产褥期抑郁状态测评及其影响因素分析

目的：测评产褥期妇女抑郁状态并探讨相关影响因素，为卫生服务部门和妇幼卫生人员对产褥期妇女实施针对性的健康干预措施和有效保障该群体的心理健康提供理论依据。方法：采用SDS抑郁自评量表测量产褥期妇女的抑郁状态；以面对面访谈形式调查社会学、医学、家庭与心理学等方面的影响因素，并应用铲检验和多因素非条件Logistic回归进行分析。结果：产妇年龄每增加一个年龄组发生抑郁的概率要增大2.046倍；产妇各不同职业抑郁发生的概率均低于农民职业者；第一胎次的产妇发生抑郁的概率较大；夫妻感情较好或一般组产妇发生抑郁的概率比感情很好组产妇增加10．204倍；仅由丈夫及其家人照顾的产妇发抑郁生的概率是丈夫及双方家人照顾类型的2.166倍。家庭的年均收入越高且新生儿发育状况越好的产妇发生抑郁的概率越小。结论年龄、产妇职业、生产胎次、怀孕原因、夫妻感情和照顾类型6个变量对产妇抑郁的发生有影响作用；家庭年均收入与新生儿生长发育状况两个因素对产褥期抑郁的发生存在交互作用。     

产褥期妇女抑郁状态及其家庭与心理学影响因素的LOGISTIC回归分析

目的:研究产褥期妇女抑郁状态的影响因素。方法:采用单因素Logistic及多因素Logistic分析,将潍坊市5家不同级别的医院作为调查点:从2003年7~11月期间在以上医院分娩的妇女用单纯随机抽样方法抽取调查对象;在产妇分娩6周内对调查对象进行访谈,获取现状资料。结果:调查的513例产褥期妇女中,抑郁发生率为8.19%。在α=0.25水准上有统计学意义的家庭与心理学因素进入多因素分析,最后筛选出"家庭年均收入""照顾类型""夫妻感情""与丈夫的家庭地位"因素对产褥期抑郁的发生有影响作用。结论:家庭年均收入越低越易于发生抑郁;照顾类型中"丈夫及其家人"组的产妇发生抑郁的概率是"丈夫及双方家人"组产妇的2.282倍;夫妻感情"较好及以下"组的产妇是"很好"组的16.918倍;与丈夫的家庭地位"不平等"组的产妇发生抑郁的危险性是"平等"组的7.901倍。     

产褥期抑郁及其影响因素的Logistic回归分析

目的:研究产褥期抑郁的影响因素,为卫生服务部门对孕产期妇女提供针对性的保健服务、提高产褥期妇女的心理健康水平以及预防产褥期抑郁的发生提供理论依据。方法:采用SDS抑郁自评量表,对产褥期妇女的抑郁状态进行测量;自行设计调查表调查产褥期抑郁的影响因素。数据用描述性指标、χ2检验以及多因素非条件Logistic回归进行统计分析,并考虑因素间交互作用对产褥期抑郁发生的影响。结果:年龄、产妇职业、生产胎次、怀孕原因、夫妻感情和照顾类型6个变量对产妇抑郁的发生有影响;家庭年均收入与新生儿生长发育状况两个变量对产褥期抑郁的发生存在交互作用。结论:产妇年龄每增大一个年龄组发生抑郁的概率增大2.046倍,产妇不同职业的抑郁发生率均低于农民,第一胎次的产妇发生抑郁的概率较大,夫妻感情较好或一般组产妇较感情很好组产妇发生抑郁的概率增加10.204倍,"丈夫及其家人"照顾类型的产妇抑郁发生的概率是"丈夫及女方或双方家人"照顾类型的2.166倍。此外,家庭的年均收入越高和新生儿发育状况越好的产妇发生抑郁的机率越小。     

产褥期妇女抑郁状态的家庭与心理学影响因素分析

目的 研究产褥期妇女抑郁状态的影响因素.方法 采用单因素及多因素Logistic分析,将潍坊市5家不同级别的医院作为调查点:从2003年7-11月期间在医院分娩的妇女用单纯随机抽样方法抽取调查对象;在产妇分娩6周内对调查对象进行访谈,获取现状资料.结果 在α=0.25水准上有统计学意义的家庭与心理学因素及两对交互作用进入多因素分析,最后筛选出家庭年均收入、照顾类型、夫妻感情、与丈夫的家庭地位等因素对产褥期抑郁的发生有影响作用.结论 家庭年均收入越低越易于发生抑郁;照顾类型中"丈夫及其家人"组的产妇发生抑郁的概率是"丈夫及双方家人"组产妇的2.282倍;夫妻感情.较好及以下"组的产妇是"很好"组的16.918倍;与丈夫的家庭地位"不平等"组的产妇发生抑郁的危险性是.平等"组的7.901倍;没有发现因素间的交互作用对产褥期妇女抑郁的发生有影响作用.     

产褥期抑郁症测评和社会学影响因素分析

目的对产褥期妇女忧郁状态进行测评，并探讨影响产褥期妇女抑郁症的社会学因素。方法采用随机分层抽样方法选择513名住院分娩产妇为调查对象，在产妇分娩6周内对调查对象采取面对面访谈形式获取现状资料，用抑郁状态自评量表测评产褥期妇女的抑郁状态，对影响产褥期妇女忧郁症的有关因素进行非条件logistic回归分析，计算OR值。结果居住农村的产妇发生抑郁症的概率较大；30岁～年龄组产妇的抑郁症发生率较高；家庭年均收入、个人收入水平越高，产妇发生抑郁症的概率越低。结论4个因素能影响产褥期妇女抑郁症发生的概率，其中居住农村、产妇高龄是危险因素，家庭高收入、产妇个人高收入是保护因素。     

产褥期抑郁及其社会影响因素分析

目的 研究产褥期妇女抑郁状态的影响因素.方法 按随机分层抽样方法确定潍坊市5家医院作为调查点,从在以上医院分娩的产妇中采用单纯随机抽样方法确定调查对象,在产妇分娩后6周内对调查对象采取面对面访谈形式获取现状资料,用SDS量表测评产褥期妇女的抑郁状态,应用四格表或R×C表χ2检验对可能的抑郁影响因素进行了探讨.结果 "居住地"、"年龄"、"产妇职业状况"、"家庭年均收入"4个因素对产褥期抑郁有影响作用.结论 居住农村、农民职业、产妇高龄、家庭低收入均能导致产褥期抑郁的发生.     

产褥期妇女卫生服务需求调查

目的调查产褥期妇女对相关卫生服务项目的需求，为卫生服务部门对产褥期妇女提供针对性的服务项目提供理论依据。方法自行设计调查表，采取面对面访谈形式对产褥期妇女生理、心理和社会功能进行调查。结果产褥期妇女对产后访视、护理及生活指导、卫生保健知识宣教、膳食营养指导、康复指导、常见病预防及情感支持7项卫生服务的需求率在85％以上，亲友陪伴、家庭卫生知识宣教、心理健康咨询及社会交流4项需求率高于60％，社会活动需求率最低为42．5％；城市产妇有10项卫生服务的需求率均高于郊区或农村的产妇。结论医疗保健部门需要不断提高卫生服务供给能力，有针对性地开展产褥期妇女卫生保健项目，并拓展相关的健康教育内容，以期更有效保障产褥期妇女的健康需求。     

人工流产前抑郁和焦虑症状的影响因素

目的探讨早孕妇女人工流产前抑郁和焦虑症状及其相关因素的关系。方法采用自制人工流产术前心理状况调查表、抑郁自评量表和焦虑自评量表，对停经34～63d、年龄15～35岁，要求人工流产的健康早孕妇女168例在人工流产前进行抑郁和焦虑症状调查。结果抑郁症状发生率为82．7％(139／168)，焦虑症状发生率为59．5％(100／168)；抑郁和焦虑症状的发生率教师低于其它职业，采用宫内节育器避孕者高于采用工具避孕和服避孕药避孕者，差异有显著性(P＜0．05)；术前心理紧张和恐惧组抑郁症状的发生率高于平静组，与男方父母关系差者焦虑症状的发生率高于一般关系和关系好者，差异有显著性(P＜O．05)；结论人工流产前抑郁和焦虑症状发生率较高，是早孕妇女人工流产前常见的精神及心理障碍。重视妇女心理卫生咨询工作和避孕措施的指导，是预防其抑郁和焦虑症状的有效措施。     

延伸式护理干预改善产褥期妇女抑郁焦虑情绪的效果评价

目的观察延伸式护理干预改善产褥期妇女抑郁和焦虑情绪的效果。方法选取2013年1~7月在湖北医药学院附属太和医院住院分娩的248例产妇资料,根据护理干预的方法将产妇分为两组,接受延伸式护理干预的产妇124例为观察组,采用常规护理干预的产妇124例为对照组。入院时、出院时、产后2周、产后4周采用抑郁自评量表和焦虑自评量表评估产褥期妇女的抑郁、焦虑状况,统计产妇对护理工作满意度及产后抑郁症发生率,比较两组结果。结果观察组产妇各时间点抑郁、焦虑评分及产后抑郁症的发生率均低于对照组(P0.05);对护理工作满意度高于对照组(P0.05)。结论延伸式护理干预可改善产褥期妇女抑郁焦虑状况,降低产后抑郁症发生率,并提高产妇对护理工作满意度。     

产褥期保健与母亲安全的关系

目的为了分析产褥期保健与母亲安全的关系。方法对河北省4个妇幼卫生项目县1990.1．1－1992．12．31死亡的全部孕产妇共87例，采用询问法进行了回顾性流行病学的调查。结果产褥期是孕产妇死亡的高发时期，产褥期死亡率为67.82％（59／87），比孕期死亡率17．24％（15／87）及分娩期死亡率14．94％（13／87）均明显增高。产褥期前三位死因为产后出血、产褥感染和妊娠合并心脏病。结论结合产褥期保健的要求提出防治产后出血、杜绝旧法接生、重视产妇营养、加强保健队伍的基本知识和基本技能训练、重视产后访视次数、质量及产妇的精神问题等措施是降低产褥期死亡率的重要措施。呼吁全社会共同努力，转变过去忽视产褥保健的观念。使妇女在产褥期从根本上获得生殖健康的权利。     

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.     

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.