三级甲等医院神经外科护士职业心理健康状况调查

目的了解三级甲等医院神经外科护士职业心理健康状况并分析其影响因素,为提升护士职业心理健康提供理论依据。方法采用便利抽样法,于2019年8—10月采用症状自评量表(SCL-90)、职业获益感问卷、社会支持量表对四川省5所三级甲等医院208名神经外科护士进行调查,采用描述流行病学分析、单因素分析、相关性分析及多元回归分析进行相关影响因素探讨。结果神经外科护士症状自评量表(SCL-90)得分为160.59±54.47,条目平均分为1.78±0.61,各因子得分均高于国内常模(P0.05)。职业获益感得分为104.00±11.49,处于中等水平;社会支持总分为37.90±5.39,其中主观支持评分为21.44±3.15,客观支持评分为9.37±2.16,社会支持利用度评分为7.10±1.62。症状自评量表总分与职业获益感及社会支持总分均呈负相关(r=-0.798、-0.765,均P0.05)。多元回归分析显示,职称、工作强度、社会支持和职业获益感是三级甲等医院神经外科护士心理健康状况的独立影响因素,可解释总变异的67.9%。结论三级甲等医院神经外科护士心理健康状况有待进一步提升,护理管理者可根据影响因素采取针对性干预策略,以提升护士心理健康水平,促进护理队伍健康发展。     

某医院护士职业紧张和职业心理相关回归分析

目的：探讨影响护士心理健康的职业紧张和职业心理因素，为提高护士的心理健康水平提供科学依据。方法：采取职业紧张与职业心理测量问卷和症状自评量表（SCL-90）对某医院545名护士进行调查，对获得的数据进行相关与逐步回归分析。结果：与护士SCL-90呈负相关的因子是心理满足、信心充足、心情平静和工作满意感（P〈0．01）；呈正相关的因子是工作冲突、心理需求、物理环境、工作危险、工作负荷、工作前景、缺乏提升机会、缺乏参与机会、缺乏社会支持（P〈0．05）。引入逐步回归方程的6个因素为心理满足、信心充足、工作危险、心情平静、缺乏社会支持和工作满意感。结论：影响护士心理健康的职业因素是多方面的，主要因素为心理满足、信心充足、工作危险、心情平静、缺乏社会支持和工作满意感。     

护士职业紧张状况与心理健康关系的调查

目的 探讨护士职业紧张状况与心理健康的关系,为提高护士的心理健康水平提供科学依据.方法 采用职业紧张量表(OSI-R)与症状自评量表(SCL-90)对743名护士进行问卷调查.结果 与成渝两地技术人员常模比较,护理人员的个体紧张反应总均分(92.14±0.69)显著高于常模值(84.78±18.16),个体应对资源总均分(123.98±0.68)显著低于常模值(130.02±17.39),差异有显著性(P<0.01).护士SCL-90总均分与职业任务各子项均呈明显正相关(P<0.01);与个体应对资源各子项均呈明显负相关(P<0.01).多元逐步回归分析显示年龄、任务过重、任务冲突、责任感、工作环境、社会支持、理性处事影响护士SCL-90的得分,对护士心理健康状况具有预测力.结论 护理人员的心理健康状况与职业紧张因素有关;社会支持、工作环境和责任感等职业紧张因素对护理人员的心理健康状况具有预测力.     

护理人员心理健康状况调查与干预对策

目的:探讨临床护士心理健康状况,并进行心理干预,以减轻心理压力,保持心理健康,提高工作质量.方法:对50名临床一线护士进行问卷调查.结果:90%的护士经常有疲倦感,经常感到心理疲惫者占80%,52%经常焦虑,32%经常有强迫症状,40%经常有职业无助感.结论:护理人员应加强自我护理意识,进行自我心理调节,正确对待处理各种压力,掌握最适合自己的减压放松方式,提高心理承受能力,以最佳身心状态投入工作.同时呼吁社会、家庭要对护士职业者充分理解和支持.     

急诊护士职业性肌肉骨骼疾患对心理健康状况影响的研究△

目的：了解急诊护士职业性肌肉骨骼疾患心理健康状况现状，并分析其影响因素，为临床护理管理者更好地保护护士身心健康提供干预指导。方法：采用一般资料调查表、症状自评量表（SCL-90）、疾病感知量表（BIPQ）和家庭支持量表，对我院133名急诊护士于2021年1月至12月进行问卷调查。结果：133名急诊护士中有118名发生过职业性肌肉骨骼疾患，发生率为88.72%。急诊护士的《症状自评量表》（SCL-90）的总均分为（1.59±0.48）分。经单因素分析、Pearson相关性分析和多元线性回归分析显示，年龄、性别、职称、工作年限、疾病感知和家庭支持是影响急诊护士心理健康的主要因素（P < 0.05）。结论：本研究显示，急诊护士职业性肌肉骨骼疾患的发生率较高，且心理健康问题较严重，作为护理管理者应该重点关注年龄小、男性、职称低、工作年限短、疾病感知严重和家庭支持差的护士，为这类人群构建更加完善的干预策略，保证护理队伍的稳定性。     

封闭病区精神科护士心理健康问题及对策

目的探讨封闭病区精神科护士的心理健康状况、影响因素及对策。方法 2011年1月-2012年2月选择32名封闭病区精神科护士为研究组,35名综合科护士为对照组,采用症状自评量表(SCL-90)进行评定分析。结果研究组SCL-90总均分、阳性项目均分、躯体化、强迫、人际关系、抑郁、焦虑、敌对等因子分显著高于对照组(P<0.05)。结论封闭病区精神科护士心理健康状况较差,需要医院管理阶层给予更多的关注。     

女性外来务工者心理健康状况及影响因素分析

目的 调查工厂企业女性外来务工者的心理健康状况,探讨心理健康影响因素.方法 采取按比例分层整群抽样方法对深圳市光明新区1485名工厂企业女性外来务工者进行心理问卷调查.问卷包括症状自评量表(SCL-90)、工作应激量表、社会支持评定量表(SSRS)及自编一般情况调查表.结果 工厂企业女性外来务工者的SCL-90总分与年龄、收入轻度相关(P＜0.000 1),19.19%的人存在心理健康问题(SCL-90任一因子分≥3).心理健康问题检出较高的依次为敌对、抑郁和强迫(检出率≥7%).多元线性逐步回归分析显示,影响心理健康的主要因素依次为工作应激、社会支持、来深圳的意愿、收入、对本地生活的适应性、工作性质.结论 有效的压力管理、增加社会支持、增加收入、增强对本地生活的适应性是促进工厂企业女性外来务工者心理健康的可行方法.     

浙江省预防接种人员心理健康状况调查

目的了解预防接种人员心理健康状况及其影响因素。方法采用分层随机抽样,在浙江省12个县抽取预防接种门诊人员开展心理健康症状自评量表(SCL-90)问卷调查,分析心理问题阳性检出率及其影响因素、SCL-90量表得分。结果浙江省预防接种人员心理健康问题检出率为32.5%(135/416),10种心理健康症状因子的检出率在5.3%-23.6%之间;SCL-90量表总平均分为1.36±0.44分,各症状因子平均分在1.17-1.61分之间。Logistic回归分析显示,公共卫生专业、工作不满意程度高、无家庭支持的预防接种人员心理问题检出率更高。结论浙江省预防接种人员的总体心理健康状态良好,并受其专业、工作满意度、有无家庭支持等因素的影响。     

护理人员心理健康水平及与医院情境因素的相关分析

目的:探讨护理人员的心理健康水平及与医院情境因素的相关性;方法:采用症状自评量表和医院情境因素问卷对116名护理人员进行测评;结果:护理人员的SCL-90总分和强迫症状、人际关系敏感、焦虑、敌意、精神病性因子均分低于全国常模(P<0.05～0.01),精神科护理人员与综合科护理人员相比,前者的SCL-90症状总分和强迫症状、人际敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性、其他9个因子均低于后者(P<0.01),医院情境因素中的工作激励、待遇满意度、医院保健、心理保健、集体精神、信息沟通6个因素与SCL-90总分及躯体化、强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性、其他10个因子呈不同程度的负相关;结论:护理人员的心理健康水平高于一般正常人群,尤其是精神科护士;优化医院情境因素有利于护士心理健康水平的提高。     

社会转型期失地农民心理健康及影响因素分析

目的 了解失地农民的心理健康状况,研究其影响因素,为制定失地农民的相关政策提供决策依据,帮助解决就业问题.方法 使用分层整群随机抽样的方法 抽取徐州市金山桥社区、茶棚社区失地农民.随机抽取一个居委会农民以症状自评量表(SCL-90)进行问卷调查,收回有效问卷1 041份.结果 被调查的失地农民中,有442人(占42.5%)心理异常.调查结果 显示,失地农民的SCL-90总均分、躯体化、焦虑、敌对、恐怖、偏执、精神病等因子得分都远高于非失地农民.多因素分析发现,年龄大、健康状况差、不能得到家人的帮助、与社会其他成员的联系少、对政策补助政策不满是影响失地农民心理健康的重要危险因素.结论 失地农民的心理健康存在个体差异;职业、年龄、性别、受教育程度、婚姻及家庭状况、社会保障状况、个人生活习惯、与社会的联系是影响失地农民心理健康的因素.     

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.     

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.