潜艇艇员长航疲劳状况及其影响因素研究

目的 调查并分析常规潜艇艇员长航疲劳状况及其影响因素,探讨改善疲劳方法.方法 干长航前1d、航行期间每3d和返航后1d采用<疲劳自觉症状调查表>对艇员疲劳状况进行调查、分析.结果 (1)艇员疲劳发生率高.艇员长航前id、航行期间、返航后1d各种疲劳自觉症状总发生率为94.22%,"经常或总是如此"因子的症状总发生率为2...     

2 121例妇科手术患者焦虑抑郁症状现状和影响因素调查

目的 调查妇科手术患者的焦虑抑郁情况,并分析其影响因素。方法 应用医院焦虑抑郁量表（HADS）对2 121例将进行妇科手术的患者进行调查。结果 妇科手术患者的焦虑抑郁总得分（9.39±5.50）分,焦虑评分（5.40±3.13）分,抑郁评分（4.00±3.08）分;妇科恶性肿瘤患者（外阴癌、宫颈癌、卵巢癌、子宫内膜癌）的焦虑发生率为31.40%～50.00%,抑郁发生率为13.31%～52.78%,良性疾病患者（子宫肌瘤、卵巢囊肿）的焦虑发生率为20.22%～20.39%,抑郁发生率为10.10%～11.59%,不同疾病间焦虑抑郁程度差异具有统计学意义（P＜0.001）;单因素方差分析结果显示妇科手术患者焦虑程度在年龄和学历方面差异具有统计学意义（P＜0.05）,抑郁程度在学历方面差异具有统计学意义（P＜0.001）。结论 妇科手术患者的焦虑抑郁水平均高于国内常模,恶性肿瘤患者焦虑抑郁程度高于良性疾病患者,其焦虑程度与学历和年龄有关,抑郁程度与学历有关。医务工作者应加强心理学知识的学习,针对患者的具体情况提供更专业、有效的心理干预。     

通道县部分中小学生考试焦虑状况调查

目的 了解中小学生考试焦虑状态及其影响因素.方法 用TAS焦虑状态自测量表调查通道侗族自治县中小学生的焦虑程度及其影响因素,调查结果 用SPSS统计软件分析.结果 共调查393名中小学生,小学生、初中生和高中生分别为86、157和150人.TAS总评分(18.06±6.022)分,最高和最低值分别为4分和35分.不同学历层次TAS评分的差异有统计学意义(P＜0.01),小学生最低为(16.66±5.876)分;小学生、初中生和高中生的重症焦虑率分别为26.74%、42.68%和46.00%,差异有统计学意义(P＜0.05).性别、家庭经济状况、父母职业对TAS评分和重症焦虑率的影响无统计学意义.结论 考试焦虑现象在被调查中小学生中普遍存在,学历层次越高,焦虑程度越严重.学校和家长应加强对学生和子女的心理疏导,降低其焦虑水平.     

舰员航行中心理—生理综合卫生保障措施的研究

目的 为了解航行时存在的心理—生理卫生学问题,如单调性(感觉、知觉缺乏,重复动作)、运动不足、生理节律紊乱,缓解精神疲劳,促进心理健康,进行了心理—生理综合卫生保障措施研究。方法 舰员30人,分成两组,实验组15人,对照组15人。采取的措施:航行期对实验组舰员实施一套体能锻炼的训练方案,进行心理健康的宣传教育和咨询;对照组未实施体能锻炼的训练方案,没有接受心理健康的宣传教育和咨询。指标:心理的疲劳问卷(睡眠情况、症状自评量表及疲劳症状),体能测试(引体向上、立定跳远、100 m跑、背肌力、左右手握力)。结果 航行5 d后,对照组舰员症状自评量表的总分和多项因子分高于实验组和国人常模,相差显著;疲劳症状问卷评分的总分和各因子分高于实验组,相差显著;睡眠情况及体能测试指标与实验组相比相差不显著。结论 开展体能锻炼进行心理健康宣传教育和咨询,有益于提高舰员的心理健康水平,缓解精神疲劳,表现为心理和疲劳问卷指标得分的改善。     

舰员航行中心理——生理综合卫生保健措施的研究

目的 为了航行时存在的心理－生理卫生学问题,如单调性（感觉、知觉缺乏、重复动作）、运动不足、生理节律紊乱,缓解精神疲劳,促进心理健康,进行了心理－生理综合卫生保障措施研究。方法 舰员30人,分成两组,实验组15人,对照组15人。采取的措施;航行期对实验组舰员实施一套体能锻炼的训练方案,进行心理健康的宣教育和咨询;对照组未实施体能锻炼的方案,没有接受心理健康的宣传教育和咨询。指标：心理的疲劳问卷（睡眠情况、症状自评量表及疲劳症状）,体能测试（引体向上、立定跳远、100m跑、背肌力、左右手握力）。结果 航行5d后,对照组舰员症状自评量表的总分和多项因子高于实验组和国人常模,相差显著;疲劳症状问卷评分的总分和各因子分高于实验组,相差显著;睡眠情况及体能测试指标与实验组相比相差不显著。结论 开展体能锻炼进行心理健康咨询教育和咨询,有益于提高舰员的心理健康水平,缓解精神疲劳,表现为心理和疲劳问卷指标得分的改善。     

辽宁省沿海地区部队官兵亚健康状况的调查

目的 调查辽宁省沿海地区部队官兵的亚健康状况及影响因素.方法 应用整群抽样方法,采用自行设计包括20项自觉症状的健康调查表进行问卷调查与分析.结果 在辽宁省沿海地区接受调查的3170例部队官兵中20项自觉症状均有发生,但发生率不同,其中,烦躁、头晕、情绪低落、乏力、失眠列居前5位,发生率分别为36.5％、31.6％、31.0％、30.7％和27.4％;不同职务、兵种、服役期和文化程度官兵的5种常见自觉症状的发生率各不相同,其中,干部烦躁、情绪低落高于战士,发生率分别为54.5％和36.1％、44.2％和30.7％(P＜0.05);海军官兵烦躁、头晕、情绪低落、乏力、失眠的发生率分别是48.8％、39.6％、43.1％、38.2％和32.9％,高于陆军、空军(P＜0.05);服役期≥9年官兵的烦躁、情绪低落、乏力和失眠的发生率为46.9％、46.0％、45.1％、38.1％,服役3～8年的官兵头晕发生率为40.4％,高于服役期≤2年、≥9年的官兵(P＜0.05);具有大学及以上学历官兵的烦躁、情绪低落、乏力发生率分别为52.5％、43.3％、42.5％,高于其他学历的官兵(P＜0.05).影响因素涉及职务、兵种、服役期和文化程度,但最重要的影响因素是服役期.结论 部分官兵的健康状况存在问题,且受到职务、兵种、文化程度,尤其是服役期等因素的影响,对服役期＞2年的官兵应积极采取预防措施,加强健康教育,定期开展健康体检工作.     

体检人群中脂肪肝患病率及相关因素调查

[目的] 探讨脂肪肝发病的相关因素.[方法] 对我院体检科2679名体检人群体重指数(BMI)、周饮酒量、血脂、血糖及脂肪肝进行检测.[结果] 脂肪肝组肥胖(体重指数(BMI)＞25)、高血脂、高血糖发生率明显高于总体人群(P＜0.01);不同年龄段脂肪肝患病率与肥胖(体重指数(BMI)＞25)有关(P＜0.01);随着周饮酒量增加,脂肪肝患病率明显增加(P＜0.01).[结论] 脂肪肝患病率与肥胖(体重指数(BMI)＞25)及周饮酒量有直接关系.     

广州市居民亚健康的组成因子及亚健康危险因素的调查

目的 调查分析广州市居民亚健康组成因子及亚健康的分布等情况,找出广州市居民亚健康的主要组成因子及影响广州市居民的亚健康危险因素.方法 针对调查目的设计调查问卷,调查内容包括18个亚健康因子及与其相关的项目,也包括个人基本情况、过去疾病健康状况及生活行为方式等;通过随机抽样对广州市居民进行调查,并对调查数据采用Excel、SPSS13.0软件进行统计分析.结果 调查显示广州市居民亚健康的组成因子主要为感觉疲劳尤其活动后与用脑后疲劳,其次是感觉记忆力差、多梦与休息不好、感觉心烦意乱、注意力不集中、焦虑等,而亚健康组成因子最不明显的是咽喉有异物感、感觉同事关系紧张.广州市居民亚健康的危险因素为初中以下与高中及中专学历水平、职工、居住天河区、荤素搭配饮食习惯、药物依赖、工作压力、熬夜、口味重饮食、选择自来水及选择矿泉水(P＜0.05);且随着学历的增加居民亚健康的发生率也有下降的趋势.结论 感觉疲劳尤其活动后与用脑后疲劳是广州市居民亚健康的主要构成因子;广州市居民亚健康与多个危险因素有关.     

北京市中老年人体质指数与死亡的相关关系

目的探讨北京市中老年人体质指数(BMI)与死亡的相关关系.方法采用前瞻对列研究方法,于1991年对北京市40岁以上的自然人群共6 209人进行基线危险因素调查后,并随访至1999年12月.对在随访期间发生的所有死亡病例按ICD-9编码进行登记,并在个体水平对BMI与总死亡及几种主要死因进行相关分析.结果近10年北京市中老年人前5位主要死因依次为心脑血管疾病、肺心病、消化道肿瘤、不明原因突然死亡、肺癌,其死亡构成比分别为33.3%、13.8%、11.2%、7.4%、5.6%.人群总死亡率及不吸烟者总死亡率均以BMI值23.6～26.2组最小,以此BMI组为参照,BMI＜21.2组上述二组人群总死亡的RR值分别为1.7和1.9,在BMI≥26.2组以上二组人群总死亡的RR值分别为1.3和1.5.BMI与心血管病死亡呈正相关,BMI≥26.2组较BMI＜21.2组心血管病死亡的RR值为1.2;BMI与肺心病、消化道肿瘤、肺癌、肺炎及不明原因突然死亡分别均呈U型关系,均以BMI值23.6～26.2组死亡率最低,与此BMI组相比,BMI＜21.2组因上述5种疾病死亡的RR值分别为14.8、1.1、5.6、2.4和2.6,BMI≥26.2组因上述5种疾病死亡的RR值分别为3.0、1.9、3.7、2.2和1.5.各BMI组均以心血管病死亡构成比最大(28.0%～54.8%).结论北京市中老年人体质指数与总死亡呈U型相关;心脑血管疾病仍是目前影响人们健康的最主要疾病,其死亡危险性随BMI的增加而增加.     

广州市居民饮用水选择与亚健康情况调查分析

目的调查广州市居民亚健康及其与广州市居民饮用水选取之间的关系,为有关部门制定相关政策提供参考依据。方法针对调查目的与要求设计调查问卷,问卷内容包括广州市居民亚健康及其各组成因子的调查,也包括个人一般情况、与健康有关的饮用水知识及其知晓情况等。随机抽取广州市10个区的966位居民进行问卷调查,并对有效问卷877份调查数据采用SPSS13.0软件进行统计分析。结果调查发现,与饮水种类选取有关的因素分别为:性别、年龄、学历、职业、收入、居住地、吸烟、饮食习惯、体育锻炼、工作压力、饮食、第三者性生活和熬夜等(P<0.05)。广州市居民饮用水种类的选取不同与亚健康发生率之间具统计学意义(P<0.05),其中选自来水者其亚健康发生率为85.2%,而选活化水者其亚健康发生率为55.6%。在对各饮用水种类分层的亚健康因子分析结果显示,不管选择何种饮用水,感觉疲劳、尤其活动后与用脑后疲劳的亚健康因子评分最高,表明发生亚健康的可能性大。除感觉耳鸣之外,各饮用水种类选取与其他健康因子的亚健康评分之间均有统计学差异(P<0.05),其中选自来水者其各亚健康因子的亚健康评分均比较高,而选活化水者其各亚健康因子的亚健康评分相对较少。结论广州市居民亚健康的发生与饮用水种类的选取有关,选自来水者发生亚健康的可能性较大,而选活化水者其发生亚健康的可能性较小。     

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.     

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.     

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.     

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.