洪灾区小学生创伤后应激反应影响因素分析

分析洪灾后小学生创伤后应激反应(PTSR)的影响因素,为灾后小学生心理重建提供参考依据.方法 使用自编洪灾暴露因素问卷、青少年心理韧性问卷(ARS)和修订版儿童事件影响量表(CRIES),对洪灾3个月后茂名市某小学837名小学生进行问卷调查,并用x2检验、线性分层回归等统计方法进行分析.结果 女生PTSR阳性检出率高于男生(P<0.01);洪灾暴露因素问卷中的“生命是否遭受威胁”、“是否目睹他人死亡”和ARS中的“情绪控制”、“积极认知”维度对小学生CRIES总分具有显著性预测作用(R2 =0.18,P<0.01).结论 洪灾时应保护学生避免暴露于恐惧性场景;灾后心理重建应注意性别差异,并着重在情绪调控、积极认知训练等方面提高青少年儿童的心理韧性,以预防或改善其创伤心理.     

Combat stress reactions, posttraumatic stress disorder, cumulative life stress, and physical health among Israeli veterans twenty years after exposure to combat

This study examined the association of initial combat stress reaction (CSR), chronic post-traumatic stress disorder (PTSD) and cumulative life stress on physical health 20 years after the 1982 war with Lebanon, in a sample of 504 Israeli veterans of the war. Two groups were assessed: male veterans who fought and suffered from CSR and a matched group of male veterans from the same units who did not exhibit such reactions. Twenty years following the war, participants were asked to rate their general physical health status, report health complaints and risk behaviors, and were screened for PTSD. CSR and, to a greater extent, PTSD, were found to be associated with general self-rated health, chronic diseases and physical symptoms, and greater engagement in risk behaviors. CSR and PTSD were also related to greater cumulative life stress since the war. Both negative and positive life events were independently related to most of the physical health measures but did not account for the associations of CSR and PTSD with poorer health. Tests of the interactions between CSR, PTSD and life stress in their association with physical health and risk behaviors showed that PTSD suppressed the effects of additional life stress (negative life events had a weaker effect on health among participants with PTSD).     

女大学生人群凉果添加剂暴露的风险评估

目的 评估广式凉果添加剂残留的人群暴露风险,为凉果的风险管理提供依据.方法 以食物频率问卷法收集大学生人群凉果摄入量数据,依国标方法检测凉果中糖精钠、甜蜜素、二氧化硫、苯甲酸、山梨酸5种添加剂残留量,采用点评估和简单分布模型评价广式凉果添加剂的暴露风险.结果 点评估(按平均值估计)显示,5种添加剂摄入量占ADI值的百分比分别为18.29％(二氧化硫)、27.72％(山梨酸)、60.24％(苯甲酸)、68.14％(糖精钠)和94.25％(甜蜜素).简单分布模型则显示,摄入量95％上下限占ADI的百分比分别为:1.24％～1.57％(二氧化硫)、1.73％～2.20％(苯甲酸和山梨酸)、12.61％～15.99％(甜蜜素)、17.33％～21.99％(糖精钠).结论 甜味剂的暴露风险相对高于防腐剂和漂白剂,在凉果消费的安全风险管理中须重视对甜味剂的管理.     

Risk factors for psychological stress among international business travellers

OBJECTIVES: This study investigated sources of self reported psychological stress among international business travellers at the World Bank, following up on a previous study showing that travellers submitted more insurance claims for psychological disorders. Hypotheses were that work, personal, family, and health concerns, as well as time zone travel, contribute to travel stress. METHODS: A travel survey was developed from focus groups and consisted of questions about these potential sources of travel stress. Surveys were sent to a random sample of staff, stratified by number of travel missions, age range, and sex. Canonical correlation analyses estimated the association between key survey items on sources of stress and two measures of travel stress. RESULTS: 498 staff completed the survey. More than a third reported high to very high travel stress. Correlations between predictors and travel stress showed that social and emotional concerns (such as impact of travel on family and sense of isolation) contributed the most to such stress, followed by health concerns, and workload upon return from travel. Surprisingly, time zone travel did not contribute to the self reported stress of these travellers. There were few modifiers of stress, although respondents suggested that a day of rest after travel and reduced workloads would help. CONCLUSIONS: The current study confirms clinical impressions about several correlates of travel stress. Similar research with travellers in other organisations could help to determine whether the findings from this study are valid and what measures can be taken to reduce the psychological health risks to travellers.

 

     

学生精神压力与家庭因素之间的关系

目的 探讨家庭因素对学生多种精神压力的影响,为改善青少年心理健康水平提供依据.方法 整群抽取辽宁省7个地级市城乡大、中学校学生25710名,采用中国青少年健康相关行为调查问卷进行调查.结果 稳定家庭的学生孤独感、失眠、离家出走、学习压力报告率较低.母亲文化程度高的学生学习压力报告率较高,母亲文化程度过低的学生孤独感、尝试出走的报告率较高.不同父亲职业间学生缺乏安全感、孤独感、学习压力、失眠、打算出走及离家出走报告率差异均有统计学意义(P值均＜0.05).结论 应关注母亲文化程度高的学生的学习压力、缺乏安全感,母亲文化程度过低的学生的孤独感、离家出走以及不稳定家庭学生的孤独感、失眠、离家出走、学习压力等方面的问题.     

师范大学生心理压力感影响因素分析

目的分析师范大学生心理压力感的影响因素,为心理健康教育提供依据。方法采用《大学生心理压力感问卷》,评估大学生心理压力感的水平并分析影响因素。结果大学生总体心理压力感水平适中,就业心理压力感和学业压力感水平相对较高,经济与地位压力感和体能与生活压力感相对较低;大学女生的人际交往压力感和就业心理压力感明显高于男生(t=2.024,P<0.05;t=2.956,P<0.001);文科学生的经济与地位压力感和就业心理压力感明显高于理科学生(t=2.768,P<0.05,t=4.152,P<0.0001);大一学生的人际交往压力感水平明显高于大三和大四年级学生(P<0.05);大四学生的学业压力感水平明显低于其他3个年级(P<0.05);大二和大三学生的就业心理压力感明显高于大一和大四(P<0.05);大一学生的总体心理压力感明显高于大四学生(P<0.05)。结论大学生的总体心理压力感存在明显的专业和年级差异,性别及城乡差异不明显。     

深圳市中学生药物滥用危险因素分析

探讨深圳市中学生药物滥用行为的危险因素,为制定预防控制中学生药物滥用的措施提供科学依据.方法 以深圳市635例精神活性物质滥用的中学生作为病例组,按照性别、年龄1:1配对原则,选取635例非药物滥用的中学生作为对照组,进行病例对照研究,采用单因素和多因素条件Logistic回归分析.结果 多因素Logistic逐步回归分析显示,中学生的学习成绩较差(OR=1.32,95%CI=1.02~1.71)、父母滥用药物(OR=3.43,95%CI=1.84~6.40)、亲戚朋友滥用药物(OR=2.08,95% CI=1.26~ 3.43)、同学滥用药物(OR=2.05,95% CI=1.38 ~3.06)、过去吸烟但现在不吸(0R=2.53,95%CI=1.43~4.47)、目前吸烟(OR=2.55,95%CI=1.32 ~4.96)、目前饮酒(OR=1.60,95%CI=1.17~2.17)均为中学生精神活性物质滥用的危险因素(P值均<0.05).结论 对中学生进行药物滥用宣传教育的同时,应加强对其周围人群的干预,建立健康的生活和学习环境,从而有效控制中学生药物滥用行为的发生.     

Risk factors to pesticide exposure and associated health symptoms among cut-flower farmers

The study looked into the risk factors associated with pesticide exposure among cut-flower farmers. A survey questionnaire was given to 102 respondents in Barangay Bahong in La Trinidad, the center of cut-flower production in the Philippines. Results showed that 32% were symptomatic or had experienced pesticide-related illnesses since their first use of pesticides. The majority of the pesticides used by the farmers were Categories Ib and II which are moderately or highly hazardous chemicals. Individuals with signs and symptoms most often centered on the eye, ear, nose and throat (EENT) (44 respondents reporting these symptoms) followed by general and neuralgic (16 respondents) and the integumentary (14 respondents). The most common general signs and symptoms manifested were weakness followed by fatigue and muscle pain then by chills and fever. The most common EENT manifestations were eye itchiness and blurring of vision. For neurological signs and symptoms, dizziness followed by headache was reported. Logistic regression showed that illnesses for the past 12 months were associated with certain risk factors such as farm use of pesticides, exposure to pesticide while applying it, respiratory inhalation of pesticide vapours and mists (p = 0.05). Moreover, those who re-entered a recently sprayed area were 20 times more likely to get ill during the past 12 months than those who did not. Those who used pesticide-contaminated pieces of fabric to wipe sweat off their faces were 2% more likely to get ill, and those who had spills on their bodies while applying pesticide were 26 times more likely to get ill. The study suggested that the risk factors to pesticide exposure should be considered in policy formulations for the cut-flower farmers in the country.     

The effects of a natural disaster on child behavior: evidence for posttraumatic stress.

OBJECTIVES. A prospective study of children examined both before and after a flood disaster in Bangladesh is used to test the hypothesis that stressful events play a causal role in the development of behavioral disorders in children. METHODS. Six months before the disaster, structured measures of selected behavioral problems were made during an epidemiological study of disability among 2- to 9-year-old children. Five months after the disaster, a representative sample of 162 surviving children was reevaluated. RESULTS. Between the pre- and postflood assessments, the prevalence of aggressive behavior increased from zero to nearly 10%, and 45 of the 134 children who had bladder control before the flood (34%) developed enuresis. CONCLUSIONS. These results help define what may be considered symptoms of posttraumatic distress in childhood; they also contribute to mounting evidence of the need to develop and evaluate interventions aimed at ameliorating the behavioral and psychological consequences of children's exposure to extreme and traumatic situations.     

南通市区初中生伤害相关行为现况

了解南通市区初中生伤害相关行为现状,为进一步干预提供依据.方法 分层随机抽取南通市区5所初中学校共1 019名学生,进行伤害相关行为问卷调查,并对性别和年级报告率进行组间比较.结果 经常步行违规的学生占4.71%;曾在不安全场所游泳的占8.73%,出现溺水情况的占2.26%;经常打架(6次以上)的占3.44%,打架受伤的占6.67%,经常被恶意取笑的占6.28%;有自杀意念、计划和自杀未遂的占22.08%,出现离家出走和相关意念的占19.33%;因学习压力大而心情郁闷的高达86.56%,因担心某事而失眠的占54.17%;跌倒受伤的占33.07%,物体砸伤或碰伤的占17.66%,骨折或关节脱臼的占6.48%,火灾烧伤或烫伤的占4.81%,自我伤害受伤占4.51%.结论 南通市初中生伤害相关行为主要表现在交通行为和不良情绪方面,不同性别和不同年级之间伤害行为的发生情况存在差异.     

中南大学大学生自杀意念及其危险因素研究

目的 了解中南大学大学生的自杀意念的出现率及其危险因素。方法 采用自制的自杀意念调查表、症状自评量表(SCL-90)、青少年生活事件量表(ASLEC)、社会支持评定量表(SSRS)以及一般资料调查表,以分层整群抽样方法,调查中南大学三个校区大学生623名。并通过多因素logistic回归模型,筛选出自杀意念的主要危险因素。结果 大学生样本中有14.6％的人最近一年内出现自杀意念,2.5％的人有详细的自杀计划和方法,1.8％的人有过自杀未遂行为。logistic回归分析揭示自杀意念的主要危险因素是对专业不满意、社会支持少、负性生活事件多以及抑郁倾向。结论大学生样本中自杀意念发生率较高,因此,根据大学生自杀意念的主要危险因素采取必要的预防措施是当前迫切需要解决的问题。     

某三甲医院医务人员血源性职业暴露危险因素分析

目的分析医务人员血源性职业暴露情况及相关危险因素,为医务人员有效规避血源性职业暴露风险提供参考。方法回顾性调查某三甲医院2012-2016年医务人员职业暴露情况,统计分析发生血源性职业暴露医务人员的年龄、工作年限、职称、职务、暴露方式、暴露部位、暴露源种类以及暴露发生的场所等情况。结果 79名发生血源性职业暴露的医务人员中≤30岁的占73.41%、工作年限≤10年的占87.34%、初级职称的占82.28%;护士是发生血源性职业暴露的主要群体,占67.09%;职业暴露发生场所以外科为主,占54.43%,高于内科(39.24%)和医技科室(6.33%);针头扎伤是医务人员发生血源性职业暴露的主要暴露方式,占83.54%;手指是主要暴露部位,占75.95%;HBV是主要的潜在感染源,占64.37%。结论对于血源性职业暴露事件,低年资医务人员和护士、外科科室、针头扎伤是发生职业暴露的高危因素。应针对发生血源性职业暴露高危因素做好职业防护宣教,制定科学、合理的防范措施,降低医务人员职业暴露概率。     

中国中学生抑郁症状危险因素的Meta分析

目的 明确中国中学生抑郁症状的危险因素,为防控工作提供参考。方法 检索中国知网（CNKI）、中国生物医学文献数据库（CBM）、维普（VIP）、万方、PubMed、Embase、Web of Science、Medline等数据库公开发表的有关中国中学生抑郁症状危险因素的文献,采用Stata 16.0软件进行Meta分析。结果 最终纳入文献38篇,累计样本量182 813,Meta分析结果显示,女生（OR=1.273,95%CI: 1.165～1.390）、高中学段（OR=1.561,95%CI: 1.255～1.942）、高年级（OR=1.206,95%CI: 1.120～1.299）、网络成瘾（OR=3.592,95%CI: 2.586～4.990）、学业成绩差（OR=2.148,95%CI: 1.711～2.698）、吸烟（OR=1.519,95%CI: 1.295～1.780）、饮酒（OR=1.544,95%CI: 1.375～1.757）、失眠（OR=3.538,95%CI: 3.075～4.070）、睡眠时间＜6h/d（OR=2.146,95%CI: 1.812～2.542）、遭受校园欺凌（OR=2.544,95%CI: 2.238～2.891）、超重肥胖（OR=1.439,95%CI: 1.289～1.607）等因素是中国中学生抑郁症状的危险因素。结论 女生、高中学段、高年级、网络成瘾、学业成绩差、吸烟、饮酒、失眠、睡眠时间＜6h/d、遭受校园欺凌、超重肥胖的中国中学生更容易产生抑郁症状。     

Risk factors for exposure to environmental tobacco smoke among ethnically diverse women in the United States

The likelihood of exposure to environmental tobacco smoke (ETS) has been shown to vary across sociodemographic characteristics, health behaviors, and the type of smoking restrictions at work. Women may be particularly at risk. The purpose of our study was to assess differences in the likelihood of exposure to ETS at home and at work among an ethnically diverse sample of women age 40 and older in the United States. We used data from the U.S. Women's Determinants Study and restricted the sample to include only nonsmoking women (n = 2326). Unadjusted and adjusted odds ratios (aOR) for exposure to ETS by sociodemographic characteristics, health risk behaviors, and the type of workplace smoking policy were calculated using logistic regression. Exposure to ETS at home was associated with being American Indian/Alaska Native (aOR 1.5, 95% CI 1.0, 2.6), age 40-44 (aOR 1.6, 95% CI 1.0, 2.6) and 45-54 (aOR 1.8, 95% CI 1.2, 2.6), having eighth grade (aOR 2.1, 95% CI 1.3, 3.6) or high school education (aOR 2.2, 95% CI 1.4, 3.3), inadequate fruit and vegetable consumption (aOR 1.5, 95% CI 1.0, 2.1), and not getting screened for breast cancer (aOR 1.5, 95% CI 1.1, 2.0). Women who did not have regular breast (aOR 1.3, 95% CI 1.9, 1.9) and cervical (aOR 2.0, 95% CI 1.5, 5.3) cancer screening were more likely to be exposed to ETS at work. Exposure to ETS at work was higher among women with some high school education (aOR 2.8, 95% CI 1.5, 5.3) and high school graduates (aOR 3.1, 95% CI 1.9, 5.1) and substantially higher for women who worked where smoking was allowed in some (aOR 15.1, 95% CI 10.2, 22.4) or all (aOR 44.8, 95% CI 19.6, 102.4) work areas. Larger effect sizes were observed for the relationship between selected risk factors and ETS exposure at work than for ETS exposure at home. Among individual risk factors, lower education level was most strongly related to ETS exposure at work. The likelihood of being exposed to ETS at work was highest for women whose workplace smoking policies allowed smoking in some or all work areas.     

阜阳市城郊小学生烧伤影响因素分析

了解阜阳市城郊小学生烧伤发生现状及其影响因素,为预防小学生烧伤的发生提供参考.方法 采用分层整群随机抽样方法,随机抽取阜阳市城郊2所小学,共调查小学生1 223名,分析小学生烧伤发生情况及影响因素.结果 1 223名小学生中,检出烧伤者126名,检出率为10.3%.其中男生烧伤90名,女生烧伤36名,男生烧伤检出率(14.2%)高于女生(6.1%)(x2=21.768,P<0.05);不同年级组学生烧伤检出率差异有统计学意义(x2=24.496,P<0.05),一、二年级组最高(15.3%),五、六年级组最低(4.8%).热水烫伤占烧伤原因构成中最高,为69.8%.农村务工家庭及监护人文化程度为小学及以下的小学生烧伤检出率最高,分别为8.3%,6.9%.多因素分析结果显示,性别、年级、家庭类型及监护人文化程度等是小学生烧伤的主要影响因素(OR值分别为0.669,0.776,0.694,0.760).结论 阜阳市城郊小学生烧伤检出率较高.建议从学校、家庭、社会等方面加大健康教育力度,以降低小学生烧伤的发生.     

Risk factors for cigarette smoking among high school students in Okinawa, Japan

The purpose of this study was to examine the relationships between risk factors and smoking status among high school students in Okinawa, Japan. We also examined if there is a dose-response relation between the number of risk factors and smoking status. Self-reported questionnaires including smoking status and potential risk factors were conducted using a sample of 1,029 students of a public senior high school in Okinawa. The percentage of smokers was 40.0% for males and 10.6% for females, and it was significantly higher for males than females. As a result of multivariate analysis, we identified four significant risk factors; peer smoking, attitude of peer toward subject smoking, intention to smoke at the age 20, and alcohol drinking. The number of these risk factors was linearly associated with increased percentage of smokers, and a linear trend was significant for both gender students. Additionally, magnitude of risk for smoking among females became considerably great compared with those of males as the number of risk factors increased. In conclusion, this study was the first study in Japan to indicate a significant dose-response relationship between the number of risk factors and smoking status among high school students. We also found that females with many risk factors had extremely increased vulnerability to smoking compared to male counterpart. These findings may be useful to identify high-risk students who need more intensive smoking prevention programs and to develop the content of effective interventions.     

产科护士血源性病原体职业暴露的影响因素及预防措施

目的 了解产科护士血源性病原体职业暴露的现状及影响因素,并探讨预防措施.方法 采用回顾性调查方法,对宁波市3所医院90名产科护士进行调查,分析产科护士血源性病原体职业暴露的现状及影响因素.结果 84份调查问卷中58名产科护士存在经皮损伤的职业暴露史,暴露率为69.1％;44名产科护士存在黏膜接触的职业暴露史,暴露率为52.4％;大部分产科护士对职业暴露相关知识掌握较好,但仍有较大的提高空间;工作年限、职称、职业暴露相关知识掌握水平、参加职业暴露预防相关培训,积极穿戴护具等是产科护士血源性病原体职业暴露的影响因素.结论 产科护士血源性病原体职业暴露的影响因素较多,可从提高护理人员自身水平、加大社会支持、加强有效行政干预等方面预防产科护士职业暴露的发生.     

医学实习生血源性物质职业暴露及影响因素分析

目的 了解医学实习生血源性物质职业暴露情况,并分析其影响因素.方法 采用分层整群抽样的方法,对某医学院护理、临床、检验医学专业的510名实习生进行问卷调查,数据统计分析用SAS 9.1软件.结果 实习1年期间,27.70%(141/509)发生过血源性物质暴露,溅入黏膜占31.19%,针头等锐器伤占66.06%,沾染伤口等其他暴露占2.75%,暴露后68.93%进行了登记,84.47%进行了立即处理;单因素分析结果表明:文化程度、专业、防护知识、培训情况与血源性物质暴露有统计学联系(P<0.05);多元logistic回归分析显示,护理和检验专业以及不知道如何处理锐利废弃物是发生血源性物质暴露的独立危险因素,与临床专业相比,护理和检验专业的学生血源性物质暴露的风险分别增高64%和287%,不知道如何处理用过的锐利废弃物者发生血源性物质暴露的风险是知道者的1.64倍.结论 医学实习生存在较高的血源性物质暴露率,主要与专业和锐利废弃物处理不当有关.