大学生抑郁及相关因素分析

目的了解广州市某高校大学生自杀意念与抑郁发生的现状,探讨两者之间的关系,为预防与干预大学生自杀行为提供参考依据。方法采用分层整群抽样方法调查2585名在校大学生,应用贝克抑郁自评量表进行评估。结果近1周内,大学生自杀意念的发生率为7．9％,抑郁的患病率为39．3％,抑郁水平与自杀意念的严重程度呈正相关（r=0．405,P〈0．001）。患有轻度抑郁（OR=4．34）、中度抑郁（OR=23．00）或重度抑郁（OR=349．85）的大学生产生自杀意念的危险性均高于无抑郁症者。结论大学生抑郁水平与自杀意念密切相关,及时识别大学生抑郁症对预测与预防该人群自杀具有重要意义。     

家庭和社会因素对大学生自杀意念的影响

目的 了解广州市大学生自杀意念的发生现状及危险因素，为预防提供相应的策略和措施。方法 采用统一的调查表，以随机抽样的方法调查广州市6所高校的大学生2143名。通过单因素检验和多因素的Logistic回归模型筛选出自杀意念的危险因素。结果 在2143名大学生中有397人出现自杀意念，其发生率为18．53％。多因素的Logistic回归模型分析揭示与自杀意念发生有关的主要危险因素是：想杀人(OR=2．912)、自觉有罪(OR=2．085)、觉得寂寞(OR=1．729)、有亲密朋友发生死亡(OR=1．683)、喜欢独居(OR=1．672)、对前途感到悲观失望(OR=1．599)等。结论 大学生中自杀意念的形成是多因素作用的结果，应采取多种预防措施，防止自杀行为的发生。     

重庆市大学生自杀意念的调查

目的 了解重庆市大学生自杀意念的报告率及其危险因素.方法 采用自制量表在重庆市随机抽取的11所大学中调查9808名大学生,了解自杀意念发生情况及相关因素,并通过多因素logistic模型发现其危险因素.结果大学生自杀意念报告率为13.0%,有自杀意念的男、女学生构成比为3:4;多因素分析显示其危险因素排列为:近一年感到绝望频率高(OR=5.07,95%CI:4.27～6.02)、近一个月心理问题对学习及日常生活的影响(OR=2.07,95%CI:1.79～2.38)、已发生性行为(OR=1.95,95%CI:1.65～2.30)、亲属有过自杀行为(OR=1.77,95%CI:1.52～2.08)、女性(OR=1.66,95%CI:1.45～1.90)、认识的人中有过自杀行为(OR=1.46,95%CI:1.28～1.67)、近一个月因疾病对学习及日常生活影响(OR=1.29,95%CI:1.08～1.52).结论 大学生样本中自杀意念报告率较高.应根据大学生自杀意念的危险因素,在高校制定和执行有针对性的自杀预防计划.     

大学生个性特征及应对压力与自杀意念的相关分析

目的了解大学生心理特征、遭遇压力、应对方式与自杀意念的关系。方法采用统一的调查表，以目的抽样的方法调查广州市某高校的大学生974名，通过单因素logistic回归和多因素的logistic回归模型筛选出自杀意念的影响因素。结果在974名大学生中，14．6％的男生、17．5％的女生有过自杀意念，二者之间无统计学差异。侨生中自杀意念的发生率（18．8％）高于中国内地生源（11．2％）。多因素的logistic回归模型分析揭示，“觉得自己总是不比别人好而自卑”（OR=4．072）、“遇到问题，不找人倾诉”（OR=2．263）、“较长时间陷入生活、学习、感情或经济压力”（OR=1．597）是自杀意念产生的危险因素；而通过体育运动放松心情（OR=0.519）是保护因素。结论引导和教育大学生树立正确的挫折观和人生态度，提高心理承受能力，防止自杀意念的产生。     

家庭环境和应对方式对大学生自杀意念影响

目的 探讨家庭环境因素及应对方式对大学生自杀意念的影响.方法 采用随机抽样方法对某城市3所高校不同年级585名学生进行自杀意念、自伤行为、抑郁自评量表以及家庭环境和简明应对方式调查.结果 被调查者中有过自杀意念的占20.9％,5.7％有过≥1次自杀行为;11.6％的大学生有过自伤行为;自杀意念组的女生比例明显高于男生,曾经有过自杀和自伤行为的比例明显高于正常组(P＜0.001);多因素逻辑回归分析表明,女生(OR=2.391)、消极应对方式(OR =2.796)、抑郁状态(OR=1.071)、存在自伤行为(OR =4.003)以及有过≥1次自杀行为(OR =5.492)是大学生自杀意念的危险因素,而家庭环境亲密度(OR=0.879)可能是自杀意念的保护性因素;未发现童年时期父母的关系以及童年时期是否受到成年人虐待与大学生自杀意念相关.结论 大学生自杀意念较高,受性别、抑郁状态、家庭环境、消极应对以及曾经的自杀和白伤行为经验影响.     

在校护理专业学生负性生活事件应激量及家庭功能与自杀意念关系的研究北大核心CSCD

目的了解青少年自杀意念的形成与家庭功能、负性生活事件各应激量及其他影响因素之间的关系。方法采用现况研究的方法,使用自杀意念自评量表、青少年生活事件量表和家庭功能指数量表等工具对江苏省常州市一所卫生高职院校和安徽省芜湖市一所医学本科院校护理专业在校学生（包括中职、高职、大专、本科）进行问卷调查。调查两所院校共发放问卷3700份,回收问卷3675份,其中有效问卷3620份,单因素分析采用χ2检验、t检验和单因素Logistic回归分析,多因素分析采用多因素Logistic回归分析。结果自杀意念的检出率为7．0％。自杀意念检出率最高的前5类特征分别为：成绩情况差（33．6％）、家庭功能严重障碍（25．8％）、成绩情况中下（11．7％）、经济情况差（10．8％）和就读于三年级（9．9％）;多因素Logistic回归分析显示负性生活事件各因子应激量中“人际关系因子”（OR=1．135,95％CI1．071～1．202）、“学习压力因子”（OR=1．169,95％CI1．101～1．241）和“外围事件因子”（OR=1．278,95％CI1．187～1．376）等3个因子应激量高是自杀意念产生的危险因素;此外就读年级越高（OR=1．980,95％CI1．302～3．008）、成绩情况差（OR=7．206,95％CI1．745～9．789）和家庭功能中度障碍（OR=2．562,95％CI1．527～2．892）至严重障碍（OR=8．287,95％CI3．154～6．917）等也是自杀意念的危险因素。结论家庭功能障碍和负性生活事件高应激量是青少年产生自杀意念的主要影响因素,家庭和学校应给予青少年必要和充足的支持,减少负性生活事件对其的影响,从而防止自杀行为的发生。     

住院精神障碍患者自杀行为危险因素分析

目的探讨住院精神障碍患者发生自杀行为的相关危险因素。方法回顾性调查1995年1月至2010年12月解放军第二六一医院18岁以上住院精神病患者的病例资料(共9 473例),分析其发生自杀行为的影响因素,单因素分析采用χ2检验,多因素分析采用非条件logistic回归。结果经非条件logistic回归分析可知,住院患者中有家族史(OR=6.106,95%CI=4.414,8.445),离异或丧偶(OR=1.733,95%CI=1.001,3.001),曾有过治疗的患者(OR=2.775,95%CI=1.795,4.291)较易发生自杀行为;41～60岁年龄组患者发生自杀的可能性低(OR=0.631,95%CI=0.436,0.915)。抑郁症(OR=4.484,95%CI=2.579,7.797),精神分裂症患者(OR=1.757,95%CI=1.124,2.747)发生自杀行为的可能性较高。结论对住院精神障碍患者应及时评估其危险因素,识别危险行为的先兆,对重点患者针对性的实施有效干预。     

广州市高校大学生自杀意念发生的危险因素

目的 了解广州市大学生自杀意念的发生情况及危险因素，为预防大学生自杀提供依据。方法 采用统一调查表，以随机抽样的方法调查广州市6所高校的大学生2143名，并通过单因素和多因素Logistic回归模型筛选出自杀意念的危险因素。结果 自杀意念的发生率为18．53％。多因素Logistic回归分析揭示，自杀意念发生的主要危险因素有曾患精神分裂症或抑郁症、服用成瘾性物质、以往有过自我伤害行为、喜欢从阴暗面看问题等。结论 自杀意念在大学生中较为常见，应加强其心理素质教育，防止自杀行为的发生。     

综合医院医师防范住院患者自杀的方法与措施

自杀是人类的悲剧。全球每年约有100．120万人自杀死亡：世界上每40秒钟有1人成功自杀．每3分钟有1人自杀未遂：自杀是15～35岁年轻人死亡原因前三位之一：每一位自杀者要严重影响至少6个人（指亲友）。自杀给家庭和社区带来的心理、社会和财务上的影响是无法估量的。自杀是生物、遗传、心理、社会、文化和环境诸因素相互作用的结果。根据北京地区40家综合医院住院病人自杀意念、自杀未遂的出现率及其危险因素的调查显示．在2914例年龄大于15岁的住院病人中，187人（6．42％；95％CI为5．58％～7．64％1有过自杀意念，其危险因素排列为：近1年感到绝望的频率高（OR=9．2.95％CI为6．5～12．9）、亲属有过自杀行为（4.3，2-3．8．31、调查当时有重性抑郁发作（2．7，1．7～4．3）、熟人有过自杀行为（2．0，1．3．2．9）、年龄小于55岁（1．7，1．2．2．3）、女性（1．5，1．1—2．1）。     

家庭因素对大学生自杀意念与自杀行为的影响研究

目的 通过分析家庭因素与大学生自杀的关系,找出危险因素和保护因素,从而为大学生自杀的预防和干预提供依据.方法 采用统一的调查表,用随机整群抽样的方法调查广州某高校在校大学生480人.运用单因素卡方检验和多因素Logistic回归进行统计分析.结果 在480名大学生中有101人出现自杀意念,其发生率为21.5%,其中有15.8%的人有详细的计划和自杀方法.多因素分析揭示,与自杀意念发生有关的主要家庭因素是:家庭成员之间的关系是否和睦(OR=0.385)、有血缘关系的其他亲属在过去是否有人自杀死亡(OR=3.675)及认识的朋友中过去任何时候是否流露过自杀念头(OR=3.033);与自杀行为发生有关的主要家庭因素是:家庭成员之间的关系是否和睦(OR=0.176)、认识的明友中过去任何时候是否流露过自杀念头(OR=5.490)、在班里的学习成绩情况(OR=2.114)等.结论 家庭因素对大学生自杀意念和自杀行为的产生有重要影响,应采取有针对性的预防措施,防止大学生自杀行为的发生.     

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.