上海市杨浦区涉苯企业职业卫生危害现状调查

目的调查涉苯企业贯彻国家职业卫生法规执行情况及现状,为建立辖区职业卫生监督的有效管理提供依据.方法依据<中华人民共和国职业病防治法>、<使用有毒物品作业场所劳动保护条例>等法律、法规和国家职业卫生标准,依法对辖区60家涉苯企业进行监督检查.结果部分用人单位法制意识淡薄,作业场所职业病危害因素检测与评价等管理制度及措施不健全 ,作业场所三苯浓度抽测点合格率为87.1%,其中7家企业三苯浓度超过国家卫生标准,苯白血病检出1例,检出率为17.7/10万.结论用人单位在职业卫生管理方面与国家职业卫生法律、法规要求尚有较大差距,潜在职业危害依然存在.因此,建立有效的职业卫生监督管理机制,是治本之策.     

Executive function and general intellectual functioning in dyskinetic cerebral palsy: Comparison with spastic cerebral palsy and typically developing controls

AimTo comprehensively describe intellectual and executive functioning (EF) in people with dyskinetic cerebral palsy (DCP), by comparing their performance with that of: 1) age- and sex-matched typically developing controls (TDC); and 2) participants with spastic cerebral palsy (SCP) matched for age, sex, term/preterm and gross motor function classification system (GMFCS).MethodThis cross-sectional study was conducted by the University of Barcelona in collaboration with five institutions. Participants were people with DCP (n = 52; 24 females, median age 20.5 y: 5mo, interquartile range [IQR] = 13.75 y: 7mo; GMFCS I–V). As comparison groups, participants with SCP (n = 20; 10 females, median age = 20.5 y: 5.5mo, IQR = 13.75 y 9mo; GMFCS I–V) and TDC (n = 52; 24 females, median age = 20 y: 4mo, IQR = 12 y 7mo) were included. Intelligence and EF were assessed using common tests in all participants.ResultsBoth CP groups had lower intelligence than TDC and performed poorer in almost all EF tasks. Intelligence was higher in DCP than SCP (z = ?2.51, p = 0.01). Participants with DCP also performed significantly better in goal-setting tasks (z = 2.27, p = 0.03) and information processing (z = ?2.54, p = 0.01) than those with SCP.ConclusionPeople with DCP present lower general intellectual functioning and poorer EF across multiple domains than typically developing controls. People with DCP have higher general intellectual functioning and better EF than people with SCP when levels of motor severity are similar.     

脑瘫精细运动功能测试量表在偏瘫型患儿中需要重新建立评估标准与程序

目的 分析脑瘫精细运动功能测试量表(FMFM)在偏瘫和非偏瘫型脑瘫间的项目功能差异(DIF)。方法 收集2001至2018年复旦大学附属儿科医院康复中心及其医联体儿童康复协作网诊断为脑瘫并行FMFM评估的患儿,从FMFM评估数据中提取偏瘫患儿对侧数据,随机选择30%样本作为DIF的焦点组样本;根据整体样本中非偏瘫型与偏瘫型的比例确定采用随机分层匹配对照组样本。采用Conquest软件把两组合并数据样本分别与FMFM中B~E区的全部56个项目以及经项目内容分析后划分出的30个单手项目和26个双手项目进行Rasch分析,以内聚拟合度(Infit)的均方来确定FMFM的单维性,标准为MnSq在0.6～1.4,并对全部56项、单双手项目组进行项目功能差异分析。结果 1 556例脑瘫患儿的3 442次FMFM评估作为整体样本和数据,焦点组198个和对照组792个FMFM评估数据进入本文分析,单独样本配对检验显示两组FMFM分值[112(96,146) vs 113(95,145)]差异无统计学意义。经过3轮项目内容分析,30个归入单手项目,26个归为双手项目。全部56个项目的难度尺度对数值之差的绝对值>0.5分别有41个(73.2%),30个单手和26个双手项目的难度尺度对数值之差的绝对值>0.5分别有23个(76.7%)和9个(34.6%)。结论 FMFM全部56个操作项目在偏瘫和非偏瘫型脑瘫间存在DIF,在单手项目中尤其显著,为了更为精准地评价偏瘫儿童的精细运动功能,需要重新建立评估标准与程序。     

早期接触临床对医学生综合能力及职业认知提升效果评价

目的探讨早期接触临床对提高医学生综合能力及强化职业认知的作用。方法选择本校2014级儿科专业五年制学生,其中在大二结束的暑假开展早期接触临床教学活动的学生为实验组(78名),未参加的学生为对照组(81名)。在活动结束后,对参加教学活动的学生进行问卷调查。同时对该年级学生小儿外科学理论课成绩及临床实习表现进行统计分析。结果超过90%的学生对早期接触临床教学活动满意,认为该活动有助于提高医学生的临床思维、强化职业认知、增强学习兴趣、提高沟通技能、促进基础与临床知识相结合。同时,后期追踪分析发现,早期接触临床活动可以提高学生理论课考试成绩,实验组学生临床工作熟练度、临床思维、动手能力及医患沟通能力均优于对照组。结论在医学生中开展早期接触临床活动,能够提高学生的综合能力,有利于培养医学生的临床思维能力及医患沟通能力,强化职业认知,为医学教育培养高素质人才奠定良好基础。     

高原军事卫生防护任职教育教学效果调查与思考

的　了解高原军事卫生防护任职教育教学效果,为教学方法改革提供依据。方法　采用调查问卷的方法,调查对象为2015至2017年参加高原军事卫生防护培训班的55名学员,调查内容包括教学效果、课程设置、教学方法以及意见建议。调查结果使用SPSS 18.0进行数据处理,结果以人数和率来表示。结果　发放问卷55份,有效问卷回收率100%。69.1%的学员认为参加该培训班很有收获,67.3%的学员认为参加该培训班对提高岗位任职能力很有帮助,71.8%的学员认为知识模块的设置很有必要。学员希望采取的授课方式依次是案例教学、实训教学、研讨交流、教员讲授、参观教学、装备教学、文献学习。结论　高原军事卫生防护培训班课程设置比较合理、对提高岗位任职能力很有帮助,任职培训学员更希望采取灵活多样的授课方式。高原军事卫生防护任职培训班人数不多,适合尝试教学方法改革。     

体力与脑力劳动者伤病缺勤及影响因素的对比研究

[目的]比较体力与脑力劳动者因伤病导致缺勤的情况,探讨危险因素,为预防伤病减少缺勤提供依据。[方法]随机整群抽样法选择3896名体力劳动者与2719名脑力劳动者,调查其伤病缺勤及影响因素。[结果]体力劳动者年均缺勤天数（5.4d）比脑力劳动者（20.8d）低,体力劳动者随年龄增高而增加。体力劳动者的年缺勤率（24.0%）比脑力劳动者（65.6%）低。logistic回归分析结果,性别和教育程度是影响体力劳动者伤病缺勤的背景因素,急性胃肠炎、恶性肿瘤、泌尿系感染等是导致缺勤的主要伤病;而婚姻状况、教育程度和年龄是影响脑力劳动者伤病缺勤的背景因素,肥胖、上呼吸道感染和糖尿病等是引起缺勤的主要疾病。[结论]导致体力与脑力劳动者缺勤的主要伤病存在差异,应根据不同劳动类型制定相应措施,预防疾病,减少缺勤。     

Relationship between using tables,chairs, and computers and improper postures when doing VDT work in work from home

This study focused on everyday furniture and computers used in work from home and aimed to investigate how improper postures increase the risk of musculoskeletal disorders using different combinations of tables, chairs, and computers. Twenty-one healthy participants were asked to perform a visual display terminal task for 30 minutes in a laboratory modeled on the work from home concept. Seven experimental conditions were set up according to the different combinations of desks, chairs, and computers. Three-dimensional body posture was measured using a magnetic tracking device. The results showed that when using a low table, floor chair, and laptop computer, the body posture above the hip was similar to that when using a dining table, chair, and desktop computer. When using a sofa, and tablet computers, or laptop computer, severe neck flexion, which is stressful to the neck, was observed. Moreover, excessive low back flexion was observed when using a floor cushion and laptop computer. We suggest that computer work while sitting on a sofa or floor cushion without a backrest is harmful to the neck and low back.     

Characteristics of COVID-19 infection clusters occurring among workers in several Asia-Pacific countries

The types of workplaces and occupations with coronavirus 2019 (COVID-19) clusters vary between countries and periods. We aimed to characterize major occupational groups with mass outbreaks of COVID-19 infections in several Asia-Pacific countries. Data on the major occupations or workplaces reporting COVID-19 cases in workplaces from January 2020 to July 2021 was collected from industrial hygiene professionals in nine countries. The proportion of workers accounted for 39.1 to 56.6% of the population in each country. The number of workers covered in the national statistics varies among nations based on their definition of a worker. None of the countries examined here have systematically collected occupational data on COVID-19 illnesses and deaths classified by type of industry, occupation, or job. Most countries experienced COVID-19 clusters among health and social care workers (HSCW) in hospitals or long-term care facilities. The types of occupations or workplaces with virus clusters in some participating countries included prisons, call centers, workplaces employing immigrants, garment facilities, grocery stores, and the military, which differed among countries, except for a few common occupations such as HSCW and those populated by immigrants. Further study is necessary in order to seek ways to control infection risks, including revisions to industrial-health-related laws.     

Tinnitus characteristics and associated variables on Tinnitus Handicap Inventory among a Hungarian population

BackgroundTinnitus is a sound precepted without an external sound stimulus. Its background can be categorised into primary and secondary cases. The secondary cases include pathologies of the external, middle and inner ear. Tinnitus can be objective or subjective; the latter can only identified by the sufferer. Previous research results have shown that tinnitus significantly affects the quality of life and daily functioning.ObjectivesTo analyse the impact of tinnitus on the daily functioning and the possible influence of demographical data and tinnitus duration on it.Methods630 patients (265 males and 365 females, 25–85 years of age) suffering from primary tinnitus were enrolled. In the Hungarian language, these patients completed the Tinnitus Handicap Inventory (THI) questionnaire and underwent a complete otorhinolaryngological examination. IBM SPSS V24 software was used for data processing; correlation tests, the Mann-Whitney U and Kruskal-Wallis non-parametric tests were used.ResultsAccording to the THI questionnaires outcomes, most patients (62.5%) were presented with a mild handicap. Based on statistical analysis, no significant correlation was observed between the total THI points and the age of the patients, along with the duration and localisation of the symptoms. However, the total THI scores of male and female patients significantly differed, indicating higher THI values in the female group (p = 0.000521).ConclusionsThe tinnitus severity was not affected by the duration, localisation of the symptoms and age but by gender, indicating higher values in the case of females.     

对接大健康产业发展的康复治疗学人才培养体系的构建

在大健康产业发展背景下,康复服务产业发展模式和服务理念逐步转变。康复人力资源是康复服务产业发展的基石,文章基于《国际功能、残疾和健康分类》(international classification of functioning,disability and health,ICF)康复科学理论体系,切合康复服务产业化和专业化需求,重构康复治疗学专业人才培养的课程体系,强化实践教学,探讨构建康复治疗学专业人才培养新模式。