抗抑郁药治疗功能性胃肠病的临床研究

目的分析抗抑郁药物治疗功能性胃肠病的临床效果。方法选取2012年到2013年的68例功能性胃肠病患者为研究对象。进行心理卫生自评表（SCL-90）评分,将结果与我国常规标准分进行比较。然后将这68例患者随机分成两组,一组服用抗抑郁药5-羟色胺再摄取抑制剂（SSRI）帕罗西汀（赛乐特）,另一组服用安慰剂治疗,治疗一个疗程（8周）后,再通过SCL-90量表记录患者的得分和消化道的症状严重程度。结果功能性胃肠病患者的SCL-90总分和各部分分数明显高于我国常规标准（P〈0．05）,其中抑郁因子和焦虑最高。经过抗抑郁治疗后,SCL-90分数较之前明显下降（P〈O．001）。从消化道临床症状来看,服用抑郁药物的效果优于服用安慰剂组（P〈O．001）。结论抗抑郁药物能够有效改善功能性胃肠病患者的精神情绪障碍,同时对消化道症状有明显的治疗效果。     

69对不孕夫妇心理状况调查

目的:了解不孕症夫妇心理健康状况,探讨生物、心理、社会因素对不孕症夫妇心理状况的影响。方法:采用症状自评量表(SCL-90)对不孕症夫妇进行心理状况调查。SCL-90每个项目按1～5分的5级评分,参照全国成人常模标准,数据采用SPSS10.0软件统计处理。结果:69对不孕症夫妇SCL-90自评总分、总均分、阳性项目数、抑郁、焦虑、人际关系敏感、敌对、躯体化等因子分均高于全国常模(P0.05)。不孕症夫妇之间女方总分、总均分、阳性项目数均高于男方(P0.001),而且夫妇双方在总分、总均分、抑郁和焦虑因子分均有高度相关性(r0.76,P0.001)。结论:不孕症能影响患者心理健康状况,尤其以抑郁、焦虑、人际关系敏感等负性情绪为主要表现。不孕症夫妇女方负性情绪大于男方,他们之间的心理状况有相关性。     

职业病患者心理健康状况及干预效果研究

目的 分析职业病患者心理健康状况,探讨应用心理干预措施的效果.方法 以整群随机抽样方法抽取本省5家职业病专科医院共526名住院职业病患者为研究对象,在实施心理干预前后采用症状自评量表(SCL-90)、医院焦虑抑郁量表(HAD)进行评定式问卷调查,与国内常模比较,分析职业病患者的心理健康状况和心理干预效果.结果 实施心理干预前,职业病患者SCL-90总分(162.34±54.21)高于全国常模(P＜0.05),其中,躯体化(1.89±0.78)、焦虑(1.78±0.46)、抑郁(1.92±0.68)、敌对(1.92±0.57)、偏执(1.51 ±0.87)等5个因子分均高于全国常模(P＜0.05或P＜0.01);而HAD焦虑维度评分(10.82±2.32)接近阳性(≥11分)水平.实施心理干预后,职业病患者SCL-90总分(135.35±40.32)和躯体化(1.67±0.53)、强迫症状(1.56±0.49)、焦虑(1.51±0.35)、抑郁(1.67±0.62)、敌对(1.59±0.49)、恐怖(1.19±0.54)、偏执(1.38±0.62)、精神病性(1.22±0.39)等8个因子分均较实施前下降(P＜0.05);SCL-90总分、总均分、阳性项目数、阳性项目均分与躯体化、焦虑、抑郁等3个因子分仍高于全国常模(P＜0.05或P＜0.01).HAD的焦虑(7.38±2.27)、抑郁(3.51±1.86)评分均低于实施前水平(P＜0.05),焦虑、抑郁维度阳性率均较实施前下降(P ＜0.001).结论 职业病患者普遍存在心理卫生问题,职业病治疗过程中给予心理干预措施有助于改善负性情绪和心理障碍,促进患者的治疗和康复.     

失眠症患者心身健康及生活质量调查

目的了解失眠症患者心身健康状况及生活质量.方法对30名失眠症患者和28名健康对照者分别进行症状自评量表(SCL-90)和生活质量综合评定问卷(GQOLI-74)评定.结果失眠症组SCL-90评定总分及躯体化、抑郁、焦虑、睡眠障碍各因子分与对照组比较,差异有非常显著性(P＜0.01),GQOLI-74评定中主观满意度及精神紧张度,负性情感、正性情感和工作与学习评分与对照组差异有显著性(P＜0.05),业余娱乐评分与对照组比较,差异有非常显著性.结论失眠症患者的心身健康状况差,往往伴有躯体化症状和抑郁、焦虑情绪,进而导致生活质量的主观满意度差.     

石油工人心理健康状况及相关因素调查分析

目的 探讨石油工人心理健康状况,以及职业紧张、人格特征和社会支持对其影响,为制定心理健康教育措施提供理论依据.方法 采用整群抽样的方法随机抽取1 100名石油工人,采用症状自评量表(SCL-90)、职业紧张量表、艾森克人格问卷中文版和社会支持评定量表进行问卷调查.以SCL-90评分纳入阳性症状者为阳性症状组,未纳入者为正常组.结果 ①1 100名石油工人SCL-90评分结果显示238(21.64％)名具有阳性症状;人际关系敏感因子得分低于全国常模,躯体化、强迫症状、抑郁、焦虑、恐怖、精神病性等因子得分均高于全国常模,差异均有统计学意义(P＜0.01);敌对因子和偏执因子得分与全国常模比较差异无统计学意义(P＞0.05);与新疆地区部分汉族职业人群SCL-90常模比较,躯体化、恐怖2个因子得分均低于该常模,抑郁、精神病性因子得分均高于该常模得分,差异均有统计学意义(P＜0.05或P＜0.01).②阳性症状组石油工人在个体紧张反应、神经质维度得分均高于正常组,主观支持、社会支持利用度维度得分均低于正常组,差异均有统计学意义(P＜0.05).③多因素逐步Logistic回归分析显示心理紧张反应、自我保健、神经质、精神质、支持利用度是影响石油工人心理应激的主要因素.结论 石油工人存在一定程度的心理健康问题且具有自身的特点,适度降低工作压力的同时增强自我保健意识,合理有效的调解情绪是预防其出现心理应激障碍的重要措施之一.     

上海市HIV感染者/AIDS病人心理健康状况研究

目的 运用症状自评量表（SCL-90）、抑郁自评量表（SDS）和焦虑自评量表（SAS）评价HIV感染者/AIDS病人心理健康状况.方法 对来自参加上海市静安区爱之家关怀活动的HIV感染者/AIDS病人和部分来自上海市公共卫生临床中心门诊部的136例HIV感染者/AIDS病人进行调查,采用基本信息表、SCL-90量表、SDS量表和SAS量表进行统一问卷调查,采用SPSS16.0进行统计分析.结果 HIV感染者/AIDS病人的心理健康状况明显比国内正常人群差,SCL-90总分、总均分及除人际关系因子分之外的各因子评分均高于全国常模（P＜0.001）,阳性症状总检出率超过40.0％;检出率较高的是抑郁、焦虑等症状,SDS总分为（53.73±12.93）分,高于国内常模（P＜0.001）,有60.3％的调查对象有抑郁症状;SAS总分为（48.79±8.76）分,高于国内常模（P＜0.001）,有41.9％的调查对象有焦虑症状.结论 针对HIV感染者/AIDS病人心理健康状况的现状,提出了在艾滋病防治工作中增加心理支持的内容,对HIV感染者/AIDS病人采用心理学量表进行筛查和评估,并根据其心理健康状况提供适宜的心理关爱和情感支持;加强医疗机构、疾病预防机构和专业心理咨询机构的合作,以便为HIV感染者/AIDS病人提供可及性更好更专业的心理健康支持服务.     

某部高射炮兵心理健康状况调查分析

目的 了解某部高射炮兵的心理健康状况及其影响因素.方法 采用自编的基本情况调查表和临床症状自评量表(SCL-90)对143名某部高射炮兵进行了调查与分析.结果 某部高射炮兵SCL-90的总分(151.88±38.39)、躯体化(1.63±0.48)、强迫症状(1.95±0.59)、焦虑(1.67±0.51)、敌对(1.78±0.62)因子得分显著高于中国军人常模(P分别＜0.05、0.01及0.001);第2年兵SCL-90各因子(除躯体化因子外)分均低于其他3组士兵;义务兵各因子(除躯体化因子外)分均低于士官,且在人际关系敏感和恐怖因子得分上差异有统计学意义(P＜0.05);初中及以下学历组在总分、躯体化、抑郁、焦虑、偏执和精神病性因子上的得分与大学及以上学历组相比差异有统计学意义(P＜0.05);城镇士兵与农村士兵相比在人际关系敏感、焦虑因子分上差异有统计学意义(P＜0.05);家庭经济状况较差组在总分、躯体化、抑郁因子分上与家庭经济状况中等组相比差异有统计学意义(P＜0.05).结论 某部高射炮兵的心理健康状况不容乐观,开展心理健康教育与疏导工作,为官兵创造良好的外界环境将有利于其心理健康水平的提高.     

地震灾区高中学生心理健康与个性相关性分析

目的了解四川省汶川地震5个月后都江堰市中学生心理健康状况与个性相关性。方法采用一般状况问卷、症状自评量表(SCL-90)和艾森克个性问卷(EPQ)对都江堰市475名中学生进行调查。结果SCL-90总分阳性率为56.15(,其中抑郁因子阳性率为50.3%,焦虑阳性率为41.3%,SCL-90总分和各因子分均高于全国常模,差异有统计学意义;女生各因子分均高于男生;阳性和阴性心理症状组学生在EPQ量表中内外向、情绪稳定性、精神质和掩饰倾向比较,差异均有统计学意义(P0.05);除内外向维度外,其他3个维度得分与SCL-90各因子得分均相关。结论地震5个月后灾区高中生仍存在不同程度的心理创伤;具有精神质倾向、情绪不稳定及性格内向的学生更易出现心理问题。     

军队大型综合医院聘用护士心理健康状况调查及分析

目的 探讨军队大型综合医院聘用护士心理健康状况及影响因素,为护理管理者提供指导依据.方法 采用症状自评量表（SCL-90）,对某军队大型综合医院257名聘用护士进行心理健康状况评估.结果 与全国女性常模比较,聘用护士SCL-90各症状因子中,躯体化、强迫症状、人际敏感、抑郁、焦虑、敌对及恐怖等项目评分明显升高（P＜0.05）;与内、外科及门诊护士比较,急诊护士SCL-90多项症状因子评分明显升高（P＜0.05）,内、外科护士SCL-90多项症状因子评分亦明显高于门诊护士（P＜0.05）.聘用护士年龄与SCL-90总分呈正相关,学历与总分呈负相关.结论 军队大型综合医院聘用护士心理健康状况较差,护理管理者应采取针对性措施,提高聘用护士心理健康水平.     

干部病房老年痴呆患者亲属心理状况调查分析

目的探讨干部病房老年痴呆患者亲属心理状况。方法应用焦虑自评量表(SAS)、症状自评量表(SCL-90),对30例老年痴呆患者亲属进行调查,并与30例非老年痴呆患者家属及中国人常模对照。结果老年痴呆患者亲属和非老年痴呆患者亲属焦虑得分分别为38.47±10.82分和35.40±6.84分,高于中国人常模,差异有统计学意义(P0.05)。老年痴呆患者亲属SCL-90量表总分、总均分、阳性项目数、阳性症状均分及躯体化、强迫症状、抑郁、焦虑因子分高于中国人常模且总分、阳性症状均分及躯体化、强迫症状因子分高于非老年痴呆患者亲属组,差异均有统计学意义(P0.05)。结论应关注老年痴呆患者亲属心理状况,给予关心、照顾和支持。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.