洪灾区7～15岁儿童的行为问题及其影响因素

目的 了解洪灾区7～15岁儿童行为问题的现状及其影响因素，以便采取相应的干预措施。方法 用Rutter，儿童行为问卷的父母和教师问卷对洪灾区7～15岁儿童的行为问题进行评定。结果 洪灾区7～15岁儿童行为问题检出率分别为9．7％(父母问卷)和11．0％(教师问卷)，男生以违纪行为(A行为)为主，而女生则以神经症性行为(N行为)为主。结论 其主要的影响因素为性别、班主任批评、感到学习负担重、有亲人在洪灾中受了重伤．洪灾中未能与家人住在一起、曾经被洪水围困等待救援和创伤后应激障碍等。儿童行为问题在我国洪灾区儿童中是一种常见的现象，应采取针对性的防制措施。     

儿童功能性便秘流行病学特点初步分析

目的：探讨西安市儿童功能性便秘流行病学特点。方法：对西安市城区及农村1001名2－12岁儿童采用问卷式调查。2－6岁以内儿童由调查人员询问家长进行填表，7－12岁儿童由老师协助按便秘的诊断标准填写问卷，对诊断为功能性便秘的儿童由调查人员查体及填写儿童便秘病例登记表。结果：西安市城区及农村2－12岁儿童共调查1001人，诊断为便秘44例，患病率为4．40％，女性高于男性，小年龄组（2－6岁）高于大年龄组（7－12岁），农村高于城市。结论：儿童便秘与性别、年龄、居住地有关，尚可能与家族史及膳食结构等因素有关。     

支持向量机在洪灾区创伤性应激障碍预测中的应用

应用支持向量机对洪灾区居民创伤性应激障碍(PTSD)的发生进行预测.使用美国<精神障碍的诊断统计手册>第四版(DSM-IV)中关于PTSD的诊断标准对洪灾区成年人进行评定,以是否发生PTSD为应变量,以影响PTSD发生的23个因素为自变量,建立基于支持向量机(SVM)的预测模型,对遭受洪灾后PTSD的发生进行预测.将影响PTSD发生的23个因素纳入预测模型后,测试集SVM分类与实际类别的一致率为88.05%,灵敏度为75.0%,特异度为89.4%.结论:应用SVM建立预测模型对于洪灾区PTSD发生的预测具有较好的效果,被纳入的23个因素作为输入向量有良好的预测效率.     

洪灾后创伤性应激障碍及其影响因素的研究

目的 了解洪灾后创伤性应激障碍的现状及其影响因素。方法 用美国《精神障碍的诊断统计手册》第四版(MSD-Ⅳ)中对于PTSD的诊断标准对洪灾区人群进行PTSD评定。结果 洪灾后PTSD检出率为30．9％，其主要的影响因素为性别(OR=2．32)，年龄(OR=1．83)，洪灾类型(OR=3．71)和对支持的满意度(OR=0．84)。结论 PTSD在我国洪灾的受灾群体中是一种常见的不容忽视的现象，应采取针对性的防制措施。     

车祸所致创伤后应激障碍的临床研究

目的 研究车祸所致创伤后应激障碍的发生情况及特点。方法 应用中国精神疾病分类方案与诊断标准第二版修订本中的急性应激障碍（ASR）和创伤后应激障碍（PTSD）诊断标准，对曾因车祸住我院治疗81例患进行诊断，按有无PTSD分为PTSD组和非PTSD组，采用症状自评量表（SCL－90），艾森克个性问卷（EPQ）及症状记录表等进行测评和比较。结果 车祸后3个月，81例中有33例（40．7％）符合ASR诊断标准，31例（38．3％）符合PSD诊断标准。与非PTSD组比较，PTSD组SCL－90总分、阳性项目数、阴性项目数及躯体化、强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐怖、其它因子分均高（P＜0．05－0．01）。PTSD组情绪稳定性倾向不稳定型（38．71％）的比率显高于对照组（P＜0．01），而中间型的(35．48％）显低于非PTSD组（P＜0．01）。对PTSD发病因素进行Logistic回归分析，进入回归方程的自变量为N、L及性别。结论 车祸所致PTSD并非罕见的精神障碍，且女性、情绪倾向不稳定、掩饰性高的个体车祸后患PTSD的危险性高。应主动提供心理干预。     

3～7岁儿童气质的影响因素研究

目的：了解3－7岁儿童气质的影响因素。方法：应用本科室研制的全国3－7岁儿童气质的常模及量表，对西安市一所幼儿园及一所小学3－7岁儿童进行了抽样调查。结果：影响3－7岁儿童气质的因素有：出生体重、出生时是否足月、家庭结构、母亲职业及父母亲婚姻关系，主要照管孩子的人及对孩子的管教态度、管教方法。结论：在家庭教育及学校心理卫生工作中应尽量避免影响心理健康的不良因素。     

中小学生家庭功能与创伤后应激障碍症状相关分析

目的 了解新冠疫情全球大流行期间成都市中小学生闭校开学后创伤后应激障碍（PTSD）症状，探索家庭功能对中小学生PTSD症状的影响。方法 利用成都儿童正向成长队列（CPCD）2020年6月新冠疫情闭校开学后的调查数据，采用儿童事件行为影响量表（CRIES-13）和儿童家庭功能评定量表（C-FAI）测量PTSD和家庭功能，Pearson相关分析PTSD症状与家庭功能之间的相关性，二元logistic回归探索家庭功能对PTSD症状的影响。结果 PTSD流行率为12.3%(972/7 924)。家庭功能与PTSD症状呈正相关（r=0.178,P<0.05），其中互相关心和父母控制维度均是PTSD症状（OR=1.382,95%CI:1.191～1.602;OR=1.148,95%CI:1.073～1.228）的危险因素。结论 良好的家庭功能对中小学生新冠疫情创伤后应激具有保护作用，改善家庭功能可能降低新冠疫情对中小学生心理健康的负面影响。     

洪灾区儿童心理创伤症状与心理韧性的关系

目的调查洪灾3个月后灾区儿童心理韧性和创伤症状的关系。方法采用修订版儿童事件影响量表（CRIES）、青少年心理韧性量表、自编洪灾创伤暴露程度问卷对690名洪灾区儿童进行调查,用方差分析、logistic回归分析进行数据分析。结果1家里受灾组在CRIES量表侵入、高唤醒因子的得分高于家里未受灾组;感受到生命威胁组在CRIES 3个因子的得分均高于未感受到生命威胁组;2心理韧性高分组在CRIES量表回避、高唤醒的因子得分低于心理韧性低分组;3 Logistic回归分析结果显示感受到生命危险、目睹死亡正向预测PTSD倾向,心理韧性量表中的情绪控制因子得分负向预测PTSD倾向,积极认知因子得分正向预测PTSD倾向。结论家里受灾、感受到生命威胁、目睹死亡是重要的洪灾创伤暴露指标;心理韧性尤其是情绪控制能力是儿童重要的复原特征,但心理韧性中的积极认知不利于其心理复原。     

口吃儿童个性特征及其影响因素初探

目的：探讨口吃儿童的个性恃征及其影响因素。方法：采用文森克个性问卷（EPQ）,对98例7－15岁口吃儿童的个性特征与非口吃儿童进行了对照研究。结果：两组儿童EPQ对各维度量表姐分均值差异无显著性（P＞0．05）;对不同程度口吃组各维度量表姐分均值分析,发现E分在轻、中、重度口吃织间差异有高度显著性（P＜0．01）。结论：口吃儿童性格多为内向,且随着口吃程度加重这种个性特征更加明显。影响口吃儿童个性特征的主要因素有：父母对儿童课余时间约束程度、学习成绩、单亲寄养家庭等。     

横县儿童脑瘫患病状况及相关因素分析

目的：了解本地区1－6岁儿童脑性瘫痪患病状况及相关因素。方法：调查13个乡镇1－6岁的儿童61912人。调查内容、方法、诊断标准及质控均按“全国小儿脑瘫的流行病学及病因学研究”方案进行。结果：横县1－6岁儿童脑瘫患病率为1．62％（100／61912）。男童患病率高于女童，差异有显著性（P＜0．01）；异常出生孕周及体重儿脑瘫发生率高，与正常出生孕周及体重儿脑瘫发生率比较，差异有显著性（P＜0．001）；脑瘫患儿中新生儿窒息、高胆红素血症、感染和家庭分娩构成比高。结论：早产、低出生体重、新生儿窒息、新生儿高胆红素血症、新生儿感染和家庭分娩可能是儿童脑瘫的危险因素。     

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 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.     

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.     

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.     

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.