based on interviews with men. Participants were randomly selected from European men, aged between 40 and 74 years, on the general electoral roll. Telephone interviews were completed with 1225 men between 1997 and 1999. Overall, the prevalence of vasectomy was 44% (95% CI, 37-52%), adjusted to the age distribution of all New Zealand men aged 40-74 years. The prevalence ranged from 57% of men aged 40-49 years to 15% of those aged 70-74 years. Catholic men had a significantly lower odds of vasectomy, and there was a trend in increasing odds of vasectomy with increasing number of marriages and level of education of the wife. The results confirm a very high prevalence of vasectomy among New Zealand men. Comparison with earlier surveys based on interviews of women showed an increasing prevalence of vasectomy in each birth cohort from the 1920s to the 1950s. Vasectomy has been popular with men across all socioeconomic groups. New Zealand is an ideal country in which to study consequences of vasectomy.     

Maternal mortality in rural Gambia: levels, causes and contributing factors

A demographic study carried out in a rural area of the Gambia between January 1993 and December 1998 recorded 74 deaths among women aged 15-49 years. Reported here is an estimation of maternal mortality among these 74 deaths based on a survey of reproductive age mortality, which identified 18 maternal deaths by verbal autopsy. Over the same period there were 4245 live births in the study area, giving a maternal mortality ratio of 424 per 100,000 live births. This maternal mortality estimate is substantially lower than estimates made in the 1980s, which ranged from 1005 to 2362 per 100,000 live births, in the same area. A total of 9 of the 18 deaths had a direct obstetric cause--haemorrhage (6 deaths), early pregnancy (2), and obstructed labour (1). Indirect causes of obstetric deaths were anaemia (4 deaths), hepatitis (1), and undetermined (4). Low standards of health care for obstetric referrals, failure to recognize the severity of the problem at the community level, delays in starting the decision-making process to seek health care, lack of transport, and substandard primary health care were identified more than once as probable or possible contributing factors to these maternal deaths.     

The effect of age and procedure on resource use for patients with cerebrovascular disease

OBJECTIVE: Many studies have described the impact of population ageing on health care expenditures, but few have assessed its impact on specific diseases adjusted for severity and procedure. This study examined the relationship between an ageing population and resource use in patients with cerebrovascular disease (CVD). METHODS: A total of 13,856 CVD patients were treated in 82 academic and 92 community hospitals. Demographic variables, clinical variables, length of stay (LOS) and total charges were analysed by age group (under 65 years, 65-74 years and 75 years or older). The independent effects of age on LOS and total charge were determined using multivariate analysis. RESULTS: There were 5172 (37%) patients under 65 years of age, 4096 (30%) 65-74 years and 4588 (33%) 75 years or older. Intracranial infarction or ischaemia was diagnosed in 69% of the patients, haemorrhage in 23% and subarachnoid haemorrhage in 9%. The overall mortality was 6% (5% in under 65 years, 5% in 65-74 years and 9% in 75 years or older; P<0.001). There were significant differences in the proportion of procedures performed in each age category. Age and procedure were significantly associated with LOS, particularly the latter. Age had no significant association with total charge, but procedure was highly associated. CONCLUSIONS: Ageing has no significant impact on total charge. Instead policy-makers should acknowledge the effect of procedures on health care costs, conduct economic evaluations and monitor use of procedures.     

A population-based study of the prevalence of abdominal aortic aneurysms in relation to bone mineral density: the Tromsø study

In a population-based study of 2,586 men and 2,806 postmenopausal women aged 55-74 years in Troms?, Norway, in 1994-1995, associations between the prevalence of abdominal aortic aneurysms and bone mineral density were examined. The presence of an abdominal aortic aneurysm was assessed by ultrasonography. The bone mineral density of the forearm was measured by single X-ray absorptiometry. In postmenopausal women aged 55-64 years (nine cases of aneurysm), the adjusted odds ratio for abdominal aortic aneurysm was 0.42 (95% confidence interval: 0.19, 0.95) for each standard-deviation increase in bone mineral density. In other age groups (65-69 years and 70-74 years) including a total of 50 cases, the corresponding odds ratios for abdominal aortic aneurysm were 1.17 and 0.70, respectively. In men aged 55-59 years, based on 45 cases, the odds ratio for abdominal aortic aneurysm was 0.72 (95% confidence interval: 0.50, 1.03). In other age groups (60-64, 65-69, and 70-74 years) including a total of 206 cases, the odds ratios ranged from 1.00 to 1.10. The associations among men (in any age group) and among women older than 64 years were not statistically significant. The authors' main conclusion is that abdominal aortic aneurysms and bone mineral density are not related. However, an association in younger subjects cannot be ruled out.     

Impact of age and procedure on resource use for patients with ischemic heart disease

OBJECTIVES: Impact of age on healthcare expenditures should be assessed by targeting on specific diseases and controlling for procedures and severity of illness. Relationship between age and resource use in patients receiving acute care medicine for ischemic heart disease (IHD) was examined. METHODS: We analyzed 19,874 IHD patients treated in 82 academic and 92 community hospitals. Length of stay (LOS), total charges (TC), and high outliers of LOS and TC were analyzed for every age group (under 65 years, 65-74 years, 75 years or older). Independent effects of age on LOS, TC, and high outliers of LOS and TC were determined using multivariate analysis. RESULTS: 7863 (39.6%) patients were under 65 years, 7181 (36.1%) between 65 years and 74 years, and 4830 (24.3%) aged 75 years or older. Proportion of angina or non-medical treatment was significantly different among three age categories (angina 72%, 75%, 71.4%; non-medical 37.3%, 40.9%, 38.9%, respectively). Significant association with LOS or TC was identified in patients receiving coronary artery bypass graft surgery with percutaneous intracoronary intervention, who were most associated with TC high outlier. CONCLUSIONS: Age had a modest impact on resource use, as compared with procedures. Policy makers need to acknowledge the impact of procedures on healthcare spending.     

Moving home: costs associated with different models of accommodation for adults with learning disabilities

This paper reports on variation in the cost and social outcomes of provision for clients with learning disabilities, resettled across different models of community accommodation; identifying personal and service-related characteristics influential on such variation. The study was conducted to inform the community reprovisioning strategy associated with the phased closure of the Gogarburn and Tornaveen learning disability hospitals in the Lothian region, Scotland. Total mean service costs, quality of life and community integration outcome data were collected and compared. Total mean service costs ranged between pound16 438 and pound74 097 per year (mean pound42 023; SD = pound16 712). Cost estimates varied by age and dependency group, with costs for elderly clients comparatively low. Overall, there was an inverse relationship between total mean costs and size of accommodation. There was no evidence of a direct relationship between costs and changes in social outcomes. Services with the lowest mean costs were, however, associated with the smallest increases in social outcomes. The most expensive services did not realise proportionally greater gains in social outcomes. The paper concludes that clients generally benefited from the transition from hospital to community accommodation. However, some experienced better outcomes than others. In the absence of a clear link between levels and type of resource use and social outcomes, it is difficult to identify which service features are more or less efficacious in achieving positive outcomes. Broader evaluation perspectives, embracing a fuller range of costs and benefits, will be required to unpack exactly what it is about different models of community care provision that leads to positive outcomes, or otherwise, for learning disability clients. A more sound evidence base is required before effective strategies can be designed to ensure that key policy outcomes are realised and social integration truly achieved.     

Antibody response to measles immunization in India

Antibody response to measles vaccine was measured in 238 subjects aged 6-15 months. Seroconversion rates ranged from 74% at 6 months of age to 100% at 13-15 months; the differences in age-specific rates were not statistically significant. The postimmunization antibody titres increased with increasing age of the vaccinee. Seroconversion rates and antibody titres in 49 subjects with grades I and II malnutrition were not significantly different from those in the 189 normal subjects.     

Concentrations and enantiomer fractions of organochlorine compounds in Baltic species hit by reproductive impairment

Concentrations and enantiomer fractions (EFs) of organochlorine compounds (OCs) were determined in tissues of gray seal (Halichoerus grypus) and salmon (Salmo salar) originating from the Baltic Sea. The selected seal specimens ranged from starved to unstarved animals, and some of them suffered from a disease complex, while the salmon samples originated from individuals, which were known to produce offspring with and without the M74 syndrome. Significant differences in residue levels and EFs were found between seal groups but not between M74 salmon and non-M74 salmon. The relations between chemical and biological variables of seal samples were investigated with multivariate statistics. Poor health status correlated strongly with age, while bad nutrition condition was associated mainly with high pollution loads and distinctively nonracemic chiral OC compositions. High biotransformation rate (as indicated by fraction of chlordane metabolites in relation to total level of chlordanes) was also associated with large deviations from racemic values and high contaminant levels.     

Childbearing in marriage and mortality from breast cancer in Norway

The relationship between childbearing and mortality from breast cancer has been studied in a cohort of 822,593 currently married Norwegian women with information on parity from the Census in 1970 and follow-up till 1985. All age groups of parous women showed significant trends of decreasing mortality rates with increasing parity. Nulliparous women had the same mortality rates as uniparous women in all age groups. In a stratified analysis, for age group 45-74 years, the relative risk for uniparous women was between 3.8 and 4.5 dependent on age at first birth compared to women with 8-9 children, age at first birth before the age of 25 and last birth after the age of 30 years. In a multivariate analysis age and parity were stronger risk factors than age at first birth, while age at last birth was nonsignificant. Among women 45-74 years the population attributable risk of breast cancer mortality due to childbearing was 72%, using women with 8-9 children as the reference group. The use of different definitions of reference group for parity is discussed.     

Factors associated with severe periodontitis in rural Cambodia

An analytical cross-sectional study was conducted with 812 subjects aged 35-74 years in Prek Russey commune, Cambodia to detect some factors associated with severe periodontitis. Four calibrated examiners employed Community Periodontal Index (CPI) to ascertain periodontal pocket depth (PD) and loss of epithelial attachment (LA). A questionnaire was used to obtain tobacco and alcohol consumption habits. One hundred (12.3%) subjects had one or more sextants with > or =4 mm PD and > or =6 mm LA (severe periodontitis). Smoking, tobacco chewing and age were significantly associated with severe periodontitis in bivariate analysis while only age and quantified smoking remained significant in a logistic regression analysis. The impact of quantified smoking on severe periodontitis was almost negligible [OR: 1.0006 (95% CI: 1.0001, 1.001)] compared to that of age [OR ranged from 8.3 at 45-54 years to 22 at 65-74 years (95% CI: 3.1, 62.3)]. Nevertheless, both age and quantified smoking can be considered as factors associated with severe periodontitis in rural Cambodians.