Links between Adolescents' Closeness to Adoptive Parents and Attachment Style in Young Adulthood

This study examined whether adolescents' closeness to adoptive parents (APs) predicted attachment styles in close relationships outside their family during young adulthood. In a longitudinal study of domestic infant adoptions, closeness to adoptive mother and adoptive father was assessed in 156 adolescents (M = 15.7 years). Approximately 9 years later (M = 25.0 years), closeness to parents was assessed again as well as attachment style in their close relationships. Multilevel modeling was used to predict attachment style in young adulthood from the average and discrepancy of closeness to adolescents' adoptive mothers and fathers and the change over time in closeness to APs. Less avoidant attachment style was predicted by stronger closeness to both APs during adolescence. Increased closeness to APs over time was related to less anxiety in close relationships. Higher closeness over time to either AP was related to less avoidance and anxiety in close relationships.     

婴幼儿心力衰竭血浆氨基末端B型利钠肽前体检测及诊断截断点的探讨

目的:对婴幼儿心力衰竭血浆氨基末端B型利钠肽前体检测(NT-proBNP)的价值及诊断截断点进行探讨,为临床诊断提供指导.方法:选取2012年6月～2014年6月间佛山市顺德区妇幼保健院诊治的心力衰竭患者及体检的健康人员各76例为研究对象,分为观察和对照组.所有研究对象行NT-proBNP及心脏射血指数(LVEF)检测,并进行组间比较.观察组患者采用改良Ross标准进行评价,并按照分级对NT-proBNP结果进行比较.同时采用ROC曲线对观察组研究对象检测的敏感性、特异性及诊断截断点予以分析,并就婴幼儿及成人进行组间比较及数据分析.结果:观察者组研究对象中成年人、婴幼儿及平均NT-proBNP含量分别为(1 325.5±148.8)、(3 106.4±593.9)、(2 548.7±368.2)ng/L,均高于对照组(P＜0.05);对两组研究对象的NT-proBNP及LVEF进行组间比较,均具有统计学差异(P＜0.05);观察组在轻、中、重3个级别的NT proBNP含量比较有统计学差异(P＜0.05);组内按年龄组比较,婴幼儿NT-proBNP含量高于成年,且具有统计学差异(P＜0.05);根据ROC曲线分析得出婴幼儿心衰阳性的NT-proBNP参考指标为500ng/L.结论:血浆氨基末端B型利钠肽前体检测在心力衰竭诊断中具有重要的价值,且婴幼儿与成人患者的诊断截断点存在差异,可以500 ng/L作为婴幼儿心衰诊断的参考值.     

中西医治疗婴幼儿腹泻病47例疗效观察

目的：观察婴幼儿腹泻病中西医结合治疗的临床疗效。方法我院2011年1月—2012年12月收治98例腹泻病患儿,随机分为西医组和中西结合2组,均以液体疗法为基础,西医组配合止泻、抗病毒、助消化药物治疗,中西结合组配以推拿捏脊、艾灸神阙穴、中药穴位外敷治疗,对2组的治疗结果进行对比分析。结果患儿住院3 d~8 d,平均4.5 d,均痊愈出院。2组治疗48 h内的总有效率比较差异有统计学意义（P<0.05）。结论以液体疗法为基础,配以推拿捏脊、艾灸神阙穴、中药穴位外敷治疗婴幼儿腹泻,疗效优于西药治疗。     

Young carers in South Africa: tasks undertaken by children in households affected by HIV infection and other illness

‘Young carers’ are children who take on adult responsibility in response to familial illness. South Africa’s high disease burden, limited health care capacity and cultural notions of children’s familial duty suggest a large population of ‘young carers’ in this country. This study aims to explore the nature of responsibility among children affected by illness in deprived South African communities. A total of 349 children and adolescents aged 10–18 years in illness-affected households in the Western Cape province were recruited via community- and school-based convenience sampling. Data about their daily life, responsibilities and the impact of familial illness were collected via semi-structured interviews. Caring tasks involving intimate contact and medical treatments were relatively common among children in the sample, and nearly all children were engaged in some type of responsibility, from caring tasks to housework, childcare and earning money. Children frequently indicated their responsibilities constituted a substantial burden. Responses suggested a tension between duty to care and appropriateness of intimate contact between parents and children required for some caring responsibilities. Children often linked their tasks burden to familial illness, though further quantitative research is needed to identify the drivers of child responsibility.     

Alcohol policy impact on young risky drinkers and their support for proposed measures

Objective: To explore the impacts of existing policies on young Australian risky drinkers' access to alcohol and to gauge their support for proposed alcohol measures. Methods: The 16–19 year old participants were recruited from three Australian states using non‐random convenience sampling, for either a face‐to‐face or online quantitative survey (N=958). The sample was deliberately selected to represent drinkers whose consumption placed them in the riskiest drinking 20–25% of their age bracket. Results: Half (49%) the sample who were younger than the Australian legal purchase age reported it was ‘easy’ to buy alcohol from bottle stores, and 75% of those who had tried to purchase alcohol, said it was ‘easy’ the last time they tried. Half of those under 18, who had attempted to enter a licensed venue, reported they did not have their identification checked last time they gained access. Ninety per cent of all respondents drank within a private location at their last risky drinking session. Sixty‐five per cent supported ‘increasing the price of [alcohol by 20¢] a standard drink if the extra 20¢ was used to support prevention and treatment of alcohol problems'. Conclusions: Age‐ or intoxication‐based restrictions to alcohol were commonly bypassed. Implications: Point‐of‐sale alcohol controls require improvement to prevent under age access. Given that a significant proportion of drinking occasions for those under 18 were in private premises, prevention strategies need to target these locations. There were diverse levels of support for strategies to reduce harm, including potential community backing for an evidence‐based proposed price policy.     

Multidisciplinary diabetes team care: the experiences of young adults with Type 1 diabetes

Background

This research examined whether young adults with Type 1 diabetes engage with the multidisciplinary consultation process and if not, then why.

Methods

We designed a web‐based self‐reported survey, available online from February to May 2011, for Australian adults 18–35 years with Type 1 diabetes. Respondents were asked about which clinicians they consulted to assist with self‐management. To expand on the results of the survey, we interviewed 33 respondents.

Results

Survey: Respondents (n = 150) consulted with the following clinicians: endocrinologist and diabetes educators: 23.3%; endocrinologist only: 18.0%; endocrinologist, diabetes educators and dieticians: 14.6%; endocrinologist, diabetes educators, dietician and general practitioners (GP): 11.3%; endocrinologist and GP: 10.6%; GP only: 4.6%; all clinicians recommended to assist with self‐management: 1.3%; 2.7% did not consult any clinician. Interview: Participants (n = 33) reported eight key disincentives to consultation with multidisciplinary clinicians. These were time constraints; provision of conflicting advice; inaccessibility of health services; variation in service standards; cost constraints; failure of clinicians to refer to other clinicians; lack of opportunity to build a therapeutic relationship; and failure of clinicians to engage in shared decision making.

Conclusion

Our results indicate that high attrition rates of young adults with Type 1 diabetes from recommended diabetes health services is linked to the failure of those services to meet the needs and preferences of their patients. The identified needs and preferences included joint consultation with multi‐disciplinary team clinicians; flexible access to advice by email or telephone consultation; and shared decision making. Patient engagement in health‐service re‐design has implications for improved health‐service delivery and enhanced treatment outcomes.