3167名离退休老年人健康体检患病情况分析

目的了解老年人身体健康状况,探讨影响老年人健康的主要疾病及预防策略,有针对性的进行健康教育指导。方法针对老年人常见病进行健康体检,收集体检资料,采用顺位及构成比法进行统计分析。结果老年人所患疾病处于前几位的分别是脑动脉硬化、白内障、高血压、高脂血症、高血糖、冠心病、脂肪肝、前列腺增生。其中脑动脉硬化、前列腺增生、白内障随年龄增加而增加,各年龄组问差异有统计学意义（P〈0．01）。各种疾病除高血压病检出率男性高于女性有统计学意义外（P〈0．05）,其它疾病不存在性别差异。结论高血压、脑动脉硬化、高脂血症、高血糖、前列腺增生是老年入主要所患疾病,需要加强相关疾病保健知识的宣教和预防干预。     

Modelling spatially correlated data via mixtures: a Bayesian approach

Summary. The paper develops mixture models for spatially indexed data. We confine attention to the case of finite, typically irregular, patterns of points or regions with prescribed spatial relationships, and to problems where it is only the weights in the mixture that vary from one location to another. Our specific focus is on Poisson-distributed data, and applications in disease mapping. We work in a Bayesian framework, with the Poisson parameters drawn from gamma priors, and an unknown number of components. We propose two alternative models for spatially dependent weights, based on transformations of autoregressive Gaussian processes: in one (the logistic normal model), the mixture component labels are exchangeable; in the other (the grouped continuous model), they are ordered. Reversible jump Markov chain Monte Carlo algorithms for posterior inference are developed. Finally, the performances of both of these formulations are examined on synthetic data and real data on mortality from a rare disease.     

Detection of Multiple Outbreaks Using Spatio-Temporal EWMA-Ordered Statistics

Spatio-temporal surveillance methods for detecting outbreaks of disease are fairly common in the literature with the scan statistic setting the benchmark. If the shape and size of the outbreaks are known in advance, then the scan approach can be designed to efficiently detect these, however, this is seldom true. Therefore we want to devise plans that are efficient at detecting a number of outbreaks that vary in size and shape. This paper examines plans which use the exponential weighted moving average statistic to build temporal memory into plans and tries to develop robust plans for detecting outbreaks of unknown shapes and sizes.     

TWO-PASS CUSUM TO IDENTIFY AGE-CLUSTER OUTBREAKS

The paper introduces a two-pass adaptive cumulative sum (CUSUM) statistic to identify age clusters (age grouping) that significantly contribute to epidemics or unusually high counts. If epidemiologists know that an epidemic is confined to a narrow age group, then this information not only makes it clear where to target the epidemiological effort but also helps them decide whether to respond. It is much easier to control an epidemic that starts in a narrow age range of the population, such as pre-school children, than an epidemic that is not confined demographically or geographically.     

Predicting Future Commitment to Care for Frail Parents Among Employed Caregivers

A study of 133 full time employees with parent care responsibilities investigated various factors that could reduce this group's future caregiving commitment to aging parents. Study factors included: caregiver attributes, level of caregiving involvement, job stress, tensions between the caregiver and the dependent parent, caregiver's level of physical and mental strain, and limited support from family and friends. The relationship between the caregiver and the parent was the best predictor of sustained commitment to caregiving. One aspect of the employees' work experience made a small, but important contribution to respondents' future care plans. Those employees who frequently adjusted their work schedule and routine to accommodate parent care demands were less likely to sustain their caregiving commitment. Reasons for these findings are explored and implications for social policy and clinical practice are discussed.     

College students with congenital heart disease: A critical time for transition

As medical and surgical advances improve, more young adults with congenital heart disease (CHD) are attending college. This case study illustrates some of the issues that these young adults may face as they attend college and discusses the role that college health practitioners can play in easing that transition. Participants: A case of a male with CHD presenting to the college health clinic with a new onset headache. Methods: The authors discuss some of the unique challenges that college health practitioners may face when caring for students with CHD. In addition, they make recommendations on how best to care for these patients and how best to coordinate care with CHD students other care providers. Results: This student with a history of coarctation of the aorta presented with new onset headaches and was found to have high blood pressure. He was diagnosed with recurrent coarctation, underwent percutaneous treatment with stenting and quickly resumed classes. Conclusions: As more students with CHD enter college, college health providers will need to understand some of the health risks that CHD students face. In addition, understanding some of the optimal ways to coordinate care with CHD providers can ease the transition that CHD students face as they enter college.     

A case–control study relating railroad worker mortality to diesel exhaust exposure using a threshold regression model

A case–control study of lung cancer mortality in U.S. railroad workers in jobs with and without diesel exhaust exposure is reanalyzed using a new threshold regression methodology. The study included 1256 workers who died of lung cancer and 2385 controls who died primarily of circulatory system diseases. Diesel exhaust exposure was assessed using railroad job history from the US Railroad Retirement Board and an industrial hygiene survey. Smoking habits were available from next-of-kin and potential asbestos exposure was assessed by job history review. The new analysis reassesses lung cancer mortality and examines circulatory system disease mortality. Jobs with regular exposure to diesel exhaust had a survival pattern characterized by an initial delay in mortality, followed by a rapid deterioration of health prior to death. The pattern is seen in subjects dying of lung cancer, circulatory system diseases, and other causes. The unique pattern is illustrated using a new type of Kaplan–Meier survival plot in which the time scale represents a measure of disease progression rather than calendar time. The disease progression scale accounts for a healthy-worker effect when describing the effects of cumulative exposures on mortality.     

College students’ knowledge about Sickle Cell Disease

ABSTRACT

Sickle Cell Disease (SCD) is a serious health problem affecting millions around the world. Key to prevention is knowledge about the disease and the reproductive implications. This study explored college students’ knowledge about SCD. Participants included 416 college students at a North Texas campus between October and December 2014. A cross-sectional survey design using an 18-question survey was used. Although most participants had heard of SCD, 21% had never heard of the disease. Furthermore, participants lacked knowledge regarding the differences between the disease and carrier status, prevalence, reproductive implications, prevention, and testing. Findings showed that couples had more knowledge about SCD compared to singles and there were no significant differences between those with children and those without indicating a need for education before they start dating. Most participants had not undergone SCD carrier screening and had no interest in screening. The Universal Prevention approach would be a suitable approach and should be utilized in improving knowledge about SCD.     

Characterizing Poliovirus Transmission and Evolution: Insights from Modeling Experiences with Wild and Vaccine‐Related Polioviruses

With national and global health policymakers facing numerous complex decisions related to achieving and maintaining polio eradication, we expanded our previously developed dynamic poliovirus transmission model using information from an expert literature review process and including additional immunity states and the evolution of oral poliovirus vaccine (OPV). The model explicitly considers serotype differences and distinguishes fecal‐oral and oropharyngeal transmission. We evaluated the model by simulating diverse historical experiences with polioviruses, including one country that eliminated wild poliovirus using both OPV and inactivated poliovirus vaccine (IPV) (USA), three importation outbreaks of wild poliovirus (Albania, the Netherlands, Tajikistan), one situation in which no circulating vaccine‐derived polioviruses (cVDPVs) emerge despite annual OPV use and cessation (Cuba), three cVDPV outbreaks (Haiti, Madura Island in Indonesia, northern Nigeria), one area of current endemic circulation of all three serotypes (northern Nigeria), and one area with recent endemic circulation and subsequent elimination of multiple serotypes (northern India). We find that when sufficient information about the conditions exists, the model can reproduce the general behavior of poliovirus transmission and outbreaks while maintaining consistency in the generic model inputs. The assumption of spatially homogeneous mixing remains a significant limitation that affects the performance of the differential equation‐based model when significant heterogeneities in immunity and mixing may exist. Further studies on OPV virus evolution and improved understanding of the mechanisms of mixing and transmission may help to better characterize poliovirus transmission in populations. Broad application of the model promises to offer insights in the context of global and national policy and economic models.     

清朝前期(1644～1839年)湖南生物灾害研究

清朝前期(1644～1839年)湖南境内发生的生物灾害主要为虫灾和疫灾。虫灾以危及稻麦的蝗灾为主,疫灾既有危及人体的瘟疫也有危害耕畜的牛瘟,对社会生产生活都造成了较大的影响。