Prevalence of smoking among bar workers prior to the Republic of Ireland smokefree workplace legislation

Background  This study establishes baseline prevalence of smoking and cigarette consumption among Cork bar workers prior to the Republic of Ireland’s (ROI) smokefree workplace legislation and compares gender- and age-specific smoking rates and estimates the adjusted odds of being a smoker for Cork bar workers relative to the general population. Methods  Cross-sectional random sample of bar workers in Cork city and cross-sectional random telephone survey of the general population were conducted prior to the smokefree legislation. Results  Self reported smoking prevalence among Cork bar workers (n = 129) was 54% (58% using cotinine-validated measures), with particularly high rates in women (70%) and 18–28 years old (72%). Within the ROI (n = 1,240) sub-sample rates were substantially lower at 28%. Bar workers were twice as likely to be smokers as the general population sub-sample (OR = 2.15). Conclusions  Cork bar workers constitute an occupational group with an extremely high smoking prevalence.     

儿童孤独症综合治疗分析

目的:探讨运用综合干预方法治疗儿童孤独症的疗效。方法:132例儿童孤独症患儿采用综合干预方法,治疗前及治疗半年后采用心理教育量表(PEP)评估治疗效果。结果:综合治疗能提高PEP各项目得分,差异均有统计学意义(P<0.05)。结论:综合治疗能提高孤独症患儿的能力,降低功能障碍。     

The limping child: an algorithm to outrule musculoskeletal sepsis

Background  The acutely limping child presents a significant diagnostic challenge. Aim  The purpose of this study was to create a clinically useful algorithm to allow exclusion of ‘musculoskeletal sepsis’ as a differential diagnosis in the child presenting with limp. Methods  Data were collected on all 286 limping children admitted to our centre over a 3-year-period. Using logistic regression analysis, the predictive model was constructed, to exclude infection. Results  Duration of symptoms, constitutional symptoms, temperature, white cell count and ESR were significantly different in children with musculoskeletal infection (P < 0.05). Multivariate analysis demonstrated that when all three variables of duration of symptoms >1, <5 days; temperature >37.0°C; and ESR >35 mm/h were present, the predicted probability of infection was 0.66, falling to 0.01 when none were present. Conclusion  This multivariate model enables us to rule out musculoskeletal infection with 99% certainty in limping children with none of these three presenting variables.     

应对方式及相关因素对医学生心理健康的影响

目的 :探讨医学生心理健康和应对方式的相关关系。方法 :对杭州师范学院医学院医学生共 2 36人 ,进行了心理健康评定量表 (SCL 90 )和应对方式问卷 (SCQ)测试。结果 :( 1)医学生中女生在解决问题 (t =- 2 75 ,P <0 0 1)、求助 (t=- 3 0 3,P <0 0 1) 2个因子分上显著高于男生 ,而合理化 (t=4 5 0 ,P <0 0 1)因子分显著低于男生 ;独生子女在求助、自责和幻想 3个因子上显著低于非独生子女 (P <0 0 1)。 ( 2 )不成熟型应对方式 (自责、幻想和退避 )与SCL 90的 9个因子均呈显著正相关 ;成熟型应对方式与SCL 90的 3个因子呈显著负相关 (P <0 0 5 )。 ( 3)SCQ各因子与心理健康水平的回归分析表明 ,自责和幼想 2个因子进入了对心理健康水平的回归方程 ,对心理健康状况的预测作用较大。结论 :应对方式对医学生心理健康状况有影响作用     

克氏孤独症行为量表的临床应用木

目的 探讨克氏孤独症行为量表对儿童孤独症与其他认知和(或)语言障碍的鉴别诊断意义.方法 对门诊32例孤独症患儿、30例伴有认知和(或)语言障碍的非孤独症惠儿及28例正常儿童进行克氏孤独症行为量表的评定.结果 孤独症组、非孤独症组与正常组的克氏孤独症行为量表的总分差异均有显著性(均P＜0.05).孤独症组克氏孤独症行为量表的14项中有6项得分显著高于非孤独症组,有11项得分显著高于正常组,均P＜0.05.结论 克氏孤独症行为量表对儿童孤独症与伴有认知和(或)语言障碍的非孤独症患者和正常儿童有鉴别诊断意义.     

Detection of Abnormalities for Diagnosing of Children with Autism Disorders Using of Quantitative Electroencephalography Analysis

Quantitative electroencephalography (qEEG) has been used as a tool for neurophysiologic diagnostic. We used spectrogram and coherence values for evaluating qEEG in 17 children (13 boys and 4 girls aged between 6 and 11) with autism disorders (ASD) and 11 control children (7 boys and 4 girls with the same age range). Evaluation of qEEG with statistical analysis demonstrated that alpha frequency band (8–13 Hz) had the best distinction level of 96.4% in relaxed eye-opened condition using spectrogram criteria. The ASD group had significant lower spectrogram criteria values in left brain hemisphere, (p < 0.01) at F3 and T3 electrodes and (p < 0.05) at FP1, F7, C3, Cz and T5 electrodes. Coherence values at 171 pairs of EEG electrodes indicated that there are more abnormalities with higher values in the connectivity of temporal lobes with other lobes in gamma frequency band (36–44 Hz).     

Association between thimerosal-containing vaccine and autism

Context  Mercuric compounds are nephrotoxic and neurotoxic at high doses. Thimerosal, a preservative used widely in vaccine formulations, contains ethylmercury. Thus it has been suggested that childhood vaccination with thimerosal-containing vaccine could be causally related to neurodevelopmental disorders such as autism. Objective  To determine whether vaccination with a thimerosal-containing vaccine is associated with development of autism. Design, Setting, and Participants  Population-based cohort study of all children born in Denmark from January 1, 1990, until December 31, 1996 (N = 467 450) comparing children vaccinated with a thimerosal-containing vaccine with children vaccinated with a thimerosal-free formulation of the same vaccine. Main Outcome Measures  Rate ratio (RR) for autism and other autistic-spectrum disorders, including trend with dose of ethylmercury. Results  During 2 986 654 person-years, we identified 440 autism cases and 787 cases of other autistic-spectrum disorders. The risk of autism and other autistic-spectrum disorders did not differ significantly between children vaccinated with thimerosal-containing vaccine and children vaccinated with thimerosal-free vaccine (RR, 0.85 [95% confidence interval {CI}, 0.60-1.20] for autism; RR, 1.12 [95% CI, 0.88-1.43] for other autistic-spectrum disorders). Furthermore, we found no evidence of a dose-response association (increase in RR per 25 µg of ethylmercury, 0.98 [95% CI, 0.90-1.06] for autism and 1.03 [95% CI, 0.98-1.09] for other autistic-spectrum disorders). Conclusion  The results do not support a causal relationship between childhood vaccination with thimerosal-containing vaccines and development of autistic-spectrum disorders.      

白三烯受体拮抗剂治疗原发性鼾症的临床疗效观察

目的评估白三烯受体拮抗剂治疗原发性鼾症(PS)儿童的临床疗效。方法选择2008年3月~2010年12月经多导睡眠监测(PSG)诊断PS儿童65例,随机分为治疗组33例,对照组32例。治疗组予白三烯受体拮抗剂治疗,治疗前进行PSG监测、鼾症儿童生活质量调查表(OSA-18)评分,治疗6个月后复查,并登记复诊资料及检查结果;对照组未予治疗,初诊时予以PSG监测、OSA-18评分,6个月随访时再次进行OSA-18评分。结果治疗组PSG监测治疗前后比较差异均无统计学意义(P > 0.05),但OSA-18评分治疗后儿童睡眠障碍(治疗前12.85±5.10,治疗后8.15±2.97,Z=-3.83,P<0.05)、身体症状(治疗前11.82±5.35,治疗后8.12±3.25,Z=-2.96,P<0.05)、对监护人影响(治疗前10.33±4.43,治疗后6.69±2.99,Z=-3.27,P<0.05)、OSA-18总分(治疗前47.73±15.63,治疗后33.94±9.40,Z=-3.53,P<0.05)较治疗前好转,差异有统计学意义。对照组随访前后OSA-18评分比较差异无统计学意义(P>0.05)。治疗组治疗后睡眠障碍较对照组明显改善,差异有统计学意义(治疗组8.15±2.97,对照组11.38±5.63,Z=-2.20,P<0.05)。结论白三烯受体拮抗剂能改善PS儿童生活质量。     

Prevalence of autism in a US metropolitan area

Context  Concern has been raised about possible increases in the prevalence of autism. However, few population-based studies have been conducted in the United States. Objectives  To determine the prevalence of autism among children in a major US metropolitan area and to describe characteristics of the study population. Design, Setting, and Population  Study of the prevalence of autism among children aged 3 to 10 years in the 5 counties of metropolitan Atlanta, Ga, in 1996. Cases were identified through screening and abstracting records at multiple medical and educational sources, with case status determined by expert review. Main Outcome Measures  Autism prevalence by demographic factors, levels of cognitive functioning, previous autism diagnoses, special education eligibility categories, and sources of identification. Results  A total of 987 children displayed behaviors consistent with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for autistic disorder, pervasive developmental disorder–not otherwise specified, or Asperger disorder. The prevalence for autism was 3.4 per 1000 (95% confidence interval [CI], 3.2-3.6) (male-female ratio, 4:1). Overall, the prevalence was comparable for black and white children (black, 3.4 per 1000 [95% CI, 3.0-3.7] and white, 3.4 per 1000 [95% CI, 3.2-3.7]). Sixty-eight percent of children with IQ or developmental test results (N = 880) had cognitive impairment. As severity of cognitive impairment increased from mild to profound, the male-female ratio decreased from 4.4 to 1.3. Forty percent of children with autism were identified only at educational sources. Schools were the most important source for information on black children, children of younger mothers, and children of mothers with less than 12 years of education. Conclusion  The rate of autism found in this study was higher than the rates from studies conducted in the United States during the 1980s and early 1990s, but it was consistent with those of more recent studies.      

Evaluation by survival analysis on effect of traditional Chinese medicine in treating children with respiratory syncytial viral pneumonia of phlegm-heat blocking Fei syndrome

Objective:To objectively evaluate the clinical effect of traditional Chinese medicine in treating children's respiratory syncytial viral pneumonia(RSVP) of phlegm-heat blocking Fei(肺) syndrome(PHBFS). Methods:A single-blinded multi-center,blocked,randomized and parallel-controlled method was adopted.The clinical study was carried out on 206 children with RSVP-PHBFS who were assigned to two groups,108 in the test group treated through intravenous dripping of Qingkailing Injection(清开灵注射液) in combination of...     

Cost of treating heart failure in an Irish teaching hospital

Background  

The prevalence of heart failure is 3 to 20 per 1,000 population, but may exceed 100 per 1,000 in the over 65 age group. Some 1–2% of the total healthcare budget is consumed in the management of heart failure.     

Irish contributions to the origins of antibiotics

Background  Pasteur commented that if we could intervene in the antagonism observed between some bacteria, it would offer ‘perhaps the greatest hopes for therapeutics.’ Some Irish scientists were crucially involved in the eventual realization of these hopes. Research  The earliest of these was John Tyndall, whose 1881 book, ‘Floating matter in the air in relation to putrefaction and infection,’ brought about general acceptance of Pasteur’s germ theory. Sir Almroth Wright, a TCD graduate, who discovered the first vaccine against typhoid fever, recruited Alexander Fleming to the London hospital where he discovered penicillin. Sequence of events  This happened when Fleming was replicating an experiment originally carried out by Bigger, Boland and O’Meara in TCD. One of Fleming’s cultures was accidentally contaminated by a mould containing penicillin which came from the collection of Charles La Touche, an Irish mycologist who was researching whether cobwebs caused asthma in the same hospital, and who later taught in UCD. This is an expanded version of a lecture to the Royal Academy of Medicine in Ireland. Much of the author’s research on which it is based was published in Research Policy 29:679–710, (2000) and the Journal of the History of Medicine and Allied Sciences 59(3):441–462 (2004).     

Pregnancy and perinatal outcomes after assisted reproduction: a comparative study

Background  Increasing use of fertility therapy has elicited concerns regarding adverse effects for expectant mothers and the health of children thus conceived. Aims  To study the risk of adverse perinatal outcomes, birth defects and pregnancy complications following assisted reproductive technology (ART). Methods  Questionnaire-based study involving 1,524 children and 1,182 pregnancies conceived following in vitro fertilisation (IVF) in two units. Outcomes were compared with the general population. Results  In the study group versus the general population; multi-foetal gestations, 26 versus 2%; singleton preterm delivery and low birth weight, 8.7 and 6.4 versus 4.3 and 4%, respectively; non-lethal congenital malformation rate, 2.6 versus 2.1%; placenta praevia, 2.8 versus 0.5%. Conclusions  Multi-foetal gestations remain the principal cause of adverse perinatal outcomes after ART. Singleton ART pregnancies have an increased risk of preterm delivery and low birth weight at term. Non-lethal congenital malformation rates are not increased following ART. Placenta praevia is increased following ART.     

抽动障碍患儿及其不同辨证分型的年龄分布情况研究

目的:探讨抽动障碍患儿的年龄分布特征,以及不同中医证型患儿的年龄分布情况,为探寻发病的影响因素,进一步指导临床用药奠定基础。方法:选择120例确诊的抽动障碍患儿,对其年龄分布特征进行频数和构成比的统计分析,并分析不同辨证分型患儿的年龄分布特点。结果:抽动障碍患儿的主要起病年龄集中在10岁以前,为总观察人群的96.6%;9~11岁为发病高峰,占患儿比例高达43.3%。肝风内动型占到所有患儿的50%,且年龄主要集中在12岁以前。结论:学龄期儿童是抽动障碍发病的主要人群,肝风内动型所占的比例最高。     

Do children separated from fathers have higher anxiety levels? A comparative analysis

BackgroundThere is limited literature from India on effect of fathers' deployment on the mental health of children. This cross-sectional analytical study investigates the difference in anxiety levels of children whose fathers are deployed in a field location and compares it with children currently located with their fathers.MethodData were collected in an army school from 200 children aged 10–17 years with fathers deployed in field locations (n = 99) and fathers currently residing with the children (n = 105) via interviewer administered and self-completed Screen for Child Anxiety-Related Disorders (SCARED) questionnaire.ResultsAnxiety scores were on an average, minimally raised above the cut-off level for children who had fathers deployed. In addition, panic disorder scores were also above the cut-off levels for these children. While scores were normal in all other domain, they were higher than that for children residing with their fathers, although the difference was not significant. Girls with fathers deployed had scores higher than cut-off scores for domains such as panic, separation anxiety and school avoidance, while boys had scores higher than cut-off scores only for panic disorders. However, the girls had significantly higher scores than boys in all domains. Girls in both groups (with and without father deployed) had higher scores than cut-off scores for panic disorders.ConclusionAnxiety levels in children were not found to be unduly affected by the deployment of fathers. But girls were found to have clinically relevant panic disorder, school avoidance and separation anxiety scores as compared with boys in the similar situation of parental separation.     

Complementary and alternative medicine use in Irish paediatric patients

Background  Although very little scientific data exists on the efficacy and side effects of complementary and alternative medicines, their profile and availability is increasing. Use among Irish children is unknown. Aims  To determine the nature and prevalence of complementary and alternative medicines (CAM) use in our paediatric population. Methods  Parental questionnaires were distributed in 13 paediatric settings over a 4-month period. Results  There were 57% of parents reported using CAM for their child. Use was significantly higher in the 2–4 years age group (34/105, 32%, P = 0.005). The commonest medicinal CAMs used were vitamins (88%), fish oils (27%) and Echinacea (26%). The commonest non-medicinal CAMs used were homeopathy (16%) and craniosacral therapy (14%). Use varied between paediatric specialties, with the highest in neurological patients (23/25, 92%, P = 0.005). Only 13% of parents had informed their Paediatrician of their child’s CAM use. Conclusions  More than half of the children surveyed had used some form of CAM, usually without their Paediatrician’s knowledge.     

中文简化版孤独症谱系障碍量表-儿童版的信效度

目的 研究中文简化版孤独症谱系障碍量表-儿童版（autism-spectrum quotient,AQ）的信效度。 方法 方便取样抽取3所学校全部学生共6 896人（对照组）,同时招募孤独症谱系障碍（autism spectrum disorder,ASD）患者86例作为病例组,所有被试均在专业人员指导下填写AQ量表;1个月后从对照组中随机抽取170人进行重测。计算AQ量表的信度和效度。 结果 入组时有效问卷为对照组6 472份,病例组86份,1月后对照组收集重测有效问卷159份。各分量表与总量表的相关性良好,为0.26~0.78,而各分量表之间相关性较小。对照组AQ总分在人群中呈连续性分布,类似于正态分布,偏斜度为-0.127,峰度为-0.124,说明AQ总分在人群中呈负偏态,稍平坦的分布。不同性别AQ得分有差异,男生组（42.09±9.92）高于女生组（40.07±9.94）,且差异有统计学意义（P<0.01）。而在病例组的研究中未体现出性别差异。年龄和AQ总分间存在相关关系（r=0.06）。比较两组总量表和各分量表得分,发现病例组得分（54.49±14.16）高于对照组（41.12±9.98）（P<0.01）,除"关注细节"以外病例组各分量表得分均高于对照组;中文简化版AQ-儿童版内部一致性良好,总量表Cronbach α系数为0.71,各分量表的系数为0.21~0.69;重测信度好,两次测量差异的平均值为0.09,且总量表和各个分量表两次测量差异均没有统计学意义（P>0.05）;全量表分受试者工作特征（ROC）曲线示曲线下面积（AUC）为0.78,最佳临床界值为48分,此时灵敏度为0.71,特异度为0.71。 结论 中文简化版AQ-儿童版具有良好的信效度,能适用于中国儿童,最佳临床界值为48分,在人群中呈连续性分布。     

Prevalence and patterns of multimorbidity in Australia

OBJECTIVES: To estimate the prevalence and patterns of multimorbidity in a sample of patients attending general practice, in the population who attended general practice in 2005, and in the Australian population. DESIGN, SETTING AND PARTICIPANTS: Secondary analyses of data from a study of prevalence of selected conditions (a substudy of the BEACH [Bettering the Evaluation And Care of Health] program); data were provided by 305 general practitioners for 9156 patients seen in July-November 2005, based on knowledge of the patient, patient self-report, and medical records. Listed conditions were classified according to the Cumulative Illness Rating Scale morbidity domains. MAIN OUTCOME MEASURES: Prevalence of morbidity in each domain; prevalence of specific patterns of multimorbidity (defined as presence of morbidity in two or more domains). RESULTS: Prevalence of multimorbidity was estimated as 37.1% of surveyed patients, 29.0% of people who attended a GP in 2005, and 25.5% of the Australian population. Prevalence and complexity (number of domains present) increased with age: 83.2% of surveyed patients aged 75 years or older had multimorbidity, 58.2% had morbidity in three or more domains, and 33.4% in four or more. Prevalence of multimorbidity did not differ between the sexes. The most common morbidity combinations were arthritis/chronic back pain + vascular disease (15.0% of sample), a psychological problem + vascular disease (10.6%) and arthritis/chronic back pain + a psychological problem (10.6%). We estimate that 10.6% of people attending a GP in 2005 and 9.3% of the population have arthritis/chronic back pain + vascular disease (+/- other morbidity types studied), and this group accounted for about 15.2 million Medicare-claimed general practice encounters in 2005. CONCLUSIONS: This study provides the first insight into prevalence and patterns of multimorbidity in Australia. Knowledge of the common combinations of multimorbidity may help in planning the health services needed in the future by an ageing population with an increasing burden of multimorbidity.     

The Association between Hospital Ownership and Technical Efficiency in a Managed Care Environment

This study assessed the association between hospital ownership and technical efficiency in a managed care environment. Hospital technical efficiency scores were calculated via the data envelopment analysis (DEA) method, employing four input variables and three output variables from the American Hospital Association Hospital Survey Data for acute care general hospitals in Florida. By utilizing the hospital technical efficiency scores as a dependent variable, we determined that non-profit hospitals were more efficient than for-profit hospitals for all 4 years examined in this study. In particular, for-profit hospitals with between 100 and 249 beds and those with more than 400 beds had lower technical efficiency scores as compared to their nonprofit peers. Another finding was that teaching hospitals were more efficient than non-teaching hospitals in 2001–2003, but not in 2004. Those variables associated with managed care, namely “number of HMO contracts” and “contracted with HMO”, however, were not shown to be statistically significant.     

用SF-36评价健康状态效用

目的　探讨用 SF- 36评价人群健康状态效用的方法。方法　在四川某城市按年龄、性别、职业分层抽取 70人 ,用配对比较法分析研究其对 SF- 36各领域及领域内各条目的心理偏好程度 ,并据此确定各领域及领域内各条目的权重值。结果　确定了所有 8个领域的权重值和除躯体活动功能领域以外的其余 7个领域内各条目的权重值。用加权法计算所得的领域得分值及合计分值与简单相加法所得结果相比 ,除社会功能领域外 ,均有显著性差异 ,但各领域得分值用两种方法计算所得结果从数据上看差异不大。结论　加权法所得效用值能更准确地反映人们对健康状态的心理偏好程度 ,但在计算领域得分值时给各条目赋予权重的意义是有限的。