心理社会因素对HIV阳性者情绪障碍的影响

目的分析心理社会因素对HIV阳性者情绪障碍的影响,为开展心理干预提供依据。方法简单抽取感染HIV的既往病例250例,利用流调中心用抑郁量表（CES-D）、焦虑自评量表（SAS）、社会支持评定量表（SSS）、应对方式问卷、艾滋病认知评定量表（AQ）及艾滋病压力量表收集相关资料,对数据进行相关、回归分析。结果 HIV阳性者的抑郁、焦虑得分均值显著高于正常人群（P〈0.001）。AIDS相关压力分别解释抑郁、焦虑总变异的比例最大（54.1%、41.2%）,自责和解决问题均与两种情绪相关,威胁和客观支持仅与抑郁相关（P〈0.01）;此外,经济状况（月收入）也与焦虑有关。结论 HIV阳性者的抑郁、焦虑程度均显著高于正常人,可针对多种心理社会因素开展干预,促进阳性者的心理健康水平。     

艾滋病患者心理社会因素与生存质量的相关性分析

目的分析艾滋病(AIDS)患者心理社会因素与生存质量的关系。方法选择2013—2016年宝鸡市疾病预防控制中心确证并接受治疗的28例AIDS患者为调查对象,采用世界卫生组织艾滋病患者生存质量简表(WHOQOL-HIV-BREF)、焦虑自评量表(SAS)、抑郁自评量表(SDS)和社会支持评定量表(SSRS),分析AIDS患者心理社会因素与生存质量的关系。结果 28例AIDS患者生存质量评分(63.57±12.71)分,社会支持评分(30.14±2.88)分,焦虑评分(66.14±5.99)分,抑郁评分(70.75±5.49)分;AIDS患者生存质量总分女性低于男性,年龄、婚姻状况、家庭收入、服药时间与生存质量总分无相关性(均P0.05);患者社会支持各维度得分与生存质量总分均呈正相关,且主观支持、支持利用度和支持总分与心理领域得分均呈正相关(rs=0.388~0.696,P0.05);患者焦虑、抑郁状态与生存质量量表各领域得分及总分均呈负相关(rs=-0.629~-0.416,P0.05)。结论 28例AIDS患者生存质量总体水平较低,应采取针对性措施,减轻AIDS患者焦虑抑郁状态,增强社会支持,不断提高AIDS患者的生存质量。     

社区老年住院慢性病患者生活质量调查及影响因素分析

目的 了解老年慢性病患者的生活质量现状,探讨其影响因素,从而提出相关对策.方法 收集在本院住院的老年慢性病患者,进行社会支持量表、症状自评量表（SCL-90）及生活质量（WHOQOL-100）评定.利用统计学方法分析影响老年住院慢性病患者生活质量的各种因素.结果 （1）在该老年慢性病患者人群中,有51.6％生活质量下降,51.6％存在心理障碍.（2）多元逐步回归分析表明,影响该老年患者人群QOL的主要因素为疾病严重程度、社会支持水平及是否患有肿瘤病.结论 老年住院慢性病患者生活质量下降是普遍的,受主要疾病严重程度、社会支持水平及是否存在肿瘤的影响.改善老年人的躯体健康,提高社会支持力度,可提高老年慢性病患者的生活质量.     

2007年菏泽市109例艾滋病病毒感染者与艾滋病病人心理状况调查

[目的]了解艾滋病病毒（HIV）感染者和艾滋病病人的心理状况及其与社会支持的相关性。[方法]2007年5月,在菏泽市选择HIV感染者和艾滋病病人109例,应用症状自评量表（SCL-90）、焦虑自评量表（SAS）、抑郁自评量表（SDS）、社会支持评定量表（SSS）进行测试。[结果]调查109例,SCL-90量表中躯体化、强迫症状、抑郁、焦虑、敌对、恐怖、偏执、精神病性因子分均高于全国常模和修订常模（P〈0．01）,人际关系因子分高于修订常模（P〈0．01）;SCL-90量表总分和各因子分之间均为高度正相关关系（P〈0．01）;42例（占38．53％）存在不同程度的焦虑症状,67例（占61．47％）存在抑郁症状;SAS量表总分、SDS量表总分、SCL-90量表总分与主观支持分、支持利用度、社会支持分,SAS量表总分、SCL-90量表总分与客观支持分均呈显著负相关（P〈0．01或〈0．05）。[结论]HIV感染者和艾滋病病人心理健康水平较差,与其社会支持相关。     

安徽省艾滋病抗病毒治疗病人生活质量与社会支持典型相关分析

目的了解接受抗病毒治疗的艾滋病病人的生活质量和社会支持现况及其相关性。方法采用简明健康调查量表（the MOS item short from health survey,SF-36）和社会支持评定量表（social science research solutions,SSRS）对选定人群进行生活质量和社会支持的调查及典型相关分析。结果抗病毒治疗艾滋病病人生活质量和社会支持得分均低于一般人群（均有P〈0.05）。病人社会支持与生活质量之间存在典型相关关系（F=7.48,P〈0.001）。反映生活质量的第一典型变量V1主要由心理健康和情绪角色限制决定;反映社会支持的第一典型变量W1主要由主观支持和对支持的利用度决定。结论抗病毒治疗艾滋病病人生活质量差,社会支持水平低。病人获得的主观支持越多或对支持的利用度越高,则其心理健康状况越好;越少或越低,则由情感问题所造成的职能限制越大。     

济南市艾滋病抗病毒治疗人群生活质量调查

目的了解济南市艾滋病抗病毒治疗人群生活质量状况,为促进该群体身心健康提供依据。方法 2016年3~7月在济南市传染病医院在知情同意的情况下采用社会支持量表(SSS)、自评抑郁量表(SDS)、焦虑自评量表(SAS)等标准化测评工具对患者的生理、心理卫生健康状况进行问卷调查。结果调查济南市艾滋病抗病毒治疗患者166例,其中92.77%(154例)为经同性性行为传播,6.02%(10例)经异性性行为传播,1.20%(2例)经受血或血制品传播;社会支持得分(30.95±4.77分)显著低于正常人群(34.56±3.73分)(P0.01);焦虑标准均分(38.20±9.76分)高于一般人群焦虑得分(29.78±0.46分)(P0.01),抑郁检出率为20.48%,SDS标准均分为(41.75±10.69)分。结论艾滋病抗病毒治疗人群的传播途径以同性性行为为主,焦虑发生率高,社会支持水平较低;在关怀中应采取措施提高其社会支持水平,改善其焦虑状态,提高抗病毒治疗患者生活质量。     

保定地区社区老年人抑郁状况及其影响因素分析

目的探讨社区老年人群的抑郁现状及其影响因素。方法从保定市159个社区中采用随机整群抽样的方法抽取1个社区。应用老年人抑郁评价量表(GDS-15)和一般情况调查表、日常生活调查表、躯体状态调查表、生存质量简表(WHOQOL-100)、社会支持量表对社区内≥60岁老年人555人进行抑郁状况、日常活动能力情况、生活质量、社会支持状况等内容的调查,并进行单因素及多因素分析。结果 555例老年人中,有抑郁症状者为53例,抑郁的患病率为9.6%。非条件Logistic回归分析表明,日常活动能力差、听力障碍、需要照顾、生活质量差、社会支持少是抑郁发生的危险因素。结论保定地区老年人抑郁症状的发生主要与躯体状况、社会心理因素相关,应加强对老年抑郁的预防。     

AIDS患者和HIV感染者心理健康及影响因素的研究

目的通过对艾滋病（acquired immunodeficiency syndrome,AIDS）患者和人类免疫缺陷病毒（human immunodeficiency virus,HIV）感染者进行心理健康及影响因素研究,把握其心理健康状况及影响因素。方法运用《症状自评量表（SCL-90）》、《应对方式问卷》、《社会支持量表》及《家庭关怀指数问卷（APGAR）》对扬州市苏北人民医院新区分院一病区住院的AIDS患者和HIV感染者进行调查。结果单样本的t检验分析显示：AIDS患者和HIV感染者在躯体化、焦虑、抑郁、精神病性的因子分和总得分高于全国常模（均有P〈0.05）,在强迫、偏执、人际敏感的因子分低于全国常模（均有P〈0.05）,而敌对和恐惧的因子分与全国常模差异无统计学意义（均有P〉0.05）;相关分析结果显示：解决问题与SCL-90总分及各维度因子分（除焦虑）呈负相关而自责与SCL-90总分及各维度因子分（除人际敏感、敌对和偏执）呈正相关,求助与焦虑呈负相关,退避与强迫、人际敏感呈正相关,主观支持与偏执呈负相关、支持利用度与躯体化和焦虑呈负相关,适应度与偏执呈负相关而成熟度与恐怖呈正相关;若以SCL-90总分作为因变量,以应对方式、社会支持和家庭关怀的各维度得分及社会人口学资料为自变量进行多元线性回归分析显示：解决问题、退避、自责和亲密度进入回归方程。结论 AIDS患者和HIV感染者的心理健康水平低于全国人群;应对方式、社会支持和家庭功能均是影响心理健康的重要因素。     

HIV感染者和AIDS病人心理状况及影响因素分析

目的了解艾滋病病毒(HIV)感染者和艾滋病(AIDS)病人的心理状态及其影响因素,为制定相关的干预策略提供科学依据。方法采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、社会支持评定量表(SSS)对36名HIV感染者和AIDS病人进行面对面的问卷调查,资料用SPSS11.5统计分析。结果 HIV感染者和AIDS病人SAS得分是38.72±3.04,SDS得分是47.36±3.67,均显著高于全国常模(分别为t=5.783,t=7.445,P均<0.01);SSS总分是29.69±1.80,显著低于全国常模(t=5.301,P<0.01)。性别、婚姻状况、配偶HIV感染状况和社会支持情况是负面情绪的影响因素。结论在HIV感染者/AIDS病人中普遍存在焦虑抑郁情绪,应加强心理咨询和心理干预。     

298例接受抗病毒治疗艾滋病患者的心理健康状况及其影响因素分析

目的 了解安徽省接受抗病毒治疗的艾滋病（acquired immunodeficiency syndrome,AIDS）患者的心理健康状况及其影响因素,为促进该人群的身心健康提供参考。方法 采取定量调查的方式对2013年1月~2014年6月在安徽省3个城市中接受CD4+T细胞检查的AIDS患者进行问卷调查,收集病人的一般人口学特征以及心理健康状况等信息进行分析。结果 研究的参与者中,有63人（21.1%）存在焦虑状况;有126人（42.3%）存在抑郁状况。多因素Logistic回归分析中,AIDS患者有宗教信仰是焦虑状况发生的相关因素（OR=2.221,95%CI:1.094~4.509）;患者具有依从性、婚姻状况为已婚或同居、文化程度为初中和大专及以上、所在地为淮北市、知晓抗病毒治疗需终生服药是抑郁状况发生的相关因素（均有P<0.05）。结论 3个城市AIDS患者焦虑和抑郁状况较为普遍且受多重因素的影响,因此增加患者的依从性、抗病毒治疗需终生服药的知晓情况等可能对于降低焦虑和抑郁情况的发生具有重要意义。     

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.