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《Vaccine》2017,35(18):2338-2342
Background and objectivesU.S. estimates of seasonal influenza (flu) vaccine uptake in 2014–2015 were 62% for 5–12 year olds, dropping to 47% for 13–17 year olds. The Healthy People 2020 goal for these age groups is 80%. It is important to understand factors associated with influenza vaccination, especially for those ages where rates begin to decline. The objective of this study was to identify factors associated with influenza vaccination acceptance in 9–13 year old children.MethodsAn online U.S. survey of mothers of children aged 9–13 assessed children's influenza vaccine uptake in the previous season, healthcare utilization, sociodemographics, and vaccine attitudes. Multivariable logistic regression identified independent predictors of influenza vaccine status.ResultsThere were 2363 respondents (Mean age = 38 years old). Referent children were 57% female and 66% non-minority race/ethnicity with a mean age of 10.6 years. By maternal report, 59% of children had received an influenza vaccine in the previous season. Predictors of influenza vaccine uptake included a recommendation or strong recommendation from a health care provider, seeing a health care provider in the past year, positive attitudes regarding the influenza vaccine, and being a minority race. Child gender, age, insurance coverage, and whether the child had a regular healthcare provider were not associated with influenza vaccine uptake (p = n.s.).ConclusionsThis sample reported overall rates of influenza vaccine uptake similar to national surveillance data, but still lower than national goals. Provider recommendations along with health attitudes and seeing a health care provider were associated with vaccine uptake. Promising interventions may include more directive physician messaging for influenza vaccine uptake in youth, encouraging more regular well-child visits during the adolescent years, and promoting influenza vaccination at alternative sites. 相似文献
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《International journal of audiology》2013,52(5):258-261
A review of the files of 152 patients with normal hearing or slight hearing loss revealed in the older age group that (1) scores on the synthetic sentence identification task (SSI, S/N = 0 dB) have a tendency to drop in comparison with the discrimination scores for phonetically balanced words in silence (PB), and that (2) the wave V of the auditory brain-stem response shows a greater latency prolongation when the stimulation rate is increased. However, no statistical correlation between these two age-linked phenomena emerged, so they seem to be the result of two independent processes. 相似文献
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Hisahiro Tonotsuka Hajime Sugiyama Daisuke Tanaka Tatsuto Ito Ayano Amagami Keigo Yonemoto Ryuichi Sato Mitsuru Saito Keishi Marumo 《Acta orthopaedica et traumatologica turcica》2020,54(6):587
ObjectiveThe aim of this study was to analyze the contamination rates of the skin under the iodophor-impregnated plastic adhesive drape (IOD) at the time of incision closure in total hip arthroplasty (THA).MethodsA total of 225 patients undergoing primary THA (28 men, 197 women; mean age=65 years; age range=30–85) were included in this study. After asepsis using a solution of 1% chlorhexidine with 83% alcohol by volume, the surgical site was painted with a 10% povidone-iodine solution, and IOD was attached tautly at the start of surgery. Swabs of the surgical site were collected as follows: swab A from the skin before IOD application, swab B from the surface of the IOD at the time of incision closure, and swab C from the skin after peeling back the IOD. The obtained samples were promptly sent for microbiological analysis. The contamination rate was determined for swabs A, B, and C, and the contamination rate of swab C was compared with that of swabs A and B, and the bacterial species were identified.ResultsPositive cultures were seen in 8 cases (3.6%) for swab A, 10 cases (4.4%) for swab B, and 22 cases (9.8%) for swab C. The contamination rate of swab C was significantly higher than that of swabs A (p=0.008) and B (p=0.028). Coagulase-negative Staphylococcus (n=10) and Cutibacterium acnes (n=7) were the most frequently cultured microorganisms from swab C.ConclusionIn THA, the contamination rate of the skin after peeling off the IOD before incision closure was higher than that of the skin immediately after sterilization with povidone-iodine and higher than that on the IOD at the time of incision closure. The detected bacterial species were considered clinically significant pathogens. Preventive measures against infection, such as minimizing stripping of the IOD or re-sterilizing bare skin after IOD stripping, should be instituted in consideration of these findings when performing THA using IOD. 相似文献
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Cynthia Arslanian-Engoren Joseph J. Sferra Milo Engoren 《Heart & lung : the journal of critical care》2018,47(1):47-53
Background
Approximately three million U.S. adult women have heart failure (HF), increasing their risk of adverse perioperative outcomes. While gender and racial differences are reported in surgical outcomes, less is known about 30-day perioperative outcomes in HF patients.Objectives
To characterize and compare gender and racial differences in 30-day perioperative outcomes in adults with new or acute/worsening HF.Methods
The 2012–2013 American College of Surgeons National Surgical Quality Improvement Program database of surgical patients (n = 9458) with HF was analyzed. Logistic regression was used to adjust for gender and racial differences in baseline covariates.Results
No gender difference in mortality (odds ratio = 0.922, 95% confidence interval = 0.0792–1.073, p = 0.294) was noted. Whites were more likely than Blacks to die 30 days after surgery (14% vs 9%, p < 0.001); after adjustment, Blacks were more likely to experience complications and be readmitted compared to Whites.Conclusions
There was no gender difference in mortality. White patients with HF were more likely to die after surgery than Black patients. 相似文献40.
Watanabe A Kohnoe S Shimabukuro R Yamanaka T Iso Y Baba H Higashi H Orita H Emi Y Takahashi I Korenaga D Maehara Y 《Surgery today》2008,38(5):404-412
Purpose To assess the risk factors of surgical site infection (SSI) in gastrointestinal surgery.
Methods Surgical site infection surveillance was conducted in 27 hospitals.
Results The incidence of SSI in the 941 patients studied was 15.5%. The factors associated with SSI were body mass index (BMI), comorbidity,
emergency procedures, wound classification, blood loss, the suture material used for intra-abdominal ligation, the method
of subcutaneous incision, the frequency of glove changes, and the absence of subcutaneous sutures. In lower alimentary tract
procedures, additional factors influencing the incidence of SSI were sex, smoking status, operating time, the suture material
used for abdominal wound closure and seromuscular sutures, and the combined resection procedures. According to a multiple
logistic regression analysis, the independent risk factors for SSI were as follows: the type of operation, blood loss, wound
classification, emergency procedures, the frequency of glove changes, the use of subcutaneous sutures, combined resection
procedures, and the material used for seromuscular suturing.
Conclusion Strict asepsis and minimal blood loss were associated with a lower incidence of SSI following gastrointestinal surgery. The
use of absorbable suture material may be involved in reducing the risk of SSI. 相似文献