A systematic review of attachment-based psychotherapeutic interventions for adopted children

Background: The link between disorders of attachment and psychopathology is well documented. Consequently, a person’s attachment style has a profound effect on his or her development and psychological well-being. At-risk populations such as adopted children are more prone to developing pervasive patterns of attachment, given the maternal disruptions they experience early in life. Objective: The aim of this review was to identify and systematically appraise the current literature addressing a range of attachment-based interventions for adopted chidren. Methods: A comprehensive search of the literature from the most recent decade was conducted. The Cochrane, Ebscohost, Sage, ScienceDirect, SpringerLink, and Wiley databases were used. Results: Three randomized controlled trials were included in this review. Two studies were conducted in the USA and one in the Netherlands. All studies made use of quantitative methodologies. Conclusion: Although each article highlighted significant findings in the respective study, there remains a deficit of empirical information aimed at addressing attachment-related behaviour in adopted children through intervention.     

The health of children adopted from India

Little information is presently available about health issues associated with intercountry adoptions. This research starts to fill this gap by surveying the health problems of 200 children from India adopted by 166 Oregon families during the period 1978–1987. Parents' responses to a mail questionnaire revealed that at least 37.5% of the children were premature. The children's birth weights and birth lengths were 3 to 4 SDs below WHO norms, and almost all the children's weights and heights by age, at time of arrival in the United States were below WHO's 50th percentile value. Feeding problems were frequent (35.0%), as were salmonella (30.5%), malnutrition (22.0%), anemia (18.5%), and developmental delays (18.0%). Many children were not tested for communicable diseases endemic to India such as hepatitis B, tuberculosis and salmonellosis. Many diseases and health problems were unanticipated by parents on the basis of medical reports received from India, and parents expressed a need for greater support and better resources in dealing with these health problems.Tara Smith-Garcia is a Nurse Consultant, 808 North Yakima, Tacoma, Washington, 98403. Julia S. Brown is Professor of Sociology in Nursing, School of Nursing, Oregon Health Sciences University, 3181 S.W. Sam Jackson Park Road, Portland, Oregon, 97201.This research was conducted in the Community Health Care Systems Department, School of Nursing, The Oregon Health Sciences University, Portland, Oregon. It was supported in part by a traineeship from the United States Government Health Service Grant Numbers 2 All and NU00250-09. The authors express their gratitude to Delores Lauber, Asian Coordinator for PLAN, for her unfailing cooperation and good will throughout the research, to Ann Scott of PLAN and Cherie Clark-Prakash of the International Mission of Hope for their kind support, and to Lydia Metje for assistance in transcribing data for analysis.     

Nurturing development of foster and adopted children

The goal of this study is to investigate early childhood teachers' perspective of teaching foster and adopted children. The main purpose is to seek suggestions how teachers can nurture the development of foster and adopted children. A 6 question survey was sent to 44 teachers pursuing graduate studies in early childhood education. Of this 50% responded. The teachers give advice regarding dispositions and academic strategies that promote nurturing development of foster and adopted children.     

从业人员72105名乙型肝炎表面抗原检测结果分析

目的了解和掌握上海市奉贤区从业人员健康人群中乙型肝炎病毒的感染情况。方法用ELISA法检测HBsAg、HBeAg。结果2006--2008年该区体检者共计72105人，检出HBsAg阳性3642人，阳性率5．05％。再从HBsAg阳性者中进一步检测HBeAg，结果HBeAg阳性者628人，阳性率17．24％。HBsAg阳性年龄分布以21～30岁组和31～40岁组最高。男性HBsAg，HBeAg阳性率明显高于女性。结论对HBsAg、HBeAg阳性者应该及时调离相应岗位，防止乙型肝炎病毒的进一步传播。     

Immunization status of internationally adopted children in Italy

An increasing number of internationally adopted children is coming to Italy, and their immunization status is unknown. We evaluated the immunization status of such children in Palermo, Italy. We searched for the presence of a BCG scar in 88 children, 49 boys and 39 girls (mean age 76+/-32 months), most of whom (98%) came from Eastern Europe. Presence of BCG scar was observed in 59 (67.1%) of them, included five children without any pre-adoptive medical records. Twenty-three out of 29 children without any evidence of BCG scar were tested by Mantoux. Seven (30.4%) of 23 were tuberculin positive and diagnosed as having latent tuberculosis infection. We also examined immunization status against poliovirus 1-3, tetanus, diphtheria, pertussis, measles, mumps, rubella and hepatitis B of 70 internationally adopted children and we compared it with the pre-adoptive immunization records of their birth country. Protective titers (>1:8) against poliovirus 1-3, were found respectively in 67.1%, 91.4%, 42.8% of 70 immunized children, and only 38.5% of them had at the same time full protection against all three types of poliovirus. Protective titers against tetanus and diphtheria were found in 91.4% and 95.7% of 70 vaccinated children. Presence of antibodies against pertussis, measles, mumps and rubella was observed respectively in 16 (32.6%) of 49, 40 (62.5%) of 64, 28 (56%) of 50 and 24 (85.7%) of 28 children who had received the vaccine. As regards hepatitis B, only 20 of 29 vaccinated children had detectable hepatitis B surface antibodies, while four of 29 vaccinated and two of 41 not vaccinated children were positive for both hepatitis B surface antibodies and hepatitis B core antibodies. Finally three of 41 not vaccinated children were both hepatitis B surface antigen and hepatitis B core antibodies positive. No relation was found between health status and immunization and between age and antibody positiveness of vaccinated children except for hepatitis B, therefore the youngest immunized children were more likely to be hepatitis B surface antibodies positive. Our data suggest that internationally adopted children should be tested for their immunization status on arrival in the adopting country, because they are not protected in a sufficient way against vaccine-preventable diseases and their pre-adoptive immunization records sometimes are lacking and frequently are scarcely reliable.     

三种HBsAg检测方法检测377份血清样本结果比较

目的对检测HBsAg的三种方法酶联免疫吸附法（ELISA）、胶体金免疫层析试验法（GICA）、化学发光微粒子免疫分析法（CMIA）进行比较分析。方法 221份乙肝患者血清作试验组及156份非乙肝患者血清作对照组,分别用以上三种方法检测HBsAg,对结果进行分析比较。结果ELISA和GICA的灵敏度和特异度均低于CMIA,差异有统计学意义。结论 ELISA、GICA操作简便,成本低廉,灵敏度亦不低,适宜基层单位普及;CMIA虽然灵敏度和特异度均高,但试剂成本高且仪器昂贵,可用作对可疑标本必要时行复查。     

对赴美领养儿童麻疹病例疫情处理方案的探讨

目的总结赴美领养儿童麻疹病例疫情处理方案和经验。方法收集了广东口岸历年赴美领养儿童麻疹病例疫情资料,对个案处理的工作记录进行整理分析。结果从2001—2009年,广东国际旅行卫生保健中心共发现了12例麻疹病例,总检出率为0.238‰。在麻疹疫情监控工作中采取合理的措施和有效的手段,做到对麻疹患者早发现、早隔离和早治疗,并通过对麻疹病例密切接触者进行免疫水平检查,对麻疹易感者进行免疫保护和观察,从而使麻疹易感者得到及时有效的保护。结论建立规范的领养儿童麻疹疫情的处理制度和规程,更有效和及时地防止麻疹病例传出国(境)外或在国内传播蔓延。     

Update: measles among children adopted from China

As of May 24, 2004, investigators have identified 10 confirmed measles cases associated with adoptees who traveled to the United States from China during March 2004. No cases have been reported since April 18, and all the ill persons have recovered without complications. CDC is now recommending that the temporary suspension of adoptions from the affected orphanage in China be ended and standard adoption procedures be resumed.     

孕产妇乙肝表面抗原阳性筛查及筛查后健康干预现况调查

目的:了解孕产妇乙肝表面抗原筛查及筛查后对HBsAg阳性孕产妇实施健康干预的现况。方法:采用等容量抽样法,在贵州省黔东南州抽取8个县,每个县随机抽取1家县级医院,随机抽取82名2010年分娩且HBsAg阳性的孕产妇作为调查对象开展现场调查。结果:黔东南州孕产妇HBsAg筛查率为97.68%,HBsAg阳性率为6.14%。在82名HBsAg阳性的被调查者中,仅54.88%的人知道自己在孕产期曾做过HBsAg的筛查,26.83%的人仍不知道自己是HBsAg感染者;48.78%的人被告知要忌烟酒,47.56%的人被告知必要时需要治疗;39.02%的人被告知HBsAg阴性的家庭成员需要接种乙肝疫苗;69.52%的人被告知接种乙肝疫苗可预防乙肝。82名孩子中仅14.63%的孩子接受了高剂量乙肝疫苗的接种,11.76%的孩子同时接种了乙肝免疫球蛋白。虽然98.78%的人都愿意在全程接种后对孩子抽血进行乙肝免疫效果的检测,但实际上仅19.51%的孩子在接种后进行了检测。结论:在贵州省黔东南州孕产妇HBsAg筛查率较高,但HBsAg阳性孕产妇对筛查知识了解较少,在筛查后得到的健康干预和帮助较少。建议完善孕产妇HBsAg筛查规范,加强落实对孕产妇及孩子的健康干预。     

吉林省珲春市朝、汉族中、小学生HBsAg、抗-HBs的检测结果分析

目的了解珲春市中小学生HBsAg携带状况和抗-HBs水平,为学校制订防治乙型肝炎（乙肝）策略提供科学依据。方法采用整群随机抽样的方法,抽取2126名中小学生采用酶联免疫吸附试验ELISA法检测HBsAg和抗-HBs。结果2126名中小学生HBsAg阳性率为1．69％,其中朝鲜族学生阳性率高于汉族学生。但经统计学处理差异无统计学意义（P〉0．05）。中学学生阳性率高于小学学生,经统计学处理差异有统计学意义（P〈0．05）;抗．HBs阳性率为55．69％,其中朝鲜族学生阳性率高于汉族学生,经统计学处理差异有统计学意义（P〈0．01）。小学学生阳性率高于中学学生,经统计学处理差异有统计学意义（P〈0．01）。结论对乙肝无免疫力的学生应给予乙肝全程免疫,抗．HBs弱阳性的给予一次加强免疫。