Health physics: its development, successes, failures, and eccentricities.

Health Physics began at the University of Chicago as a science and profession during the early World War II years. It was initiated by Drs. A.H. Compton and R.S. Stone, director and associate director, respectively, of the early Plutonium Project cryptically called the Metallurgical Laboratory. It was to be a science and a profession to protect radiation workers and members of the public from exposure to ionizing radiation. It succeeded to some extent in this objective but during the past decade in the United States, it has reverted into an organization primarily to protect the nuclear industry from liability resulting from radiation exposure.     

Sex therapy: the successes, the failures, the future.

Sexual dissatisfaction or dysfunction occurs in one fifth to one third of the adult population. Although great advances have been made in the pharmacological treatment of impotence, psychological and relationship therapy remain the mainstay of the treatment of sexual problems within relationships.     

Childhood obesity: successes and failures of preventive interventions

Despite progress toward assuring the health of today's young population, the 21^st century began with an epidemic of childhood obesity. There is general agreement that the situation must be addressed by means of primary prevention, but relatively little is known about how to intervene effectively. The evidence behind the assumption that childhood obesity can be prevented was discussed critically in this roundtable symposium. Overall, there was general agreement that action is needed and that the worldwide epidemic itself is sufficient evidence for action. As the poet, writer, and scholar Wittner Bynner (1881–1968) wrote, "The biggest problem in the world could have been solved when it was small".     

Use of small-bore feeding tubes: successes and failures

PURPOSE OF REVIEW: Early enteral nutrition is the preferred option for feeding patients who cannot meet their nutrient requirements orally. This article reviews complications associated with small-bore feeding tube insertion and potential methods to promote safe gastric or postpyloric placement. We review the available bedside methods to check the position of the feeding tube and identify inadvertent misplacements. RECENT FINDINGS: Airway misplacement rates of small feeding tubes are considerable. Bedside methods (auscultation, pH, aspirate appearance, air bubbling, external length of the tube, etc.) to confirm the position of a newly inserted small-bore feeding tube have limited scientific basis. Radiographic confirmation therefore continues to be the most accurate method to ascertain tube position. Fluoroscopic and endoscopic methods are reliable but costly and are not available in many hospitals. Rigid protocols to place feeding tubes along with new emerging technology such as CO2 colorimetric paper and tubes coupled with signaling devices are promising candidates to substitute for the blind placement method. SUMMARY: The risk of misplacement with blind bedside methods for small-bore feeding tube insertion requires a change in hospital protocols.     

Effects of job insecurity from a workplace closure threat on fatigue and psychological distress

The aim of this study was to prospectively investigate the effect of potential workplace closure, an externally attributed form of job insecurity, on fatigue and psychological distress. In April 1999, the minister responsible announced that a governmental agency would close down one of its two locations. Baseline data from the employees were available before the closure announcement (n = 574) because they were enrolled in the Maastricht Cohort Study on "Fatigue at Work." In the closure group, the relative risk for becoming a psychological distress case was 1.61 (95% confidence interval [CI] = 1.27-2.05) during 13 months after the closure threat. Within the closure group, a difference in relative risk for psychological distress was observed between employees who self reported an increase in job insecurity (relative risk = 1.85; 95% CI = 1.41-2.42) and employees who did not report an increase in job insecurity (relative risk 1.14; 95% CI = 0.58-2.24)     

Fortification strategies to meet micronutrient needs: successes and failures

Food fortification is likely to have played an important role in the current nutritional health and well-being of populations in industrialized countries. Starting in the early part of the 20th century, fortification was used to target specific health conditions: goitre with iodized salt; rickets with vitamin D-fortified milk; beriberi, pellagra and anaemia with B-vitamins and Fe-enriched cereals; more recently, in the USA, risk of pregnancy affected by neural-tube defects with folic acid-fortified cereals. A relative lack of appropriate centrally-processed food vehicles, less-developed commercial markets and relatively low consumer awareness and demand, means it has taken about another 50 years for fortification to be seen as a viable option for the less-developed countries. The present paper reviews selected fortification initiatives in developing countries to identify different factors that contributed to their successful implementation, as well as the challenges that continually threaten the future of these programmes. Ultimately, the long-term sustainability of fortification programmes is ensured when consumers are willing and able to bear the additional cost of fortified foods. There has been an enormous increase in fortification programmes over the last couple of decades in developing countries. Considerable progress has been made in reducing vitamin A and I deficiencies, although less so with Fe, even as Zn and folic acid deficiencies are emerging as important public health problems. Food fortification based on sound principles and supported by clear policies and regulations can play an increasingly large role in this progress towards prevention and control of micronutrient malnutrition.     

Perceived discrimination,psychological distress and health

Racism and discrimination can have significant implications for health, through complex biopsychosocial interactions. Latino groups, and particularly Puerto Ricans, are an understudied population in the United States in terms of the prevalence of discrimination and its relevance to health. Participants in our study were 45‐ to 75‐year‐old (N = 1122) Puerto Ricans. The measures were perceived discrimination, depressive symptomatology (CES‐D), perceived stress (PSS), self‐rated health, medical conditions, blood pressure, smoking and drinking behaviours, demographics. Our findings show that 36.9 per cent of participants had at some time experienced discrimination, with men, those with more years of education, currently employed and with higher incomes being more likely to report it. Experiences of discrimination were associated with increased levels of depressive symptoms and perceived stress. When controlling for covariates, perceived discrimination was predictive of the number of medical conditions, of ever having smoked and having been a drinker, and having higher values of diastolic pressure. Depressive symptoms are a mediator of the effect of perceived discrimination on medical conditions, confirmed by the Sobel test: z = 3.57, p < 0.001. Mediating roles of perceived stress, smoking and drinking behaviours were not confirmed. Increased depressive symptoms might be the main pathway through which perceived discrimination is associated with a greater number of medical diagnoses.     

A test of the relationship between race, socioeconomic status, and psychological distress

Contrary to the general position in the research literature, Kessler and Neighbors have argued that race has independent effects on psychological distress among the lower class in the United States. They claim that lower-class blacks have significantly higher levels of distress than lower-class whites and this result is due to race rather than social class. A test of this proposition is presented in this paper. These data do not support the contention that race makes a difference in levels of psychological distress among the lower class. We found, that, as income increases among blacks and whites, psychological distress decreases and this is especially true for blacks. However, there was no significant difference between blacks and whites at the lowest income levels.     

Age differences in associations between psychological distress and chronic conditions

Objective  

To examine associations between psychological distress (PD) and chronic health conditions among different age groups in a representative population sample.     

大学生心理调适能力与自杀自伤行为的关联

探讨大学生自杀相关心理行为和自伤行为的发生情况及其与自我心理调适能力的关系,为大学生自杀、自伤行为的干预提供基础资料.方法 采用问卷调查的方法,对安徽省合肥市某高校825名大学生进行一般人口特征、心理复原力、自悯、宽恕等方面调查.结果 大学生自杀意念、自杀计划、自杀准备、自杀行动报告率分别为9.9%,3.5%,2.5%和1.8%,自伤行为报告率为11.8%.与宽恕他人维度得分中分组相比,宽恕他人得分偏高是自杀心理行为(OR=0.26)和自伤行为(OR=0.31)的负相关因素(P值均<0.05);心理调适能力各量表总分中,与心理复原力量表(CD-RISC)得分中分组相比,低分组是自伤行为的正相关因素(OR=2.11),高分组是自杀相关心理行为的负相关因素(OR=0.51)(P值均<0.05);与自我怜悯量表及Hearland宽恕量表得分中分组相比,低分组均是自杀相关心理行为的正相关因素(OR值分别为1.66,2.28),高分组均是自杀相关心理行为(OR值分别为0.33,0.44)、自伤行为(OR值分别为0.35,0.39)的负相关因素(P值均<0.05).结论 心理复原力、自我怜悯、宽恕水平与自杀相关心理行为和自伤行为关系密切.高校可通过提高大学生自我心理调适能力来降低自杀、自伤行为的发生风险.     

The relationship between psychosocial work characteristics and fatigue and psychological distress

OBJECTIVES: To examine the associations between psychosocial work characteristics and fatigue in employees in the Maastricht Cohort Study. A second objective was to compare the relationships for fatigue versus psychological distress with these psychosocial work characteristics. METHODS: The design was cross-sectional and included 11,020 employees who responded to the self-administered baseline questionnaire of the Maastricht Cohort Study. Fatigue was measured with the Checklist Individual Strength, a 20-item self-report instrument. Psychological distress was measured with the 12-item version of the General Health Questionnaire. Psychosocial work characteristics comprised: psychological demands, decision latitude, and social support at work as measured by the Job Content Questionnaire, as well as emotional demands at work, physical demands at work, job insecurity, and conflict with supervisor/co-worker, which were assessed with items from existing Dutch questionnaires. RESULTS: Low decision latitude and low social support at work were associated with fatigue in both men and women. Associations were also found between emotional demands at work, job insecurity, physical demands and conflict with supervisor and fatigue in men; and high psychological demands and fatigue in women. As regards psychological distress, there was no association with low decision latitude, but strong associations with emotional demands and conflict with supervisor in both genders. CONCLUSIONS: The study provides strong support for associations between psychosocial work characteristics and fatigue in men and women, even after adjustment for psychological distress. Moreover, it suggests some differential effects of psychosocial work characteristics on fatigue and psychological distress.