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1.
神经节苷脂治疗重型颅脑损伤的临床观察 总被引：2，自引：0，他引：2
目的：探讨神经节苷脂（GM-1）在急性颅脑损伤治疗中的应用。方法：对40例急性颅脑损伤患者静脉滴注GM-1 500mg加生理盐水250ml静滴／第1d；400mg加生理盐水250ml静滴／第2d；300mg加生理盐水250ml静滴／第3d；200mg加生理盐水250ml静滴／第4d；5d后100mg加生理盐水250ml／d静滴共10d，后改为GM-140mg。结果：治疗组在随访结束后，GCS评分、语言功能评分、远期综合生活质量评估等方面均明显优于对照组（P〈0．05）。结论：GM-1具有较好的催醒作用，对提生存质量、降低死亡率，促进脑功能恢复和改善预后具有较好的疗效。 相似文献
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BACKGROUND: To determine whether CT-detected cerebral infarct in young children is associated more often with abuse or unintentional head injury. METHODS: Retrospective case-control study of injured children under age 6 who had abnormal initial head CT scans and who were admitted to the only Level I pediatric trauma center in Washington State for closed head injury (CHI) from January 1, 1992 to December 31, 1998. RESULTS: Fifteen children developed cerebral infarct after CHI during the 7 year period. These cases were compared to 53 controls (those who did not develop infarct). After adjusting for the presence of SDH and for severity of injury, patients with infarcts were six times more likely to have been abused than patients without infarcts (OR 6.1; 95% CI, 1.02-36.0). CONCLUSIONS: Cerebral infarct after CHI appears to result more frequently from abuse than unintentional injury in young children. 相似文献
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采取分层抽样法,从山东农村抽取小学四、五、六年级,初一、初二、高一、高二学生共473人,使用儿童恐惧调查表-Ⅱ(FSSC-Ⅱ)对农村儿童青少年恐惧的内容进行了研究。结果发现:(1)农村儿童青少年最常见的恐惧事件主要与危险和伤害及社会关系有关;(2)随着年龄的增长,农村儿童青少年的总体恐惧水平、危险与伤害的恐惧及未知和不确定事物的恐惧水平逐渐下降,而社会关系恐惧的水平则随年龄的增长逐渐上升;(3)随着年龄的增长,农村儿童青少年恐惧对象的数目逐渐下降;(4)农村女生在总体恐惧水平、各维度恐惧水平及恐惧对象的数目上均显著地高于男生。 相似文献
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Anderst JD 《Child abuse & neglect》2008,32(3):405-413
OBJECTIVE: The primary objective was to determine which of the examined factors prompted physicians to initiate a further abuse evaluation in young children with minor head injury. The recording of important historical elements in the charts of these patients was also evaluated. METHODS: Charts of 349 children less than 3 years of age with minor head injury were retrospectively reviewed. Age, race, sex, insurance status, findings on head CT, mechanism of injury, witnessing of event and delay in seeking care were analyzed for association with performance of skeletal survey and referral to Child Protective Services (CPS). RESULTS: Increased odds of CPS referral and increased odds of obtaining a skeletal survey were associated with positive findings on head CT, delay in seeking care, and unknown mechanism of injury. Despite a known association of age/ambulatory status with abuse, the age of the child was not associated with increased odds of abuse evaluation, and younger age was not associated with increased odds of documenting whether the injury was witnessed or when the injury occurred. Documentation of timing of injury was lacking in 29.2% of the charts. Witnessing of the event was undocumented in 48.7% of cases. CONCLUSION: Clinicians may not be using readily available, important information when considering the initiation of an abuse evaluation in young children. Clinicians seeing acutely injured children may need further education regarding developmental status and its effect on mechanisms of injury and the importance of detailed documentation in cases where abuse is a possible cause of injury. PRACTICE IMPLICATIONS: Historical factors associated with injuries in young children continue to be poorly documented. Increased pediatric training for emergency medicine physicians, clinical protocols for evaluation and documentation of injured children, and regular continuing medical education on child development and its implications on mechanisms of injury for clinicians practicing in acute care settings are needed changes that may bring about improvements. 相似文献
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报告57例脑弥漫性轴索损伤,占同期重型颅脑损伤的21％,其主要临床特征是大多数病人为车祸致伤,伤后立即持续昏迷,CT显示无占位效应的脑白质内单发或多发小出血灶以及脑室、脑池和蛛网膜下腔出血等改变。本文结合文献对弥漫性轴索损伤的临床诊断和治疗进行了讨论。 相似文献
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Bennett S Ward M Moreau K Fortin G King J Mackay M Plint A 《Child abuse & neglect》2011,35(11):930-936
Objective
We sought to determine the incidence, clinical features, and demographic profile of head injury secondary to suspected child maltreatment (abuse or neglect) in Canada to help inform the development and evaluation of prevention programs for abusive head injuries.Methods
From March 1, 2005 to February 28, 2008, an average of 2,545 paediatricians and paediatric subspecialists were surveyed monthly through the established network of the Canadian Paediatric Surveillance Program. We calculated incidence rates using the number of confirmed cases over the product of the duration of the study (3 years) and population estimates by age group.Results
There were 220 confirmed cases of head injury from suspected child maltreatment. The annual incidence rate was 14.1 per 100,000 for children less than 1 year of age and 1.4 per 100,000 for those less than 15 years. Seventy three percent (141) of cases involved infants less than 12 months of age and 52% (100) of cases involved infants less than 6 months of age. Seventy-five percent (165) of cases presented to the emergency room. With regard to outcome, 12% (27) of cases resulted in death and 45% (75) of survivors had neurological sequelae at discharge. Thirty percent (67) of all cases, as well as 30% (8) of deaths were previously known to child welfare authorities.Conclusion
This study provides an estimate of the rate of head injury secondary to suspected child maltreatment in Canada. The young age and poor medical outcomes of those involved highlights the need for prevention efforts that are implemented early in life. Given that a significant percentage of injured infants and children were already known to child welfare authorities, the study also highlights the need to establish and evaluate additional preventive efforts for parents and caregivers already in the child welfare system. 相似文献8.
ObjectivesTo describe the outcome of referral to the statutory authorities for infants under 2 years with non-accidental head injury (NAHI), and to establish whether the authorities held sufficient information to develop a risk profile for these cases.MethodsRetrospective review of cases admitted to hospital in Auckland, New Zealand from 1988 to 1998. Records from the hospital admission, child protective services and Police were reviewed, up to 19 years from diagnosis.ResultsOf 39 infants, 33 survived to leave hospital. Documentation of risk factors was erratic, and sometimes incongruent between agencies. Inter-agency case conferences took place in 17/39 (44%). The Department of Child, Youth and Family Services (CYF) used an informal family agreement to secure safety in 15/33 survivors (45%). Family Group Conferences occurred in 17/33 (52%). Nine of 33 were placed permanently outside the home (27%), two (6%) with unrelated caregivers. Charges were laid in 18/39 cases (46%). Fifteen cases came to trial, with 14 convictions (36%). Of the survivors, 44% were later renotified to CYF. There was no obvious relationship between type of intervention and re-notification.ConclusionsEnsuring the safety of an infant with NAHI, and identifying and taking appropriate action with regard to the offender, are complex tasks. In New Zealand, data collection is often incomplete and inter-agency practice and collaboration is variable. Although the rate of prosecution was relatively high by international standards, many children were later notified again for further concerns of abuse or neglect, suggesting that our interventions have been only partially successful.Practice implicationsThis paper suggests that all infants admitted to hospital with non-accidental head injury should become part of a prospective inter-agency research study, using a standardised data collection instrument. This should include the systematic collection of all data known or suspected to be associated with risk of child abuse, and incorporate long-term prospective follow-up, regardless of child protective or legal outcomes. Without large numbers followed prospectively and according to sound methodology, it is difficult to prove which forms of intervention are better than others at reducing the risk of further abuse. 相似文献
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Sandra T. Acosta 《Educational studies》2014,40(1):98-115
The purpose of this study was to examine a factor triad consisting of family, school and student variables contributing to New Zealand adolescents’ science literacy performance on Programme for International Student Assessment 2006. Results indicated that the selected variables in our study explained 25% of total differences in New Zealand students’ science achievement. Family socio-economic status (SES) as well as adolescents’ motivation to learn science and general value of science were influential factors in students’ science achievement. Findings also revealed a statistically significant interaction effect between SES and first-generation immigrant students but not between SES and second-generation immigrant students. Although parents’ perception of general value of science showed a positive effect on adolescents’ scientific performance, its predictive power was relatively weak. 相似文献
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Background and objective
Expectations and beliefs are important predictors of outcome following minor head injury. In this paper, the primary purpose is to develop a simple symptom expectation questionnaire for minor head injury for use in future research studies. 相似文献12.
OBJECTIVE: This study aimed to examine the level of sexual abuse knowledge and self-protection skills in a sample of female Chinese adolescents with mild mental retardation. It was hypothesized that the participants would exhibit impoverished knowledge on sexual abuse and related self-protection strategies. METHOD: A total of 77 female Chinese adolescents aged from 11 to 15 years old who met the inclusion criterion of the study were recruited from four special schools for mental retardation. The Chinese versions of the Personal Safety Questionnaire and the "What If' Situation Test (Wurtele, 1990) were administered orally to the participants during individual interviews. RESULTS: Participants were more able to accurately recognize inappropriate than appropriate touches and sexual requests, and possessed limited information about sexual abuse. They were also inadequate in protecting themselves against sexual abuse, and had the most difficulty in reporting the sexually abusive incident and characteristics of the offender. Regression analyses also showed that their sexual abuse knowledge was the best predictor for self-protection skills. CONCLUSION: The present findings provided strong cross-cultural support to previous Western studies that found females with mild mental retardation of high risk to sexual abuse and in need of specially designed prevention program to enhance their competency against sexual victimization and exploitation. With modification and refinement, measurement scales used in the Western general population could be extended to Chinese adolescents with mental retardation. Suggestions on the design of the sexual abuse prevention programs, limitations of the present study, and recommendations for future studies were also discussed. 相似文献
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Abstract We compared adolescents identified as having mild mental retardation, learning disabilities, behavioral disorders, and no known handicaps on regular classroom sociometric status extended to include measures of social impact and social preference. Students attended regular classroom physical education classes in six high schools from two adjacent school districts. We administered a rating scale sociometric in physical education classes where students with mild handicaps were enrolled. Results indicated that not all students with mild handicaps were similar in social acceptance, rejection, and preference. Students with mild handicaps also differed in composition of subgroups labeled popular, rejected, neglected, controversial, and average. We discuss implications concerning social standing differences across types of mild handicaps and the value of examining sociometric status in the manner employed here. 相似文献
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Jonathan Cohen 《Annals of dyslexia》1986,36(1):287-300
The relationship between learning disabilities and psychological development is a complex, ongoing intrapsychic and psychosocial
process. The results of two clinical-psychological investigations about a group of learning-disabled children and a group
of learning-disabled adolescents is summarized. Although the learning-disabled youngsters were psychologically more heterogeneous
than homogeneous, several common configurations emerged that characterized these children and adolescents: (1) problems in
work and learning (due to the learning disability itself and to psychogenic factors related directly and/or indirectly to
the disability); (2) chronic, low-level depression and relatively high, free floating anxiety; (3) characteristic unconscious
concerns about self and others. In addition, learning disabilities organize psychological development in determining strengths,
weaknesses, interests, and defensive strategies. And, the intermittent nature of mild to moderately severe learning disabilities
seems to contribute to a sense of being traumatized and to character riqidity. The educational and clinical implications are
briefly discussed. 相似文献
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目的:研究急性脑损伤早期脑微循环和脑微血管超微结构的改变。方法:采用Feeney's脑落体撞击致伤动物模型,实验动物选用Wistar大鼠,应用内源性过氧化物酶(EPOX)细胞化学示踪微血管。结果:急性脑损伤后2—72小时脑微循环改变的总体特征为“稀”、“细”、“淡”,即伤区及周围血管稀少,管径变细,颜色变淡,提示,脑损伤后早期脑微血管处于高度收缩状态或管腔狭窄、闭塞,血循环减少。结论:脑微循环障碍、脑缺血是继发性脑损害的重要因素,救治重型颅脑损伤要重视防治脑微循环障碍,纠正脑缺血。 相似文献
16.
Skeletal surveys (SSs) have been identified as a key component of the evaluation for suspected abuse in young children, but variability in SS utilization has been reported. Thus, we aimed to describe the utilization patterns, yield, and risks of obtaining SS in young children through a systematic literature review. We searched PubMed/MEDLINE and CINAHL databases for articles published between 1990 and 2016 on SS. We calculated study-specific percentages of SS utilization and detection of occult fractures and examined the likelihoods that patient characteristics predict SS utilization and detection of occult fractures. Data from 32 articles represents 64,983 children <60 months old. SS utilization was high (85%-100%) in studies of infants evaluated by a child protection team for suspected abuse and/or diagnosed with abuse except in one study of primarily non-pediatric hospitals. Greater variability in SS utilization was observed across studies that included all infants with specific injuries, such as femur fractures (0%–77%), significant head injury (51%–82%), and skull fractures (41%–86%). Minority children and children without private insurance were evaluated with SS more often than white children and children with private insurance despite lack of evidence to support this practice. Among children undergoing SS, occult fractures were frequently detected among infants with significant head injury (23%–34%) and long bone fractures (30%) but were less common in infants with skull fractures (1%–6%). These findings underscore the need for interventions to decrease disparities in SS utilization and standardize SS utilization in infants at high risk of having occult fractures. 相似文献
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Carrie L. Shandra Dennis P. Hogan 《International Journal of Disability, Development & Education》2009,56(4):363-379
This article uses data from the National Longitudinal Survey of Youth 1997 (NLSY97) to examine the relationship between disability, parental and youth university expectations in 1997, and youth high school completion and university enrolment by 2003. Results indicate that educational attainment is not equal for young adults with and without disabilities in the United States. Parents—but not adolescents—are likely to reduce their educational expectations when adolescents have a mild or serious disability, net of school performance. These parental—but not adolescent—expectations are significantly associated with high school completion. Finally, even after controlling for educational expectations and school performance, youth with serious disabilities are much less likely to graduate from high school than youth without disabilities. Despite the considerable strides made in the implementation of the Individuals with Disabilities Education Act, students with disabilities are not achieving educational parity in graded schooling. 相似文献
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Replication studies are essential with any construct of interest in order to provide further depth and understanding. This study replicated Siegle and Schuler's (2000) perfectionism study with gifted early adolescents. Perfectionism differences among grade level, birth order, and gender were explored using a between-subjects factorial MANOVA. Similar to the previous study, we found that the FMPS is an appropriate measure of perfectionism in gifted adolescents (grades 6–8) and that females have greater concern over Organization than males. However, there were many differences in our results compared to the previous study, highlighting the continued need to study and replicate existing work before generalizations can be made about gifted early adolescents. 相似文献
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For adolescents and adults with mild to moderate intellectual disabilities (or, in the UK, learning disabilities or learning difficulties), the achievement of successful engagement with, and construction of meaning from, texts necessitates the implementation and use of specifically designed and adapted teaching strategies and resources. The careful selection and application of appropriate resources is vital to allow learners with intellectual disabilities to engage and participate with texts in positive, enjoyable and meaningful ways. The challenge for teachers of adolescents and adults with intellectual disabilities is to overcome the limited availability of suitable literacy resources for these learners. In this article, Michelle Morgan, who teaches literacy at the University of Queensland, and Karen Moni, director of the secondary programmes in the School of Education at the University of Queensland, identify the literacy needs and reading practices of adolescents and adults with intellectual disabilities based upon findings from an action research investigation. They go on to explore ways in which teachers can meet the challenge of limited resources for these learners through the specific and deliberate adaptation and creation of suitable texts. 相似文献