岳阳市学龄儿童行为问题城乡差异及其影响因素分析

目的研究学龄儿童行为问题城乡差异及其影响因素。方法运用"Rutter儿童行为量表"和家庭环境因素调查问卷,随机抽样调查4 863名6～13岁在校学龄儿童行为问题及家庭环境因素。结果学龄儿童家庭环境因素城乡差异显著(P0.05),城区学龄儿童父母文化程度普遍高于农村学龄儿童父母文化程度。农村学龄儿童家庭环境中口角家庭、暴力家庭、经济状况差的家庭、家长对儿童教育所花精力少的家庭及儿童受隔代监护、单亲监护、亲友监护和同辈/自我监护等不良因素的比例高于城区学龄儿童家庭。岳阳市学龄儿童行为问题现患率为9.19%,其中城区为4.94%、农村为14.03%,农村:城市=2.84:1(χ2=119.69,P0.05),学龄儿童行为问题男性多于女性,男性儿童行为问题"A行为""M行为""N行为",女性儿童则为"A行为""N行为""M行为",学龄儿童行为问题随年龄增长而增加。结论农村学龄儿童家庭环境不良因素多于城区,农村学龄儿童行为问题现患率高于城区,男性高于女性,学龄儿童行为问题现患率与年龄相关联。     

岳阳市学龄儿童行为问题现况调查

目的了解岳阳市学龄儿童行为问题现况，为进一步研究其影响因素及干预技术提供依据。方法运用“Rutter儿童行为量表”，对岳阳市城区、湖区、丘陵、山区4836名6～13岁在校学龄儿童行为问题进行调查。结果岳阳市学龄儿童行为问题现患率9．19％，其中男生11、76％，女生6．59％，男：女=1．7：1（P〈0．01）；湖区、丘陵、山区儿童行为问题差异小显著（P〉0．05），但高于城区儿童，农村：城区=2.84：1（P〈0．01）；儿童行为问题现患率随年龄增大而升高，6～10岁儿童现患率为7．33％，11～13岁儿童现患率达12.94％（P〈0．01）；学龄儿童各类行为问题构成存在差异（P〈0、01），“A行为”〉“N行为”〉“M行为”，男生“A行为”〉“M行为”〉“N行为”，女生则为“N行为”〉“M行为”〉“A行为”（P〈0．01）。城区与农村儿童行为问题构成差异不显著（P〉0.05）。结论岳阳市学龄儿童行为问题现患率为9.19％；儿童行为问题整体上男生多于女生，农村高于城区；“A行为”〉“N行为”〉“M行为”，男生以“A行为”，女生以“N行为”为主要构成；行为问题随年龄增大而升高，11～13岁儿章多于6～10岁儿童。     

学龄儿童行为问题与伤害关系的前瞻性队列研究

目的 探讨学龄儿童行为问题与伤害发生之间的关系。方法 整群抽取马鞍山市区三所小学的2005名学龄儿童，以研究开始时经Rutter儿童行为问卷评定的有、无行为问题的学龄儿童分别作为暴露与非暴露两个队列，开展为期一年伤害发生情况的随访观察，用非参数检验法分析两队列儿童伤害发生率有无差异，并用多分类有序反应变量的logistic回归模型分析儿童伤害的影响因素。结果 儿童伤害发生率为42．51％，有行为问题组儿童伤害年发生率为64．87％，无行为问题组儿童伤害年发生率为38．85％，两组间差异有显著性(u=-6．054，P=0．000)。不同类型的行为问题儿童伤害发生率分别为：违纪(A)行为66．99％，神经症(N)行为67．41％，混合性(M)行为61．40％，不同行为组间两两比较差异无显著性(A行为与N行为间比较u=-0．052，P=0．958；A行为与M行为间比较u=-0．400，P=0．689；N行为与M行为间比较u=-0．364，P=0．716)。多因素分析结果提示，儿童伤害的影响因素为儿童行为问题、儿童出生时母亲年龄、母亲孕期不良因素、母亲文化程度、家庭防范措施及儿童上学家长接送。其中儿童的行为问题是儿童伤害发生的主要影响因素。结论 学龄儿童中有行为问题者是发生伤害的高危人群，在制订伤害干预措施时，应尤其重视儿童行为问题的预防及控制，以达到理想的干预效果。     

学习困难儿童智力、行为及家庭环境155例现况调查

【目的】 探讨学龄儿童学习困难的相关因素和干预策略。 【方法】 对155例学习困难儿童进行智力和行为测试、家长问卷、治疗与指导。 【结果】 155例学习困难儿童的总智商均值低于正常标准(P＞0.01),其中边缘智商儿童占37.42%, 有两项以上行为问题的儿童占78.7%。 【结论】 说明儿童学习困难是多元因素所致,智力因素是先决条件,非智力因素诸如生长环境、教育环境、行为问题均是学习困难的重要因素。     

沈阳市学龄儿童行为问题与家庭环境的相关分析

目的了解沈阳市学龄儿童行为问题流行现状及其家庭影响因素,为采取相应的干预措施提供依据。方法应用Rutter儿童行为问卷和家庭环境量表中文版(FES-CV),对沈阳市5个城区的2 612名一~六年级小学生的行为问题及家庭环境进行调查。结果沈阳市学龄儿童行为问题检出率10.8%,A行为、N行为、M行为的检出率分别为3.5%,4.7%,2.5%;沈阳市学龄儿童行为问题与家庭矛盾性呈正相关,与家庭亲密度、组织性、知识性呈负相关。结论沈阳市学龄儿童行为问题受家庭亲密度、矛盾性、组织性和知识性影响。     

湖南省农村3～7岁留守儿童长处和困难问卷调查分析

【目的】探讨湖南省农村3~7岁留守儿童情绪行为问题,为进一步干预提供参考依据。【方法】采用自拟儿童基本情况调查表、儿童长处和困难问卷(SDQ)对1 605例农村3~7岁儿童进行调查评估。【结果】留守儿童困难问题检出率为3.2%。留守儿童同伴交往问题评分显著高于非留守儿童(t=2.318,P0.05)。男性留守儿童品行问题、多动注意不能、同伴交往问题及困难总分评分显著高于女性留守儿童(t=2.283~3.525,P0.001~0.050)。女性留守儿童情绪症状及亲社会行为评分显著高于男性留守儿童(t=-3.160~-2.332,P0.01~0.05)。与留守儿童困难问题有关的影响因素为留守儿童自身心理状况、主要监护人主观感受、留守儿童日常照顾状态、主要监护人对照顾留守儿童的意愿以及留守儿童物质生活保障。【结论】农村留守现象影响儿童情绪行为问题,应注重留守儿童情绪行为问题干预。     

岳阳市学龄儿童行为问题与家庭环境因素的病例-对照研究

[目的]了解岳阳市学龄儿童行为问题的家庭环境影响因素,为有效开展家庭干预提供依据.[方法]随机抽取从现况调查中用"Rutter儿童行为量表"确认为有行为问题的儿童120名作病例组,以年龄、性别、学校班级、家庭住址作配对条件,采用1:1配对从同批现况调查中用"Rutter儿童行为量表"测试无行为问题的儿童120名作对照,比较两组儿童家庭环境的构成差异.[结果]儿童行为问题与父母文化程度、教育所花精力、说理沟通教育方式呈负相关,与单亲家庭类型呈正相关.[结论]岳阳市学龄儿童行为问题受家庭环境因素影响,单亲家庭、父母对儿童教育所花精力、说理与沟通教育方式是主要影响因素.     

早期儿童气质对学龄期儿童行为问题的预测效果初探

【目的】探讨早期儿童气质对学龄期儿童行为问题的预测作用,为儿童气质及儿童行为问题的临床咨询与指导提供参考。【方法】孕母满32周进入研究队列,采用Carey儿童气质问卷、家庭环境量表分别在婴儿期、学龄前期、学龄期评价儿童气质及其家庭环境,并使用CBCL儿童行为问题量表对学龄期儿童行为问题进行评价。【结果】1)逐步多元回归分析发现,婴儿期气质"节律性"、学前期气质"反应强度"、母亲年龄、8岁时家庭"父母情绪"、2岁时家庭"父母参与"与学龄期儿童行为问题有显著联系,共同解释56.6%的学龄期儿童行为问题。2)婴儿期阶段,气质"节律性"和"情绪性"、1岁家庭环境"总分"、母亲年龄预测学龄儿童行为问题,可以解释学龄期儿童行为问题的33%;学前期,气质"反应强度"、母亲年龄和3岁时家庭"父母参与"可以预测学龄儿童行为问题,解释学龄期儿童行为问题的34.3%;学龄期时,气质"适应性"、"坚持性"、母亲年龄和家庭"教育材料"与学龄行为问题有密切联系,可解释学龄期儿童行为问题的38.4%。儿童早期气质特点联合家庭环境("父母参与"、"父母情绪"和"教育材料")、母亲年龄以及儿童性别等因素对学龄期儿童行为问题具有较显著的预测作用。【结论】为减少儿童行为问题的发生,应及早对高龄母亲、家庭养育环境不良、具有消极气质特点的男童采取积极干预。     

安徽省贫困地区学龄儿童膳食营养状况影响因素研究

【目的】 了解安徽省贫困地区学龄儿童膳食现况,寻找影响营养状况的原因,为进行营养干预措施提供科学依据。 【方法】 采取体格检查和问卷调查相结合的方法,对安徽省贫困地区学龄儿童膳食状况进行测量和调查。 【结果】 安徽省贫困地区学龄儿童营养不良率为81.7%,超重率为1.8%,多因素分析显示,营养不良与性别(OR=0.865,P=0.038)、年级和吃早餐的频率(OR=1.727,P=0.001)有关,超重与性别(OR=2.359,P=0.002)、父母未外出务工(OR=1.478,P=0.048)和年级有关。 【结论】 在安徽省贫困地区学龄儿童中营养不良情况非常普遍,应当积极开展营养健康教育,帮助学龄儿童获取营养基础知识、树立与合理营养有关的正确态度、培养健康的饮食行为。     

成都市学龄儿童的睡眠行为调查

【目的】了解成都市学龄儿童的睡眠行为及与睡眠障碍发生的关系,为临床干预提供参考。【方法】2005年9~11月间在成都5个城区随机抽取2848名学龄儿童,进行儿童睡眠状况问卷调查。【结果】成都市学龄儿童的睡眠时间随年龄增加而逐年减少,各年龄组比较差异有显著性(P<0.05)。睡眠障碍的总发生率为58.08%。各年龄组之间的睡眠行为有一定的差异性,具有良好睡眠行为的学龄儿童发生睡眠障碍的机率比没有良好睡眠行为的儿童低。【结论】目前成都市学龄儿童的睡眠时间普遍减少,睡眠障碍的发生率较高,睡眠不良行为的发生也较多,一定程度上影响了睡眠质量。这一现象应得到社会各方面的关心和重视。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

Fatigue and health in a seafaring population

Background Occupational fatigue is relatively common withinthe general population and has been linked to reduced performance,injury and longer term ill-health. Despite growing acknowledgementof this problem in the maritime sector, little research hasbeen conducted into the risk factors, prevalence and consequencesof seafarers' fatigue. Aims To examine the prevalence of fatigue among seafarers, identifypotential risk factors and assess possible links with poor performanceand ill-health. Methods Cross-sectional questionnaire survey of seafarers workingin the offshore oil support, short-sea and deep-sea shippingindustries. A number of tools were used including the fatiguesubscale of the profile of fatigue-related symptoms, the CognitiveFailures Questionnaire, the General Health Questionnaire andthe SF36 General Health scale. Results In all, 1855 questionnaires were completed giving anoverall response rate of 20%. Fatigue symptoms were associatedwith a range of occupational and environmental factors, manyunique to seafaring. Reporting a greater number of risk factorswas associated with greater fatigue [e.g. OR = 2.53 (1.90–3.35)for those with three or four risk factors and OR = 9.54 (6.95–13.09)for those with five or more risk factors]. There was also astrong link between fatigue and poorer cognitive and healthoutcomes, with fatigue the most important of a number of riskfactors, accounting for 10–14% of the variance. Conclusions Seafarers' fatigue could impact on safety withinthe industry and may be linked to longer term individual ill-health.It can only be addressed by considering how multiple factorscombine to contribute to fatigue.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.