Validity of Birth Certificate and Hospital Discharge Data Reporting of Labor Induction

Purpose

To examine the concordance of labor induction measures derived from birth certificate and hospital discharge data with each other and with maternal report.

Human papillomavirus vaccination coverage among females and males,National Health and Nutrition Examination Survey,United States, 2007–2016

BackgroundHuman papillomavirus (HPV) vaccination has been routinely recommended at age 11–12 years in the United States for females since 2006 and males since 2011. Coverage can be estimated using self/parent-reported HPV vaccination collected in the National Health and Nutrition Examination Survey (NHANES) for a wider age range than other national surveys. We assessed vaccination coverage in 2015–2016, temporal trends by age, and the validity of self/parent-reported vaccination status.MethodsParticipants aged 9–59 years completed an interview collecting demographic and vaccination information. Weighted coverage was estimated for two-year NHANES cycles by age group for 2007–2008 to 2015–2016 for females (N = 14318) and 2011–2012 to 2015–2016 for males (N = 7847). Temporal trends in coverage were assessed from 2007–2008 to 2011–2012 for females and from 2011–2012 to 2015–2016 for both sexes. Sensitivity and specificity of self/parent-reported vaccination were assessed using provider-verified vaccination records from a pilot study in 14–29 year-olds.ResultsIn 2015–2016, ≥1 dose coverage among females was highest in 14–19 (54.7%) and 20–24 (56.0%) year-olds and lower in successively older age groups. Among males, ≥1 dose coverage was highest in 14–19 year-olds (39.5%) and lower at older ages. Coverage was similar in 9–13 year-old females and males. Between 2007–2008 and 2011–2012, there were increases among females younger than 30 years. Between 2011–2012 and 2015–2016, there were increases among female age groups including 20–39 year-olds; male coverage increased among ages 9–13, 14–19, and 20–24 years. Self/parent-reported receipt of ≥1 dose had a sensitivity and specificity of 87.0% and 83.3%. Performance was lower for 3 doses.ConclusionsWhile overall HPV vaccination coverage remains low, it is higher in females than males, except in 9–13 year-olds. There have been increases in coverage among many age groups, but coverage has stalled in younger females. Adequate validity was demonstrated for self/parent-reported vaccination of ≥1 dose, but not 3 doses, in a pilot study.     

Metabolic syndrome: pathogenesis, medical care and dental implications

BACKGROUND: The dental literature contains little information about metabolic syndrome (MetS) and its dental implications. TYPES OF STUDIES REVIEWED: The authors conducted a MEDLINE search for the period 2000 through 2005, using the term "metabolic syndrome" to define its pathophysiology, medical treatment and dental implications. RESULTS: MetS is the co-occurrence of abdominal obesity, hyper-triglyceridemia, reduced high-density lipoprotein cholesterol levels, hypertension and impaired fasting glucose, which results from consumption of a high-calorie diet and decreased levels of physical activity superimposed on the appropriate genetic setting. Components of MetS synergistically promote the development of atherosclerosis, resulting in myocardial infarction and stroke. CLINICAL IMPLICATIONS: Deteriorating oral health status is associated with worsening of the atherogenic profile. Tooth loss often results in chewing difficulties because of inadequate occlusive surfaces and may lead to alterations in food selection and dietary quality. This, in turn, adversely affects body composition and nutritional status, both of which are related to vascular health. Dentists should develop treatment plans that preserve and restore the dentition, thus ensuring maximum masticatory efficiency and affording patients the optimum opportunity to consume food that will not foster atherogenesis.     

Screening for cardiovascular risk factors in a dental setting

BACKGROUND: The authors assessed the utilization of oral health care professionals (OHCPs) as a resource for identifying patients who were unaware of their increased risk of developing cardiovascular disease (CVD). METHODS: OHCPs administered a CVD risk-screening questionnaire, measured blood pressure and tested cholesterol levels, high-density lipoprotein levels and hemoglobin A1c (HgA1c) levels using "finger-stick" blood testing in 100 patients treated in a dental school clinic who were unaware of their CVD risk status. The authors determined the prevalence of specific risk factors (that is, smoking and abnormal levels of systolic blood pressure, lipids, body mass index and HgA1c) and calculated Framingham 10-year coronary heart disease (CHD) risk scores. RESULTS: Seventeen percent of the 100 patients (35 percent of men, 5 percent of women) had an increased global risk of experiencing a CHD event within 10 years (Framingham risk score>10 percent). Seventy-three percent of participants had one or more risk factors and 31 percent had two or more risk factors present. More men than women had low levels of high-density lipoprotein (45 percent [18/40] of men versus 3.3 percent [2/60] of women; P<.0001). The mean Framingham CHD risk score increased with increasing risk factor burden. CONCLUSIONS: OHCPs identified patients with an increased CHD risk who could benefit from primary prevention activities. A substantial proportion of study patients who were unaware of their risk status were at an increased risk of experiencing a CHD event within 10 years. OHCPs could contribute to public health CHD control efforts.     

北京工业大学教职工健康体检结果分析

目的 了解北京工业大学教职工身体健康状况.方法 对北京工业大学2012年教职工健康体检结果进行统计分析.结果 参加体检的4 191例中共检出异常者3 687例,异常率达87.97％,共检出疾病36种,主要以咽炎、脂肪肝、高脂血症、高血压、乳腺增生症、糖尿病或空腹血糖≥7.0 mmol/L等多见,男教职工体检异常率明显高于女教职工（均P ＜0.05）.结论 北京工业大学教职工健康状况不容乐观,应重视教职工定期体检,加强教职工医疗保健、健康教育,落实各项预防措施.     

Does Homeostasis Model Assessment of Insulin Resistance have a predictive value for post-coronary artery bypass grafting surgery outcomes?

Objective

This study aims to investigate whether pre-operative Homeostasis Model Assessment Insulin Resistance (HOMA-IR) value is a predictor in non-diabetic coronary artery bypass grafting patients in combination with hemoglobin A1c, fasting blood glucose and insulin levels.

Methods

Eighty one patients who were admitted to Cardiovascular Surgery Clinic at our hospital between August 2012 and January 2013 with a coronary artery bypass grafting indication were included. Patients were non-diabetic with <6.3% hemoglobin A1c and were divided into two groups including treatment and control groups according to normal insulin resistance (HOMA-IR<2.5, Group A; n=41) and high insulin resistance (HOMA-IR>2.5, Group B; n=40), respectively. Pre-operative fasting blood glucose and insulin were measured and serum chemistry tests were performed. The Homeostasis Model Assessment Insulin Resistance values were calculated. Statistical analysis was performed.

Results

There was a statistically significant difference in fasting blood glucose and HOMA-IR values between the groups. Cross-clamping time, and cardiopulmonary bypass time were longer in Group B, compared to Group A (P=0.043 and P=0.031, respectively). Logistic regression analysis revealed that hemoglobin A1c was not a reliable determinant factor alone for pre-operative glucometabolic evaluation of non-diabetic patients. The risk factors of fasting blood glucose and cardiopulmonary bypass time were more associated with high Homeostasis Model Assessment Insulin Resistance levels.

Conclusion

Our study results suggest that preoperative screening of non-diabetic patients with Homeostasis Model Assessment Insulin Resistance may improve both follow-up visit schedule and short-term outcomes, and may be useful in risk stratification of the high-risk population for impending health problems.     

The development of a brief self-report questionnaire to measure ‘recent’ Rash Impulsivity: A preliminary investigation of its validity and association with recent alcohol consumption

Background

Traditionally, impulsivity has been regarded as a stable trait. However, a series of longitudinal and behavioural laboratory studies has found that impulsivity can fluctuate within individuals, suggesting that it has a state as well as a trait manifestation. Whilst existing impulsivity questionnaires tap the former, there is no self-report instrument to assess recent fluctuations in impulsivity.Research aims and designThe present study set out to develop and undertake preliminary validation of a measure of ‘recent’ impulsivity, focusing in particular on Rash Impulsivity. Part of the construct validation of the resulting Recent Rash Impulsivity Scale (RRIS) entailed examining its association with recent alcohol intake, since there are well-documented reciprocal relationships between alcohol consumption and inhibitory control. In developing the RRIS, items from existing trait impulsivity questionnaires were converted into a ‘previous two weeks’ format. The pilot RRIS was then administered, along with a parallel trait version (Trait Rash Impulsivity Scale; TRIS) and a well-established trait impulsivity measure (the BIS-11; Patton, Stanford & Barratt, 1995), to two cohorts of first-year undergraduates aged 17 to 25 (N = 240), on two occasions one month apart. Information about habitual and recent alcohol intake was also gathered.

Results

Factor analyses on both the RRIS and TRIS identified two factors: ‘Cognitive Impulsivity’ (CogImp) and ‘Motor Impulsivity’ (MotImp). Consistent with the RRIS being sensitive to fluctuations in impulsivity, it was found that, as predicted: i) the RRIS was somewhat less strongly correlated than the TRIS with an established trait measure (the BIS-11; Patton et al., 1995); ii) the test–retest stability of ‘Total’ scores (CogImp and MotImp) was weaker for the RRIS than the TRIS; iii) there was evidence that the RRIS MotImp and Total scales were more strongly predicted by recent alcohol intake than were their trait equivalents; and iv) the RRIS CogImp and Total scales correlated more strongly with their trait equivalents in participants whose alcohol consumption had remained stable recently (relative to their habitual intake), compared to those whose consumption had recently changed.

Conclusions

These data suggest that transient changes in impulsivity can be assessed via self-report, and that the RRIS is sensitive to recent changes in alcohol intake. Subject to a more intensive and detailed validation, it is thus promising as a tool for tapping and characterising fluctuations in behavioural control and for exploring a range of factors to which this might be associated.     

比较“法体系”视角下我国执业药师考试模式探讨

本文基于执业医师考试管理较为成熟,其管理依据为《执业医师法》体系较为完善的原因.两者同属人力资源管理领域,对比研究、探讨当前执业药师考试制度.