[Development of the National Norms of Negligence on children aged 0 to 35 months in rural areas of China].

OBJECTIVE: To develop the National Norms of Negligence (NNN) for rural children aged 0 to 35 months. METHODS: According to multi-stage stratified cluster sampling principle, 10 provinces or municipalities (Jilin, Shanxi, Shanxi, Beijing, Anhui, Jiangsu, Hunan, Hubei, Yunnan, Chongqing) in China were selected. A national research group was formed collaboratively. A questionnaire was designed by ourselves. According to several statistical analysis methods, such as item, factor and reliability analysis etc. we determined the norm. The evaluation criteria of the scale were determined by percentile method. Finally, the reliability and validity of the norm were evaluated. RESULTS: In total, 2310 children were surveyed, in which the effective sample were 2227, with an effective rate as 96.4%. The scale consisted of 6 neglected dimensions and 65 items in total. The total Cronbach's a coefficient of the scale was 0.903, with the split-half reliability coefficient as 0.829, the parallel reliability as 0.720 and the re-test reliability as 0.678, respectively. The total neglect cut-off score of this scale was 139. CONCLUSION: The scale seemed to have perfect stability and reliability and all the statistical indicators met the psychometric demands.

[Development of national neglect norms for children aged 3 to 6 years in rural areas of China].

OBJECTIVE: To develop the national neglect norms for rural children aged 3 to 6 years, which are suitable for Chinese situations. METHODS: According to the multi-stage stratified cluster sampling principle, 84 towns of 10 provinces or municipalities were selected in China. Children aged 3 to 6 years were surveyed in November 2010, the sample of analysis were 3240 (of whom males were 49.6% (1608/3240) and the Han nationality were 93.3% (3023/3240)). Questionnaire was designed by authors and deleted items that did not meet the requirements through several statistical analysis methods, such as item analysis method, factor analysis method, reliability analysis method. The reliability analysis and validity analysis were used to test the stability and reliability of the norm. The evaluation criteria of the scale was determined by the percentile method, then the initial development of the norm completed. RESULTS: After deleting inappropriate items by statistical processing, finally, the scale consisted of 57 items, and included 6 neglected dimensions (physical neglect, emotional neglect, educational neglect, safe neglect, medical neglect and social neglect). Its item loadings ranged from 0.359 to 0.789, which met the statistical requirements. The scale's total Cronbach α coefficients 0.904, the total split-half reliability coefficients were 0.820, the 6 neglect dimensions' Cronbach α coefficients ranged from 0.620 to 0.815, the 6 neglect dimensions' split-half reliability coefficients ranged from -0.034 to 0.789, the scale's parallel reliability were 0.785 and it's re-test reliability were 0.613. After construct validity, external validity and content validity testing, the result showed that this scale could effectively reflect the real neglected status of children investigated. The total neglect cut-off score of this scale were 121. CONCLUSION: The scale has good stability and reliability. And it adapts Chinese conditions and it's convenient to operate.

[The status of child neglect among rural areas children aged 0 - 6 years in China].

OBJECTIVE: To explore the status of child neglect among rural areas children aged 0 - 6 years in China. METHODS: A total of 7411 rural children aged 0 - 6 years old who were composed of two age groups (3315 children aged 0 - 2 years old and 4096 children aged 3 - 6 years old) were multistage stratified randomly sampled from 84 villages which were representative of 10 provinces of China, in accordance with sex and age in November 2010. To identify the child neglect based on the Neglect Norms for Children Aged 0 to 2 and 3 to 6 Years Old in Rural Areas of China, SPSS 13.0 was employed for analyzing neglect frequency and degree for every group of different age, sex and neglect type (including physical, emotional, educational, medical, safety and social neglects). χ(2) test and analysis of variance were also used. RESULTS: The degree of child neglect for the children aged 0 - 2 years old was 45.01 ± 7.56, the neglect frequency was 54.9% (1819/3315); the degree of child neglect for the children aged 3 - 6 years old was 44.42 ± 7.57, the neglect frequency was 53.8% (2203/4096). The neglect frequency of children aged 0, 1, 2 years old were 58.5% (654/1117), 52.2% (597/1144), 53.9% (568/1054) (P < 0.05). For children aged 3 - 6 years old, the degrees of emotional and safety neglect for males (44.60 ± 7.86, 36.82 ± 9.03) were higher than females (44.03 ± 7.72, 36.25 ± 9.05) (P < 0.05); and the frequencies of emotional and social neglect for males (16.8% (349/2072), 28.3% (586/2072)) were also higher than females (14.1% (286/2024), 24.8% (503/2024)) (P < 0.05). All children of two age groups suffered neglect mainly on one of the six neglect types (incidences were 20.6% (683/3315) and 22.7% (931/4096)). For 0-2 age groups, the higher neglect frequencies happened in the single-parent family and the remarried family (62.5% (15/24) and 63.2% (12/19)), but for children aged 3 - 6 years old groups, it happened in the single-parent family (60.0%, 27/45). CONCLUSION: Degree and frequency of child neglect among children aged 0 to 6 years old in the rural areas of China are high, and we should find out risk factors and provide efficient prevention measures.

[Influencing factors on depression among medical staff in Hunan province under ordinal regression analysis].

OBJECTIVE: To understand the situation of depression and its related influencing factors among medical staff in Hunan province. METHODS: Data were collected through random sampling with multi-stage stratified cluster. Wilcoxon rank sum test, Kruskal-Wallis H test and Ordinal regression analysis were used for data analysis by SPSS 17.0 software. RESULTS: This survey was including 16,000 medical personnel with 14, 988 valid questionnaires and the effective rate was 93.68%. RESULTS: from the single factor analysis showed that factors as: level of the hospital grading, gender, education background, age, occupation, title, departments, the number of continue education, income, working overtime every week, the frequency of night work, the number of patients treated in the emergency room etc., had statistical significances (P < 0.05). Data from ordinal regression showed that the probabilities related to depression that clinicians and nurses suffering from were 1.58 times more than the pharmacists (OR = 1.58, 95%CI: 1.30 - 1.92). The probability among those whose income was less than 2000 Yuan/month was 2.19 times of the ones whose earned more than 3000 Yuan/month (OR = 2.19, 95%CI: 2.05 - 2.35). The higher the numbers of days with working overtime every week, the frequencies of night work, and the numbers of patients being treated at the emergency room, with more probabilities of the people with depression seen in our study. CONCLUSION: Depression seemed to be common among doctors and nurses. We suggested that the government need to increase the monthly income and to reduce the workload and intensity, lessen the overworking time, etc.

[Analysis on influences of guardians on behavior of left-behind children aged 3 to 7 years in countryside].

OBJECTIVE: To explore the influences of guardians on emotion and behavior of rural left-behind children aged 3 to 7 years. METHODS: A self-designed questionnaire of children's condition and Children Strengths and Difficulties Questionnaire (the edition for parents, SDQ) were used to investigate 805 left-behind children aged 3 to 7 years in countryside. RESULTS: The prevalence of difficulty among left-behind children was 3.5%, in male it was 4.1% and in female 2.7%, the difference was not significant (chi(2) = 1.154, P > 0.05) between male and female. The scores of peer communication problems among associate the left-behind children were (2.30 +/- 1.86), which was significantly higher than that (2.09 +/- 1.74) of not left-behind children (P < 0.05). The score of emotion symptom was (2.76 +/- 1.84) and the total score of difficulty was (11.41 +/- 4.77) among left-behind children was significantly higher than those of left-behind children with one parent stayed out (2.29 +/- 1.64) and (10.41 +/- 5.18), were significantly different (t = -2.489 - 2.006, P < 0.05), the score of social behavior (6.39 +/- 2.26) was significantly lower than that of left-behind children with father or mother stayed out (7.34 +/- 2.18, P < 0.001). The score of social behavior of children whose guardians had higher education level (7.02 +/- 2.21) was significantly higher than those with guardians who were illiterate or semiliterate (6.20 +/- 2.44, P < 0.01). CONCLUSIONS: There are evident problems in emotion and behavior among left-behind children with parents staying out. One of parents should stay home to care for children. To improve educational level of guardian will be beneficial to development of physical and mental health among left-behind children.

[Study on emotional, behavioral problems and related determinants among stranded children aged 4 to 7 years in the rural areas of China].

OBJECTIVE: To understand emotional, behavioral problems and related determinants among rural stranded children and to provide evidence for further psychological support. METHODS: A total of 3944 caregivers of children in the rural areas and aged 4 to 7 years but without parents around, were randomly selected. Data were collected through Strengths and Difficulties Questionnaires (the edition for parents, SDQ). RESULTS: The overall prevalence of children with behavioral/emotional problems was 43.6% among those stranded children including 8.3% having experienced emotional symptoms, 9.5% reported to be displaying 'conduct' problems, 8.7% exhibited significant hyperactivity/inattention, 18.9% experienced peer relationship problems and 16.8% having prosocial behaviors. The prevalence of behavioral/emotional problems was significantly higher in boys than those in girls and in lower age groups. Significant differences were also found in conduct problems, hyperactivity/inattention and prosocial behaviors (P<0.01). The result from logistic regression analysis showed that factors as education level and motivation of the caregivers as well as financial support from the parents were related to emotional/ behavioral problems among the stranded children. CONCLUSION: The prevalence of emotional and behavioral problems was high among children living the rural areas but without their parents around which should call for psychological intervention.

[A case-control study on genetic and environmental factors regarding polydactyly and syndactyly].

OBJECTIVE: To explore the genetic and environmental factors related to the development of polydactyly and syndactyly, and to provide evidence for prevention on birth defects. METHODS: A hospital-based case-control study was conducted. 111 cases and 222 controls were interviewed with standardized questionnaires. Logistic regression models were used to select risk factors. RESULTS: Research data through univariate analysis showed that the occurrence of polydactyly and syndactyly were associated with educational level, annual average income per family member, meat and egg intake during early pregnancy, family heredity history, exposure to hazardous substance before pregnancy, serious pregnant reaction etc. of the pregnant women. As shown in multivariable logistic model, some factors, including annual average income of per family member (OR = 0.240), meat and egg intake during early pregnancy (OR = 0.182), could reduce the risk of the development of polydactyly and syndactyly. Other factors including family heredity history (OR = 10.187), exposure to hazardous substance before pregnancy (OR = 3.029), could increase the risk of developing polydactyly and syndactyly. The attributable risks (%) of family heredity history and exposure to hazardous substance before pregnancy were 90.18% and 66.99% respectively. CONCLUSION: Genetic factor was the leading cause on the development of polydactyly and syndactyly. In addition, environmental factors, such as family economic condition, nutritional status during early pregnancy and working condition before pregnancy were associated with the development of polydactyly and syndactyly.

[The status on care and nutrition of 774 children staying in rural areas while parents were in towns].

OBJECTIVE: To understand the status on care and nutrition of children living in the rural areas (so called 'left-behind' children) while their parents were seeking for jobs in the urban areas. METHODS: Cross-sectional study was employed in this investigation. The group of 'left-behind' children (n = 774) and the comparison group (n = 774) were identified. The ascertainment methods mainly included questionnaire, anthropometrics measurements, food-frequency, and laboratory examination. RESULTS: Data from this study revealed that the guardians of the 'left-behind' children had less ability to ensure daily food that the children demanded than the control group and the 'left-behind' children were more likely to be poorly attended (chi2 = 6.671, P = 0.036; xhi2 = 15.053, P = 0.001). Mothers who chose to work outside of their households would tend to choose bottle-feeding or decrease the duration of breastfeeding for their infants (chi2 = 5. 051, P = 0.031; t = -7.201, P = 0.001). The intake of milk and bean products in children younger than 2 years old and cereal intake in children aged 2 to 4 in the group of 'left-behind' children were obviously lower than that seen in the control group (t = -2.150, P = 0.032; t = -2.054, P = 0.040 respectively). The 'left-behind' children were in high prevalence of anemia, and showed significant difference when comparing with the control group (chi2 = 4.560, P = 0.033). CONCLUSION: Children under 'left-behind' situation were in poor nutrition. Recognition of this situation by the communities, parents and extended families would facilitate more attention and effective intervention programs to improve the situation.

[Risk prediction model of perinatal congenital heart disease].

Through analyzing the influencing factors of congenital heart disease (CHD), it is aimed to establish CHD risk prediction model in fetus, and simultaneously provide theoretical foundation for CHD prevention. One-factor logistic regression method was used to screen the significant factors regarding CHD, and to separately adopt multiple-factor non-conditional logistic regression method and decision tree to set up model prediction fetus CHD risk and to analyze the advantages and shortcomings. Correct classification rates turned to be 80.93% and 82.79% respectively among 215 'training samples' by the two methods and the rates were 85.45% and 89.09% respectively among 55 'testing samples'. The alliance of logistic regression and decision tree can overcome influence by co-linearity to guarantee the accuracy and perfection, as well as promoting the predictive accuracy.