中文版VoiSS量表用于评价嗓音状况的信效度研究

目的对用于检测嗓音疾病的嗓音症状量表(VoiSS)中文版进行信效度检验。方法使用VoiSS量表中文版对412名长沙市中小学教师嗓音状况进行现场问卷调查,进而评价其信度和效度。结果 VoiSS量表中文版的Cronbach’sα系数为0.958,且3个维度的Cronbach’sα系数均大于0.90。Spearman-Brown系数为0.888,Split-Half系数为0.887。各条目与所属维度的Pearson相关系数r均大于0.50。因子分析提取公因子4个,解释的总方差累计百分比为63.936%。验证性因子分析模型拟合效果较好。结论 VoiSS量表中文版的信度和效度评价结果较好,适合应用于中国文化背景下的嗓音疾病筛查。     

工作内容量表在建筑行业职工中应用的信度和效度

[目的]评估中文版工作内容量表（JobContentQuestionnaire,JCQ）在建筑行业职工中应用的效度和信度。[方法]于2008年4～7月间,采用多阶段随机抽样法抽取包头市在建建筑工地的551名工龄在1年以上的在职职工为研究对象,应用JCQ问卷进行职业紧张状况的调查和评价。[结果]问卷的应答率为95％。信度：JCQ5个模块的同质信度Cronbaeh’sα系数为0．60~0．82。效度：主成分分析方差最大正交旋转提取4个因子,4个因子的条目组成与JCQ量表4个模块组成一致。Pearson相关分析提示问卷主要模块与生理、心理健康状况均具有相关性（P〈0．05或P〈0．01）。[结论]工作内容量表JCQ在包头市建筑行业中使用有较好的信度和效度。     

工作内容量表(中文版)在医务人员中的验证

目的 开发中文版《工作内容量表》(job content questionnaire,JCQ)(1．5版)，考评它在临床医务人员中的使用情况。方法 将Robert Karasek编写的英文版JCQ泽成中文，并回泽。以云南省两家综合医院内科、外科、妇产科、急诊科的临床医护人员(320例)为样本，评定信度和效度，随机抽取24例在一周后进行重测，以评定重测信度。结果 中译本回译一致率95％，问卷有效回答率92．8％(297例)。JCQ含8个模块，共49个条目。8个模块的同质信度Cronbach'a系数的0．52-0．86，复测信度0．87-0．95；主成分因子分析提取8个因子，方差累积贡献率46．95％，进行方差最大正交旋转，8个因子的条目组成与JCQ量表中除不稳定工作因素(JI)以外的7个模块组成一致。Pearson相关检验证实问卷大部分条目的结构效度较好，但宏观工作自主度、JI两个模块的部分条目的相关性较低，考虑为不同的文化背景所致。结论 JCQ中文译本能够反映其理论基础中三个与职业紧张相关的维度。中文JCQ在效度、信度上符合心理测量学的要求，但部分条目仍须作进一步深入文化调试。     

工作内容量表（JCQ22）在噪声作业工人中的应用

目的 评价中文版工作内容量表（job content questionnaire,JCQ22）在噪声作业工人中的信度和效度,检验该量表应用于噪声作业人群中的可推广性。
方法 采取自愿填写的方式,对500名某汽车制造企业噪声作业工人进行JCQ22的问卷调查,并随机抽取其中40位调查者,间隔两周后进行重复调查。问卷的信度采用内部一致性信度和重测信度进行分析;内容效度采用相关分析,结构效度采用探索性因子进行分析。
结果 本次问卷中的工作内容量表的Cronbach's α系数为0.933,问卷的内部一致性信度较好;重复调查结果显示两次的测得得分差异无统计学意义（P>0.05）,且量表中三个维度两次测评的相关系数均大于0.9（P < 0.01）,说明重测一致性好;各维度得分与量表总得分的相关系数均大于0.8（P < 0.01）,说明内容效度较高;探索性因子分析结果显示:KMO值为0.933,Bartlett球形检验值为7 835.941（P < 0.01）,表示各变量间有一定的相关性,适合因子分析;提取4个公因子,解释的累计方差贡献率达66.583%,进行方差最大正交旋转,4个公因子的条目载荷与工作内容量表的结构框架基本一致。
结论 中文版工作内容量表（JCQ22）具有较好的信度和效度,能够较好地反映噪声作业工人的职业紧张状况,适用于评价噪声作业工人的心理状况。
     

疲劳量表-14在汽车装配作业工人中的信度和效度检验

目的检验疲劳量表-14(Fatigue Scale-14,FS-14)在汽车装配作业工人中的信度和效度。方法采用FS-14对588名汽车装配作业工人进行调查,选用项目区分度对FS-14进行项目分析;采用Cronbachsα系数评估量表内部一致性信度,Spearman-Brown系数评估量表分半信度;运用各条目得分与总分的相关性和因子分析方法验证量表的各条目与量表一致性和结构效度。结果项目分析:躯体疲劳和脑力疲劳维度能够区分调查对象的不同躯体疲劳和脑力疲劳水平(P0.01);信度:量表的Cronbachsα系数为0.809,躯体疲劳和脑力疲劳2个维度的Cronbachsα系数分别为0.800和0.677,Spearman-Brown系数为0.676;效度:各条目得分与总分之间的Pearson相关系数为0.369~0.690(P0.01),KOM值为0.852。共提取3个公因子,累计方差贡献率为48.839%;每个公因子均涵盖了躯体疲劳和脑力疲劳。结论FS-14在汽车装配作业工人中具有较好的信度和效度,而脑力疲劳维度需根据实际工作进一步完善修订。     

顺应喂养行为评价量表的汉化及信效度检验

目的 汉化顺应喂养行为评价量表（RFPAT），并在我国6～12月龄婴儿照护者中检验其信度和效度。方法 通过直译、回译、文化调试，形成中文版顺应喂养行为评价量表。对402名6～12月龄婴儿照护者进行调查，测评该量表的信效度。结果 中文版顺应喂养行为评价量表共4个维度（喂养环境、恰当喂养、识别婴儿信号、回应性互动）、15个条目。量表的Cronbachα系数为0.899，折半信度为0.823，重测信度为0.892；量表的内容效度指数均值为0.960，条目水平内容效度指数为0.833～1.000；因子分析提取出4个公因子，累计方差贡献率为65.008%，各条目因子载荷量为0.609～0.821（均＞0.400）；验证性因子分析的模型拟合度较好。结论 中文版顺应喂养行为评价量表信效度良好，可用于评价我国6～12月龄婴儿照护者顺应喂养行为。     

两种问卷在民航后勤职工职业紧张调查中信效度分析

目的比较工作内容问卷1．0（JCQ1．0）与付出-回报失衡问卷（ERI）对民航后勤职工的职业紧张调查结果及信效度的差别。方法分别使用JCQ1．0核心版和ERI核心版对110名民航后勤职工进行职业紧张问卷调查,评定问卷的信度和效度。结果根据JCQ1．0的测试结果,高职业紧张、被动型、主动型及低职业紧张的比例分别为23．6％、20．9％、24．5％和30．9％;根据ERI的测试结果,59．1％的员工存在职业紧张。JCQ1．0三个模块的Cronbach仪系数为0．10～0．51,分半信度0．50;ERI三个模块的Cronbach“系数为0．35～0．79,分半信度0．78。Pearson相关检验证实两问卷大部分条目的结构效度较好,提取的因子方差累计贡献率分别为64．62％（JCQ1．0）和58．08％（ERI）。结论ERI问卷在民航职工中具有较好的信度与效度,JCQ1．0问卷在该人群中的应用尚需要进一步验证和修订。     

健康素养敏感型沟通量表的汉化及信效度分析

目的汉化健康素养敏感型沟通量表(HL-COM)并检验其信效度。方法按照Brislin翻译原则对HL-COM量表进行翻译和文化调适。本研究为横断面研究, 选择湖北省3所三甲医院门诊及住院部就诊的患者进行问卷调查, 回收样本434例。利用Cronbach′sα系数和分半信度评价量表的信度, 采用量表水平的内容效度指数(S-CVI)和条目水平的内容效度指数(I-CVI)等指数评价内容效度, 采用探索性因子分析和验证性因子分析进行结构效度检验, 再进行跨性别的测量等值性检验。结果中文版HL-COM包括9个条目, 与原英文版量表的形式和条目数量相同。量表信度:Cronbach′sα系数=0.938, Spearman-Brown分半系数=0.926;内容效度:S-CVI=0.926, I-CVI为0.833～1.000;探索性因子分析共提取1个公因子, 累积方差贡献率68.541%;验证性因子分析结果表明模型拟合良好, 各拟合指标为:卡方/自由度(χ2/df)=2.794, 标准拟合指数(NFI)=0.974, 标准化均方根残差(SRMR)=0.025, 拟合优度指数(GFI)=0.962, 近...     

DTSQs量表在2型糖尿病患者中应用的信度、效度和反应度初步评价

目的 初步评价糖尿病治疗满意度问卷当前版(DTSQs)最表在中国2型糖尿病患者中应用的信度、效度和反应度.方法 以上海市3家医院和广州市4家医院门诊2型糖尿病病例为研究对象,采用中文版DTSQs问卷调查结合实验室检测的方法 收集资料,应用信度分析、因子分析结合结构方程模型、多元协方差分析分别评价DTSQs的信度、效度和反应度.结果 满意度维度分半信度系数为0.807,Cronbach α系数为0.717;探索性因子分析结果 显示,3个公因子累计方差贡献率为67.656%;拟合度检验结果 显示,相对χ2=4.95,DK=0.18;不同性别、不同血糖控制水平组患者DTSQs量表3个维度得分向量不同.研究数据支持DTSOs量表的理论假设,中文版DTSQs量表具有较高的信度和结构效度.结论 初步认为DTSQs量表中文版可以在中国2型糖尿病患者中应用.     

NHP量表在中牟县外来务工人员生活质量测量中的信度和效度分析

目的探讨诺丁汉健康量表(Nottingham Health Profile,NHP)用于城市外来务工人员生活质量测定的信度和效度。方法采用分层整群抽样的方法,于2008年3-4月间,在郑州市中牟县随机抽取723名外来务工人员进行生活质量测量。用Spearman-Brown公式计算量表的折半信度,Cronbach’sα系数衡量其内部一致性信度,因子分析方差最大旋转法分析其结构效度,Spearman秩相关来考察其内容效度。结果 NHP量表折半信度系数是0.71;总的Cronbach’sα系数为0.75,各维度Cronbach’sα系数均小于0.70,其中最小值0.26(精力水平维度),最大值0.63(情绪反应维度);所有维度的集合效度定标试验成功率为50.00%,区分效度定标试验成功率除去躯体活动维度为95.80%外,其余各维度均为100.00%;因子分析产生的两个公因子,分别代表生理健康和心理健康,累积方差贡献率为60.00%。结论中文版健康测量量表NHP具有良好的信度、效度和可接受性,可以应用于城市外来务工人员生活质量测定,但需在实际应用中进一步完善。     

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.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

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.