短效催眠药三唑仑、唑吡坦和佐匹克隆对人体认知能力的影响

目的 观察正常人服用短效催眠药三唑仑、唑吡坦和佐匹克隆对认知能力的副作用,为制定飞行人员的合理用药方案提供科学依据。方法 8名健康男性青年志愿者,在4次试验(每次间隔5d)中交叉服用三唑仑0．25mg、唑吡坦10mg、佐匹克隆7．5mg和安慰剂,采用随机双盲设计给药,分别在服药前4h、服药后1h、2h、3h、4h、6h、8h、10h各完成1次认知能力测试,同时观察用药不良反应。测试内容包括：(1)斯坦福嗜睡量表;(2)单双重任务(包括四数连加正确率、心理运动能力及两者复合的双重任务)能力;(3)声光刺激反应(包括声光反应时、声光运动时、临界闪光融合频率和注意分配)能力。用两因素重复测量的方差分析比较药物间与不同用药后时间认知能力的差别。结果与安慰剂组比较,唑吡坦和佐匹克隆在用药后能明显提高斯坦福嗜睡量表分值(安慰剂组最高2．O分,两药物组分别达到4．O和3．4分);唑吡坦、佐匹克隆可明显降低心理运动能力(分别为9．2％和11．0％);唑吡坦可明显降低双重任务保持率;佐匹克隆可明显降低四数连加正确率和双重任务正确率。三唑仑对各项指标的影响均不显著。结论 3种短效催眠药在用药约6h后,对认知能力的影响消失,其中三唑仑的副作用最小。     

解放军预防医学杂志2003年第21卷学科分类总题录索引

述　评加强预防医学学术交流全心全意为部队健康服务　　—纪念《解放军预防医学杂志》创刊 2 0周年　晁福寰 (1) :1………………………………………………高技术战争对军事预防医学训练的要求　及对策张晓丽等 (2 ) :79…………………………………我军恙虫病流行病学研究回顾与展望　陶开华等 (3) :15 7…………………………………………军事作业医学研究现状及展望刘洪涛等 (5 ) :313…………新时期军事医学研究所地位作用及发展　方向探讨王常有等 (6 ) :391………………………………劳动卫生学短效催眠药唑吡坦和三唑仑对人体前庭　功能…     

超生理浓度的软脂酸和瘦素对大鼠胰岛素影响的实验研究

目的研究高浓度长链游离脂肪酸(LC-FFA)即2mM软脂酸(Palmitate) 和/或15ng/ml瘦素(Leptin)对正常成年SD雄性大鼠胰岛培养液中胰岛素(Insulin,Ins)浓度的影响. 方法将经过2mM软脂酸、15ng/ml瘦素处理过的大鼠胰岛培养液用放射免疫分析法测定Ins浓度. 结果①培养第2日,2mM软脂酸组Ins浓度比对照组高,(156.37±9.26)vs(51.28±7.11)(单位mIU/L,以下同),差异有极显著意义(P<0.001); 第4日,(16.62±1.92)vs(19.83±9.27),差异不显著(P>0.05);②培养第2日,15ng/ml瘦素组Ins浓度比对照组高,(176.30±3.20)vs(51.28±7.11),差异有极显著意义(P<0.001);第4日,(18.73±1.72)vs(19.83±9.27),差异不显著 (P>0.05);③培养第2日,2mM软脂酸+15ng/ml瘦素组Ins浓度比对照组高,(166.86±15.87)vs(51.28±7.11),第4日,比对照组浓度低,(10.72±1.72 )vs(19.83±9.27),差异均有极显著意义(P<0.001);④培养第2日,2mM软脂酸组与2mM软脂酸+15ng/ml瘦素组相比,(156.37±9.26)vs(166.86±15.87),Ins浓度差异不显著(P>0.05);第4日,2mM软脂酸组Ins浓度高,(16.62±1.92)vs(10.72±1.72),差异有极显著意义(P<0.001);⑤培养第2日,15ng/ml瘦素组与2mM软脂酸+15ng/ml瘦素组相比,(176.30±3.20)vs(166.86±15.87),差异不显著(P>0.05);第4日,15ng/ml瘦素组Ins浓度高,(18.73±1.72)vs(10.72±1.72),差异有极显著意义(P<0.001);⑥2mM软脂酸组Ins浓度比15ng/ml瘦素组低,培养第2日,(156.37±9.26)vs(176.30±3.20),差异有极显著意义(P<0.001);第4日,(16.62±1.92)vs(18.73±1.72),差异显著 (P<0.05). 结论软脂酸和瘦素均刺激Ins释放; 15ng/ml瘦素在第4日继续对抗2mM软脂酸的脂毒性、脂凋亡作用.     

不同价态锰对神经母细胞瘤细胞的氧化损伤作用

目的　探讨不同价态、不同浓度锰引起神经细胞的脂质过氧化对细胞的损伤作用。方法　分别用 0 ,0 2 5 ,0 5 0 ,0 75mmol/L二价锰、三价锰对神经母细胞瘤细胞 (SH SY5Y)染毒 2 4h ,观察测定细胞超氧化物歧化酶 (SOD)、谷胱甘肽过氧化物酶 (GSH Px)、丙二醛 (MDA)、GSH Px/MDA及细胞膜脂荧光各向异性的变化。结果　二价锰、三价锰染毒各低、中、高剂量组细胞SOD活力 [(5 2 2 1 2± 5 7 74 ) ,(4 98 38± 37 2 9) ,(4 6 4 86± 2 4 0 9)和 (4 99 79± 30 86 ) ,(4 77 2 3± 6 1 6 6 ) ,(4 35 95± 74 0 4 )NU/mg蛋白 ]与对照组[(86 1 2 4± 35 74 )NU/mg蛋白 ]比较明显降低 ,差异有显著性 (P <0 0 5 ) ;GSH Px活力 [(1 9 0 4± 5 1 6 ) ,(1 7 74± 5 91 ) ,(1 5 99± 5 6 2 )和 (1 6 5 8± 6 1 9) ,(1 5 79± 7 2 9) ,(1 4 2 3± 5 2 0 )活力单位 ]均较对照组[(2 9 2 3± 7 83)活力单位 ]降低 ,差异有非常显著性 (P <0 0 1 ) ;GSH Px/MDA较对照组降低 ,差异有显著性 (P <0 0 5 ) ,而MDA和细胞膜脂荧光各向异性有所升高 (P <0 0 5 ) ;相同染毒剂量情况下 ,三价锰组上述指标的变化比二价锰组明显。结论　锰通过抑制SOD、GSH Px活力 ,降低细胞抗氧化能力 ,造成细胞膜功能的损伤。三     

感染性脑水肿发生的机理研究

目的　观察实验性感染性脑水肿时β -内啡肽 (β -EP)的变化以探讨感染性脑水肿的发病机理。方法　采用兔百日咳菌液感染性脑水肿模型 ,观察生理盐水组 (NS ,n =7)、百日咳菌液组 (PB ,n =7)两组兔脑组织含水量、大脑皮层、海马、血浆及脑脊液中 β -EP含量变化。 结果　PB组脑组织含水量显著高于NS组 (P<0 0 1) ,大脑皮层、海马、血浆及脑脊液中 β -EP含量分别为 (5 6 2 8± 11 6 6 )pg/mg ,(85 97± 33 76 )pg/mg ,(10 6 33± 2 4 96 )ng/ml,(2 4 9± 0 6 6 )ng/ml,均显著高于NS组 (18 5 0± 2 0 1)pg/mg ,(2 2 5 2± 6 0 7)pg/mg ,(43 80± 19 6 3)ng/ml,(1 14± 0 39)ng/ml,P均小于 0 0 1)。结论　感染性脑水肿时 ,大脑皮层、海马、血浆及脑脊液中β -EP含量明显增加 ,引起脑水肿的发生和发展。     

连续肾替代治疗在外科严重脓毒症并发毛细血管渗漏综合征中的治疗价值

Objective To investigate the clinical therapeutic value of CRRT on severe sepsis coincidence with capillary leak syndrome in surgical patients. Methods 38 patients suffering from severe sepsis coincidence with capillary leak syndrome were random divided into routine group ( n = 18 ) and CRRT group ( n =20). Both groups were given routine treatment, while the patients of CRRT group were given CRRT in addition. Red blood cell count (RBC), haematoglobin level, blood platelets count, leukocyte count, hematocrit (HCT), plasma-albumin level, central venous pressure ( CVP), arterial blood pressure ( ABP), urinary production change of every hour, oxygenation index condition ( PO2\FiO2 ) were measured at 0, 12, 24, 48,72 hour following routine treatment or CRRT. Additionally, serum levels of tumor necrosis factor- a (TNF-α), interleukin-6 (IL-6) and interleukin-8(IL-8) were determined at the same time. Results Blood platelets count, HCT, plasma-albumin level in CRRT group were significantly higher than those of routine group [72 h: (211. 75 ± 45. 23 ) × 109 vs ( 135.67 ± 41.45 ) × 109 ;0. 43 ± 0. 05 vs 0. 35 ±0. 04; (48. 60 ±4. 76) g/L vs (41.17 ±4. 64) g/L, P <0. 01 ]. WBC were significantly lower than those of routine group[72 h:(7.58 ±2.31) ×109 vs (13.77 ±2.67) × 109, P <0.01]. Change of ABP, PO2\FiO2, urinary production for every hour was notably increased than those of routine group [72 h: (94. 25 ±8.60) mmHg vs ( 84. 22 ± 7. 37 ) mmHg; 345. 25 ± 35. 21 vs 304. 22 ± 38. 74; ( 80. 15 ± 14. 54 ) ml vs (62. 72 ± 12. 33) ml, P <0. 01 ]. The serum levels of TNF-α, IL-6 and IL-8 of CRRT group were markedly decreased compared with those of routine group(72 h:249. 55 ±99. 60 vs 368. 83 ±97. 11 ;600. 75 ±98. 31 vs 718. 94 ± 92. 00 ;665. 35 ±138. 44 vs 843. 22 ±123. 95 , P <0. 01,P <0.05). Conclusions CRRT can significantly improve patient's condition, which may be an effective nechanism to treat the surgical patients with severe sepsis coincidence with capillary leak syndrome.     

口腔念珠菌病患者唾液硝酸根分泌能力升高

Objective To observe the alterations of saliva nitrate and nitrite level in patients with oral candidiasis. Methods Parotid saliva and whole saliva were collected from 33 patients and 34 healthy volunteers. Concentrations of nitrate and nitrite in saliva were determined by high-performance liquid chromatography. Follow-up observation was performed on 10 patients after treatment. The data were statistically analyzed with independent-samples t test or paired-samples t test at α=0. 05. Results There was significant increase of the concentrations and secretion rate of parotid saliva nitrate in patient group as compared with controls: (49. 70±0. 50) vs (21.51±0. 60) mg/L (t=2. 692,P=0. 009) and (27.71±0. 50) vs (12. 55±0. 60)μg/min (t=2. 554, P=0. 013), respectively. Significantly increased concentrations and secretion rate of nitrate and nitrite [nitrate: (6. 46±0. 94) vs (1.11±0. 70) mg/L (t=3.792,P=0.000); nitrite: (8.48±0.58) vs (3.39±0.53) mg/L (t=2.888,P=0.005); nitrate secretion rate: (10. 57±0. 91) vs (2. 10±0. 74)μg/min (t=3.464, P=0. 001) ; nitrite secretion rate:(13.91±0.55) vs (6.42±0.58)μg,/min (t=2.397,P=0.020)]were revealed in whole saliva of patients group. Significantly decreased nitrate and nitrite levels were also observed in patients after treatment, especially the changes of parotid saliva nitrate secretion rate [(37. 50±0. 50) vs (14. 34±0. 64)μg/min (t=3. 142, P=0. 012)], whole saliva nitrate [(14.29±1.01) vs (2. 59±1.03) mg/L (t=3.475, P=0. 007)]and whole saliva nitrate secretion rate [(25.97±0. 93) vs (4. 12±1.00)μg/min (t=3. 922,P=0. 003)]. Conclusion The present study revealed the significant increase of salivary nitrate and nitrite level in patients with oral candidiasis is considered to be associated with the host defense reaction.     

口腔念珠菌病患者唾液硝酸根分泌能力升高

Objective To observe the alterations of saliva nitrate and nitrite level in patients with oral candidiasis. Methods Parotid saliva and whole saliva were collected from 33 patients and 34 healthy volunteers. Concentrations of nitrate and nitrite in saliva were determined by high-performance liquid chromatography. Follow-up observation was performed on 10 patients after treatment. The data were statistically analyzed with independent-samples t test or paired-samples t test at α=0. 05. Results There was significant increase of the concentrations and secretion rate of parotid saliva nitrate in patient group as compared with controls: (49. 70±0. 50) vs (21.51±0. 60) mg/L (t=2. 692,P=0. 009) and (27.71±0. 50) vs (12. 55±0. 60)μg/min (t=2. 554, P=0. 013), respectively. Significantly increased concentrations and secretion rate of nitrate and nitrite [nitrate: (6. 46±0. 94) vs (1.11±0. 70) mg/L (t=3.792,P=0.000); nitrite: (8.48±0.58) vs (3.39±0.53) mg/L (t=2.888,P=0.005); nitrate secretion rate: (10. 57±0. 91) vs (2. 10±0. 74)μg/min (t=3.464, P=0. 001) ; nitrite secretion rate:(13.91±0.55) vs (6.42±0.58)μg,/min (t=2.397,P=0.020)]were revealed in whole saliva of patients group. Significantly decreased nitrate and nitrite levels were also observed in patients after treatment, especially the changes of parotid saliva nitrate secretion rate [(37. 50±0. 50) vs (14. 34±0. 64)μg/min (t=3. 142, P=0. 012)], whole saliva nitrate [(14.29±1.01) vs (2. 59±1.03) mg/L (t=3.475, P=0. 007)]and whole saliva nitrate secretion rate [(25.97±0. 93) vs (4. 12±1.00)μg/min (t=3. 922,P=0. 003)]. Conclusion The present study revealed the significant increase of salivary nitrate and nitrite level in patients with oral candidiasis is considered to be associated with the host defense reaction.     

口腔念珠菌病患者唾液硝酸根分泌能力升高

Objective To observe the alterations of saliva nitrate and nitrite level in patients with oral candidiasis. Methods Parotid saliva and whole saliva were collected from 33 patients and 34 healthy volunteers. Concentrations of nitrate and nitrite in saliva were determined by high-performance liquid chromatography. Follow-up observation was performed on 10 patients after treatment. The data were statistically analyzed with independent-samples t test or paired-samples t test at α=0. 05. Results There was significant increase of the concentrations and secretion rate of parotid saliva nitrate in patient group as compared with controls: (49. 70±0. 50) vs (21.51±0. 60) mg/L (t=2. 692,P=0. 009) and (27.71±0. 50) vs (12. 55±0. 60)μg/min (t=2. 554, P=0. 013), respectively. Significantly increased concentrations and secretion rate of nitrate and nitrite [nitrate: (6. 46±0. 94) vs (1.11±0. 70) mg/L (t=3.792,P=0.000); nitrite: (8.48±0.58) vs (3.39±0.53) mg/L (t=2.888,P=0.005); nitrate secretion rate: (10. 57±0. 91) vs (2. 10±0. 74)μg/min (t=3.464, P=0. 001) ; nitrite secretion rate:(13.91±0.55) vs (6.42±0.58)μg,/min (t=2.397,P=0.020)]were revealed in whole saliva of patients group. Significantly decreased nitrate and nitrite levels were also observed in patients after treatment, especially the changes of parotid saliva nitrate secretion rate [(37. 50±0. 50) vs (14. 34±0. 64)μg/min (t=3. 142, P=0. 012)], whole saliva nitrate [(14.29±1.01) vs (2. 59±1.03) mg/L (t=3.475, P=0. 007)]and whole saliva nitrate secretion rate [(25.97±0. 93) vs (4. 12±1.00)μg/min (t=3. 922,P=0. 003)]. Conclusion The present study revealed the significant increase of salivary nitrate and nitrite level in patients with oral candidiasis is considered to be associated with the host defense reaction.     

口腔念珠菌病患者唾液硝酸根分泌能力升高

Objective To observe the alterations of saliva nitrate and nitrite level in patients with oral candidiasis. Methods Parotid saliva and whole saliva were collected from 33 patients and 34 healthy volunteers. Concentrations of nitrate and nitrite in saliva were determined by high-performance liquid chromatography. Follow-up observation was performed on 10 patients after treatment. The data were statistically analyzed with independent-samples t test or paired-samples t test at α=0. 05. Results There was significant increase of the concentrations and secretion rate of parotid saliva nitrate in patient group as compared with controls: (49. 70±0. 50) vs (21.51±0. 60) mg/L (t=2. 692,P=0. 009) and (27.71±0. 50) vs (12. 55±0. 60)μg/min (t=2. 554, P=0. 013), respectively. Significantly increased concentrations and secretion rate of nitrate and nitrite [nitrate: (6. 46±0. 94) vs (1.11±0. 70) mg/L (t=3.792,P=0.000); nitrite: (8.48±0.58) vs (3.39±0.53) mg/L (t=2.888,P=0.005); nitrate secretion rate: (10. 57±0. 91) vs (2. 10±0. 74)μg/min (t=3.464, P=0. 001) ; nitrite secretion rate:(13.91±0.55) vs (6.42±0.58)μg,/min (t=2.397,P=0.020)]were revealed in whole saliva of patients group. Significantly decreased nitrate and nitrite levels were also observed in patients after treatment, especially the changes of parotid saliva nitrate secretion rate [(37. 50±0. 50) vs (14. 34±0. 64)μg/min (t=3. 142, P=0. 012)], whole saliva nitrate [(14.29±1.01) vs (2. 59±1.03) mg/L (t=3.475, P=0. 007)]and whole saliva nitrate secretion rate [(25.97±0. 93) vs (4. 12±1.00)μg/min (t=3. 922,P=0. 003)]. Conclusion The present study revealed the significant increase of salivary nitrate and nitrite level in patients with oral candidiasis is considered to be associated with the host defense reaction.     

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.     

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.     

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.