Survey of adolescents with severe intellectual handicap.

A diagnostic survey was undertaken of children aged 11 to 19 years in Tameside with severe learning difficulties (intelligence quotient less than or equal to 50). Eighty-two children were identified and their medical records reviewed. A specific diagnosis for the retardation was documented in 25 (30%) of the children, 18 of whom had Down''s syndrome. A probable aetiology or a disorder of unknown aetiology had been identified in a further 21 (26%) children. To confirm the existing diagnosis, identify new diagnoses, and offer genetic counselling, the parents of 63 children were offered detailed reassessment of their child. Fifty three children were reviewed, and a specific disorder identified in 25 out of 31 previously undiagnosed children. The most frequent diagnoses made were fragile X syndrome and Rett''s syndrome. On completion of the survey, 61 of the 82 children (74%) had a specific diagnosis or probable aetiology identified, 12 (15%) had associated disorders such as cerebral palsy, and in only nine of the 82 children (11%) were there no clues at all to the cause of their retardation.     

Parents, physicians, and antibiotic use

BACKGROUND: Emergence of resistant bacterial pathogens has increased concerns about antibiotic prescribing patterns. Parent expectations and pressure may influence these patterns. OBJECTIVE: To understand how parents influence the prescribing patterns of physicians and what strategies physicians believe are important if we are going to reduce inappropriate use of oral antimicrobial agents. DESIGNS AND METHODS: One thousand pediatricians who are members of the American Academy of Pediatrics were asked to complete a semi-structured questionnaire. The physicians were chosen randomly by the American Academy of Pediatrics. RESULTS: Nine hundred fifteen pediatricians were eligible and 610 surveys were analyzable, for a response rate of 67%. The majority of respondents were male (56%), worked in a group practice (51%), saw an average of 114 patients per week and were in practice for 14 years. Forty percent of the pediatricians indicated that 10 or more times in the past month a parent had requested an antibiotic when the physician did not feel it was indicated. Forty-eight percent reported that parents always, most of the time, or often pressure them to prescribe antibiotics when their children are ill but antibiotics are not indicated. In follow-up questions, approximately one-third of physicians reported they occasionally or more frequently comply with these requests. Seventy-eight percent felt that educating parents would be the single most important program for reducing inappropriate oral antibiotic use and 54% indicated that parental pressure, in contrast to concerns about legal liability (12%) or need to be efficient in practice (19%), contributed most to inappropriate use of oral antibiotics. CONCLUSIONS: Pediatricians acknowledge prescribing antimicrobial agents when they are not indicated. Pediatricians believe educating parents is necessary to promote the judicious use of antimicrobial agents.     

广西某县原发性肝癌危险因素的非条件Logistic回归分析

目的：调查广西某县肝癌危险因素,为该县开展肝癌防治研究提供科学依据。方法：从该地区恶性肿瘤发病登记报告中,随机选择１９９６年～１９９７年肝癌患者３５０例为病例组：并随机选择１５２８例正常人群进行调查,为对照组;用非条件Ｌｏｇｉｓｔｉｃ回归模型进行多因素分析。结果有８个因素最终选入多因素非条件Ｌｏｇｉｓｔｉｃ回归模型,包括饮水类型,１０年前玉米月用量,心理情绪,ＨＢｓＡｇ和肝癌家庭史等。结论：广西某     

Anxiety and depression in the workplace: effects on the individual and organisation (a focus group investigation)

BACKGROUND: While the prevalence of anxiety and depression has increased, little is known of the impact on working life. The aim of this study was to explore the effects of anxiety and depression and the treatment for these conditions on performance and safety in the workplace. METHOD: Nine focus groups were conducted with employees who had suffered anxiety and depression. A further 3 groups comprised staff from human resources and occupational health. The sample comprised 74 individuals aged 18-60 years, from a range of occupations. Results were presented to a panel of experts to consider the clinical implications. RESULTS: Workers reported that the symptoms and medication impaired work performance, describing accidents which they attributed to their condition/medication. Respondents were largely unprepared for the fact that the medication might make them feel worse initially. Employees were reluctant to disclose their condition to colleagues due to the stigma attached to mental illness. LIMITATIONS: People who had experienced problems with managing their symptoms and medication at work are more likely to volunteer to participate in such a study than those who had a satisfactory experience. Also, the researchers had no background information on severity of mental health problems of participants. CONCLUSIONS: Anxiety and depression were associated with impaired work performance and safety. The authors consider the implications for health care and the management of mental health problems at work.