特大爆炸事故幸存者创伤后应激障碍的初步研究

  目的  探讨事故灾难后民众创伤后应激障碍（PTSD）和抑郁状况及其影响因素。  方法  2015年10 — 12月,采用整群取样的方法选取天津经济技术开发区21家企业的2 456名员工,运用PTSD平民版筛查问卷（PCL-C）,简版流调中心抑郁量表（CES-D-10）和简版心理韧性量表（CD-RISC-10）进行调查。  结果  PTSD、抑郁、二者共病检出率分别为20.09 %、28.29 %、14.36 %,男性的PTSD检出率以及PTSD和抑郁的共病检出率明显高于女性（22.37 % vs 17.27 %,χ² = 9.37,P < 0.01; 15.87 % vs 12.50 %,χ² = 5.33,P < 0.05）,抑郁检出率无性别差异（χ² = 1.12,P > 0.05）。logistic回归分析显示,影响PTSD、抑郁和二者共病的因素分别为身体受伤（OR = 2.430,P < 0.01; OR = 1.863,P < 0.05; OR = 1.903,P < 0.05）、爆炸造成严重损失（OR = 1.343,P < 0.01;OR = 1.464,P < 0.001; OR = 1.513,P < 0.001）、心理韧性（OR = 0.335、0.274、0.275,Ps < 0.001）。  结论  身体受伤、爆炸造成严重损失是PTSD和抑郁的风险因素,而心理韧性是PTSD和抑郁的保护因素。     

急诊科护士职业价值观与工作环境的相关性研究

  目的  了解中国急诊科护士抑郁症状发生情况及影响因素。  方法  于2019年7 — 9月采用多阶段分层抽样方法,在中国内地31个省（自治区、直辖市）抽取20 136名工作时间 ≥ 6个月的急诊科护士进行自填问卷调查,应用SPSS 22.0进行一般描述性统计、χ²检验及多因素二元logistic回归分析。  结果  急诊科护士抑郁症状发生率为26.82 %。多因素二元logistic回归分析显示,年龄 ≥ 45岁（OR = 0.710）、已婚（OR = 0.707）、高级职称（OR = 0.677）、自评健康状况好（OR = 0.276）或一般（OR = 0.506）、睡眠质量好（OR = 0.358）或一般（OR = 0.575）是急诊科护士抑郁症状发生的保护因素;饮酒（OR = 1.425）或已戒酒（OR = 1.391）、日均工作时长 ≥ 10 h（OR = 1.272）、工作压力较大（OR = 2.358）或非常大（OR = 5.731）、曾经历工作场所暴力（低频次：OR = 1.675;中频次：OR = 3.290;高频次：OR = 5.982）是急诊科护士抑郁症状发生的危险因素。  结论  工作压力、不良的行为生活方式、工作场所暴力与急诊科护士抑郁症状显著相关,需结合中国医疗卫生体系现状完善急诊科护士的工作结构和管理方案。     

互联网使用对中老年人心理健康的影响: 异质性特征与作用机制检验

  目的  了解中国老年人互联网使用现状及其对抑郁症状影响,为提高老年人心理健康、降低抑郁的发生提供参考依据。  方法  收集2018年中国家庭追踪调查（CFPS）数据中6302名 ≥ 60岁老年人的相关数据,分析中国老年人互联网使用现状及其对抑郁症状的影响。  结果  6302名 ≥ 60岁中国老年人中,使用互联网者789人,互联网使用比例为12.52 %;抑郁症状阳性537例,检出率为8.52 %。在控制了性别、年龄、文化程度、婚姻状况、户口类型、是否有医疗保险、是否领取养老保险、是否吸烟、是否饮酒、是否锻炼、是否患慢性病、生活自理程度、与子女联系频率、与子女关系和自评健康状况等混杂因素后,多因素非条件logistic回归分析结果显示,使用互联网中国老年人出现抑郁症状阳性的风险为不使用互联网中国老年人的0.444倍（OR = 0.444, 95 % CI = 0.268～0.735）。  结论  中国老年人互联网使用率较低,使用互联网有助于降低老年人的抑郁患病风险。     

Development of a scale to measure symptoms of anxiety and depression in the general UK population: the psychiatric symptom frequency scale.

OBJECTIVES: The psychiatric symptom frequency (PSF) scale was developed to assess symptoms of anxiety and depression (i.e. affective symptoms) experienced over the past year in the general population. This study aimed to examine the distribution of PSF scores, internal consistency, and factor structure and to investigate relationships between total scores for this scale and other indicators of poor mental health. PARTICIPANTS: The Medical Research Council national survey of health and development, a class stratified cohort study of men and women followed up from birth in 1946, with the most recent interview at age 43 when the PSF scale was administered. MAIN RESULTS: The PSF scale showed high internal consistency between the 18 items (Cronbach's alpha = 0.88). Ratings on items of the scale reflected one predominant factor, incorporating both depression and anxiety, and two additional factors of less statistical importance, one reflecting sleep problems and the other panic and situational anxiety. Total scores were calculated by adding 18 items of the scale, and high total scores were found to be strongly associated with reports of contact with a doctor or other health professional and use of prescribed medication for "nervous or emotional trouble or depression," and with suicidal ideas. CONCLUSIONS: The PSF is a useful and valid scale for evaluating affective symptoms in the general population. It is appropriate for administration by lay interviewers with minimal training, is relatively brief, and generates few missing data. The total score is a flexible measure which can be used in continuous or binary form to suit the purposes of individual investigations, and provides discrimination at lower as well as upper levels of symptom severity.     

Validation of the Rasch-based Depression Screening in a large scale German general population sample

Background  

The study aimed at presenting normative data for both parallel forms of the "Rasch-based Depression Screening (DESC)", to examine its Rasch model conformity and convergent and divergent validity based on a representative sample of the German general population.     

Restrained eating (weight concerns) in the general population and among students

Restrained eating in a random sample of 2115 adults was studied as part of a broad health survey. Interview questions were derived from Herman and Polivy's Restraint Scale (1975, 1980). Restrained eaters were predominantly normal and overweight women under 65 years of age. Significantly more women (20.7%) than men (8.9%) were restrained eaters. A similar prevalence of restrained eating was observed in students and same-age nonstudents. There was substantial overlap (but not congruence) between respondents who were dieting and being a restrained eater. Binge eating was reported more often by restrained eaters than unrestrained subjects. The relationship between restrained eating and bulimia-related atypical eating disorders is discussed.     

The relationship between the visual analog scale and the SF-36 scales in the general population: an update.

OBJECTIVE: To update the 1993 relationship between the visual analog scale (VAS) and the 8 SF-36 scales found in the Israeli Jewish urban population aged 45 to 75 years and reported in Medical Decision Making. METHODS: Interviews with a sample of 2505 persons representing the same population in 2000 were used to estimate the above relationship. RESULTS: The distributions of the VAS and the SF-36 8 scales were similar in 1993 and in 2000. In 2000, the Role-Emotional scale was not associated with the VAS, while the General Health scale proved to be its major determinant. Generally, the effects of the SF-36 scales on the VAS did not change between 1993 and 2000. DISCUSSION: The relationship between the VAS and the SF-36 scales was found generally stable in the general population between 1993 and 2000, controlling for sociodemographic changes. The estimated relationship might be useful in predicting VAS scores from SF-36 scales in the general population.     

Adapting the Jalowiec coping scale in Norwegian adult psoriasis patients

The aim of the present study was to adapt the Jalowiec Coping Scale (JCS) to accommodate adult patients with psoriasis. The sample comprised 334 patients who were treated consecutively at three dermatology departments in the eastern Norway. A total number of 273 hospitalised patients (20) and out-patients (80) completed the questionnaire, yielding a response rate of 82. The study assessed the reliability and the face, content and construct validity of the Norwegian version of the JCS. In addition, researchers investigated the most frequently used/effective coping strategies, the relationships between demographic/clinical variables, self-reported physical symptoms and the use of coping strategies. The results (correlational coefficients and interitem s) indicated that there was an overlap in substantive content among the original JCS' subscales, due either to measurement error (bias or response style) and/or because the patients in the present study were in a demanding situation in relation to their disease, which may have activated a variety of coping strategies. A factor analysis resulted in a three-factor solution (confrontive problem-solving, normalising/optimistic and combined emotive) with satisfactory internal consistency. This factor solution comprised 31 items with an explained variance of 37 of the total pool of items. The most frequently used and effective coping strategies could be labelled as emotion-focused (optimistic/maintain control). Significant correlations were found between age, hospital setting, self-reported physical symptoms and different coping subscales. However, further studies are needed to assess the validity and reliability of the JCS among different population groups in Norway.     

Fatigue in the general population: a translation and test of the psychometric properties of the Norwegian version of the fatigue severity scale

OBJECTIVE: A study was undertaken to test the psychometric properties of the Fatigue Severity Scale (FSS), and to explore the relationship between fatigue and sociodemographic variables in the general population. METHOD: A national representative sample of 1893 respondents was randomly selected from a pool of 4,000 Norwegians aged 19-81 years. A mailed questionnaire that included the FSS was used to measure fatigue severity. RESULTS: The FSS showed satisfactory internal consistency (Cronbach's alpha 0.88). The prevalence of high fatigue (FSS score > = 5) was 23.1% in the total sample. More women (26.2%) than men (19.8%) experienced high fatigue (p = 0.004). Respondents with chronic illness (more than six months) reported a higher mean (M = 4.69, SD = 1.35) than the rest of the sample (M = 3.67, SD = 1.17) (p<0.001). An inverse correlation was found between fatigue and level of formal education (r = 0.20, p<0.001). CONCLUSION: The psychometric properties of the Norwegian version of FSS were satisfactory. To avoid over-diagnosing people for high level of fatigue, the threshold for high fatigue probably should be 5 on the FSS scale instead of 4 as had been suggested originally, but further validation of the cut-off point is needed.     

Reference intervals for blood Cd and Pb in the general population of Sardinia (Italy)

The reference values (RVs) for blood Cd and Pb of 215 adult subjects non-occupationally exposed and living in Sardinia (insular Italy) were assessed. Age, sex, smoking, alcohol drinking and living area were used to stratify the reference group. After collection from volunteers, samples were acid digested in a microwave oven and metals were determined by sector field inductively coupled plasma mass spectrometry. The RVs expressed as 5th-95th percentiles (geometric mean, GM) were 0.24-1.82 μg/l (0.53 μg/l) for blood Cd and 13.2-87.3 μg/l (33.4 μg/l) for blood Pb. Females had GM levels of Cd (0.58 μg/l) higher than males (0.49 μg/l); subjects aged <40 years had less Cd (0.44 μg/l) than old subjects (>60 years; 0.56 μg/l); Cd in smokers (1.23 μg/l) was 3-times higher than in non-smokers (0.42 μg/l) and correlated with the number of cigarettes per day. The alcohol intake and place of living did not influence blood Cd. The GM values of blood Pb in males (44.4 μg/l) were higher than in females (24.7 μg/l); subjects less than 40 years-old (27.5 μg/l) showed lower Pb than elderly individuals (>60 years, 41.2 μg/l); drinkers (42.2 μg/l) had Pb 2-times higher than non-drinkers (24.4 μg/l). Blood Pb was not significantly affected by smoking and place of living. As revealed by multiple linear regression, the predictor variables were, in order of weight, smoke ? age for blood Cd levels, and sex = age ? alcohol for blood Pb levels.     

深圳市人群庚型肝炎病毒感染状况调查

目的 探讨深圳市一般人群中庚型肝炎病毒（HGV）感染情况及其影响因素。方法 随机抽取研究对象,用酶联免疫反应法（ELISA）检测该人群中抗－HGV,对阳性者用逆转录PCR（RT－PCR）检测血清中HGV RNA。结果 抗－HGV阳性率为9.33%。男女分别为9.51%和9.13%;HGV RNA阳性率为2.33%,男女分别为2.45%和2.20%,年龄组间抗－HGV和HGV RNA阳性率差异均无显著性;单因素和logistic回归分析未显示肝炎病史、近期手术史、注射史、拔牙史及乙型肝炎疫苗接种史等因素与HGV感染有关,职业人员中以中学生及教师的HGV RNA阳性率较高。结论 深圳市一般人群中HGV感染率较高,但其流行因素尚等进一步研究。     

An estimation of the daily intake of di(2-ethylhexyl)phthalate (DEHP) and other phthalates in the general population.

We analyzed 85 urine samples of the general German population for human specific metabolites of phthalates. By that we avoided contamination with the parent phthalates being omnipresent in the environment and for the first time could deduce each individual's internal exposure to phthalates without contamination. Determined were the secondary metabolites mono(2-ethyl-5-hydroxyhexyl)phthalate (5OH-MEHP) and mono(2-ethyl-5-oxo-hexyl)phthalate (5oxo-MEHP) of di(2-ethylhexyl)phthalate (DEHP) and the primary monoester metabolites of DEHP, di-noctylphthalate (DnOP), di-n-butylphthalate (DnBP), butylbenzylphthalate (BBzP) and diethylphthalate (DEP). Based on these internal exposure values we calculated the daily intake of the parent phthalates using urinary metabolite excretion factors. For DEHP we determined a median intake of 13.8 micrograms/kg body weight/day and an intake at the 95th percentile of 52.1 micrograms/kg body weight/day. The tolerable daily intake (TDI) value settled by the EU Scientific Committee for Toxicity, Ecotoxicity and the Environment (CSTEE) is 37 micrograms/kg body weight/day. Twelve percent of the subjects (10 out of 85 samples) within our collective of the general population are exceeding this value. Thirty-one percent of the subjects (26 out of 85 samples) had values higher than the reference dose (RfD) of 20 micrograms/kg body weight/day of the U.S. Environmental Protection Agency (EPA). For DnBP, BBzP, DEP and DnOP intake values at the 95th percentile were 16.2, 2.5, 22.1 and 0.42 micrograms/kg body weight/day respectively. Our results unequivocally prove that the general German population is exposed to DEHP to a much higher extent than previously believed. This is of greatest importance for public health since DEHP is not only the most important phthalate with respect to its production, use, occurrence and omnipresence but also the phthalate with the greatest endocrine disrupting potency. DEHP is strongly suspected to be a developmental and reproductive toxicant. We are not aware of any other environmental contaminant for which the TDI and RfD are exceeded to such an extent within the general population. The transgressions of the TDI and RfD for DEHP are accompanied by considerable ubiquitous exposures to DnBP and BbzP, two phthalates under scrutiny for similar toxicological mechanisms.     

Carpal tunnel syndrome: prevalence in the general population.

To study the prevalence of carpal tunnel syndrome (CTS) in the general population and the value of brachialgia paraesthetica nocturna (BPN) in diagnosing CTS, an age and sex stratified random sample of 715 subjects was taken from the population register of Maastricht (The Netherlands) and surrounding villages, between September 1983 and July 1985. The response rate was 70%. Of these, 12 CTS cases had already been diagnosed. Of the remaining subjects, 64 (13 men, 51 women) woke up because of BPN. Among these subjects 1 man and 23 women were found to have CTS. The prevalence rate of undetected CTS was 5.8% [95% confidence interval (CI): 3.5-8.1%] in adult women; 3.4 percent (95% CI: 1.5-5.3%) had already been diagnosed as CTS. The overall prevalence rate for men was 0.6% (95% CI 0.02-3.4%). These figures have to be regarded as minimal estimates. The overall diagnostic value of BPN for CTS was 38%, while for women only this was 45% (95% CI: 31-60%).     

Transvestic fetishism in the general population: prevalence and correlates

We used a random sample of 2,450 18-60 year-olds in the general population of Sweden to study the prevalence as well as the social, sexual, and health correlates of transvestic fetishism (sexual arousal from cross-dressing). Almost three percent (2.8%) of men and 0.4% of women reported at least one episode of transvestic fetishism. Separation from parents, same-sex sexual experiences, being easily sexually aroused, pornography use, and higher masturbation frequency were significantly associated with transvestic fetishism. A positive attitude to this sexual practice and paraphilia indicators--sexual arousal from using pain, exposing genitals to a stranger, and spying on others having sex--were particularly strong correlates to the dependent variable.