某海运集团船员幽门螺杆菌感染调查

目的 调查船员幽门螺杆菌(helicobacter pylori,HP)的感染情况及其影响因素.方法 采用随机整体抽样方法,对238名体检船员进行问卷调查和13C-尿素呼气试验检测.结果 船员HP感染率为61.8％,稍高于我国HP平均感染率59％,但明显高于广东省的平均感染率42％.船员HP感染呈现随船龄上升的趋势,与文化程度、航行时间、饮食、吸烟以及近期出现的上消化道症状等因素具有相关性(P＜0.05).结论 船员由于职业特性属于HP高感染群体,必须采取积极措施予以保护.提高个人素质,注意饮食卫生,改善居住环境,缩短航行时间、戒除吸烟嗜好,可降低船员HP的感染率.     

Improving patient safety using the sterile cockpit principle during medication administration: a collaborative,unit-based project

Aim To implement the sterile cockpit principle to decrease interruptions and distractions during high volume medication administration and reduce the number of medication errors. Background While some studies have described the importance of reducing interruptions as a tactic to reduce medication errors, work is needed to assess the impact on patient outcomes. Methods Data regarding the type and frequency of distractions were collected during the first 11 weeks of implementation. Medication error rates were tracked 1 year before and after 1 year implementation. Results Simple regression analysis showed a decrease in the mean number of distractions, (β = −0.193, P = 0.02) over time. The medication error rate decreased by 42.78% (P = 0.04) after implementation of the sterile cockpit principle. Conclusions The use of crew resource management techniques, including the sterile cockpit principle, applied to medication administration has a significant impact on patient safety. Implications for nursing management Applying the sterile cockpit principle to inpatient medical units is a feasible approach to reduce the number of distractions during the administration of medication, thus, reducing the likelihood of medication error. ‘Do Not Disturb’ signs and vests are inexpensive, simple interventions that can be used as reminders to decrease distractions.     

某部飞行人员与地勤人员军事训练软组织损伤流行病学调查

目的通过调研沈阳战区陆航某部寒区飞行人员与地勤人员军事训练伤的发生与分布情况,分析其发生的流行病学特点及趋势。方法设计制作《部队训练伤管理情况调查问卷》,分别抽取陆航某部直升机飞行人员100人、地勤人员300人进行问卷调查。结果共回收有效问卷377份,其中,飞行人员有效问卷98份,地勤人员有效问卷279份。飞行人员训练伤发生率为30.6%(30/98),显著高于地勤人员的21.8%(61/279)。其中,飞行人员发生训练伤最多的部位是脚踝11例(36.7%)、膝盖11例(36.7%);地勤人员训练伤最多的部位是腰部25例(41.0%)。飞行人员与地勤人员发生训练伤的类型最多的均是腰肌劳损,分别为15例(50.0%)和26例(42.6%)。训练伤发生时间最多的是在春季,占全年的41.8%。结论飞行人员与地勤人员训练伤发生率均较高,有针对性地实施预防保护措施可降低训练伤的发生率。     

极地与非极地航线空勤人员所受光子和中子宇宙辐射剂量比较

目的 比较极地与非极地航线空勤人员(包括飞行员和空乘人员)所受光子和中子引起的宇宙辐射剂量。方法 选取北京-纽约航线作为极地航线,以非极地航线作为对照组,将极地航线与非极地航线进行比较。采用四元件光致发光(OSL)剂量计和CR-39径迹探测器对极地航线与非极地航线空勤人员个人辐射剂量进行测定。结果 极地航线组空勤人员的年平均有效剂量和千小时有效剂量分别为(5.79±0.92) mSv/年、(3.10±0.27) mSv/kh,非极地航线组分别为(2.14±0.64) mSv/年、(2.21±0.46) mSv/kh,极地航线组与非极地航线组之间的年平均有效剂量( t =30.25, P<0.05)和千小时有效剂量( t =7.60, P<0.05)差异均有统计学意义。极地航线和非极地航线飞行员的千小时有效剂量均高于空乘人员,二者差异有统计学意义( t =7.96、4.70, P<0.05)。结论 极地航线空勤人员的有效剂量高于非极地航线,但是未超过国家标准规定限值20 mSv/年。     

团体干预法对公交司售人员控烟知识态度与行为影响

目的探讨团体控烟干预对公交司售人员控烟知识、态度与行为的影响。方法采用包括成立领导机构、出台内部管理办法、创造控烟氛围、培训知识、主题研讨、提供戒烟帮助、典型经验会等综合措施对襄阳市公交公司进行团体控烟干预研究。结果干预6个月前后,364名调查对象知识得分分别为(45.1±6.7)分和(70.6±7.2)分,态度认知率分别为68.9%和86.3%,吸烟率前后分别为68.0%和32.7%,经t检验、χ2检验,差异有统计学意义(P0.05)。结论通过团体干预实施,有效的提高了司售人员的控烟知识水平,增强了控烟积极性,即时干预吸烟率有了明显下降,团体干预方法值得推广。     

舰艇人员心理应激源调查问卷的编制

目的考察舰艇人员心理应激源的类型及其对人员心理的影响,编制《舰艇人员心理应激源调查问卷》,为制订针对性干预措施提供依据。方法在文献检索、专家访谈和半结构式问卷调查的基础上,编制初测问卷,对初测数据(n=251)进行探索性因素分析及信度、效度检验。结果该问卷包括舰艇环境、家庭、工作关系与领导风格4个因子,共54个项目。经检验,其信度系数均在0.8以上,问卷各因子得分与问卷总分相关系数在0.743~0.956之间(P0.01)。结论该问卷达到了心理测量学的要求,可用于舰艇人员心理应激的测量。     

潜艇军人的述情障碍特点及与应对方式关系

目的探讨潜艇军人的述情障碍特点以及述情障碍程度与所用应对方式的关系。方法采用20个条目多伦多述情障碍量表(TAS-20)、应付方式问卷(CSQ)、自编一般资料问卷对369名潜艇军人进行测评。据一般资料特征将被试分为义务兵、士官、军官组,独生子女与非独生子女组,对不同组别的TAS得分进行比较;以TAS得分区分述情障碍高、中、低分组,对3组的CSQ各分量表得分进行比较;对369名潜艇军人的CSQ得分与TAS得分进行相关分析。结果义务兵、士官与军官组的TAS总分、F1、F3因子分间差异具有统计学意义(F=8.18,11.19,3.42;P<0.05);独生子女组F3因子分高于非独生子女组差异具统计学意义(t=2.67,P<0.01);述情障碍高、低、中分组的CSQ6个分量表得分差异均具统计学意义(F=12.48,37.58,20.24,23.88,32.40,23.19;P<0.01),两两比较中,高分组在不成熟型或混合型应对方式自责、幻想、避让和合理化因子得分上高于中、低分组(P<0.01);在成熟型应对方式解决问题、求助分量表得分上低于中、低分组(P<0.01)。相关分析显示,应付方式分量表中解决问题、求助分量表得分与TAS总分及各因子分间负相关有统计学意义(r=-0.192～-0.350,P<0.01),自责、幻想、退避、合理化各分量表得分与TAS总分及各因子分间正相关有统计学意义(r=0.169～0.505,P<0.01)。结论义务兵、士官、军官的述情障碍程度不同,主要体现在情感辨认与外向性思维上;潜艇军人的应对方式与述情障碍程度有关,高述情障碍者倾向于采用不成熟应对方式。     

Effects of submarine escape training on the pulmonary function and carbon dioxide retention in the escape

Objective Fast buoyancy ascent escape used in submarine escape is the most probable choice of survival in case of a submarine accident.Rate of success for escape depends very much on the extent of training,in spite of the fact that rapid compression and decompression pose great challenges to the human body in terms of enormous stresses.To minimize stresses experienced during sub escape training has always been a research subject for us.Lungs are susceptible to rapid change in pressure during escape.Dynamic pulmonary function and the end-tidal PCO2 ( PETCO2 ) might be the best indicator for its effect on the pulmonary function of the submarine escapee.Methods Five male navy divers received submarine escape trainings,at different depths from 3-60 m.They were compressed at different rates (with pressure doubled every 20 s or 30 s),in the simulated submarine escape tower located in the Naval Medical Research Institute.The gas of end-expiration was collected immediately after escape,respiratory rate (RR) and dynamic pulmonary function were closely monitored,and PETCO2 was determined with the mass spectrometer.Results Experimental results showed that forced expiratory volume in 1 second (FEV1.0) tended to increase with increasing depth,and that it increased significantly at 50 m and 60 m,when compared with the basic data (P ＜ 0.05 ),and it was coupled with a decrease in forced expiratory flow at 25 ％ ( FEF25％ ),indicating that it had certain effect on the function of small airways.PETCO2 and RR all elevated markedly following escapes.No significant differences could be seen in RR following escapes at various depths.PETCO2 and depth ( r =0.387,P ＜ 0.01 ) were positively correlated with compression rate ( r =0.459,P ＜ 0.01 ) and RR ( r =0.467,P ＜ 0.01 ).CO2 retention might be attributed to pulmonary ventilation disorder induced by rapid changes in pressure.PETCO2 was within normal range,following escapes at various depths,suggesting that increased RR might be induced by stresses rather than CO2 retention.No significant differences could be noted in PETCO2 and RR,following escapes with different compression rates,indicating that lower compression rate might not necessarily mitigate stresses of the body.Conclusions Based on the pulmonary reaction experienced by the trainees,it was recommended that submarine escape training be conducted at a depth no deeper than 50 m,so that possible airway lesion might be minimized.The benefit of lower compressing rate at shallower escape depths remained to be identified.