放疗科护士睡眠障碍及与孤独感的关系

目的了解放疗科护士睡眠障碍及与孤独感的关系。方法随机选取放疗科护士191例为调查对象,使用匹兹堡睡眠质量指数量表(PSQI)和UCLA孤独量表进行调查,采用多元线性回归分析孤独感对睡眠状况的影响。结果 58.64%(112例)的护士有睡眠障碍。已婚护士PSQI总分及睡眠效率得分(8.55±1.92,1.52±0.99)高于未婚护士(7.81±2.28,1.10±1.06),差异有统计学意义(t=2.435,2.843,均P0.05)。集体住宿护士PSQI总分及主观睡眠质量和睡眠障碍得分高于在家居住护士,每周夜班≥2次护士主观睡眠质量得分(1.68±0.81)高于≤1次护士(1.36±0.77),大专文化程度护士PSQI总分及日间功能障碍得分(8.43±1.98,1.43±0.86)高于本科及以上护士(7.36±2.41,1.18±0.72),家庭关系较融洽护士PSQI总分及睡眠障碍得分低于家庭关系一般及隔阂多护士。自评压力较轻护士PSQI总分及主观睡眠质量、入睡时间、睡眠时间及日间功能障碍得分低于压力较大护士。年龄30~34岁护士PSQI总分及睡眠障碍和日间功能障碍得分高于25和25～29岁护士,差异均有统计学意义(P0.05或P0.01)。孤独感得分进入PSQI总分的回归方程(β=0.295,P0.05)。结论放疗科护士睡眠障碍发生率高,其睡眠状况因不同人口学特征而存在差异,孤独感对放疗科护士睡眠状况具有预测关系。     

哮喘儿童父母睡眠质量现状调查及相关因素分析

目的探讨哮喘儿童父母睡眠质量现状及其影响因素,为探索改善哮喘患儿父母睡眠质量的干预策略提供科学依据。方法应用一般资料调查表、匹兹堡睡眠质量量表(PSQI)及儿童睡眠习惯问卷调查157例哮喘儿童父母。结果哮喘儿童父母PSQI得分总分为(5.41±2.33)分,显著高于国内常模(P<0.01)。单因素分析结果显示:患儿父母睡眠质量与性别、学历、工作状态、劳动强度及家庭月收入有关;相关分析结果显示:哮喘儿童睡眠与父母的睡眠质量存在正相关关系(r=0.303,P<0.05)。结论哮喘儿童父母睡眠质量不高,患儿的睡眠习惯是潜在的干预切入点,可结合其睡眠质量变化特征,采取针对性干预措施改善其睡眠质量。     

郑州市流动初中学生父母教养方式和睡眠质量状况分析

目的 了解郑州市流动初中生父母教养方式和睡眠质量状况,探索两者间存在的关系,为流动儿童健康发展提供支持。方法 采用整群抽样的方法在郑州市流动人口较多地域的6所中学进行调查,共调查1 344名流动初中学生。调查问卷采用自编信息表、匹兹堡睡眠质量指数量表(PSQI)、父母教养方式问卷(s-EMBU)进行。结果 郑州市流动初中学生的PSQI总均分为（5.67±3.77）分。睡眠存在问题的学生为28.13%。初三年级的PSQI总分最高,3个年级相比较差异有统计学意义(F值为23.54, P＜0.01)。随着年级的增高,PSQI总分、主观睡眠质量、日间功能障碍、睡眠时间等方面得分呈现上升趋势。睡眠无问题组与睡眠存在问题组母亲和父亲教养方式3个维度的得分相比较差异均有统计学意义(t值分别为-7.53、6.38、-4.84、-7.23、5.89、-2.89,P值均＜0.01)。结论 郑州市流动初中学生父母教养方式与睡眠质量存在相关系;父母对学生越关心,学生的睡眠质量越好,相反则越差。     

河南省某批援鄂医疗队睡眠质量调查

目的了解河南省某批援鄂医疗队睡眠质量情况,为提供干预措施提供参考。方法采用整群抽样方法,使用匹兹堡睡眠质量指数(Pittsburgh sleep quality index, PSQI)量表对河南省某批援鄂医疗队睡眠质量进行调查,采用描述流行病学方法对调查对象基本情况进行分析,对性别、年龄、职称、专业、学历、从业年限两组或多组间PSQI得分进行t检验或方差分析,采用SPSS 20.0软件进行统计分析。结果回收有效问卷131份,PSQI平均得分8.29±3.89,主观睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、催眠药物使用、日间功能障碍平均得分分别为0.71±0.77、2.01±0.96、1.21±0.93、0.85±1.05、2.07±0.66、0.20±0.65、1.24±0.95。睡眠好、睡眠一般、睡眠差的人数分别占15.27%、29.77%、54.96%。不同性别、年龄、职称、职业、学历、从业年限之间的差异均无统计学意义(P0.05)。结论河南省某批援鄂医疗队睡眠质量较差,需要采取干预措施。     

护理干预对癌症患者睡眠障碍的效果分析

目的探讨护理干预对癌症住院睡眠障碍的效果。方法采用匹兹堡睡眠质量量表(PSQI)问卷式调查,对肿瘤医院85例存在睡眠障碍癌症住院患者进行护理干预,评估其干预前后睡眠障碍效果。结果经过护理干预后,患者PSQI平均值由7.78±0.73降至4.12±0.63,差异具有统计学意义(t=12.51,P<0.01)。结论通过针对性护理干预可改善患者睡眠障碍状况。     

西藏不同海拔地区藏族青少年睡眠质量及影响因素分析

目的比较不同海拔地区藏族青少年的睡眠质量,并了解在高海拔地区影响青少年睡眠质量的因素,为后续干预提供依据。方法于2 016年8—10月,在西藏低海拔县中学(海拔2 800 m)选取来自高海拔(4 300 m)的227名学生(移居组)及来自低海拔的97名学生(低海拔组),在高海拔县中学(4 300 m)通过分层随机抽样选取306名学生(高海拔组)参加调查,通过自填式问卷调查获得学生相关信息,睡眠质量通过匹兹堡睡眠质量问卷测量,父母教养方式通过藏文版简式父母教养方式问卷进行测量。结果高海拔组学生的睡眠质量因子得分(1.80±0.62)高于较低海拔组(1.55±0.65)和移居组(1.54±0.60)(P 0.01),睡眠质量更差;入睡时间因子得分(2.04±0.77)高于低海拔组(1.67±0.64)(P 0.01)和移居组(1.89±0.73)(P 0.05),入睡时间最长;睡眠障碍因子得分(2.11±0.39)高于低海拔组(1.98±0.38)及移居组(1.99±0.48)(P 0.05),睡眠障碍更多;总分(4.64±1.93)也高于低海拔组(3.76±1.93)(P 0.01)及移居组(4.13±2.00)(P 0.05),总体睡眠质量更差。日间功能障碍因子高海拔组得分(2.13±0.69)高于低海拔组(1.96±0.63)(P 0.05),高海拔组学生日间功能障碍较低海拔组更多。但睡眠时间因子得分低海拔组(1.13±0.40)及移居组(1.13±0.37)高于高海拔组(1.05±0.33)(P 0.05),睡眠时间较高海拔组短。经多因素分析,总体睡眠质量的影响因素有海拔及父母的拒绝教养方式。结论西藏不同海拔地区藏族青少年的睡眠质量受海拔及父母教养方式的影响。     

某部潜艇官兵长航后睡眠质量及其相关因素研究

目的探讨潜艇官兵长航后睡眠质量、相关因素及其应对策略。方法采用匹兹堡睡眠指数量表(PSQI)、艾森克个性问卷(EPQ)、社会支持量表(SSRS)对部分潜艇官兵长航后进行调查,并对其中部分官兵检测某些血清生化指标。结果长航后32名潜艇官兵(研究组)与66名备航潜艇官兵PSQI(对照组)分值比较,研究组PSQI总分[(6.81±2.64)分]、睡眠质量[(1.68±0.65)分]、睡眠效率[(2.11±0.69)分]显著高于对照组[(4.88±3.12)分、(0.85±0.70)分、(0.94±0.12)分](P0.01),入睡时间[(1.57±1.23)分]也显著高于对照组[(1.00±0.92)分](P0.05);长航后PSQI总分与SSRS的主观支持(SS)呈显著负相关(P0.05),与SSRS余项无相关(P0.05),与EPQ-E呈显著负相关(P0.01),与P、N、L分无显著相关(P0.05);与LDL-L、GGT呈显著正相关(P0.05)。结论潜艇官兵长航后睡眠质量有显著下降,睡眠质量与个性和血清生化指标关系密切,对此提出加强睡眠健康管理应对措施。     

语言障碍儿童的睡眠状况研究

目的 研究语言障碍儿童的睡眠状况以及睡眠问题的发生情况,为从睡眠角度指导语言障碍的综合干预提供参考。方法 2018年1-4月在青岛大学附属青岛妇女儿童医院招募语言障碍儿童78名,并选择年龄、性别匹配的94名正常儿童作为对照组。采用自行编写的睡眠调查问卷,调查两组儿童近1个月的睡眠情况。采用t 检验、χ²检验及确切概率法进行统计分析。结果 病例组睡眠问题的发生率显著高于对照组(52.56% vs. 37.23%,χ²＝4.062,P＜0.05)。其中,入睡困难的发生率显著高于对照组(47.44% vs. 31.91%,χ²＝4.318, P＜0.05)。病例组夜间就寝显著晚于对照组(21.91±0.73 vs. 21.51±0.55,t=4.070, P＜0.001),夜间睡眠时间显著少于对照组[(9.29±0.86) h vs. (9.67±0.76 h),t=-3.162,P＜0.05]。病例组中独立入睡的儿童,睡眠问题的发生率显著低于需要帮助入睡的儿童(41.30% vs. 68.75%,χ²＝5.701,P＜0.05)。夜醒后家长给予适当应答者,睡眠问题的发生率显著低于无应答及立即应答者(33.33% vs. 61.53% vs. 62.50%,χ²＝6.359,P＜0.05)。结论 语言障碍儿童睡眠问题的发生率高,夜间就寝时间晚、睡眠时间少。入睡方式、夜醒家长反应可影响其睡眠。在语言障碍儿童的综合干预中,需要充分关注其睡眠状况。     

南方某区官兵睡眠状况及影响因素分析

目的 研究南方某区官兵睡眠状况及影响因素,为采取干预措施提供参考.方法 采用匹兹堡睡眠质量指数(PSQI)量表对2077名南方某区官兵的睡眠状况进行调查.结果 (1)南方某区官兵睡眠指数为9.15±3.60,睡眠质量指数总分＞7的官兵占67.6％;官兵的主观睡眠质量、入睡时间、睡眠时间、睡眠效率、日间功能障碍、睡眠指数因子得分均高于常模,差异有显著性(P＜0.01);睡眠障碍、睡眠药物因子得分均低于常模,差异有显著性(P＜0.01).(2)不同部别、职别、文化程度、年龄及是否独生子女的官兵之间,睡眠指数差异有显著性(P＜0.05,P＜0.01).PSQI部分因子与部别、文化程度、是否独生子女呈显著正相关(P＜0.05,P＜0.01),但相关系数较低.结论 南方某区官兵睡眠质量较差,部别、职别、文化程度、年龄、是否独生子女可能是主要影响因素.     

长期健康管理策略对女性绝经过渡期相关症状及生存质量的影响

目的探讨长期健康管理策略对绝经过渡期女性绝经相关症状及生存质量的影响。方法选择2018年4月～2019年3月中南大学湘雅医学院附属海口医院就诊的绝经过渡期患者100例,按照随机数字表法分成两组,每组50例,对照组给予常规护理,观察组在对照组的基础上实施长期健康管理策略,干预前后,采用绝经症状评价量表(MRS)评价绝经相关症状,采用匹兹堡睡眠质量指数量表(PSQI)评价睡眠质量,采用绝经生存质量量表(MENQOL)评价患者的生存质量。结果干预后观察组MRS评分低于对照组[(13.27±1.59)分vs(9.08±1.36)分](t=14.160,P0.05),干预后观察组PSQI量表评分低于对照组[(9.69±1.26)分vs(6.81±0.75)分](t=13.888,P0.05),干预后观察组MENQOL量表评分低于对照组[(3.19±0.35)分vs(2.62±0.37)分](t=7.914,P0.05)。结论长期健康管理策略可以减轻绝经过渡期女性的相关症状,提高睡眠质量,改善患者生存质量。     

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.     

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.     

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.     

Psychopathological features of a patient population of targets of workplace bullying

BACKGROUND: A strong association between workplace bullying and subsequent anxiety and depression, indicated by empirical research, suggests that bullying is an aetiological factor for mental health problems. AIMS: To evaluate levels of stress and anxiety-depression disorder developed by targets of workplace bullying together with outcome at 12 months and to characterize this population in terms of psychopathology and sociodemographic features. METHODS: Forty-eight patients (36 women and 12 men) meeting Leymann Inventory of Psychological Terror criteria for bullying were included in a prospective study. Evaluations were performed at first consultation and at 12 months using a standard clinical interview, a visual analogue scale of stress, the Hospital Anxiety and Depression (HAD) scale, the Beech scale of stress in the workplace and a projective test (Picture-Frustration Study). RESULTS: At first consultation, 81% of patients showed high levels of perceived stress at work and 83 and 52% presented with anxiety or depression, respectively. At 12 months, only 19% of working patients expressed a feeling of stress at work. There was a significant change in symptoms of anxiety while there was no change in symptoms of depression. Stress at work and depression influenced significatively capacity to go back to work. At 12-month assessments, workers showed a significantly better score on the HAD scale than non-workers. Over half the targets presented a neuroticism-related predominant personality trait. CONCLUSION: Workplace bullying can have severe mental health repercussions, triggering serious and persistent underlying disorders.     

The rise and fall in incidence of malignant mesothelioma from a British Naval Dockyard, 1979-1999

BACKGROUND: The incidence of malignant mesothelioma in Britain is predicted to rise over the next 15-25 years because of past failure to protect the workforce against inhalation of asbestos. In British Naval dockyards, alternative insulation materials and respiratory protection were introduced from the mid-1960s. Aims This study was carried out to investigate the effects of these control measures on mesothelioma deaths in dockyard workers. METHODS: Cases of mesothelioma of the pleura and peritoneum between 1979 and 1999 in workers from the Devonport Naval Dockyard, south-west England, were sought from coroners' and medico-legal records. RESULTS: Three hundred and one cases were identified, 7% peritoneal. The peak incidence occurred in 1991 with 25 cases per annum (quadratic model fit R(2) = 74.2%, P < 0.001) and we predict that by 2003 the incidence will fall to fewer than five cases per annum. The mean time between first exposure and presentation was 48.5 years [95% confidence interval (CI) = 47.3-49.8], but this was significantly shorter in the more heavily exposed trades, when compared with the less heavily exposed (42 years, 95% CI = 39.0-45.0, versus 49.5 years, 95% CI = 48.2-50.9). Those with higher exposure were also at significantly greater risk of peritoneal disease (P < 0.023, Fisher's exact test). CONCLUSION: The reduction in incidence of mesothelioma is greater than can be accounted for by reduction in numbers of dockyard workers over the last 50 years. Changes in insulation materials and improved industrial hygiene measures introduced into the Devonport Dockyard from the mid-1960s have resulted in an earlier decline in the incidence of malignant mesothelioma than that predicted for the British workforce as a whole.     

Organophosphate toxicity and occupational exposure

The ubiquitous organophosphates present a continuing health hazard in agriculture, public health eradication programmes and as chemical warfare agents. Despite significant progress in understanding the potential mechanisms of toxicity far beyond the commonly accepted mechanism of cholinesterase inhibition in intentional exposures, the precise health effects following occupational exposures are yet to be completely defined. A much greater understanding exists of the clinical features of organophosphate poisoning. These are characterized by a triphasic response involving an initial acute cholinergic phase, an intermediate syndrome (both associated with high mortality) and a disabling but non-lethal delayed polyneuropathy. The delayed polyneuropathy may occur in the absence of the cholinergic or intermediate phases. However, progress is still required in order to improve the quantification and assessment of occupational exposures and the implementation of appropriate preventive measures. Finally, evidence-based guidelines for appropriate or optimal therapeutic interventions following poisoning are required urgently and collaborative work with colleagues in developing countries, where the occurrence of organophosphate exposures is more frequent, may provide the answers.     

Miliaria rubra of the lower limbs in underground miners

This report documents a case series of miliaria rubra of the lower limbs in miners at a deep underground metalliferous mine in tropical arid Australia. During the summer months of February and March 1999, all cases of miliaria rubra of the lower limbs in underground miners seen at the mine's medical centre were clinically examined and administered a questionnaire. Twenty-five patients were seen, an incidence of 56.4 cases per million man-hours. Miliaria rubra was most often located between the ankle and knee (88% of cases). Twenty-four percent had concurrent folliculitis and 20% had concurrent tinea. Thirty-two percent had a personal history of asthma. Walking through ground-water and splashing of the legs was common. Three to 4 weeks of sedentary duties in air conditioning was generally required to achieve resolution of miliaria rubra. The incidence of miliaria rubra of the lower limbs is 38% of the incidence of heat exhaustion at the same mine. The length of disablement is greater, however. Atopics may be at increased risk of miliaria rubra. Control measures are discussed.     

Planning research

The starting point for any research project should be a question.Once this has been defined and the relevant scientific literaturereviewed, a protocol should be drawn up. This will be used notonly as a guide to the conduct of the study and in the preparationof the final report, but also in seeking any financial supportand approvals that are required for the investigation. A protocolis normally arranged in sections covering the background tothe study, the question(s) that it will address, the methodsthat will be used for the collection and analysis of data, thestatistical power of the investigation (where relevant), anyethical considerations, and the financial input that will beneeded. A pilot study is often helpful where aspects of thestudy method are untried or of uncertainvalidity.     

Stress in the Norwegian police service

BACKGROUND: High levels of stress have been attributed to the conditions of police work, but there is little empirical evidence for this. AIMS: To develop a new instrument to measure job stress in the police; to assess the most severe and frequent police stressors; to compare levels of stress according to the demographic and organizational factors; and to study stress in relation to personality traits, work locus of control and coping strategies. METHODS: A comprehensive nationwide questionnaire survey of 3272 Norwegian police at all hierarchical levels, including the Norwegian Police Stress Survey (NPSS), the Job Stress Survey, the Basic Character Inventory, the Work Locus of Control Scale, and the Coping Strategies Scale. RESULTS: Work injuries were appraised as the most stressful but least frequent stressor and job pressure was reported the least severe but most frequent stressor. Females experienced job stressors less frequently, but appraised them as more severe than men did. Older police officers reported more job pressure severity and fewer work injuries. The police in districts where peer support was planned but not implemented, and who worked in districts with more than 50,000 inhabitants, perceived the lack of support more severely than others. The correlations between stress and personality traits, work locus of control, and coping were moderate. CONCLUSIONS: The NPSS captures police-specific stressors that are not adequately measured by global stress instruments. The study of stress in police work should preferably involve a nationwide use of police-specific stress instruments.