早期教育对足月正常儿智能影响的研究

目的:进一步了解早期教育对婴幼儿智能、体能等方面的影响.方法:对47例足月正常新生儿进行早期潜能开发的指导和训练,设立对照组.两组儿童每年进行一次婴幼儿智能发育量表测试.结果:两组儿童体格发育指标发育差异不显著(P＞0.05),两组儿童智能发育指数和运动发育指数差异显著,早教组智能发育和运动发育指数均高于对照组(P＜0.01).结论:早期教育对婴幼儿智能发育有非常重要意义.     

婴幼儿语言发育迟缓的临床分析

目的 探讨婴幼儿期语言发育迟缓儿童的病因和干预效果.方法 用S-S语言发育评定法及Gesell智能评估法对113例3岁以内语言发育迟缓的患儿进行评估,制定干预措施,评价疗效.结果 3岁以内语言发育迟缓患儿中特异性口语表达迟缓较为常见(45%),该类儿童经训练后,语言发育商由45.80±16.90上升到88.51±9.51,经比较有统计学意义(t=-15.70.P<0.01).精神发育迟滞及孤独症患儿在3岁以内语言发育迟缓者中仍占多数(分别为28%和27%),经过系统训练后,该类儿童的语言发育商也能够得到明显的提高,与训练前比较,其语言发育商由43.91±16.36提高54.52±16.04,经比较有统计学意义(t=-3.67,P<0.01),但大部分患儿无法得到完全恢复.结论 早期发现和早期干预对于语言发育迟缓儿童的康复至关重要.     

智能低下儿童病因及早期干预研究

目的为探索智能低下儿童训练的有效方法.方法分析163例智能低下儿童的高危因素;按波特奇(Portage)及弱智儿童早期教育法进行功能训练,训练2个疗程以上的56例为训练组;训练1～2次的31例为对照组,分析训练效果.结果163例智能低下儿童中母孕期有高危因素者136例(83.5%);训练组儿童智商(IQ)或发育商(DQ)训练前得分66.1±3.7;训练后得分82.66±9.57,差异有显著性(P＜0.01);新生儿颅内出血、新生儿窒息和过期产儿训练效果好,训练前后IQ(DQ)差异有显著性(P＜0.05,P＜0.01);1～5岁患儿训练前后IQ(DQ)差异有显著性(P＜0.05,P＜0.01).结论智能发育落后的儿童,在5岁前按Portage及弱智儿童早期教育法坚持训练,会取得显著效果.     

高危新生儿情感及智能发育早期干预

目的 探讨高危新生儿情感及智能发育早期干预措施.方法 186例高危儿,其中足月儿99例,早产儿87例.分别随机分成干预组和对照组,进行影响智能发育有关因素调查并做组间均衡比较.干预组以健康教育、情感和智能开发为突破口,找出最佳起点并应用自行编制的<婴幼儿智能开发与发育简明表>制定个别化早期训练方案,进行情感和大动作、精细动作、认知能力、语言、社会行为六个能区康复训练,并指导家长开展家庭训练.追踪随访至一岁半,比较分析干预组和对照组各能区的发育商及总发育商.结果 干预组无论是足月高危儿(除社交行为外)还是早产高危儿各个能区的发育商和总发育商均显著提高(P＜0.05,P＜0.01).早产高危儿改善幅度更为显著.结论 应用干预措施能显著促进高危儿的情感及智能发育,表明干预措施的有效性,对早产高危儿进行早期干预更有积极意义.     

北京市怀柔区0～2岁儿童早期发展干预研究

[目的]探讨儿童早期综合发展干预措施对儿童发展的影响. [方法] 选择2004年6月～2006年7月出生于怀柔区的正常足月新生儿120人,按照1:1配对分组,分为实验组和对照组60对.对实验组进行早期发展系统指导,两组均定期监测.并于生后1岁、1.5岁、2岁用进行智能测查. [结果]体格发育主要指标(体重、身长)两组间差异无显著性;试验组儿童血红蛋白在6个月、1岁、1. 5岁和2岁时均高于对照组(P＜0.05);贫血的患病率在1岁组时试验组低于对照组(P＜O.05);试验组儿童的母亲拥有较高的育儿知识知晓率;试验组于1岁、1.5和2岁时发育商均高于对照组(P＜O.01). [结论]早期干预可以降低婴儿贫血的患病率;早期干预通过改变母亲的知、信、行对子女的生长发育产生积极的影响;早期干预可以提高婴幼儿的智能发育.     

早期干预中应物能高低对粗大运动影响的探讨

[目的]探讨早期干预对0～2岁应物能不同、运动发育异常儿童粗大运动能力的影响.[方法]将76例0～2岁发育异常小儿分为应物能正常组[发育商(developmental quotient,DQ)值＞75]和应物能低下组(DQ值＜75),均采用Vojta法、Bobath法等早期干预方案进行综合训练.将初次发现及3个月后Gesell发育商复测运动DQ值进行对比评估.[结果]①两组小儿经早期干预综合治疗后应物能及粗大运动DQ值均有显著提高(P＜0.01);②应物能正常组粗大运动改善程度明显优于应物能低下组(P＜0.01);③应物能低下小儿应物能与粗大运动呈现明显相关性(P＜0.01).[结论]在早期干预综合治疗中提高小儿应物能可更有效的提高粗大运动能力.     

陕西省部分地区3岁以下儿童体格发育影响因素研究

目的 了解陕西省部分地区3岁以下儿童体格发育的相关影响因素,为进一步实施干预措施提供理论依据.方法 2012年7至12月随机整群抽取陕西省西安市和宝鸡市的2 479名3岁以下儿童,对其体格发育情况进行调查,按照人体标准测量方法测量其身高、体重,采用调查问卷了解儿童情况、家庭情况及父母情况,并对结果进行分析.结果 影响3岁以下儿童体格发育的因素主要有:儿童性别(t=-6.017～-2.136,均P＜0.05)、出生体重(t=2.216～5.724,均P＜0.05)、出生身长(t=2.291 ～5.045,均P＜0.05)、分娩方式(t=2.270 ～3.323,均P＜0.05)、家庭人口数(t=-2.684 ～-6.680,均P＜0.05)、居住地(t=-5.512 ～-2.452,均P＜0.05)以及父母亲文化程度(t=2.228 ～3.830,均P＜0.05;t =2.120 ～3.681,均P＜0.05).出生体重及出生身长较高,居住在城市,父母亲文化程度较高,分娩方式为顺产的儿童,其体格发育较好,且男童的体格发育均高于女童;而家庭人口数较多会对儿童的体格发育产生不利影响.结论 家庭和父母情况对3岁以下儿童体格发育的影响作用比较突出,是影响3岁以下儿童体格发育不可忽视的因素,文化程度较低的儿童父母是儿童保健健康教育的重点人群.     

高危儿管理和早期干预网络的建立及效果评定

目的 建立高危儿管理和早期干预网络,降低高危儿智力低下、营养不良的发生率.方法 新生儿出院前家长在辖区保健机构办理儿童保健手册时,医生依据分娩记录对新生儿进行高危因素筛查,筛查出的高危儿依托儿童保健系统管理网络及时上报并根据高危因素的不同进行分层、分级管理和早期干预,参照鲍氏早期教育资料进行干预,并辅以科学喂养相关知识的指导.结果 通过对设立的高危儿干预组、高危儿未干预组和健康对照组婴儿1岁时进行测评的结果显示:干预组的儿童智能发育指数为90.62±9.18,明显高于未干预组的发育平均指数83.43±15.95(t=7.190,P<0.01),与健康对照组的91.04±13.11基本接近(t=0.419,P>0.05);未干预组的儿童中重度营养不良的发生率(18.37%)明显高于干预组(4.00%)(χ2=8.652,P<0.05).结论 通过健全的高危儿管理网络对高危儿进行管理和早期干预可以提高儿童智能发育指数和体格发育水平,减少智力残疾和中、重度营养不良的发生.     

早期干预对婴幼儿社会情绪发展的影响

目的 探讨早期综合干预对培养婴幼儿社会情绪能力发展及健全人格的影响.方法 选择2007年9月1日至12月31日出生于怀柔区并在怀柔区妇幼保健院进行定期体检的新生儿60人,随机分成干预组和对照组各30人.干预组除常规保健指导外,由经培训的专业人员负责进行健全人格培养的个体化指导,两组均定期随访.在婴儿1～4个月和2岁完成儿童气质量表,2.5～3岁时采用幼儿人格发展趋向量表、婴幼儿智能发育量表等标准化工具进行评估.结果 干预组幼儿人格发展趋向量表(t=5.393,P<0.001)、婴幼儿智能发育量表(智力发育指数:t=2.420、神经运动发育指数:t=2.176,均P<0.05)的各项平均分及气质特点(χ2=12.543,P=0.014)与对照组比较差异均有统计学意义(均P<0.05);干预组的结果 均显著优于对照组.结论 早期干预能显著促进婴幼儿社会情绪能力和健全人格的发展,0～2岁是培养婴幼儿健全人格的黄金时期.     

婴幼儿早期教育效果分析

目的 探讨早期教育时0～2岁婴幼儿体格、智能发育的影响,以便制定本地区早期教育实施方案,进一步促进儿童早期发展.方法 选择2005年8～10月在长春市妇产科医院出生的正常足月新生儿共112例,随机分为实验组和对照组,每组各56例,两组小儿均按儿童保健系统管理要求定期接受健康检查及保健指导,同时对实验组小儿进行定期脑潜能开发训练指导.于出生后1岁、1岁半、2岁时分别对两组小儿进行体格和智能发育检查.结果 两组小儿体格发育的主要指标体重和身长比较无显著性差异(P＞0.05),而两组小儿的智能发育比较存在显著性差异,实验组小儿1岁、1岁半、2岁时的发育商明显高于对照组(f分别为7.84、8.52、8.76,均P＜0.01).结论 早期教育能够促进婴幼儿的智能发育,提高发育商.     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

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.     

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.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

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.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.