关于低出生体重儿生长模式的思考

低出生体重儿发生率是衡量社会发展和妇幼保健状况的重要指标。低出生体重不仅直接增加新生儿死亡率和儿童早期的患病率,而且与儿童的远期预后密切相关。本文从低出生体重儿的生长特点、生长追赶的利弊以及营养管理等方面,探讨适于低出生体重儿的最佳生长模式,以求改善这一特殊群体的近期健康和远期生活质量。     

关于低出生体重儿生长模式的思考

低出生体重儿发生率是衡量社会发展和妇幼保健状况的重要指标.低出生体重不仅直接增加新生儿死亡率和儿童早期的患病率,而且与儿童的远期预后密切相关.本文从低出生体重儿的生长特点、生长追赶的利弊以及营养管理等方面,探讨适于低出生体重儿的最佳生长模式,以求改善这一特殊群体的近期健康和远期生活质量.     

从家长的角度探讨有关低出生体重儿的生命伦理学问题

为了了解家长关于低出生体重儿医疗救治权的观点,为医疗决策提供伦理学依据,按1：1匹配各选择124例单胎低出生体重儿及正常儿建立队列,调查两组家长对低出生体重儿医疗救治观点的认识。结果显示,两组家长大多认同低出生体重儿应积极救治且医疗救治权应当由医生和家长共同决定。因此,应加强围产期保健教育,积极预防低体重儿出生。     

关于低出生体重儿诊疗最优化原则的思考

出生体重及低出生体重发生率是衡量社会发展和妇幼保健状况的重要指标。低出生体重不仅直接增加新生儿和婴儿的患病率和死亡率,而且与儿童的远期预后如生长发育落后、智力低下、脑瘫及成年期胰岛素抵抗密切相关。通过运用诊疗最优化的原则,对低出生体重儿进行预防,及早干预治疗,可提高其生命质量。     

关于低出生体重儿诊疗最优化原则的思考

出生体重及低出生体重发生率是衡量社会发展和妇幼保健状况的重要指标.低出生体重不仅直接增加新生儿和婴儿的患病率和死亡率,而且与儿童的远期预后如生长发育落后、智力低下、脑瘫及成年期胰岛素抵抗密切相关.通过运用诊疗最优化的原则,对低出生体重儿进行预防,及早干预治疗,可提高其生命质量.     

低出生体重与代谢综合征

低出生体重是发生成年期代谢综合征的高危因素。“代谢程序化”与“营养程序化”概念的提出对人们从多层面认识该现象的内在机制有重要指导作用。随着对发生机制研究的深入,人们终将找到预防低出生体重发生成年期代谢综合征的早期干预措施。     

低出生体重与代谢综合征

低出生体重是发生成年期代谢综合征的高危因素."代谢程序化"与"营养程序化"概念的提出对人们从多层面认识该现象的内在机制有重要指导作用.随着对发生机制研究的深入,人们终将找到预防低出生体重发生成年期代谢综合征的早期干预措施.     

姜守明、耿亮:《西方社会保障制度概论》

科学出版社 2 0 0 2年 12月 ,2 2 9页　　为了借鉴国外的经验和教训 ,促进我国社会保障制度的建设 ,自上世纪 90年代以来 ,我国已有相当数量的介绍、研究国外 ,特别是西方发达国家社会保障制度的著作和论文问世 ,其中不乏对外国学者的译注。在这数目繁多的同领域论著中 ,姜守明、耿亮合著的《西方社会保障制度概论》(以下简称“概论”)是颇有特色的一本。特色首先在于它的篇幅。以往同类论著中 ,有的过于概括简明 ,难窥全貌 ;有的又鸿篇巨制 ,巨细无遗 ,难得要领。当然这和作者研介宗旨有关 ,本无可厚非。而《概论》仅 3 0万字 ,由总论 ,而…     

产前诊断中的伦理学问题

探讨我国产前诊断技术开展的现状,阐述产前诊断面临的伦理道德问题及其相应的伦理学处理原则,建议开创一个伦理学评价体系,使产前诊断向着合理、完善的方向发展,从而达到提高人口出生质量、确保母婴健康的社会共同目标。     

论管子治道思想中的社会保障思想

社会保障思想是管子治道思想的重要内容。其内容包括： 社会保障的主体范围, 社会保障的具体制度, 社会保障的作用等。管子的社会保障治道思想对当代国家的启示意义有： 一是社会保障是国家的重要职能, 二是建立和完善社会保障制度是一项复杂的系统工程, 三是建立和完善社会保障制度具有重要的意义和作用。     

Children born with very low birth weight show difficulties with sustained attention but not response inhibition

Children born with very low birth weight perform poorly on executive function and attention measures. Any difficulties with sustained attention may underpin impairments in performance on tasks measuring higher order cognitive control. Previous sustained attention research in very low birth weight cohorts has used tasks that involve arousing stimuli, potentially spoiling the measure of sustained attention. The aim of this study was to compare the performance of very low birth weight and normal birth weight children on a well-controlled task of sustained attention. The Fixed and Random versions of the Sustained Attention to Response Task were given to 17 very low birth weight and 18 normal birth weight children. The very low birth weight group performed the Fixed and Random Sustained Attention to Response Tasks in a similar manner as the normal birth weight group on all measures except for the omission error and Slow Frequency Area under the Spectra variables on the Fixed Sustained Attention to Response Task. These measures index lapses in sustained attention that may be underpinned by declining arousal. The very low birth weight group showed no response inhibition deficits. Omission errors and slow-timescale response-time variability on predictable tasks may thus present sensitive indices of difficulties with sustained attention and arousal associated with premature birth and low birth weight.     

The Mediating Effects of Verbal Skills in the Relationship Between Low Birth Weight and Childhood Aggressive Behaviour

Prenatal and perinatal risk factors, such as low birth weight, have been linked to higher levels of aggressive and destructive behaviours during childhood. Although low birth weight is associated with childhood externalizing behaviour, the mechanisms underlying this relationship remain open to empirical investigation. The current study extends the current literature by examining whether verbal skills mediate the relationship between low birth weight and childhood externalizing behaviour. A longitudinal analysis of data from the Fragile Families and Child Well‐being Study reveals that verbal skills appear to mediate the influence of low birth weight on serious aggression and destructive behaviour at age 5. The implications of this research are discussed. Copyright © 2012 John Wiley & Sons, Ltd.     

Birth weight and cognitive ability in childhood: a systematic review

Individual differences in cognitive ability may in part have prenatal origins. In high-risk (low birth weight/premature) babies, birth weight correlates positively with cognitive test scores in childhood, but it is unclear whether this holds for those with birth weights in the normal range. The authors systematically reviewed literature on the relationship between normal birth weight (more than 2,500 g) and childhood intelligence in term (37-42-week gestation) deliveries. Six studies met the inclusion criteria, and the authors present a comprehensive narrative review of these studies. There was a small, consistent, positive association between birth weight and childhood cognitive ability, even when corrected for confounders. Parental social class accounted for a larger proportion of the variance than birth weight, and these 2 variables were largely independent.     

The contribution of visual processing to academic achievement in adolescents born extremely preterm or extremely low birth weight

Children born extremely preterm (EP, <28 weeks) and/or extremely low birth weight (ELBW, <1000 g) have more academic deficiencies than their term-born peers, which may be due to problems with visual processing. The aim of this study is to determine (1) if visual processing is related to poor academic outcomes in EP/ELBW adolescents, and (2) how much of the variance in academic achievement in EP/ELBW adolescents is explained by visual processing ability after controlling for perinatal risk factors and other known contributors to academic performance, particularly attention and working memory. A geographically determined cohort of 228 surviving EP/ELBW adolescents (mean age 17 years) was studied. The relationships between measures of visual processing (visual acuity, binocular stereopsis, eye convergence, and visual perception) and academic achievement were explored within the EP/ELBW group. Analyses were repeated controlling for perinatal and social risk, and measures of attention and working memory. It was found that visual acuity, convergence and visual perception are related to scores for academic achievement on univariable regression analyses. After controlling for potential confounds (perinatal and social risk, working memory and attention), visual acuity, convergence and visual perception remained associated with reading and math computation, but only convergence and visual perception are related to spelling. The additional variance explained by visual processing is up to 6.6% for reading, 2.7% for spelling, and 2.2% for math computation. None of the visual processing variables or visual motor integration are associated with handwriting on multivariable analysis. Working memory is generally a stronger predictor of reading, spelling, and math computation than visual processing. It was concluded that visual processing difficulties are significantly related to academic outcomes in EP/ELBW adolescents; therefore, specific attention should be paid to academic remediation strategies incorporating the management of working memory and visual processing in EP/ELBW children.     

完善我国基本医疗保障制度的法律思考

由于公民社会保障制度在具体立法、司法存在立法不健全、层次低、法律实施机制不健全等问题,特别是基本医疗保障法律体系需进一步完善.制定和健全基本医疗保险制度基本法是医疗体制改革、社会主义市场经济体制必然要求.     

Social determinants of health,prenatal maternal stress,and earlier birth during the COVID-19 pandemic

During the COVID-19 pandemic, pregnant women, especially those from socioeconomically disadvantaged and marginalized groups, experienced unprecedented stress. Prenatal stress and social determinants of health (SDoH) such as lower education and lack of a relationship partner are known to contribute to earlier birth. However, whether SDoH and stress independently contribute or whether the harmful impact of SDoH is mediated by stress is unknown. Moreover, the contributions of these factors has not been investigated in the context of a communal health crisis such as the COVID-19 pandemic. To examine these processes, we used a longitudinal cohort of 2473 women pregnant during the COVID-19 pandemic who reported a live birth. We compared structural equation models predicting gestational age at birth from SDoH (race/ethnicity, education, financial security, health insurance, relationship status, and lifetime abuse) and from prenatal maternal stress related and unrelated to the COVID-19 pandemic. Results indicate that the association of SDoH with earlier birth was partially mediated by prenatal stress. These findings help uncover mechanisms explaining health disparities in the U.S. and highlight the need to address both SDoH and the stress that these factors produce in under-resourced and marginalized communities.     

Very Low Birth Weight and Attention Deficit/Hyperactivity Disorder

It is well recognized that reaction time performance of term-born children with a normal birth weight (NBW > 2500 g) who fulfill the DSM-IV criteria for attention deficit/hyperactivity disorder (ADHD) in the primary school age is sensitive for the presentation rate of stimuli. They have been found to perform more poorly in conditions of relatively slow event rates as compared with fast event rates. The purpose of the current study was to explore whether reaction time performance of children with very low birth weight (VLBW < 1500 g) with or without ADHD showed the same sensitivity for the factor presentation rate of stimuli compared to children with a normal birth weight plus ADHD. To this end, reaction time performance of four groups of children was compared on a Go/No-Go test with a fast presentation rate of 1 second and a slow presentation rate of 6 seconds. Groups were: children with VLBW plus ADHD, children with VLBW only, children born full term with normal birth weight (NBW >2500 g) plus ADHD, and children born full term without ADHD (the control group). Findings indicated that, compared to the non-ADHD groups, the groups with ADHD (NBW and VLBW) showed a more dramatic decline in their reaction time performance in the slow condition: a state regulation deficit. In addition, both groups showed a response inhibition deficit. No difference was found in reaction time performance between the groups of children with VLBW only and the control group.