广州市青少年伤害及相关危险行为分析

目的了解广州市青少年伤害及相关危险行为现状,为制定干预措施提供依据。方法随机抽取广州市6类16所学校学生3800名进行有关伤害行为的问卷调查。结果总的伤害报告率为46.9%,男生高于女生;普通初中的学生是伤害的高发人群;跌落伤和物体砸伤或碰伤是发生率较高的伤害类型;发生率较高的危险行为主要为受到欺辱、交通违章、与他人打架等;感到没有安全保障、非健康的心理状态等心理问题的发生率较高。结论青少年中存在多种容易导致伤害的行为,应根据青少年伤害发生特征采取有效预防措施,以减少伤害的发生。     

绍兴市青少年伤害相关因素心理易感性分析

目的了解绍兴市大中学生伤害发生现况,探讨心理社会因素对大中学生伤害发生的影响,为伤害的预防控制提供依据。方法整群抽取绍兴市1所大学、2所高中、2所初中的学生作为研究对象,在基线调查的基础上,继续前瞻性地进行了3次随访调查,完成1a的队列研究。采用自填式问卷调查的方式收集研究对象的人口统计学变量、各类伤害的发生率等。同时使用《亚健康多维评定问卷》评价青少年的心理卫生状况。结果绍兴市青少年伤害发生率为76.2%,男性伤害的发生率要高于女性,差异有统计学意义(χ2=13.850,P0.01)。多因素分析结果显示,学习负担轻的青少年发生意外伤害的危险性较学习负担重者低,处于亚健康状态的青少年相对于健康状态者,其危险性增大了2.472(1.477～4.137)倍。结论青少年伤害发生率高,学习负担和亚健康状态可较好预测伤害发生。     

兰州市伤害住院青少年主要伤害类型分析

目的 探讨伤害住院青少年的主要伤害类型，为预防青少年伤害的发生提供依据。方法 采取整群抽样的方法，抽取兰州市2所综合性医院1994—2001年青少年伤害住院病历1828份，对不同伤害类型进行分析。结果 青少年伤害住院病人以他杀、交通事故最多，分别为27．74％，25．55％。交通事故平均住院时间为22．6d，意外跌落为18．5d，二均高于平均住院时间17．38d。交通事故和意外跌落治愈率分别为73．88％，70．60％，均低于80．42％的平均水平；病死率分别为4．50％，4．12％，均高于2．24％的平均水平。结论 青少年伤害住院病人以他杀、交通事故最多，交通事故和意外跌落危害最大。     

哈尔滨市部分区县青少年伤害特征及相关因素调查

了解和掌握青少年伤害发生情况、特征及相关影响因素,为开展学生伤害干预和监测工作提供依据.方法 采用整群随机抽样方法,对哈尔滨市2个区/县的10所学校2 006名学生开展伤害回顾性问卷调查.结果 青少年伤害发生率为8.77%,伤害的处理方式以门诊/急诊处理(41.08%)为最多;男生伤害发生率(10.75%)明显高于女生(6.34%);主要伤害类型为跌坠伤(39.39%)、扭伤(30.30%)和锐器伤(9.76%),中毒(0.34%)最低;多因素非条件Logistic回归分析结果显示,性别、出生方式、夜间睡眠情况、作业难度、容易激动、喜欢从事一些动作迅速的活动、危险行为因素均为青少年伤害的主要影响因素(P值均<0.05).结论 校园内仍存在一定的安全隐患与伤害危险行为,应通过制定学校一家庭一社会综合干预策略来促进青少年的身心健康.     

辽宁省儿童青少年伤害现况调查

目的了解辽宁省儿童青少年伤害发生现况，为预防工作的开展提供依据。方法采用多级抽样方法，对辽宁省6个市／县3644名0～18岁者过去1a中伤害情发生情况进行回顾性调查。结果伤害总发生率为17．07％，农村显著高于城市（OR=1．61，95％CI为1．32～1．96），男性显著高于女性（OR=1．84，95％CI为1．54～2．20），6～岁组发生率最高（22．98％），0～岁组发生率最低（0．81％）。伤害类型前5位依次为跌倒、锐器割刺伤、运动伤、撞击挤压伤和非机动车交通事故，伤害损伤性质前5位为开放性伤、浅表伤、扭伤劳损、骨折和烧烫伤，7～9月为伤害的高发季节。结论辽宁省每年约有1／6儿童青少年发生伤害，应开展有针对性的伤害防控工作。     

安徽省城市青少年伤害流行病学特征分析

目的 了解安徽省青少年伤害相关行为和伤害现状,为制定预防控制措施提供科学依据.方法 使用全国统一的<中国青少年健康相关行为调查问卷>,采用分层整群抽样抽取安徽省3个城市10 840名青少年进行问卷调查.采用EpiData 3.0建立数据库,用SPSS 11.0对数据进行统计,采用描述性分析x2检验.结果 安徽省城市青少年伤害发生率为16.4%.伤害的主要原因依次有扭伤、跌坠伤,发生地点主要是家中、学校内体育场/馆和学校其他地方、公路街道或车站/渡口/码头等.伤害相关危险行为曾经发生过的报告率均较高,大多在20%～90%之间;经常或总是发生的报告率在10%左右,大多为男生高于女生.不同家庭环境中伤害及相关危险行为的发生率亦不同.结论 安徽省青少年伤害及相关危险行为的发生率较高.建议学校、家庭及社区积极开展对青少年的安全和心理卫生教育,采取积极有效的措施,预防和控制伤害的发生.     

江苏省城市青少年伤害现况及危险因素分析

目的了解江苏省青少年伤害流行状况及危险因素,为制定伤害干预措施提供科学依据。方法按照全国青少年健康相关行为调查领导小组办公室统一制定的监测方案和调查问卷,采用整群随机抽样,对江苏省5个城市33826名青少年进行匿名问卷调查。结果江苏省城市青少年伤害发生率为12.6%,男生为15.5%,女生为9.9%,男生伤害的报告率高于女生(χ2=230.27,P0.01);1次伤害的发生率为9.5%,2次及以上伤害的发生率为3.1%。扭伤和跌坠伤是学生最常见的受伤原因,骨关节伤和割刺伤是最常见的受伤结果。伤害的发生与家庭类型、学校类型、父亲职业、男生吸烟饮酒行为及不良情绪有关。结论青少年是伤害的高危人群。应针对原因采取措施,减少伤害的发生。     

上海市青少年运动伤害现状调查

目的了解上海市青少年运动伤害现况,为青少年运动伤害预防提供依据。方法采用分层整群抽样方法,抽取上海市11所初中和9所高中共4 334名学生,对其过去1 a中的运动伤害情况进行问卷调查。结果青少年运动伤害发生率为5.61%,男生伤害发生率高于女生(P<0.05);损伤368人次,人次发生率为8.49%。伤害以春、秋季多发。运动伤害主要发生在下午(46.58%)、进行篮球运动时(45.86%)。受伤时活动地点以校内运动场所(有教师或教练指导)为主。运动伤害最主要原因排在前3位的是注意力不集中(24.46%)、运动量过大(17.12%)、准备活动不充分(14.13%)。损伤部位以下肢的踝部(29.69%)、上肢的手、肘、腕部(20.73%)、下肢的膝部(12.89%)为主。75.96%的运动伤害身体活动受限程度为关节活动轻微受限和明显受限。结论开展以学校为主体的综合干预措施对降低青少年运动伤害发生非常重要。     

柳州市青少年伤害相关行为调查

目的了解柳州市青少年学生伤害相关行为的现状,为制定有效的预防措施提供依据。方法采用分层整群随机抽样法,对柳州市17所大、中学校在校学生4023名进行伤害相关行为发生情况的问卷调查。结果在过去12个月中,被调查学生的伤害发生率为31.15%。0.71%的学生有过自杀计划,25.38%的学生经常因学习压力而感到心情不愉快;6.11%的学生经常被恶意取笑,1.04%经常被索要财物,2.24%经常被排斥在集体活动之外;8.76%的学生过去1a里有4次及以上去过无安全措施的地方游泳;在过去30d里,骑车逆行的占35.6%,闯红灯、乱穿马路的占20.11%,过马路不走人行道的占65.22%。柳州市青少年伤害相关行为的发生率因学校类型、性别不同而存在差异。结论柳州市青少年学生存在多种伤害相关行为。应针对不同学校类型和性别的学生采取相应的措施进行干预,防止或减少危险健康行为的发生。     

我国学生伤害的现况影响因素及对策研究

根据1990年WHO报告,世界上大多数国家,尤其是发达国家,非故意伤害是青少年致伤、致残和致死的主要原因.是全球关注的公共卫生问题[1].     

Variability and vulnerability at the ecological level: implications for understanding the social determinants of health

OBJECTIVES: We examined variability in disease rates to gain understanding of the complex interactions between contextual socioeconomic factors and health. METHODS: We compared mortality rates between New York and California counties in the lowest and highest quartiles of socioeconomic status (SES), assessed rate variability between counties for various outcomes, and examined correlations between outcomes' sensitivity to SES and their variability. RESULTS: Outcomes with mortality rates that differed most by county SES were among those whose variability across counties was high (e.g., AIDS, homicide, cirrhosis). Lower-SES counties manifested greater variability among outcome measures. CONCLUSIONS: Differences in health outcome variability reflect differences in SES impact on health. Health variability at the ecological level might reflect the impact of stressors on vulnerable populations.     

A social marketing approach to changing mental health practices directed at youth and adolescents

The mental health problems of children are of increasing social concern. Many best practices have been developed but often not implemented. Social marketing has been suggested as an innovative, useful approach to this challenge-along with others in the health care field. However, much confusion exists over what the approach entails, where it has been applied and how it can be adapted to significant social challenges such as changing mental health practices directed at youth and adolescents. This article defines key terms, offers historical perspective and provides a specific approach and set of models to implement an effective social marketing strategy in a range of contexts.     

A diagnostic approach to understanding entrepreneurship in health care

Health care is quite different from other industries because of its organizational structure, service delivery, and financing of health services. Balancing costs, quality, and access presents unique challenges for each stakeholder group committed to promoting the health and healing of its citizens. Using the diagnostic approach to health care entrepreneurship, we created a framework from research in the field to understand the predisposing, enabling, and reinforcing factors most relevant to successful entrepreneurship.     

A critical realist approach to understanding and evaluating heart health programmes

Secondary prevention programmes for Coronary Heart Disease (CHD) aim to reduce cardiovascular risks and promote health in people with heart disease. Though programmes have been associated with health improvements in study populations, access to programmes remains low, and quality and effectiveness is highly variable. Current guidelines propose significant modifications to programmes, but existing research provides little insight into why programme effectiveness varies so much. Drawing on a critical realist approach, this article argues that current research has been based on an impoverished ontology, which has elements of positivism, does not explore the social determinants of health or the effects on outcomes of salient contextual factors, and thereby fails to account for programme variations. Alternative constructivist approaches are also weak and lacking in clinical credibility. An alternative critical realist approach is proposed that draws on the merits of subjectivist and objectivist approaches but also reflects the complex interplay between individual, programme-related, socio-cultural and organizational factors that influence health outcomes in open systems. This approach embraces measurement of objective effectiveness but also examines the mechanisms, organizational and contextual-related factors causing these outcomes. Finally, a practical example of how a critical realist approach can guide research into secondary prevention programmes is provided.     

Youth mentoring: a social development approach to youth health promotion. Grantmakers In Health

On November 3, 1999, GIH convened a forum, co-sponsored with Grantmakers for Children, Youth and Families (GCYF), featuring grantmakers who have made major commitments to youth mentoring as a health promotion strategy as well as researchers and those operating programs in the field. Participants engaged in a lively and open exchange of ideas, experiences, and information about what grantmakers can do to support and improve such programs. This Issue Brief brings together keypoints from the day's discussion with factual information on youth mentoring and grantmaker activities drawn from a background paper prepared for Dialogue participants.     

A sense-making approach to understanding adolescents' selection of health information sources

The authors propose that information sources are best understood as constructed by individuals in an attempt to find answers to questions of immediate relevance. Contact profiles, or patterns of source use for particular information, determine what constitutes a source for an individual. The study explores how adolescents acquire and use health information. Data analyses based on a probability sample of 200 adolescents identified nine contact profiles and supported four study hypotheses. Contact profiles differ according to health topics and are related to message sending and seeking regarding human sexuality and birth control. Adolescents with peer-media, home-oriented or multi-source contact profiles about human sexuality and birth control were more likely than others to be the peer advisors on this topic, and those with peer-media and multi-source profiles the ones more likely to be the information seekers about it. Contact profiles are also related to adolescents' health decision making capacity. Adolescents with peer-media and multi-source profiles for human sexuality and birth control information and those with home-oriented profiles for alcohol and smoking information engaged in more health decision making steps than those with other profiles. Finally, contact profiles are also related to awareness and contact with new information sources. Adolescents with peer-oriented and multi-source profiles were more likely than others to be aware of and have contacted a new peer education program in the school.     

A developmental-contextual approach to understanding mental health and well-being in early adulthood

There is an increasing awareness of the social and economic burden of untreated mental illness. However, the question remains whether the individuals who are not identified as having a mental disorder are mentally healthy and socially functioning. This study aims to examine the sequence of Keyes's (Keyes, C. L. M. (2002). The mental health continuum: from languishing to flourishing in life. Journal of Health and Social Behavior, 43, 207–222.) mental health categories based on psychological status and well-being, and to identify qualitative differences in these categories by developmental-contextual factors and concurrent physical health status and social functioning. This study uses data from the UK 1958 National Child Development Study. Information was collected on the cohort members from childhood to age 33 years. Psychological distress (measured using the Malaise Inventory) and well-being (self-efficacy and appraisals of life circumstances) were assessed at age 33 years. Multinomial (polytomous) logistic regression models were used to examine the effects of individual characteristics and social contextual factors from childhood through adolescence on cross categorisations of psychological distress and well-being. Our findings suggest that there are similar early life predictors for both poor psychosocial functioning and mental ill-health. Our results also demonstrated a clear gradient of physical health and social functioning across mental health categories, even in the absence of mental disorder. Individual and social contextual factors in early life appear to offer clues as to why the absence of psychological distress does not always imply good mental health or social functioning.