2017年湖南省中小学生视力不良现况及环境影响因素分析

目的 了解湖南省中小学生视力不良分布状况及影响因素,为政府制定防治策略提供科学依据。 方法 于2017年抽取湖南省8 129名小学四年级到高中三年级学生进行体检和问卷调查,采用适当的统计方法对数据进行分析。 结果 2017年湖南省中小学生总体视力不良率为64.9%,有随教育阶段(小学44.4%,初中73.2%,高中78.8%)升高的趋势(χ²_趋势=702.732, P<0.001);轻度、中度、重度视力不良率分别为6.6%,19.9%和38.5%,其中轻度视力不良率(小学8.1%,初中6.8%,高中4.6%)随教育阶段升高而减少(χ²_趋势=25.452,P<0.001),重度视力不良率(小学17.0%、初中44.2%、高中56.3%)随教育阶段升高而升高(χ²_趋势=870.331, P<0.001);各教育阶段学生轻度、中度、重度视力不良构成比差异有统计学意义(χ² =365.232,P<0.001),随教育阶段升高,轻度、中度视力不良构成比下降,重度视力不良构成比上升。城区中小学生视力不良率高于县城(χ²=10.013, P=0.002),女生高于男生(χ²=86.021, P<0.001),城区和县城女生分别高于城区和县城男生(χ²=29.891及63.352, P<0.001),城市男生高于乡镇男生(χ²=17.228, P<0.001)。中小学生视力不良环境影响因素中,平均每天户外活动时间超过2 h(OR=0.725,95%CI:0.661~0.796)及监护人和老师经常提醒读写姿势(OR=0.793,95%CI:0.720~0.873)为保护因素,平均每天写作业超过2 h(OR=1.520,95%CI:1.383~1.67)及平均每天使用电子设备上网超过2 h(OR=1.358,95%CI:1.224~1.507)为危险因素。 结论 2017年湖南省中小学生视力不良率及重度视力不良率均较高,且随教育阶段升高。城市为重点地区,女生为重点人群。应采取措施减少中小学生写作业时间及使用电子设备时间,监护人及老师应及时提醒学生保持正确读写姿势和增加户外活动。     

社区蛋糕店一起沙门氏菌食物中毒事件的流行病学调查

目的 对发生在社区蛋糕店的一起食物中毒事件进行流行病学调查分析,查明致病因子、致病食品及其污染来源,为今后预防类似事件的发生提供参考。 方法 采用现场流行病学调查、食品卫生学调查和实验室检验相结合的方法。 结果 本次事件共发现病例14例,病例的临床表现相似,主要为腹泻、腹痛、发热、呕吐。发病潜伏期中位数为9.25 h(3.2~14.6 h)。所有病例发病前均食用过HG糕店制售的三文治,经剂量反应关系分析,认为三文治食用量和疾病严重程度存在相关性 (r=0.583,P=0.029)。病例肛拭子、呕吐物及粪便、剩余三文治和三文治生产原料等标本中均检出肠炎沙门氏菌,不同来源标本中分离到的阳性菌株经脉冲场凝胶电泳(pulsed-field gel electrophoresis,PFGE)分子分型分析具有同源性。 结论 该起事件是一起因食用社区蛋糕店制售的受沙门氏菌污染的三文治引起的食物中毒事件。     

居家腹膜透析患者手卫生现状调查及对策

目的调查居家腹膜透析患者手卫生现状,并提出对策。方法利用上门随访时机,采用问卷调查结合现场考核洗手、换液操作,对68例居家腹膜透析患者进行调查。结果手卫生相关知识问卷表明,腹膜透析患者各项手卫生知识合格率均很低,合格率最高的是洗手指征,也只有45.59%,最低的是专门的洗手设施合格率仅有11.76%;居家腹膜透析患者洗手指征执行率为39.71%,洗手合格率22.06%,手标本培养合格率为14.71%。结论居家腹膜透析患者洗手不规范,手卫生依从性差,应强化手卫生相关知识,积极改善洗手设施,配备速干手消毒剂,提高洗手率及洗手的规范性。     

Assessing clinicians' perspectives about the identification and management of antipsychotic medication side‐effects: Psychometric evaluation of a survey questionnaire

Eliciting clinicians' views about antipsychotic medication side‐effects may assist in understanding strategies that could enhance the identification and management of these side‐effects. The present paper details the development and psychometric evaluation of a questionnaire that captures clinicians' perceptions about these issues. An initial item set was derived from a literature review, and then refined by an expert content validity panel that assessed the relevance of the items. The online questionnaire was distributed to Australian mental health nurses and 140 fully completed questionnaires were returned. Principal components analysis yielded two robust scales that conceptually tapped “system responsibility” and “personal confidence”. These scales may be used to advance knowledge about how mental health nurses' attitudes towards the assessment and management of antipsychotic medication side‐effects influences their clinical behaviour.     

End-of-life care in intensive care units: family routines and environmental factors

The purpose of this study was to describe family care routines and to explore environmental factors when patients die in Swedish intensive care units (ICUs). The main research questions were: what are the physical environmental circumstances and facilities when caring for patients in end‐of‐life and are there any routines or guidelines when caring for dying patients and their families? A questionnaire was sent to 79 eligible Swedish ICUs in December 2003, addressed to the unit managers. The response rate was 94% (n = 74 units). The findings show that, despite recommendations highlighting the importance of privacy for dying ICU patients and their families, only 11% of the respondents stated that patients never died in shared rooms in their ICU. If a patient dies in a shared room, nurses strive to ensure a dignified good‐bye by moving the body to an empty room or to one specially designated for this purpose. The majority (76%) of the units had waiting rooms within the ICU. The study also revealed that there is a need for improvements in the follow‐up routines for bereaved families. Many units reported (51%) that they often or almost always offer a follow‐up visit, although in most cases the bereaved family had to initiate the follow‐up by contacting the ICU. Guidelines in the area of end‐of‐life care were used by 25% of the ICUs. Further research is necessary to acquire a deeper knowledge of the circumstances under which patients die in ICUs and what impact the ICU environment has on bereaved families.     

Injury in West Virginia: A Statewide Survey

Objective: To determine an estimate of the period prevalence of medically attended injury in West Virginia via a statewide random telephone survey.
Methods: A statewide random telephone survey, the West Virginia Social Indicator Survey (WVSIS), was modified to incorporate questions regarding the incidence and mechanisms of injury. The WVSIS is periodically conducted on a representative cross-section of West Virginians to gather information about their social and economic conditions as well as to monitor change in the quality of their lives over time.
Results: Of the 1,498 households interviewed, 412 (28%) reported having sustained injuries for which medical care had been obtained. This translates to a conservative estimate of 231,000 medically attended injuries within West Virginia in 1993. The average age of those injured was 35 years. Falls were the most frequently reported causes of injury, with motor vehicle crashes being the second most reported cause. Most injury victims (70%) were treated in an ED. Most respondents (67%) were able to suggest ways in which the injuries might have been avoided. Only 37% of the respondents with children 13 years of age reported ever having received injury prevention information from a physician. The most commonly reported physician advice concerned childhood poisoning (34%).
Conclusions: Injury questions added to ongoing state health surveillance surveys provide valuable insight into population-based injury rates and potential preventive measures.