An epidemiological analysis on accidental mortality among children under five in Zhejiang Province during last ten years / 预防医学

Objective TostudythetrendofaccidentaldeathamongchildrenunderfiveinZhejiangProvinceduringthelast tenyears,andfurthertoprovidepreventivestrategiesforreducingtheaccidentalmortalityintheregion.Methods By stratified cluster random sampling,all the children under five from 30 sampling areas of Zhejiang Province from 2005 to 201 4 were enrolled.The accidental injury mortalities were investigated by descriptive analysis and chi -square test for lineartrend.Results Theunder-fivemortalitycausedbyaccidentaldeathdemonstratedadecreasedtrendinZhejiang Province between 2005 and 201 4,from 2.52‰in 2005 to 1.48‰in 201 4.During 2005 to 201 4,the accidental mortality rate caused by accidental injuries of neonatal was reduced by 70.05%,1 -1 1 months old by 45.60%,and 1 -4 years old by 31.63% with statistical significance (P<0.05 ).The major cause of accidental death among infants was accidental asphyxia.The top cause in 1 -4 years old children was drowning,followed by traffic incidents and falls.The accidental mortality rate in rural regions decreased faster than that in urban regions.Compared with the resident population, decreasing was slower in cause -mortality rate in floating population.The gap between resident and floating population becamewiderfrom2005to2014.Conclusion Accidentalinjuriesarethemostcriticalmortalfactorstochildrenunder five.The prevention programs should be carried out especially on the floating population.The prevention of accidental asphyxia is critical to infants,while drowning and traffic incidents is critical to 1 -4 years old children.

Environmental risk factors for autism spectrum disorders in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the environmental risk factors for autism spectrum disorders (ASD) in children.</p><p><b>METHODS</b>In this case-control study, 81 boys with ASD, 74 boys with global developmental delay (GDD), and 163 healthy boys were enrolled. A self-designed nurturing environment questionnaire was used to record general demographic data, family social-economic status, parents' living habits and environmental exposure, maternal health status during pregnancy, birth situations, and rearing environment after birth. Multivariate logistic regression was used to identify environmental risk factors for ASD and GDD.</p><p><b>RESULTS</b>Multivariate logistic regression analysis showed that six environmental risk factors such as maternal occupational toxicant exposure, diseases during pregnancy and a history of passive smoking, children's birth places, the frequency of outdoor activities in the second year after birth, and the opportunities to communicate with other age-matched children were significantly associated with the incidence of ASD (OR=20.67, 3.559, 2.422, 2.646, 23.820, and 5.081, respectively; P<0.05). Among the above six risk factors, passive smoking during pregnancy, the opportunities to communicate with their peers, and the frequency of outdoor activities in the second year after birth were also significantly associated with the incidence of GDD (P<0.05).</p><p><b>CONCLUSIONS</b>Maternal occupational toxicant exposure, diseases during pregnancy, and low level of children's birth places may be the specific risk factors associated with ASD, and passive smoking during pregnancy, fewer opportunities to communicate with their peers, and fewer outdoor activities in the second year after birth are non-specific risk factors for ASD, indicating that the development of ASD may be influenced by both genes and environmental factors.</p>

Study on the Social Adaptation of Chinese Children with Down Syndrome

PURPOSE: To evaluate social adjustment and related factors among Chinese children with Down syndrome (DS). PATIENTS AND METHODS: A structured interview and Peabody Picture Vocabulary Test (PPVT) were conducted with a group of 36 DS children with a mean age of 106.28 months, a group of 30 normally-developing children matched for mental age (MA) and a group of 40 normally-developing children matched for chronological age (CA). Mean scores of social adjustment were compared between the three groups, and partial correlations and stepwise multiple regression models were used to further explore related factors. RESULTS: There was no difference between the DS group and the MA group in terms of communication skills. However, the DS group scored much better than the MA group in self-dependence, locomotion, work skills, socialization and self-management. Children in the CA group achieved significantly higher scores in all aspects of social adjustment than the DS children. Partial correlations indicate a relationship between social adjustment and the PPVT raw score and also between social adjustment and age (significant r ranging between 0.24 and 0.92). A stepwise linear regression analysis showed that family structure was the main predictor of social adjustment. Newborn history was also a predictor of work skills, communication, socialization and self-management. Parental education was found to account for 8% of self-dependence. Maternal education explained 6% of the variation in locomotion. CONCLUSION: Although limited by the small sample size, these results indicate that Chinese DS children have better social adjustment skills when compared to their mental-age-matched normally-developing peers, but that the Chinese DS children showed aspects of adaptive development that differed from Western DS children. Analyses of factors related to social adjustment suggest that effective early intervention may improve social adaptability.