Childcare as a stabilizing influence on HPA axis functioning: a reevaluation of maternal occupational patterns and familial relations

The influence of family relations, maternal occupational characteristics, and childcare1The UK terms "childcare," childcare centres' and "nurseries" are used throughout this paper to define group care for children prior to starting their first year of formal schooling at age 4 years and are used synonymously with the American terms "day-care" and "preschool." This form of group care is provided in a formal setting, outside the family home and excludes "childminding" (i.e., childcare that may be group based and offered at the home of the care provider/childminder). In the UK, this form of childcare is offered from zero to 4 years old. Children are separated according to their age into small groups usually consisting of 10-15 children. In the present study, all children were in the preschool-aged group (3-4 years old). Where childcare of a different or more generic form is referred to, then this has been made clear in the context or stated in the text. utilization on preschool children's cortisol production were investigated in 56 mother-child dyads. Family characteristics and maternal employment, childcare and child temperament were reported by mothers. Morning and evening levels of children's salivary cortisol were obtained. Children in highly expressive or reserved families exhibited higher cortisol levels compared to children in moderately expressive families. Elevated levels of cortisol were detected in children of mothers reporting low levels of job role quality or high levels of emotional exhaustion. Frequent childcare use was found to protect children against the physiological effects of low maternal job role quality and emotional exhaustion. Findings underscore the pervasive role of the family as set within an external support system and highlight the potential physiological impact of these interacting contexts for children. Further research is needed to fully understand current findings and to develop appropriate psycho-physiological interventions.     

粤西农村地区居民主观幸福感调查

目的 了解农民主观幸福感和生活满总度状况.方法 采用主观幸福感单一项目测量、幸福感阶梯量表和生活满意度自编问卷,对粤西农村地区228例居民进行抽样调查.结果 ①大部分农村居民具有较高的主观幸福感,但农民幸福感的均值略低于中值水平;②农民的主观幸福感不存在性别差异,但在年龄上则表现出统计学上的显著差异,中年农民群体的主观幸福感显著低于年轻群体和老年群体;③农村居民的未来幸福感显著高于目前幸福感和过去幸福感;④农村居民的住房、经济与其主观幸福感的关系最大,有超过半数(51.3%)的农民对经济收入感到不满念.结论 应重点关注中年农民群体的幸福感和生活满意度,增加农民经济收入是提高他们主观幸福感的根本途径.     

The effects of oestrogen therapy on the sex life of post-menopausal women

The literature concerning sexual behaviour around the time of the menopause is reviewed. Mentioned is a decline in sexual activity and satisfaction in women which is attributed to the changes in the women themselves, and not merely a reaction to the decline in the sexual capacity of their husbands.

Forty women were treated during 1 yr with oestrogens. The eventual effect of this treatment on sexual activity and satisfaction was investigated and compared with a group who had undergone partial treatment only. The results show that in the completely treated Group A, symptoms such as hot flushes and depression diminished, and the pain of sexual relations was relieved. As a consequence of this improvement, coital activity and satisfaction were more gratifying. The partially treated Group B showed a clear decline in sexual activity and in sexual satisfaction.     

中国人的婚姻质量状况

目的：调查中国人婚烟满意状况。方法：用中国人婚姻质量问卷对1303名已婚者进行调查，其中夫妻配对资料224对。结果：无论是男性还是女性，总体满意度都处于中等水平，基本上呈正态分布，仅在性格相容和子女婚姻两个维度有统计学差异；约60％以上的人觉得自己的婚姻比较满意，30％的人认为基本满意，5％的体验到非常满意，只有2％左右的人感到不满意；夫妻婚姻质量具有较高的相关性，主观满意度一致的人数占60％以上，不一致或很不一致的人数只占100％。结论：中国人的总体婚姻质量处于中等水平，90％的夫妻对自己的婚姻感到满意，只有2％左右的人感到不满意。     

Maslach倦怠量表-服务行业版在警察中的修订及应用分析

目的对Maslach倦怠量表-服务行业版(MBI-HSS)进行修订,并了解我国警察工作倦怠现状。方法采用MBI-HSS对4855名警察进行测试并对量表作出信、效度分析。结果修订后的量表保持原有的三维度结构,具有良好的结构效度(CFI=0.945,TLI=0.936,GFI=0.947,AGFI=0.930,NFI=0.942,IFI=0.945,RM-SEA=0.060),总量表和分量表的内部一致性信度、重测信度均大于0.70。综合三个维度的结果发现,男性警察的倦怠程度高于女性警察,警龄在6-15年的警察倦怠程度最严重,离异警察的倦怠程度高于已婚和未婚警察,学历低的警察倦怠程度较高。结论修订后的MBI-HSS可作为测量我国警察工作倦怠的有效工具。警察的工作倦怠在性别、警龄、婚姻状况、受教育程度方面存在差异。     

Enhancing a primary care environment: a case study of effects on patients and staff in a single general practice

BACKGROUND: Few studies have examined the effect on patients and staff of the physical environment in primary care facilities. AIM: To explore changes in patient and staff satisfaction, patient anxiety, and patient-doctor communication when a GP surgery moves from old premises to enhanced purpose-built accommodation. DESIGN OF STUDY: Questionnaire surveys, interviews, and focus groups pre- and post move. SETTING: An urban general practice in Bristol. METHOD: Patient questionnaires assessed anxiety (Spielberger State-Trait Anxiety Inventory; STAI), satisfaction with the environment, and communication during the consultation. Staff questionnaires assessed satisfaction with the environment and job satisfaction. Qualitative methods explored patient and staff views in more depth. RESULTS: A total of 1118 pre-move and 954 post-move patient questionnaires showed significant increases in satisfaction scores for reception/waiting areas (mean 6.46, 95% confidence interval [CI]=5.97 to 6.95) and consulting rooms (mean 3.80, 95% CI=3.44 to 4.15) in the new premises. Patients' satisfaction with patient-doctor communication also increased (mean 0.88, 95% CI=0.30 to 1.46) and anxiety scores were significantly reduced before and after the consultation in the new premises compared with the old (STAI mean difference before consultation 0.72, 95% CI=0.37 to 1.08; mean after consultation 0.37, 95% CI=0.03 to 0.72). Patients highlighted the increased space and light, more modern appearance, greater comfort, and novel works of art in the new surgery. Staff workplace satisfaction increased significantly after moving and remained higher than in the old building. CONCLUSION: This large-scale study examining the effects of a UK primary care environment on patients and staff shows that an enhanced environment is associated with improvements in patients' perception of patient-doctor communication, reduction in anxiety, and increases in patient and staff satisfaction.     

高师贫困生自我效能感与主观幸福感的特点及关系研究

目的分析高师贫困生自我效能感、主观幸福感的特点及关系，为心理健康教育提供依据。方法采用一般自我效能感量表、生活满意度量表、快乐感量表，对218名贫困生和216名非贫困生进行测查。结果①高师贫困生生活满意度、快乐感显著低于非贫困生（t=4．811，P〈0．001；t=2．504，P〈0．05），自我效能感差异不显著。②高师贫困生自我效能感存在性别差异（t=2．117，P〈0．05），男生的自我效能感显著高于女生；生活满意度年级差异显著（F=3．547，P〈0．05），大一学生的生活满意度显著高于大二和大三学生，大二和大三之间的差异不显著。③高师贫困生自我效能感与生活满意度、快乐感呈显著正相关（r=0．349，P〈0．01；r=0．436，P〈0．01）。自我效能感水平越高，幸福感越强。结论高师贫困生主观幸福感相对较低，自我效能感与主观幸福感显著相关，通过提升自我效能感水平可以增强主观幸福感。     

总责任护士主导的医护一体化护理模式在创伤骨科的应用

目的探讨总责任护士主导的医护一体化临床护理模式在创伤骨科的应用效果。 方法选择2016年7月至2017年6月在南京大学医学院附属鼓楼医院创伤骨科行手术治疗的骨折患者200例，按照入院先后顺序分为对照组90例(实施创伤骨科常规护理)和观察组110例(实施医护一体化工作模式，包括成立医护合作小组、实施总责任护士主导的医护一体化查房、个体化诊疗方案的共同决策、疼痛管理、早期出院计划与延续护理)。比较2组患者的术后护理效果和医护合作满意度。对数据行t检验和χ²检验。 结果总责任护士主导的医护一体化模式下，观察组患者术后72 h内数字评分法(NRS)评分为(4.09±1.64)分，疼痛干预有效率为77.57%，对照组术后72 h内NRS评分为(5.15±1.69)分，疼痛干预有效率为57.95%，2组比较差异均有统计学意义(P值均小于0.05)；观察组下肢深静脉血栓、泌尿系统感染、便秘的发生例数分别为2、1、3，对照组下肢深静脉血栓、泌尿系统感染、便秘的发生例数分别为9、7、11，两组比较差异均有统计学意义(χ²＝4.486、4.296、6.812，P＝0.027、0.036、0.009)。观察组术后康复开始时间为(21.48±6.41)h，术后住院时间为(11.08±2.19)d；对照组术后康复开始时间为(36.48±10.75)h，术后住院时间为(13.95±2.93)d，2组比较差异均有统计学意义(t＝11.670、－7.616，P值均小于0.05)。2组医护合作满意度结果显示，观察组患者信息的交流得分为(3.78±0.85)分，共同参与治疗或护理决策得分为(3.86±0.87)分，医师和护士的关系得分为(4.00±0.84)分，总分为(3.87±0.67)分；对照组患者信息的交流得分为(3.32±1.00)分，共同参与治疗或护理决策得分为(3.23±0.93)分，医师和护士的关系得分为(3.45±0.96)分，总分为(3.33±0.84)分，2组比较差异均有统计学意义(P值均小于0.05)。 结论总责任护士主导的医护一体化护理模式的应用，以亚专科为核心，重新整合医护资源，共同参与制订患者的诊疗护理方案，共同聚焦患者安全与质量，加强了医护间的配合，提高了医疗护理服务质量，提升医护合作满意度。     

Characteristics of employment and job satisfaction in nontraditional dental hygiene practice settings

Little is known concerning the employment characteristics of hygienists practicing in nontraditional settings. Respondents were identified through screening (n = 38,380) a listing of the entire population of hygienists licensed in the United States. The screening identified 1,301 hygienists practicing in nontraditional settings. These hygienists were mailed comprehensive questionnaires; completed questionnaires were returned by 84.3 percent of the hygienists. Data were collected describing hygienists' reasons for seeking employment in nontraditional settings, their sources of information concerning job opportunities in nontraditional settings, benefits, and job satisfaction. The main source of information concerning employment opportunities in nontraditional settings was "word of mouth." Hygienists were motivated to seek employment in nontraditional settings primarily by a desire for a more challenging position and personal satisfaction. The hygienists were overwhelmingly satisfied with all aspects of nontraditional employment except opportunities for advancement. Respondents were found to receive standard benefits similar to those of employees in other industries.     

Couples d’âge mûr et sexualité : comprendre l’impact des dynamiques relationnelles

Increased life expectancy creates the prospect of prolonged marital intimacy. However, mature couples face many challenges — physiological, cultural, and familial — and they must be able to mobilize their individual and relational resources to maintain good levels of marital and sexual satisfaction. The aim of this study is to highlight various factors that contribute to the conjugal and sexual satisfaction of older couples, and to discuss the stressing of these factors in a crisis context. 534 participants aged between 18 and 74 years old answered several questionnaires measuring their degree of sexual and conjugal satisfaction as well as the areas of strength and fragility in the relational dynamics of their couple. In addition, five couples also accepted a semi-structured interview on their relationship dynamics and their vision of the ageing couple. The results highlight the major impact of several variables contributing to an increase in relational and sexual satisfaction within couples (e.g. health concerns, conflict management, fondness…). Furthermore, a comparison between the scores of the over-51s and the younger ones highlights the areas of strength of older partners. These different factors will be discussed. Finally, we will propone therapeutic advices aimed at supporting the areas of strength of mature couples in order to accompany them towards long-term relational and sexual fulfillment.