2010年世界博览会安保某部队官兵焦虑和抑郁状况及其影响因素研究

目的了解世博安保一线部队官兵焦虑、抑郁状况及其影响因素,为后期干预提供依据。方法 2010年8月在上海世博会安保某屯兵点随机抽取200名官兵为研究对象。采用焦虑自评量表(SAS)和抑郁自评量表(SDS)对调查对象进行焦虑和抑郁状况评价,采用简明应对方式问卷和社会支持评定量表对影响焦虑和抑郁情绪的因素进行评价。结果共收回有效问卷182份,有效率91.0%。研究对象焦虑和抑郁发生率分别为19.2%和37.4%,高于常模(P<0.05)。SAS标准分均分为41.78±10.64分,与社会支持、客观支持、支持利用呈成负相关(P<0.05),与主观支持无相关性,与消极应对方式成正相关(P<0.05)。SDS标准分均分为44.50±10.80分,与社会支持、客观支持呈负相关(P<0.05),与主观支持、支持利用度没有相关性,与消极应对方式呈正相关(P<0.05)。军龄是焦虑发生率的影响因素,是否独生子女、年龄、文化程度、家庭所在地、参加安保时间与官兵焦虑和抑郁发生率没有关系。结论执行世博安保任务中期部队官兵有较高的焦虑、抑郁发生率,官兵的社会支持和应对方式对焦虑、抑郁情绪有影响。     

孕产妇焦虑和抑郁与产后抑郁症的关系

目的探讨孕产妇焦虑和抑郁情绪与产后抑郁症的关系。方法用医院焦虑自评量表(SAS)、抑郁自评量表(SDS)调查59例孕妇,比较孕妇在孕期、产时的焦虑与抑郁评分,并以艾迪产后抑郁量表(EPDS)跟踪调查至产后42 d,EPDS≥13分为阳性,即可确诊为产后抑郁症。结果产时SAS评分(46.02±9.12)和SDS评分(53.24±9.45)明显高于孕期SAS评分(36.12±11.51)和SDS评分(45.00±12.03),差异有统计学意义(P<0.01);EPDS≥13分(产后抑郁症)9例,阳性率为15.25%。9例产后抑郁症患者产时焦虑与抑郁评分较高。结论产时焦虑和抑郁情绪比孕期重;产时焦虑和抑郁情绪与产后抑郁症的发生有关。     

海训官兵睡眠质量与焦虑抑郁的关系

目的了解海训官兵的睡眠质量与焦虑抑郁情绪之间的关系,并探讨影响睡眠质量的相关因素。方法采用匹兹堡睡眠质量指数(PSQI)、焦虑自评量表(SAS)、抑郁自评量表(SDS),对某部764名海训官兵进行调查。结果43.0%海训官兵睡眠质量较差,21.5%的官兵有焦虑情绪,61.3%的官兵存在抑郁,且19.9%的官兵焦虑、抑郁情绪并存。PSQI总分与SAS、SDS得分呈正相关,相关系数分别为0.55和0.48。多元回归分析结果表明,影响PSQI总分的因素,按其回归系数依次为睡眠效率(0.79)、睡眠时间(0.71)、日间功能障碍(0.65)、睡眠质量(0.64)、入睡时间(0.59)、睡眠障碍(0.57)和催眠药物(0.13)。结论焦虑、抑郁情绪是影响海训官兵睡眠质量的重要因素,海训期间全程的心理辅导十分必要。     

某部密闭驻训官兵负性情绪调查与对策分析

目的观察密闭驻训官兵负性情绪特点,探讨针对性干预策略。方法采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、症状自评量表(SCL-90)对83名密闭生存官兵分别在驻训前、驻训1周后、驻训2周后进行动态情绪测评,观察负性情绪变化特征,并通过Logistic回归分析负性情绪的相关因素。结果 (1)官兵密闭驻训后负性情绪明显,驻训1周SAS评分为(37.60±2.12)、SDS为(35.71±3.29)、SCL-90总分为(138.20±5.73),驻训2周SAS评分为(41.53±1.87)、SDS为(39.50±3.12)、SCL-90总分为(149.31±7.12),均显著高于军人常模(P0.01)。(2)驻训1周、驻训2周负性情绪显著高于驻训前(P0.01),驻训2周显著高于驻训1周(P0.05),驻训1周SCL-90躯体化、焦虑、抑郁、恐怖和精神病性因子分较驻训前明显增高(P0.01),驻训2周躯体化、焦虑、抑郁、恐怖因子分较驻训1周进一步增高(P0.05);(3)年龄、参训情况和学历为负性情绪的对抗因素,有助于降低负性情绪反应;独生子女为负性情绪的危险因素,其OR值为2.455。结论密闭驻训官兵负性情绪明显,需要根据驻训进程和个体情况开展针对性心理干预。     

心理护理对提高急诊护理质量的效果分析

目的探讨心理护理对提高急诊科护理质量的效果。方法总结2011年1月—2012年1月159例急诊阑尾炎患者护理干预经验,并比较干预前后患者焦虑自评量表得分和抑郁自评量表得分变化情况,并统计患者干预前后生命体征的变化。结果干预前患者心率明显快于干预后[(85.6±5.9)次/min](P<0.05),同时干预前患者收缩压和舒张压亦显著高于干预后[(123.4±13.9)mm Hg、(77.1±13.6)mmm Hg](P<0.05),干预后患者焦虑自评量表[(31.9±2.6)分]和抑郁自评量表得分[(32.5±2.8)分]均恢复到正常范围,且显著低于干预前(P<0.05)。结论在急诊科实施有效的心理护理干预能稳定患者心理情绪减轻焦虑,更好的维持患者生命体征的平稳。     

HIV感染者和AIDS病人心理状况及影响因素分析

目的了解艾滋病病毒(HIV)感染者和艾滋病(AIDS)病人的心理状态及其影响因素,为制定相关的干预策略提供科学依据。方法采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、社会支持评定量表(SSS)对36名HIV感染者和AIDS病人进行面对面的问卷调查,资料用SPSS11.5统计分析。结果 HIV感染者和AIDS病人SAS得分是38.72±3.04,SDS得分是47.36±3.67,均显著高于全国常模(分别为t=5.783,t=7.445,P均<0.01);SSS总分是29.69±1.80,显著低于全国常模(t=5.301,P<0.01)。性别、婚姻状况、配偶HIV感染状况和社会支持情况是负面情绪的影响因素。结论在HIV感染者/AIDS病人中普遍存在焦虑抑郁情绪,应加强心理咨询和心理干预。     

神经内科患者焦虑与抑郁症状的临床研究

目的:分析神经内科住院患者焦虑及抑郁状况.方法:回顾性分析2011年1~12月医院收治的神经内科住院患者160例的临床资料,应用焦虑自评量表(SAS)、抑郁自评量表(SDS)统计患者的焦虑、抑郁状况.结果:癫痫患者中焦虑伴抑郁的发生率女性(61.9%)明显高于男性(26.1%);脑卒中患者中,焦虑症状女性发生率为(46.9%)明显高于男性(18.2%),差异均有统计学意义(P<0.05).针对患有焦虑、抑郁的患者实施14d的心理干预后患者的HAMA评分为(7.41±1.25)分低于干预前的(15.12±2.36)分,抑郁、焦虑症状均优于干预前,差异均有统计学意义(P<0.05).结论:分析神经内科住院患者的焦虑、抑郁情况,有助于护理人员有针对地制定措施进行干预,缓解患者不良情绪,提高其治疗效果.     

生活事件对孕妇情绪的影响

目的:探讨日常生活事件对孕妇情绪的影响,为孕期保健提供依据。方法:利用方便抽样抽取293例孕妇,采用焦虑自评量表(SAS)、抑郁自评量表(SDS)和自评生活事件量表(LES)对孕妇进行问卷调查。采用SPSS 11.5建立数据库并进行统计分析。结果:孕妇抑郁、焦虑症状检出率分别为5.5%、8.2%,生活事件总分为(223.18±129.30)分,负性生活事件总分为(79.89±63.80)分。负性生活事件与抑郁、焦虑显著相关(P<0.01)。结论:孕妇孕期经历的日常生活事件和焦虑、抑郁情绪相关。应采取有效措施,尽量减少负性生活事件的发生,帮助孕妇顺利、安全度过妊娠和分娩期。     

辽宁省艾滋病病毒感染者/病人焦虑和抑郁状态分析及影响因素研究

目的了解辽宁省艾滋病病毒感染者/病人的心理健康状况,分析影响心理健康的社会因素,为其心理干预提供依据。方法应用焦虑自评量表(SAS)和流调用抑郁自评量表(CES-D)对775名辽宁省沈阳、大连、抚顺、丹东4个城市可随访的艾滋病病毒感染者/病人进行流行病学调查。结果被调查者焦虑标准分为49.30±11.77,抑郁标准分为22.50±10.81,均显著高于中国常模。性别、婚姻、文化程度对焦虑和抑郁情绪的产生具有统计学意义,年龄对抑郁情绪的产生具有统计学意义。结论艾滋病病毒感染者/病人的焦虑和抑郁情绪状态应引起足够重视,并采取有针对性的干预措施加以改善,以提高心理健康水平。     

老年冠心病负性情绪的综合心理干预

目的探讨心理干预对老年冠心病患者负性情绪的影响。方法选择67例老年冠心病患者,应用焦虑自评量表(SAS)、抑郁自评量表(SDS)及症状自评量表(SCL-90)评定患者情绪状况,分为干预组35例和对照组32例,干预组采用常规治疗加综合心理干预,比较两组疗效。结果干预组症状明显改善,p<0·01。结论老年冠心病人住院期间进行全程心理干预,可减轻和缓解焦虑抑郁和躯体症状,有效地促进患者康复。     

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.     

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.     

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.     

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.