凉山州受艾滋病影响彝族青少年社交焦虑现状及影响因素

目的了解凉山州受艾滋病影响彝族青少年的社交焦虑现状,探究社交焦虑的影响因素,为降低受艾滋病影响彝族青少年的社交焦虑提供理论依据。方法采用一般情况调查问卷、社交焦虑问卷、社会支持量表、孤独感量表对435名受艾滋病影响彝族青少年进行问卷调查。采用t检验、方差分析、Pearson相关分析、分层线性回归分析对该人群的社交焦虑现状进行单因素和多因素分析。结果社交焦虑的总分为(8.40±3.66)分,社交回避及苦恼得分(3.15±1.63)分和害怕否定评价得分(5.32±2.64)分,显著高于常模;该人群社交焦虑检出率为57.9%,其中男生和女生社交焦虑检出率分别为55.5%和61.2%。分层线性回归分析结果显示,孤独感是社交焦虑的主要影响因素,对社交焦虑有显著的正向预测作用(β=-0.28,P0.01,ΔR2=10.3%),社会支持对社交焦虑有负向预测作用(β=-0.18,P0.01,ΔR2=5.2%),消极应对方式对社交焦虑水平有正向预测作用(β=-0.23,P0.01,ΔR2=4.4%)。结论凉山州受艾滋病影响彝族青少年的社交焦虑水平较高,孤独感、社会支持与消极应对方式是其社交焦虑水平的主要影响因素。在未来针对该人群的社交焦虑干预时,应重点关注孤独感水平、社会支持以及应对方式,采取针对性的措施降低其社交焦虑水平,进而提高其心理健康水平。     

学龄前儿童睡眠障碍的影响因素分析

目的探讨分析学龄前儿童睡眠障碍影响因素。方法选择从2017年5月-2018年5月本辖区入托体检的500例学龄前儿童,应用CSHQ问卷评估,并收集儿童的相关资料,资料包括:①家长睡眠时间(包括晚11点之前、晚11点之后);②睡前活动情况(包括剧烈活动、非剧烈活动);③电子产品接触时间(包括>2 h/d、≤2 h/d);④睡前情绪(包括哭闹及兴奋、平静);⑤家长情绪状态(包括焦虑抑郁、非焦虑抑郁);⑥睡前故事(包括是、否);⑦进食情况:包括是否有食物过敏、进食节律(快、慢),偏食挑食因素(是、否),睡前饮食因素(饥饿、过饱),喝水多少和夜间排尿因素(包括有、无);⑧呼吸道及慢性疾病史(包括是、否);同时,应用Logistic多因素回归分析学龄前儿童睡眠障碍于上述因素的关系。结果睡眠障碍学龄前儿童的家长睡眠时间因素、睡前活动情况因素、电子产品接触时间因素、睡前情绪因素、家长情绪状态因素、睡前故事因素、进食情况因素、呼吸道及慢性疾病史因素与无睡眠障碍学龄前儿童比较,均差异有统计学意义(P<0.05);经多因素Logistic回归分析可知,家长睡眠时间因素、睡前活动情况因素、电子产品接触时间因素、睡前情绪因素、家长情绪状态因素、睡前故事因素、进食情况因素、呼吸道及慢性疾病史因素均为学龄前儿童睡眠的主要影响因素。结论学龄前儿童睡眠障碍的发生概率比较高,家长睡觉晚、睡前剧烈运动、电子产品接触时间长,睡前情绪兴奋,家长焦虑,睡前没有讲故事或讲恐怖故事,进食过饱或过饥饿、食物过敏、挑食、进水多或夜尿、呼吸道疾病或慢病都是导致学龄前期儿童睡眠障碍的主要因素,临床需加强重视。     

良性癫痫儿童家长焦虑情绪及影响因素的探讨

良性癫痫(Benign Epilepsy)是儿童癫痫的一种常见类型，约占儿童癫痫的15％～25％，一般认为预后良好。临床中发现患儿家长存在烦恼、担忧及不同程度的焦虑。为此，笔者对济宁医学院附属金乡医院癫痫研究所诊治的74例良性癫痫患儿家长的焦虑情绪及其影响因素进行研究，现报告分析如下。     

受艾滋病影响儿童的心理安全感及社交焦虑

目的了解受艾滋病影响儿童心理安全感和社交焦虑的现状及关系,为制定帮扶政策及干预提供参考。方法采用问卷法,调查232名受艾滋病影响儿童和1 640名普通儿童,使用t检验、Pearson相关和多元回归分析等方法比较组间差异、分析社交焦虑对心理安全感的影响。结果受艾滋病影响儿童心理安全感显著低于普通儿童(t=6.61,P0.01),社交焦虑显著高于普通儿童(t=-22.29,P0.01);女童的社交焦虑得分(26.58±2.61)分,显著高于男童(18.91±2.35)分,(t=-23.51,P0.01);女童的心理安全感得分(28.83±11.08)分,显著低于男童(57.68±15.74)分,(t=16.14,P0.01);相关分析表明,受艾滋病影响儿童的心理安全感及各维度与社交焦虑各维度呈显著负相关(r=-0.637～-0.695,P0.01);受艾滋病影响女童和社交回避及苦恼状况负向预测心理安全感及其各维度,同学关系差可以正向预测心理安全感及其各维度,R~2值在54%～56%之间(P0.01)。结论受艾滋病影响儿童社交焦虑偏高、心理安全感水平偏低,降低社交焦虑能有效改善他们的心理安全感。     

福建省美沙酮维持治疗者焦虑抑郁现状及影响因素分析

目的 了解福建省美沙酮维持治疗者的焦虑、抑郁现状及其影响因素,为提高治疗依从性提供依据.方法 在福建省5个地市6家美沙酮维持治疗(MMT)门诊开展问卷调查,对所收集的信息进行整理分析,采用Logistic回归分析受治者焦虑、抑郁影响因素.结果 共调查510名MMT受治者,32.2％受治者存在焦虑,44.7％受治者存在抑...     

受艾滋病影响儿童心理健康干预方法探索

目的探索能够有效促进受艾滋病影响儿童心理健康的干预策略。方法选取河南省某县受艾滋病影响的10～15岁儿童45名,进行为期10个月的综合心理支持,干预前后进行问卷调查测量干预效果。结果干预前有焦虑不安等负性心理体验的儿童占44.4%(20/45),干预后下降到20.0%(9/45);症状自评量表SCL-90测量的强迫症状、人际关系敏感、抑郁、焦虑以及偏执等各个因子,干预之后均显著改善。结论综合心理支持对于促进受艾滋病影响儿童的心理健康具有积极意义。     

养老机构老年人跌倒现状及影响因素分析

目的 探讨昆明市养老机构老年人跌倒现状,并分析其影响因素。方法 采用分层随机整群抽样法,选取昆明市6所养老机构223名老年人,采用自制问卷对老年人进行面对面问卷调查,调查内容包括一般人口社会学特征、生活行为方式、既往病史与用药史、心理状况和跌倒史,分析跌倒现状,单因素和多因素分析跌倒影响因素。结果 223名老年人跌倒发生率为36.8%。年龄70～74岁(OR=3.385)、年龄75～79岁(OR=3.059)、患有关节炎(OR=1.220)、长期服用镇静催眠药(OR=1.049)是老年男性发生跌倒的危险因素,经常参加体育锻炼(OR=2.085)是老年男性发生跌倒的保护性因素,长期服用止痛药(OR=1.446)是老年女性发生跌倒的危险因素。结论 养老机构老年人跌倒发生率较高,应全方面分析老年人情况,进行疾病管理和用药管理,同时鼓励其积极参与体育锻炼加强自身体质健康,从而预防跌倒。     

乌鲁木齐市学龄前儿童生长发育调查

目的 了解新疆乌鲁木齐市学龄前儿童生长发育状况及影响因素,为促进儿童保健工作提供参考依据.方法 2019年4月-2020年1月,采用分层整群抽样方法,选取乌鲁木齐市7个区14所幼儿园1 153名儿童开展问卷调查并测量体格,参照WHO标准评价营养状况.结果 乌鲁木齐市7个区学龄前儿童,3～7岁同年龄组男女童身高差异无统计学意义(t=1.442,1.286,1.183,1.106,1.387,P＞0.05),6岁～组不同性别儿童体重差异有统计学意义(t=2.953,P＜0.05),其他年龄组差异均无统计学意义(t=1.324,1.217,1.709,1.355,P＞0.05).经济开发区儿童低体重(20.0％)和生长迟缓(21.4％)检出率最高,沙依巴克区儿童消瘦检出率最高(20.2％),高新区儿童超重(18.9％)和肥胖(15.0％)检出率最高.年龄(t=23.668,15.045)、性别(t=-2.415,-3.516)和家庭月平均收入水平(t=-4.495,-2.996)影响儿童的身高和体重,差异有统计学意义(P＜0.05).结论 乌鲁木齐市学龄前儿童面临肥胖与营养不良双重问题;应因势利导,针对不同区域儿童生长发育状况开展个体化营养干预,改善儿童营养状况.     

慢性病老年人心理健康现状及影响因素

目的调查分析慢性病老年人的心理健康现状及影响因素。方法运用老年抑郁量表、状态-特质焦虑问卷、情绪-社交孤独问卷对177例慢性病老年人进行调查。结果慢性病老年人抑郁、状态焦虑、特质焦虑、孤立和孤独得分分别为(12.97±6.74)、(43.62±8.47)、(44.76±7.87)、(12.46±8.32)、(11.51±8.45)分;抑郁检出率为64.4%;婚姻状况、患慢性病种数对抑郁得分有显著影响(P0.05),年龄影响状态焦虑(P0.05),学历影响状态焦虑、特质焦虑、社交孤独、社交孤立、孤独总分(P0.01,P0.05),情绪孤立、社交孤立、情绪孤独、社交孤独均受婚姻状况影响(P0.001,P0.01),职业影响情绪孤立(P0.05)。结论慢性病老年人心理健康状况较一般老年人差,应加强精神支持,促进心理健康。     

认知行为疗法改善受艾滋病影响儿童自我意识水平的个案研究

正受艾滋病影响儿童更容易产生消极的社会心理和认知结果[1],迫切需要在对这些儿童的物质救助基础上进一步开展心理干预[2]。本研究拟对一名凉山州自我意识水平较低的受艾滋病影响儿童使用认知行为疗法进行心理咨询,目的是探究认知行为疗法对受艾滋病影响儿童自我意识水平的改善作用及其可行性,为受艾滋病影响儿童心理健康提供有效的干预方法。     

四川省凉山州HIV/AIDS患者污名化与焦虑抑郁的关系

目的 了解四川省凉山州艾滋病病毒(HIV)感染者/艾滋病(AIDS)患者(简称HIV/AIDS患者)污名化与焦虑、抑郁的关系.方法 采用自制一般资料问卷、简版污名化量表、广泛性焦虑障碍量表(GAD-7)、抑郁症筛查量表(PHQ-9)对751例HIV/AIDS患者进行问卷调查.采用线性回归进行统计学分析.结果 本次研究有...     

High incidence of zinc deficiency among Filipino children with compensated and decompensated liver disease

Background and Aim: The role of zinc in the nutrition and growth of children with chronic liver disease is poorly defined. The present study determined the serum zinc levels of children with compensated liver disease (CLD) and decompensated liver disease (DLD) and compared this with healthy children. Zinc levels were also correlated with the severity of liver disease as measured by Child?Pugh scores. Methods: The study comprised of 60 children 0–10 years of age with chronic liver disease, defined as CLD (n = 30) if the Child?Pugh score was < 6, and DLD (n = 30) if the Child?Pugh score was ≥ 6. Thirty healthy children 0–10 years served as controls. Serum zinc levels were measured by atomic absorption spectrometry. Results: The 90 patients included 30 with CLD (mean age: 4.54 years: 21 boys; mean Child?Pugh score: 5.83), 30 with DLD (mean age: 1.39 years; 17 boys; mean Child?Pugh score: 9.53) and 30 healthy children (mean age: 4.6; 16 boys). Zinc levels of patients with CLD were significantly lower compared with the healthy controls (Mean [standard deviation]: 68.07 [31.55]vs 89.9 [25.9]µg/dL, P = 0.000), but significantly higher compared to the patients with DLD (48.8 [26.8]µg/dL). Correlation studies showed that the higher the Child?Pugh score, the lower the zinc levels (r = ?0.460) Conclusions: Children with chronic liver disease, whether in a compensated or decompensated state, had lower serum zinc levels compared with the healthy controls. As the severity of liver disease worsened, the zinc levels decreased. The study suggests that zinc supplementation should constitute part of the micronutrient intake of children with chronic liver disease.     

Gender and age differences in pain, coping and health status among children with chronic arthritis

OBJECTIVE: To investigate pain, coping and health status in children with chronic arthritis. Additional aims were to explore gender variations in pain, coping and health status, and the same factors in children under 16 years versus children 16 years or older. METHODS: For 125 children (43 boys) with a median age of 14.1 years (range 10.3-17.8) disability and discomfort were assessed (Childhood Health Assessment Questionnaire, CHAQ). Pain, coping, fatigue, sleeping and satisfaction with life were evaluated (Visual Analogue Scales). The Pain Intensity Scale was used to assess the variation in pain intensity during one week. RESULTS: The CHAQ disability index (DI) was 0.63. In the total sample, girls had larger numbers of affected joints in upper extremities (p = 0.028) and more days with morning pain (p = 0.025) than boys. Boys reported greater perceived ability to reduce pain than girls (p = 0.020). Compliance with treatment was more frequent in girls than in boys (p = 0.029). In children 16 years of age and older, boys reported greater perceived ability to control pain (p = 0.032) and to reduce pain than girls (p = 0.001) and fewer days with worst pain in the mornings (p = 0.013), as well as less pain variations over the period of a day (p = 0.014) and over a period of a week (p = 0.035). CONCLUSIONS: As a group, the children were clearly affected by their arthritis. Pain was related to the severity of disease. Some significant gender and age differences were highlighted, which should be considered in clinical pain management.     

Higher rates of bleeding and use of treatment products among young boys compared to girls with von Willebrand disease

There are limited observational studies among children diagnosed with von Willebrand Disease (VWD). We analyzed differences in bleeding characteristics by sex and type of VWD using the largest reported surveillance database of children with VWD (n = 2712), ages 2 to 12 years old. We found that the mean ages of first bleed and diagnosis were lowest among children with type 3 VWD. It was even lower among boys than girls among all VWD types, with statistically significant difference among children with type 1 or type 3 VWD. Children with type 3 VWD also reported higher proportions of ever having a bleed compared to other VWD types, with statistically higher proportions of boys compared to girls reporting ever having a bleed with type 1 and type 2 VWD. A similar pattern was observed with the use of treatment product, showing higher usage among type 3 VWD, and among boys than girls with type 1 and type 2 VWD. While there were no differences in life quality or in well-being status by sex, children with type 3 VWD showed a greater need for mobility assistance compared to children with type 1 and type 2 VWD. In an adjusted analysis among children with type 1 VWD, boys showed a significant association of ever bleeding [hazard ratio 1.4; P-value <.001)] compared to girls. Understanding phenotypic bleeding characteristics, well-being status, treatment, and higher risk groups for bleeding among pre-adolescent children with VWD will aid physicians in efforts to educate families about bleeding symptoms.     

Serum ferritin in Danish children and adolescents

Serum ferritin concentrations were measured in 909 urban Danish schoolchildren (451 boys, 458 girls) 6 to 17 years old. The children had been randomly selected and served as an urban reference population. Geometric mean ferritin values were identical in boys and girls 6 to 15 years old, while 16- and 17-year-old boys had higher values than girls (P < 0.01). There was a slight rise in mean ferritin values from 6 to 11 years, followed by a temporary fall during the subsequent adolescent growth period. Geometric mean ferritin values and significant differences were as follows: Children 6 to 11 years old (n = 335), 29 μg/l and adolescents 12 to 15 years old (n = 417), 26 μg/l (P < 0.01): Adolescent boys 16 to 17 years old (n = 76), 32 μg/l and adolescent girls same age (n = 81), 24 μg/l (P < 0.01). The frequencies of low ferritin values < 10 μg/l (i.e. exhausted iron stores) were: Children 6 to 11 years old, 2.1%: Adolescents 12 to 15 years old, 5.0%: Adolescent boys 16 to 17 years old, 0.0%: Adolescent girls 16 to 17 years old, 11.1%. High ferritin values > 60 μg/l (i.e. large iron reserves) were observed in 6.2% of boys and 6.9% of girls.     

我国部分农村地区受艾滋病影响的儿童社会心理健康状况定性研究

目的通过儿童和儿童抚养人的视角，初步了解中国部分农村地区父母感染艾滋病对儿童社会心理健康的影响。方法采用半结构化访谈的方法，对19名受艾滋病影响的儿童，20名儿童抚养人以及8名社区关键知情人进行调查。结果大多数儿童存在害怕、焦虑、悲伤、自卑等心理问题。针对儿童的歧视现象仍然存在，主要表现为对儿童的孤立、漠视和拒绝。儿童依赖抚养人和同伴获得心理上的支持。结论受艾滋病影响的儿童心理健康问题不容忽视，应该采取适当的干预措施改善这些儿童的心理健康状态。     

Epidemiology of hypertension among a population of school children in Sousse, Tunisia

BACKGROUND: Pediatric hypertension is a field of increasing interest and importance. Early identification of children at risk for hypertension is important to prevent the serious, long-term complications associated with the condition. In Tunisia, there are no data available on the cardiovascular disease risk profile, such as hypertension, in the population of children. OBJECTIVE: To establish the prevalence of hypertension, the percentile distribution of blood pressure and the inter-relationships between hypertension and other cardiovascular disease risk factors among school children. METHODS: An epidemiological survey was conducted based on a representative sample of 1569 urban school children in Sousse, Tunisia. RESULTS: The prevalence of arterial hypertension was 9.6%, with no significant difference between boys (9.2%) and girls (9.9%). The prevalence of systolic and diastolic hypertension was 6.4% and 4.5%, respectively. In both boys and girls, systolic pressure had a highly significant positive correlation with height (boys: r=0.33, P<0.001; girls: r=0.08, P=0.02), weight (boys: r=0.47, P < or = 0.001; girls: r=0.35, P<0.001) and triglyceride concentrations (boys: r=0.13, P<0.001; girls: r=0.10, P=0.006). Among boys, a positive correlation was found between systolic blood pressure and age (r=0.12, P=0.001) and, among girls, a negative correlation was found (r=-0.12, P=0.001). CONCLUSION: This information will be used to help launch a regional program of heart health promotion in schools.     

Association of elevated serum alanine aminotransferase with metabolic factors in obese children: sex-related analysis

Alanine aminotransferase (ALT) elevations are considered a surrogate marker of nonalcoholic liver disease and predict later development of diabetes and metabolic syndrome in adults. The aim of the present study is to evaluate the prevalence of high ALT levels in obese children using updated and sex-related cutoff ALT value (ALT >30 IU/L for boys and >19 IU/L for girls). We also analyzed the association between ALT levels and metabolic factors in the 2 sexes. Three-hundred fifty-eight obese children (168 boys and 190 girls; age range, 6-16 years) were studied. Inclusion criteria were as follows: obesity, defined by an individual body mass index (BMI) greater than or equal to the 95th percentile for age and sex; negativity of markers for viral hepatitis; and no alcohol consumption. Two hundred six nonobese children (92 boys and 114 girls; age range, 6-16 years) served as a control group for ALT levels. The percentage of obese children with elevated ALT was 36% in boys and 55% in girls. Obese boys with ALT greater than 30 IU/L showed higher mother's BMI (P < .025), BMI, waist circumference, insulin resistance evaluated with homeostasis model assessment (HOMA-IR) index (P < .0001, for all), and systolic and diastolic blood pressure (P < .025, for both) compared with those with ALT not exceeding 30 IU/L. The ALT levels correlated positively with mother's BMI, BMI, waist circumference, HOMA-IR, triglycerides, and blood pressure. In linear regression analysis, waist circumference was the only independent factor associated with ALT level (β = 0.370, t = 3,905, P < .0001). Obese girls with ALT greater than 19 IU/L exhibited lower age (P < .025) and higher triglycerides (P < .0001) than girls with ALT not exceeding 19 IU/L. The ALT levels correlated positively with triglycerides and HOMA-IR and negatively with age and Tanner stage. In linear regression analysis, ALT levels were independently associated only with triglycerides (β = 0.330, t = 4.588, P < .0001). Our study shows that a high proportion of obese children present elevated ALT levels. This abnormality is associated in boys, more than in girls, with preclinical traits of the metabolic syndrome. The adoption of sex-related cutoff of ALT levels is desirable also for the pediatric population.