辽西地区健康体检者血脂水平调查分析

目的了解来我院体检的辽西地区体检人员的血清总胆固醇(TC)和血清三酰甘油(TG)水平与性别之间的关系。方法对11817例地方体检人员的检查资料进行整理分析,按性别进行分组,分为男性体检人员组(6656例)和女性体检人员组(5161例),用酶法检测体检者TC和TG水平,运用统计学方法(t检验,卡方检验)对检验结果进行调查分析。结果男性体检人员组的TC和TG水平与女性体检人员组的TC和TG水平比较差异均有统计学意义(P<0.05)。男性体检人员组中TC异常的发生率为44.01%(2929/6656),女性体检人员组中TC异常的发生率为28.19%(1455/5161),男性体检人员组的TC异常的发生率和女性体检人员组的TC异常的发生率比较差异有统计学意义(P<0.05)。男性体检人员组中TG异常的发生率为45.43%(3024/6656),女性体检人员组中TG异常的发生率为16.93%(874/5161),男性体检人员组的TG异常的发生率和女性体检人员组的TG异常的发生率比较差异有统计学意义(P<0.05)。结论辽西地区男性的TC和TG水平高于女性,并具有显著性差异。TC和TG异常的发生与性别因素相关。     

Publishing data from electronic health records while preserving privacy: A survey of algorithms

The dissemination of Electronic Health Records (EHRs) can be highly beneficial for a range of medical studies, spanning from clinical trials to epidemic control studies, but it must be performed in a way that preserves patients’ privacy. This is not straightforward, because the disseminated data need to be protected against several privacy threats, while remaining useful for subsequent analysis tasks. In this work, we present a survey of algorithms that have been proposed for publishing structured patient data, in a privacy-preserving way. We review more than 45 algorithms, derive insights on their operation, and highlight their advantages and disadvantages. We also provide a discussion of some promising directions for future research in this area.     

Iron Deficiency Is Associated with Food Insecurity in Pregnant Females in the United States: National Health and Nutrition Examination Survey 1999-2010

Food-insecure pregnant females may be at greater risk of iron deficiency (ID) because nutrition needs increase and more resources are needed to secure food during pregnancy. This may result in a higher risk of infant low birth weight and possibly cognitive impairment in the neonate. The relationships of food insecurity and poverty income ratio (PIR) with iron intake and ID among pregnant females in the United States were investigated using National Health and Nutrition Examination Survey 1999-2010 data (n=1,045). Food security status was classified using the US Food Security Survey Module. One 24-hour dietary recall and a 30-day supplement recall were used to assess iron intake. Ferritin, soluble transferrin receptor, or total body iron classified ID. Difference of supplement intake prevalence, difference in mean iron intake, and association of ID and food security status or PIR were assessed using χ² analysis, Student t test, and logistic regression analysis (adjusted for age, race, survey year, PIR/food security status, education, parity, trimester, smoking, C-reactive protein level, and health insurance coverage), respectively. Mean dietary iron intake was similar among groups. Mean supplemental and total iron intake were lower, whereas odds of ID, classified by ferritin status, were 2.90 times higher for food-insecure pregnant females compared with food-secure pregnant females. Other indicators of ID were not associated with food security status. PIR was not associated with iron intake or ID. Food insecurity status may be a better indicator compared with income status to identify populations at whom to direct interventions aimed at improving access and education regarding iron-rich foods and supplements.     

Measures of initiation and progression to increased smoking among current menthol compared to non-menthol cigarette smokers based on data from four U.S. government surveys

There are no large-scale, carefully designed cohort studies that provide evidence on whether menthol cigarette use is associated with a differential risk of initiating and/or progressing to increased smoking. However, questions of whether current menthol cigarette smokers initiated smoking at a younger age or are more likely to have transitioned from non-daily to daily cigarette use compared to non-menthol smokers can be addressed using cross-sectional data from U.S. government surveys. Analyses of nationally representative samples of adult and youth smokers indicate that current menthol cigarette use is not associated with an earlier age of having initiated smoking or greater likelihood of being a daily versus non-daily smoker. Some surveys likewise provide information on cigarette type preference (menthol versus non-menthol) among youth at different stages or trajectories of smoking, based on number of days smoked during the past month and/or cigarettes smoked per day. Prevalence of menthol cigarette use does not appear to differ among new, less experienced youth smokers compared to established youth smokers. While there are limitations with regard to inferences that can be drawn from cross-sectional analyses, these data do not suggest any adverse effects for menthol cigarettes on measures of initiation and progression to increased smoking.     

Issues and considerations in the use of serologic biomarkers for classifying vaccination history in household surveys

Accurate estimates of vaccination coverage are crucial for assessing routine immunization program performance. Community based household surveys are frequently used to assess coverage within a country. In household surveys to assess routine immunization coverage, a child's vaccination history is classified on the basis of observation of the immunization card, parental recall of receipt of vaccination, or both; each of these methods has been shown to commonly be inaccurate. The use of serologic data as a biomarker of vaccination history is a potential additional approach to improve accuracy in classifying vaccination history. However, potential challenges, including the accuracy of serologic methods in classifying vaccination history, varying vaccine types and dosing schedules, and logistical and financial implications must be considered. We provide historic and scientific context for the potential use of serologic data to assess vaccination history and discuss in detail key areas of importance for consideration in the context of using serologic data for classifying vaccination history in household surveys. Further studies are needed to directly evaluate the performance of serologic data compared with use of immunization cards or parental recall for classification of vaccination history in household surveys, as well assess the impact of age at the time of sample collection on serologic titers, the predictive value of serology to identify a fully vaccinated child for multi-dose vaccines, and the cost impact and logistical issues on outcomes associated with different types of biological samples for serologic testing.     

National trends in school victimization among Asian American adolescents

The “model minority” perception of Asian American students often ignores the academic and social challenges that many face in schools. One area that has received less attention is the school victimization experiences of Asian American adolescents. While some qualitative researchers have explored factors contributing to school victimization in recent years, missing in the literature is the scope of these incidents among Asian Americans. This paper contributes to this literature by (1) examining national trends in the victimization of Asian American adolescents in schools over the last decade and (2) investigating how victimization varies according to their gender, socioeconomic status, and achievement levels. The results show that although Asian American adolescents are consistently less likely to be bullied relative to other students, they are more likely to report experiences of racial discrimination. Victimization incidents for Asian Americans also differ by gender and academic achievement levels.     

Validation and utilisation of a digital version of the survey instrument for natural history,Aetiology and Prevalence of Patellofemoral pain studies (eSNAPPS)

ObjectiveThis study validated the newly adapted electronic SNAPPS (eSNAPPS) against the original paper SNAPPS. Subsequently, the study estimated the prevalence of PFP in running participants and spectators attending three mass-participant running events in the United Kingdom by using the eSNAPPS tool.DesignThis study had two parts. Firstly, a validation of the original paper version of the SNAPPS tool. Secondly, if validation was achieved, eSNAPPS was used in a prevalence study.ParticipantsA convenience sample of running participants and spectators aged 18–40 years attending the mass participation running events.Main outcome measureThe 12-month prevalence of PFP.Results: eSNAPPS was valid in identifying those with PFP (ICC 0.99 for Overall agreement, p < 0.0001). In the prevalence study, a total of 1080 running participants and spectators completed the eSNAPPS. The overall prevalence of PFP was 17.4% (95%CI: 15.2%, 19.8%); 20.5% of males (16.5, 24.9) and 15.7% of females (13.1, 18.7) had PFP. Prevalence was 17.4% (15.2, 19.8) in spectators and 16.7% in running participants (14.5, 19.0).ConclusionThe overall PFP prevalence in this study was slightly smaller than those previously reported in the literature. Findings also show that there were similar prevalence estimates in spectators and running participants.     

The relationship between perceived role and appropriate use of peripherally inserted central catheters: A survey of vascular access nurses in the United States

BackgroundThe presence and proliferation of vascular access nursing in hospital settings has been identified as a potential contributor to growing demand, and possible overuse, of peripherally inserted central catheters (PICCs).ObjectiveWe examined vascular access nurses’ perceived role related to use of PICCs and the association with appropriateness of PICC use in hospitals.DesignA web-based survey was administered to members of two vascular access professional organizations.ParticipantsOf 2762 potentially eligible respondents who accessed the link, 1698 (61%) completed the survey. This sample was further restricted to vascular access nurses who worked in a U.S. hospital (n = 1147).MethodsRespondents were categorized based on perceived role: 1) an operator who inserts PICCs; 2) a consultant whose views are not valued by the care team (unvalued consultant); 3) a consultant whose views are valued by the care team (valued consultant). Facility and respondent characteristics, reported practices, leadership support and relationships with other providers were compared across groups using chi-squared tests and analysis of variance. Multivariable logistic regression was used to assess the association between perceived role and reported percentage of PICCs placed for inappropriate reasons.ResultsAmong the 1147 respondents, 210 (18%) viewed themselves as operators, 683 (59%) as valued consultants, 236 (21%) as unvalued consultants, and 18 (2%) could not be categorized. A significantly higher percentage (93%) of valued consultants reported that vascular access nurses placed the majority of PICCs at their facility, compared to operators (83%) or unvalued consultants (76%) (p < 0.001). After adjustment, compared with operators, valued consultants were significantly more likely to report that <10% of PICCs at their facility were inserted for inappropriate reasons (OR 1.7, p = 0.002); the finding was reversed for unvalued consultants (OR 0.69, p = 0.06).ConclusionsVascular access nurses and their perceived role as part of the healthcare team are associated with PICC use in hospitals. Strong inter-professional collaboration and respect may help ensure more appropriate use of PICCs.