儿童功能性便秘与心理行为因素的相关性研究

【目的】 探讨儿童功能性便秘患儿心理行为及气质、家庭环境特征,为儿童功能性便秘的预防和心理干预提供依据。 【方法】 确诊为功能性便秘的106例患儿和212例健康对照组儿童,由其家长填写Achenbach儿童行为量表(CBCL)、儿童气质量表、家庭环境量表-中文版(FES-CV)、儿童多动行为调查表。 【结果】 1)功能性便秘组儿童行为问题发生率(22.64%)高于健康对照组(12.26%)(P<0.05),4~5岁功能性便秘男童体诉、不成熟、攻击三个因子得分和女童社交退缩、抑郁、肥胖、分裂样四个因子高于对照组相应因子得分(P<0.05);6~11岁功能性便秘男童抑郁、强迫性、多动、攻击性四个因子得分和女童分裂样强迫性、体诉、违纪三个因子得分高于对照组相应因子得分(P<0.05)。2)功能性便秘组儿童在规律性、适应度、坚持度和注意分散度四个气质维度得分低于对照组(P<0.05)。3)家庭环境方面功能性便秘患儿的亲密度、知识性、独立性、控制性四个方面得分低于正常对照组,矛盾性方面的得分高于对照组。(P<0.05)。 【结论】 功能性便秘儿童行为问题发生率高,有独特的气质特点,家庭环境不良,应给予心理干预。     

Tourette综合征儿童的行为特征分析

【目的】对不同性别的Tourette综合征(Tourette syndrome,TS)儿童的行为特征进行分析,为临床治疗提供参考。【方法】采用Achenbach儿童行为量表(Child Behavior Checklist,CBCL)对66名TS男童(TS男童组)、23名TS女童(TS女童组)分别与40名正常男童(对照男童组)、20名正常女童(对照女童组)进行对照研究。【结果】 TS组的行为问题发生率(52.8%)较对照组(15.0%)明显增高;TS男童强迫性、体诉及攻击三种行为问题发生率高于对照组男童(P0.05),其9个行为因子的得分均显著高于对照组男童(P0.01);TS女童的抑郁、社交退缩行为问题发生率高于对照组女童(P0.01),其抑郁、残忍、社交退缩、体诉、攻击、违纪行为因子分值高于对照组女童。【结论】不同性别的TS儿童具有不同的行为特征,在临床治疗上应根据其特征进行相应的心理行为治疗。     

学龄前弱视儿童心理行为问题的临床研究

【目的】探讨学龄前弱视儿童的心理行为问题,分析其发生发展过程及相关因素。【方法】采用Achenbach儿童行为量表(Achenbach Child Behavior Checklist,CBCL)家长用表对98例弱视患儿和102例正常对照组儿童进行评定分析。【结果】与正常对照组相比,弱视患儿CBCL家长用表的异常率明显增高,差异有非常显著性(P<0.01)。4～5岁除男女童社交退缩、攻击因子明显高于正常儿童外,男童违纪、幼稚因子差异也有显著性(P<0.05);6岁以上男童交往不良、多动、违纪、攻击性因子明显高于正常儿童,女童体诉、社交退缩因子差异也有显著性(P<0.05)。【结论】弱视患儿存在明显的心理行为问题,应该给予必要的干预。     

家庭环境对学前儿童行为问题影响调查

[目的]探讨家庭环境对学前儿童行为问题的影响特点。[方法]采用Achenback＇s儿童行为量表（CBCL）和家庭环境调查问卷对南通市1 772名46周岁学前儿童进行调查。[结果]家教方式较差的男童主要表现为社交退缩、违纪等8个因子,而女童主要为体诉、攻击行为等6个因子;母亲孕期情绪不良的男童主要表现为攻击、违纪等7个因子,而女童为忧郁、分裂样等7个因子;家庭结构复杂的男童主要表现为社交退缩、分裂样等5个因子,而女童为分裂强迫、抑郁等4个因子。[结论]不同的家庭环境对学前儿童行为问题的影响特点各有侧重。     

慢性病儿童心理行为特征及影响因素探讨

【目的】探讨慢性病儿童的心理行为特点及相关因素。【方法】采用少儿艾森克个性问卷(Eysen-ckPersonalityQuestionnaire,EPQ)和Achenbach儿童行为筛查量表(AchenbachChildBehaviorChecklist,CBCL,),对研究儿童进行测试和比较,并收集患儿个人及父母健康状况等信息,进行多元逐步回归分析。【结果】除12~16岁组男童外,慢性病组中其他年龄组儿童CBCL总分和内向性行为得分均显著高于正常对照组;慢性病6~11岁组中男童在抑郁、交往不良、多动和攻击性因子得分和女童在抑郁、社交退缩、体诉、性问题和攻击性因子得分显著高于正常对照组(P<0.05);12~16岁女童组在焦虑强迫、体诉、抑郁退缩、不成熟和残忍因子得分显著高于对照组。多元线性回归分析后得出:影响慢性病儿童CBCL总分的因素由强到弱为年平均住院天数、父母心理状况、疾病稳定情况、父母亲健康状况以及患儿课外活动和体育活动影响程度。【结论】慢性病儿童有更多的心理行为问题,在治疗躯体疾病的同时,对慢性病息儿及家庭进行社会心理干预非常必要。     

儿童分泌性中耳炎鼓膜置管术后生活质量的研究

目的评价鼓膜置管术对儿童分泌性中耳炎患儿生活质量的影响,为治疗方案的选择提供依据。方法采用中文版慢性耳病调查量表、OM-6调查问卷及儿童行为量表,对36例(54耳)分泌性中耳炎患儿行鼓膜置管术术前、术后进行评分,分析其对患儿生活质量的影响。结果中文版慢性耳病调查量表治疗前后各维度均值相比差异均有统计学意义(P均0.01);OM-6调查问卷结果示除了言语障碍外,治疗前后其他各维度均值相比差异均有统计学意义(P均0.01);儿童行为量表示男童在分裂样、抑郁、强迫性、社交退缩、多动、攻击性方面手术前后的得分均值相比差异均有统计学意义(P均0.05),女童在抑郁、社交退缩、分裂强迫、多动、攻击性方面的得分均值相比差异均有统计学意义(P均0.05)。结论鼓膜置管术后儿童分泌性中耳炎患儿的生活质量明显提高。     

6～11岁注意缺陷多动障碍儿童行为问题分析

[目的]分析不同性别、不同年龄及不同智商水平注意缺陷多动障碍(attention deficit hyperactivity disor-der,ADHD)儿童行为问题发生的特点和差异,为临床上ADHD的治疗和干预提供参考依据.[方法]对门诊符合DSM-Ⅳ诊断标准的321名ADHD儿童进行Achenbach儿童行为量表(CBCL)检查和瑞文标准推理测验(CRT),比较不同性别、不同年龄、不同智商水平ADHD儿童行为问题发生的特点和差异.[结果]ADHD男童在多动、违纪、攻击性方面行为因子得分显著高于女童,而女童在抑郁、社交退缩方面行为因子得分显著高于男童(P值均＜0.05).行为问题的检出率有随年龄增大而增高的趋势,其中在交往不良、多动、攻击性、违纪方面,9～11岁年龄组与6～8岁年龄组相比,差异有显著性(P值均＜0.05).智商优秀组、中间组、边缘组三组行为问题的发生率分别为71.8%,83.6%,100%,差异无显著性(P＞0.05),但边缘组和优秀组相比,差异有显著性(P＜0.05).[结论]ADHD儿童行为因子得分存在性别差异;随年龄增大行为问题有增加的趋势;智商边缘者更容易出现行为问题.     

抽动障碍学龄期儿童行为问题与母亲亲职压力关系

探讨抽动障碍学龄期儿童行为问题与母亲亲职压力之间的关系,为抽动障碍学龄期儿童的科学干预提供数据.方法 使用Achenbaeh儿童行为量表(CBCL)和亲职压力简表(PSI-SF)对佛山市妇幼保健院儿童保健科83例学龄期抽动障碍患儿与佛山市某小学91名正常儿童进行比较分析.结果 学龄期抽动障碍组儿童的行为问题多于正常对照组(t=-9.06,P<0.01);抽动障碍组儿童母亲亲职压力总分、各分量表得分均高于正常对照组(t值分别是-4.52,-3.66,-2.07,-5.15,P值均<0.05);男童行为问题总分、分裂性、抑郁、体诉、社交退缩与亲职困扰分量表呈正相关(r值分别为0.20,0.23,0.18,0.22,0.20, P值均<0.05),女童行为问题总分、抑郁、社交退缩、体诉、多动、残忍与亲子互动失调分量表呈正相关(r值分别为0.41,0.51,0.42,0.43,0.29,0.30,0.28,P值均<0.05).结论 学龄期抽动障碍儿童比正常儿童行为问题多,交际能力较差,病例组母亲普遍存在较高水平的亲职压力.母亲感受到的亲职困扰越多,男童出现内向性行为问题越多;而亲子互动功能失调与女童行为问题的出现有关.     

非言语型学习障碍儿童的认知方式与行为特征的研究

【目的】 了解非言语型学习障碍(nonverbal learning disabilities,NLD)儿童认知方式与行为特征,探讨影响NLD发病的因素。 【方法】 对符合ICD-10和DSM-III筛查诊断标准31名NLD儿童、24名言语型学习障碍(verbal learning disabilities, VLD)儿童和40名正常儿童,采用镶嵌图形测验(EFT)和棒框测验(RFT)测量认知方式,Achenbach儿童行为量表测量行为问题。数据采用单因素方差分析和多重比较分析。 【结果】 NLD儿童的EFT的不同难度的三部分成绩和总成绩都比正常对照组儿童得分低(P<0.01),而VLD儿童仅总成绩低于正常对照组(P<0.05)。NLD儿童RFT的偏差明显大于正常对照组和VLD儿童(P<0.05),但VLD儿童与正常对照组的差异无统计学意义。NLD男童的社交能力和学校学习情况得分显著低于对照组,VLD男童亦表现出同样的问题;NLD男童各因子的得分明显高于对照组男童,在分裂样、抑郁、强迫性、体诉、社交退缩、多动、攻击性方面也比VLD男童得分高。 【结论】 NLD儿童认知方式以场依存性为主,其行为问题亦比正常儿童和VLD儿童突出。     

合肥市区4～6岁儿童艾氏量表得分分析

了解合肥市区４－６岁学龄前儿童艾氏行为量表的得分特征。「方法」编制儿童心理行为状况父母问卷调查表,通过分层抽样对４６１名男童和４３１名女童进行调查。「结果」男童量表总分显著高于女童;单项得分中,男童有２８项显著高于女童,６项显著低于女童,合肥市区男童忧郁、攻击两分量表划界分高于常模,女童分裂样焦虑,社会退缩两分表高于常模。     

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.