新疆多民族膝骨关节炎病人股骨后髁角的测量及其临床意义

目的 测量新疆地区多民族膝骨关节炎病人股骨后髁角（posterior condylar angle，PCA）并探讨其临床意义。方法 2020年1月至2020年12月，对我科收治的因膝骨关节炎行全膝关节置换术（total knee arthroplasty，TKA）的381例（729膝）病人行膝关节CT扫描，其中男103例，女278例；汉族223例，维吾尔族108例，哈萨克族50例；年龄为（68.5±7.3）岁（46~89岁）；左膝363个，右膝366个；其中259例（458膝）同时完善膝关节MRI扫描。通过与股骨机械轴垂直的断层图像测量外科经股骨上髁轴（surgical transepicondylar axis，STEA）和股骨后髁线（posterior condylar line，PCL），测量PCA值。比较不同民族、性别、侧别之间的PCA值。结果 根据MRI测得的PCA为2.97°±1.47°，根据CT测得的PCA为3.01°±1.49°，CT与MRI测量得到的PCA值比较，差异无统计学意义（P=0.732）。不同民族的PCA比较，汉族：3.13°±1.51°、维吾尔族：2.81°±1.48°、哈萨克族：2.85°±1.39°，汉族的PCA大于维吾尔族，差异有统计学意义（P=0.011）；不同侧别的PCA比较，左侧：3.16°±1.53°、右侧：2.85°±1.44°，左侧PCA大于右侧，差异有统计学意义（P=0.005）；男性与女性人群的PCA比较，差异无统计学意义（P=0.168）。维吾尔族男性病人的PCA小于女性，差异有统计学意义（P＜0.001）；汉族病人左侧的PCA大于右侧，差异有统计学意义（P=0.005）。结论 新疆地区膝骨关节炎病人行TKA时可采用CT或MRI测量PCA，以PCL外旋3°截骨可实现相对匹配的股骨旋转对线，汉族病人左膝PCL外旋截骨稍＞3°，维吾尔族男性病人PCL外旋截骨＜3°，提倡联合多种方法校准股骨旋转对线。     

The development of a questionnaire to assess past year physical activity in a multi-ethnic/racial urban population

SummaryObjectives Describe the development of a questionnaire to assess past year physical activity, including activities of daily living, in a multi-ethnic/racial cohort. Describe energy expenditure (EE) patterns in the sample used for questionnaire development.Methods 24-hour activity recalls were collected from a convenience sample (N=367) at four New York City health agencies (October 1999–February 2000). EE was determined at the population, subgroup, and individual level. EE distributions were compared.Results Activities identified were similar to those on established questionnaires. Subgroup and individual EE differences were noted. Median EE at the Chinese and Puerto Rican sites were lower than those at the Caribbean or Dominican sites. No clear age pattern was apparent. Overall, a greater percentage of daily EE was spent in low intensity activities. The resultant 30-minute interviewer-administered questionnaire ascertains patterns (frequency and duration) of domain-specific (recreational, household, occupational, and transportation) activity. This information combined with published intensity levels provides summary EE measures.Conclusion Variation in EE levels requires information on activity type and amount. Summary activity measures can be used to rank individuals analogous to nutrient food frequency measures.

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ZusammenfassungZiele Beschreibung der Entwicklung eines Fragebogens zur Erhebung der körperlichen Aktivität, einschliesslich Alltagsaktivitäten, während der letzten 12 Monate in einer multiethnischen Kohorte. Beschreibung der Energieverbrauchsprofile in der zur Entwicklung des Fragebogens verwendeten Stichprobe.Methoden 24-Stunden-Aktivitäts-Erinnerungsprotokolle wurden für eine Gelegenheitsstichprobe (N=367) aus vier Gesundheitszentren von New York City erhoben (Oktober 1999–Februar 2000). Der Energieverbrauch wurde für die Gesamtpopulation, Untergruppen und die einzelnen Individuen bestimmt.Resultate Die identifizierten Aktivitäten sind mit jenen bereits existierender Fragebogen vergleichbar. Für Untergruppen und auf individuellem Niveau wurden Unterschiede im Energieverbrauch festgestellt. In den chinesischen und porto-ricanischen Zentren war der mediane Energieverbrauch geringer als in den karibischen und dominikanischen Zentren. Es wurden keine klaren Unterschiede zwischen verschiedenen Altersgruppen festgestellt. Im Allgemeinen wurde täglich prozentual mehr Energie mit Aktivitäten geringer Intensität verbraucht. Der auf Grundlage dieser Resultate entwickelte Fragebogen wird in einem persönlichen Interview von ca. 30 Minuten Dauer angewendet und erfasst Muster (Häufigkeit und Dauer) spezifischer Aktivitäten aus den Bereichen Freizeit, Haushalt, Beruf und Transport. Eine Kombination der so erhobenen Information mit publizierten Intensitätsniveaus liefert Gesamtwerte des Energieverbrauchs.Schlussfolgerung Aufgrund der Variationen im Niveau des Energieverbrauchs sind Angaben zu Art und Dauer der Aktivitäten notwendig. Die Gesamtwerte des Energieverbrauchs eignen sich zur Rangierung der Individuen, wie dies für Verzehrsdaten bei Food-Frequency-Fragebogen üblich ist.

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RésuméObjectifs Décrire le développement d'un questionnaire évaluant l'activité physique de l'année précédente et inclure les activités de la vie quotidienne dans une cohorte multiethnique. Décrire les profils de dépense énergétique dans l'échantillon utilisé pour développer le questionnaire.Méthodes Les rappels de l'activité de 24 heures ont été récoltés dans un échantillon de convenance (N=367) dans quatre centres de santé de la ville de New York (octobre 1999 à février 2000). La dépense énergétique a été déterminée au niveau de la population, du sous-groupe et de l'individu.Résultats Les activités identifiées sont semblables à celles d'autres questionnaires. Ii y avait des différences de dépense énergétique au niveau individuel et de sous-groupe. La dépense énergétique médiane dans les sites chinois et portoricains était inférieure à celle des sites caribéens et dominicains. Il n'y avait pas de changements apparents liés à l'âge. En général, un fort pourcentage de la dépense énergétique quotidienne résulte d'activités de faible intensité. Le questionnaire qui a été développé à partir de ces résultats est administré par un interviewer, dure 30 minutes et identifie les modes (fréquence et durée) d'activités dans des domaines spécifiques (loisirs, domicile, professionnel et transports). Cette information, combinée à des niveaux d'intensité publiés dans la littérature, permet d'obtenir une mesure synthétique de l'énergie dépensée.Conclusions La variation de la dépense énergétique requiert une information sur le type et la quantité d'activité. Les mesures synthétiques peuvent être utilisées pour classer les individus selon la dépense énergétique comme on le fait pour l'apport énergétique avec les questionnaires de fréquence alimentaire.

     

Sociodemographic and substance use correlates of tobacco use in a large, multi-ethnic sample of emergency department patients

Strong evidence suggests marked disparities among ethnic minorities in relation to tobacco use. To date, a majority of the data available discusses tobacco use in the general population. Using a sample of Latino, non-Latino Black (NLB), and non-Latino White (NLW) patients presenting to the emergency departments, the present study examined sociodemographic and substance use correlates of past 3-month tobacco use. Over 48,000 patients were interviewed as part of a screening and brief intervention program in southern California. Overall, although NLB adults reported the greatest prevalence of tobacco use compared to NLWs and Latinos (43% vs. 34% and 22% respectively), associations between tobacco use, demographics and substance use were similar across groups. Males, younger individuals, those with lower income, and being at higher risk for alcohol and drug use were more likely to report recent tobacco use. Future tobacco interventions in emergency settings should highlight these specific risk factors for Latinos, NLBs, and NLWs.     

Skittish,shielded, and scared: Relations among behavioral inhibition,overprotective parenting,and anxiety in native and non-native Dutch preschool children

This study examined behavioral inhibition and overprotective parenting as correlates and predictors of anxiety disorder symptoms in preschoolers with a multi-cultural background (N = 168). Parents of 3- to 6-year-old children completed a set of questionnaires twice, 12 months apart. Parents were also interviewed with the Anxiety Disorders Interview Schedule for DSM-IV at the 12-month point to assess the clinical severity of children's anxiety symptoms. Behavioral inhibition consistently emerged as a significant concurrent correlate of anxiety symptoms and this was particularly true for social anxiety symptoms. Overprotective parenting also emerged as a significant correlate of anxiety, but only in the case of non-social anxiety symptoms and mainly in non-native Dutch children. Prospective analyses revealed that behavioral inhibition was a significant predictor of social anxiety symptoms, while overprotective parenting did not explain significant variance in the development of children's anxiety over time. The support for an interactive effect of behavioral inhibition and overprotective parenting was unconvincing. Finally, it was found that children who exhibited stable high levels of behavioral inhibition throughout the study ran the greatest risk for developing an anxiety disorder.     

The effectiveness of a structured group education programme for people with established type 2 diabetes in a multi-ethnic population in primary care: A cluster randomised trial

Background and aimsStructured self-management education has been shown to be effective in type 2 diabetes (T2DM) but more research is needed to look at culturally appropriate programmes in ethnic minority groups, where prevalence of T2DM is higher and diagnosis earlier. The study tested the effectiveness of a group education programme for people with established T2DM in a multi-ethnic primary care population.Methods and resultsCluster randomised trial conducted in two multi-ethnic UK sites. Practices were randomised (1:1) to a structured T2DM group education programme or to continue with routine care. A culturally-adapted version was offered to South Asians, who formed the majority of ethnic minority participants. Other ethnic minority groups were invited to attend the standard programme. Primary outcome was change in HbA1c at 12 months. All analyses accounted for clustering and baseline value.367 participants (64(SD 10.8) years, 36% women, 34% from minority ethnic groups) were recruited from 31 clusters. At 12 months, there was no difference in mean change in HbA1c between the two groups (?0.10%; (95% CI: ?0.37, 0.17). Subgroup analyses suggested the intervention was effective at lowering HbA1c in White European compared with ethnic minority groups. The intervention group lost more body weight than the control group (?0.82 kg at 6 months and ?1.06 kg at 12 months; both p = 0.03).ConclusionOverall, the programme did not result in HbA1c improvement but in subgroup analysis, a beneficial effect occurred in White Europeans. Findings emphasise a need to develop and evaluate culturally-relevant programmes for ethnic minority groups.     

Validation of the English version of the Asthma Quality of Life Questionnaire in a multi-ethnic Asian population

The purpose of study was to assess the validity, reliability and acceptability of the English version of the Asthma Quality of Life Questionnaire in a multi-ethnic Asian population. The English version of the Standardized Asthma Quality of Life Questionnaire (AQLQ-S) and the Asthma Control Questionnaire (ACQ) were self-completed by 119 English-speaking Chinese, Malay and Indian asthmatic subjects, aged 17-78. Spirometric measurements, peak expiratory flow rate, current clinical symptoms and treatment requirements were documented. Reliability and responsiveness were analyzed in a subgroup of 57 patients who were reassessed 6 weeks later. The Cronbach alpha reliability coefficient for internal consistency of the AQLQ-S was 0.97 (0.96-0.98) for the overall score. The intraclass correlation coefficient (ICC) overall score was 0.97 (95% CI: 0.94-0.99) while the responsiveness index was 1.29 with strong longitudinal validity for clinical and spirometric measures of asthma severity and asthma control score (p < 0.001). The results of this study showed that the English version of the AQLQ-S is a sensitive and valid instrument for measuring health-related quality of life in asthmatic subjects from a multi-ethnic Asian population.     

Vaccine hesitancy among parents in a multi-ethnic country,Malaysia

BackgroundVaccine hesitancy is a threat in combating vaccine-preventable diseases. It has been studied extensively in the Western countries but not so among Asian countries.ObjectivesTo assess the test-retest reliability of the Parent Attitudes about Childhood Vaccines (PACV) questionnaire in Malay language; to determine the prevalence of vaccine hesitancy among parents and its associations with parents' socio-demographic characteristics.MethodsForward and backward translation of PACV in Malay language was carried out. The reliability of the Malay-PACV questionnaire was tested among parents with children. The same questionnaire was used to study vaccine hesitancy among parents in a tertiary hospital in Kuala Lumpur. Information pertaining to socio-demographic characteristics, sources of information regarding vaccination and vaccine hesitancy were collected. Associations between vaccine hesitancy with socio-demographic factors were tested using Multivariable Logistic Regression.ResultsThe Spearman correlation coefficient and Cronbach alpha for total PACV was 0.79 (p < 0.001) and 0.79 respectively. The intra-class correlation coefficients of the subscales ranged from 0.54 to 0.90 demonstrating fair to excellent reliability. A total of 63 (11.6%) parents were noted to be vaccine hesitant. In the univariate analyses, vaccine hesitancy was associated with unemployed parents, parents who were younger, had fewer children and non-Muslim. In the multivariate model, pregnant mothers expecting their first child were four times more likely to be vaccine hesitant compared to those who already had one or more children (aOR: 3.91, 95% CI: 1.74–8.79) and unemployed parents were also more likely to be vaccine hesitant (aOR: 1.97, 95% CI: 1.08–3.59). The internet (65.6%) was the main source of information on vaccination followed by brochures (56.9%).ConclusionThe Malay-PACV questionnaire is reliable to be used. The prevalence of vaccine hesitancy among the multi-ethnic Malaysians was comparable with other populations. Pregnant mothers expecting their first child and unemployed parents were found to be more vaccine hesitant.     

贵州省14个民族育龄女性叶酸代谢关键酶基因位点多态性调查

目的调查贵州省多民族育龄女性叶酸代谢关键酶MTHFR(C677T,A1298C),MTRR A66G基因多态性,获取本地区多民族育龄女性叶酸利用能力情况,同时为叶酸营养增补方案提供分子医学理论依据,更好地指导孕期保健。方法选取2018年2月至2019年10月在本院产科进行备孕及孕期检查的女性作为研究对象,共计7761例(其中汉族6317例、苗族349例、布依族292例、土家族265例、侗族158例、彝族81例、仡佬族71例、穿青族64例、回族38例、白族35例、壮族35例、满族23例、黎族20例、仫佬族13例)。采集并提取研究对象口腔黏膜上皮脱落细胞,抽提DNA,利用荧光定量PCR方法检测并分析受检者MTHFR(C677T,A1298C)和MTRR(A66G)基因分型情况。结果贵州省汉族育龄女性MTHFR C677T位点基因型和等位基因频率与当地苗族、布依族、侗族育龄女性相比差异有统计学意义(P<0.05),与其他少数民族(土家族、彝族、仡佬族、穿青族、回族、白族、壮族、满族、黎族、仫佬族)相比无显著性差异(P>0.05);贵州省汉族与苗族、布依族育龄女性MTHFR A1298C位点基因型和等位基因频率相比有显著性差异,与其他少数民族(土家族、侗族、彝族、仡佬族、穿青族、回族、白族、壮族、满族、黎族、仫佬族)相比无显著性差异;贵州省汉族育龄女性MTRR A66G位点基因型与当地土家族、穿青族、白族育龄女性比较有统计学意义,汉族育龄女性MTRR A66G位点等位基因频率与当地布依族、土家族相比有显著性差异,与其他民族比较无统计学意义。结论贵州省多民族育龄女性叶酸代谢关键酶基因位点多态性有其自身特点,部分与当地汉族育龄女性有区别,具有民族特性,可以有针对性地制定符合当地民族特征的个性化叶酸补服方案。     

汉、壮、瑶、苗、侗5个民族在校大学生的骨密度比较研究

目的了解广西多民族在校大学生的骨密度现状及其差异性,为提高多民族在校大学生骨密度水平和预防骨质疏松提供理论依据。方法随机抽取广西某高校汉族、壮族、瑶族、苗族及侗族共2726名在校大学生,采用超声骨密度仪测量右跟骨骨密度,包括骨质指数、T值和Z值。结果男性在校大学生的骨质指数、T值及Z值民族间差异均无统计学意义(P0.05);女性在校大学生的骨质指数民族间差异有统计学意义(P0.05),其中汉壮、汉瑶女大学生组间的骨质指数差异有统计学意义(P0.05),而女大学生的T值和Z值民族间差异均无统计学意义(P0.05)。结论广西多民族在校大学生的骨密度水平差异无统计学意义,仅有在校女大学生的骨质指数存在民族差异。建议在校大学生应加强锻炼、均衡饮食和补充钙类食物的摄入,提高骨质健康。     

Knowledge of gestational diabetes among a multi-ethnic cohort in Australia

Objectiveto explore knowledge about gestational diabetes (GDM) among a multi-ethnic sample of women who were receiving antenatal care in Melbourne, Australia.Designcross-sectional comparative survey.Settingdiabetes clinic located in a public hospital in Melbourne's Western suburbs.Participants143 pregnant women with GDM from Vietnamese, Indian, Filipino and Caucasian backgrounds.Findings200 questionnaires were distributed and 143 were returned (response rate 71.5%). There were statistically significant differences between ethnic groups in terms of educational level (p=0.001) and fluency in English (p=0.001). Educational levels, measured in completed years of schooling, were lowest among Vietnamese [mean 8.5 years, standard deviation (SD) 1.0], Filipino (mean 8.9 years, SD 1.5) and Caucasian [mean 10.2 years, SD 0.9] women. Indian women had a higher mean level of education (11.6 years, SD 0.9). Fluency in English was reported by 100% of Caucasian, Indian and Filipino women, but 53.3% of Vietnamese women required interpreter services. The women's answers varied with ethnicity and educational status. Vietnamese and Filipino women displayed the least knowledge about GDM and food values. Caucasian women also scored poorly on general knowledge about GDM. Indian women scored highest across all areas of interest.Key conclusionsVietnamese women had the poorest English skills and lowest educational levels, and were identified as the group at greatest risk of misunderstanding GDM. English language proficiency alone, however, was not associated with better comprehension of GDM in this study. Higher educational level was the only factor linked to increased comprehension. It is, therefore, important that new educational strategies are developed to address lower health literacy as well as cultural factors when caring for multi-ethnic populations with GDM. This approach may also serve to address lower levels of comprehension among Caucasian populations.