绍兴市16～30月龄婴幼儿孤独症谱系障碍筛查结果分析

目的通过对16～30月龄的儿童进行孤独症谱系障碍(ASD)的筛查及诊断,得出绍兴市儿童ASD的患病率及早期筛查的可行性。方法使用改良版婴幼儿孤独症筛查量表(M-CHAT-R/F)对绍兴市妇幼保健院儿童保健门诊体检的1 944例儿童进行筛查,对筛查阳性者进行电话访谈、转诊及评估。结果共筛查出134例阳性儿童,筛查阳性率为6. 89%;共诊断出5例ASD患儿,总ASD患病率为2. 57‰。结论绍兴市ASD患病率与国内报道结果相符。在儿童健康体检时进行ASD早期筛查具有可行性,有利于儿童孤独症谱系障碍的早期诊断和干预。     

孤独谱系障碍早期筛查模式在儿童保健服务系统中的应用研究

目的 了解××市孤独谱系障碍(autism spectrum disorder,ASD)患病情况,探讨在儿童保健系统中实施ASD早期筛查有效模式。方法 采用分层整群抽样法,抽取1.5~3.0岁幼儿2 090人。应用定期反复三级筛查逐级转诊模式,孤独症筛查量表(CHAT-23)、克氏孤独症行为量表(Clancy Autism Behavior Rating Scale,CABRS)为一级筛查工具,可疑者由儿童精神科医生依DSM-Ⅴ标准进行确诊;半年后复查。结果 首次一级筛查,ASD阳性448人,筛查阳性率21.44%;半年复筛现漏诊4人,假阳性2人;终确诊ASD 26人,患病率1.24%。结论 据DSM-Ⅴ诊断标准,应用CHAT-23和CABRS为一级筛查工具,××市ASD患病率接近美国最近报道,普遍高于国内,提示在儿童保健系统中两量表结合,有助于早期识别ASD;采用定期反复三级筛查逐级转诊模式,利于ASD早期发现和减少漏诊,适合推广。     

婴幼儿孤独症筛查问卷的初步编制和信效度分析

目的 编制适合中国文化背景的婴幼儿孤独症筛查问卷,并检验其信效度.方法 借鉴国内外相关研究成果和参考DSM-5孤独症谱系障碍(ASD)症状标准,编制婴幼儿孤独症筛查问卷(SQAT),选取门诊或体检儿童238名和康复训练机构患儿392名进行初测,2～4周后对其中28名被试进行重测,部分儿童接受校标检测.通过专家评价、条目...     

中文版量化的婴幼儿孤独症筛查量表信效度研究

目的 评估中文版量化的婴幼儿孤独症筛查量表(Q-CHAT)的信度和效度,以期为孤独症谱系障碍(ASD)的早期筛查提供合适的工具.方法 2019年7月—2020年1月分别采用量化的婴幼儿孤独症筛查量表(Q-CHAT)和儿童孤独症评定量表(CARS)对符合《精神障碍诊断和统计手册》第5版(DSM-5)ASD诊断标准的91例...     

深圳市18~24月龄婴幼儿孤独症谱系障碍筛查及3年随访研究

【目的】 通过对18~24月龄婴幼儿进行早期孤独症谱系障碍(autism spectrum disorders,ASD)筛查并随访3年,了解深圳市ASD的患病率及早期诊断的可行性。 【方法】 用婴幼儿孤独症检测表(Checklist for Autism in toddlers,CHAT)量表对深圳市南山区、宝安区和龙岗区的3 624名婴幼儿进行筛查,对筛查阳性者进行转诊、电话访谈、诊断评估及3年随访。 【结果】 筛查阳性婴幼儿244人,总筛查阳性率为5.77%;共诊断ASD儿童10名,其中3例PDD-NOS,7例孤独症,总患病率为2.76‰,均为男性。第一次诊断评估为可疑ASD患儿在3年随访后仍旧符合ASD的诊断标准。 【结论】 深圳市ASD患病率低于国外报道结果,高于国内其他地区的报道。利用儿童保健系统进行孤独症的早期筛查具有可行性,有利于孤独症的早期诊断和早期干预。     

早期孤独谱系障碍社区筛查量表的编制与信度、效度分析

目的 编制适用于社区的简单、便利、灵敏度高的早期孤独谱系障碍筛查量表,并对该量表进行信度和效度分析.方法 以美国精神障碍诊断统计手册第四版(DSM-Ⅳ)的孤独症临床表现和诊断标准为基础,参考婴幼儿孤独症筛查量表(CHAT)、孤独症行为量表(ABC)、儿童孤独症评定量表(CARS)、孤独症诊断访谈量表(中文修订本)(ADI-R)等编制成早期孤独谱系障碍社区筛查量表(EASSC).在深圳市随机选取6～24月龄儿童9 860人作为筛查对象,对该量表进行信度、效度检验.结果 该量表各因子和总分的评定者信度分别为0.945、0.973、0.874、0.952、0.962;重测信度分别为0.936、0.910、0.925、0.853、0.949.该量表的分半信度为0.917.该量表和ABC量表间的校标关联效度为0.835.当分界值为9分时,该量表的灵敏度为0.912,特异度为0.898.结论 该量表具有较好的信度和效度,费时少,容易填写,适用于早期孤独谱系障碍的社区筛查,具有一定的推广使用价值.     

孤独症的共病问题及其对诊疗的影响

正孤独症(autism)患病率高达0.1%~1%~[1-2],终身影响和社会负担之重已经引起广泛重视和重点研究。在2013年颁布的美国精神障碍诊断与统计手册第5版(DSM-5)中将孤独症归入孤独谱系障碍(autism spectrum disorder,ASD)~[3-4]。ASD是指以社会交往困难,语言交流障碍和兴趣范围狭窄及刻板行为主要临床表现的一组神经发育障碍。包含了     

海南省0~6岁儿童孤独症谱系障碍的现况调查及影响因素分析

目的 了解海南省0~6岁儿童孤独症谱系障碍的患病情况及其影响因素。方法 抽查海南省18个市（县）0~6岁儿童37 862人,采用儿童发育问题预警征象调查表筛查,再由专科医师现场诊断,采用一般描述统计、χ²检验、非条件logistic回归分析孤独症现况及影响因素。结果 共诊断235例孤独症儿童,总患病率为0.62%,其中男童为0.99%,女童为0.17%,男童高于女童（χ²=101.91,P=0.000）。随年龄增长孤独症患病率上升（χ²=288.62,P=0.000）。城市孤独症患病率高于其他地区,差异有统计学意义（χ²=114.77,P=0.000）。是否足月、新生儿窒息、父亲性格、父亲有嚼槟榔或吸烟习惯、母孕期总体情绪状态以及母亲人流史为孤独症的影响因素。结论 海南省0~6岁儿童孤独症谱系障碍的患病率居国内较高水平并受遗传因素、孕产过程、父母在孕前及孕期不良行为、习惯等综合因素的影响。     

孤独症筛查量表(CHAT-23)的应用研究

【目的】研究CHAT-23作为孤独症筛查量表在中国内地的可行性及有效性并探索一套适合于初级儿童医疗保健机构使用的筛查流程。【方法】选取卢湾区18~24月龄儿童作为筛查对象,运用CHAT-23量表对其进行ASDs筛查;选择孤独症谱系障碍患儿为病例组,正常儿童为对照组,计算CHAT-23家长填写问卷的灵敏度、特异度及阳性预测值;部分儿童家长重新填写问卷,计算问卷的重测信度。【结果】卢湾区共筛查了484人,发现2名疑似孤独症谱系障碍患儿;该问卷的灵敏度及特异度分别为0.941和0.884。问卷加Section B当面访谈的阳性预测值为50%;该问卷的重测信度(kappa值)为0.50。【结论】CHAT-23孤独症筛查量表灵敏度和特异度均较高,是一种适用于初级医疗保健机构的孤独症筛查量表,适合在中国内地推广。     

95例孤独症儿童血串联质谱检测的分析报告

目的应用串联质谱(tandem mass spectrometry,MS/MS)技术进行孤独症谱系障碍(autism spectrum disorder,ASD)儿童的遗传代谢病(inborn errors of metabolism,IEM)筛查,了解ASD患儿的高发IEM病种,并探讨IEM与儿童ASD之间的关系。方法利用MS/MS技术对2010年11月-2013年12月于复旦大学附属儿科医院儿童保健科门诊就诊、根据DSM-Ⅳ诊断标准确诊的95名ASD患儿的血液样本进行IEM筛查。结果 1名(1.95%)患儿存在苯丙酮尿症,1名(1.95%)患儿戊二酸血症-II型不能除外,其他患儿(96.1%)均不存在本研究所涉及的IEM。结论本研究为晚诊断的苯丙酮尿症与ASD之间的关联提供了案例支持,苯丙酮尿症可能是儿童ASD的共患病之一;戊二酸血症-II型与ASD之间可能存在一定联系。对于IEM高危患儿、特别是生后未行新生儿筛查的ASD患儿,及时地进行IEM筛查对于全面诊断和治疗ASD有着重要意义。     

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.     

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.     

Fatigue and health in a seafaring population

Background Occupational fatigue is relatively common withinthe general population and has been linked to reduced performance,injury and longer term ill-health. Despite growing acknowledgementof this problem in the maritime sector, little research hasbeen conducted into the risk factors, prevalence and consequencesof seafarers' fatigue. Aims To examine the prevalence of fatigue among seafarers, identifypotential risk factors and assess possible links with poor performanceand ill-health. Methods Cross-sectional questionnaire survey of seafarers workingin the offshore oil support, short-sea and deep-sea shippingindustries. A number of tools were used including the fatiguesubscale of the profile of fatigue-related symptoms, the CognitiveFailures Questionnaire, the General Health Questionnaire andthe SF36 General Health scale. Results In all, 1855 questionnaires were completed giving anoverall response rate of 20%. Fatigue symptoms were associatedwith a range of occupational and environmental factors, manyunique to seafaring. Reporting a greater number of risk factorswas associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35)for those with three or four risk factors and OR = 9.54 (6.95–13.09)for those with five or more risk factors]. There was also astrong link between fatigue and poorer cognitive and healthoutcomes, with fatigue the most important of a number of riskfactors, accounting for 10–14% of the variance. Conclusions Seafarers' fatigue could impact on safety withinthe industry and may be linked to longer term individual ill-health.It can only be addressed by considering how multiple factorscombine to contribute to fatigue.     

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.     

Hydrazine inhalation hepatotoxicity

Abstract Hydrazine is a hazardous chemical commonly used as a reactant in rocket and jet fuel cells. Animal studies have demonstrated hepatic changes after hydrazine inhalation. Human case reports of hydrazine inhalation hepatotoxicity are rare. We report a case of mild hepatotoxicity following brief hydrazine vapour inhalation in a healthy young man, which resolved completely on expectant management.     

Fitness standards in airline staff

Employers have a legal duty to manage safety and to meet this duty it is necessary to control risks arising from pre-existing medical conditions. Such conditions can be identified at the time of job placement, but there is little published information about the approach to fitness standards by most airlines. This review is therefore limited to the practice of one major airline. It is illustrated by reference to various occupations within the airline, with the associated rationale.