1 280名3~6岁儿童情绪与行为问题调查研究

【目的】 调查了解3~6岁儿童情绪与行为问题,为早期干预提供理论依据。 【方法】 采用自拟儿童基本情况调查表、儿童长处和困难问卷(Strengths and Difficulties Questionnaire,SDQ)对1 280名3~6岁儿童进行调查评估。 【结果】 3~6岁儿童困难问题检出率为11.6%。情绪或行为异常检出率为33.9%。SDQ各因子异常检出率分别为情绪问题2.3%,品行问题7.1%,多动注意不能11.5%,同伴交往问题3.9%,亲社会行为18.6%。男童SDQ因子异常检出率,多动注意不能为13.4%、同伴交往问题4.9%及亲社会行为20.9%均显著高于女童8.8%、2.4%及15.4%,差异有统计学意义(χ²=5.188~6.288,P<0.05)。儿童不同年龄间SDQ困难总分、品行问题、多动注意不能、亲社会行为异常检出率差异有统计学意义(χ²=8.235~19.206,P<0.001~0.05)。与儿童情绪与行为问题有关的影响因素为儿童性别及生活状况、父亲外出务工、母亲文化程度。 【结论】 3~6岁儿童情绪与行为问题发生率较高,应重视儿童情绪与行为问题干预。     

我国八省小学生心理状况及家长对其评价分析

目的分析我国儿童心理问题现状及其影响因素,为儿童心理健康促进工作提供依据。方法利用中国疾病预防控制中心青年基金"我国学龄儿童主要慢性病干预模式及适宜技术研究"数据。应用长处与困难问卷(strengths and difficulties questionnaire,SDQ)家长版,分析我国8省21 480名6～13岁小学生的心理行为现状及其影响因素。结果 SDQ困难总分(T)、情绪(E)、品行(C)、多动与注意缺陷(H)、同伴交往(P)及亲社会因子(S)平均分分别为(12.93±4.50),(2.30±1.93),(2.38±1.43),(4.02±1.66),(4.23±1.69),(6.29±2.10)。农村儿童在困难总分、情绪、多动与注意缺陷和品行因子得分均高于城市儿童(均有P<0.05)、同伴交往因子及亲社会因子得分低于城市儿童(均有P<0.05);家长文化水平低的儿童困难总分、情绪、多动与注意缺陷和品行因子得分高于家长文化水平高的儿童(均有P<0.05),同伴交往因子及亲社会因子得分低于家长文化水平高的儿童(均有P<0.05)。10.2%的家长主观认为...     

铜陵市学龄前儿童情绪和行为问题调查及其影响因素分析

目的 了解铜陵市学龄前儿童情绪和行为问题现状及其影响因素,为制定相应的干预措施提供依据。方法 采取整群随机抽样法,抽取铜陵市11所幼儿园2 408名学龄前儿童的父母进行调查,内容包括一般情况调查表、长处和困难问卷(SDQ)(父母版)。结果 获得有效问卷2 184份。SDQ困难总分和5个因子异常检出分别是252人(11.5%)、1 052人(48.2%);男童的困难总分、品行问题、多动注意不能、同伴交往问题、亲社会行为得分高于女童(P＜0.05);各年龄组儿童的SDQ困难总分、品行问题、多动注意不能、同伴交往问题和亲社会行为得分差异有统计学意义(P＜0.05)。Logistic 回归分析显示,儿童情绪和行为问题的危险因素有:父亲吸烟半包以上、性别是男童、胎儿窘迫、非核心家庭。母亲本科及以上文化程度是保护因素。儿童年龄越小发生情绪和行为问题的风险越大。结论 铜陵市学龄前儿童情绪和行为问题发生率较高,应进行针对性的早期干预。     

沈阳市中小学生心理健康状况与人格特征关系

目的了解辽宁省沈阳市中小学生心理健康状况及其与人格特征的关系,为心理健康教育提供依据。方法采用分层整群抽样方法对辽宁省沈阳市7所中学和4所小学的1 499名中小学生进行问卷调查。结果沈阳市中小学生的心理健康问题检出率为19.3%,其中男生和女生的检出率分别为20.7%和18.2%;长处与困难问卷(SDQ)情绪症状、品行问题、多动注意不能、同伴交往问题、社会行为得分和困难总分分别为(2.9±2.4),(2.5±1.8),(3.2±2.1),(3.2±1.7),(7.3±2.4)和(11.9±6.1)分,与常模比较,情绪症状、品行问题、同伴交往问题得分和困难总分均高于常模(P0.01);艾森克人格问卷(EPQ)内外向(E)、精神质(P)、神经质(N)和掩饰(L)得分分别为(17.7±4.8),(3.6±3.3),(8.2±5.8)和(15.0±3.8)分;相关分析结果表明,E和L与社会行为呈正相关关系(P0.01),与情绪症状、品行问题、多动注意不能、同伴交往问题和困难总分均呈负相关关系(P0.01);P和N与社会行为因子呈负相关关系(P0.01),与情绪症状、品行问题、多动注意不能、同伴交往问题和困难总分均呈正相关关系(P0.01);多元线性回归分析结果表明,人格特征中E(β=-0.220)、P(β=0.195)、N(β=0.428)和L(β=-0.172)与心理健康水平密切相关,并影响中小学生心理健康水平(P0.01)。结论沈阳市中小学生心理健康问题较多;人格特征对心理健康有预测作用。     

音乐治疗对注意缺陷多动障碍临床症状疗效的随机对照研究

目的比较音乐治疗合并药物治疗与单纯药物治疗对儿童注意缺陷多动障碍(attention deficit and hyperactive disorder,ADHD)的疗效。方法将66例ADHD儿童随机分为研究组和对照组,研究组给予音乐治疗结合盐酸哌甲酯缓释剂治疗,对照组仅给予盐酸哌甲酯缓释剂治疗。两组均予治疗前及治疗16周后采用Conners父母症状问卷、父母用儿童长处和困难问卷(Strengths and Difficulties Questionnaire,SDQ)评估ADHD的临床症状。结果 1)研究组和对照组治疗后SDQ品行问题、多动注意不能及困难总数因子得分差异具有统计学意义(P0.05),研究组治疗后SDQ情绪因子得分明显下降,差异达到统计学意义(P0.05或0.01);2)研究组和对照组治疗后Conners量表学习问题、品行问题、多动冲动及多动指数因子得分差异具有统计学意义(P0.05);3)治疗后研究组SDQ因子中的情绪问题、同伴交往和困难总分得分均低于对照组,差异具有统计学意义(P0.05);4)治疗后研究组Conners父母量表的品行问题因子得分小于对照组,差异具有统计学意义(P0.05)。结论音乐治疗合并药物治疗比单纯药物治疗能够更好地改善ADHD儿童的症状。     

柳州市学龄期儿童情绪与行为问题分析

目的 对柳州市学龄期儿童进行长处和困难问卷(SDQ,家长版)调查,分析柳州市学龄期儿童存在的心理行为问题。方法 2014年10月-2015年7月采用分层整群随机抽样法抽取柳州市27所小学11 205名学生进行长处和困难问卷(家长版)调查,所得数据进行性别和年级差异比较,计数资料的比较采用χ²检验,计量资料的比较采用t检验或方差分析。结果 柳州市学龄期儿童情绪和行为问题阳性检出率为4.1%~36.9%,其中困难总分阳性检出率为11.8%,女生情绪问题(9.1%)检出率高于男生(7.6%)(χ²=7.358,P＜0.05)。不同性别儿童的SDQ困难总分和各因子得分差异有统计学意义,女生情绪症状和亲社会行为得分高于男生,男生品行问题、多动、同伴交往和困难总分得分高于女生(P＜0.05)。各年级儿童在SDQ各因子及困难总分得分上差异均具有统计学意义,低年级儿童多动注意不能问题得分高于高年级儿童,而儿童品行、同伴交往及困难总分得分低于高年级儿童(P＜0.05)。结论 柳州市学龄期儿童情绪和行为问题发生率较高,应针对不同年级、性别进行早期干预。     

学龄期注意缺陷多动障碍儿童情绪和行为问题分析

目的探讨柳州市学龄期注意缺陷多动障碍(ADHD)儿童的情绪和行为特征,为制定科学有效的综合治疗方案提供依据。方法以符合DSM-IV诊断标准的468例ADHD儿童为病例组,采用长处与困难量表(SDQ)父母版比较ADHD儿童与1 404例正常健康儿童的情绪行为特征。结果两组SDQ得分比较,ADHD儿童情绪、品行问题、多动注意不能、同伴交往以及困难总分均高于对照组儿童(P=0. 000),亲社会因子得分对照组高于ADHD组(P=0. 000)。不同性别ADHD儿童SDQ得分比较,女童亲社会行为得分高于男童(P=0. 022)。品行问题和多动注意不能因子得分在不同年级ADHD儿童中比较差异有统计学意义(P0. 05)。结论 ADHD儿童多伴随情绪、品行问题、注意力集中不能等问题,ADHD男童的困难总分高于女童。ADHD儿童的干预训练要根据儿童行为特征及性别差异采取有针对性的方案。     

青少年侵害的发生现状及影响因素

【目的】探讨青少年侵害的发生现状及影响因素,以引起有关部门的关注。【方法】采用青少年侵害问卷自评版(Juvenile Victimization Questionnaire,JVQ)和自编一般情况调查表对山东省两地区初一、初二、高一、高二年级的3 155名学生进行调查,采用非条件Logistic逐步回归法分析多重侵害的影响因素。【结果】经历至少一种侵害类型的占66.31%,发生率较高的侵害类型有目击某人被赤手空拳殴打、物品被偷、物品被故意破坏、家人或舍友物品被盗等。多重侵害的发生率为16.89%,其中低、高度多重侵害发生率分别为12.29%和4.60%。多重侵害发生率男生显著高于女生;初中生显著高于高中生;独生子女显著高于非独生子女;学习成绩中下等青少年显著高于中上等青少年;家庭经济较差青少年显著高于家庭经济较好青少年(均P0.01)。年龄较小、独生子女、居住在农村、居住拥挤、家庭经济较差、饮酒、玩游戏、看色情书或音像制品是多重侵害发生的危险因素。【结论】青少年侵害及多重侵害的发生率较高,与多方面因素有关,应该引起家庭、学校和社会的广泛关注。     

农村青少年儿童期创伤与情绪行为问题的关系

【目的】 调查农村青少年儿童期创伤、情绪行为问题的发生情况,探讨儿童期创伤与青少年情绪行为问题的关系。 【方法】 2010年7-8月采用方便抽样,对山东省东、中、西部六个地区的1 200名农村青少年采用儿童期创伤问卷简化版(Childhood Trauma Questionnaire-Short Form,CTQ-SF)、长处与困难问卷(自评版)(The Self-Report Strengths and Difficulties Questionnaire,SDQ)和一般信息问卷进行调查。 【结果】 不同性别间SDQ困难总分女生大于男生(t =-2.26,P＜0.05),不同年龄段间困难总分差异有高度统计学意义(t =-3.58,P＜0.001)。儿童期创伤高分组的情绪行为问题高于低分组,差异均具有统计学意义(P＜0.05)。儿童期创伤总分及其五个维度与SDQ困难总分及其四个维度均呈显著相关(r=0.068~0.231,P均＜0.05)。 【结论】 农村青少年儿童期创伤与情绪行为问题有一定的关系,应该采取积极措施避免和减少个体在儿童期所受到的创伤,促进青少年的健康发展。     

学龄前儿童视屏时间与睡眠状况对其情绪及行为问题的影响

  目的  研究学龄前儿童视屏时间和睡眠状况与其情绪及行为问题之间的相关性,探讨视屏时间与睡眠状况对学龄前儿童情绪及行为问题的联合作用。  方法  选取2017年11月―2017年12月扬州市8所幼儿园的2 946名3~6岁学龄前儿童作为研究对象,问卷调查学龄前儿童视屏行为、睡眠状况和学龄前儿童情绪及行为问题等情况,采用二分类logistic回归分析模型分析视屏时间与睡眠状况对学龄前儿童情绪及行为问题的影响。  结果  调整混杂因素后,发现视屏时间＞1 h/d的学龄前儿童发生品行问题、多动、同伴交往、长处与困难问卷(strengths and difficulties questionnaire, SDQ)困难总分可疑或异常的风险更高(P＜0.05);睡眠时间＜10 h/d发生多动、同伴交往可疑或异常的风险更高(P＜0.05);睡眠质量不良发生情绪症状、品行问题、多动、同伴交往、SDQ困难总分可疑或异常的风险更高(P＜0.001)。联合作用分析显示,睡眠时间＜10 h/d合并视屏时间＞1 h/d的学龄前儿童发生多动、SDQ困难总分可疑或异常的风险更高(P＜0.05);睡眠质量不良合并视屏时间＞1 h/d更易发生情绪症状、品行问题、多动和SDQ困难总分可疑或异常(P＜0.001)。  结论  视屏时间＞1 h/d和睡眠质量不良对学龄前儿童情绪及行为问题更易产生负面影响。     

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.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

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.     

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.     

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.     

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.