Remissions in maternal depression and child psychopathology: a STAR*D-child report

Context  Children of depressed parents have high rates of anxiety, disruptive, and depressive disorders that begin early, often continue into adulthood, and are impairing. Objective  To determine whether effective treatment with medication of women with major depression is associated with reduction of symptoms and diagnoses in their children. Design  Assessments of children whose depressed mothers were being treated with medication as part of the multicenter Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial conducted (between December 16, 2001 and April 24, 2004) in broadly representative primary and psychiatric outpatient practices. Children were assessed by a team of evaluators not involved in maternal treatment and unaware of maternal outcomes. Study is ongoing with cases followed at 3-month intervals. Setting and Patients  One hundred fifty-one mother-child pairs in 8 primary care and 11 psychiatric outpatient clinics across 7 regional centers in the United States. Children were aged 7 to 17 years. Main Outcome Measures  Child diagnoses based on the Kiddie Schedule for Affective Disorders and Schizophrenia; child symptoms based on the Child Behavior Checklist; child functioning based on the Child Global Assessment Scale in mothers whose depression with treatment remitted with a score of 7 or lower or whose depression did not remit with a score higher than 7 on the Hamilton Rating Scale for Depression. Results  Remission of maternal depression after 3 months of medication treatment was significantly associated with reductions in the children's diagnoses and symptoms. There was an overall 11% decrease in rates of diagnoses in children of mothers whose depression remitted compared with an approximate 8% increase in rates of diagnoses in children of mothers whose depression did not. This rate difference remained statistically significant after controlling for the child's age and sex, and possible confounding factors (P = .01). Of the children with a diagnosis at baseline, remission was reported in 33% of those whose mothers' depression remitted compared with only a 12% remission rate among children of mothers whose depression did not remit. All children of mothers whose depression remitted after treatment and who themselves had no baseline diagnosis for depression remained free of psychiatric diagnoses at 3 months, whereas 17% of the children whose mothers remained depressed acquired a diagnosis. Findings were similar using child symptoms as an outcome. Greater level of maternal response was associated with fewer current diagnoses and symptoms in the children, and a maternal response of at least 50% was required to detect an improvement in the child. Conclusions  Remission of maternal depression has a positive effect on both mothers and their children, whereas mothers who remain depressed may increase the rates of their children's disorders. These findings support the importance of vigorous treatment for depressed mothers in primary care or psychiatric clinics and suggest the utility of evaluating the children, especially children whose mothers continue to be depressed.      

电子文献著录格式

采用快速血糖检测仪检测52例出诊救护昏迷病人的血糖,血糖为0．6mmol／L～1．8mmol／L的有18例,血糖为3．9mmol／L～7．8mmol／L的有5例,血糖为28．0mmol／I。～33．3mmol／L的有27例,血糖出现“Hi”的有2例。对检测为低血糖者给予50％葡萄糖治疗,高血糖者给予生理盐水加胰岛素治疗,经处理后病人意识逐渐清醒。认为在出诊救护昏迷病人时进行快速血糖检测可及时发现血糖过高或过低所致的昏迷,为正确救治赢得时间,可提高抢救质量。     

不同层次护生对生活护理认同度的调查研究

目的 了解不同层次护生对生活护理的认同情况,以期提高护理质量.方法采用自行设计的问卷,调查在该院实习的95名本科护生、76名大专护生、116名中专护生对生活护理的认同情况.结果 本科护生对生活护理知识的认同虽然高于大中专护生,但对实施生活护理的认同低于大中专护生,护生对实施生活护理的认同普遍偏低(P＜0.05).结论 临床护理教育工作者应注重从思想上加深护生对生活护理的认识,提高其认同水平,促进职业素质的养成.     

海南省流动儿童查漏补种控制麻疹效果分析

目的了解海南省7岁以下流动儿童基本情况和免疫接种状况,探索提高流动儿童麻疹疫苗接种率策略,为加速海南省实现消除麻疹目标提供依据。方法每年3月利用外省流动人口进入海南务工、旅游、务工人员探亲返回高峰,在全省进行专项免疫状况摸底登记调查和疫苗查漏补种活动,3～5月麻疹发病流行高峰前快速补种麻疹等疫苗;通过发病率评估查漏补种效果。结果专项查漏补种后,流动儿童免疫接种率大幅提高,流动儿童麻疹发病率、构成比大幅下降;2009、2010年海南省麻疹发病率均为0.5/100万,降至历史和全国最低水平,提前2年实现消除目标。结论海南省流动儿童查漏补种策略控制麻疹效果显著,消除了流动儿童麻疹接种薄弱人群,为海南省提前实现消除麻疹目标提供了必要条件,可为全国消除麻疹行动提供策略依据。     

海南省2010年麻疹强化免疫效果评价

摘要：目的分析评价海南省2010年麻疹减毒活疫苗（Mv）强化免疫效果。方法综合分析麻疹强化免疫接种率、麻疹监测系统资料及AEFI监测系统资料。结果全省强化免疫共接种8月龄～6岁目标儿童772850人,报告接种率为96．93％,其中常住儿童报告接种率为97．05％,流动儿童报告接种率96．19％,两组人群强化免疫接种率差异有统计学意义（x2=-253．557,P〈0．05）,分年龄组报告接种率均〉95％,系统评估接种率为97．7％,调查两市县接种率无统计学意义（x2=0．812,P〉0．05）,2010年、2011年、2012年全省麻疹发病率分别为0．5／100万,0．47／100万、0．33／100万。结论海南省2010年开展NV强化免疫进一步提高了8月龄～6岁儿童MV的接种率,确保了适龄儿童MV抗体水平,并形成人群有效的免疫屏障,从而巩固了我省提前消除麻疹的现有成绩,但是要确保实现2012年消除麻疹的目标,必须在确保常规免疫高接种率的同时进一步提高mv及时接种率,同时开展流动人口查漏补种工作。     

卫生政策科研本体构建研究

在对现有科研本体和本体构建方法进行分析的基础上,利用Protege工具进行开发,选择0WL作为卫生政策科研本体描述语言,阐述了构建过程,初步设计了卫生政策科研本体模型,最后提出了问题和展望。     

人参皂苷Rg1及其真菌转化产物的糖残基立体构型的确定

前期研究结果[1][2]表明有两株菌株可以将人参皂苷Rg1转化为稀有人参皂苷F1;结合真菌转化技术与化学分析方法测定了人参皂苷Rg1及其转化产物人参皂苷F1的糖残基的绝对构型,发现人参皂苷Rg1及其转化产物均为D-型葡萄糖.本实验建立一种将真菌转化技术与化学分析方法结合起来,用以测定不同位置糖的绝对构型及其比例的方法.     

地塞米松联合异烟肼鞘内注药治疗结核性脑膜炎疗效分析

目的观察地塞米松联合异烟肼鞘内给药治疗结核性脑膜炎的临床疗效。方法 将临床确诊的60例结核性脑膜炎患者回顾性均分两组,两组均采用常规抗结核治疗联合使用脑脊液置换加鞘内给药治疗方案,对照组单用异烟肼鞘内注药,治疗组采用地塞米松联合异烟肼鞘内注药。观察两组患者临床症状与体征变化,颅内病灶吸收情况和脑脊液的变化。结果 地塞米松联合异烟肼给药4周后脑脊液检测基本恢复正常,患者症状与体征均显著改善,颅内压力降至正常,脑脊液的白细胞数、蛋白、糖、氯化物的恢复时间均短于对照组。结论 地塞米松联合异烟肼鞘内给药是治疗结核性脑膜炎更为有效的方法。     

空气压力波治疗仪在下肢骨折术后DVT预防中的应用

目的探讨空气压力波循环治疗仪在预防下肢骨折术后深静脉血栓形成中的作用。方法将2012年1月—2013年1月下肢骨折术后患者298例随机分为试验组及对照组,试验组采用空气压力波循环治疗仪治疗,对照组采用常规治疗,比较2组患者术后到拆线期间下肢静脉血栓形成率。结果试验组下肢静脉血栓形成率明显低于对照组,差异有统计学意义(P<0.01)。结论空气压力波循环治疗仪用于下肢骨折术后患者预防深静脉血栓形成具有显著作用。