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1.
《Vaccine》2022,40(5):706-713
BackgroundThe COVID-19 pandemic has disrupted healthcare, including immunization practice and well child visit attendance. Maintaining vaccination coverage is important to prevent disease outbreaks and morbidity. We assessed the impact of the COVID-19 pandemic on pediatric and adolescent vaccination administration and well child visit attendance in the United States.MethodsThis cross-sectional study used IBM MarketScan Commercial Database (IMC) with Early View (healthcare claims database) and TriNetX Dataworks Global Network (electronic medical records database) from January 2018–March 2021. Individuals ≤ 18 years of age who were enrolled during the analysis month of interest (IMC with Early View) or had ≥ 1 health encounter at a participating institution (TriNetX Dataworks) were included. We calculated the monthly percent difference between well child visit attendance and vaccine administration rates for 10 recommended pediatric/adolescent vaccines in 2020 and 2021 compared with 2018–2019. Data were stratified by the age groups 0–2 years, 4–6 years, and 9–16 years.ResultsIn IMC with Early View, the average monthly enrollment for children 0–18 years of age was 5.2 million. In TriNetX Dataworks, 12.2 million eligible individuals were included. Well child visits and vaccinations reached the lowest point in April 2020 compared with 2018–2019. Well child visit attendance and vaccine administration rates were inversely related to age, with initial reductions highest for adolescents and lowest for ages 0–2 years. Rates rebounded in June and September 2020 and stabilized to pre-pandemic levels in Fall 2020. Rates dropped below baseline in early 2021 for groups 0–2 years and 4–6 years.ConclusionsWe found substantial disruptions in well child visit attendance and vaccination administration for children and adolescents during the COVID-19 pandemic in 2020 and early 2021. Continued efforts are needed to monitor recovery and catch up to avoid outbreaks and morbidity associated with vaccine-preventable diseases.  相似文献   
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目的 预测“十四五”期间我国城乡人口和基层医疗卫生机构“2 + X”家庭医生团队数量,探究我国城乡家庭医生服务覆盖情况,为家庭医生健康发展提供科学依据。方法 依据2013—2019年相关数据,采用GM(1,1)灰色预测模型预测2020—2025年我国城乡人口数和“2 + X”家庭医生团队数量和相关卫技人员数。观察每 2000 服务人口标准下,2018—2025年我国城乡“2 + X”家庭医生团队服务人数和服务覆盖率。结果 2020—2025年我国城镇人口数逐年增长,到2025年增至98 831万人;城市基层医疗卫生机构全科医生数、注册护士数、家庭医生团队数量逐年增长,到2025年分别增至171 712人、848 324人、171 712个;全科医生与护士比逐年上升,到2025年升至1∶4.94;2018—2025年我国城市“2 + X”家庭医生团队服务人口覆盖率逐年上升,到2025年升至35%。2020—2025年我国乡村人口数逐年下降,到2025年降至48 053万人;乡镇基层医疗卫生机构全科医生数、注册护士数、家庭医生团队数量逐年增长,到2025年分别增至447 672人、854 976人、447 672个;全科医生与护士比逐年下降,到2025年降至1:1.91;2018—2025年我国乡村“2 + X”家庭医生团队服务人口覆盖率逐年上升,理论上2022年实现全面覆盖。结论 2018—2025年我国城乡“2 + X”家庭医生团队数量逐年增加,但城市家庭医生缺口较大,应加强全科医学人才培养,增强家庭医生职业吸引力,缩小城乡全科医生薪资差距,优化家庭医生服务覆盖均衡性。  相似文献   
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目的 本研究针对成都市基层医疗卫生服务机构,调查分析了家庭医生服务开展现况、存在的问题,以及家医服务平台的建设情况并提出了改进建议。方法 本研究共抽取了成都市六个基层社区卫生服务机构,对每家机构的1名管理人员和1个家庭医生团队分别进行深入访谈和专题小组访谈,调查时间为2020年12月—2021年2月。结果 成都市双向转诊取得一定成效,但下转难情况依然突出;有偿签约效果不好,居民就诊观念需转变;基层卫生技术人员不足,家医服务增加了日常工作量;家医信息化平台存在诸多问题,功能亟需改善;家医的绩效考核制度有一定激励作用,但仍需完善;基层卫生投入不足,家医政策落地难。结论 规范分级诊疗秩序,畅通双向转诊通道;加强官方媒体宣传力度,转变居民就诊观念;提升基层职业吸引力,培养优质人才;加强信息化建设,完善家庭医生信息化服务平台;健全家庭医生绩效考核制度,调动工作积极性;完善家医配套政策与措施,强化基层机构服务能力。  相似文献   
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Introduction and objectivesNon-alcoholic steatohepatitis (NASH) is a severe form of non-alcoholic fatty liver disease (NAFLD) that can progress to liver cirrhosis, liver failure and hepatocellular carcinoma. It is the second leading cause of liver transplant in the US. We aim to investigate the prevalence, demographics and risk factors NASH patients in the US.Patients and methodsWe used a large database (Explorys IBM) that aggregates electronic health records from 26 nationwide healthcare systems. We identified adults with NASH between 2010-2020. Demographics including age, gender and race were collected. NASH risk factors including Diabetes Millets (DM), Hyperlipidemia (HLD), Hypertension (HTN) and Obesity were also collected. Cochran-Armitage test was used to assess the statistical significance of year-by-year trend. Univariable and multivariable logistic regression were used to estimate the odds ratio (OR) of risk factors.ResultsNASH annual prevalence rate increased from 1.51% in 2010 to 2.79% in 2020 (p < 0.0001). The proportion of patients with NASH by gender was 54.1% female vs 45.9% male (OR 1.04 [0.91-1.11]). Caucasian had higher odds of NASH than non-Caucasian (OR 1.42 [1.31-1.54]). NASH is strongly associated with DM and obesity (OR 18.61 [17.35-19.94]) and (OR 20.97 [17.87-23.21]), respectively. Other components of metabolic syndrome were associated with NASH to a lesser degree; HTN (OR 3.24 [3.20-3.28]) and HLD (OR 4.93 [4.85-4.01]).ConclusionThe prevalence of NASH has significantly increased in the US in the last decade. This is likely related to the increased prevalence of risk factors as well as increased awareness of the disease.  相似文献   
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BackgroundObesity in children contributes to higher risks of various chronic diseases in adulthood and the prevalence has increased worldwide including Japan.ObjectivesThis study aims to examine the association between sleep duration at night in children aged 2.5 years and the subsequent risk of obesity at age 5.5 years.MethodsThis study is embedded in the Longitudinal Survey on Babies Born in the 21st Century, which recruited families who had a child born in Japan in 2001. The multivariable logistic regression models were applied to calculate odds ratios (OR) and 95 % confidence intervals (CI) of childhood obesity at 5.5 years, defined as percentage of overweight (POW) ≥ 20 % and body mass index (BMI) ≥ 95th percentile of this study population according to sleep duration at night collected at 2.5 years child age.ResultsAmong 25,378 children, 2.6 % and 3.7 % were obese at age 5.5 years defined by POW and BMI respectively. Compared with night sleep duration > 11 h/d, shorter sleep durations in 2.5 years-old children were associated with higher risk of obesity at 5.5 years; the multivariable ORs (95 %CI) were 1.05 (0.81–1.35), 1.23 (0.93–1.62) and 1.54 (1.04–2.31) for sleep duration 10, 9 and ≤ 8 h/d, respectively; p-trend = 0.03. The observed association differed according to the children (child’s sex, napping habits, and children frequently play at park), and family characteristics (mother’s age at delivery and mother’s level of education).ConclusionShort night sleep duration among girls aged 2.5 years was associated with risk of obesity at age 5.5 years, suggesting the importance of sufficient sleep duration at night for the prevention of obesity.  相似文献   
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目的:观察家庭远程锻炼指导在社区老年肌少症危险人群中的应用效果。方法:选取110名社区老年肌少症危险人群为研究对象,按照随机数字表法将其分为对照组与观察组各55名。对照组给予常规健康教育,观察组在对照组基础上采用家庭远程锻炼指导,比较两组教育前后体质量指数(BMI)、肌肉率、脂肪率、握力水平、步速、5次起坐时间、运动功能[老年人运动功能量表(GLFS-25)]评分和跌倒效能[跌倒效能量表(FES)]评分。结果:教育后,两组肌肉率比较,差异无统计学意义(P>0.05);观察组BMI高于对照组,脂肪率低于对照组,差异有统计学意义(P<0.05);观察组握力水平和步速均高于对照组,5次起坐时间短于对照组,差异有统计学意义(P<0.05);观察组GLFS评分低于对照组,FES评分高于对照组,差异均有统计学意义(P<0.05)。结论:在常规健康教育基础上采用家庭远程锻炼指导可提高社区老年肌少症危险人群BMI、握力水平和步速,缩短5次起坐时间,以及降低脂肪率、GLFS评分,提高FES评分,其效果优于单纯常规健康教育。  相似文献   
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《Saudi Pharmaceutical Journal》2022,30(10):1497-1506
BackgroundAcute childhood diarrhea is one of the most common causes of dehydration, and if severe, can potentially lead to death as well. The present study was aimed at evaluating the knowledge and attitudes of community pharmacy professionals towards the management of acute childhood diarrhea and comparing them with their actual practices in Jazan Province, Kingdom of Saudi Arabia (K.S.A).MethodsSimulated patient visits and a cross-sectional survey making use of a 27-item self-report questionnaire were conducted amongst a sample of 303 community pharmacy professionals (51.2 % male and 48.8 % female) with an age range of 25–56 years, between August 1 and December 1, 2021, in Jazan Province, Saudi Arabia. Convenience sampling technique was used for the recruitment of the participants.ResultsSignificant positive correlations were seen between knowledge score (self-report survey) and practice score (simulated patient visit) regarding patients’ history taking (r = 0.65; p < 0.01), drug recommendations (r = 0.71; p < 0.01) and providing information regarding food and fluid intake (r = 0.44; p < 0.01). The alpha coefficients for all the items of the survey instrument were noted to be greater than (or) equal to the 0.70 threshold for almost all sections, hence indicating good reliability and internal consistency of the developed scale.ConclusionIn the present study, even though we observed improved participants’ performance during the self report survey, their performance level greatly dropped in actual practice. This warrants for a need for educational programs to improve their actual dispensing practices. The present study has also shown simulated patient visits to be a reliable, simple and a robust method of assessing the actual dispensing practices of community pharmacy professionals.  相似文献   
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目的 分析西安市2015—2018年百日咳流行病学特征,为预防和控制百日咳传播提供参考。方法 采用描述流行病学方法,对中国疾病预防控制信息系统中2015—2018年期间西安市百日咳报告病例和此期间西安市百日咳哨点监测病例的数据进行统计学分析。结果 西安市2015—2018年共报告百日咳确诊病例1 635例,发病率分别为3.97/10万、4.11/10万、4.85/10万和5.28/10万,发病有逐年上升趋势(χ2趋势 = 21.719,P<0.001);高发季为3—8月(2015—2018年分别占该年度总发病数的75.73%、66.76%、78.97%和80.27%);以3~6月龄发病比例最高(2015—2018年分别占该年度总发病数的50.58%、48.60%、48.36%和41.22%);未全程接种疫苗患儿所占比例最大(2015—2018年分别为36.26%、23.74%、42.76%和33.73%),未到接种年龄就发病所占比例有逐年升高趋势(χ2趋势 = 10.302,P = 0.001),无免疫史患儿比例呈逐年降低趋势(χ2趋势 = 36.088,P<0.001);3种实验室检测方法中荧光PCR的检出率最高(40.12%);传播模式除了散发病例,出现了家庭聚集现象,且所有流行病学相关病例均被漏诊或误诊。结论 西安市近年来百日咳发病率有明显上升趋势,<6月龄婴儿为主要发病人群,百日咳的日常监测仍有待加强,且其家庭聚集式传播现象值得关注。  相似文献   
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