Citizen science in the community: Gaining insight in community and participant health in four deprived neighbourhoods in the Netherlands

The aim of this study was to examine if citizen science contributes to gaining insight into community health and to the health of the citizen scientists themselves. Therefore, thirteen citizens in four deprived neighbourhoods were trained as citizen scientists to conduct research in their own communities. Results showed that the citizen scientists identified forty (health related) themes in their communities. The citizen scientists reported an increase in their overall self-perceived health which, however, was not significantly demonstrated in the prequestionnaire and postquestionnaire.     

儿童社区获得性肺炎血清维生素A的变化及与免疫功能相关性

目的 研究社区获得性肺炎(community acquired pneumonia,CAP)患儿血清维生素A(vitamin A,VA)水平及与免疫功能的相关性,为肺炎病情评估提供一定参考。方法 以入住新乡医学院第一附属医院PICU的63例重度社区获得性肺炎(severe community acquired pneumonia, SCAP)患儿(SCAP组)、普通儿科病区的30例轻度社区获得性肺炎(mild community acquired pneumonia, MCAP)患儿(MCAP组),以及同期体检的30名健康儿童(对照组)为研究对象,检测其血清中VA和免疫球蛋白(immunoglobulin,Ig)G、IgA、IgM水平,及SCAP组体内T淋巴细胞亚群(总T淋巴细胞、CD4、CD8、CD4/CD8),并对SCAP组体内VA水平及以上指标的相关性进行分析。结果 3组性别和年龄差异无统计学意义;血清中VA的平均含量分别为0.36、0.25和0.19 mg/L,CAP组VA的含量较对照组明显降低,且SCAP组明显低于MCAP组(P<0.05)。根据WHO推荐的VA诊断标准,3组VA临床缺乏/亚临床缺乏率分别为10.00%、36.67%和61.90%,差异有统计学意义(P<0.05)。CAP组血清中Ig水平较对照组明显降低,且SCAP组明显低于MCAP组(P<0.05)。SCAP组血中总T淋巴细胞、CD4、CD8和CD4/CD8的平均水平分别为53.28%、30.26%、20.24%和1.59;分析VA水平与免疫相关指标关系发现VA水平与Ig(IgG、IgA、IgM)水平、总T淋巴细胞、CD4呈正相关,与CD8水平不相关。结论 肺炎患儿血清VA水平与病情严重程度及机体免疫功能相关。     

The success of Australia’s ‘No Jab,No Pay’ policy at a local level; retrospective clinical audit of a single medical practice assessing incidence of catch-up vaccinations

Vaccination is a vital health care initiative to prevent individual and population infection. To increase vaccination rates the federal government implemented the ‘No Jab, No Pay’ policy, where eligibility for several government benefits required children to be fully vaccinated by removing ‘conscientious objections’ and expanding the age range of children whose families receive benefits. This study assesses the impact of this policy at a local area within a single medical practice community in NSW, Australia. A retrospective clinical audit was performed between 2012 and 2017 on a single general practice's vaccination records for children ≤19 years. Catch-up vaccinations were assessed based on age at vaccination. Incidence of catch-up vaccinations was assessed for each of four years before and two years after the implementation of the ‘No Jab, No Pay’ policy in January 2016, along with the age of children and vaccination(s) given. Catch-up vaccinations were assessed temporally either side of implementation of ‘No Jab, No Pay’. Comparing the average annual vaccination catch-up incidence rate of 6.2% pre-implementation (2012–2015), there was an increase to 9.2% in 2016 (p < .001) and 7.8% in 2017 (p = .027). Secondary outcome measurement of catch-up vaccination incidence rates before (2012–2015) and after (2016–2017) ‘No Jab, No Pay’ implementation showed statistically significant increases for children aged 8–11 years (3.2%–5.6%, p = .038), 12–15 years (7.5%–14.7%, p < .001) and 16–19 years (3.3%–10.2%, p < .001) along with a statistically significant reduction in children aged 1–3 years (11.4%–6.2%, p = .015). Also, catch-up rates for DTPa significantly increased after program implementation. This study demonstrates that the Australian federal government vaccination policy ‘No Jab, No Pay’ was coincident with an increase in catch-up vaccinations within a rural NSW community served by one medical practice, especially for older children.     

Walking speed as a predictor of community mobility and quality of life after stroke

Background: Community mobility (CM) is considered a part of community reintegration that enhances Quality of Life (QoL). Achieving an appropriate gait speed is essential in attaining an independent outdoor ambulation and satisfactory CM.

Objective: The aim of this study was to identify whether gait speed is a predictor of CM and QoL in patients with stroke following a multimodal rehabilitation program (MRP).

Methods: This was a baseline control trial with 6-months follow-up in an outpatient rehabilitation setting at a university hospital. Twenty-six stroke survivors completed the MRP (24 sessions, 2 days/wk, 1 hr/session). The MRP consisted of aerobic exercise, task-oriented exercises, balance exercises and stretching. Participants also performed an ambulation program at home. Outcome variables were: walking speed (10-m walking test) and QoL (physical and psychosocial domains of Euroquol and Sickness Impact Profile).

Results: At the end of the intervention, comfortable and fast walking speed increased by an average of 0.16 (SD 0.21) (*p < .05) and 0.40 (SD 0.51) (**p < .001) m/s, respectively. After the intervention, all participants achieved independent outdoor ambulation with an increase of 34.14 of walking minutes/day in the community and a decrease of sitting time of 95.45 minutes/day. Regarding QoL there were increased mean scores on the physical and psychosocial dimensions of Euroquol and the Sickness Impact Profile, respectively (**p < .001).

Conclusions: The results suggest that improved walking speed after the MRP is associated with CM and higher scores in QoL. These findings support the need to implement rehabilitation programs to promote increased speed.