医护学生艾滋相关歧视量表的初步编制与评价

目的初步编制医护学生艾滋相关歧视量表,并评价其信度和效度。方法通过查阅文献,在医务人员艾滋相关歧视量表基础上编制医护学生艾滋相关歧视量表。并用初步编制的量表调查449名南通大学医护学生。采用应答率分析、临界比检验、相关分析及因子分析法删除条目。克朗巴赫仅（Cronbach’s α）系数和哥德曼分半信度（GuttmanSplit—Half）系数评价量表信度。因子分析和相关分析评价量表效度。结果通过条目删除后终量表保留19个条目,共5个因子综合反映回避、泄密、污名和恐惧4个维度,累计贡献率为62．21％。各条目与其所在维度的斯皮尔曼（Spearman）相关系数均〉0．5。各维度与总分的Spearman相关系数介于0．489～0．743之间。量表Cronbach’s α系数为0．849,GuttmanSplit—Half系数为0．906。各个维度的Cronbach’s仪介于0．769～0．899之间。结论医护学生艾滋相关歧视量表具有较好的信度和效度,可作为今后研究医护学生艾滋相关歧视的测量工具。     

社区高血压患者社会资本与心理健康的关系

目的评价社会资本量表的信度和效度,分析社区高血压患者社会资本与心理健康的关系。方法采用多阶段整群随机抽样的方法,对上海市某区高血压患者经知情同意进行问卷调查。其中社会资本量表是在相关理论和研究基础上,通过多次专家咨询,对量表的条目进行设计和修改而成,应用Cronbach’s α系数、评分者信度及探索性因子分析对其信度和效度进行评价;世界卫生组织5项心理健康量表用于测评患者心理健康状况。采用多因素非条件logistic回归分析高血压患者社会资本与心理健康状况的关系。结果社会资本量表的Cronbach’s α系数为0．628,量表各维度Cronbach’s α系数为0．507～0．793。评分者信度P值为0．001-0．715。各维度得分与量表总得分相关系数为0．500～0．928。因子分析的KMO值为0．706,提取了3个公因子,共解释了60．99％的方差变异。在控制其他可能的影响因素后,社区高血压患者信任参与程度和心理健康状况呈正相关（OR=1．740,P〈O．01）。结论社会资本量表有较好的信度、效度,社会资本是社区高血压患者心理健康的重要影响因素,尤其是提高患者社区活动参与意识和社区信任感对改善高血压患者心理健康有着积极的促进作用。     

中文版Zarit护理负担量表的评价

目的评价中文版Zafit护理负担量表的信度和效度。方法采用修订后的中文版Zafit护理负担量表进行问卷调查，并评价量表的修订效果。结果量表总的Cronbach‘s α系数为0．88，信度较高；条目敏感性分析显示量表反应度较好，各条目均可保留。各条目与总分的相关系数均有统计学意义（P〈0．05），量表的内容效度较高；除条目5外，各因子内部条目的相关系数均大于外部相关系数，量表结构效度较好。结论中文版Zarit护理负担量表具有较好的应用价值。     

《小学突发事件应急预案评估量表》的开发与信度、效度研究

目的 开发与研究《小学突发事件应急预案评估量表》,为完善现有预案提供科学依据。方法 应用文献查阅、德尔菲专家咨询、预评估等方法开发完善评估初始量表,应用差异系数确定量表条目,应用因子分析探索量表结构,应用同质性信度、分半信度、重测信度评价量表信度,应用内容效度和结构效度评价量表效度。结果 形成含有21个条目、满分100分的评估量表,分为5个维度,即“成员明确”、“职责分工”、“预防制度”、“报警与应对”和“应急标识”。量表的Cronbach’s α系数为0.827,Spearman-Brown系数为0.884,重测系数为0.972。量表条目与评估内容的关联性强,21个核心条目与所属维度的相关系数在0.366～0.999（P ＜0.05）。结论 基于动态分析的角度以及现有应急预案的整体水平,该评估量表覆盖指标全面,评分细则清晰,区分度较高,具有良好的信度和效度,实用性和可操作性强。     

工作能力指数量表的评价研究

目的 评价工作能力指数(work ability index,WAI)量表的内在结构及其条目合理性。方法 采用“工作能力指数”量表,对不同行业6429名在职职工进行工作能力测试,剔除不合格或项目不全者,最终纳入统计分析的对象为4354名。同时,按系统抽样原则从工作能力测试对象中袖取10％进行功能能力(包括脑力能力、肌肉骨铬功能)测定,剔除测试项目不全者,有530名纳为统计分析对象。采用因子分析、相关分析和列联表x^2检验等方法进行WAI量表评价。结果 WAI量表7个条目(W1—W7)分别由4个公因子支配(条目W1、W2由公因子F1支配,条目W3、W4由公因子F3支配,条目W5由公因子F4支配,条目W6、W7由公因子F2支配),累计贡献率为79．80％,条目W1—W7的公因子方差均高于0.60。除少数测试指标外,脑体功能能力主、客观指标问均具有相关关系(P＜0.05),体力功能分级、脑力功能分级与工作能力分级的一致率分别为60．19％和61．89％,分级之间相关关系具有统计学意义(P＜0．01)。结论 工作能力是多种因素的综合体现,WAI量表的部分条目应作修订。     

防社交孤独社区自我效能量表在社区老年人中应用的信效度评价

目的 探讨防社交孤独社区自我效能量表(the Community’s Self-efficacy Scale for preventing social isolation)在社区老年人中应用的信效度,为预防老年人社交孤独提供科学依据。方法 便利抽取辽宁省沈阳市694例社区老年人进行问卷调查,运用SPSS20.0和AMOS17.0软件处理数据。结果 该量表总Cronbach’s α系数和分半信度分别为0.974和0.948,社区网络和邻里监督分维度的Cronbach’s α系数为0.955和0.962,重测信度为0.926;条目 - 总分Pearson相关系数范围是0.894～0.944(P＜0.05),条目水平的内容效度指数（I - CVI）为0.830～1.000,量表水平的内容效度指数（S - CVI/UA）为0.875,平均量表水平的内容效度指数（S - CVI/Ave）为0.979;探索性因子分析提取到2个公因子的累积方差贡献率为89.154%,各条目共同度为0.872～0.907;验证性因子分析中χ2/df = 2.516,RMSEA = 0.066,GFI = 0.993,AGFI = 0.937,TLI = 0.989,IFI = 0.993,CFI = 0.993,标准化回归系数为0.85～0.98。结论 中文版CSES量表信效度良好,可用于我国老年人社区自我效能感的评估。     

综合性工作能力指数量表的同质性信度评价

目的综合性工作能力指数(Comprenhensiveworkabilityindex,CWAI)量表同质性信度评价。方法选择有代表性的行政机关、教育、纺织、煤炭、石油化工和医疗卫生等行业的单位作为抽样目标,采用整群随机抽样方法抽取上述单位的在职职工作为研究对象,CWAI量表的同质性信度评价以上述单位1800例职工作为研究样本。方法采用条目与总分的一致性、Cronbachsα系数、Spearman-Brown系数、θ系数和Ω系数等方法评价CWAI量表的同质性信度。结果CWAI量表同质性信度评价结果显示,CWAI量表各条目(W1~W5)得分与量表总分(CWAI)的相关系数介于0·14~0·75之间(P<0·01);总体而言,Cronbachsα系数(0·701~0·808)、Spearman-Brown系数(0·860)、θ系数(0·703~0·845)和Ω系数(0·802~0·942)均符合心理测量学对量表的测量要求。结论CWAI量表具有较好的同质性信度。     

综合性工作能力指数量表应用信度和效度研究

目的评价综合性工作能力指数（CWAI）量表对钢铁技术工人调查时的信度和效度,为该量表应用提供依据。方法分层整群抽样方法抽取某钢铁企业914名技术工人作为研究对象,对CWAI量表同质性信度和结构效度进行评价。同质性信度评价采用量表条目与总分的一致性、折半信度、Cronbach’sα系数、θ系数与Ω系数方法;结构效度评价采用因子分析方法。结果CWAI量表条目、维度得分与总分的相关系数介于0.27~0.73,各维度与总分间大于0.60;整体量表的Spearman-Brown相关系数、Cronbach’sα系数、θ系数与Ω系数分别为0.72、0.85,0.86和0.95。各维度的Cronbach’sα系数、θ系数与Ω系数,除W2接近0.60外,其余均大于0.75。结构效度分析,提取8个公因子,累积贡献率为77.63%,各条目的公因子方差在0.64~0.96之间。除W2外,W1、W3、W4-1~W4-3、W4-4~W4-5、W4-6~W4-7、W5分别在各自对应的公因子上有较大负荷,基本与理论构想相符。少数条目存在不稳定现象。结论CWAI量表在对钢铁技术工人调查时有稳定及较好的信度和效度,但需对少数条目进行修订。     

不同健康状况的中老年人社会资本量表的信度及效度评价

目的 评价中老年人社会资本量表的信效度，探索其在不同健康状况的中老年人群间的区分度。方法 针对已编制的中老年人社会资本量表，采用多阶段分层随机抽样方法，在四川省成都市及泸州市共抽取1 367名50岁及以上中老年居民进行问卷调查。运用Cronbach’s α系数、Pearson相关系数、t检验、探索性因子分析等方法评价量表的信度和效度。结果 1 367名中老年调查对象的社会资本量表总Cronbach’s α系数为0.67，各维度条目与总分的相关系数在0.30～0.79之间，具有良好的信度；探索性因子分析表明，14个条目提取出5个特征根大于1的因子，累积方差贡献率为68.84%；现患慢性疾病的中老年病例组人群的个人社会资本得分、家庭社会资本得分、社团社会资本得分、社区社会资本得分及社会资本总得分均低于未患病的对照人群组，宏观社会资本得分高于对照人群组，且差异均有统计学意义 (均 P＜0.01)，提示该量表具有较好的区分度。结论 中老年人社会资本量表具有较好的信度和效度，且对不同健康状况的50岁及以上中老年人中有较好的区分度。     

珠海市居民健康素养评价指标研究

目的探索中国公众健康素养评价指标。方法应用整群抽样方法在珠海市香洲、斗门和金湾3个行政区内分别抽取6个居委会和6条行政村15～69岁人群进行问卷调查,调查内容主要为人群基本情况（12项）、健康素养量表（20项）、自我健康评价量表（18项）3部分。应用Cronbach仅系数、折半信度对量表信度进行一致性检验,应用因子分析评价量表结构效度,并建立因子分析模型,提取模型公因子,分析各量表的维度,并对自我健康评价因子和健康素养因子进行Pearson相关分析。结果共调查3000人,实际回收有效问卷2823份,有效问卷率94．1％。健康素养量表Cronbach α系数、折半信度分别为0．886、0．789;抽样适度测定值（KMO）〉0．70,Battlett球型检验结果显示P〈0．01。健康素养因子模型包括健康知识、行为、技能和理念4个主要公因子成分,共解释原始变量54．56％的信息。自我健康评价量表Cronbach α系数、折半信度分别为0．852、0．729;KMO〉0．70,Battlett球型检验结果显示P〈0．01。自我健康评价因子模型包括身体状态、心理状态和社会适应状态3个主要公因子成分,共解释原始变量57．15％的信息。社会适应状态因子与健康知识、行为、技能和理念均呈正相关（P〈0．01）;身体状态因子与知识、技能和理念呈正相关关系（P〈0．01）;心理状态因子与行为和技能呈负相关关系,与理念呈正相关关系（P〈0．01）。结论初步建立珠海市居民健康素养量表及其评价指标体系,可从健康知识、行为、技能和理念4个主要方面评价居民素养水平。     

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.