中小学校长工作压力及应对与心理健康关系

目的探讨中小学校长工作压力、社会支持、应对方式与心理健康关系,为提高中小学校长心理健康水平提供依据。方法整群抽取贵州省某地区中小学校长培训班的培训学员180人,使用中小学校长工作压力问卷、社会支持评定量表、简易应对方式问卷和自测健康评定量表进行调查,并利用结构方程模型软件Amos 6.0进行路径分析。结果中小学校长总体工作压力平均分为(3.14±0.96)分(理论范围1～5分),其中考试升学得分压力最高,为(3.03±1.00)分,人际关系压力得分最低,为(1.99±0.89)分,总体工作压力处于中等水平;中小学校长心理健康平均分为(84.29±14.28)分(理论范围0～120分),其心理健康水平处于中等偏上水平;中小学校长工作压力、社会支持总分、主观支持和积极应对与心理健康水平的相关均有统计学意义(P<0.05);结构方程模型结果表明,工作压力直接影响个体心理健康水平,主观支持通过中介作用影响工作压力和心理健康的关系,主观支持通过积极应对方式对心理健康有间接影响。结论中小学校长主观支持与积极应对在工作压力和心理健康关系中起中介作用。     

广西民族地区贫困大学生社会支持、应对方式与心理健康分析

目的探讨民族地区贫困大学生社会支持、应对方式与心理健康的关系。方法采用分层整群抽样方法抽取广西壮族自治区某高校大学生824名,进行社会支持量表、简易应对方式量表和SCL-90量表问卷调查,并对数据进行相关和回归分析。结果贫困大学生的躯体化(1.45±0.50)、精神病性(1.47±0.51)、抑郁(1.51±0.54)、焦虑(1.50±0.51)、恐怖(1.45±0.51)、偏执(1.47±0.52)6个因子和总均分(1.51±0.48)与非贫困大学生的躯体化(1.33±0.48)、精神病性(1.38±0.52)、抑郁(1.33±0.48)、焦虑(1.42±0.54)、恐怖(1.37±0.52)、偏执(1.39±0.53)6个因子和总均分(1.43±0.50)间差异均有统计学意义(前2个因子P0.01,后4个因子和总均分P0.05)。贫困大学生主观支持分(24.46±6.41)和非贫困大学生的主观支持分(25.30±5.58)差异显著(P0.05)。贫困大学生SCL-90各因子除强迫症状、人际关系敏感与社会支持各项得分在0.05水平上呈显著负相关外,其余各因子都在0.01水平上呈显著负相关。SCL-90各因子与对支持的利用度呈显著负相关(P0.01);除强迫症状外,SCL-90各因子与积极应对维度呈显著负相关(P0.01),SCL-90各因子与消极应对维度相关不显著。主观支持、消极应对、积极应对、对支持的利用度进入回归模型(P0.01),对心理健康预测作用的大小依次为主观支持、消极应对、积极应对、对支持的利用度,修正后的判定系数为0.050、0.055、0.071、0.077。结论贫困大学生的心理健康水平低于非贫困大学生;贫困大学生的社会支持因素、积极应对方式影响其心理健康水平,但主要受其主观支持因素的影响。     

急诊留观患者社会支持对心理健康与应对方式的中介作用

目的探讨急诊留观患者心理健康与应对方式的关系及社会支持的中介作用。方法采用症状自评量表(SCL-90)、社会支持量表(SSRS)和简易应对方式问卷(SCSQ),调查2018年10月—2019年3月陕西省某部队附属医院急诊留观患者共120名,通过建立中介作用方程模型,检验社会支持的中介效应。结果随机抽取120名急诊留观住院患者,平均年龄(38±1.38)岁;男性68人,占56.7%;女性52人,占43.3%;学历主要集中在高中,占30.8%;心理健康测评阳性68人,占56.7%,阴性52人,占43.3%;急诊留观患者躯体化、人际关系敏感、抑郁和焦虑、敌对和精神病性6个因子的得分高于全国成人常模(均P0.05);心理健康测评阴性留观患者的主观支持及消极应对得分均高于阳性者;积极应对得分低于阳性者(P0.05);心理健康与积极应对方式呈正相关(均P0.01),与消极应对方式呈负相关(r=-0.482,P0.01),与主观支持呈正相关(r=0.520,P0.01);客观支持与积极应对方式呈正相关(r=0.411,P0.01),与消极应对方式呈负相关(r=-0.448,P0.01);采用结构方程模型对两种应对方式的中介作用进行检验,两个模型的各项拟合指标良好,心理健康与应对方式、心理健康与社会支持及应对方式与社会支持之间的路径系数均达到显著水平(P0.01)。结论心理健康对社会支持、积极应对方式和消极应对方式都有预测作用,同时应注重应对方式的中介作用,通过提高社会支持和采取积极应对方式提高心理健康水平。     

高寒山区军人心理健康社会支持应对方式及自我和谐的调查

目的探讨驻高寒山区军人心理健康、社会支持、应对方式、自我和谐状态,以便采取措施提高他们的心理健康水平。方法采用症状自评量表（SCL-90）、社会支持评定量表、应对方式问卷（CSQ）、自我和谐量表（SCCS）对驻高寒边远山区部队的1009名军人进行测评,结果与驻内地军人进行比较。结果高寒山区军人SCL-90中的躯体化、强迫、抑郁因子分（1．33±0．38、1．50±0．48和1．37±0．44）与内地军人（1．28±0．49、1．56±0．53和1．30±0．51）比较,社会支持评定中的社会支持总分、客观支持因子分（40．12±7．40、8．34±3．36）与内地军人（41．47±7．77、9．55±3．44）比较,CSQ中的自责、幻想、退避、合理化,SCCS中的自我与经验的不和谐、自我的灵活性、自我的刻板性与内地军人比较,差异均有显著性（P〈0．05,P〈0．01）。结论驻高寒边远山区军人心理状况有其特点,心理健康与自我和谐、应对方式及社会支持密切相关。     

贫困大学生社会支持和应对方式与心理健康的相关研究

目的了解贫困大学生社会支持状况、应对方式特点及其与心理健康状况的关系，为高校贫困大学生心理卫生工作提供依据。方法采用SCL-90、社会支持评定量表（SSRS）、应对方式问卷（CSQ）对梅州地区2所高校大学生进行问卷调查，对306份有效问卷进行分析。结果贫困生SCL-90各症状因子分均高于普通大学生；贫困大学生的社会支持状况更差，在主观支持、支持总分上差异有显著性；贫困大学生更多地采用消极的应对方式，自责因子与普通大学生比较差异有显著性。社会支持、应对方式与身心健康水平显著相关，自责、幻想应对方式和对支持的利用度可进入回归方程。结论贫困生的心理健康水平较差。需改善贫困大学生的社会支持，引导他们采用积极的应对方式，有针对性地加强对贫困大学生的心理健康教育和咨询。     

儿科护士压力应对和社会支持与心理健康的关系

目的：研究儿科护士压力应对方式、社会支持与心理健康的关系,为进行循证团体心理干预寻找理论支持。方法采取分层抽样的方法,使用一般情况调查表、症状自评量表（ SCL-90）、应对方式问卷和社会支持评定量表对福建省福州儿童医院临床科室护士111名进行问卷调查。结果17．82％的儿科护士心理健康筛查阳性,比中国常模高（χ2＝4．36,P＜0．05）。客观支持、主观支持、支持利用度及解决问题型的压力应对方式均与SCL-90总分存在极其显著的负相关（ r值分别为-0．27、-0．38、-0．24、-0．40,均P＜0．01）;自责型及幻想型的压力应对方式与SCL-90总分存在显著的正相关（r＝0．37,P＝0．00;r＝0．26,P＝0．02）;解决问题型应对方式与社会支持三维度均显著正相关（r值分别为0．27、0．44、0．26,均P＜0．01）,求助型应对方式与支持利用度显著正相关（r＝0．32,P＝0．00）,而退避型应对方式与主观支持显示负相关（r＝-0．28,P＝0．02）。结论不同的压力应对方式及社会支持程度与儿科护士的心理健康状况显著相关,尤其是解决问题型应对方式及主观支持水平高的儿科护士,心理健康状况较好。主观支持程度能显著预测儿科护士的心理健康状况。     

急诊及普通病房护士心理健康状况的比较研究

目的:探讨急诊及普通病房护士心理健康状况的差别。方法:采取整群抽样方法随机选择我市3所综合性医院共144名护士。采用症状自评量表(SCL-90)调查急诊科及普通病房护士的心理健康状况。结果:所有医护人员的SCL-90的总分为(142.81±20.77),明显高于国内常模的(129.6±38.70),且各因子得分与国内常模比较,各因子差异均具有统计学意义(P<0.05)。急诊组和普通病房组护理人员SCL-90各因子得分比较,各因子差异均有统计学意义(P<0.05)。结论:护理人员整体心理健康水平较一般人群差;急诊科护理人员的心理状态较普通病房护士的心理状况差。     

女性社区工作者主观幸福感及影响因素研究

目的探讨女性社区工作者主观幸福感的现状及其影响因素。方法按类分层、分段、随机、整群的抽样方法抽取167名杭州市女性社区工作者,采用纽芬兰纪念大学幸福度量表（MUNSH）、社会支持量表（SSRS）、特质应对方式问卷（TCSQ）、焦虑自评量表（SAS）和抑郁自评量表（SDS）进行调查。结果杭州市女性社区工作者的主观幸福感中正性情感和体验得分远大于负性情感和体验,分别为4．43±2．90、2．61±2．52和7．26±3．94、4．37±3．26;正性情感与文化程度呈负相关（r=-0．237,P〈0．01）;主观幸福感现与焦虑情绪、抑郁情绪、特质应对（积极应对、消极应对）、社会支持（客观支持、主观支持、对支持的利用度）存在不同程度相关;影响总幸福度的因素依次为消极应对、积极应对、主观支持、利用度、SDS、文化程度（-4．757,P〈0．01;3．457,P〈0．01;2．985,P〈0．01;-2．722,P〈0．01;2．417,P〈0．05）。结论杭州市女性社区工作者总体自觉幸福和满意,其主观幸福感与文化程度、焦虑抑郁情绪、应对方式和社会支持有密切关系。     

大学生社会支持及应对方式与心理健康水平分析

目的 了解大学生心理健康水平与社会支持及应对方式之间的相关性。方法采用分层整群抽样的方法对武汉工业学院423名大学生进行SCL-90自评量表、社会支持评定量表、应对方式问卷调查分析。结果学生心理健康总体水平偏低。因子分≥3的检出率为7．80％。主要的心理问题是强迫、人际关系敏感和抑郁。不同心理健康状况大学生社会支持、应付方式差异有统计学意义（P〈0．05）。社会支持3个维度、积极应对方式与SCL-90总分及各因子分之间呈负相关，消极应对方式与SCL-90总分及各因子分之间星正相关。结论社会支持及应对方式对大学生心理健康具有影响作用。     

高血压患者应对方式与心理健康关系研究

目的 了解高血压患者心理健康状态及患者所采用的应对方式的相关性。方法 选取在河北北方学院第一附属医院心血管内科住院治疗的高血压患者237例,使用症状自评量表(SCL-90)和医学应对问卷(MCMQ)对所有患者进行调查;采用独立样本t检验进行高血压患者和常模的比较,心理健康和应对方式相关性采用Pearson相关分析。结果 高血压患者SCL-90总分及五个因子(躯体化、抑郁、焦虑、恐怖、偏执)得分均显著高于常模(t₁=4.377,P₁<0.05;t₂=2.429,P₂<0.05;t₃=3.627,P₃<0.05;t₄=3.380,P₄<0.05;t₅=2.263,P₅<0.05),应对方式中面对因子显著高于常模(t=6.545,P<0.05)、回避因子显著低于常模(t=-3.246,P<0.05)、屈服因子差异无统计学意义;面对因子与除强迫症状、敌对、恐怖因子外的其他因子及总分呈负相关(P<0.05);回避因子与除敌对因子外的其他因子及总分呈负相关(P<0.05);屈服因子与除强迫症状、敌对、偏执、精神病性因子外的其他因子与总分呈正相关(P<0.05)。结论 高血压患者的心理健康水平明显低于常人;面对和回避应对方式对高血压患者心理健康有积极作用,屈服应对方式对高血压患者心理健康有消极作用。     

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.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

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.     

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.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.