摩托车驾驶员驾驶行为的特点与交通事故的关系

目的探讨摩托车驾驶员的驾驶行为特点与交通事故的关系.方法采用自编的摩托车驾驶员驾驶行为问卷和个人资料调查表对800名摩托车驾驶员进行测试.结果①男驾驶员较女驾驶员有较多的超速及违规[(17.23±5.82)分vs(15.07±4.94)分]、警觉安全行为[(25.67±5.28)分vs(24.51±5.14)分],错误行为[(13.03±3.69)分vs(13.94±4.12)分]两者差异有显著性;②16～25岁组驾驶员的冲动行为[(20.05±6.74)分]较多,警觉安全行为[(23.32±4.95)分]较少;③小学文化的驾驶员超速及违规[(18.93±6.36)分]较多;④已婚驾驶员冲动行为[(17.80±6.67)分],超速及违规行为[(16.59±5.60)分]较少,警觉安全行为[(26.18±5.12)分]较多;⑤有驾照的驾驶员冲动行为[(18.00±6.62)分]、错误行为[(12.97±3.77)分],警觉安全行为[(26.03±5.18)分];⑥在碰撞事故中事故驾驶员冲动行为[(19.98±7.14)分]、超速及违规[(17.95±5.95)分]、错误行为[(13.76±3.73)分]上与安全驾驶差异有显著性(P＜0.01).非碰撞事故中仅在错误行为[(13.44±3.78)分]上差异有显著性(P＜0.01).结论摩托车驾驶员驾驶行为与交通事故关系重大,应注重此方面的训练和教育.     

有无冲动行为注意缺陷多动障碍患儿认知功能的差异

目的 比较有和无冲动行为的注意缺陷多动障碍(ADHD)患儿认知功能的差异.方法 根据Barratt冲动性量表的评分将ADHD患儿分为ADHD有冲动组和无冲动组,用韦氏儿童智力量表、逻辑记忆测验、威斯康星卡片分类测验评估其认知功能.结果 有冲动组在逻辑记忆[(10.28±3.79)分 vs (13.36±4.69)分]、威斯康星卡片分类测验的总应答数[(125.79±10.78)分 vs (103.51±8.87)分]、准确应答数、持续错误数[(41.76±16.35)分 vs (23.62±13.17)分]、完成分类数等方面均差于无冲动组,差异有显著性,而2组在总智商[(93.56±13.42)分 vs (95.12±14.15)]分方面无明显差异.结论 有冲动行为的ADHD患儿较无冲动行为的患儿认知功能受损更严重.     

驾驶行为问卷中文版的信效度研究

目的 考察汽车驾驶员驾驶行为问卷的信度效度.方法 随机抽取成都120名小汽车驾驶员进行测试,进行因素分析和信效度的检验.结果 ①问卷抽取3个因素:错误行为、超速及违规行为和疏忽行为,可解释项目总方差的42.027%.②问卷各因素的Cmnbach α系数分别为0.834,0.765和0.644.各因素与总问卷之间的相关显著,分别为0.859,0.824和0.676(P<0.01).③与安全驾驶员相比,事故驾驶员在驾驶行为总分和超速及违规行为分上较高(P<0.05～0.01).结论 DBQ具有较好的信度和效度.是测试小汽车驾驶员驾驶行为的有效工具.     

汽车驾驶员应对方式与驾驶行为和事故的关系

目的 探讨驾驶员应对方式与驾驶行为、事故的关系.方法 采用简单随机抽样方法,抽取347名驾驶员进行应对方式问卷、驾驶行为问卷的调查.结果 (1)除回避性应对与驾驶行为相关不显著外,对抗性应对、情绪性应对与驾驶行为有显著正相关( r=0.18～0.56,P＜0.01);积极评估应对与驾驶行为有显著负相关(r=-0.34～-0.41,P＜0.01).(2)积极评估应对、对抗性应对和情绪性应对对错误行为和疏忽行为均有显著的预测作用,解释率分别为33.5％和23.5％.对抗性应对和积极评估应对对超速及违规行为有显著预测作用,解释率为40.2％.(3)在轻微事故和一般事故中,事故驾驶员和安全驾驶员均在对抗性应对上差异有统计学意义(t=-2.75;2.80,P＜0.01).结论 驾驶员应对方式是影响驾驶行为和事故安全的重要因素.     

精神医学专业与临床医学专业学生心理健康和心理防御方式的比较

目的 比较精神医学专业与临床医学专业学生心理健康和心理防御方式的差异.方法 应用防御方式问卷(DSQ)和症状自评问卷(SCL-90),对177名精神医学专业学生和330名临床医学专业学生的心理健康状况和心理防御方式进行评估.结果 精神医学专业组SCL-90总分[(1.27±0.28)分]及各因子评分均低于临床医学专业组[(1.49±0.34)分],差异具有显著性;2组在DSQ各维度差异均具有显著性,临床医学专业组在不成熟型防御方式中的抱怨[(3.49±1.77)分 vs(3.96±1.65)分]、幻想[(5.06±2.47)分 vs(5.55±2.36)分]、分裂[(4.31±1.07)分 vs(4.61±1.35)分]、躯体化方面[(3.69±1.82)分 vs(4.06±1.53)分]评分高于精神医学专业组,差异具有显著性;精神医学专业组在成熟型防御方式中的升华[(6.26±1.49)分 vs(5.79±1.64)分]、幽默[(4.97±1.22)分 vs(4.68±1.28)分]方面评分高于临床医学专业组,差异具有显著性.在中间型防御方式上,精神医学专业组在反作用形成、理想化、同一化方面评分高于临床医学专业组,差异具有显著性,临床医学专业组在解除、假性利他、伴无能全能、隔离、否认方面评分高于精神医学专业组,差异具有显著性.结论 精神医学专业学生的心理健康状况优于临床医学专业学生,精神医学专业学生较临床医学专业学生较多地使用积极的心理防御方式.     

慢性疲劳综合征患者生活方式的特征

目的 探讨慢性疲劳综合征(CFS)患者生活方式的特征,为临床干预提供理论依据.方法 对329例CFS患者和363例健康体检者分别采用疲劳评定量表、饮食行为量表和生活习惯调查表进行调查.结果 饮食行为量表结果显示,CFS人群的代理摄食因子[(0.39±0.22)分vs(0.35±0.21)分]和饮食内容因子[(0.32±0.16)分vs(0.29±0.15)分]积分显著高于对照组(P＜0.05),而体质认识、饮食心理、满腹感、饮食方法、饮食节律等因子积分2组之间差异无显著性(P＞0.05).生活习惯调查表显示,CFS人群的外出办事次数显著低于对照组[(0.86±0.83)分vs(1.05±1.19)分,P＜0.05],自觉体力状况良好程度[(1.26±0.64)分vs(1.41±0.60)分]和目前身体状况的良好程度[(1.16±0.70)分vs(1.28±0.65)分]显著高于对照组(P＜0.05),且CFS人群多有便秘习惯[(0.82±0.97)分vs(0.67±0.88)分,P=0.043].结论 慢性疲劳综合征多伴有对健康概念的认识不正确,存在不健康的生活习惯;采取综合干预措施将有助于控制和预防CFS的发生发展.     

伴和不伴攻击行为精神分裂症患者认知功能的对照研究

目的比较伴和不伴攻击行为精神分裂症患者认知功能的差异.方法根据修改版外显行为攻击量表的评分将精神分裂症患者分为研究组(伴攻击行为组)和对照组(不伴攻击行为组),用韦氏成人智力量表、逻辑记忆测验、Benton线方向判断测验、威斯康星卡片分类测验评估其认知功能.结果研究组在逻辑记忆[(9.45±3.67)分vs(12.58±4.71)分]、Benton线方向判断测验[(19.78±5.21)分vs(25.21±4.37)分]、威斯康星卡片分类测验的总应答数[(119.53±5.65)次vs(105.68±5.79)次]、准确应答数、持续错误数[(42.23±20.29)次vs(25.15±21.48)次]、完成分类数均与对照组差异有显著性,但两组在总智商[(92.46±15.35)vs(94.12±14.68)]方面差异无显著性.结论伴有攻击行为的精神分裂症患者较不伴攻击行为的精神分裂症患者认知功能受损更严重.     

联想词序列训练对老年人记忆效率的影响

目的探讨联想词序列训练法与随机序列训练法对老年人记忆效率的影响。方法选择我院2017年6月～2018年1月门诊收治的无明显认知障碍的老年人60例,评估基线认知功能后随机分成实验组及对照组两组,实验组进行联想词序列训练,对照组进行随机序列训练,通过AVLT评估两组患者的记忆力。结果与随机序列训练组相比,联想词序列训练组即刻记忆得分AVLT2[(9.5±2.1)分vs (8.1±2.3)分]、AVLT3[(12.4±2.6)分vs (9.6±2.9)分]、即刻记忆总分AVLT-123[(28.2±5.7)分vs (23.0±5.5)分]、短时记忆AVLT4[(11.7±2.9)分vs (8.6±2.8分)]、长时记忆AVLT5[(10.8±2.9)分vs (8.1±3.0)分]、再认AVLT6[(13.8±2.3)分vs (12.3±2.4)分]、总得分AVLT-T[(64.5±9.4)分vs (52.0±9.8)分]均有显著性提高,差异有统计学意义(P0.05)。结论联想词序列训练法可增强老年人记忆效率。     

加巴喷丁与左旋多巴治疗血液透析患者不宁腿综合征的疗效观察

目的:探讨加巴喷丁与左旋多巴治疗血液透析患者不宁腿综合征的疗效.方法:选取血液透析且合并不宁腿综合征(RLS)48例患者作为研究对象.按用药情况分为加巴喷丁组与左旋多巴组,各24例.研究前后均使用RLS严重程度评分量表(IRLS)及匹兹堡睡眠质量指数评分量表(PSQI)对患者症状进行评分.检测患者治疗前后的全段甲状旁腺激素(iPTH)及β2微球蛋白(β2-MG)水平.结果:加巴喷丁组患者IRLS评分[(20.40±6.75)vs(11.40±3.31)分]及PSQI评分[(13.00±2.58)vs(4.80±1.62)分]较治疗前下降(P<0.05),左旋多巴组患者IRLS评分[(21.90±5.63)vs(16.10±5.22)分]及PSQI评分[(14.10±2.33)vs(8.10±2.02)分]较治疗前下降(P<0.05).治疗后加巴喷丁组IRLS评分低于左旋多巴组[(11.40±3.31)vs(16.10±5.22)分],差异有统计学意义(P<0.05);PSQI评分低于左旋多巴组[(4.80±1.62)vs(8.10±2.02)分],差异有统计学意义(P<0.05).2组治疗前后iPTH及β2-MG水平无明显改变(P>0.05).2组均未发现严重不良反应.结论:加巴喷丁与左旋多巴在改善血液透析患者的不宁腿症状及其睡眠质量中均安全有效,加巴喷丁疗效优于左旋多巴.     

基于4R危机理论的管理模式在血站采血护士职业暴露预防控制中的应用

目的探讨基于4R危机理论的管理模式在血站采血护士职业暴露预防控制中的应用效果。方法选择2018年7月至2019年12月期间佳木斯市中心血站的36名血站护士为研究对象。2018年7—12月给予常规的职业防护管理方案。2019年7—12月实施基于4R危机理论的管理模式。对比干预前后护士的职业暴露认知能力、职业认同感及职业风险行为。结果干预后护士职业暴露认知能力均高于干预前,其中环境风险[(17.0±2.7)分vs.(16.5±2.3)分]、事故风险[(22.9±2.4)分vs.(18.8±2.5)分]、生物风险[(16.9±2.1)分vs.(15.1±2.8)分]、化学风险[(19.2±2.6)分vs.(17.2±2.3)分]、物理风险[(16.8±2.8)分vs.(14.4±2.3)分]比较,差异均有统计学意义(P0.05);职业认同感显著高于干预前,干预后护士职业风险行为(5.55%)显著低于干预前(25.0%),各项目比较,差异均有统计学意义(P0.05)。结论基于4R危机理论的管理模式应用于血站护士职业暴露预防控制中,可有效提高护士的职业暴露认知能力、职业认同感,降低职业风险行为,值得临床推广。     

Head injuries to children riding bicycles

This article examines the characteristics of 150 children who were admitted to Brisbane hospitals with head injuries that were caused by bicycle riding. These children constitute over 20% of all the children with head injuries who were admitted to hospital; accidents involving bicycle riding are the second largest single cause of head injury in these children, after falls. There was one death in the group, and three children were moderately disabled nine months after the injury. These four children all had Glasgow coma scores of less than 9 on their admission to hospital. Only two of the 150 children wore helmets. A survey of a random subgroup of children who had sustained head injuries confirmed our opinion that many children owned helmets but did not wear them for fear of peer derision. It is suggested that this refusal can be overcome by a combination of legislative enforcement, helmet design and promotion.     

Injuries to children riding BMX bikes

One hundred children presented over 40 days with BMX bike injuries, 40 of which had been sustained while trying to perform stunts. Injuries in this series were compared with previously reported injuries from accidents on ordinary bicycles. BMX bike injuries differed little from ordinary bike injuries except in the greater proportion of injuries due to stunts and the smaller incidence of head injuries.     

Unrestricted riding in pickup truck cargo beds poses significant hazards

Individuals riding in the beds of pickup trucks face significant risks of debilitating injury or death, yet Mississippi currently has no legislation restricting ridership in truck beds. Data collection on accidents involving truck bed passengers indicates that children make up the majority of victims. Such accidents impose a heavy burden on society in terms of both medical expenses and impaired quality of life for the victims.     

"Perthes-like" changes in a free riding untreated congenital dislocated hip

The development of avascular necrosis of the femoral head (AVN) after the treatment of congenital dislocation of the hip (CDH) is a well-known complication, but the coexistence in an old child of untreated CDH and ischemic changes of the femoral head has not been reported. Many authors and several years of clinical observation have shown that Perthes-like changes do not occur unless the two sides of the joint are in contact. The purpose of this paper was to report a case of Perthes-like disease that occurred in an untreated CDH, and to discuss the possible pathogenesis. The patient is an 8-year-old African American girl, who presented with a leg length discrepancy, and very mild complaints at the left hip. Physical examination revealed left hip stiffness with a positive Galeazzi sign. Pelvic radiographs showed a complete high riding dislocation of the left hip, with a small and dense femoral head. MRI showed a decreased signal of the entire femoral head. Hematologic and metabolic work-up was normal. Although the vascular theory seems to be well accepted in the pathogenesis of Perthes disease, it does not seem that the contact between the femoral head and the acetabulum is necessary to produce ischemic changes of the femoral epiphysis.     

青少年自我伤害和自杀倾向现状及与健康相关行为的关联性

目的 了解青少年自我伤害和自杀倾向现状,分析其与运动、饮食行为的关联性,为开展健康教育和行为干预提供依据。方法 采用分层整群随机抽样法随机抽取上海市闵行区的小学、初中、高中和职高共计11 661名学生进行匿名问卷调查。采用卡方检验分析相关因素的分布特征,多因素非条件Logistic回归分析自杀倾向的危险因素。结果 自杀倾向报告率为14.2%,其中青春期前期的报告率为11.3%,中期的报告率为17.1%,后期的报告率为18.4%。Logistic回归分析显示,自杀倾向的影响因素有：和父母生活在一起、不健康饮食行为、体重超重、受欺侮（OR=1.93）、感到孤独（OR=2.84）、因学习压力而不愉快（OR=1.85）、失眠（OR=1.88）、离家出走（OR=8.67）、青春期阶段（中期OR=1.40,后期OR=1.23）及成绩描述等。自杀倾向的危险因素有：青春期阶段（中期OR=1.40,后期OR=1.23）、不健康饮食行为（OR=1.22）、体重超重（OR=1.20）、受欺侮（OR=1.93）、感到孤独（OR=2.84）、因学习压力而不愉快（OR=1.85）、失眠（OR=1.88）、离家出走（OR=8.67）;自杀倾向的保护因素有：和父母生活在一起（OR=0.82）、男性（OR=0.70）和成绩描述为好和中等（OR=0.80和0.82）。结论 上海市闵行区青少年的自杀倾向低;影响青少年自杀倾向的因素主要集中在离家出走和感到孤独上,相关部门应对青少年进行相应的心理健康教育,采取综合干预措施,提高青少年的整体健康水平。     

Carbon monoxide poisoning in children riding in the back of pickup trucks.

OBJECTIVE - To describe the case characteristics of a series of children poisoned with carbon monoxide while traveling in the back of pickup trucks. DESIGN - Pediatric cases referred for treatment of carbon monoxide poisoning with hyperbaric oxygen between 1986 and 1991 were reviewed. Those cases that occurred during travel in the back of pickup trucks were selected. Clinical follow-up by telephone interview ranged from 2 to 55 months. SETTING - A private, urban, tertiary care center in Seattle, Wash. PATIENTS - Twenty children ranging from 4 to 16 years of age. INTERVENTION - All patients were treated with hyperbaric oxygen. MAIN OUTCOME MEASURES - Characteristics of the poisoning incident and clinical patient outcome. RESULTS - Of 68 pediatric patients treated for accidental carbon monoxide poisoning, 20 cases occurred as children rode in the back of pickup trucks. In 17 of these, the children were riding under a rigid closed canopy on the rear of the truck, while three episodes occurred as children rode beneath a tarpaulin. Average carboxyhemoglobin level on emergency department presentation was 18.2% +/- 2.4% (mean +/- SEM; range, 1.6% to 37.0%). Loss of consciousness occurred in 15 of the 20 children. One child died of cerebral edema, one had permanent neurologic deficits, and 18 had no recognizable sequelae related to the episode. In all cases, the truck exhaust system had a previously known leak or a tail pipe that exited at the rear rather than at the side of the pickup truck. CONCLUSIONS - Carbon monoxide poisoning is a significant hazard for children who ride in the back of pickup trucks. If possible, this practice should be avoided.