2015年内蒙古登记流动人口新涂阳肺结核患者特征分析

目的 了解2015年内蒙古登记的常驻人口和流动人口新涂阳肺结核患者的特征,为制定流动人口结核病防治策略提供依据.方法 利用结核病信息管理系统(新),对2015年登记的常驻人口和流动人口1 989例新涂阳肺结核患者的年龄、性别、职业特征分类,利Excel软件进行分析.结果 2015年内蒙古登记新涂阳肺结核患者1 989例,其中流动人口患者355例,占新涂阳患者总数的16.49％ (328/1 989).流动人口新涂阳肺结核患者中男性患者占66.16％ (217/328),女性患者占33.84％ (111/328),高于常驻人口女性患者构成比30.40％ (205/1 661).不同年龄分布,常驻人口和流动人口均以45～54岁年龄组所占比例最高,分别为20.12％和21.97％;不同职业分布,流动人口和常驻人口患者均为农民所占比例最高,其次为家政、家务及待业,流动人口所占比例19.28％高于常驻人口所占比例15.47％.结论 2015年内蒙古新涂阳肺结核患者常驻人口与流动人口相比,在性别、年龄、职业等具有不同的分布特征.     

深圳工厂育龄女性流产现状调查及相关因素分析

目的:了解社区工厂育龄女性意外妊娠情况和流产情况,并分析影响流产的社会学因素.方法:采用匿名问卷调查,了解对象的年龄、文化程度、收入、职业等社会学信息和1年内意外妊娠率以及流产率,使用统计学软件分析流产情况和社会因素的关系.结果:社区工厂育龄群众的流产率为8.9％,其中83.6％为人工流产或药物流产.26～ 30岁组和31～35岁组人群是流产率最高的人群,分别为12.3％和11.4％,另外小于20岁的人群流产率为3.49％.收入较高的人群组(家庭月收入超过1万元)流产率也较高,为10.53％.非深圳户籍人口流产率(9.2％)高于深圳户籍人口(8.21％).采用避孕药避孕和其他避孕方法的对象,发生流产情况较其他人群组高.结论:社区工厂育龄女性意外妊娠和流产发生率较高,尤其是平常选用药物避孕和其他避孕方法的人群,应加强对部分人群的避孕方法的教育.     

抑郁症的心理治疗

就抑郁症的治疗而言,综合治疗是提高疗效的有效方法.现有研究显示抑郁症药物治疗对70％的患者有效,临床治愈率在30％～35％左右,伴有躯体生物性特征症状的抑郁症更易成为难治性抑郁症,而心理治疗以及电痉挛治疗、重复经颅磁刺激治疗等物理治疗不仅可以提高抑郁症的疗效,在某些人群中可以达到主要的治疗效果,如轻度抑郁症患者,心理治疗可能是最佳的方法之一.     

基于CIDI-SF量表的体外受精-胚胎移植妇女抑郁状况及影响因素

目的:探讨接受体外受精-胚胎移植(IVT-EF)妇女过去1年的抑郁状况及其影响因素。方法:2018年6月—2019年6月本院对接受IVT-EF治疗的妇女进行问卷调查。采用世界卫生组织(WHO)短版复合性国际诊断访谈表(CIDI-SF)评估接受IVT-EF治疗的妇女过去1年内的抑郁状况,自设问卷测量其影响因素。结果:293例接受IVT-EF治疗的妇女中60例(20.5%)在过去1年内曾出现过抑郁状态,经CIDI-SF诊断为重度抑郁发作(MDE)的有12例,粗患病率为4.1%。MDE人群中出现自杀观念8例,3例从未将自己的情况告知过医务人员和家人,接受过正规精神治疗的只有2例。Logistic回归分析结果显示,IVT-EF妇女抑郁状态的影响因素有学历(OR=3.20, 95%CI 1.48～6.92)、体重变化(OR=2.77, 95%CI 1.35～5.68)、睡眠情况(OR=0.24, 95%CI 0.12～0.47)及近2年重大负性事件(OR=0.30, 95%CI 0.14～0.66)。结论:应用CIDI-SF量表可发现IVT-EF妇女抑郁状态及重度抑郁发作的发生率均较高,特别是有自杀观念者占比较高,而主动求医者较少;IVF-ET妇女抑郁状态的影响因素具有一定的特异性,医务人员应结合患者自身特点及影响因素主动识别及时干预。     

厦门市集美区MSM人群双性性行为特征及影响因素

目的 了解男男性行为人群(MSM人群)双性性行为特征及影响因素,为制定针对性干预措施提供依据.方法 分析厦门市集美区2017-2019年MSM干预工作问卷中基本人口学资料,以及距调查1年内的性行为特征.结果 MSM人群442人中,双性组占17.9％(79人).同性性行为特征:双性组通过浴池、公园公厕、朋友介绍寻找同性性...     

地奥司明片治疗痔疮急性发作临床观察

目的:比较分析地奥司明片和肛泰栓治疗痔疮急性发作的临床疗效.方法:选取丽水市中心医院收治的痔疮急性发作患者126例,随机分为治疗组和对照组,每组63例.治疗组给予口服地奥司明片治疗,对照组给予肛泰栓治疗.比较两组的治疗效果.结果:治疗组患者的治疗总有效率92.1％,明显高于对照组71.4％,且差异有统计学意义(P＜0.05).治疗组患者的便血、肛门疼痛和肛门下坠感等症状消失时间均不同程度地少于对照组的相关症状,且差异有统计学意义(P＜0.05).治疗组不良反应的发生率4.8％,明显少于对照组14.3％,且差异有统计学意义(P＜0.05).结论:地奥司明片治疗痔疮急性发作的总有效率为92.1％,疗效显著,且能在较短的时间内改善患者症状,明显改善患者的生活质量,值得临床应用.     

癫痫用药讲究正规

癫痫是一种复杂、发作不确定的常见的神经系统慢性疾病。有各种不同的病因和临床表现，常见症状为突然丧失意识、摔倒在地、四肢抽搐、口吐涎沫等。“正规治疗”是使癫痫患者摆脱疾病的惟一途径，正规的药物治疗可使70％-80％的病人癫痫发作在最初5年内缓解，其中50％可完全停药，药物治疗无效的难治性癫痫病人中，有一部分可以通过手术治疗治愈。所谓“正规治疗”，简单地说是早期诊断，根据癫痫类型准确选择药物，确定最佳用量后，长期规则服用，不能随意中断，待“发作”有效控制后，才可缓慢减药或停药。与其他疾病不同，癫痫治疗起来不能“立竿见影”，需要长期耐心的药物治疗和定期随访。     

集体心理治疗对社交焦虑症患者的疗效观察

目的 探讨集体心理治疗对社交焦虑患者的疗效.方法 将中山市人民医院心理咨询门诊的120例社交焦虑患者(年龄14～35岁),随机分为试验组(药物治疗加集体心理治疗)60例,药物组(药物治疗)60例,观察12周,应用症状自评(SCL-90)、自评抑郁量表(SDS)、自动思维问卷(ATO)、交往焦虑量表(IAS)以及抑郁问卷(BDI)进行评定,观察两组治疗青少年社交焦虑患者疗效的有关因素.结果 试验组8周后各量表评分试验组显著低于药物组(p<0.5),12周更加明显(p<0.1).结论 集体心理治疗能有效改善其人际关系敏感度、交往焦虑程度、消极思维习惯等症状,不但提高其生存质量,而且促进其社会功能的恢复.     

海口地区鼻咽癌放射治疗流行病学分析

目的 了解海口地区鼻咽癌患者放射治疗的流行病学临床特征.方法 选择2004年1月～2011年12月期间海口地区进行放射治疗的患者为研究对象,共计1941例.回顾分析进行放射治疗的不同年龄组、不同临床分期、不同性别和地域患者构成比情况,对照分析进行放射治疗的不同年龄组患者中断治疗和非肿瘤死亡者.结果 接受治疗的人群多集中在40～59岁,所占比率高达75.4％,位居第1.该地区进行放射治疗的患者临床分期以Ⅲ期最多,占所有被调查人群的47.0％.80.0％的被调查人群生存期仅为1年.接受治疗的患者男性居多,男女所占比例的比率为2.4∶1,而区域多来自农村,农村和城镇所占比例的比率为2.3∶1.≥55岁组患者中断治疗及非肿瘤死亡者发生率显著高于＜55岁组患者(P＜0.05).结论 为提高放疗效果,应强化早期筛查,做到早诊断早治疗,同时应对老年患者采取个体化放疗方案,减少中断治疗和非肿瘤性死亡比例.     

强迫症治疗现状的调查

目的了解在上海心理咨询中心就诊的难治性强迫症患者的治疗现状.方法采用HAMD、HAMA、Yale Brown、社会功能缺陷筛查量表(SDSS)、自制的强迫症诊疗现状调查表,对在上海心理咨询中心就诊的159例强迫症患者进行调查.结果①药物治疗99例(66.3%),心理治疗32例(20.1%),药物加心理治疗28例(17.6%).②既往治疗首选方式氯丙咪嗪治疗最多,占52.3%;本次治疗以心理治疗最多占31.7%.③有效107例(67.6%),无效52例(32.4%).④无效与有效者做HAMA、SDSS、治疗连续性比较,有显著差异(P<0.05).结论目前强迫症的临床治疗仍以药物治疗为主,心理治疗逐步受到重视.     

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.