应用Demirjian法测量乳牙列期儿童的牙龄研究

目的观察乳牙列期儿童在4~6岁期间恒牙胚生长发育规律,探索Demirjian法在该群体牙龄研究的适用性。方法在深圳市幼儿园小班随机抽取4岁左右汉族儿童75名(男童40名,女童35名),连续三年定期拍摄的全颌曲面断层X光片进行牙齿生长发育观察,并采用Demirjian法进行牙龄研究。结果在4~6岁乳牙列期儿童第二磨牙、第二前磨牙和第一前磨牙处于牙冠发育阶段,第一磨牙、尖牙、侧切牙、中切牙处于牙根发育阶段。同龄女童的牙齿发育阶段显著领先于男童。除3.5~4.5岁组男童及4.5~5.5岁组女童的牙龄估计值与实际年龄差异无统计学意义外,各组提示Demirjian法评估值与实际年龄有差异(P0.05)。结论 Demirjian法不能直接用于4~6岁乳牙列期儿童牙龄评估,后期需进一步扩大样本,探讨该年龄段儿童的牙龄评估曲线。     

增城市2-12岁儿童单纯性肥胖的因素研究

目的:了解增城市2~12岁儿童肥胖情况及影响因素。方法:以2~5岁儿童体重指数≥20 kg／m2,6~12岁儿童 体重指数≥21 kg／m2,并排除继发性肥胖作为儿童肥胖的诊断标准,于2003年1~12月间在增城市随机抽取6所小学及6所幼儿 园共3 848名2~12岁儿童,在严格质量控制的条件下由专人负责对其家长进行儿童生长发育与家庭社会因素、睡眠健康问卷调查。 结果:在调查的3 848名儿童中,肥胖儿童281人,肥胖率为7.3％。影响儿童肥胖的主要因素包括儿童年龄、父亲年龄、入睡困 难、喜食鸡蛋等。结论:应针对相关因素进行预防,以保证儿童的健康成长。     

宁波市1～6岁儿童孤独症谱系障碍调查

目的了解宁波市1~6岁儿童孤独症谱系障碍(ASD)分布特征及危险因素。方法采取分层整群抽样方法,对2014年6—12月宁波市5个县(市、区)1~6岁儿童进行ASD筛查。另选取在宁波市妇女儿童医院与康宁医院随访的46例ASD患儿及按年龄、性别(1∶3)匹配正常儿童进行病例对照研究,采用多因素条件Logistic回归分析ASD影响因素。结果共筛查12 123名1~6岁儿童,筛查阳性40例,筛查阳性率为3.30‰,最终确诊ASD儿童14例,患病率为1.15‰。多因素条件Logistic回归分析结果显示,1岁内户外活动时间少(OR=3.637,95%CI:1.069~12.404)、困难抚养型气质、独走出现的月龄大(OR=1.795,95%CI:1.302~2.474)和母亲生育年龄大(OR=7.973,95%CI:1.297~49.009)是ASD的危险因素。结论 ASD患病率相对偏高;应关注具有ASD发病因素的儿童,做到早筛查、早诊断、早干预,以改善ASD患儿的预后。     

群体儿童生长发育2年调查分析

目的: 了解宝山区群体儿童生长发育现状, 探索WHO推荐的NCHS标准评价与上海市市区0~6岁儿童体格发育评价标准之间差异。方法: 对该地区2003年5月15日~6月30日期间104所幼儿园2~6岁19 507名儿童, 应用上海市市区0~6岁儿童体格发育评价标准和WHO0~6岁儿童身高体重评价标准, 评价结果与2002年资料对照分析。结果: 4项体格测量结果比去年指标有所提高, 经过上海评价标准与WHO评价标准对照分析, 群体儿童生长落后倾向在减少, 但儿童超重倾向有所增加。结论: 两种评价标准差距在缩小, 该区儿童超重现象应引起高度重视。     

福建省不同区域8 ~ 10岁儿童及孕妇尿碘、盐碘、甲状腺结节间的相关关系

目的:了解福建省不同区域8 ~ 10岁儿童及孕妇尿碘、盐碘、甲状腺结节间的相关关系,初步探讨甲状腺疾病的影响因素。方法:2019年9 - 11月采用横断面研究方法,选择福建省东山县和平潭县作为调查点。根据纳入标准,在东山县选择孕妇140名、8 ~ 10岁儿童270名,在平潭县选择孕妇189名、8 ~ 10岁儿童368名...     

无锡市1~6岁儿童孤独症患病现状调查

目的:了解无锡市1~6岁儿童孤独症患病情况,并进行干预性治疗。方法:采用整群随机抽样方法对无锡市25521名1~6岁儿童进行横断面调查,采用婴幼儿孤独症筛查表(CHAT)、克氏孤独症行为量表筛查,采用DSM-IV诊断标准和儿童孤独症评定量表(CARS)诊断,评估程度。结果:25 521名儿童中确诊孤独症25名,现患病率0.98‰,男女比例3.2∶1,城区患病率6.22‰,明显高于郊区患病率0.54‰(P<0.05),患病年龄高峰与3年心理行为门诊自然就诊患病年龄高峰相似。结论:无锡市1~6岁儿童孤独症患病率在国内外报道的患病率低范围内,家长、保健医生对孤独症的识别能力有待提高。     

黔南地区0～3岁布依族和苗族儿童肾脏发育状况及影响因素比较研究

目的:探讨黔南地区0~3岁布依族和苗族儿童肾脏发育状况及其影响因素,为少数民族儿童肾脏发育的研究提供依据。方法:选取2013年1月~2013年12月收集的1 360名儿童作为研究对象,按民族分为布依族组(668名)和苗族组(692名),两组按年龄均分为:1~6个月,6个月~1岁,1~2岁,2~3岁4个年龄组。分别进行问卷调查,测量两组各年龄段儿童身高、体重及超声检查肾脏体积,并对影响儿童肾脏生长发育的相关因素进行Logistic多元回归分析。结果:布依族组668名儿童中,肾积水4例(0.59%),肾发育不全3例(0.45%),多囊肾2例(0.29%),肾脏发育异常检出率为1.35%(9/668);苗族组692名,出现肾积水5例(0.72%),肾发育不全4例(0.58%),多囊肾4例(0.58%),肾脏发育异常检出率为1.87%(13/692);两组比较,差异无统计学意义(χ2=0.61,P>0.05)。布依族组1~6个月、6个月~1岁、1~2岁和2~3岁年龄段身高、体重及体表面积分别与苗族组比较,差异均有统计学意义(P<0.01)。布依族组1~6个月和6个月~1岁年龄段左肾长径、左肾宽径、左肾前后径、左肾体积、右肾长径、右肾宽径、右肾前后径及右肾体积分别与苗族组比较,差异均无统计学意义(P>0.05);而布依族组1~2岁和2~3岁年龄段上述指标分别与苗族组比较,差异均有统计学意义(P<0.01)。多因素Logistic回归分析结果表明,年龄、民族、高蛋白类食物摄入量、乳制品食物摄入量等是影响两民族儿童肾脏生长发育的主要因素。结论:黔南地区布依族与苗族儿童肾脏体积存在一定的差别,原因可能是两民族儿童遗传体质、生活环境及营养条件不同所致。     

3~6岁儿童血压自然变化规律及儿童血压的轨迹现象

目的:了解儿童血压的自然变化规律和儿童血压的“轨迹”现象,为预防成人高血压提供预示价值。方法:采取整群抽样,1988年抽取10个地州市县6种民族3~6岁儿童8 381名,2002年在1988年基础上抽取16个地州市县12种民族3~6岁儿童15 878名进行横向血压调查,2002~2004年在横向调查基础上,选择2~5岁4个年龄组儿童作为纵向研究对象,连续追踪3年的血压变化。结果:单因素分析显示,男、女儿童血压均值均随年龄增长而增高。儿童血压与父母亲收缩压(SBP)、舒张压(DBP)、儿童年龄、身高、体重、儿童体重指数(BM I)均呈正相关,并有非常显著意义(P<0.01),多元线性逐步回归分析,年龄剔除方程,固定身高体重等生长发育指标后,儿童SBP、DBP前后无明显变化。相关系数法显示:儿童期各年龄组无论SBP、DBP均呈显著正相关,并有非常显著意义(P<0.01);百分位数法显示:血压偏高发生率2002年和2004年均为11.6%,高血压发生率2003年和2004年均为6.1%,存在轨迹现象。结论:儿童时期血压随年龄上升的现象,是儿童生长发育的一个伴随现象,年龄对血压的影响不是一种必然结果,儿童血压存在“轨迹”现象。     

3～6岁肥胖和正常体重儿童血压、体围及皮褶厚度对比分析

目的:了解3~6岁肥胖儿童与正常体重儿童在血压、体围和皮褶厚度等生理指标的差异,旨在了解肥胖对学龄前儿童健康的损害。方法:采用病例对照的方法对全国11个城市的6051名3~6岁儿童进行研究。对研究对象进行体重、身高、血压、腰围、臀围和皮褶厚度测量,使用2006年世界卫生组织颁布的身高标准体重值标准作为肥胖筛查标准。结果:肥胖组儿童体重、身长、血压、腰围、臀围和皮褶厚度均明显高于正常体重组儿童,肥胖儿童中收缩压偏高、舒张压偏高和腰臀比大于1的比例分别为28·3%、23·2%和17·1%,而正常体重儿童中该比例分别为6·0%、4·7%和7·0%。结论:在3~6岁这一年龄段,肥胖已表现出对儿童心血管健康的损害。     

2005年东台市1971例学龄前儿童视力调查

为了解我市儿童视力情况,遂于2005年8~9月对东台市城区6所幼儿园的1971名3~6岁儿童进行了视力调查,现将结果报告如下。1对象与方法1.1对象东台市城区6所大型幼儿园3~6岁儿童1971名,其中男童1072名(54.39%),女童899名(45.61%)。3岁~组448名(22.73%),4岁~组694(35.21%),5~6岁组82     

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.