妇科恶性肿瘤患者生存质量调查及其相关因素分析

目的研究妇科恶性肿瘤患者术后生存质量的现状,探讨相关因素和有效治疗途径。方法分别调查我院2010年5月-2011年3月期间收治的50例妇科恶性肿瘤患者和50例妇科良性肿瘤患者。对两组妇科肿瘤患者均采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、生存质量测定表(WHO-QOL-100)进行调查,结果运用统计学方法进行分析。结果①恶性肿瘤组患者的各项生存质量指数均显著低于良性肿瘤组患者(P<0.05)。②对照组患者的焦虑、抑郁状态明显轻于恶性肿瘤组患者(P<0.05)。结论恶性肿瘤组患者术后情绪和生存质量明显差于对照组,提示需加强对患者的心理护理,从患者具体情况出发,建立积极、乐观的生活态度,提高患者的生存质量。     

妇科恶性肿瘤术后心理状态和干预研究

目的:对妇科恶性肿瘤患者术后心理行为进行分析和干预的研究。方法:采用生存质量量表、焦虑自评量表(SAS)及抑郁自评量表(SDS),对妇科恶性肿瘤患者心理干预组90人及对照组50人进行问卷调查评估分析。结果:妇科恶性肿瘤患者文化程度越高抑郁、焦虑指数越高(P<0.05);对照组术后焦虑、抑郁情绪指数高于心理干预组(P<0.01);心理干预组躯体功能、心理功能、社会功能维度评分显著优于对照组(P<0.05)。结论:妇科恶性肿瘤患者多存在抑郁、焦虑、恐惧情绪,通过科学、系统、正规的术前心理干预,可帮助患者减少甚至解除手术引起的焦虑、抑郁、恐惧情绪,并对术后心理、性生活、人际关系、社会支持等方面的生活质量有明显改善的调适作用。     

妇科恶性肿瘤患者心理状态调查

[目的]探讨妇科恶性肿瘤患者的心理状态,为干预治疗提供依据.[方法]采用症状自评量表、焦虑自评量表和抑郁自评量表对妇科恶性肿瘤患者进行1:1的病例对照调查.[结果]病例组SCL-90各因子与对照组相比,在躯体化、强迫、人际关系敏感、抑郁、焦虑、敌意、恐惧、偏执、精神病等因子分均显著高于对照组(P<0.05);SAS及SDS评定,其累积分病例组均显著高于对照组(P<0.05),其中20%的妇科恶性肿瘤患者存在焦虑症状,轻、中、重度分别占14%、5%、1%,33%存在抑郁症状,轻、中、重度分别占16%、10%、7%.[结论]妇科恶性肿瘤患者在一定程度上存在着抑郁、焦虑、人际关系敏感、躯体化等一系列不良的心理问题,因此,应注重对患者进行疾病治疗和心理辅导.     

湿疹患者的心理状况及其对睡眠质量的影响

[目的]探讨湿疹患者的心理状况及其对睡眠质量的影响。[方法]用症状自评量表（SCL-90）作为心理状况调查问卷,测评湿疹患者躯体化、强迫、人际关系、恐怖、抑郁、焦虑、敌对、偏执和精神病性等9个症状因子;选用抑郁自评量表（SDS）测评湿疹患者的抑郁;选用焦虑自评量表（SAS）测评患者的焦虑;测评睡眠采用睡眠质量调查表,测评入睡、睡眠维持、睡眠自评、睡眠时间比、午休时间、梦忆情况、睡眠总时间等因子。[结果]湿疹患者与正常常模的SCL-90评分比较,在躯体化、人际关系、恐怖、抑郁、焦虑、偏执等因子的评分差异有统计学意义（P﹤0.05）;在156例湿疹患者中有抑郁情绪者57例（占36.54%）、有焦虑情绪者66例（占42.31%）,有抑郁和焦虑情绪患者的自评量表得分与正常人常模得分之间的差异有统计学意义（P﹤0.05）;抑郁组与对照组的睡眠质量比较,在入睡、睡眠维持、睡眠自评、睡眠总时间和睡眠质量总分5个方面的差异有统计学意义（P﹤0.05）;焦虑组与对照组的睡眠质量比较,在入睡、睡眠维持、睡眠自评、睡眠总时间和睡眠质量总分五个方面的差异有统计学意义（P﹤0.05）。[结论]湿疹患者存在着较多的心理问题,焦虑和抑郁情绪严重影响着他们的睡眠质量;医务人员对他们除了要进行常规的药物治疗外,还要积极干预他的心理障碍,努力改善他们的睡眠质量。     

机车乘务员自测健康与抑郁焦虑情绪的相关性

[目的]了解铁路机车乘务员自测健康状况与抑郁、焦虑情绪的相关性,为保护机车乘务员身心健康,确保铁路行车安全提供依据。[方法]用自测健康评定量表(SRHMS)、自评抑郁量表(SDS)、Zung焦虑自评量表(SAS)作为测评工具,对某铁路机务段机车乘务员598人进行现场调查和测试。[结果]3个子量表得分差异有统计学意义(P﹤0.05);心理健康子量表分20岁~与40岁~组之间比较差异有统计学意义(P﹤0.05)。机车乘务员中有抑郁、焦虑情绪者分别占75.25%和65.72%。抑郁与无抑郁、焦虑与无焦虑情绪者自测健康各维度得分比较差异均有统计学意义(P﹤0.05)。相关分析显示抑郁、焦虑标准分与自测健康量表各维度得分相关系数有统计学意义(P﹤0.01),它们之间呈不同程度的负相关;自测健康量表中各维度得分之间相关系数有统计学意义(P﹤0.01),它们之间呈不同程度的正相关。[结论]铁路机车乘务员自测健康与抑郁、焦虑情绪有关。应采取多方面有效措施,提高机车乘务员的身心健康水平。     

家属同步健康教育对妇科恶性肿瘤患者生活质量的影响

目的 探讨实施家属同步健康教育对妇科恶性肿瘤患者生活质量的影响.方法 将96例需手术、化疗的妇科恶性肿瘤患者随机分成观察组和对照组,各48例.两组患者入院后均按照宜宾市第一人民医院妇科已制订好的妇科恶性肿瘤健康教育计划单执行;观察组在此基础上对患者家属实施同步健康教育.分别于健康教育干预前、干预1个月、3个月后采用欧洲癌症患者生活质量调查核心量表(ERTC QLQ-C30)、抑郁自评量表(SDS)和焦虑自评量表(SAS)评分和比较两组生活质量、抑郁和焦虑症状评分.结果 健康教育干预1个月和3个月后,观察组在角色、认知、情绪、社会功能和总健康状况得分方面高于干预前和对照组(t =2.84～10.16,均P＜0.05);观察组疲倦、恶心呕吐、失眠、食欲下降和便秘症状得分低于干预前和对照组(t=3.27 ～9.67,均P＜0.05);观察组SAS和SDS得分低于干预前和对照组(t=2.95～7.46,均P＜0.05).结论 实施家属同步健康教育可提高妇科恶性肿瘤患者的生活质量,降低患者的抑郁和焦虑程度.     

综合心理干预对初诊2型糖尿病患者生存质量及住院天数的影响

[目的]探讨心理干预对初诊2型糖尿病患者心理健康状况、生存质量及住院天数的影响。[方法]将2008年7月～2008年12月在南昌大学第一附属医院内分泌科住院的72名初诊2型糖尿病患者随机分为心理干预组和对照组,两组均进行药物治疗,干预组合并半年的心理干预;治疗前后采用症状自评量表(SCL-90)、糖尿病生存质量特异性量表(DSQL)进行评定,比较两组的心理健康状况、生存质量及住院天数。[结果]与对照组比较,干预组在治疗后躯体化、抑郁、焦虑因子、生存质量总分下降明显,住院天数少于对照组,差异具有统计学意义(P﹤0.05)。[结论]综合心理干预可以改善2型糖尿病患者的心理健康状况,提高患者的生存质量,减少住院天数。     

老年高血压伴糖尿病患者的心理干预治疗

[目的]探讨心理干预治疗对老年高血压伴糖尿病患者的精神症状及药物降压疗效的影响。[方法]将90例老年高血压伴糖尿病患者随机分为2组,其中心理干预组45例,给予氯沙坦进行药物治疗,在此基础上再给予心理干预;对照组45例,只给予氯沙坦药物治疗。2组均治疗4周,采用焦虑自评量表(SAS)和抑郁自评量表(SDS)评估病人治疗前后的焦虑、抑郁程度,测量治疗前后2组患者的血压值,比较疗效。[结果]心理干预4周后干预组患者不仅SAS、SDS标准分与干预前比差异有统计学意义(P﹤0.05),干预组血压下降与对照组相比差异有统计学意义(P﹤0.05)。[结论]老年性高血压伴糖尿病患者在使用降压药物的同时若给予适当的心理干预,能取得更好的降压效果,同时也有利于患者的身心健康。     

团体心理治疗对乳腺癌患者生存质量的影响

目的 探讨团体心理治疗对乳腺癌患者生存质量和情绪的影响.方法 将本院96例乳腺癌患者按随机数字表法分为两组,每组48例.观察组采用常规治疗及团体心理治疗,对照组只采用常规治疗.两组治疗前后采用焦虑自评量表(SAS)、抑郁自评表(SDS)及生命质量测定量表(FACT-B)评分,比较两组乳腺癌患者焦虑、抑郁发生率及生存质量的差异.结果 干预前两组患者焦虑自评量表(SAS)、抑郁自评表(SDS)及生命质量测定量表(FACT-B)评分比较差异均无统计学意义(P＞0.05),观察组患者干预后焦虑及抑郁评分均低于干预前(P＜0.01),而对照组干预后焦虑及抑郁评分与干预前比较无明显变化(P＞0.05),观察组患者干预后焦虑及抑郁评分均低于对照组(P＜0.01);观察组患者干预后生存质量总分及各领域得分均高于干预前(P＜0.01),对照组干预后生存质量总分及各领域得分与干预前比较无明显变化(P＞0.05),观察组患者干预后生存质量总分及各领域得分均高于对照组,其差异均有统计学意义(P＜0.01).结论 乳腺癌患者术后实施团体心理治疗,能减少其负性情绪,降低其焦虑、抑郁发生率,并改善生存质量,可作为乳腺癌辅助治疗的方法.     

帕金森病患者家属心理状况及社会支持度研究

[目的]了解帕金森病患者家属的心理状态及社会支持度情况。[方法]采用症状自评量表(SCL-90)、抑郁自评量表(SDS)、焦虑自评量表(SAS)以及社会支持评定量表,对135名帕金森病患者家属进行研究,并与国内常模进行比较。[结果]帕金森病患者家属SCL-90躯体化、抑郁、焦虑和偏执等指标均显著高于国内常模,SDS、SAS得分亦明显高于国内常模,社会支持度低于国内常模(P﹤0.05)。[结论]帕金森病患者家属存在严重的心理问题,其社会支持度不高。应对家属提供心理帮助,提高其社会支持度,以提高他们的身心质量。     

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 human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

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.     

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.     

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.     

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.