Environmental exposures,breast development and cancer risk: Through the looking glass of breast cancer prevention

This review summarizes the report entitled: Breast Cancer and the Environment: Prioritizing Prevention, highlights research gaps and the importance of focusing on early life exposures for breast development and breast cancer risk.     

医学教育环境评估量表在我国口腔医学生中应用的信度与效度分析

目的：评价医学教育环境评估量表（DREEM）在我国口腔医学生中应用的信度和效度。方法：采用DREEM量表中文版在重庆医科大学口腔医学本科生中进行问卷调查,最终对调查结果进行统计学分析,考评量表的信度和效度。其中信度采用内部一致性信度和分半信度进行分析;效度采用探索性因素分析和收敛效度进行分析。采用SPSS 22.0软件包对数据进行信度和效度检验。结果：共回收有效问卷260份。量表总的Cronbach α系数为0.936,Guttman 分半信度系数为0.816。经过探索性因子分析,提取5个因子,累积贡献率达47.071%,显示量表存在预想的连带关系和逻辑关系。量表的Spearman等级相关系数为0.447~0.556之间。结论：医学教育环境评估量表在我国口腔医学生中应用具有良好的信度和效度,可在我国口腔医学教育环境的评价中进一步推广应用。     

中文修订版护理院治疗性环境筛查量表的信效度检验

目的检验中文修订版护理院治疗性环境筛查(Therapeutic Environment Screening Survey for Nursing Home,TESS-NH)量表信度和效度。方法通过系统的翻译、回译、德尔菲专家咨询对英文版TESS-NH量表汉化、修订,确立中文修订版TESS-NH量表的内容和条目,并进行信度和效度检验。结果中文修订版TESS-NH量表内容效度指数(CVI)平均值为0.980,折半信度为0.712,总量表Cronbach′sα系数为0.808,5个维度Cronbach′sα系数为0.716~0.770,重测信度为0.859,不同评定者间信度为0.872;各条目在所提取的相应公因子上的载荷值均大于0.5,因子分析提取的6个公因子共解释总变异的69.706%。结论中文修订版TESS-NH量表具有较好的信度和效度,可用于中国养老机构老年痴呆治疗性环境质量水平的评价和研究。     

基于医生视角下网络环境对医患关系的影响研究

通过对医生群体的问卷调查,了解医生上网习惯情况、医生与患者的网络交流沟通情况、网络环境对医生实际诊疗的影响、网络环境下新闻媒体对医生的影响以及医生群体关于网络发展对医患关系影响的综合看法。指出了目前网络环境给医患关系带来的影响：互联网成为一些医生知识信息更新与积累的源地,网络成为一些医生与患者交流互动的重要平台,医生需要应对日益增多的“网络型”患者,医生对媒体负面报道的反应性出现转变。     

室内环境因素对支气管哮喘控制的影响

目的探讨室内环境影响因素对支气管哮喘（简称哮喘）的影响。方法采用现场问卷调查的方法,选择在我院哮喘门诊规律就诊的患者,调查室内环境因素对哮喘控制水平的影响。结果实际完成调查问卷440份,其中男性197例,女性243例,平均年龄（35．861±10．063）岁。达到哮喘控制人数112例（25．45％）,部分控制人数252例（57．27％）,未控制人数76例（17．27％）。采用多因素Logistic回归分析去除相互影响后的结果显示：使用地毯、饲养带毛宠物、主动吸烟、被动吸烟、近1年内家庭装修这5个因素将会对哮喘的控制产生不利影响。同时采用每周热水清洗床上用品加上防螨枕套或空气净化器的任何两种方法的组合将会改善哮喘的控制情况,预测发生控制水平为3级的风险的相对危险度分别为OR0．322（95％CI0．116～0．892）及OR0．378（95％CI0．148～0．969）。结论多种环境因素均会对哮喘的控制产生不利影响,但一些控制环境因素手段的组合将有利于我们更好的控制哮喘。     

Epidemiologic characteristics of resistant microorganisms present in reserves from an intensive care unit

In this study, significant contamination in the intensive care unit environment was observed (P < .004). Sampling of inanimate surfaces and equipment found vancomycin-resistant Enterococcus faecalis, ciprofloxacin-resistant Staphylococcus aureus and S epidermidis, and multiresistant Acinetobacter baumannii with similarities (60%-80%) to blood culture isolates.     

Multivariate Cholesky Models of Human Female Fertility Patterns in the NLSY

Substantial evidence now exists that variables measuring or correlated with human fertility outcomes have a heritable component. In this study, we define a series of age-sequenced fertility variables, and fit multivariate models to account for underlying shared genetic and environmental sources of variance. We make predictions based on a theory developed by Udry [(1996) Biosocial models of low-fertility societies. In: Casterline, JB, Lee RD, Foote KA (eds) Fertility in the United States: new patterns, new theories. The Population Council, New York] suggesting that biological/genetic motivations can be more easily realized and measured in settings in which fertility choices are available. Udry’s theory, along with principles from molecular genetics and certain tenets of life history theory, allow us to make specific predictions about biometrical patterns across age. Consistent with predictions, our results suggest that there are different sources of genetic influence on fertility variance at early compared to later ages, but that there is only one source of shared environmental influence that occurs at early ages. These patterns are suggestive of the types of gene–gene and gene–environment interactions for which we must account to better understand individual differences in fertility outcomes. Edited by John Hewitt and Wendy Slutske