Prevention of Behavior Problems for Children in Foster Care: Outcomes and Mediation Effects

Parent training for foster parents is mandated by federal law and supported by state statues in nearly all states; however, little is known about the efficacy of that training, and recent reviews underscore that the most widely used curricula in the child welfare system (CWS) have virtually no empirical support (Grimm, Youth Law News, April-June:3-29, 2003). On the other hand, numerous theoretically based, developmentally sensitive parent training interventions have been found to be effective in experimental clinical and prevention intervention trials (e.g., Kazdin and Wassell, Journal of the American Academy of Child and Adolescent Psychiatry, 39:414-420, 2000; McMahon and Forehand, Helping the noncompliant child, Guilford Press, New York, USA, 2003; Patterson and Forgatch, Parents and adolescents: I. Living together, Castalia Publishing, Eugene, OR, USA, 1987; Webster-Stratton et al., Journal of Clinical Child Pyschology Psychiatry, 42:943-952, 2001). One of these, Multidimensional Treatment Foster Care (MTFC; Chamberlain, Treating chronic juvenile offenders: Advances made through the Oregon Multidimensional Treatment Foster Care model, American Psychological Association, Washington, DC, USA, 2003), has been used with foster parents of youth referred from juvenile justice. The effectiveness of a universal intervention, KEEP (Keeping Foster Parents Trained and Supported) based on MTFC (but less intensive) was tested in a universal randomized trial with 700 foster and kinship parents in the San Diego County CWS. The goal of the intervention was to reduce child problem behaviors through strengthening foster parents' skills. The trial was designed to examine effects on both child behavior and parenting practices, allowing for specific assessment of the extent to which improvements in child behavior were mediated by the parenting practices targeted in the intervention. Child behavior problems were reduced significantly more in the intervention condition than in the control condition, and specific parenting practices were found to mediate these reductions, especially for high-risk children in foster families reporting more than six behavior problems per day at baseline.     

实施综合防制,加强法制管理,依靠科技进步——四川省防制狂犬病成效显著

四川省是全国狂犬病的高发区,1984 年发病死亡1262 例,达历年高峰,位居全国首位。疫情先后波及158 个县,高发病区占全省发病地区的73.68% 。经15 年连续开展防制,采取一系列措施后,成效显著。90 年代起发病呈持续下降趋势,至1998 年已无病例发生,疫区范围也明显缩小,1994 年流行面减少88% 。目前已无发病县,已达到基本控制狂犬病目标。分析认为:执行“政府组织、部门配合、群众参与、科学防治、依法管理、社会监督”的方针和措施是取得防制成效的保证;实施以犬免疫为主的“管、免、灭”并结合暴露后的正规处理伤口及全程免疫注射的综合防制措施,是获得防制成功的关键     

The impact of COVID-19 vaccination programme in the Republic of San Marino: Focus on effectiveness of Gam-Covid-Vac

ObjectiveThe adenovirus-based vaccine Gam-COVID-Vac (Sputnik V) showed promising effectiveness in a phase 3 clinical trial; however, data concerning its impact at a population level are scarce. The Republic of San Marino (RSM) conducted a SARS-CoV-2 vaccination programme mainly based (>80%) on Gam-COVID-Vac. Our aims were to investigate the impact of Gam-COVID-Vac vaccination programme and its effectiveness in a retrospective observational study based on the entire RSM population aged ≥12 years.MethodsWe calculated the incidence rate and the vaccine effectiveness (VE) in the entire RSM population not previously infected, against SARS-CoV-2 infection and COVID-19–related hospitalization, from 25 February to 1 October 2021, considering any vaccine and separately according to the vaccine used. Vaccine effectiveness was calculated using a multivariable negative binomial regression model as 1-Incidence Rate Ratio.ResultsDuring the study period, 21 568/28 791 (74.9%) not previously infected subjects received at least one dose of the Gam-COVID-Vac (84%) or BNT162b2, vaccines with 98% completing the vaccination schedule. Overall, 1634 SARS-CoV-2 infections and 166 COVID-19-related hospitalizations were observed with 17 COVID-19-related deaths reported. Incidence rates of SARS-CoV-2 infection and COVID-19-related hospitalization were 7.11 and 0.49/100 000 person-days in the fully vaccinated population, respectively. The adjusted overall VE was 67.6% (95% CI: 61.8–72.5) against SARS-CoV-2 infection and 87.9% (95% CI: 77.4–93.5) against COVID-19-related hospitalizations.Gam-COVID-Vac against SARS-CoV-2 infection VE peaked 91.8% (95% CI: 86.3–95.1) in the first bimester from the second dose, declining to 57.8% (95% CI: 42.2–69.2) at 6 months. Protection against hospitalization with COVID-19 was overall 91.6% (95% CI: 81.5–96.2), with no relevant waning trend over time.DiscussionOur study demonstrated the effectiveness of overall vaccination (Gam-COVID-Vac [84%] and BNT162b2 [16%]) in the prevention SARS-CoV-2 infection (pre-Omicron variant), waning over time but still with sustainable effectiveness against COVID-19-related hospitalization in the Republic of San Marino.     

高压氧治疗慢性肝炎的临床疗效分析

目的　观察高压氧治疗对慢性肝炎患者肝脏血流、肝功能的影响以及临床症状与体征的改变。方法　用高压氧治疗 3 2例慢性肝炎 ,并与对照组比较 ,用多普勒B超测定患者的门静脉右支血流量 ,并抽血查肝功能。结果　高压氧治疗后患者的肝功能明显改善 ,治疗组高压氧治疗前门静脉右支血流量为( 0 .3 18± 0 .10 1)L min ,治疗后门静脉右支血流量为 ( 0 .3 78± 0 .10 2 )L min ,门静脉右支血流量明显增高 ,乏力、纳差、腹胀、腹泻、肝区疼痛及黄疸、腹水、肝大、脾大明显改善 ,与对照组相比 ,差异有显著性意义 (P <0 .0 5 )。结论　高压氧治疗慢性肝炎可增加患者的门静脉右支血流量 ,改善肝功能 ,改善临床症状与体征     

清洁灌肠方法的改进与评价

目的改进清洁灌肠方法 ,以减少不良反应、改善灌肠效果。方法将 12 0例需清洁灌肠的患者随机分为实验组和对照组 ,每组 60例 ,对照组采用传统清洁灌肠方法 ,灌肠时间平均约为 5min ,实验组采用密闭式输液装置连接 16号导尿管 ,插入肛门深度增加为 17～ 2 0cm ,灌肠时间延长为平均约 3 0min。观察灌肠效果及灌肠中的不良反应。结果与对照组比较 ,实验组灌肠液量多 (P <0 .0 1)、灌肠液保留时间长 (P <0 .0 1) ,灌肠效果优良率高(P <0 0 1) ,且不良反应少。结论改进后的清洁灌肠方法改善了清洁灌肠的效果 ,并减少了清洁灌肠过程中病人的不良反应     

Efectividad de programas formativos orientados al consumo de alcohol en atención primaria: revisión sistemática

ObjectiveTo evaluate the effectiveness of training activities directed at Primary Health Care personnel on the management of patients with alcohol consumption problems.DesignA systematic review of randomised controlled trials.Data sourcesTrip Database, Cochrane Central Register of Controlled Trials (CENTRAL), Medline, EMBASE, CINAHL, Web of Science, Scopus, Alcohol and Alcohol Problems Science Database - ETOH and FAMILY RESOURCES DATABASE. The search was performed in June 2017.Study selectionThe final sample was n = 3 studies. Randomised controlled trials, indexed until 30 May 2017, with the objective of assessing the effectiveness of training programs directed at Primary Care providers in the management of patients with alcohol abuse disorder were included.Data extractionThe main variables were expressed in terms of effectiveness of the training program: level of global implementation, screening of alcohol consumption, intervention in patients with a consumption risk, and level of support required.ResultsThree Randomised controlled trials, published from 1999 to 2004, were included. Both screening and short intervention techniques showed an increase of its application in the three studies after the development of the three training programs. Statistical significance in terms of effectiveness was achieved in 2 of the 3 selected trials: both in detection of risk consumers, and in short intervention.ConclusionThe development of training programs in the management of patients with alcohol abuse disorder is an effective strategy for Primary Care providers, allowing the implementation of population screening, as well as the application of intervention techniques.     

2018年《北京市控制吸烟条例》在东城、朝阳区餐馆实施效果调查

目的 评估《北京市控制吸烟条例》（《条例》）实施效果。方法 2018年4月通过分层阶段抽样方法,选择北京市东城、朝阳区93家餐馆,在午餐和晚餐时间进行暗访随访,观察餐馆内吸烟现象,并与实施前半年、实施1个月的结果进行比较。结果 餐馆禁烟标识张贴率（76.3%）和服务员对《条例》整体认知程度均较高。总体吸烟发生率（29.0%）低于实施前半年的吸烟率（36.7%）,高于实施1个月的吸烟率（14.8%）。未发现服务员主动劝阻行为。商业建筑内餐馆吸烟发生率（3.3%）低于非商业建筑内餐馆（41.3%）,差异有统计学意义（P<0.05）。结论 《条例》实施效果低于实施1个月。禁烟标识张贴率和服务员认知水平与法规实际遵守情况相背离。应加强对餐馆经营者和公众的宣传和教育。     

Effectiveness of Lanzhou lamb rotavirus vaccine in preventing gastroenteritis among children younger than 5 years of age

BackgroundLanzhou Lamb rotavirus (LLR) vaccine was licensed in China in 2000. It was the only vaccine available in private market before 2018. However, the data about the post-marketing effectiveness is very limited. To assess the vaccine effectiveness (VE), we conducted a case-control study based on the hospital surveillance system in Beijing from 2015 to 2017.MethodsSeven hospitals located in seven districts in Beijing, from October 1, 2015, to March 31, 2017, were included. The VE of LLR vaccine was assessed in laboratory-confirmed rotavirus infection among children younger than five years old through a case-control design, using rotavirus-negative cases as controls. LLR vaccination was documented from a vaccination registry. VE was estimated adjusting for age group, gender, study site, the month of illness onset and interval days between illness onset to sampling through a logistic regression model.ResultsA total of 598 cases and 1766 controls were included in this study. The vaccine average coverage rate during 2015–2017 among children younger than five years old was 10.8% in Beijing. The adjusted VE for LLR vaccine of 1 dose versus 0 dose was 34.9% (95%CI, 5.3–55.3). We also obtained the adjusted VE of 87.7% (95%CI, 32.7–97.8) for patients with the severity score ≥11, 36.2% (95%CI, 4.7–57.3) for children of 2–35 months age group and 40.8% (95%CI, 7.8–61.9) against G9 rotavirus infection. Vaccinated cases were less likely to have watery stool (OR = 0.42) and have diarrhea longer than 5 days (OR = 0.47) than unvaccinated cases.DiscussionLLR vaccine conferred protection against rotavirus disease. Children who were vaccinated presented with less severe clinical manifestations. An immunization schedule of receiving all three doses in the first year should be preferred.     

Complementary/alternative medicine for supportive cancer care: development of the evidence-base

Aim The aim of this article is to compare the evidence relating to the effectiveness of complementary/alternative medicine (CAM) in palliative cancer care as it existed in 2000 and 2005. Methods Our comparison is based on systematic reviews using the same methodology at these two points in time. Results The results reveal a buoyant research activity in this sector. Consequently, new evidence for 19 CAM modalities has emerged between 2000 and 2005. For some treatments, the evidence is encouraging but for very few, it is as yet fully convincing. Conclusion It follows that further research is warranted, particularly in areas where the data already looks encouraging.