对立违抗性障碍儿童行为特征及伙伴关系初步研究

[目的]探讨对立违抗性障碍（oppositional defiant disorder,ODD）儿童的行为特征及伙伴关系,以期对ODD的干预提供参考.[方法]在学校收集ODD患儿34名和正常对照组34名,所有患儿均符合DSM-Ⅳ中ODD诊断标准.用Conners父母问卷（Parent Symptoms Questionnaire,PSQ）评定儿童行为,用同伴评定法评定伙伴关系.[结果]PSQ中的品行、学习问题、心身障碍,冲动-多动分量表及多动指数得分ODD儿童均明显高于对照组儿童,差异有非常显著性（t=3.07～6.46,P＜0.01）.[结论]ODD儿童存在更多的行为问题以及伙伴关系不良,以敌对、消极抵抗、冲动、自我控制力差为主要特征.     

冲动控制任务时对立违抗性障碍儿童的功能核磁共振研究

【目的】探索对立违抗性障碍（oppositional defiant disorder，ODD）儿童冲动控制任务时的脑功能特点。【方法】10例ODD和10例对照组男童，以GOSTOP冲动控制为刺激任务，进行功能性核磁共振成像（functional magnetic resonance imaging，fMRI）；然后对两组数据标准化、合并和平均；比较两组脑激活图像的分布和各个激活区域的面积。【结果】两组儿童大脑的额极（额中回、额下回和眶部前部）和部分颞极（颞下回、颞中回）明显激活，两组激活区域分布没有质的差异；对照组在以上相关区域激活较集中，其他脑区激活少；ODD组在以上区域激活面积大于对照组，此外还可见其他多处皮质和皮质下结构被激活。【结论】额极在冲动行为控制中扮演重要角色；ODD组比对照组需要动用更多的额极及其他脑区参与冲动控制任务，提示ODD儿童额极功能相对低下。     

团体认知治疗对网络成瘾大学生负性情绪与冲动性的干预效果

  目的  采取团体认知治疗方法,比较干预组和对照组网络成瘾大学生在负性情绪以及冲动性方面的差异变化,探索团体治疗网络成瘾的效果。  方法  将招募的贵阳某高校33名网络成瘾大学生随机分为干预组(16名)和对照组(17名),在干预前后进行网络成瘾量表、抑郁自评量表、焦虑自评量表、UPPSP冲动行为量表的测量。采用事件相关电位(ERP)技术,检测两组被试在干预前后与冲动抑制功能相关的脑电成分差异。  结果  对照组干预前后两次网络成瘾、焦虑、抑郁及冲动性的得分变化均无统计学意义(P值均>0.05);对照组后测N1波幅高于前测(t值分别为-3.32,-3.19,P值均<0.05),N2、P3的波幅变化均无统计学意义(P值均>0.05)。干预组干预前后的抑郁、焦虑得分下降(t值分别为2.20,2.45,P值均<0.05);消极紧迫感及积极紧迫感得分下降(t值分别为3.84,3.44,P值均<0.05);干预组干预后,N1波幅的反应任务(GO)和停止任务(STOP)均高于前测(t值分别为-3.08,-2.72,P值均<0.05),N2、P3的STOP均低于前测(t值分别为2.10,2.07,P值均<0.05)。  结论  团体认知治疗可以改善网络成瘾大学生的负性情绪,降低冲动性水平,并在一定程度上改善其冲动控制功能。     

注意缺陷多动障碍儿童冲动行为与焦虑抑郁情绪的相关研究

目的研究ADHD儿童冲动行为与焦虑、抑郁情绪的关系,进一步探索不良情绪与冲动症状的关系。方法以2005年1月-2007年7月就诊的187名(8～12岁)ADHD儿童为研究组,同时选取年龄相当的126名为儿童对照组。2组儿童分别完成Barratt冲动性量表和儿童焦虑性情绪障碍筛查表、儿童抑郁障碍自评量表。结果冲动组、ADHD非冲动组和对照组焦虑、抑郁情绪差异有统计学意义(P值均0.05),冲动组在除社交恐怖以外的焦虑各分量表及总分、抑郁总分上高于ADHD非冲动组和对照组(P值均0.05),在学校恐怖和抑郁总分上高于ADHD非冲动组(P值均0.05);ADHD非冲动组的躯体/惊恐和分离焦虑得分高于对照组(P值均0.05);Bar-ratt冲动性量表的3个因子及总分与除社交恐怖外的焦虑各分量表及焦虑总分、抑郁总分呈显著正相关(P值均0.05)。结论ADHD儿童存在明显的焦虑、抑郁情绪,焦虑抑郁情绪越强烈,冲动行为越显著。     

冲动性人格特征与农村地区自杀未遂的关系

目的探讨冲动性人格特征与自杀未遂的关联。方法从我国4个农业县的自杀行为医院登记系统获取自杀未遂案例,从其中3个县分层随机抽样获取健康对照者。分别访谈案例对象本人、家属和亲友,收集案例对象的人口学资料、精神健康情况、冲动人格特征和攻击行为等信息。结果共有118例自杀未遂案例(未遂组)和140例健康对照者(对照组)被纳入研究。未遂组[(40.3±13.0)岁]较对照组[(49.7±13.9)岁]年轻(P 0.001),女性比例更高(66.1% vs 46.4%,P=0.002)。单因素分析未遂组的冲动性量表总分和攻击行为总分的高分比例均高于对照组。多因素Logistic回归结果提示,依据知情人报告的信息,冲动性量表总分高(OR=59.56,95% CI:10.80～328.40)或该量表的认知冲动分量表高分(OR=10.49,95% CI:2.20～49.98)和行为冲动分量表高分(OR=5.63,95% CI:1.41～22.59)是升高自杀未遂的风险;依据本人提供信息,认知冲动分量表高分(OR=3.55,95% CI:1.09～11.54)和自我攻击分量表得分中等(OR=4.14,95% CI:1.33～12.88)是升高自杀未遂的风险。结论冲动人格特征是自杀未遂的独立危险因素。需要采取生命价值观教育和其他综合措施减少"冲动"自杀行为。     

大学生冲动性、文化取向对饮酒行为的影响

目的了解大学生冲动性、内隐与外显文化取向与饮酒行为的关系,为大学生心理健康提供理论依据。方法采用内隐联想测验程序和冲动性、文化取向量表,对60名在校大学生进行测量。结果规律饮酒者、非饮酒者与偶尔饮酒者的内隐文化取向得分分别为(-65.46±155.00)、(186.86±337.04)、(150.32±225.80)分,差异有统计学意义(F=3.45,P0.05);规律饮酒者、非饮酒者与偶尔饮酒者的冲动性得分分别为(72.75±5.63)、(63.89±6.56)、(66.75±7.14)分,差异有统计学意义(F=3.74,P0.05);内隐文化取向与饮酒行为之间存在负相关(r=-0.29,P0.05),冲动性与饮酒行为之间存在正相关(r=0.33,P0.05),运动冲动性与内隐文化取向效应值可以预测饮酒行为。结论大学生冲动性对饮酒行为具有显著的正向预测作用,而内隐文化取向对饮酒行为具有显著的负向预测作用。     

大学生冲动性在无聊倾向与进食行为间的中介作用

分析大学生无聊倾向、冲动性与进食行为之间的关系,为指导大学生形成健康进食行为提供参考.方法 采用大学生无聊倾向问卷、Barrat冲动性量表和进食行为问卷,对从黑龙江省2所大学方便抽取的957名大学生进行调查.结果 不同性别大学生进食行为得分差异有统计学意义,女生限制性进食、情绪性进食和外因性进食得分均高于男生(t值分别为5.48,6.70,6.14,P值均<0.05);不同年级学生得分差异无统计学意义(F值分别为1.17,0.42,0.89,P值均>0.05).无聊倾向与冲动性、情绪性进食、外因性进食均呈正相关(P值均<0.05),与限制性进食相关无统计学意义;冲动性与限制性进食、情绪性进食和外因性进食均呈正相关(P值均<0.05).冲动性在无聊倾向预测情绪性进食和外因性进食间均起到部分中介效应,所占比例分别为44.89%,47.29%.结论 无聊倾向既可直接又可间接通过冲动性对大学生情绪性进食和外因性进食行为产生影响.     

替代递减疗法在青少年网络成瘾干预中的应用效果

探讨替代递减治疗在网络成瘾干预中的应用和效果,为制定有效的网络成瘾干预措施提供参考.方法 在武汉某网瘾训练机构招募青少年学员66名,随机分为上网时间内容替代递减综合干预组(研究组31名)和正常营地干预组(对照组35名),在干预前后分别对受试对象进行网络成瘾诊断量表、Barratt冲动量表、焦虑自评量表、抑郁自评量表评定.实验设计采用干预前后测设计.结果 研究组和对照组干预后网络依赖诊断问卷评分均下降(P值均<0.01);研究组干预后Barratt冲动量表认知冲动性评分降低(P值均<0.05),且干预后认知冲动性评分低于对照组(P<0.05);研究组和对照组干预后抑郁和焦虑量表评分较干预前下降,研究组干预后焦虑自评量表评分低于对照组(P值均<0.05).结论 替代递减综合干预能有效降低网瘾者的网络成瘾水平,降低焦虑和抑郁情绪,减少心理阻抗,可以作为网络成瘾有效干预方案.     

伴和不伴对立违抗障碍的注意缺陷多动障碍儿童智力和反应抑制功能分析

目的探讨伴和不伴对立违抗障碍(ODD)的注意缺陷多动障碍(ADHD)儿童智力和反应抑制功能特点,为证明ODD是否会加重ADHD认知损害提供参考依据。方法 2015年1月-2017年11月选取符合美国精神障碍诊断与统计手册第五版(DSM-5)诊断标准的ADHD共患ODD(ADHD+ODD)、单纯ADHD(ADHD)、以及年龄、性别相匹配的正常健康儿童各30例,采用韦氏儿童智力测试第四版(WSIC-Ⅳ)对其进行智力测试,Stroop效应测试对其反应抑制功能进行评估并进行对比。结果两病例组在智力测试方面,言语理解、工作记忆、加工速度、认知效率指数、总智商方面均落后于对照组(F=3.663、5.761、5.436、9.468、6.412,P均0.05);ADHD+ODD组的一般能力指数落后于正常对照组(F=2.751,P0.05);两病例组在反应抑制功能测试中的字义干扰时间均多于对照组,差异具有统计学意义(F=7.910,P0.05);两病例组之间智力及反应抑制功能比较,差异均无统计学意义(F=2.703、0.578,P均0.05)。结论 ADHD儿童智力及反应抑制功能均落后于正常儿童,共病ODD会加重ADHD的儿童一般能力损害,但不会加重反应抑制功能损害。     

健康管理对糖尿病患者认知和行为改变的效果评价

[目的]对糖尿病患者进行健康管理,并从认知、行为、生活质量、焦虑程度4个方面进行评价,以探寻有效的健康管理模式. [方法]选取某市三甲医院内分泌科门诊糖尿病患者114名,随机分为干预组(57人)和对照组(57人).两组均逐一填写调查问卷,对干预组实施为期5个月的健康管理,5个月后,两组患者再次填写问卷.[结果]5个月后,干预组其认知、行为评分均增高,改变具有统计学意义(P＜0.05),而对照组行为评分出现下降.干预组生活质量评分、焦虑评分均降低,其改变具有统计学意义(P＜0.05).对照组生活质量评分、焦虑评分均增高.[结论]健康管理能有效提高糖尿病患者的认知,熏塑健康的生活方式,提高生活质量.     

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.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

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.     

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.     

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.     

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.