列车乘务员SCL—90评定结果分析

采用ＳＣＬ—９０症状自评量表对某铁路分局４６７名列车乘务员的心理卫生状况进行了分析。结果显示总均分、阳性症状均分、阳性项目数、九组症候群因子分、达到或超过中等严重程度的发生频数均显著高于对照组。经多元逐步回归分析,仅细菌总数和二氧化碳对列车乘务员心理卫生状况有一定影响,其原因多与工作环境的不良因素和工作性质有关。     

电子阴道镜检查在宫颈癌筛查中的临床价值

目的:评价电子阴道镜在宫颈癌筛查诊断中的价值及临床意义。方法:对860例妇科患者进行电子阴道镜检查,并在阴道镜下定点组织活检。结果:860例电子阴道镜检查结果中,发现异常90例,异常率为10.5%。其中50例为CIN I级,28例为CINII级~Ⅲ级,12例为宫颈癌。镜下定位活检送病理诊断确诊CIN I级45例,CINII级-Ⅲ级26例,宫颈癌12例,确诊率分别为90%、92.9%和100%。结论:电子阴道镜检查是提高宫颈癌筛查诊断率的重要手段。     

Inter-tester reliability of passive intervertebral and active movements of the cervical spine

Measurements of active range of motion (AROM) and passive intervertebral movements (PIM) of the cervical spine are frequently used for patients with neck pain. However, there is a paucity of studies that investigate the psychometric properties of these measurements. Objectives of this study were to: (1) determine the inter-tester reliability of PIM, AROM, and the effects of AROM on symptom provocation; (2) establish the minimal detectable change (MDC) in cervical AROM; and (3) determine the association between AROM and disability. Thirty subjects (age 41+/- 12) with neck pain participated in this study. Two masked examiners performed the measurements during the same testing session. PIM was assessed manually and recorded as hypomobile or normal. AROM was measured in degrees with a gravity goniometer. The effect of AROM on patient's symptoms was recorded as no change, decreased, increased, centralization, or peripheralization. Measures of AROM had moderate to substantial reliability (.78 - .91) and resulted in a MDC adequate for clinical use (from 9 degrees to 16 degrees). The effect of AROM on symptom provocation resulted in Kappa values that ranged from slight to substantial (.25 - .87). Measures of PIM resulted in substantial and moderate reliability of assessing occipital-atlas mobility, tenderness of the transverse processes of atlas, and symptom provocation during PIM testing of the lower cervical segments. Fair Kappa values were observed during judgment of mobility in the C2 segment and symptom reproduction during PIM of C2 and C5. The additional PIM had Kappa values that ranged from none to slight. Low prevalence of positive findings likely resulted in an artificial deflation of the Kappa statistic during some PIM measures. Measures of AROM in saggital and transverse planes were associated with disability scores (r = .43 and .40, respectively). Findings are relevant to the planning of future studies to establish the criterion validity of these tests to guide the selection of interventions and establish prognosis in patients with neck pain.     

Exercise intervention and health checks for middle-aged men with elevated cardiovascular risk: A randomized controlled trial

Abstract

Objective. To study the effects of a health check by a nurse alone or combined with an exercise intervention in middle-aged men at increased cardiovascular risk. Design. A randomized controlled trial. Setting and intervention. Primary care in Kirkkonummi municipality with 36 000 inhabitants. A health check by a nurse alone or combined with an exercise intervention to controls with no intervention was compared. Subjects. A total of 168 men aged 35 to 45 years with at least two cardiovascular risk factors and physical activity (PA) frequency < 3 times a week. Main outcome measures. Metabolic syndrome (MetS) as defined by International Diabetes Federation/American Heart Association and self-reported PA frequency. Results. Overall, focusing on health increased physical activity frequency in middle-aged men. After one year, 19% had increased PA to ≥ 3 times a week (95% CI 12–26). All study groups increased PA to ≥ 3 times: 26% of men in the exercise intervention group, 15% of men in the health check group, and 16% of controls. The differences between the groups were not statistically significant. The intervention did not have any meaningful impact on MetS or other cardiovascular outcomes at one-year follow up. Conclusions. Physical activity increased in all study groups of middle-aged men in this health-promotion trial. The interventions had no effect on metabolic syndrome or other cardiovascular outcomes in the participants. The trial increased awareness and collaboration in physical activity promotion among municipal health care and exercise services.     

患者满意度对护理质量的监督促进作用

目的 :通过调查患者满意度 ,促进护理工作质量的提高。方法 :每月末 ,护理部事先不通知 ,发放调查问卷并当场收回 ,于 2 4h内及时反馈患者的意见 ,由科室制定整改措施。结果 :年护理质量对照差异有显著性 (P <0 0 1) ,各项护理指标均显著上升。结论 :调查患者满意度 ,增强了护士主动服务的意识和护患沟通 ,落实了基础护理、健康教育等 ,保证了护理安全 ,护理管理更具有人性化 ,护理质量全面提高     

Prevalence of diabetes mellitus in individuals with airflow obstruction in a Japanese general population: The Yamagata-Takahata Study

Background

Diabetes has been reported as a comorbidity of chronic obstructive pulmonary disease (COPD) in Western countries, but it has not been demonstrated in epidemiological reports in Japan. The purpose of this study was to clarify whether the relationship between airflow obstruction and diabetes can be confirmed in a Japanese general population.

大学生自我接纳与自我和谐的关系

目的:了解大学生自我接纳与自我和谐的现状以及两者之间的关系,为心理健康教育提供教学参考。方法:采用自我接纳量表和自我和谐量表,对南京某两所大学大一至大四880名学生进行问卷调查。结果:在本研究中大学生自我和谐程度优于全国常模,符合心理健康的标准,在性别、生源地和是否独生上没有显著差异。自我接纳总分与自我和谐总分显著负相关(r=-0.597,P0.01);自我接纳因子和自我的灵活性、自我与经验的不和谐、自我的刻板性3个因子相关性显著(r=0.265,-0.612,-0.230;P0.01);自我评价因子和自我的灵活性、自我与经验的不和谐、自我的刻板性3个因子相关性显著(r=0.237,-0.442,-0.097;P0.01)。回归分析表明,自我接纳因子和自我评价因子均对自我和谐有正向预测作用。结论:自我接纳是影响大学生自我和谐的重要因素。     

Reliability and accuracy of heart rate variability metrics versus ECG segment duration

Despite the exponential growth in heart rate variability (HRV) research, the reproducibility and reliability of HRV metrics continues to be debated. We estimated the reliability of 11 metrics calculated from 5 min records. We also compared the accuracy of the HRV metrics calculated from ECG records spanning 10 s to 10 min as compared with the metrics calculated from 5 min records. The mean heart rate was more reproducible and could be more accurately estimated from very short segments (<1 min) than any of the other HRV metrics. HRV metrics that effectively highpass filter the R–R interval series were more reliable than the other metrics and could be more accurately estimated from very short segments. This indicates that most of the HRV is caused by drift and nonstationary effects. Metrics that are sensitive to low frequency components of HRV have poor repeatability and cannot be estimated accurately from short segments (<10 min).     

关于生化自动分析仪噪音核查和反应限核查的几点讨论

生化自动分析仪在进行噪音核查和反应限核查之前，均已完成线性核查，已确定线性反应区，从吸光度-时间回归线计算出每分钟吸光度变化速度（△A／min）。在此基础上进行噪音核查（Noise Check）和反应限核查（Reaction Limit Check）。     

Evaluation of the accuracy of “ChE check mobile” in measurement of acetylcholinesterase in pesticide poisoning

Background: Acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) are used in clinical management to confirm the diagnosis and indicate the severity of organophosphorus and carbamate poisoning. ChE check mobile is a new portable cholinesterase testing system developed in Germany. The study aims to evaluate the accuracy of ChE check mobile compared to the standard reference method and Test-mate ChE system.

Methods: Patients with organophosphorus and carbamate poisoning were recruited from two general hospitals in Sri Lanka between September 2013 and November 2014. The AChE was measured using the three methods.

Results: Blood samples were collected from 185 self-poisoned patients (170 organophosphorus and 15 carbamate) and 20 normal individuals. ChE check mobile correlated well with spectrophotometer readings (Pearson’s correlation coefficient 0.87) but gave higher values (Mean bias for AChE: +6.55 (95% CI: ?11 to 24) U/g Hb). A similar positive bias from Test-mate results was also observed. Applying a correction factor derived from the volunteer samples (dividing by 1.353) greatly improved agreement in pesticide poisoned patients.

Conclusions: ChE check mobile system allowed for rapid determination of AChE activity but gave somewhat higher AChE compared to other methods. Applying a correction factor of 1.353 provide a good agreement to both reference and Test-mate ChE machine in this setting.