大学生故意自伤行为与自杀行为的相关性研究

目的 了解大学生故意自伤行为和自杀行为的发生情况,并分析其相关性.方法 整群选取某医科大学4063名一、二年级在校生为研究对象,采用x2检验比较不同性别大学生故意自伤行为、自杀行为检出率差异,建立多因素logistic回归模型拟合多种研究变量对故意自伤行为-自杀行为的影响.结果 4063名大学生最近1年故意自伤行为检出率为13.4％,其中单次自伤检出率为3.7％,多次自伤检出率为9.6％,男生高于女生;最近1年自杀意念、自杀计划、自杀未遂和自杀行为的检出率分别为4.5％、1.4％、0 6％和4.9％,性别间差异无统计学意义(P＞0.05).采用多元logistic回归分析,以有自伤无自杀组为参考,有自伤有自杀组表现为积极应对程度低(OR=0.5,95％CI:0.3 ～ 0.8)、伙伴个数相对较少(3～5个vs.≤2个:OR=0.6,95％CI:0.3 ～0.9;≥6个vs.≤2个:OR=0.4,95％CI:0.2～0.8);消极应对(OR=2.1,95％CI:1.2 ～ 3.7)、抑郁症状(OR=2.9,95％CI:1.6 ～ 5.2)、焦虑症状(OR=2.2,95％CI:1,2 ～ 3.8)、睡眠问题(OR=1.7,95％CI:1.1～2.8)、自评体型偏胖(偏胖vs.正常:OR=2.0,95％CI:1.1～3.6)较为常见.logistic回归分析发现,大学生故意自伤行为者中自杀行为的发生风险显著增加(OR=4.7,95％CI:3.5～6.4),而抑郁、应对方式、自评体型等社会心理因素会减弱两者的关联程度(OR=3.3,95％CI:2.4 ～ 4.5).自杀行为发生的风险随自伤次数的增加而增加(OR=3.1 ～ 10.0),社会心理因素也会减弱两者的关联(OR=2.4～5.9).结论 自伤行为虽然不是个体自杀行为发生的信号,但有必要在自伤者中开展自杀行为发生可能性的评估.     

消化内镜医师肌肉骨骼疾患相关疼痛的现状调查分析

目的 了解我国消化内镜医生群体肌肉骨骼疾患(MSDs)相关疼痛的患病现状及影响因素,为改善MSDs提供参考依据.方法 通过微信调查问卷形式向消化内镜医生定向发放并收集各项数据,以是否疼痛进行分组并采用SPSS 23.0分析患病的影响因素.结果 75.5％的消化内镜医医师存在肌肉骨骼疾患相关疼痛,其中表示肩部的疼痛最为严重的占41.06％,单因素分析显示疼痛与年龄、工作年限和操作数量有关;Logistic分析显示疼痛与操作数量＞5000例(OR=2.007,95％ CI:0.830～4.856)及＞15 a工作年限(OR=2.056,95％ CI.0.408～10.354)有关且差异有统计学意义(P＜0.05).内镜操作总量＞5000例的医生患病率高达84.8％.结论 我国现阶段消化内镜医师的MSDs相关疼痛现状不容忽视,亟需制定有效的预防或干预措施.     

社会心理因素对妇产科医务人员工作相关肌肉骨骼疾患的影响

目的分析探讨社会心理因素对妇产科医务人员工作相关肌肉骨骼疾患(WMSDs)的影响,以降低社会心理负荷,促进职业健康。方法选取某市各级医院的妇产科医务人员679人为研究对象,主要为妇科、产科医生以及助产士,采用自主研发的肌肉骨骼问卷调查其肌肉骨骼疾患状况,并进行横断面研究,对可能的危险因素进行多元Logistic回归分析。结果 3个因素影响妇产科医务人员的WMSDs:自觉身体健康状况差,自觉竭尽全力,单一工作姿势。自觉身体健康状况差的WMSDs患病风险是自觉身体健康状况良好的11.063倍(OR=11.063,95%CI=2.680~45.666,P=0.001);自觉竭尽全力(OR=2.762,95%CI=1.285~5.935,P=0.009)和单一工作姿势(OR=1.862,95%CI=1.174~2.953,P=0.008)是WMSDs不可忽视的危险因素。结论社会心理因素对妇产科医务人员的WMSDs有一定程度的影响,从社会心理因素出发研究相关的预防改善措施具有重要意义。     

低出生体重儿发生的相关危险因素分析

目的 研究低出生体重儿发生的相关危险因素,探讨降低低出生体重儿的相关措施.方法 应用病例对照研究方法,对100例低出生体重儿和300例正常新生儿的相关资料进行单因素分析及非条件多因素Logistic回归分析.结果 母亲年龄(OR=3.232;95％ CI:0.453～ 3.348)、孕周(OR=2.454;95％CI:0.975 ～ 2.349)、双胎及多胎妊娠(OR=2.642;95％ CI:0.723 ～ 2.348)、妊娠期高血压疾病(OR=2.236;95％ CI:0.455～ 2.445)是低出生体重儿发生的相关危险因素,母亲文化程度(OR=3.642;95％ CI:1.347 ～ 3.425)、家庭月收入(OR=3.532;95％ CI:1.436～2.335)是低出生体重儿发生的保护性因素.结论 针对母亲年龄、孕周、双胎及多胎妊娠、妊娠期高血压疾病等危险因素开展针对性的防治工作是降低低出生体重儿发生率的有效措施.     

学龄前儿童反复呼吸道感染状况及相关因素分析

目的 探讨学龄前儿童反复呼吸道感染状况及相关因素,为制定预防措施提供依据.方法 采用随机抽样方法,抽取义乌市学龄前儿章850名的监护人进行问卷调查,内容包括社会经济状况、抚育因素、生活环境因素等.采用X2检验及多因素Logistic回归分析反复呼吸道感染影响因素.结果 义乌市学龄前儿童反复呼吸道感染率为24.9％,影响反复呼吸道感染的因素主要有家庭人均月收入(OR=1.22,95％CI=1.01～1.47)、母亲生育年龄(OR =0.95,95％ CI =0.91 ～0.99)、哮喘(OR =2.05,95％CI=1.15 ～3.68)、佝偻病(OR=3.91,95％CI=1.88 ～8.13)、零食(OR=1.54,95％CI=1.18 ～2.02)、孩子平常出行的交通方式(OR=1.34,95％CI=1.03～1.74)、同住者是否吸烟(OR=1.59,95％CI=1.16 ～2.20).结论 学龄前儿童反复呼吸道感染影响因素来自多个方面.应建立良好健康习惯,预防反复呼吸道感染的发生.     

维吾尔族和汉族人群非酒精性脂肪肝相关危险因素分析

目的 探讨维吾尔族和汉族非酒精性脂肪肝(NAFLD)的危险因素,为NAFLD的预防和治疗提供科学依据.方法 采用横断面研究方法对4 318名维吾尔族和汉族健康体检人群进行问卷调查,同时对其体质指数、腰围、血压、血糖、血脂、血尿酸(SUA)等生化指标进行检测.采用多因素非条件logistic回归分析NAFLD的相关危险因素.结果 维吾尔族和汉族人群NAFLD检出率分别为45.2％(716/1 584)、36.1％(986/2 734)；高尿酸血症检出率分别为9.5％(150/716)、17.2％(470/2 734)；SUA水平分别为(288.98±90.46)、(326.49±98.43) μmol/L；上述指标差异均有统计学意义(P＜0.01).多因素非条件logistic回归分析显示,男性(OR=1.476,95％CI:1.149～1.898)、年龄(OR=1.036,95％CI:1.028～1.044)、维吾尔族(OR=1.337,95％CI:1.114～1.604)、肥胖(OR=5.682,95％CI:4.731～6.823)、高血压(OR=1.260,95％CI:1.036～1.531)、淋巴细胞计数升高(OR=1.404,95％CI:1.221～1.613)、血红蛋白浓度升高(OR=1.018,95％CI:1.010～1.026)、高尿酸血症(OR=3.059,95％CI:2.278～4.107)、高甘油三酯血症(OR=2.328,95％CI:1.946～2.786)、低高密度脂蛋白胆固醇(OR=1.401,95％CI:1.119～1.755)以及高血糖(OR=2.004,95％CI:1.496～2.685)是发生NAFLD的危险因素.结论 维吾尔族人群发生NAFLD的危险较汉族高,SUA水平与NAFLD密切相关.     

公务员人群中脂肪肝患病影响因素的病例对照研究

目的 了解公务员脂肪肝患病情况及其影响因素,探讨预防发病的干预措施.方法 于2008年9～12月,采用整群抽样的方法对天津市某区公务员进行健康状况及影响因素的问卷调查.应用SPSS17.0建立Logistic回归模型,对公务员人群的脂肪肝影响因素进行分析.结果 公务员人群中脂肪肝患病率为17.86％.多因素分析结果显示脂肪肝患病影响因素有:年龄(OR=0.074,95％CI:1.050～1.105)、性别(OR =-1.207,95％CI:0.223～0.402)、体重指数(OR=0.385,95％CI:1.360～1.587)、饮酒(OR=0.990,95％CI:1.459～4.964)、吸烟(OR=0.852,95％CI:1.485～3.707)、睡眠时间(OR=-0.165,95％CI:0.723～0.995)、按时吃饭情况(OR=0.693,95％CI:1.582～2.530)、高血压(OR=1.340,95％CI:3.031～4.817)、高血脂(OR=1.431,95％CI:2.700～6.483)、腰臀比(OR=2.734,95％CI:6.098～18.920)、亚健康分值(OR=-0.048,95％CI:0.936～0.970).结论 公务员人群脂肪肝患病率较高,公务员是各种慢性病发病的高危人群,是今后开展健康管理的重点群体.     

天津市某郊县健康体检人群代谢综合征的患病情况及危险因素分析

目的 对天津市某郊县健康体检人群的代谢综合征(metabolic syndrome,MS)患病情况及其危险因素进行研究,为制定农村居民MS防治措施提供科学依据.方法 以天津某郊县医院健康体检人群为基础,采用病例对照研究方法,共收集病例278例,对照1 843例,分析研究对象MS的发生情况,并采用非条件logistic回归进行相关危险因素的分析.结果 天津市某郊县健康体检人群MS患病率为13.11％(按全国人口年龄构成标化患病率为13.01％,按天津市人口年龄构成标化患病率为13.04％),男性和女性患病率分别为13.96％和12.40％(按全国人口年龄构成标化患病率为13.70％和12.51％);文化程度(OR =0.687,95％CI:0.561～0.840)、体力劳动程度(OR =0.552,95％ CI:0.473 ～0.644)、体育锻炼(OR=0.517,95％CI:0.404～0.662)是MS的保护因素,高腰臀比(OR=2.246,95％CI:1.699～2.969)、饮食偏甜或偏成(OR=16.936,95％ CI:7.477 ～38.360)、食用畜肉多(OR=1.692,95％CI:1.319～2.169)、高血压家族史(OR=1.817,95％CI:1.330～2.481)、糖尿病家族史(OR=1.756,95％CI:1.235～2.495)是MS的危险因素.结论 MS是一种与环境和生活方式相关的异常健康状态,应尽早针对相关危险因素采取预防控制措施.     

女性系统性硬皮病发病影响因素的病例对照研究

目的 探讨月经生育因素、日常生活方式和环境因素与女性系统性硬皮病(systemic sclerosis,SSc)患病的关联.方法 2012年8月～2015年12月,收集来自于安徽医科大学附属医院的100例女性SSc患者和来自于合肥市社区的400例女性对照的相关信息,用单因素和多因素非条件Logistic回归分析影响SSc患病的因素.结果 单因素Logistic回归分析发现11个因素与SSc的患病有关.多因素Logistic回归分析显示,肥胖(0R=0.464,95％ CI:0.229～0.939)为SSc的保护因素,而农民(OR=4.458,95％ CI:2.379～8.352)、教师/会计/文员(OR=9.740,95％ CI:3.153 ～30.909)、制鞋/服装/纺织工人(OR=16.150,95％ CI:4.933 ～ 52.873)、偏瘦(OR=3.733,95％ CI:1.440 ～9.636)、服用避孕药(OR=3.994,95％ CI:1.291 ～ 12.361)、流产(OR =4.679,95％ CI:2.365 ～9.258)、其他接触的人吸烟(OR =5.059,95％ CI:2.582～9.913)、噪声暴露(OR =2.184,95％ CI:1.018～4.685)、有机溶剂暴露(OR =4.432,95％ CI:1.158～16.965)、药物过敏史(OR =3.564,95％ CI:1.425～8.916)为SSc患病的危险因素.结论 多个环境因素与SSc的患病有关,应针对性加强SSc的预防和患者康复工作.     

重庆市机关事业单位工作人员高血压患病率及危险因素调查

目的 了解重庆市机关事业单位工作人员的高血压患病现状及危险因素,为该人群高血压防控工作提供科学依据.方法 采用横断面调查的方法,对重庆市1 000名机关事业单位工作人员进行问卷调查和体格测量,运用多因素Logistic回归分析高血压的影响因素.结果 有效完成问卷调查和体格测量929人,其中高血压患者136人,粗患病率14.6％,年龄标化患病率17.6％.年龄(OR=2.9S,95％ CI:2.77～3.19)、性别(OR =0.47,95％ CI:0.23～0.71)、食用豆制品(OR =2.35,95CI:2.13 ～2.57)、食用咸菜或泡菜(OR =0.67,95％CI:0.45～0.89)、坚持体育锻炼(OR=1.82,95％CI:1.55 ～2.09)、体质指数(OR=2.17,95％CI:2.02 ～2.32)是高血压的独立影响因素.结论 重庆市机关事业单位工作人员的高血压患病危险因素普遍存在,应通过健康教育、定期体检、对食堂进行干预等综合防控措施来有效抑制该人群的高血压流行形势.     

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.