儿童虐待与忽视研究的相关问题

由于人类文明的进步和医学模式的转变，儿童虐待与忽视((CNA)成为国际上普遍关注的公共卫生领域研究的热点问题。它是一个复杂的、涉及多方面的、全世界普遍存在的现象。近年来许多国家致力于儿童虐待与忽视问题的探讨和干预，该文概述了CAN问题的产生背景和“国际防止CAN协会”的作用，介绍了CAN的基本概念和危害，旨在强调开展CAN研究及提高公众认识的必要性和紧迫性。     

儿童虐待与忽视问题的国际研究进展

儿童虐待与忽视是一个非常复杂的、涉及多方面的现象 ,包括有各种各样的虐待与忽视形式。它可以发生在家庭内外孩子成长的任何地方。而且 ,因为社会和文化价值观的不同 ,不同的民族关于儿童虐待与忽视的界定标准有很大的差异。该文介绍了各国关于儿童虐待与忽视的概念、判断标准、相关理论、危险因素及常用量表。旨在为中国开展儿童虐待与忽视问题的研究提供有用的信息     

儿童虐待与忽视问题的国际研究进展

儿童虐待与忽视是一个非常复杂的、涉及多方面的现象，包括有各种各样的虐待与忽视形式。它可以发生在家庭内外孩子成长的任何地方。而又，因为社会和文化价值观的不同，不同的民族关于儿童虐待与忽视的界定标准有很大的差异。该文介绍了各国关于儿童虐待与忽视的概念、判断标准、相关理论、危险因食及常用量表。旨在为中国开展儿童虐待与忽视问题的研究提供有用的信息。     

留守儿童自我意识在心理虐待与忽视和孤独感间的中介作用

儿童虐待与忽视已成为国际上普遍关注的公共卫生领域的热点问题.目前,国际上一般将儿童虐待与忽视分为4种类型,即身体虐待、性虐待、心理虐待和各种形式的忽视,其中心理虐待与忽视是儿童虐待与忽视的核心成分,可对儿童造成广泛、深远的不良影响[1-3].以往研究表明,忽视能够正向预测儿童孤独感程度[4];遭受忽视的儿童比正常儿童表现得更为孤独[5];儿童心理虐待与忽视和自我意识之间存在负相关,儿童虐待对自我概念的发展造成不良影响,情感虐待、忽视对自我意识具有负向预测作用[6-7].     

儿童虐待对健康和行为的影响及其机制

儿童虐待与忽视的发生具有很大的隐匿性，种族文化的影响使其界定亦不一致。然而，儿童虐待与忽视对儿童乃至成年后心身健康的影响是显而易见的，这一国际性问题的研究已逐渐延伸到探讨虐待对儿童造成的身心伤害机制和有效社会干预体系的建立。该文介绍了国外有关儿童虐待对儿童及其成年后的心身健康产生伤害的机制方面所做的研究，从行为、认知、社会化和情感四个方面进行了叙述，旨在为国内开展儿童虐待和忽视研究提供参考。     

儿童心理虐待和忽视的现状及其不良影响

随着儿童虐待研究的深入,人们对儿童虐待的认识不断加深。儿童心理虐待和忽视会导致儿童行为和认知异常,情感障碍,严重影响儿童心理健康,甚至会导致自残、自杀等严重后果,是一个严重的公共卫生问题。本文介绍了儿童心理虐待和忽视的流行现状,并对心理健康状况的不良影响和预防干预措施进行了探讨,以期为促进儿童身心健康发展提供有力支持。     

大学生自尊在儿童期情感虐待与攻击性间的中介作用

儿童虐待是指对儿童有义务抚养、监管及有操纵权的人做出足以对儿童的健康生存、生长发育及尊严造成实际的或潜在的伤害行为,包括各种形式的躯体和情感虐待、性虐待、忽视及对其进行经济性剥削[1].国际卫生组织将儿童虐待主要划分为躯体虐待、情感虐待、性虐待以及忽视等4种类型.其中情感虐待是儿童虐待的核心组成部分[2],它是指父母或看护人等经常对孩子侮辱、恐吓、指责、轻视或孤立等,或忽视孩子的情感需要[3].目前国内外学者主要研究情感虐待与情绪问题(抑郁、焦虑、孤独感)、认知问题(情绪面孔反应、情绪面孔注意偏向)以及心理健康问题[4-5]的关系.     

基于发展生态理论的儿童虐待风险因素及其累积效应

儿童虐待(child abuse)是一种广泛存在的社会问题[1],指对儿童有抚养义务、看管和操纵权利的人做出足以对儿童心理健康、成长发育造成潜移默化影响的伤害行为,分性虐待、躯体虐待、情感虐待、躯体忽视和情感忽视5种类型[2].据报道,美国儿童虐待的发生率高达53%[3];我国大学生儿童期虐待比例为47.1%,其中情感虐待、情感忽视和躯体忽视所占比例较高[4].在中学生样本中虐待比例高达78%[5].可见,父母对孩子的虐待在我国的发生率非常高,可能与我国对儿童虐待的预防措施还处于初步发展阶段有关.因此,需明确影响儿童虐待的风险因素,并使用更好的预测方式即累积风险视角来识别和预测儿童虐待的发生风险.     

中国儿童虐待流行病学研究的文献系统评价研究

目的 初步掌握中国0~17岁儿童虐待问题的流行现状,为制定和实施预防儿童虐待策略提供建议。方法 通过对近20年(1992-2012年)的国内外文献进行检索,获取较全面的、有代表性的中国儿童虐待流行病学研究资料,参考证据质量分级和推荐强度系统(GRADE)方法编制了文献质量评价体系,对文献质量和内容进行系统分析。结果 筛选出84篇文献综合分析中国儿童虐待的流行现状的文献,其中仅研究躯体虐待的文献有11篇,仅研究情感虐待的有3篇,仅研究性虐待的15篇,仅研究忽视的12篇,其余均为多种虐待同时研究。1)躯体虐待:城市地区儿童遭受躯体虐待的发生率为41.2%~67.3%,农村地区为32.4%~39.4%。不同研究对躯体虐待的测量方法不一致。2)情感虐待:目前尚没有统一的情感虐待测量方法,不同研究显示的儿童情感虐待发生率存在较大差异,发生率在10.6%~67.1%之间。3)性虐待:现有研究比较多的是调查16岁前发生的性虐待,多采用成年人回顾的方式进行调查。男性遭受性虐待的发生率为10.2%~23.0%,女性遭受性虐待的发生率为14.2%~25.5%。4)忽视:国内研究者从1999年开始进行忽视评价工具和标准的研究,形成了适用于城乡人群、针对不同年龄阶段儿童的中国忽视评价量表。城市3~17岁儿童的被忽视发生率为22.4%~32.8%,农村0~6岁儿童的被忽视发生率为53.7%~54.9%,暂无农村6岁以上儿童被忽视发生率的数据。结论 中国儿童虐待问题不容忽视,需要在儿童虐待定义、调查工具编制、全国流行现状等方面开展深入研究。     

儿童虐待及受害儿童心理健康的研究（综述）

儿童虐待是一种尚未被人们充分认识的重要问题。虐待对儿童造成的伤害可持续很长一段时间,甚至伴随受害者一生。儿童虐待是指在相关责任、义务和能力的条件下,各种形式的躯体和精神虐待、性虐待、忽视或其他形式的剥削,导致儿童的心理健康以及生存发展受到实际或潜在的伤害。相对于发达国家,我国儿童虐待问题的研究起步较晚,急需在社区或学校开展预防儿童虐待教育的研究,制定操作性较强的儿童保护法案或条例,提高公众保护儿童权利的意识,为受害者提供健康服务。     

High Prevalence of Low Birth Weight Babies Born to Pregnant Women Referred to a District Hospital in Rural Zambia

Maternal and Child Health Journal - Low birthweight (LBW) is a significant public health problem in sub-Saharan Africa and LBW in rural Zambia is high. Our study explored the prevalence of LBW for...     

儿童预防接种信息化管理现状问题及发展

儿童预防接种信息化管理是利用计算机信息系统对儿童预防接种信息进行管理,代替以往的手工操作,同时利用网络交换技术实现数据交换,从而全面提高各级的工作效率和信息利用及时性、利用率,达到高效管理,解决异地接种和漏种问题,推动预防接种工作的深入开展。发达国家早在20世纪70年代即开始这方面工作,20世纪90年代初中国经济发展较快的东部地区也开始了这方面的尝试并取得了一定成效。但由于缺乏明确的政策支持、"虚假接种信息"易于实现等问题,发展受到一定制约。2005年卫生部决定依托国家突发公共卫生事件应急信息平台,建立以家庭为单位的儿童预防接种信息库,在国家级构建基于数据交换标准的信息平台,用以存储每年全国约1 500万出生儿童的预防接种信息,动态收集儿童预防接种信息资料,实现数据自动整合、分离与共享。这一工作的完成将是继传染病网络直报后又一个重大的公共卫生事件,将使中国的预防接种监测数据收集迈入新的阶段,进而使中国卫生决策更为准确、及时。     

Child abuse: current problems and key public health challenges

Child abuse has recently been recognized by the World Health Organization as a major worldwide health problem impairing the health and welfare of children and adolescents. This paper attempts to look at child abuse from a public health perspective taking into account the vast cultural diversity in which children and adolescents live focusing on the issue of abuse and violence in a broad public health perspective, and trying to highlight the need for greater attention to be given to possible country-specific interventions.     

Child maltreatment in Canada: an understudied public health problem

Child maltreatment is a major public health problem associated with impairment in childhood, adolescence, and extending throughout the lifespan. Within Canada, high-quality child maltreatment studies have been conducted and are critical for informing prevention and intervention efforts. However, compared to other parts of the world (e.g., United States, United Kingdom, the Netherlands, and Mexico), the number of studies conducted in Canada is far fewer and the data used to study this important public health problem are less diverse. Importantly, to date, representative data on child maltreatment from the general population at the national level in Canada do not exist. This means that many questions regarding child maltreatment in Canada remain unanswered. To advance our understanding of child maltreatment in Canada and to make significant strides towards protecting Canadian children and families, research using Canadian data is essential. To begin to meet these important public health goals, we need to invest in collecting high-quality, nationally representative Canadian data on child maltreatment. Solutions for the barriers and challenges for the inclusion of child maltreatment data into nationally representative Canadian surveys are provided.     

中国儿童营养状况15年变化分析——中国食物营养监测系统建立15年

目的建立一个食物营养监测系统作为每十年一次的全国营养调查的补充,及时了解经济社会快速发展中中国食物与营养变化与趋势,发现新的公共营养问题,为制定相关政策提供科学依据。方法通过试点确立以卫生部在全国设立的145个疾病监测点为基础,结合国家统计局600多个样本区、县,进行二次抽样,确定40个全国食物营养监测点。采用世界卫生组织推荐的儿童身高体重值作为参考标准,计算年龄别身高(HAZ),年龄别体重(WAZ)和身高别体重(WHZ)的Z评分值,以Z值小于-2作为生长迟缓、低体重和消瘦的判别标准。利用住户调查得到食物消费数据,使用中国DDP方法评价膳食摄入。结果15年间5次营养监测结果数据可靠,膳食摄入结果与全国营养调查一致。监测结果已做为国家数据,成为制定政策的依据。结论1990~2005 15年儿童生长发育状况得到很大改善,但是必须注意要将儿童辅食喂养列为与提倡母乳喂养同等重要的位置;高度重视改善妇女与儿童的贫血问题;重点改善西部地区儿童营养状况,为西部经济持续发展服务;关注农村进城务工妇女儿童的营养不良这个新的公共卫生问题。     

基于CAN的通讯适配器的开发

CAN总线上的节点是网络上的信息接收和发送站,本文介绍CAN总线系统智能结点接口电路的设计;CAN接口电路软件的设计,解决传统的RS232接口设备向CAN接口转换的问题。     

Victimization and poly-victimization among school-aged Chinese adolescents: Prevalence and associations with health

ObjectiveGiven the limited number of systematic studies on child victimization in China, this study aimed to investigate the prevalence of child victimization and poly-victimization, and to examine the associations between victimization and negative health outcomes.MethodUsing a 2-stage stratified sampling procedure, 18,341 adolescents aged 15 to 17 years old were recruited from 6 cities in China during 2009 and 2010. Adolescents completed a self-administered questionnaire containing items about child victimization and health outcomes (e.g. health-related quality of life, posttraumatic stress disorder [PTSD], depression, deliberate self-harm, and suicide ideation). Structured multiphase logistic regression analyses were conducted to examine the associations between these factors.ResultsThe lifetime prevalence of at least one form of victimization was 71%, whereas that of poly-victimization was 14%. Child victimization in the preceding year was associated with gender, age, number of siblings, and location of schools. Child victims were more likely to report PTSD and depressive symptoms, self-harm ideation, and poor physical and mental health.ConclusionThis study provided reliable estimates of the association between child victimization and health using a large and diverse sample in China. Based on the nature of the documented associations, several suggestions for public health professionals were offered.     

Incarcerating Pregnant and Parenting Women,the New Witch Hunt: A Policy Analysis

Maternal and Child Health Journal - The mass incarceration of pregnant and parenting women is a serious problem in U.S. A policy focus is needed that takes a public health approach. This paper...     

Developing management systems with cross-cultural fit: assessing international differences in operational systems

Experiences in the Yunnan Maternal and Child Health Project, a 6-year CAN 6 million dollars bilateral initiative implemented in 10 counties (population 2.4 million) in Yunnan, China, are used to illustrate management approaches that successfully bridge cross-cultural differences in operational systems between donor and recipient countries. Donor institutions, local implementing agencies, and partner executing organizations each operate within specific assumptions about how governance structures, financial and administrative systems, human resource infrastructure, communications systems, and monitoring and reporting mechanisms function. These 'system domains' vary across cultures and countries, and become more evident as projects deal with capacity constraints, concerns about accountability, and rapid socioeconomic and political change during implementation. Management teams must be able to identify areas of poor fit among operational systems and respond appropriately. An assessment tool is offered, which management partners can use, as a basis for joint reflections on potential risks, identification of mitigation strategies, and establishing operational systems that are a fit for the funder as well as for partner agencies responsible for executing the project.     

The clinical algorithm nosology: a method for comparing algorithmic guidelines.

Concern regarding the cost and quality of medical care has led to a proliferation of competing clinical practice guidelines. No technique has been described for determining objectively the degree of similarity between alternative guidelines for the same clinical problem. The authors describe the development of the Clinical Algorithm Nosology (CAN), a new method to compare one form of guideline: the clinical algorithm. The CAN measures overall design complexity independent of algorithm content, qualitatively describes the clinical differences between two alternative algorithms, and then scores the degree of similarity between them. CAN algorithm design-complexity scores correlated highly with clinicians' estimates of complexity on an ordinal scale (r = 0.86). Five pairs of clinical algorithms addressing three topics (gallstone lithotripsy, thyroid nodule, and sinusitis) were selected for interrater reliability testing of the CAN clinical-similarity scoring system. Raters categorized the similarity of algorithm pathways in alternative algorithms as "identical," "similar," or "different." Interrater agreement was achieved on 85/109 scores (80%), weighted kappa statistic, k = 0.73. It is concluded that the CAN is a valid method for determining the structural complexity of clinical algorithms, and a reliable method for describing differences and scoring the similarity between algorithms for the same clinical problem. In the future, the CAN may serve to evaluate the reliability of algorithm development programs, and to support providers and purchasers in choosing among alternative clinical guidelines.