徐州市农村中学生睡眠状况及其影响因素分析

目的 探讨徐州市农村中学生睡眠质量现状以及影响因素,为中学生睡眠障碍的有效干预提供科学依据.方法 分层整群随机抽取徐州市部分农村的1385名中学进行匹兹堡睡眠质量指数(PSQI)测评,并同时调查研究对象的社会人口学特征及睡眠质量的相关影响因素.结果 徐州市农村中学生睡眠障碍的发生率为36.6％,初中生的发生率为32.4％,高中生为40.0％.男生睡眠障碍的发生率为39.7％,女生为32.5％.年级和性别差异均有统计学意义(P值均＜0.05).年级、睡眠环境、交往压力、体育锻炼进入睡眠障碍的多因素Logistic回归方程.结论 徐州市农村中学生的睡眠障碍问题较为严重,且与多种因素有关,应及时采取有效的干预措施,提高中学生的睡眠质量.     

青少年睡眠时间静态活动与超重肥胖的关系

目的 探讨中小学生睡眠时间、静态活动与超重肥胖的关系,为制定预防和干预青少年肥胖策略提供依据.方法 采用自行编制的“学生营养状况及饮食行为调查表”,对多阶段分层整群抽取的湖北省3 182名城乡中小学生进行睡眠时间、静态活动调查,并在现场测量身高、体重等指标,分析睡眠时间与静态活动对超重肥胖的影响.结果 中小学生超重肥胖检出率为11.7％,其中男生为14.8％,女生为8.5％,男生超重肥胖检出率显著高于女生(x2=30.49,P＜0.05);小学生超重检出率显著高于中学生(x2=72.40,P＜o.05).调查前的过去7d里,小学生睡眠不足1 003例,占98.9％;中学生睡眠不足1 659例,占76.5％,差异有统计学意义(x2=253.40,P＜0.05).小学生各项静态活动平均每天≥2 h的分别为看电视(13.6％)、上网(33.7％),中学生分别为看电视(13.5％)、上网(23.5％),中、小学生之间差异均有统计学意义(P值均＜0.05).睡眠不足、看电视和上网时间均≥2 h的学生超重肥胖率分别为12.3％,13.0％和15.8％.Logistic回归分析显示,上网时间长(≥2 h)的学生发生超重肥胖的危险性是上网时间短(＜2 h)学生的1.393倍(P＜0.05).结论 长时间上网为中小学生超重肥胖的独立危险因素.     

高校教职工慢性病现患研究及干预措施探讨

[目的]了解高校教职工慢性病患病情况及影响因素,为采取干预措施提供科学依据. [方法]对该高校的教职工进行健康体检,并对结果进行统计分析. [结果]超重及肥胖患病率38.68%,高脂血症患病率37.98%,脂肪肝患病率17.54%,高血压患病率14.99%,糖尿病患病率4.31%,均随年龄增长而有增高趋势,男性高于女性,差异有统计学意义(P＜0.05-0.01).超重及肥胖人群高脂血症、脂肪肝、高血压、糖尿病的患病率均高于体质量正常人群.差异有统计学意义(P＜0.01).教师人群高血压的患病率高于普通人群,差异有统计学意义(P＜0.01),而普通人群在超重及肥胖、高脂血症、脂肪肝患病率高于教师人群,差异有统计学意义(P＜0.01). [结论]高校教职工慢性病患病率较高,应采取多种干预措施,有效控制和降低慢性病的患病率. 17.54%,高血压患病率14.99%,糖尿病患病率4.31%,均随年龄增长而有增高趋势,男性高于女性,差异有统计学意义(P＜0.05～0.01).超重及肥胖人群高脂血症、脂肪肝、高血压、糖尿病的患病率均高于体质量正常人群.差异有统计学意义(P＜0.01).教师人群高血压的患病率高于普通人群, 异有统计学意义(P＜0.01),而普通人群在超重及肥胖、高脂血症、脂肪肝患病率高于教师人群,差异有统计学意义(P＜0.01). [结论]高校教职工慢性病患病率较高,应采取多种干预措施,有效控制和降低慢性病的患病率. 17.54%,高血压患病率     

男性铁路货运调度员职业应激与睡眠障碍的关系

目的 初步探讨职业应激相关因素对睡眠的影响.方法 采用整群抽样方法,使用睡眠障碍、工作内容问卷和职业紧张测量工具对93名某铁路货运编组站男性调度员进行睡眠障碍和职业应激相关因素调查.结果 工作需求、工作紧张因素、抑郁症状、躯体症状、每日紧张感、工作心理控制源高水平组睡眠障碍评分高于低水平组,差异有统计学意义(P＜0.01或P＜0.05),而低决定自由度组睡眠障碍评分高于高水平组,差异有统计学意义(P＜0.05).睡眠障碍评分与决定自由度、工作需求、工作紧张因素、心理卫生、抑郁症状、状态焦虑、躯体症状、每日紧张感、特质焦虑、应激易感性评分相关系数有统计学意义(P＜0.01或P＜0.05).低决定自由度、抑郁症状、每日紧张感和工作无意义是睡眠障碍的危险因素.结论 职业应激与睡眠障碍有关.     

重庆市主城区中学生近视患病状况调查

目的 了解重庆市主城区中学生近视患病状况,为中学生近视眼的预防和控制提供科学依据.方法 2011-09-01/10-28采取分层整群随机抽样的方法,对重庆市主城区中学生视力状况进行调查,并对调查结果使用Epidata3.02双录查错,用SPSS18.0统计软件包进行统计分析.结果 重庆市主城区中学生近视患病率为60.68％,其中男、女生近视患病率分别为58.30％、63.25％,差异有统计学意义(x2=4.41,P＜0.05);重点中学与普通中学学生近视患病率分别为68.78％、56.91％,差异有统计学意义(x2=22.22,P＜0.01);初一、初二、初三、高一、高二、高三近视患病率分别为33.64％、52.04％、62.68％、69.40％、75.09％和75.72％,线性卡方趋势性检验有统计学意义(x2=149.52,P＜0.01).轻、中、重度近视分别占近视总人数的17.27％、38.04％和44.69％.其中重点中学与普通中学近视程度的差异有统计学意义(H=60.90,P＜0.01),不同年级之间近视程度的差异有统计学意义(H=210.60,P＜0.01).结论 重庆市主城区中学生近视率较高,且近视程度较为严重.女生近视患病率高于男生,重点中学近视患病率及患病程度均高于普通中学,近视患病率及患病程度随学习年限的升高而增加.     

帕罗西汀治疗脑卒中睡眠障碍的临床观察

目的 评价帕罗西汀治疗脑卒中睡眠障碍的疗效和安全性.方法 68例脑卒中睡眠障碍患者随机分成治疗组(帕罗西汀组,n=36)和对照组(艾司唑仑组,n=32),分别口服帕罗西汀20 mg/d和艾司唑仑2 mg/d,疗程均为14d.治疗结束后分别对患者睡眠障碍量表(SDRS)评分、不良反应进行分析.结果 治疗组和对照组总有效率分别为83.33％和81.25％,组间比较差异无统计学意义(P＞0.05).在治疗结束时,两组SDRS评分较治疗前均显著降低(P＜0.05),组间比较改善程度差异无统计学意义(P＞0.05).两组不良反应多为嗜睡、口苦、头晕,治疗组和对照组不良反应总发生率分别为8.33％和37.5％,组间比较差异有统计学意义(P＜0.05).结论 帕罗西汀治疗脑卒中睡眠障碍安全有效.     

唐山市居民糖尿病患病情况调查

目的　调查唐山地区居民糖尿病的流行特点.方法　采用整群随机抽样调查的方法,通过问卷及检测空腹血糖对研究对象进行调查,并对调查结果进行统计分析.结果 唐山市居民糖尿病患病率为6.15％.男性患病率为5.40％,女性患病率为6.73％,不同性别人群糖尿病的患病率差异无统计学意义(x2=1.747,P＞0.05).不同年龄段居民的糖尿病患病率差异有统计学意义(x2=30.701,P＜0.05),70岁以上居民患病率为9.54％,30岁以下居民患病率为0.50％.城市居民患病率为7.10％,乡镇居民患病率为4.92％,差异有统计学意义(x2=4.612,P＜0.05).文化水平越高患病率越低,差异有统计学意义(x2=14.117,P＜0.05).体重过低人群患病率3.73％,肥胖人群患病率9.61％,差异有统计学意义.结论 不同年龄、地区、文化水平、体重指标人群糖尿病的患病率不同,应根据不同人群特点开展糖尿病防控工作.     

我国6城市小学生高血压患病现状

目的 了解城市儿童高血压患病情况,为高血压早期预防策略的制定提供基础数据.方法 采用多阶段随机整群抽样方法,从北京、哈尔滨、济南、重庆、广州和上海抽取6～13岁小学生9793名.按照统一的标准测量方法测量身高、体重及腰围,采用直立式水银血压计测量血压,参考我国儿童高血压诊断标准进行高血压诊断.通过家长问卷调查获取家庭信息.结果 儿童高血压患病率为10.8％,女生(11.9％)高于男生(9.7％)(P＜0.01).肥胖儿童高血压患病率(28.3％)高于超重(16.7％)及正常体重儿童(7.5％)(P＜0.01).不同年龄女生高血压患病率差异有统计学意义(P＜0.05).随着母亲文化程度的增加,女生高血压患病率逐渐降低(P＜0.05);不同家庭收入水平间儿童高血压患病率差异无统计学意义(P＞0.05).结论 我国儿童高血压患病情况较为普遍,需要加强对儿童高血压的预防控制措施.     

低压缺氧环境对急进高原驻训官兵血压的影响

目的 探讨低压缺氧环境对急进高原驻训官兵血压的影响并分析相关因素,为制定有效的防治对策提供科学依据.方法 选择2010年8月至2010年10月某部参加高原驻训的官兵256例为调查对象,按年龄分为＜40岁组(192例)和≥40岁组(64例).监测血压,分析血压升高与年龄、吸烟、睡眠障碍以及负性情绪的关系.结果 256例被调查者高血压患病率达32.03％,明显高于成人血压普查的患病率(11.88％)；血压升高发生率在≥40岁组(60.94％)、吸烟组(42.00％)、有睡眠障碍组(51 65％)以及有负性情绪组(51.92％)显著高于＜40岁组(22.40％)、不吸烟组(17.92％)、无睡眠障碍组(21.21％)以及无负性情绪组(26.96％),差异有统计学意义(P＜0.01).结论 低压缺氧环境可增加急进高原驻训官兵高血压的患病率,年龄≥40岁,有吸烟、睡眠障碍及负性情绪更明显,是防治的重点.     

驻京部队离退休老干部糖尿病患病现况调查

目的 调查驻京部队离退休老干部中糖尿病的患病现况.方法 采用随机整群抽样的方法,进行血糖、体质指数等进行横断面调查.结果 被调查对象共2115例,筛查出糖尿病患者457例,整体患病率为21.61%,随年龄增长糖尿病患病率呈上升趋势,差异有统计学意义(P＜0.05),肥胖组、超重组患病率均高于正常组(P＜0.05).结论...     

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.     

Die sogenannte Vinylchlorid-Krankheit—eine berufsbedingte Systemsklerose?

Zusammenfassung Es wurden 13 Arbeiter untersucht, die zwischen 1 3/4 und 18 Jahren in einem PVC-herstellenden Betrieb beschäftigt waren. 8 von ihnen wiesen sklerodermieartige Hautveränderungen (Abb. 2) auf, die histologisch charakterisiert sind durch Verbreiterung und Homogenisierung der kollagenen Faserbündel (Abb. 3 u. 4) sowie Fragmentation und Rarefizierung der elastischen Fasern (Abb. 5). Bei 7 Patienten bestanden trommelschlegelartige Auftreibungen einzelner Fingerendphalangen (Abb. 1). 11 Patienten zeigten Durchblutungsstörungen der Extremitäten (4 von diesen ein Raynaud-Syndrom) und 6 Patienten Acroosteolysen einzelner Fingerendphalangen (Abb. 6, Tabellen 1–3).Darüber hinaus bestand bei allen Patienten eine Thrombocytopenie, bei 12 Patienten eine Splenomegalie, bei 11 Patienten eine Einschränkung der Leberfunktion (erhöhte BSP-Retention). An der Leber ließ sich histologisch bei den 5 laparoskopierten Patienten eine deutliche Fibrosierung der Portalfelder nachweisen. Bei 4 Patienten bestanden Oesophagusvaricen (Tabellen 4 u. 5). 8 Patienten zeigten eine Partialinsuffizienz mit Hinweisen für vorwiegend restriktive Veränderungen.Die hier beschriebenen Veränderungen gehen weit über das bisher bekannte Acroosteolysesyndrom hinaus. Es wird der dringende Verdacht geäußert, daß langfristige Vinylchlorid-Exposition dieses komplexe Krankheitsbild verursacht. Daher wird für diese systemische Krankheit die Bezeichnung Vinylchlorid-Krankheit vorgeschlagen.Wir danken Frau E. Voigtländer für die Herstellung der klinischen und histologischen Abbildungen.     

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.     

Empathic processes: perception by medical students of patients'' anxiety and depression

Perceptions by medical students of patients' affective states were investigated, and the effect of the students' own emotions on such perceptions. One hundred and one fourth-year medical students rated the levels of anxiety and depression of three women patients presented on videotape, rated their own levels of anxiety and depression and completed a questionnaire on aspects of the rating process. Students had widely different and often inappropriate perceptions of patients' levels of anxiety and depression. Students who consistently overrated anxiety or depression in patients, compared to those who consistently underrated, were themselves significantly more anxious or depressed. These data suggest a need in medical education for systematic teaching of empathic skills and for recognition of potential bias in clinical decision-making arising from the clinician's own emotional state.