放疗科护士睡眠障碍及与孤独感的关系

目的了解放疗科护士睡眠障碍及与孤独感的关系。方法随机选取放疗科护士191例为调查对象,使用匹兹堡睡眠质量指数量表(PSQI)和UCLA孤独量表进行调查,采用多元线性回归分析孤独感对睡眠状况的影响。结果 58.64%(112例)的护士有睡眠障碍。已婚护士PSQI总分及睡眠效率得分(8.55±1.92,1.52±0.99)高于未婚护士(7.81±2.28,1.10±1.06),差异有统计学意义(t=2.435,2.843,均P0.05)。集体住宿护士PSQI总分及主观睡眠质量和睡眠障碍得分高于在家居住护士,每周夜班≥2次护士主观睡眠质量得分(1.68±0.81)高于≤1次护士(1.36±0.77),大专文化程度护士PSQI总分及日间功能障碍得分(8.43±1.98,1.43±0.86)高于本科及以上护士(7.36±2.41,1.18±0.72),家庭关系较融洽护士PSQI总分及睡眠障碍得分低于家庭关系一般及隔阂多护士。自评压力较轻护士PSQI总分及主观睡眠质量、入睡时间、睡眠时间及日间功能障碍得分低于压力较大护士。年龄30~34岁护士PSQI总分及睡眠障碍和日间功能障碍得分高于25和25～29岁护士,差异均有统计学意义(P0.05或P0.01)。孤独感得分进入PSQI总分的回归方程(β=0.295,P0.05)。结论放疗科护士睡眠障碍发生率高,其睡眠状况因不同人口学特征而存在差异,孤独感对放疗科护士睡眠状况具有预测关系。     

哮喘儿童父母睡眠质量现状调查及相关因素分析

目的探讨哮喘儿童父母睡眠质量现状及其影响因素,为探索改善哮喘患儿父母睡眠质量的干预策略提供科学依据。方法应用一般资料调查表、匹兹堡睡眠质量量表(PSQI)及儿童睡眠习惯问卷调查157例哮喘儿童父母。结果哮喘儿童父母PSQI得分总分为(5.41±2.33)分,显著高于国内常模(P<0.01)。单因素分析结果显示:患儿父母睡眠质量与性别、学历、工作状态、劳动强度及家庭月收入有关;相关分析结果显示:哮喘儿童睡眠与父母的睡眠质量存在正相关关系(r=0.303,P<0.05)。结论哮喘儿童父母睡眠质量不高,患儿的睡眠习惯是潜在的干预切入点,可结合其睡眠质量变化特征,采取针对性干预措施改善其睡眠质量。     

郑州市流动初中学生父母教养方式和睡眠质量状况分析

目的 了解郑州市流动初中生父母教养方式和睡眠质量状况,探索两者间存在的关系,为流动儿童健康发展提供支持。方法 采用整群抽样的方法在郑州市流动人口较多地域的6所中学进行调查,共调查1 344名流动初中学生。调查问卷采用自编信息表、匹兹堡睡眠质量指数量表(PSQI)、父母教养方式问卷(s-EMBU)进行。结果 郑州市流动初中学生的PSQI总均分为（5.67±3.77）分。睡眠存在问题的学生为28.13%。初三年级的PSQI总分最高,3个年级相比较差异有统计学意义(F值为23.54, P＜0.01)。随着年级的增高,PSQI总分、主观睡眠质量、日间功能障碍、睡眠时间等方面得分呈现上升趋势。睡眠无问题组与睡眠存在问题组母亲和父亲教养方式3个维度的得分相比较差异均有统计学意义(t值分别为-7.53、6.38、-4.84、-7.23、5.89、-2.89,P值均＜0.01)。结论 郑州市流动初中学生父母教养方式与睡眠质量存在相关系;父母对学生越关心,学生的睡眠质量越好,相反则越差。     

河南省某批援鄂医疗队睡眠质量调查

目的了解河南省某批援鄂医疗队睡眠质量情况,为提供干预措施提供参考。方法采用整群抽样方法,使用匹兹堡睡眠质量指数(Pittsburgh sleep quality index, PSQI)量表对河南省某批援鄂医疗队睡眠质量进行调查,采用描述流行病学方法对调查对象基本情况进行分析,对性别、年龄、职称、专业、学历、从业年限两组或多组间PSQI得分进行t检验或方差分析,采用SPSS 20.0软件进行统计分析。结果回收有效问卷131份,PSQI平均得分8.29±3.89,主观睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、催眠药物使用、日间功能障碍平均得分分别为0.71±0.77、2.01±0.96、1.21±0.93、0.85±1.05、2.07±0.66、0.20±0.65、1.24±0.95。睡眠好、睡眠一般、睡眠差的人数分别占15.27%、29.77%、54.96%。不同性别、年龄、职称、职业、学历、从业年限之间的差异均无统计学意义(P0.05)。结论河南省某批援鄂医疗队睡眠质量较差,需要采取干预措施。     

护理干预对癌症患者睡眠障碍的效果分析

目的探讨护理干预对癌症住院睡眠障碍的效果。方法采用匹兹堡睡眠质量量表(PSQI)问卷式调查,对肿瘤医院85例存在睡眠障碍癌症住院患者进行护理干预,评估其干预前后睡眠障碍效果。结果经过护理干预后,患者PSQI平均值由7.78±0.73降至4.12±0.63,差异具有统计学意义(t=12.51,P<0.01)。结论通过针对性护理干预可改善患者睡眠障碍状况。     

西藏不同海拔地区藏族青少年睡眠质量及影响因素分析

目的比较不同海拔地区藏族青少年的睡眠质量,并了解在高海拔地区影响青少年睡眠质量的因素,为后续干预提供依据。方法于2 016年8—10月,在西藏低海拔县中学(海拔2 800 m)选取来自高海拔(4 300 m)的227名学生(移居组)及来自低海拔的97名学生(低海拔组),在高海拔县中学(4 300 m)通过分层随机抽样选取306名学生(高海拔组)参加调查,通过自填式问卷调查获得学生相关信息,睡眠质量通过匹兹堡睡眠质量问卷测量,父母教养方式通过藏文版简式父母教养方式问卷进行测量。结果高海拔组学生的睡眠质量因子得分(1.80±0.62)高于较低海拔组(1.55±0.65)和移居组(1.54±0.60)(P 0.01),睡眠质量更差;入睡时间因子得分(2.04±0.77)高于低海拔组(1.67±0.64)(P 0.01)和移居组(1.89±0.73)(P 0.05),入睡时间最长;睡眠障碍因子得分(2.11±0.39)高于低海拔组(1.98±0.38)及移居组(1.99±0.48)(P 0.05),睡眠障碍更多;总分(4.64±1.93)也高于低海拔组(3.76±1.93)(P 0.01)及移居组(4.13±2.00)(P 0.05),总体睡眠质量更差。日间功能障碍因子高海拔组得分(2.13±0.69)高于低海拔组(1.96±0.63)(P 0.05),高海拔组学生日间功能障碍较低海拔组更多。但睡眠时间因子得分低海拔组(1.13±0.40)及移居组(1.13±0.37)高于高海拔组(1.05±0.33)(P 0.05),睡眠时间较高海拔组短。经多因素分析,总体睡眠质量的影响因素有海拔及父母的拒绝教养方式。结论西藏不同海拔地区藏族青少年的睡眠质量受海拔及父母教养方式的影响。     

语言障碍儿童的睡眠状况研究

目的 研究语言障碍儿童的睡眠状况以及睡眠问题的发生情况,为从睡眠角度指导语言障碍的综合干预提供参考。方法 2018年1-4月在青岛大学附属青岛妇女儿童医院招募语言障碍儿童78名,并选择年龄、性别匹配的94名正常儿童作为对照组。采用自行编写的睡眠调查问卷,调查两组儿童近1个月的睡眠情况。采用t 检验、χ²检验及确切概率法进行统计分析。结果 病例组睡眠问题的发生率显著高于对照组(52.56% vs. 37.23%,χ²＝4.062,P＜0.05)。其中,入睡困难的发生率显著高于对照组(47.44% vs. 31.91%,χ²＝4.318, P＜0.05)。病例组夜间就寝显著晚于对照组(21.91±0.73 vs. 21.51±0.55,t=4.070, P＜0.001),夜间睡眠时间显著少于对照组[(9.29±0.86) h vs. (9.67±0.76 h),t=-3.162,P＜0.05]。病例组中独立入睡的儿童,睡眠问题的发生率显著低于需要帮助入睡的儿童(41.30% vs. 68.75%,χ²＝5.701,P＜0.05)。夜醒后家长给予适当应答者,睡眠问题的发生率显著低于无应答及立即应答者(33.33% vs. 61.53% vs. 62.50%,χ²＝6.359,P＜0.05)。结论 语言障碍儿童睡眠问题的发生率高,夜间就寝时间晚、睡眠时间少。入睡方式、夜醒家长反应可影响其睡眠。在语言障碍儿童的综合干预中,需要充分关注其睡眠状况。     

某部潜艇官兵长航后睡眠质量及其相关因素研究

目的探讨潜艇官兵长航后睡眠质量、相关因素及其应对策略。方法采用匹兹堡睡眠指数量表(PSQI)、艾森克个性问卷(EPQ)、社会支持量表(SSRS)对部分潜艇官兵长航后进行调查,并对其中部分官兵检测某些血清生化指标。结果长航后32名潜艇官兵(研究组)与66名备航潜艇官兵PSQI(对照组)分值比较,研究组PSQI总分[(6.81±2.64)分]、睡眠质量[(1.68±0.65)分]、睡眠效率[(2.11±0.69)分]显著高于对照组[(4.88±3.12)分、(0.85±0.70)分、(0.94±0.12)分](P0.01),入睡时间[(1.57±1.23)分]也显著高于对照组[(1.00±0.92)分](P0.05);长航后PSQI总分与SSRS的主观支持(SS)呈显著负相关(P0.05),与SSRS余项无相关(P0.05),与EPQ-E呈显著负相关(P0.01),与P、N、L分无显著相关(P0.05);与LDL-L、GGT呈显著正相关(P0.05)。结论潜艇官兵长航后睡眠质量有显著下降,睡眠质量与个性和血清生化指标关系密切,对此提出加强睡眠健康管理应对措施。     

某区8126名官兵睡眠状况调查

目的调查某区8126名官兵睡眠状况,为采取干预措施提供参考。方法采用匹兹堡睡眠质量指数量表对官兵的睡眠状况进行调查分析。结果该区官兵PSQI总分和各成份(除睡眠障碍外)得分均明显高于驻平原士兵和地方成人;未婚官兵睡眠质量、入睡时间、睡眠障碍和PSQI总分均明显高于已婚官兵(P0.05);士官的睡眠质量、入睡时间、睡眠障碍和PSQI总分均明显高于干部和义务兵(P0.01);海军官兵睡眠质量、入睡时间、睡眠障碍、日间功能障碍和PSQI总分均明显高于陆军和空军官兵(P0.01),陆军官兵睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、日间功能障碍和PSQI总分均也明显高于空军(P0.01)。结论该区官兵睡眠质量较差,应引起关注。     

长期健康管理策略对女性绝经过渡期相关症状及生存质量的影响

目的探讨长期健康管理策略对绝经过渡期女性绝经相关症状及生存质量的影响。方法选择2018年4月～2019年3月中南大学湘雅医学院附属海口医院就诊的绝经过渡期患者100例,按照随机数字表法分成两组,每组50例,对照组给予常规护理,观察组在对照组的基础上实施长期健康管理策略,干预前后,采用绝经症状评价量表(MRS)评价绝经相关症状,采用匹兹堡睡眠质量指数量表(PSQI)评价睡眠质量,采用绝经生存质量量表(MENQOL)评价患者的生存质量。结果干预后观察组MRS评分低于对照组[(13.27±1.59)分vs(9.08±1.36)分](t=14.160,P0.05),干预后观察组PSQI量表评分低于对照组[(9.69±1.26)分vs(6.81±0.75)分](t=13.888,P0.05),干预后观察组MENQOL量表评分低于对照组[(3.19±0.35)分vs(2.62±0.37)分](t=7.914,P0.05)。结论长期健康管理策略可以减轻绝经过渡期女性的相关症状,提高睡眠质量,改善患者生存质量。     

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.     

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.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

The risk of heat exhaustion at a deep underground metalliferous mine in relation to surface temperatures

The risk of heat exhaustion at a deep underground metalliferous mine was assessed in relation to thermal conditions prevailing on the surface. For each day of a 1-year prospective case series of heat exhaustion, surface 24-h mean wet and dry bulb temperatures were recorded. From this data, 24-h mean wet bulb globe temperatures were derived using certain assumptions. The three surface temperature variables were significantly higher on those days on which heat exhaustion occurred, compared to those days on which it did not occur (P < 0.001). The relative risk of heat exhaustion on days when the 24-h mean wet bulb globe temperature was in the range 26.0-28.0 degrees C was 4.82 (95% confidence interval 2.12-10.96). Surface temperature data could be used at this mine to warn miners about the risk of heat exhaustion.