医务人员职业紧张与代谢综合征的关系

采取横断面调查，了解医务人员代谢综合征(metabolic syndrome, MS)患病情况及职业紧张程度，利用统计学方法分析二者的关系。结果显示，医务人员不同程度职业紧张者MS患病风险均高于无职业紧张者；任务过重、任务不适、任务冲突、责任感、业务紧张、心理紧张和躯体紧张均为MS患病的危险因素(P<0.05)。     

男性警察职业紧张与代谢综合征的关系

目的 探讨导致男性警察代谢综合征(metabolic syndrome,MS)患病的职业紧张因素.方法 采用随机整群抽样的方法,从某市公安局现管辖的分局中抽取4个分局,以该4个分局的全体男性警察作为调查对象,共纳入1490名.采用统一设计的健康调查问卷和职业紧张量表进行流行病学调查,同时进行体格检查和生化指标检测,应用χ2检验和logistic回归模型进行分析.结果 1490名研究对象中,实际完成问卷1483名,合格问卷1480份,其中MS患者有237例,患病率为16.0%(237/1480).高度、中度及缺乏职业紧张者MS组分别有8、39和23例,非MS组有14、114和131例,高度与中度缺乏职业紧张者MS患病风险分别为缺乏职业紧张者的4.82倍(95%CI:1.50～15.41)和3.33倍(95%CI:1.62～6.79).任务过重、任务不适和责任感MS组得分分别为(38.76±6.83)、(25.74±7.22)、(25.76±6.27)分;非MS组得分分别为(37.55±6.85)、(24.50±6.58)、(25.05±5.95)分.多因素logistic回归分析显示,任务过重、任务不适和责任感可能为MS患病的职业紧张危险因素,OR(95%CI)值分别为1.06(1.02～1.10)、1.04(1.02～1.07)、1.03(1.01～1.06).结论 任务过重、任务不适和责任感为导致男性警察MS患病的职业紧张危险因素.

Abstract：

Objective To explore the occupational stress factors associated with the prevalence of metabolic syndrome(MS) among male policemen.Methods Using cluster sampling method,we selected four Public Security Bureau within the jurisdiction of the station now in somesity.All the male police were included as research objects,and finally 1490 persons were selected,health and occupational stress inventory-revised (OSI-R) questionnaire were used for epidemiological surveys,and anthropometric examination and chemical indicators were also measured at the same time.The analysis methods were chi-square test and unconditional logistical regression.Results Among the 1490 of research objects,1483 completed the questionnaire,and 1480 of the eligible questionnaires were available.237 cases were MS,and the prevalence rate was 16.0%(237/1480).The number of cases who were high,moderate and lack of occupational stress in MS group were 8,39 and 23,that in non-MS were 14,114 and 131,respectively.The odds of occupational stress with the highest and medium among policemen than who were lack were 4.82 (95%CI:1.50-15.41) and 3.33(95%CI:1.62-6.79); the average score of role ambiguity,role insufficiency and responsibility in the group of MS were (38.76±6.83),(25.74±7.22),(25.76±6.27);and that in non-MS were (37.55±6.85),(24.50±6.58),(25.05±5.95).The logistical regression analysis showed that : the likely three occupational risk stress factors which influencing the prevalence of MS were role ambiguity,role insufficiency and responsibility,and the OR(95%CI) were 1.06 (1.02-1.10),1.04 (1.02-1.07) and 1.03 (1.01-1.06),respectively.Conclusion Role ambiguity,role insufficiency and responsibility were the occupational risk stress factors associated with the prevalence of MS among male policemen.     

女医生工作紧张状况及影响因素

目的:了解北京市女医生工作紧张状况,探讨影响女医生紧张反应的因素,为今后制定符合我国国情的干预措施、保持和提高女医生的工作能力和健康水平提供科学依据。方法:采用职业紧张量表(OSI-R)和工作能力指数量表(WAI)测试300名女医生的工作紧张和工作能力变化。结果:①女医生紧张程度及紧张反应有随年龄增高的趋势,低年龄组应对资源得分显著优于高年龄组。文化程度高的女医生工作紧张得分高,紧张反应重,应对资源得分也较文化程度低组分值高。已婚及离异者较未婚者表现更多的职业紧张及紧张反应,而未婚者较前两者寻求更多的缓解紧张的措施。②女医生个体紧张反应、躯体紧张反应、人际关系紧张反应的主要影响因素为职业任务、任务冲突、理性处事、自我保健;业务紧张反应的主要影响因素为职业任务、任务过重、文化程度、理性处事、工作环境、责任感;心理紧张反应的主要影响因素为职业任务、任务冲突、个体应对资源、任务模糊。③医院等级、职业任务过重、任务不适、业务紧张反应、躯体紧张反应和理性处事是影响女医生工作能力的主要因素。结论:北京市女医生紧张反应明显,影响女医生紧张反应的主要因素有职业任务、任务冲突、理性处事和自我保健。而职业紧张和医院等级是影响女医生工作能力的主要因素。因此,我们应针对不同的紧张源,从不同角度着手缓解不同级别医院的女医生的工作紧张,以保护和提高她们的工作能力。     

男性公安民警职业紧张与睡眠质量的关系

目的探讨男性公安民警睡眠质量与职业紧张间的关系。方法调查天津市6518名男性公安民警的睡眠质量、年龄和锻炼等一般情况,采用职业紧张量表进行职业任务紧张、个体紧张反应以及个体应对资源测试,采用多因素非条件Logistic回归模型分析睡眠质量的影响因素。结果中度及高度职业任务紧张、中度及高度紧张反应和高度缺乏应对资源能显著降低睡眠质量(P0.05),其中任务不适、任务过重、工作环境、躯体紧张反应以及心理紧张反应是影响男性公安民警睡眠质量的危险因素;休闲活动、自我保健和社会支持是睡眠质量的保护因素。结论职业紧张影响男性公安民警睡眠质量,应采取针对性措施提高睡眠质量。     

视屏显示终端作业者职业紧张及影响因素分析

目的 探讨视屏显示终端(VDT)作业者职业紧张程度、紧张反应及其影响因素.方法 应用职业紧张调查表(OSI-R)对某市302名视屏显示终端作业者及208名对照者进行对比研究.结果 VDT组职业任务总分及任务过重、责任感及工作环境子项得分较对照组高(P<0.01);紧张反应总分及业务、心理和躯体紧张反应子项得分高于对照组(P<0.01);应对资源总分及休闲、自我保健、社会支持及理性处事子项得分均低于对照组(P<0.01).逐步回归分析结果显示,影响VDT作业紧张反应因素有任务冲突、责任感、工作环境、每天VDT作业时间、VDT作业工龄、社会支持和理性处事差异有统计学意义(P<0.05).结论 VDT作业者视屏作业紧张和紧张反应显著增高.应采取有效措施缓解其紧张反应.     

技术工人职业紧张及影响因素分析

目的探索技术工人职业紧张状况及其影响因素。方法采用职业紧张量表(OSI-R),对技术工人(研究组)903例和工厂、机关、服务和商业职工(对照组)319例,共计1222例进行研究。结果技术工人的职业任务、紧张反应总均分及各子项得分均显著高于对照组(P<0·01),自我保健子项得分显著高于对照组(P<0·01)。紧张反应与职业任务呈明显正相关(r=0·358,P<0·01)。任务冲突、工作环境、责任感、任务模糊为个体紧张反应、业务、心理、人际关系(责任感、任务模糊除外)、躯体紧张反应(任务模糊除外,但包括任务不适、任务过重)的主要影响因素;年龄是个体紧张反应、业务、人际关系紧张反应的主要影响因素;娱乐休闲、理性处事可降低个体紧张反应、心理、人际关系紧张反应;社会支持可降低业务紧张反应;自我保健可降低躯体紧张反应。结论针对技术工人的主要紧张源,紧张反应及其影响因素,采取有针对性的干预措施,以降低技术工人的职业紧张程度,保护和促进工作能力是职业卫生领域面临的重要任务之一。     

深圳市某电子企业洁净车间职业紧张现状及影响因素分析

目的 调查某电子企业洁净车间作业人员职业紧张现状,并分析其影响因素。 方法 采用职业紧张量表(OSI-R),对洁净车间作业人员(研究组)297名和非洁净普通空调车间(对照组)301名,共计598名人员进行研究。 结果 研究组职业任务问卷、责任感、工作环境、躯体紧张反应、娱乐休闲、理性处事得分与对照组相比,差异有统计学意义(P<0.05);且除责任感外,研究组上述项目得分均高于对照组。研究组中不同教育程度、工龄、婚姻状况的作业人员的职业紧张问卷及各子项得分差异均无统计学意义(P>0.05)。Logistic回归分析表明有责任感和对工作环境要求高是躯体紧张反应的危险因素,自我保健是躯体紧张反应的保护因素。 结论 洁净车间特殊的工作环境是引起作业人员职业紧张的重要因素,应采取针对性措施,降低洁净车间作业人员职业紧张反应,保护工人身心健康。     

医生紧张反应的影响因素分析

目的 探讨医生紧张反应的影响因素,改善医生身心健康水平. 方法采用横断面调查方法,于2008年5-7月随机抽取辽宁省20所医院的1 635名医生进行问卷调查.职业紧张量表(OSI-R)中的个体紧张反应问卷(PSQ)评价医生紧张反应,应用多元线性回归分析探讨紧张反应的影响因素. 结果医生PSQ平均分值为86.91.按照多元线性回归分析标准化系数的顺序,调整性别、年龄、婚姻状况、教育背景、医院等级、职务、夜班、每周工作时间后,医生紧张反应的影响因素为:任务冲突、任务不适、社会支持、责任感、任务过重、自我保健、理性处理. 结论应加强医生的健康教育项目及职业教育项目,提高医生的个体应对能力,降低职业紧张,促进医生身心健康水平,提高生命质量.     

医师职业紧张及其影响因素的研究

目的 了解医师职业紧张的现状及其影响因素。方法 应用职业紧张量表修订版(OSI-R)对深圳市三级、二级、一级医院医师(医师组)342名及后勤管理人员(对照组)356名进行调查。结果 医师组职业任务和应对资源得分高于对照组，有非常显著差异(P＜0．01)。医师的主要紧张源为任务过重、任务不适和责任感。医师仅人际关系紧张反应子项得分显著高于对照组(P＜0．01)。医师紧张反应的主要影响因素为任务过重、任务不适、任务冲突、责任感、工作环境、休闲、社会支持和理性处事。结论 医师暴露于较高的职业紧张因素水平，增强个体应对能力可降低紧张反应。     

南充市中小学教师职业紧张反应与呼吸系统疾病关系调查

目的 探讨中小学教师职业紧张反应与呼吸系统疾病的关系以及职业紧张反应的影响因素,为制定相应的防治措施提供科学依据.方法 对南充市11所中小学的689名教师的基本信息、职业紧张反应等相关情况进行横断面调查.结果 高紧张反应组的中小学教师在任务过重、角色模糊上得分低于正常紧张组教师,在社会支持上得分低于正常紧张组教师,差异有统计学意义;高紧张组教师患慢支炎、慢性鼻窦炎、咽炎和总体呼吸系统疾病的风险分别是正常组教师的3.37,2.02,1.53和1.52倍;紧张反应的主要影响因素有年龄、社会支持、任务过重和呼吸系统疾病患病情况4个因素.结论 中小学教师的职业紧张反应与呼吸系统疾病患病情况有关.     

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.     

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.