智力低下(MR)儿童干预效果追踪观察与探讨

目的:探讨智力低下(MR)儿童特殊教育与训练效果,为提供最佳的干预对策提供依据。方法:采用儿童适应行为评定量表和韦氏儿童智力量表,对48例MR儿童进行干预训练前、后适应行为商数和智商测试。结果:MR儿童适应行为评定量表得分随年龄增长而增加,适应行为总分普遍增高,各因子得分训练后比训练前明显增高,P<0.01。尤其是独立功能因子和社会自制因子比较,差异显著,P<0.01。智力商数比较,以操作智商比较差异显著,P<0.01。结论:教育和训练对MR儿童社会适应行为、智商水平有促进作用。     

四川阿坝州藏羌汉族儿童青少年体成分分析

目的 了解四川藏、羌、汉族儿童青少年体成分状况，分析其在生长发育过程中的变化特点。方法 利用生物电流阻抗法（BIA）测定四川省阿坝藏羌自治州7～18岁藏、汉、羌族1822名男女儿童青少年的体成分。结果 男、女生瘦体重均随着年龄的增长而增加，且有显著的相关性（r=0.75）。男生的瘦体重年增加值随年龄增长呈增加趋势，女生则随年龄的增长而减少。男生体脂百分比在13．1％～22．3％之间，随着年龄的增长而减少；女生的体脂百分比在23.8％～29．8％之间，随年龄的增加而增加。羌族儿童少年的体脂百分比有高于汉族、藏族的趋势，但男生只在12，15岁时显著高于汉族，女生在12岁时显著高于藏族。结论 藏、羌、汉族儿童青少年体成分随着青春发育表现出性别和民族差异，提示性别、民族可能也是造成儿童青少年体成分差异的影响因素。     

40例低出生体重儿童社会适应知为智商水平对照研究

对４０例低出生体重儿童采用儿童适应行为评定量表和韦氏儿童智力量表进行测试，发现该组儿童适应行为评定得分随年龄增长而增加，但发展水平普遍低于对照组。提示应重视和加强对此类儿童特殊 的早期教育和训练，并为其有针对性地进行早期教育和训练提供科学依据。     

40例低出生体重儿童社会适应行为智商水平对照研究

对40例低出生体重儿童采用儿童适应行为评定量表和韦氏儿童智力量表进行测试,发现该组儿童适应行为评定得分随年龄增长而增加,但发展水平普遍低于对照组。提示应重视和加强对此类儿童特殊的早期教育和训练,并为其有针对性地进行早期教育和训练提供科学依据。     

学习障碍儿童的家庭环境和心理行为分析及干预

目的 分析学习障碍儿童的家庭环境和心理行为。方法 设研究组、对照组，分别对两组儿童参照采用家庭环境量表（FES-CN）和Achenbach儿童行为量表（CBCL）进行调查评估；对研究组儿童给予心理行为治疗同时，进行家庭干预。结果 学习障碍组儿童家庭文化性、亲密度、组织性、情感表达因子得分低于正常对照组儿童家庭得分，矛盾性因子得分高于对照组，差异有统计学意义；学习障碍组儿童行为问题发生率为37％，对照组为14．5％，差异有显著性；研究组与对照组行为因子比较，多动、社交退缩、抑郁、交往不良因子的差异有显著性；研究组儿童学习成绩在治疗前后比较差异有显著性。结论家庭环境失调与儿童学习障碍有一定关系；学习障碍儿童较正常儿童存在更多的行为问题；对学习障碍儿童进行个体治疗，同时着重于家庭干预可提高儿童的学习成绩。     

岳阳市学龄儿童行为问题现况调查

目的了解岳阳市学龄儿童行为问题现况，为进一步研究其影响因素及干预技术提供依据。方法运用“Rutter儿童行为量表”，对岳阳市城区、湖区、丘陵、山区4836名6～13岁在校学龄儿童行为问题进行调查。结果岳阳市学龄儿童行为问题现患率9．19％，其中男生11、76％，女生6．59％，男：女=1．7：1（P〈0．01）；湖区、丘陵、山区儿童行为问题差异小显著（P〉0．05），但高于城区儿童，农村：城区=2.84：1（P〈0．01）；儿童行为问题现患率随年龄增大而升高，6～10岁儿童现患率为7．33％，11～13岁儿童现患率达12.94％（P〈0．01）；学龄儿童各类行为问题构成存在差异（P〈0、01），“A行为”〉“N行为”〉“M行为”，男生“A行为”〉“M行为”〉“N行为”，女生则为“N行为”〉“M行为”〉“A行为”（P〈0．01）。城区与农村儿童行为问题构成差异不显著（P〉0.05）。结论岳阳市学龄儿童行为问题现患率为9.19％；儿童行为问题整体上男生多于女生，农村高于城区；“A行为”〉“N行为”〉“M行为”，男生以“A行为”，女生以“N行为”为主要构成；行为问题随年龄增大而升高，11～13岁儿章多于6～10岁儿童。     

2005年临沂市部分城乡中小学生脉搏、血压调查

[目的]了解儿童少年脉搏、血压发育现状。[方法]2005年4～6月，在临沂市抽取部分中小学生进行脉搏、血压的测定。[结果]检测5760人，其中城区男生、城区女生、乡村男生和乡村女生各1440人，脉搏均随着年龄的增长而逐渐下降（P〈0．01）；各年龄段女生均高于男生。男女生收缩压和舒张压均随年龄的增长而升高。[结论]中小学生脉搏、血压的发育规律与国内有关报道一致。     

酉阳小学生形态发育6年追踪观察

为了解我校儿童生长发育情况．于1988年对一年级新生124名进行了生长发有追踪观察；由于学生转学或作学，至1993年观察结束后得有效卡片93张，其中男生50入，女生43人。观察内容有身高、体重、胸围3项指标。每年6月份进行检查，按《儿童少年卫生学》有关要求进行，在检查中做到人员固定，器材固定，时间固定，以保证资料的准确性和可靠性。6年间各年龄组的身高，体重及胸围均值（见附表）。男、女生的形态发育水平均随年龄增长而增加，6年追踪观察结果，男生身高平均增长2573cm．体重平均增长13．27kg，胸围平均增长9.79cm；女生身高平均增…     

学龄儿童自我意识影响因素的研究

目的：探讨学龄儿童自我意识的影响因素。方法：采用Piers-Harris儿童自我意识量表和自制家庭及在校情况问卷，对1326名9－12岁儿童进行现场调查。结果：儿童自我意识及行为、智力与学校情况、合群、幸福与满足等因子，女生得分离于男生；处我意识随年龄增加得分降低；在家庭环境中父母化程度、职业、性格、教养方式、家庭关系等对学龄儿童自我意识均有影响；学校情况中教师态度、学习成绩、与小伙伴关系及好朋友个数等对学龄儿童自我意识亦有明显影响。结论：家庭环境及学校环境对学龄儿童自我意识的形成和发展都起重要的作用，改善家庭及学校环境，可降低儿童因自我意识出现不良倾向引起行为、学习、人格等障碍的发生率。     

单纯性肥胖儿童心理行为及智商的调查

目的：探讨单纯性肥胖症对儿童心理行为及智商的影响。方法 应用儿童适应行为评定量表和韦氏学龄儿童智力量表对单纯性肥胖组的对照组儿童各182名（年龄7－14岁）进行了心理行为的智商的测试。结果：肥胖组心理行为总得分及各因子得分均显著低于对照组（P＜0．05），肥胖组与对照组总平均适应行为商数（ADQ）分别为125．63与170．85，差异有统计学意义（P＜0．01），并且言语智商（IQ）、操作智商（IQ）及总智(IQ)肥胖组均低于对照组（P＜0．01）。结论；单纯性肥胖儿童存在着显著的心理障碍并且影响智力的发展。     

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.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

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.