儿童社交焦虑量表的中国城市常模

【目的】建立儿童社交焦虑量表(Social Anxiety Scale for Children,SASC)的中国城市常模并检验其信度和效度。【方法】在全国14个城市采样2 019例(男1 012,女1 007),平均年龄(11.29±2.34)岁,由学生填写SASC;焦虑组儿童填写SASC、SCARED,其父母填Achenbach儿童行为量表(Child Behavior Checklist,CBCL)。【结果】量表的重测信度为0.538~0.839、半分信度0.81、Crobach a系数0.58~0.79、项目与总分的一致性在0.27~0.76之间。量表的效度较好,与Achenbach CBCL、SCARED的相应分量表相关,社交焦虑组儿童得分高于常模组,对社交焦虑性障碍诊断的灵敏度为0.69,特异度为0.75。【结论】儿童社交焦虑量表可用于我国儿童社交焦虑症状的评估。     

城市3～6岁儿童家庭养育环境量表的编制及其信度效度研究

【目的】编制完全本土文化背景的儿童早期家庭养育环境评价量表。【方法】查阅有关文献和专家访谈,构建儿童养育环境条目库,经试验性测试形成"初始问卷"。分层随机抽取232名3~6岁儿童家长初步测试,探索性因素分析形成"3~6岁儿童家庭养育环境试用问卷"。再次分层随机抽取10个市县城区3~6岁儿童,完成696份"试用问卷"测评,部分儿童完成"CBCL量表"测试。删除CR值达不到显著水平、与总分相关系数<0.30的条目以及项目负荷量<0.4的条目,形成正式量表后进行信度检验和效度检验。【结果】量表由53个条目组成,同质信度克伦巴赫α系数为0.930,分半信度为0.871,重测信度系数0.707;量表总分与儿童CBCL总分之间呈明显负相关(r=-0.455),内容效度和结构效度均达到良好水平。【结论】量表信度、效度良好,各项指标均达到了测量学的要求,可以作为3~6岁儿童家庭养育环境的评价工具。     

婴幼儿孤独症筛查量表的修订与临床应用研究

【目的】以孤独症筛查量表FOSPAC-R为蓝本,修订婴幼儿孤独症筛查量表,并对该量表进行信度和效度分析。【方法】引入修订FOSPAC-R量表,并选择儿童孤独症组、正常儿童组和语言障碍以及其他发育障碍的儿童组作为研究对象对该量表进行信度、效度检验。【结果】该量表各项目的评定者信度和重测信度(r)分别为0.573~1和0.539~1,量表总分的评定者信度和重测信度分别为0.993和0.984。量表项目的内部一致性较好(Cronbach’sα=0.827)。量表的区分效度[F(2,78)=220.749、P0.001]。各项目的鉴别诊断效度均达良好的水平。【结论】该量表有较好的信度和效度,符合量表的编制要求,可用于婴幼儿孤独症的筛查。     

中国3～6岁城区儿童忽视常模的研制

目的 研究评价儿童忽视的工具和标准；同时为父母及保教人员科学养育孩子提供行为指南。方法 （1）在全国7个行政大区25个代表性城市2－6岁儿童中随机抽取有效样本1457例，男女各半，少数民族占4.9%。（2）儿童忽视问卷由6个层面的146个题项组成。（3）对所收集的数据，经题项难易度分析、项目分析、因素分析和内部一致性检验，逐步删除不适宜题项、层面和年龄组；经信度分析、效度分析，从而形成正式量表；再确定相应的参数，最终完成常模的研制。结果 （1）一般特征：男童与女童量表忽视总分比较无显著性差异；男、女童在6个忽视层面得分均值比较也均无显著性差异。（2）量表的形成：经过项目分析、因素分析及内部一致性检验，逐步删除53个不适宜题项及1个层面，最终形成由5个层面91个题项组成的总量表；再经信度分析（总量表及各忽视层面的内部一致性系数α、分半信度，重测信度，平行信度等）和效度分析（结构效度、外部效度、表面效度等），结果均较理想，达到了常模的要求。（3）忽视界值点的确定：总量表及每一忽视层面得分的第90百分位数（P90）分别是：身体忽视怪面35分、情感忽视层面80分、教育忽视层面40分、医疗忽视层面15分、安全忽视层面20分；总忽视界值点190分。结论 本忽视常模由5个层面91个题项组成，可分别 评价儿童在身体、情感、教育、医疗、安全方面所受到的忽视及其程度，也可用来衡量父母及有关人员在看护孩子时的行为和态度。     

回族学龄期儿童自我意识水平及其影响因素分析

【目的】 了解回族学龄期儿童自我意识的发展水平及其影响因素。 【方法】 采用儿童自我意识量表(PHCSS)和自编一般情况调查问卷对495名回族中小学生进行调查分析与评价。 【结果】 回族学龄期儿童自我意识总体水平显著低于全国城市常模(P＜0.001);女生的行为、焦虑、合群3个因子的得分及总分显著高于男生(P＜0.05);随着年级的增高,回族儿童自我意识得分降低;家庭环境因素中父母文化程度、职业、家庭收入、家庭类型对儿童自我意识均有影响;学校因素中学习成绩、师生关系、与同学关系对儿童自我意识的各因子及总分均有明显影响。 【结论】 学龄期儿童正处于自我意识发展的关键时期,营造良好的家庭与学校环境,是提高儿童心理健康水平的有力保障。     

广泛性发育障碍筛查问卷中文版的信度、效度分析

【目的】 修订广泛性发育障碍筛查问卷(Pervasive Developmental Disorders Screening Questionnaire,PDDSQ),并进行信度、效度及敏感度、特异度分析,为我国大样本人群开展孤独症早期筛查提供简便、有效的工具。 【方法】 选择孤独症、脑瘫和精神发育迟滞、正常对照儿童12~47月共639名、4~18岁727名作为研究对象,检验PDDSQ中文版的信度和效度。 【结果】 采用探索性因素分析,两个年龄段问卷各提取2个因子,用AMOS 17.0进行结构方程模型的验证性因素分析,结果显示具有较好的效度。2个年龄段的筛查问卷内部一致性信度Cronbach α 系数分别为0.903和0.925,分半信度分别为0.818和0.861,一个月后重测信度分别为0.707和0.641。 【结论】 修订后的PDDSQ中文版具有较好的信度和效度,适用于中国开展孤独症人群筛查。     

昆山地区托幼机构6～7岁儿童行为问题流行病学调查

【目的】了解昆山地区托幼机构6～7岁儿童的行为问题现状,为卫生行政部门制定相关决策提供依据。【方法】采用Conners父母症状问卷(Parent Symptom Questionnaire,PSQ),对昆山地区托幼机构的7 149名6～7岁儿童的行为问题进行调查,并将结果与Conners国内常模进行比较。【结果】昆山地区托幼机构6～7岁儿童注意缺陷多动障碍症状阳性总检出率为3.43%,男童的检出率(4.48%)高于女童(2.25%),差异有高度统计学意义(χ2=26.63,P0.01);不同年龄组间冲动-多动、焦虑、多动指数等因子检出率差异具有统计学意义(P值均0.05);男童的品行问题、冲动-多动、多动指数等因子得分均高于女童(P值均0.05);男童冲动-多动因子得分较国内常模较低、多动指数因子得分较国内常模较高(P值均0.05);女童的品行问题、心身问题、冲动-多动、焦虑以及多动指数得分均较国内常模高(P值均0.05)。【结论】昆山地区学龄前儿童多动等行为问题明显,应早期预防、早期干预。     

中国城市9～18岁学生攻击问卷标准化常模研制

目的建立中国城市9～18岁学生攻击问卷标准化常模,为青少年攻击行为相关研究、诊断、干预和治疗提供科学依据。方法采用多阶段分层整群抽样方法,在全国东、西、南、北、中5个省内抽取23 904名中小学生进行攻击行为问卷调查,综合考虑统计学检验结果和自变量效果量大小,进行城市常模制定。结果中文版BWAQ具有良好的信效度。常模样本AQ总分和各分量表分的性别、年龄差异存在交互作用。根据效果量>0.2的原则,将年龄分段为9～11岁组、12～15岁组、16～18岁组;筛选出需要分别计算常模界点的性别年龄组。根据常模样本各性别年龄组原始得分换算成标准T分数,获得中国城市9～18岁中小学生攻击问卷标准化常模。结论本常模利用T分划分出明确的等级界限,便于在实际工作中应用。     

236名4～6岁男童行为问题与家庭环境的相关分析

【目的】了解4～6岁儿童行为问题发生情况，探讨与其相关的因素。【方法】用Achenbach儿童行为量表、家庭环境量表中文版(以下简称FES-CV)进行调查，结果进行典型相关分析。【结果】男童行为问题发生率为9．6％，Y2(情感表达)、Y9(组织性)的得分越高，Y3(矛盾性)的得分越低，则Y4(社交退缩)、Y6(违纪)、Y1(分裂样)的得分越低。【结论】亲密度、组织性得分越高的家庭，男童行为问题发生越少；矛盾性得分高的家庭儿童行为问题越多。     

2～3岁幼儿行为量表全国城市常模的制定

[目的]制定2～3岁儿童行为检查表中国城市常模。[方法]根据中国民族文化背景，在全国六大行政区16个省市的城区按随机原则分层抽取2468名2～3岁正常儿童，测查2～3岁CBCL六个行为因子(社交退缩、抑郁、睡眠问题、躯体诉述、攻击行为和破坏行为)及内向性、外向性和行为问题总分的均值、百分位及标准分，并进行信度、效度检验，制定全国城市常模。[结果]制定出常模的分半、复测信度、同质性信度及效度良好。[结论]该量表适用于我国2～3岁婴幼儿行为异常的评价，可为临床诊断和观察干预效果提供客观依据。     

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.     

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.