中学生健康素养量表的编制及其信度效度评价

目的编制适合我国中学生的健康素养评价量表,并评价其信度和效度。方法依据世界卫生组织(WHO)提出的健康素养定义,根据《中小学生健康教育指导纲要》和《中、小学生健康教育规范》有关青少年健康教育的内容,设计量表概念框架、构建中学生健康素养量表条目池,然后在上海市中学生中进行调查,应用探索性因子分析和结构方程模型对量表的效度进行检验,应用内部一致性对量表信度进行检验。结果本次研究共有498名中学生参与调查,通过临界比值、因子载荷和Cronbach’sα系数进行条目筛选,最终形成31个条目的中学生健康素养量表。通过探索性因子分析和验证性因子分析,量表构建成为健康理念、健康知识、健康生活方式与行为、健康认知技能和操作技能5个维度(χ2=520.748,P=0.00,CFI=0.920,TLI=0.912,RMSEA=0.022,RMSEA 90%CI=0.014~0.028,WRMR=1.048)。量表的Cronbach’sα系数为0.739,问卷各维度的Cronbach’sα系数为0.541~0.679。结论所编制的中学生健康素养量表具有较好的效度和内部一致性。     

糖尿病特异性生存质量量表的信度与效度初探

目的通过对引进的中文版糖尿病特异性生存质量量表(CN-ADDQOL)的信度和效度进行评价,旨在为糖尿病患者生存质量的测评提供敏感、有效的工具。方法对697例糖尿病患者采用相关分析和结构方程模型对CN-ADDQOL的信度和效度进行评价。结果CN-ADDQOL的Cronbachα系数为0.941,表明量表具有很好的内部一致性;CN-ADDQOL19个条目的因子载荷均有统计学意义(P<0.05),且绝大部分条目的因子载荷值均在0.4以上,说明量表具有较好的结构效度。结论CN-ADDQOL具有较好的信度和效度,值得推广应用。     

糖尿病自我管理行为量表应用于社区糖尿病患者自我管理中的信度与效度研究

目的：验证糖尿病自我管理行为量表(SDSCA量表)在社区糖尿病患者中应用的信度与效度。方法：使用糖尿病自我管理行为量表调查412名在上海市某社区管理的糖尿病患者,采用内部一致性信度和折半信度检验法评价量表的信度,采用结构效度、集合效度、区分效度和内容效度检验法评价量表的效度。结果：量表的Spearman-Brown系数、Cron bach’sα分别为0.743、0.791。KMO=0.851,Bartlett’s球形检验显示差异有统计学意义(χ²=1931.698,P<0.01),探索性因子分析结果与理论模型一致。验证性因子分析的NFI=0.958,CFI=0.935,GFI=0.928,RMSEA=0.029。集合、区分效度定标试验成功率均为100%。所有条目的I-CVI>0.78,Kappa值>0.74。结论：SDSCA量表内容简洁,条目适量,应用于社区糖尿病病人自我管理,表现出良好的信度与效度。     

高校学生电子媒介健康素养量表的编制及评价

目的编制适合高校学生的电子媒介健康素养量表,并评价该量表的信度和效度。方法通过将eHealth Literacy Scale（eHEALS）翻译为中文,结合文献、定性访谈、预测试进行修订。使用修订后的量表对1163名高校学生的电子媒介健康素养进行评估。结果高校学生电子媒介健康素养量表由20个条目组成,分为3个纬度：健康信息获取能力和健康信息评价能力和健康信息实践能力。量表各个维度的Cronbach＇s α系数在0.836-0.895之间,量表的所有条目的Cronbach＇s α 系数为0.915,说明量表具有较好的内部一致性。量表的因子分析载荷系数在0.451～0.829之间,3个维度与其对应的条目的相关系数有统计学意义（P〈0.05）。1163名学生所得的总分为（68.03-4-13.04）分,各条目平均（3.40±0.08）分。结论高校学生电子媒介健康素养量表有较好的的结构效度、内容效度和内部一致性,可作为评估高校学生电子媒介健康素养的工具。     

中国头颈癌生命质量测定量表QLICP-HN的研制与考评

[目的]研制中国版头颈癌生命质量测定量表QLICP-HN,并对其进行评价。[方法]通过提出量表条目形成条目池、确定条目的形式与回答选项、条目分析与筛选、预调查与量表考评、修改完善制定出中国版的头颈癌患者生命质量测量量表QLICP-HN,并通过133例头颈癌患者进行的生命质量测定对量表进行评价。[结果]5个领域的重测信度均在0.90以上;各领域内部一致性信度的α值均在0.7以上;各条目与其领域的相关系数r值均在0.6以上。该量表在入院治疗后4周就基本上可以反映生命质量的变化。[结论]QLICP-HN中文版具有较好的信度、效度和反应度,可用于中国头颈癌患者的生命质量测定。     

非酒精性脂肪性肝病患者自我管理量表的初步开发及信效度分析

目的初步编制非酒精性脂肪性肝病患者自我管理量表,并对其进行信度和效度检验。方法基于文献研究和半结构访谈法,初步拟定非酒精性脂肪性肝病患者自我管理量表条目池,经2轮专家意见咨询后形成量表初稿,选取218名非酒精性脂肪性肝病患者作为调查对象,整理数据后进行条目筛选和信效度评估。结果编制完成的非酒精性脂肪性肝病患者自我管理量表共包括31个条目和疾病防治管理、日常生活管理、疾病知识管理、心理认知管理、不良生活方式管理5个维度。总量表内部一致性信度(Cronbach'sα)系数为0.899,重测信度系数为0.876,分半信度为0.871;采用主成分分析法提取出的5个公因子之间相关系数为0.127~0.248,各因子与总量表的相关系数为0.308~0.799,总量表的内容效度指数为0.933,各条目的内容效度指数均大于0.8。结论初步编制的非酒精性脂肪性肝病患者自我管理量表具有较好的信度和效度,可为以后相关量表的研究提供一定参考。     

预防医学本科生专业满意度量表编制 及其信度效度研究

摘要:目的　编制具有预防医学专业特色的本科生专业满意度测量量表。方法　查阅文献与专家访谈,构建预防医学本科生专业满意测量条目库,经专家咨询等方法形成“初始量表”。选取109名预防医学本科生进行预试验,探究性因素分析形成“预防医学本科生专业满意度测量量表测试版”。再次选取4所不同学校的250名预防医学本科生完成测试版量表,进行验证性因素分析,形成正式量表后进行量表信度与效度检验。结果　量表由4个维度、39个条目构成,具有较好的内部一致性（α系数大于0.8）与建构信度（ρc大于0.8）,且具有良好的内容效度与结构效度。结论　量表信度、效度均良好,可以应用于预防医学本科生专业满意度的评价。     

职业人群健康素养量表编制及其信度、效度评价

[目的]编制中文版的职业人群健康素养量表,并评价该量表的信度、效度和人群应用效果。[方法]本研究以上海某区城乡常住居民中的在职人员为研究对象。在文献研读和专家咨询的基础上,初定条目;通过走访不同工作性质的在职人员实施认知访谈,修正条目,形成量表初稿。采用多阶段整群随机抽样方法,在全区13个街(镇)逐级抽取居委、楼组和家庭,在调查对象知情同意的基础上,对抽样家庭中的所有在职人员实施调查,收集调查对象的个体特征、健康素养、行为特征等信息。运用Epi Data 3.1软件建立数据库,运用SPSS 18.0软件对量表进行分析评估。[结果]职业人群健康素养量表由26个条目组成,分为7个维度,包括信息评价利用能力、劳动福利利用能力、卫生服务利用能力、工作危害识别能力、工作危害防护能力、职业健康的维权意识和健康意识。因子分析的KMO(Kaiser-Meyer-Olkin)统计值为0.873,提取的7个公因子可解释55.762%的方差变异。各条目在相应维度上的负荷介于0.438~0.928之间,条目与所属维度的相关性有统计学意义(P<0.001)。量表总Cronbach’sα为0.887,各维度Cronbach’sα介于0.654~0.900之间;两次测量结果的内部相关系数ICC为0.938,各个条目的内部相关系数ICC介于0.779~0.956之间,提示量表具有很好的内部一致性和重测信度。将量表测量变量作为数值、分类变量的分析结果显示,量表具有较好的区分能力。[结论]所编制的职业人群健康素养量表具有较好的信度、效度和人群应用效果,可用于职业人群健康素养水平测量。     

基于有限理性的住院患者信任度评价量表研制

以有限理性与患者信任为基础,结合公立医院现状和患者人群特征,开发住院患者信任度评价量表。方法通过鉴别度分析、一致性检验、因子分析等确定编制量表的信度和效度。结果量表所有条目高低分组差异检验均达到0.05的显著水平,内部一致性Cronbach's Alpha系数为0.960,KMO检验值>0.80,Bartlett球型检验P<0.05,因子分析量表维度结构合理。结论基于有限理性的住院患者信任度评价量表有较高的鉴别度、信度和效度,具有一定的适用性、科学性和实用性,可用于住院患者信任度评价。     

社区全科医生糖尿病综合防治知识水平测评的组织

目的对社区卫生服务中心全科医生实施糖尿病综合防治知识测评,了解全科医生掌握的知识水平是否适合社区糖尿病防治工作的需要。方法设计糖尿病综合防治知识测评量表,通过闭卷形式实施知识测评,运用克朗巴哈α信度系数评价测试量表内部一致性。结果知识测评量表信度α系数大于0.86,说明测试量表内部结构一致性较好,可以客观地反映全科医生掌握糖尿病综合防治知识水平;参加知识测评的48名全科医生平均得分63.34分。结论政府相关部门要为全科医生提供糖尿病综合防治知识的系统学习机会,促进全科医生熟练地掌握糖尿病综合防治知识与技能,提高他们控制社区糖尿病管理的效率。     

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.