癫痫儿童30例心理行为分析

【目的】　对癫痫患儿的心理、行为进行调查,为临床诊治提供依据。【方法】　应用青少年测试软件对30例癫痫儿童进行Conner’s量表(父母)、艾森克个性问卷、瑞文标准测试的检测。　【结果】　疾病组与正常对照组Conner’s量表(父母)结果比较差异有显著性(P<0.01),提示疾病组有明显的多动问题。N 情绪稳定性差异有显著性(P<0.01),提示疾病组有明显的情绪问题。瑞文标准测试结果比较差异有显著性(P<0.01),提示疾病组抽象推理能力明显低于正常对照。　【结论】　癫痫儿童存在一定的心理行为问题,治疗目标不仅要控制临床发作,还要提高患儿的生存质量,医生应与教师、家长共同商讨患儿的治疗、教育和心理支持问题。     

Conners父母、教师问卷在3～7岁儿童中的临床应用研究

【目的】探讨Conners父母、教师问卷在3～7岁儿童的1临床运用及与气质、教养方式的关系。【方法】采用Conners父母症状问卷(Parent Symptom Questionnaire，PSQ)、Conners教师问卷(Teacher Rating Scale，TRS)、3～7岁中国学龄前儿童气质量表及子女教育控制源量表(Parenting Locus of Control Scale，PLOC)对190名儿童进行测查。【结果】PSQ各分量表得分性别、年龄之间差异无显著性。TRS各分量表男童得分高于女童，年龄小的儿童得分高于年龄大些儿童。PSQ的品行问题、学习问题、冲动—多动、多动指数与TRS相关。麻烦型气质的儿童行为问题比平易型多；各气质维度与多项行为因子相关有显著性。PSQ与PLOC教育成效、父母的责任、子女控制、父母控制相关。【结论】PSQ适于3～7岁儿童行为问题的评估。儿童行为问题与气质、教养方式密切相关。     

昆山地区托幼机构6～7岁儿童行为问题流行病学调查

【目的】了解昆山地区托幼机构6～7岁儿童的行为问题现状,为卫生行政部门制定相关决策提供依据。【方法】采用Conners父母症状问卷(Parent Symptom Questionnaire,PSQ),对昆山地区托幼机构的7 149名6～7岁儿童的行为问题进行调查,并将结果与Conners国内常模进行比较。【结果】昆山地区托幼机构6～7岁儿童注意缺陷多动障碍症状阳性总检出率为3.43%,男童的检出率(4.48%)高于女童(2.25%),差异有高度统计学意义(χ2=26.63,P0.01);不同年龄组间冲动-多动、焦虑、多动指数等因子检出率差异具有统计学意义(P值均0.05);男童的品行问题、冲动-多动、多动指数等因子得分均高于女童(P值均0.05);男童冲动-多动因子得分较国内常模较低、多动指数因子得分较国内常模较高(P值均0.05);女童的品行问题、心身问题、冲动-多动、焦虑以及多动指数得分均较国内常模高(P值均0.05)。【结论】昆山地区学龄前儿童多动等行为问题明显,应早期预防、早期干预。     

心理治疗儿童注意缺陷多动障碍的疗效观察

【目的】观察心理治疗儿童注意缺陷多动障碍(attenticndeficithyperactivitydisorder,ADHD)的疗效。【方法】采用心理治疗(支持性心理治疗,认知行为治疗)ADHD50例。治疗组和对照组用Conners简明症状问卷(abbreviatedsymptomquestionnaire,ASQ)评定治疗效果,两组同时用Conners父母症状问卷因子对照治疗效果。【结果】ASQ总分<1为治愈、1~1.5为好转、>1.5为未治愈。治疗组治愈46例,好转4例;对照组治愈40例,好转10例;Conners父母症状问卷因子,品行问题、学习问题、身心障碍、焦虑治疗前后对照差异有非常显著性(P<0.001);冲动-多动、多动指数治疗前后对照,差异无显著性(P>0.05)。【结论】使用心理行为治疗ADHD效果显著、心理治疗方法简单,值得推广应用。     

云南四个民族儿童注意缺陷多动障碍流行病学调查

【目的】了解云南不同地区、不同民族儿童注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)患病率流行病学情况并探索ADHD患儿的临床分型。【方法】使用美国精神障碍(DSM-Ⅳ)ADHD诊断标准制定的DSM-Ⅳ症状量表作为评定学生在学校的行为症状问卷;同时采用Conners父母症状问卷(PSQ)作为评定学生在学校外的行为问卷,对云南汉、彝、傣、哈尼等四个不同民族有代表性的九所小学5650名学生进行流行病学分析,并将其分为注意缺陷为主型(ADHD-Ⅰ)、多动-冲动为主型(ADHD-HI)及混合型(ADHD-C)三个表型,无的为正常组。【结果】5650例儿童经PSQ筛选阳性者971例(17.18%),经教师用DSM-Ⅳ量表筛选阳性者636例(11.26%);二者均为阳性,符合DSM-Ⅳ标准儿童402例,诊断为ADHD,总体患病率为7.12%;其中男290例(5.13%),女112例(1.98%);男∶女=2.59∶1。汉族儿童患病率为7.5%,少数民族儿童总体患病率为6.04%,其中傣族为3.36%,哈尼族为4.62%,彝族为8.90%,各民族儿童间患病率差异有显著性;亚型分布:ADHD-I占42.79%,ADHD-HI占11.44%,ADHD-C占45.77%。【结论】四民族儿童间ADHD患病率不同,提示ADHD发病与各民族文化背景、生活环境不同有关。     

昆明市小学生行为问题及影响因素分析

目的了解昆明市区小学生行为问题及其影响因素,为儿童身心健康发展提供参考依据。方法采用整群随机抽样的方法,应用Conners父母问卷(PSQ)对昆明市辖区2 175名6～14岁小学生进行评定。结果男生的品行问题、学习问题、冲动-多动和多动指数均分皆高于女生(P值均<0.01);冲动-多动和多动指数得分均为低、中龄组>高龄组(P值均<0.05);父亲低学历组儿童的学习问题、品行问题、冲动-多动和多动指数得分均高于中等学历组和高等学历组儿童(P值均<0.05),父母关系差是PSQ所有因子分异常的危险因素(P值均<0.05)。结论昆明市小学生行为问题的发生有性别、年龄差异,家庭环境影响儿童行为问题亦明显。     

系统性家长培训对注意缺陷多动障碍儿童干预效果评估与分析

【目的】了解注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)儿童的家长对疾病相关知识的了解现状和系统性家长培训对患儿的干预效果。【方法】在采用一般情况调查表、疾病知识问卷和Conner′s父母问卷(PSQ)对63例ADHD儿童的家长进行调查之后,以讲座、观看VCD、现场互动、布置作业等形式开展了系统性家长培训工作,让家长全面了解儿童ADHD科学知识,与子女建立良好亲子关系,掌握一些帮助子女的方法。培训6个月后应用PSQ与家长未接受系统培训的53例对照组患儿进行比较。【结果】培训前大多数家长对疾病相关知识不甚了解,培训后家长相关知识了解情况大为改善。PSQ评估结果显示家长培训组患儿在家长接受培训后学习问题、多动-冲动、多动指数等因子分明显低于对照组(P0.05),家长对系统培训的满意度达90%以上。【结论】针对ADHD患儿家庭开展系统性家长培训工作是十分必要和有效的。     

注意缺陷多动障碍儿童气质特点研究

【目的】为了解注意缺陷多动障碍(attentiondeficithyperactivitydisorder,ADHD)儿童行为的异质表现和气质特点,为临床有效干预提供依据。【方法】选用两年来本院门诊采用美国精神障碍诊断和统计手册第3版修订本(DSM-Ⅲ-R)诊断标准,诊断为ADHD的115例儿童,其中男102例,女13例,平均年龄(8.6±1.8)岁。采用张劲松等修订的3~12岁儿童气质问卷。【结果】两年来门诊ADHD儿童以男性为主,占门诊ADHD儿童总人数的88.70%,女性仅占11.30%,二者差异有非常显著性(P<0.001)。ADHD儿童气质类型以难养型为主,结果有非常显著性(P<0.01)。难养型ADHD儿童活动水平、节律性、趋避性、适应性、反应强度、情绪本质、坚持性项目得分明显高于其它类型,差异有非常显著性(P<0.01)。【结论】活动多、注意力低下的儿童出现行为问题的频率较高,消极情绪和社交退缩明显的儿童,行为问题也多。建议尽早了解儿童的气质特点,给予积极的行为影响因素,会使ADHD儿童行为问题得到遏制。     

镇江市3～7岁儿童行为问题流行病学调查

目的:探讨镇江市3～7岁儿童行为问题的流行病学特点,为减少儿童行为问题的发生提供干预措施。方法:应用Conners父母症状问卷(Parent Symptom Questionnaire,PSQ)和自编儿童行为影响因素调查表对724名3～7岁城乡儿童进行调查。结果:3～7岁儿童行为问题检出率为13.1%,男童检出率为17.0%,女童检出率为9.2%,两者相比差异有统计学意义(P<0.01)。男女童在品行问题上差异有统计学意义(P<0.05),在冲动多动及多动指数上差异有统计学意义(P<0.01)。单因素分析发现对3～7岁儿童行为问题有影响的因素有母亲孕期焦虑或抑郁、孕期身体健康状况、父亲文化、产期合并症、儿童既往史以及儿童开始讲话时间。多元逐步回归分析发现孕期焦虑或抑郁、孕期身体健康状况不良、产期合并症是行为问题发生的主要危险因素。结论:儿童行为问题是多因素作用的结果,孕妇保持良好情绪及减少产期合并症对减少儿童行为问题有重要意义。     

对立违抗性障碍儿童行为特征及伙伴关系初步研究

[目的]探讨对立违抗性障碍（oppositional defiant disorder,ODD）儿童的行为特征及伙伴关系,以期对ODD的干预提供参考.[方法]在学校收集ODD患儿34名和正常对照组34名,所有患儿均符合DSM-Ⅳ中ODD诊断标准.用Conners父母问卷（Parent Symptoms Questionnaire,PSQ）评定儿童行为,用同伴评定法评定伙伴关系.[结果]PSQ中的品行、学习问题、心身障碍,冲动-多动分量表及多动指数得分ODD儿童均明显高于对照组儿童,差异有非常显著性（t=3.07～6.46,P＜0.01）.[结论]ODD儿童存在更多的行为问题以及伙伴关系不良,以敌对、消极抵抗、冲动、自我控制力差为主要特征.     

Arsenic,cadmium, cobalt,copper, lead,mercury, molybdenum,selenium and zinc concentrations in liver,kidney and muscle in Australian sheep

Matched muscle, liver and kidney samples from 152 sheep in different states of Australia were analysed for trace elements. Mean levels found in muscle, livers and kidneys were 0.010, 0.010 and 0.011 mg kg⁻¹ (fresh weight) for arsenic; 0.0035, 0.280 and 0.853 mg kg⁻¹ for cadmium; 0.006, 0.060 and 0.044 mg kg⁻¹ for cobalt; 0.74, 66.0 and 2.72 mg kg⁻¹ for copper; 0.007, 0.040 and 0.057 mg kg⁻¹ for lead; 0.0025, 0.0034 and 0.0061 mg kg⁻¹ for mercury; 0.014, 1.05 and 0.44 mg kg⁻¹ for molybdenum; 0.09, 0.31 and 0.95 mg kg⁻¹ for selenium; and 40.4, 37.2 and 20.8 mg kg⁻¹ for zinc. The lead, mercury and arsenic concentrations in meat and organs may be regarded as low, but the concentrations of cadmium in kidney and livers are sometimes relatively high. Apart from cadmium, lead and selenium, tissue trace element concentrations were not related to the age of the investigated animals. Differences in essential and non-essential trace element accumulation in sheep reared in different regions (states and territories) of Australia were also evaluated. Cadmium, lead and selenium were the only elements that appeared to show significant regional differences. Overall the results show that concentrations of the elements considered are within current acceptable ranges.     

Tuberculosis in Salvador, Bahia, Brazil, in the 1990s

The characteristics of tuberculosis (TB) cases and deaths were analyzed in order to characterize the epidemiological profile of TB (incidence and mortality) in Salvador, Bahia, Brazil, in the 1990s. Annual incidence and mortality rates were calculated by gender, age bracket, and clinical forms of the disease using databases from the Tuberculosis Information System of the Bahia State Health Secretariat and the Mortality Information System of the Brazilian Ministry of Health. TB spatial distribution was analyzed according to health district. Cases and deaths were predominantly in males in the 15 to 39 year group. The pulmonary form showed the highest incidence and mortality. The existing data did not corroborate the hypothesis that AIDS/TB co-infection might contribute to maintaining the high mortality rates. The greater occurrence of tuberculosis in certain health districts may be associated with population density and unfavorable living conditions.     

Homocysteine, folate, vitamin B12, and cardiovascular risk in Indians, Malays, and Chinese in Singapore

OBJECTIVE: To examine the hypothesis that the higher rates of coronary heart disease (CHD) in Indians (South Asians) compared with Malays and Chinese is partly attributable to differences in blood concentrations of homocysteine, and related blood concentrations of folate and vitamin B12. DESIGN: Cross sectional study of the general population. SETTING: Singapore. PARTICIPANTS: Random sample of 726 fasting subjects aged 30 to 69 years. MAIN RESULTS: Mean plasma total homocysteine concentrations did not show significant ethnic differences; values were Indians (men 16.2 and women 11.5 mumol/l), Malays (men 15.0 and women 12.5 mumol/l), and Chinese (men 15.3 and women 12.2 mumol/l). Similarly, the proportions with high plasma homocysteine (> 14.0 mumol/l) showed no important ethnic differences being, Indians (men 60.0 and women 21.9%), Malays (men 53.9 and women 37.8%), and Chinese (men 56.6 and women 30.6%). Mean plasma folate concentrations were lower in Indians (men 8.7 and women 10.9 nmol/l) and Malays (men 8.5 and women 10.8 nmol/l), than Chinese (men 9.7 and women 13.8 nmol/l). Similarly, the proportions with low plasma folate (< 6.8 nmol/l) were higher in Indians (men 44.9 and women 36.6%) and Malays (men 45.3 and women 24.5%) than Chinese (men 31.4 and women 12.6%). Mean plasma vitamin B12 concentrations were lowest in Indians (men 352.5 and women 350.7 pmol/l), then Chinese (men 371.1 and women 373.7 pmol/l), and then Malays (men 430.5 and women 486.0 pmol/l). CONCLUSION: While there were ethnic differences for plasma folate and vitamin B12 (in particular lower levels in Indians), there was no evidence that homocysteine plays any part in the differential ethnic risk from CHD in Singapore and in particular the increased susceptibility of Indians to the disease.     

Murine Typhus in Austin,Texas, USA, 2008

In August 2008, Texas authorities and the Centers for Disease Control and Prevention investigated reports of increased numbers of febrile rash illnesses in Austin to confirm the causative agent as Rickettsia typhi, to assess the outbreak magnitude and illness severity, and to identify potential animal reservoirs and peridomestic factors that may have contributed to disease emergence. Thirty-three human cases of confirmed murine typhus were identified. Illness onset was reported from March to October. No patients died, but 23 (70%) were hospitalized. The case-patients clustered geographically in central Austin; 12 (36%) resided in a single ZIP code area. Specimens from wildlife and domestic animals near case-patient homes were assessed; 18% of cats, 44% of dogs, and 71% of opossums had antibodies reactive to R. typhi. No evidence of R. typhi was detected in the whole blood, tissue, or arthropod specimens tested. These findings suggest that an R. typhi cycle involving opossums and domestic animals may be present in Austin.     

Gender,play, language,and creativity in preschoolers

This study explored the effects of a child's gender and school setting on preschoolers' language abilities (receptive vocabulary), creativity, and social play. The participants were primarily European-American children who spoke English as a primary language (nine children were bilingual), and were from middle income socioeconomic backgrounds. There were 20 girls and 33 boys. Ages ranged from 3.11 to 6.60 years with a mean age of 4.66 years. On separate occasions, children individually completed the Goodenough-Harris Draw-a-Person Test and the Peabody Picture Vocabulary Test-IV. We also recorded the children's social play using Howes and Matheson's [1992. Sequences in the development of competent play with peers: Social and social pretend play. Developmental Psychology, 28, 961–974] scale. We employed a time sampling approach and also notated the area in which the child was playing. We found that gender and school setting influenced children's language abilities and social play. For example, children in the preschool that engaged in pretend play with greater frequency performed well on the receptive vocabulary test. We also found that certain classroom areas generated different types of social play. We discuss the applied value of our findings as these relate to future research.     

Vitamins, selenium, iron, and coronary heart disease risk in Indians, Malays, and Chinese in Singapore

STUDY OBJECTIVE: To examine the hypothesis that the higher rates of coronary heart disease (CHD) in Indians (South Asians) compared with Malays and Chinese is partly because of differences in antioxidants (vitamins A, C, and E, and selenium) and pro-oxidants (iron). DESIGN: Cross sectional study of the general population. SETTING: Singapore. PARTICIPANTS: Random sample of 941 persons aged 30 to 69 years. MAIN RESULTS: There were moderate correlations between vitamin A and vitamin E, and between these vitamins and selenium. Mean plasma vitamins A and E were similar by ethnic group. Vitamin A concentration for Indians were (men 0.66 and women 0.51 mg/l), Malays (men 0.67 and women 0.54 mg/l), and Chinese (men 0.68 and women 0.52 mg/l). Vitamin E concentrations for Indians were (men 12.9 and women 12.8 mg/l), Malays (men 13.6 and women 13.3 mg/l), and Chinese (men 12.6 and women 12.6 mg/l). In contrast, mean plasma vitamin C concentrations were lower in Indians (men 5.7 and women 6.9 mg/l) and Malays (men 5.1 and women 6.4 mg/l) than Chinese (men 6.3 and women 8.4 mg/l). Mean serum selenium was lower in Indians (men 117 and women 115 micrograms/l) than Malays (men 122 and women 122 micrograms/l) and Chinese (men 126 and women 119 micrograms/l). Mean serum ferritin was much lower in Indians (men 132 and women 50 micrograms/l) than Malays (men 175 and women 85 micrograms/l) and Chinese (men 236 and women 92 micrograms/l). MAIN CONCLUSIONS: Lower vitamin C and selenium in Indians, particularly in combination, could play a part in their increased risk of CHD. Vitamins A and E, and ferritin (iron) have no such role. Lower vitamin C in Indians and Malays is probably because of its destruction by more prolonged cooking. In Indians, lower selenium is probably because of a lower dietary intake and the much lower ferritin to a lower dietary intake of iron and its binding by phytates.