A Weight Management Program Within a High School Health Center

A program for helping adolescent students manage their weight was implemented within a school-based health center to promote evidence-based practice and identify barriers to successful weight management. Voluntary student participation included 6 visits with an advanced practice registered nurse. Body mass index screenings (n = 702) and system variables for case-managed students (n = 41) were examined to identify treatment gaps. Despite a high number of eligible students (n = 250), a low percentage of students (16%) enrolled in case management services. Building effective and sustainable approaches for weight loss in this population requires adequate staffing and community resources.     

1998—2017年天津市滨海新区塘沽地区儿童青少年死亡原因与减寿分析

目的 了解天津市滨海新区塘沽地区5～19岁儿童青少年的主要死亡原因,为政府等相关部门制定干预措施及政策提供可靠依据。方法 按照国际疾病分类法(ICD-9 和ICD-10)统一编码。用粗死亡率、标化死亡率、死因构成比、潜在减寿年数(PYLL)、潜在减寿率(PYLLR)、标化减寿年数(SPYLL)和标化减寿率(SPYLLR)等健康测量指标对天津市滨海新区塘沽地区20年间的死亡报表进行分析。采用Excel 2017、SPSS 20.0 软件进行统计分析,死亡率的比较采用χ2检验。结果 天津市滨海新区塘沽儿童青少年死亡率为39.02/10万,标化死亡率为5.63/10 万,男性死亡率为27.6/10 万,女性死亡率为18.4/10万,男性高于女性,差异有统计学意义(χ2 =2.87,P<0.05)。损伤中毒(17.33/10万)和肿瘤(9.13/10 万)是危害儿童青少年最主要的死因,占全死因死亡的67.8%。儿童青少年全死因PYLL 为15175.5人年,SPYLL 为8497.37 人年,潜在减寿率 为11.8‰,标化潜在减寿率 为29.5‰。结论 损伤中毒、肿瘤是天津市滨海新区塘沽地区5～19 岁儿童青少年的主要死因,要采取行之有效的干预措施减少死亡,降低疾病负担和寿命损失,促进儿童青少年的身心健康。     

Family accommodation mediates the impact of childhood anxiety on functional impairment

BackgroundAnxiety disorders are the most common childhood-onset psychiatric disorders and are extensively associated with child functional impairment. Data suggest that family accommodation plays a role in the association between anxiety severity and functional impairment in children, but more empirical evidence is needed.MethodsParticipants were 425 clinically anxious children (ages 6–17 years), and their mothers. We first examined associations between child anxiety symptom severity, family accommodation, and child functional impairment. Next, we investigated the hypothesized mediation pathway linking anxiety severity to child impairment through increased family accommodation using structural equation modeling. We tested two models: one using parent ratings of their child’s anxiety and the other using the child’s self-ratings. Finally, we estimated the effect sizes of the mediation pathway in both models.ResultsFamily accommodation was significantly correlated with all the study variables. Child functional impairment was significantly correlated with parent-rated and self-rated child anxiety severity. Both structural equation models provided excellent fit for the data and supported the theoretical model by which family accommodation significantly explains part of the association between anxiety symptoms and functional impairment. The indirect effect sizes indicate that family accommodation accounts for between a fifth and a half of the impairment associated with symptom severity.ConclusionsThe data provide important empirical evidence that family accommodation mediates the association between child anxiety and functional impairment and accounts for up to 50 % of this association. These findings contribute to the growing understanding of the critical role of family accommodation and underscore the importance of assessing accommodation when evaluating and treating anxious children.