学龄期注意缺陷多动障碍儿童情绪和行为问题分析

目的探讨柳州市学龄期注意缺陷多动障碍(ADHD)儿童的情绪和行为特征,为制定科学有效的综合治疗方案提供依据。方法以符合DSM-IV诊断标准的468例ADHD儿童为病例组,采用长处与困难量表(SDQ)父母版比较ADHD儿童与1 404例正常健康儿童的情绪行为特征。结果两组SDQ得分比较,ADHD儿童情绪、品行问题、多动注意不能、同伴交往以及困难总分均高于对照组儿童(P=0. 000),亲社会因子得分对照组高于ADHD组(P=0. 000)。不同性别ADHD儿童SDQ得分比较,女童亲社会行为得分高于男童(P=0. 022)。品行问题和多动注意不能因子得分在不同年级ADHD儿童中比较差异有统计学意义(P0. 05)。结论 ADHD儿童多伴随情绪、品行问题、注意力集中不能等问题,ADHD男童的困难总分高于女童。ADHD儿童的干预训练要根据儿童行为特征及性别差异采取有针对性的方案。     

我国八省小学生心理状况及家长对其评价分析

目的分析我国儿童心理问题现状及其影响因素,为儿童心理健康促进工作提供依据。方法利用中国疾病预防控制中心青年基金"我国学龄儿童主要慢性病干预模式及适宜技术研究"数据。应用长处与困难问卷(strengths and difficulties questionnaire,SDQ)家长版,分析我国8省21 480名6～13岁小学生的心理行为现状及其影响因素。结果 SDQ困难总分(T)、情绪(E)、品行(C)、多动与注意缺陷(H)、同伴交往(P)及亲社会因子(S)平均分分别为(12.93±4.50),(2.30±1.93),(2.38±1.43),(4.02±1.66),(4.23±1.69),(6.29±2.10)。农村儿童在困难总分、情绪、多动与注意缺陷和品行因子得分均高于城市儿童(均有P<0.05)、同伴交往因子及亲社会因子得分低于城市儿童(均有P<0.05);家长文化水平低的儿童困难总分、情绪、多动与注意缺陷和品行因子得分高于家长文化水平高的儿童(均有P<0.05),同伴交往因子及亲社会因子得分低于家长文化水平高的儿童(均有P<0.05)。10.2%的家长主观认为...     

铜陵市学龄前儿童情绪和行为问题调查及其影响因素分析

目的 了解铜陵市学龄前儿童情绪和行为问题现状及其影响因素,为制定相应的干预措施提供依据。方法 采取整群随机抽样法,抽取铜陵市11所幼儿园2 408名学龄前儿童的父母进行调查,内容包括一般情况调查表、长处和困难问卷(SDQ)(父母版)。结果 获得有效问卷2 184份。SDQ困难总分和5个因子异常检出分别是252人(11.5%)、1 052人(48.2%);男童的困难总分、品行问题、多动注意不能、同伴交往问题、亲社会行为得分高于女童(P＜0.05);各年龄组儿童的SDQ困难总分、品行问题、多动注意不能、同伴交往问题和亲社会行为得分差异有统计学意义(P＜0.05)。Logistic 回归分析显示,儿童情绪和行为问题的危险因素有:父亲吸烟半包以上、性别是男童、胎儿窘迫、非核心家庭。母亲本科及以上文化程度是保护因素。儿童年龄越小发生情绪和行为问题的风险越大。结论 铜陵市学龄前儿童情绪和行为问题发生率较高,应进行针对性的早期干预。     

音乐治疗对注意缺陷多动障碍临床症状疗效的随机对照研究

目的比较音乐治疗合并药物治疗与单纯药物治疗对儿童注意缺陷多动障碍(attention deficit and hyperactive disorder,ADHD)的疗效。方法将66例ADHD儿童随机分为研究组和对照组,研究组给予音乐治疗结合盐酸哌甲酯缓释剂治疗,对照组仅给予盐酸哌甲酯缓释剂治疗。两组均予治疗前及治疗16周后采用Conners父母症状问卷、父母用儿童长处和困难问卷(Strengths and Difficulties Questionnaire,SDQ)评估ADHD的临床症状。结果 1)研究组和对照组治疗后SDQ品行问题、多动注意不能及困难总数因子得分差异具有统计学意义(P0.05),研究组治疗后SDQ情绪因子得分明显下降,差异达到统计学意义(P0.05或0.01);2)研究组和对照组治疗后Conners量表学习问题、品行问题、多动冲动及多动指数因子得分差异具有统计学意义(P0.05);3)治疗后研究组SDQ因子中的情绪问题、同伴交往和困难总分得分均低于对照组,差异具有统计学意义(P0.05);4)治疗后研究组Conners父母量表的品行问题因子得分小于对照组,差异具有统计学意义(P0.05)。结论音乐治疗合并药物治疗比单纯药物治疗能够更好地改善ADHD儿童的症状。     

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。     

父母教养方式及其一致性与学龄前儿童情绪和行为问题的关联研究

目的探讨父母教养方式及其一致性与学龄前儿童情绪和行为问题的关联。方法于2017年10-11月,采用整群抽样方法,以湖北、安徽、江苏11个城市的109所幼儿园为研究现场,将3~6岁的儿童纳入研究,共27987名,回收有效问卷(问卷均由家长或主要监护人填写完成)27200份。采用“长处和困难问卷”和“父母行为量表”收集学龄前儿童情绪和行为问题并对父母教养方式进行评定,并分析不同特征的学龄前儿童情绪和行为异常率的差异;以学龄前儿童情绪和行为问题为因变量,以父母支持/参与和强制/敌意为自变量,采用多因素logistic回归模型分析学龄前儿童情绪和行为问题与父母教养方式及其一致性的关联。结果27200名研究对象的年龄为(4.35±0.96)岁,男性13975名(51.4%),城市儿童24634名(90.6%),独生子女17916名(65.9%)。父母双方支持/参与均高占14.9%,均低11.9%;父母双方强制/敌意均高占15.2%,均低11.3%。学龄前儿童情绪症状、品行行为、多动行为、同伴交往、困难总分、亲社会行为异常率分别为9.5%、9.5%、18.2%、24.5%、11.2%和10.2%。多因素logistic回归模型分析显示,调整性别、独生子女、居住地区、家庭经济状况、母亲年龄和文化程度、父亲文化程度等因素后,与父亲/母亲高支持/参与、低强制/敌意的学龄前儿童相比,父亲/母亲低支持/参与和高强制/敌意者情绪症状、品行行为、多动行为、同伴交往、困难总分和亲社会行为出现异常的风险较高(P值均<0.05);与父母双方均高支持/参与、均低强制/敌意的学龄前儿童相比,父母双方均低支持/参与和均高强制/敌意者情绪症状、品行行为、多动行为、同伴交往、困难总分和亲社会行为出现异常的风险较高(P值均<0.05)。结论父母教养方式及其一致性与学龄前儿童情绪和行为问题相关。     

中国7省市农村地区4～7岁留守儿童情绪与行为问题及其影响因素研究

目的 了解中国7省市农村地区留守儿童情绪与行为问题及其影响因素.方法 采用长处与困难问卷(SDQ,父母版),对随机选择的3944名农村4～7岁留守儿童看护人进行问卷凋查.结果 留守儿童情绪与行为问题检出率为43.6%;其中,情绪问题检出率8.3%,品行问题检出率9.5%,多动注意不能榆出率8.7%,同伴交往问题检出率18.9%,亲社会行为检出率16.8%.男性留守儿童困难总分、品行问题、多动注意不能和亲社会行为等异常检出率均高于女性,差异有统计学意义;低年龄组留守儿童SDQ困难总分和各因子异常检出率相对较高,其中,品行问题、多动注意不能和亲社会行为等异常榆出率,各年龄组之间差异有统计学意义(P<0.01).多因素分析结果表明,留守儿章得到照顾程度、看护人文化程度、看护意愿以及其父母是否按时寄抚养费等因素与其情绪和行为问题有关.结论 农村留守儿童情绪与行为问题发生率较高,留守儿童心理健康问题值得关注.     

中国7省市农村地区4～7岁留守儿童情绪与行为问题及其影响因素研究

目的 了解中国7省市农村地区留守儿童情绪与行为问题及其影响因素.方法 采用长处与困难问卷(SDQ,父母版),对随机选择的3944名农村4～7岁留守儿童看护人进行问卷凋查.结果 留守儿童情绪与行为问题检出率为43.6%;其中,情绪问题检出率8.3%,品行问题检出率9.5%,多动注意不能榆出率8.7%,同伴交往问题检出率18.9%,亲社会行为检出率16.8%.男性留守儿童困难总分、品行问题、多动注意不能和亲社会行为等异常检出率均高于女性,差异有统计学意义;低年龄组留守儿童SDQ困难总分和各因子异常检出率相对较高,其中,品行问题、多动注意不能和亲社会行为等异常榆出率,各年龄组之间差异有统计学意义(P<0.01).多因素分析结果表明,留守儿章得到照顾程度、看护人文化程度、看护意愿以及其父母是否按时寄抚养费等因素与其情绪和行为问题有关.结论 农村留守儿童情绪与行为问题发生率较高,留守儿童心理健康问题值得关注.     

中国7省市农村地区4～7岁留守儿童情绪与行为问题及其影响因素研究

目的 了解中国7省市农村地区留守儿童情绪与行为问题及其影响因素.方法 采用长处与困难问卷(SDQ,父母版),对随机选择的3944名农村4～7岁留守儿童看护人进行问卷凋查.结果 留守儿童情绪与行为问题检出率为43.6%;其中,情绪问题检出率8.3%,品行问题检出率9.5%,多动注意不能榆出率8.7%,同伴交往问题检出率18.9%,亲社会行为检出率16.8%.男性留守儿童困难总分、品行问题、多动注意不能和亲社会行为等异常检出率均高于女性,差异有统计学意义;低年龄组留守儿童SDQ困难总分和各因子异常检出率相对较高,其中,品行问题、多动注意不能和亲社会行为等异常榆出率,各年龄组之间差异有统计学意义(P<0.01).多因素分析结果表明,留守儿章得到照顾程度、看护人文化程度、看护意愿以及其父母是否按时寄抚养费等因素与其情绪和行为问题有关.结论 农村留守儿童情绪与行为问题发生率较高,留守儿童心理健康问题值得关注.     

中国7省市农村地区4～7岁留守儿童情绪与行为问题及其影响因素研究

目的 了解中国7省市农村地区留守儿童情绪与行为问题及其影响因素.方法 采用长处与困难问卷(SDQ,父母版),对随机选择的3944名农村4～7岁留守儿童看护人进行问卷凋查.结果 留守儿童情绪与行为问题检出率为43.6%;其中,情绪问题检出率8.3%,品行问题检出率9.5%,多动注意不能榆出率8.7%,同伴交往问题检出率18.9%,亲社会行为检出率16.8%.男性留守儿童困难总分、品行问题、多动注意不能和亲社会行为等异常检出率均高于女性,差异有统计学意义;低年龄组留守儿童SDQ困难总分和各因子异常检出率相对较高,其中,品行问题、多动注意不能和亲社会行为等异常榆出率,各年龄组之间差异有统计学意义(P<0.01).多因素分析结果表明,留守儿章得到照顾程度、看护人文化程度、看护意愿以及其父母是否按时寄抚养费等因素与其情绪和行为问题有关.结论 农村留守儿童情绪与行为问题发生率较高,留守儿童心理健康问题值得关注.     

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.     

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.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.     

Psychopathological features of a patient population of targets of workplace bullying

BACKGROUND: A strong association between workplace bullying and subsequent anxiety and depression, indicated by empirical research, suggests that bullying is an aetiological factor for mental health problems. AIMS: To evaluate levels of stress and anxiety-depression disorder developed by targets of workplace bullying together with outcome at 12 months and to characterize this population in terms of psychopathology and sociodemographic features. METHODS: Forty-eight patients (36 women and 12 men) meeting Leymann Inventory of Psychological Terror criteria for bullying were included in a prospective study. Evaluations were performed at first consultation and at 12 months using a standard clinical interview, a visual analogue scale of stress, the Hospital Anxiety and Depression (HAD) scale, the Beech scale of stress in the workplace and a projective test (Picture-Frustration Study). RESULTS: At first consultation, 81% of patients showed high levels of perceived stress at work and 83 and 52% presented with anxiety or depression, respectively. At 12 months, only 19% of working patients expressed a feeling of stress at work. There was a significant change in symptoms of anxiety while there was no change in symptoms of depression. Stress at work and depression influenced significatively capacity to go back to work. At 12-month assessments, workers showed a significantly better score on the HAD scale than non-workers. Over half the targets presented a neuroticism-related predominant personality trait. CONCLUSION: Workplace bullying can have severe mental health repercussions, triggering serious and persistent underlying disorders.     

The rise and fall in incidence of malignant mesothelioma from a British Naval Dockyard, 1979-1999

BACKGROUND: The incidence of malignant mesothelioma in Britain is predicted to rise over the next 15-25 years because of past failure to protect the workforce against inhalation of asbestos. In British Naval dockyards, alternative insulation materials and respiratory protection were introduced from the mid-1960s. Aims This study was carried out to investigate the effects of these control measures on mesothelioma deaths in dockyard workers. METHODS: Cases of mesothelioma of the pleura and peritoneum between 1979 and 1999 in workers from the Devonport Naval Dockyard, south-west England, were sought from coroners' and medico-legal records. RESULTS: Three hundred and one cases were identified, 7% peritoneal. The peak incidence occurred in 1991 with 25 cases per annum (quadratic model fit R(2) = 74.2%, P < 0.001) and we predict that by 2003 the incidence will fall to fewer than five cases per annum. The mean time between first exposure and presentation was 48.5 years [95% confidence interval (CI) = 47.3-49.8], but this was significantly shorter in the more heavily exposed trades, when compared with the less heavily exposed (42 years, 95% CI = 39.0-45.0, versus 49.5 years, 95% CI = 48.2-50.9). Those with higher exposure were also at significantly greater risk of peritoneal disease (P < 0.023, Fisher's exact test). CONCLUSION: The reduction in incidence of mesothelioma is greater than can be accounted for by reduction in numbers of dockyard workers over the last 50 years. Changes in insulation materials and improved industrial hygiene measures introduced into the Devonport Dockyard from the mid-1960s have resulted in an earlier decline in the incidence of malignant mesothelioma than that predicted for the British workforce as a whole.     

Organophosphate toxicity and occupational exposure

The ubiquitous organophosphates present a continuing health hazard in agriculture, public health eradication programmes and as chemical warfare agents. Despite significant progress in understanding the potential mechanisms of toxicity far beyond the commonly accepted mechanism of cholinesterase inhibition in intentional exposures, the precise health effects following occupational exposures are yet to be completely defined. A much greater understanding exists of the clinical features of organophosphate poisoning. These are characterized by a triphasic response involving an initial acute cholinergic phase, an intermediate syndrome (both associated with high mortality) and a disabling but non-lethal delayed polyneuropathy. The delayed polyneuropathy may occur in the absence of the cholinergic or intermediate phases. However, progress is still required in order to improve the quantification and assessment of occupational exposures and the implementation of appropriate preventive measures. Finally, evidence-based guidelines for appropriate or optimal therapeutic interventions following poisoning are required urgently and collaborative work with colleagues in developing countries, where the occurrence of organophosphate exposures is more frequent, may provide the answers.     

Miliaria rubra of the lower limbs in underground miners

This report documents a case series of miliaria rubra of the lower limbs in miners at a deep underground metalliferous mine in tropical arid Australia. During the summer months of February and March 1999, all cases of miliaria rubra of the lower limbs in underground miners seen at the mine's medical centre were clinically examined and administered a questionnaire. Twenty-five patients were seen, an incidence of 56.4 cases per million man-hours. Miliaria rubra was most often located between the ankle and knee (88% of cases). Twenty-four percent had concurrent folliculitis and 20% had concurrent tinea. Thirty-two percent had a personal history of asthma. Walking through ground-water and splashing of the legs was common. Three to 4 weeks of sedentary duties in air conditioning was generally required to achieve resolution of miliaria rubra. The incidence of miliaria rubra of the lower limbs is 38% of the incidence of heat exhaustion at the same mine. The length of disablement is greater, however. Atopics may be at increased risk of miliaria rubra. Control measures are discussed.     

Planning research

The starting point for any research project should be a question.Once this has been defined and the relevant scientific literaturereviewed, a protocol should be drawn up. This will be used notonly as a guide to the conduct of the study and in the preparationof the final report, but also in seeking any financial supportand approvals that are required for the investigation. A protocolis normally arranged in sections covering the background tothe study, the question(s) that it will address, the methodsthat will be used for the collection and analysis of data, thestatistical power of the investigation (where relevant), anyethical considerations, and the financial input that will beneeded. A pilot study is often helpful where aspects of thestudy method are untried or of uncertainvalidity.     

Stress in the Norwegian police service

BACKGROUND: High levels of stress have been attributed to the conditions of police work, but there is little empirical evidence for this. AIMS: To develop a new instrument to measure job stress in the police; to assess the most severe and frequent police stressors; to compare levels of stress according to the demographic and organizational factors; and to study stress in relation to personality traits, work locus of control and coping strategies. METHODS: A comprehensive nationwide questionnaire survey of 3272 Norwegian police at all hierarchical levels, including the Norwegian Police Stress Survey (NPSS), the Job Stress Survey, the Basic Character Inventory, the Work Locus of Control Scale, and the Coping Strategies Scale. RESULTS: Work injuries were appraised as the most stressful but least frequent stressor and job pressure was reported the least severe but most frequent stressor. Females experienced job stressors less frequently, but appraised them as more severe than men did. Older police officers reported more job pressure severity and fewer work injuries. The police in districts where peer support was planned but not implemented, and who worked in districts with more than 50,000 inhabitants, perceived the lack of support more severely than others. The correlations between stress and personality traits, work locus of control, and coping were moderate. CONCLUSIONS: The NPSS captures police-specific stressors that are not adequately measured by global stress instruments. The study of stress in police work should preferably involve a nationwide use of police-specific stress instruments.