Bronchial foreign body: should bronchoscopy be performed in all patients with a choking crisis?

The aspiration of a bronchial foreign body (FB) remains a common pediatric problem with serious and sometimes fatal sequelae. The diagnosis is often delayed or overlooked. With the aim of determining a reliable clinical and/or radiologic finding to indicate the requirement for bronchoscopy, 100 patients admitted to our hospital because of FB aspiration who underwent rigid bronchoscopy were retrospectively studied. The clinical and radiologic data were compared with the bronchoscopy findings, which revealed that the history of a choking crisis was the clinical parameter that showed the highest sensitivity (97%) with high specificity (63%), and that other symptoms and radiology, even those with high sensitivity (88% and 85%, respectively), had low specificity (9%). We conclude that bronchoscopy should be performed in all patients with a history of a choking crisis even if they have normal radiologic findings and few symptoms.     

综合医院应对危机和突发公共卫生事件的探讨

各种各样的灾难对人类造成的危害与日俱增,综合医院如何应对危机和突发公共卫生事件是一个新的课题.就危机和突发公共卫生事件发生医院可能遇到的问题,如何增强危机意识,构建现代危机和突发公共卫生事件管理体系,努力培养医学救治队伍等问题进行了探讨.     

学校心理干预对中小学生心身健康水平的影响

目的了解心理卫生教育对中小学生心身健康的影响. 方法以学校心理卫生教育干预形式,结合家庭干预,对小学四年级一个班52名学生和初中一个班50名学生进行一个学期16课时的心理教育和四个学时的家长公开课相结合.以53名同校四年级和51名同校初二另二个班学生为对照,用SCL--90分别进行测查. 结果心身健康水平有显著提高,其中强迫、人际敏感、焦虑、精神病性四项心理指标的提高较为显著,男女生干预前后在某些指标上的变化却有差异.本实验对有轻微心理症状学生的心身健康水平的改善最为明显,而对存在明显心理障碍学生的心身健康水平的改善不明显. 结论心理干预能够减少或消除不良因素,预防心理疾病的发生,提高中小学生的心身健康水平.     

三资企业从业人员心理卫生状况调查

[目的 ]　了解三资企业从业人员心理卫生现状。　 [方法 ]　采用症状自评量表 (SCL— 90 )对 776名三资企业从业人员心理卫生情况进行调查及分析。　 [结果 ]　三资企业从业人员SCL— 90量表得分均值高于全国常模 (P<0 .0 1) ;5年工龄以下 ,操作工人的躯体化、强迫症状、敌对、偏执、精神病性症状得分均值高于行政管理人员 (P <0 .0 5或P <0 .0 1) ;除强迫症状、精神病性症状外 ,有毒有害接触人员得分均值高于不接触有毒有害作业人员 (P <0 .0 5或P<0 .0 1) ;除敌对、精神病性症状外 ,女性得分均值高于男性 (P <0 .0 5或P <0 .0 1)。 5年以上工龄 ,除精神病性症状外 ,操作工人得分均值高于行政人员 (P <0 .0 5或P <0 .0 1) ;接触有毒有害人员以及女性得分均值分别高于不接触有毒有害人员和男性 (P <0 .0 5或P <0 .0 1)。　 [结论 ]　三资企业从业人员存在一定心理问题 ,有必要开展职业心理卫生的健康干预。     

公共卫生危机管理探讨

本文以社会学、心理学的相关原理为理论基点 ,论述了危机、卫生危机及公共卫生危机的概念、因素和影响 ,探讨了政府在公共卫生危机管理中应对策略 ,以资政府相关组织借鉴。     

桂西山区中学生伤害与心理健康状况的关系

目的了解桂西山区少数民族中学生伤害的发生与心理健康状况的关系,以便为预防和控制青少年伤害的发生提供科学依据.方法以随机整群抽样的方法,对桂西3所中学1 855名中学生采用SCL-90症状自评量表进行心理健康测评,并作伤害问卷调查.结果伤害总发生率为32.02%,发生2次及以上伤害的发生率为10.51%;初中生伤害发生率明显高于高中生,男女生伤害发生率差异无显著性.发生伤害学生的心理健康水平明显低于未发生伤害的学生,尤以强迫、精神病性、焦虑、躯体化、抑郁较为突出.多因素Logistic回归分析表明,年龄、父亲文化程度以及SCL-90因子中躯体化、强迫、人际敏感、抑郁、焦虑、精神病性为伤害发生的主要影响因素.结论 心理健康状况可能是影响伤害发生的重要因素,加强心理健康维护可控制伤害的发生.     

Changes in the Household Calorie Supply during the 1994 Economic Crisis in Mexico and Its Implications on the Obesity Epidemic

To characterize the effects of the 1994 economic crisis on calorie sources of Mexican households, five nutrition surveys done every leap year (1992–2000) in national representative samples (> 10,000 households) were analyzed. Each household was visited during 7 days to collect data on foods purchased, exchanged or home-grown and their monetary value. We selected 88 food items to calculate kilocalories/ person/day and cost in pesos/megacalorie (CPMC) for rural-urban strata (localities <2500, ≥2500). The food items were classified in 8 groups and the summation of kilocalories and CPMCs of items in each group were our units of analysis. Linear regressions for 1992–2000 were performed, and slopes and intercepts were used to characterize changes. Available calories showed very little change at the height of the economic crisis. Expensive calories (meat in ur-bans, eggs and milk in rurals, and industrialized meat and soft drinks in both) tended to increase, whereas the most inexpensive staples (cereals, legumes, sugars) decreased their share in both strata. An increase in obesigenic calories was seen, notably in soft drinks, despite a cost increase second only to meat. Main conclusions were: (1) the economic crisis did not affect total calories availability in Mexican households; (2) the 1992–2000 trends in calorie sources were contrary to any crisis effect in rurals and urbans (i.e., expensive foods increased and inexpensive staples decreased); (3) there were sizable rural-urban differences in number, source, and cost of calories; and (4) obesigenic calories increased and soft drinks emerged as a food with its own dynamic.     

学生心理障碍影响因素Logistic回归分析

目的:探讨学生心理障碍的影响因素,为今后的干预提供科学依据。方法:应用SCL-90自评量表测评分析,采用1:2配比病例对照研究,对学生进行心理调查及艾森克人格(EPQ)问卷。结果:心理障碍组学生SCL-90各因子均分离于正常组,经Logistic回归分析,单因素分析选出9项因子(P<0.05),多因素分析有4项因素进入回归模型。结论:学生心理障碍与学生同家庭成员关系,父亲理解的程度,对学习的要求程度以及人格特征和个性特质有关。     

住院治疗的不孕患者心理健康调查

目的 了解住院治疗不孕的患者心理健康情况。方法 根据相关文献采用自行设计调查表，对因不孕入院手术的患者100例进行有关心理健康调查。结果多数患者存在不同程度的心理问题。100％认为不孕很痛苦，98％内心承受不同程度的心理压力，93％被生育困扰，70％认为不孕检查和治疗带来心理压力和精神紧张，另外自感烦躁、自卑、绝望，认为不孕影响夫妻感情、性生活，影响与家人关系及婚姻，影响工作及生活态度。结论 心理因素是不孕诊治过程中不容忽视的重要因素，可能直接或间接影响不孕症治疗的疗效，所以在进行躯体疾患诊治的同时，应重视心理治疗以提高不孕治疗成功率。