Patient and clinician experiences with cross-border reproductive care: A systematic review

ObjectivesThis review analyzes the experiences of patients and clinicians with regards to international cross-border reproductive care (CBRC) for the purpose of conception.MethodsElectronic databases PubMed, Embase, Web of Science, and Scopus were searched using ‘medical tourism’ AND ‘assisted reproductive technology’ from 1978 to 2020.ResultsPredominant patient motivators for CBRC were cost and legality of assisted reproduction technology (ART) in one's home country, followed by cultural factors like shared language, religion, and cultural familiarity. Clinicians suggested global laws for CBRC would reduce the potential for exploitation of vulnerable populations but believed the enactment of international regulations unlikely and, even if enacted, difficult to enforce.ConclusionsWhile patient and clinician experiences with CBRC varied, patients frequently cited financial and legal reasons for pursuing CBRC, while many providers had concern for the patient’s safety.Clinical practice implicationsThis review recommends clinicians involved in family planning counsel patients seeking treatment abroad by: (i) informing patients of the risks and benefits of treatment abroad, (ii) establishing guidelines and standards for clinicians on resuming patient care post-CBRC, and (iii) creating a directory of reputable CBRC clinicians and experts.     

Attachment parenting: an exploration of demographics and practices

The goal of this study was to identify parenting behaviors practiced by a self‐selected group of North American parents who identify themselves as attachment parents. This type of parenting is based on behaviors that are focused on infant needs and demands perhaps more strongly than are traditional mainstream western parenting practices. However, little is known about the demographics of the parents or the actual parameters of their behaviors. In order to further investigate these behaviors, a self‐report questionnaire was developed for use in the study. This questionnaire was included, without return postage, in an international parenting magazine, Compleat Mother. A sample of 275 mothers returned the instrument. Respondents were predominantly married, college educated and White. The respondents reported that of their infants the majority were exclusively breastfed on the infant’s cue and for an extended period of time, coslept and were held or nursed during the transition to sleep. These practices are discussed through a cross‐cultural perspective.     

老年人医院获得性尿路感染菌群分类及耐药性分析

目的了解老年患者医院内获得性尿路感染致病菌的菌群分布及其对抗生素的耐药情况。为临床合理使用抗生素提供依据。方法回顾调查我院2002．12～2006．5老年医院获得性尿路感染患者的临床资料，分析病原学及细菌学特点，抗生素的耐药监测。结果共收集致病菌169株，其中革兰氏阴性菌116株（68．6％）．革兰氏阳性菌37株（21．9％），真菌15株（8．9％）。革兰氏阴性菌中大肠埃希菌检出率最高（37.3％），其次为不动杆菌（8．3％）．22％的大肠埃希菌产超广谱β-内胺酰酶。革兰氏阴性菌对亚胺培南、阿米卡星、头孢哌酮加舒巴坦的敏感性最高，而对氨卞西林、环丙沙星、氨曲南的耐药率大都在50％以上。革兰氏阳性菌以葡萄球菌最多见（12．4％），其次为肠球菌（5．9％）。革兰氏阳性菌对青霉素、克林霉素、红霉素、左氧氟沙星的耐药率多在60％以上，而对万古霉素敏感性高。结论老年医院获得性尿路感染以革兰氏阴性杆菌为优势菌株且耐药性日趋严重，对亚胺培南、阿米卡星、头孢哌酮敏感性较高。革兰氏阳性球菌感染宜以万古霉素为首选。     

Multifidus muscle size in adolescents with and without back pain using ultrasonography

Objective

The purposes of this study were; a) to compare multifidus muscle cross sectional area (CSA) in male adolescents suffering from low back pain (LBP) with healthy male adolescents using ultrasonography (US), and b) to assess the correlation between multifidus muscle size and demographic variables.

Foot disorders in the elderly: A mini-review

Ageing process is associated with changes to the aspect, biomechanics, structure and function of the foot, it may be related with a marked presence of foot conditions, pain, disability and other overall health problems that constitute a major public health concern.Also, the prevalence of epidemiologic research found an incidence of foot problems which is even higher as a consequence of increasing life expectation. Several studies have also suggested that such foot disorders currently affect between 71 and 87% of older patients and are a frequent cause of medical and foot care.Thus, these kind problems are extremely common conditions in the general population, especially in the elderly who are associated with poor quality of life, balance impairment, increase the risk of falls, dificulty on putting shoes, fractures, restrict mobility and performance of activities of daily living that turn can produce serious physical, mental and social consequences in the older people.The role of the physician in the assessment, evaluation, and examination of foot problems is very important, yet it is often an overlooked and undervalued component of geriatric health care.The purpose of this article is to review and to provide an overview of the most common foot deformities precipitating factors, clinical presentation, evidence-based diagnostic evaluation, and treatment recommendations with a view to preventing medical conditions or deformities affecting the feet that may alter foot condition and general health amongst the elderly.     

2015年云南省人体土源性线虫感染调查

目的　了解云南省人体土源性线虫病流行现状,为制定全省土源性线虫病防治对策提供科学依据。方法　2015年,采用分层整群随机抽样方法抽取云南省10个县（市）共20个调查点。以各调查点1岁及以上本地常住人口为调查对象,收集调查对象粪便,采用改良加藤厚涂片法检查土源性线虫虫卵并计数,并用试管滤纸培养法鉴别钩虫虫种,3~6岁儿童同时采用透明胶纸肛拭法检查蛲虫卵。结果　共粪检5 067人,检出土源性线虫感染950人,总感染率为18.75%,其中蛔虫、鞭虫、钩虫感染率分别为7.52%、8.47%、9.02%。3 ~ 6岁儿童同时采用透明胶纸肛拭法检查446人,检出蛲虫感染5人。对160例钩虫感染者采用试管滤纸培养法进行钩虫虫种鉴别,其中美洲钩虫感染139人、十二指肠钩虫感染16人、混合感染5人,分别占86.88%（139/160）、10.00%（16/160）和3.12%（5/160）。蛔虫、鞭虫和钩虫轻度感染者分别占67.98%（259/381）、88.58%（380/429）和94.53%（432/457）。调查的4个生态区中,以藏东⁃川西生态区人体土源性线虫感染率最高（31.79%）;10个调查县（市）中,以贡山独龙族怒族自治县人体土源性线虫感染率最高（50.13%）,宁蒗彝族自治县最低（0.40%）;高、中和低3类经济水平地区人体土源性线虫感染率分别为5.67%（43/759）、26.67%（610/2 287）和14.70%（297/2 021）;不同生态区、调查县和经济水平地区人体土源性线虫感染率差异均有统计学意义（χ2 = 342.20、814.60、201.34,P < 0.05）。男性土源性线虫感染率为18.21%（441/2 422）,女性为19.24%（509/2 645）,差异无统计学意义（χ2 = 0.89,P > 0.05）;各年龄组均有感染者,以1 ~ 9岁年龄组土源性线虫感染率最高（25.88%）;不同民族感染者中,以独龙族居民土源性线虫感染率最高（82.09%）;不同职业居民中,以学龄前儿童土源性线虫感染率最高（25.06%）;不同文化程度居民中,以文盲人群土源性线虫感染率最高（24.80%）;不同年龄组、民族、职业和文化程度人群土源性线虫感染率差异均有统计学意义（χ2 = 46.50、1 016.96、36.33、52.43,P 均 < 0.05）。结论　云南省人体土源性线虫感染率仍处于较高水平,应继续加强对低龄儿童、文化程度较低人群、农民、老人和少数民族居民等重点人群防治工作。     

2009—2013年云南省边境地区传染病类突发公共卫生事件流行特征分析

目的通过了解云南省边境地区传染病类突发公共卫生事件流行特征,以指导边境地区传染病防控工作。方法对2009—2013年间云南省边境地区的传染病类突发公共卫生事件资料进行整理和描述分析,资料来源于《中国疾病预防控制信息系统》。结果云南省25个边境县(市)共报告传染病类突发公共卫生事件110起,占全省疫情的16.72%。主要为一般事件(Ⅳ级),占74.55%;发病7 086例,死亡15人;疫情波及446 213人,罹患率为1.59%。甲类传染病事件4起,占3.64%;乙类46起,占41.82%;丙类33起,占30.00%;其他27起,占24.54%。事件主要发生于每年3—5和9—12月份,以水痘等呼吸道传染病为主,主要发生在学校。境外输入传染病事件6起,均为缅甸输入。结论传染病跨境输入,特别是甲类传染病跨境输入引起的突发公共卫生事件,是云南省边境地区疾病预防控制工作的一个难点和重点。     

我院2013年大肠埃希菌分布与耐药性分析

目的：了解南方医科大学附属郑州人民医院2013年大肠埃希菌分布及其对常用抗菌药物的耐药性,为临床选择抗菌药物提供参考。方法对2013年各科室标本中分离的630株大肠埃希菌进行抗菌药物敏感试验,依据2010年 CLSI 标准判读,并进行分析。结果630株大肠埃希菌中以中段尿、脓液及痰液检出最多,分别占50.00％、26.67％、17.94％。大肠埃希菌对一、二、三代头孢菌素,庆大霉素及喹诺酮类药物的耐药率较高,对阿米卡星、头孢西丁、碳青霉烯类抗菌药物、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦的敏感性好,但出现了2株耐碳青霉烯类抗菌药物的大肠埃希菌。结论大肠埃希菌是泌尿道感染的常见致病菌,其对常用的抗菌药物耐药率较高。规范使用抗菌药物对防止和延缓细菌耐药具有重要意义。     

Issues in cross‐cultural validity: Example from the adaptation,reliability, and validity testing of a Turkish version of the Stanford Health Assessment Questionnaire

Objective

Guidelines have been established for cross‐cultural adaptation of outcome measures. However, invariance across cultures must also be demonstrated through analysis of Differential Item Functioning (DIF). This is tested in the context of a Turkish adaptation of the Health Assessment Questionnaire (HAQ).

Methods

Internal construct validity of the adapted HAQ is assessed by Rasch analysis; reliability, by internal consistency and the intraclass correlation coefficient; external construct validity, by association with impairments and American College of Rheumatology functional stages. Cross‐cultural validity is tested through DIF by comparison with data from the UK version of the HAQ.

Results

The adapted version of the HAQ demonstrated good internal construct validity through fit of the data to the Rasch model (mean item fit 0.205; SD 0.998). Reliability was excellent (α = 0.97) and external construct validity was confirmed by expected associations. DIF for culture was found in only 1 item.

Conclusions

Cross‐cultural validity was found to be sufficient for use in international studies between the UK and Turkey. Future adaptation of instruments should include analysis of DIF at the field testing stage in the adaptation process.