Community intervention and public policy in the prevention of antisocial behavior

As academic clinical science moves to community intervention to achieve impact on population prevalence of antisocial behavior disorders, exciting potential is tempered by realistic caution. Three kinds of efforts are noted. First, individual evidence-based therapies are being implemented at scale. Difficulties in high-fidelity implementation are noted, and the unlikelihood of population impact is highlighted. Second, communities are receiving new resources to support individuals, although connecting community resources to highest-risk individuals is difficult. Third, community factors are being targeted for change through policy reform, with mixed results. As the field moves in this direction, the importance of adhering to principles of scientific rigor and empirical evidence is emphasized, to keep scientist-practitioners from overstepping their bounds.     

四川省2008与2004年城市青少年健康危险行为比较分析

目的了解青少年健康危险行为的报告率、分布及其变化情况,为制定相关干预措施提供科学依据。方法分别于2004和2008学年对四川省青少年健康危险行为进行问卷调查,并对2次结果进行比较分析。结果 2008年与2004年比较,报告率上升的有偏食(41.6%)、经常喝碳酸饮料(19.1%)、自行采取减肥措施(31.9%)、较长时间看电视(41.2%)、长时间玩电子游戏(12.4%)、骑自行车违规(55.5%)、失眠(12.8%)、有离家出走意念(42.6%)、目前饮酒(35.9%)、曾使用过毒品(4.4%)、长时间上网(11.4%)。结论青少年部分危险行为报告上升,应引起社会、学校、家庭的关注,大力开展健康教育与健康干预,防止或减少危害健康行为的发生。     

The effects of an intensive behavior and nutrition intervention compared to standard of care on weight outcomes in CF

Inadequate intake and suboptimal growth are common problems for patients with CF and a critical target for intervention. The purpose of this study was to compare the growth outcomes of children with CF who participated in a randomized clinical trial to improve energy intake and weight to children with CF receiving standard of care during the same time period. Our primary outcome was change in body mass index z‐score (BMI z‐score) over 2 years. An exploratory outcome was forced expiratory volume at 1‐sec (FEV₁) over 2 years. Participants were children ages 4–12 with CF, who participated in a randomized clinical trial of behavior plus nutrition intervention versus nutrition education alone, and a matched Comparison Sample receiving standard of care drawn from the Cystic Fibrosis Foundation (CFF) Registry. Children in the Clinical Trial Group (N = 67) participated in a 9‐week, nutrition intervention and were followed at regular intervals (3, 6, 12, 18, and 24 months) for 2 years post‐treatment to obtain anthropometric and pulmonary function data. For each child in the Comparison Sample (N = 346), these measures were obtained from the CFF Registry at matching intervals for the 27‐month period corresponding to the clinical trial. Over 27 months, children in the Clinical Trial Group (the combined sample of the behavior plus nutrition and the nutrition alone) demonstrated significantly less decline in BMI z‐score, ?0.05 (SD = 0.68, CI = ?0.23 to 0.13), as compared to children in the Comparison Sample, ?0.21 (SD = 0.67, CI = ?0.31 to ?0.11). No statistically significant differences were found for decline in FEV₁ between children in the Clinical Trial Group and the Comparison Sample. The key implication of these findings is that intensive behavioral and nutritional intervention is effective and needs to be adapted so that it can be broadly disseminated into clinical practice. Pediatr Pulmonol. 2011; 46:31–35. © 2010 Wiley‐Liss, Inc.     

Prevalence of sexually transmitted infections and the sexual behavior of elderly people presenting to health examination centers in Korea

Sexually transmitted infections are diseases provoking a great social and economic burden as well as health-related problems, and with the aging of society and the extension of life expectancy sexually transmitted infections in the elderly have drawn more attention these days. For the management of sexually transmitted infections in this population, basic epidemiological data need to be established. In this study, 1804 persons from the general population aged over 60 years visiting health examination centers were tested for syphilis, gonorrhea, and chlamydia, and interviewed about the patterns of sexual behavior of elderly people through questionnaires. The prevalence rates of syphilis, gonorrhea, and chlamydia recorded were 0.222% (4/1804), 0 (none), and 0.776% (14/1804), respectively. The results of the survey showed that the sexual life of the elderly people was currently active, and the sexual behavior of chlamydia patients was distinguished in some characteristics from that of the general participants. Political management to prevent sexually transmitted infections needs to be continued in elderly people as it is in other age groups. More detailed follow-up studies are necessary to determine the incidence and prevalence rates of the diseases in the elderly population in future, and the results of this study are considered to be useful as basic data for such studies.     

护理干预对婴儿腹部手术术中低体温现象的影响

目的：探讨护理干预对居家腹膜透析病人依从性的影响研究。方法：选择100例持续性非卧床式腹膜透析病人分为观察组和对照组。观察组出院后每月通过家庭随访进行健康教育。对照组每1～2个月来医院复诊。两年后观察两组病人的自我管理能力。结果：观察组病人的遵医行为优于对照组（P〈0．05），腹膜透析并发症低于对照组。结论：家庭随访可提高病人的遵医行为，增强病人的自我管理能力。     

Executive control and dimensions of problem behaviors in preschool children

Background: Despite the widespread recognition of the importance of executive control (EC) in externalizing psychopathology, the relation between EC and problem behavior has not been well characterized, particularly in typically developing preschoolers. Method: Using the sample, battery of laboratory tasks, and latent variable modeling methods described in Wiebe, Espy, and Charak (2008) , systematic latent dimensions of parent‐rated problem behavior, measured by integrating scales from developmental and clinical traditions, were determined empirically, and then were related to EC. Results: Substantial relations between EC and problem behaviors were revealed by extracting the common variance of interest and eliminating extraneous variance, which were robust to estimated child intelligence and differed somewhat in preschool boys and girls. Conclusion: Preschool EC measured by laboratory tasks appears to tap abilities that strongly and robustly support broad control processes enabling behavioral regulation across cognitive and emotional domains.     

Long-term natural history of Crohn＇s disease

Crohn＇s disease is a chronic inflammatory granulomatous process that usually involves different sites in the intestinal tract. Genetic and environmental factors are thought to play a role in its etiology and pathogenesis. The disorder has a heterogeneous clinical expression and data from tertiary care settings have documented its female predominance, occasional familial nature, and high rate of stricture formation and penetrating disease. It may appear from early childhood to late adulthood, although over 80% are currently diagnosed before age 40 years, usually with terminal ileal and colonic involvement. Several studies have now shown differences in phenotypic clinical expression depending on the initial age at diagnosis, with pediatric-onset disease being more severe and more extensive with more involvement of the upper gastrointestinal tract compared to adult-onset disease. In addition, longterm studies from these tertiary care settings have documented that the disorder may evolve with time into a more complex disease with stricture formation and penetrating disease complications （i.e. fistula and abscess）. Although prolonged remission with no evidence of inflammatory disease may occur, discrete periods of symptomatic and active granulomatous inflammatory disease may re-appear over many decades. Long-term studies on the natural history have also suggested that discrete events （or agents） may precipitate this granulomatous inflammatory process.     

Gait abnormalities differentially indicate pain or structural joint damage in monoarticular antigen-induced arthritis

Gait abnormalities have been suggested to provide an objective measure for joint pain in animal models. Here, we aimed to assess whether parameters of gait analysis correlate with measures of pain-related behavior in experimental monoarthritis. For this purpose, antigen-induced arthritis was induced in the left knee joints of 68 female Lewis rats, of which 30 were treated with tumor necrosis factor-alpha(TNF)-neutralizing compounds. During the course of arthritis, paw print analysis parameters and measures for mechanical and thermal hyperalgesia were obtained. Knee joints harvested on either day 3 or day 21 were scored histologically for signs of inflammation and cartilage and bone destructions. Data were compared to those obtained from 33 immunized control rats and correlated for days 3 and 21. Arthritic rats showed distinct asymmetric gait abnormalities. In the acute stage of antigen-induced arthritis, but not in the chronic phase, there was a significant correlation between the gait parameter ‘left–right distance’ and measures of primary and secondary hyperalgesia. Both in the acute and chronic phases, however, the gait parameter ‘angle between paws’ indicating outward rotation of paws mainly correlated with joint destruction as assessed using histology. Etanercept treatment exhibited pronounced anti-nociceptive and pro-locomotional effects, but the described correlations remained. In conclusion, some parameters of gait analysis may represent a good measure for arthritis pain, mainly in acute inflammation, while others are increasingly influenced by mechanical joint deformation as indicated by cartilage and bone destructions. Thus, gait abnormalities may not unequivocally be suitable for objective pain assessment in all stages of experimental arthritis.