印度成人对于儿童眼保健的认识及贫困因素对其的影响

目的：探讨印度金奈地区成人对于儿童视力筛查的认识以及贫困因素对其的影响。
　　方法：此研究采用为期4wk的现况研究方法,于2012－12在印度金奈市及周边社会经济发展水平较低的地区,随机选取参加拓展营的个体作为研究对象。在接受了免费的视力筛查之后,与他们进行了一个简短的半结构性面谈。每隔两位选取一位受访者在一开始就被问及是否有儿童居住在他们住宅区,回答肯定者则纳入此项研究。
　　结果：本研究共纳入120人,其中38％（95％CI：30～47）的人指出在他们住宅区内至少有一名儿童先前接受过眼部检查（组1）,62％（95％CI：53～70）的参与者表示无儿童曾经接受过眼科检查（组2）。采用简单贫困记分卡方法测量两组贫困比分并无统计学差异。
　　结论：据不到半数的参与者回忆,他们的孩子之前曾接受过眼部检查。在贫困比分上,确认之前曾接受过眼部检查的参与者与没有接受过眼科检查的参与者之间无统计学差异。与孩子从未接受过眼科检查的参与者相比,那些孩子接受过眼部检查的参与者对该检查抱有更积极的态度。研究表明,成人对于孩子接受眼部检查重要性的认识不受贫困程度的影响,提高成人对于儿童接受眼部检查的认识可能需要更多的干预措施而不是扶贫。     

儿童外伤性眼内炎的临床疗效分析

目的:探讨儿童外伤性眼内炎的治疗效果.方法:回顾性研究2 ～11岁儿童确诊为外伤性眼内炎24例24眼的治疗方法及结果.所有患儿入院后立即行患眼的玻璃体腔内注药(万古霉素1mg/0.1mL+头孢他啶2.25mg/0.1mL+地塞米松0.4 mg/0.1 mL),第2d,23例重症者行玻璃体切除+晶状体切除术,充填硅油者10例、无菌空气者8例、C3F8者3例、灌注液者2例.1例轻症者72h后再次注射.结果:术后随访6 ～ 78mo,所有病例炎症控制,4例眼球萎缩(3例硅油眼).7例硅油眼已取出硅油并植入IOL.BCVA:＜0.02者12例,0.02～0.1者4例,0.15 ～0.3者4例,0.5 ～1.0者4例.16例(70％)较入院视力提高,4例(17％)不变,3例(13％)下降,1例不配合.结论:及时行玻璃体腔内注射广谱抗生素、玻璃体切除术能改善儿童外伤性眼内炎的预后.     

屈光参差性弱视患儿综合治疗效果的相关因素研究

目的：探究影响屈光参差性患儿综合治疗效果的相关因素,为临床干预提供理论依据。

方法：选取我院2013-10/2014-10间收治的100例屈光参差性弱视患儿,经过6～18mo的治疗后根据治疗效果分为A、B、C三组,A组54例,治疗效果判定为治愈; B组34例,治疗效果判定为进步; C组12例,治疗效果判定为无效。对其年龄、依从性、屈光参差程度、屈光参差类型、弱视程度、注视性质进行分析。

结果：三组患者之间屈光参差类型差异无统计学意义(P>0.05),而三组患者之间年龄、治疗依从性、屈光参差程度、弱视程度、注视性质相比差异有统计学意义(P<0.05)。通过回归方程分析各因素对综合治疗效果影响程度依次为弱视程度、屈光参差程度、注视性质、年龄、依从性。

结论：屈光参差性患儿综合治疗效果与年龄、治疗的依从性、屈光参差程度、弱视程度、注视性质密切相关,而与患儿的屈光参差类型无明显的相关性。     

儿童眼外伤性角膜损伤或穿孔行多层羊膜覆盖治疗的研究

目的：研究儿童眼外伤性角膜损伤或穿孔行多层羊膜覆盖治疗的效果。

方法：随机选取2012-05/2015-05我院收治的儿童眼外伤性角膜损伤或穿孔患儿60例72眼,依据治疗方法将这些患儿分为两组,研究组30例36眼和对照组30例36眼。给予对照组患儿单层羊膜覆盖治疗,给予研究组患儿多层羊膜覆盖治疗。

结果：研究组患儿的羊膜持续时间显著长于对照组(P<0.05),角膜水肿消退时间均显著短于对照组(P<0.05),新生血管生成<3个象限比例28%(10/36)显著高于对照组17%(6/36)(P<0.05),无生成比例11%(4/36)显著低于对照组28%(10/36)(P<0.05),视力为0.3～1.0占11%(4/36)显著高于对照组3%(1/36)(P<0.05),手动/眼前～0.1占56%(20/36)显著低于对照组72%(26/36)(P<0.05)。

结论：儿童眼外伤性角膜损伤或穿孔行多层羊膜覆盖治疗的效果良好。     

综合治疗儿童弱视255例疗效观察

目的：探讨综合治疗各种类型儿童弱视的疗效。

方法：对确诊为弱视的患儿255例386眼,采用戴镜矫正、遮盖疗法、增视能训练系统、CAM训练、红光刺激等综合治疗。并对弱视的年龄、类型及弱视程度与疗效关系进行分析。

结果：弱视治疗总有效率为94%,总治愈率为71%。轻度弱视、3～6岁年龄段和屈光不正性弱视治愈率最高。

结论：综合治疗法对儿童弱视疗效确切,年龄、弱视类型及弱视程度对疗效影响显著。     

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.     

A Humanistic Approach to Understanding Child Consumer Socialization in US Homes

We present findings from a qualitative, multisite, multi-method, longitudinal study of parents and their preschool-aged children that explores the intersections of marketing influences in the home and in the larger outside world of children. Findings indicate that preschoolers represent complicated and nuanced “consumers in training” beyond predictions based on their “perceptual stage of development.” Specifically, our data revealed interesting ways in which marketing and consumer culture can foster a number of pro-social consumer outcomes (e.g., charity, gift-giving, financial literacy). We also noted an emerging understanding by preschoolers of the social meanings of goods for identity construction and product evaluation. Finally, through a presentation of an idiographic case, we show how consumer socialization cannot be attributed to one factor such as media but is based on multiple and concurrent factors—parents, siblings, peers, and home environment—that act to moderate, mediate, and provide meaning for marketing messages.     

Growing Strong and Healthy with Mister Bone: An Educational Program to Have Strong Bones Later in Life

Optimal peak bone mass and bone health later in life are favored by a sufficient calcium intake in infancy, childhood and adolescence. The purpose of this study was to test a new educational program created to monitor and to improve calcium and vitamin D intake in children. Nutritional habits in children were evaluated through a food frequency questionnaire (FFQ) to assess the intake of calcium, vitamin D, dairy products, and total caloric energy at baseline and after seven months of exposure to a unique educational program applied between November 2013 and May 2014 in 176 schoolchildren (48% male, 52% female) attending the fourth and fifth grades of two selected primary schools in Florence, Italy. A significant increase of calcium (from 870 ± 190 to 1100 ± 200 mg/day, p < 0.05), and vitamin D (from 3.6 ± 1.53 to 4.1 ± 2 µg/day) intake in children was documented after the educational program. The amount of specific foods important for bone health consumed, such as milk and vegetables, increased significantly, both in male and female children (p < 0.05). The proposed educational program appears to be effective in modifying calcium intake in children, with a significant increase in the consumption of dairy products and vegetables, but without a significant change in the total caloric intake.     

儿童屈光参差性弱视立体视觉中枢区激活的fMRI远期研究

目的：运用血氧水平依赖性功能核磁共振成像技术(BOLD-functional magnetic resonance imaging,BOLD-fMRI)阶段性评价屈光参差性弱视儿童在规范弱视训练后视皮质相关功能区激活情况。

方法：收集先期研究及后续收集屈光参差性弱视儿童共13例进行任务态组块模式(Blocks)的功能磁共振(fMRI)研究,采用前后对照t检验对规范弱视治疗18mo和24mo及终止治疗6mo后的脑功能激活数据进行分析。图像处理平台为Matlab 7.12.0.635的SPM8软件。

结果：各阶段功能区激活主要集中在左枕叶(Brodmann 18区)、枕中回(Brodmann 19区)、边缘叶(Brodmann 19区)、双侧顶上小叶(Brodmann 7区)、右枕叶舌回(Brodmann 17区),弱视治疗24mo激活范围无明显扩大,差异无统计学意义(mean T=1.014,P>0.01),终止治疗6mo后激活范围差异无统计学意义(mean T=0.9793,P>0.01)。

结论：屈光参差性弱视治疗2a后视中枢基本稳定,持续弱视治疗对于视中枢功能重建无显著作用。     

Changes of intraocular pressure and refractive status in children following cycloplegic refraction with 1% cyclopentolate and 1% tropicamide

Purpose:

To evaluate the effect of cycloplegic mydriasis with 1% cyclopentolate and 1% tropicamide on the intraocular pressure (IOP) and refractive status of children for cycloplegic refraction and compare the [OP and refractive changes between hyperopic and myopic groups.

Methods:

This study was designed as a retrospective cohort study. Ninety one children received cycloplegic mydriasis. The IOP was measured with a noncontact tonometer before cycloplegic administration. One drop of 1% cyclopentolate was administered, which was followed by two drops of 1% tropicamide at an interval of 10 minutes. The IOP was then measured 30 minutes after tropicamide instillation. Autorefraction was assessed with an autorefractometer before and after cycloplegic mydriasis.

Results:

The mean age of the 44 girls and 47 boys was 7.3 ± 2.4 years. The mean precycloplegic IOP was 14.45 ± 2.47 mmHg and the mean postcycloplegic IOP was 15.06 ± 3.08 mmHg in all eyes. A significant difference was noted in the IOP change (p = 0.033). In the 39 hyperopic eyes, the mean precycloplegic IOP and postcycloplegic IOP were 14.54 ± 2.53 mmHg and 15.69 ± 3.35 mmHg, respectively. There was a significant difference in the IOP change (p = 0.008). In the 52 myopic eyes, the mean precycloplegic IOP and postcycloplegic IOP were 14.38 ± 2.44 mmHg and 14.61 ± 2.80 mmHg, respectively (p = 0.72). There was no significant IOP change in the myopic group. The postcycloplegic IOP was significantly different between the hyperopic and the myopic groups (p = 0.021). Three eyes (3.3%) had an IOP elevation more than 5.0 mmHg after cycloplegic mydriasis. Postcycloplegic refraction showed significant hyperopic shifts in all eyes (p < 0.0001).

Conclusion:

Cycloplegic mydriasis with 1% cyclopentolate and 1% tropicamide caused IOP changes in preschool and school-aged children with hyperopia. Ophthalmologists should be very cautious in monitoring IOP changes for children with cycloplegic medication use.