青少年网络使用卷入度与心理动机的关系研究及量表编制

目的 探讨青少年网络使用卷入度的有效测量指标;分析青少年网络使用心理动机的特征及与网络使用卷入度间的关系.方法 结合已有文献和深度访谈编制问卷,对青少年进行调查,对数据进行信度和效度检验、探索性因素分析和验证性因素分析.结果 网络使用卷入度的测量模型与数据拟合符合统计要求(x2=3.58,P =0.311,x2/df=1.192 ＜3,RSMEA =0.014);青少年网络使用心理动机分为情感获取性和信息获取性动机两个维度,均与网络使用卷入度各项指标存在正相关;心理动机和网络使用卷入度的关系模型与数据拟合达到统计学要求(x2=11.32,P=0.333＞0.05,x2/df=1.33 ＜3,RSMEA =0.011),情感获取性动机路径系数(0.875)大于信息获取性动机(0.640).结论 上网广度、上网时长、上网方式多样性、上网地点多样性和网络技能等5项指标对青少年网络使用卷入度具有较好的预测作用;情感获取性动机对网络使用卷入度的影响更大.     

Agreement between state registry,health record,and self-report of influenza vaccination

BackgroundDocumentation of influenza vaccination, including the specific product received, is critical to estimate annual vaccine effectiveness (VE).MethodsWe assessed performance of the Michigan Care Improvement Registry (MCIR) in defining influenza vaccination status relative to documentation by provider records or self-report among subjects enrolled in a study of influenza VE from 2011 through 2019.ResultsThe specificity and positive predictive value of MCIR were high; however, >10% of vaccinations were identified only by other sources each season. The proportion of records captured by MCIR increased from a low of 67% in 2013–2014 to a high of 89% in 2018–2019, largely driven by increased capture of vaccination among adults.ConclusionsState vaccine registries, such as MCIR, are important tools for documenting influenza vaccination, including the specific product received. However, incomplete capture suggests that documentation from other sources and self-report should be used in combination with registries to reduce misclassification.     

Agreement between qualitative exposure estimates and quantitative exposure measurements

A method for qualitative estimation of the exposure at task level was used and validated with actual measurements in five small factories. The results showed that occupational hygienists were in general the most successful estimators. Plant supervisors and workers handled the estimation method less successfully because of more misclassification of the tasks. The method resulted, in general, in a classification of tasks in four exposure categories ranging from no exposure to high exposure. The exposure categories correlated positively with mean concentrations, but showed overlapping exposure distributions. This resulted in misclassification of the exposure for individual workers when a relatively large interindividual variability in exposure levels within an exposure category was present. The results show that this method can be used for workplace exposure zoning, but that the usefulness of the estimates for epidemiological purposes is not clear-cut and depends strongly on the actual exposure characteristics within a workplace. A combination of the qualitative exposure estimation method together with assessment of the exposure levels by measurements makes a rearrangement of tasks or individual workers possible and could improve the validity of this method for epidemiological purposes.     

Integration between epidemiology and Internet

The objective of this study is to present some theoretical reflections on Internet as an integration tool in an epidemiology service. Considering this perspective, it focuses epidemiology and Internet; Internet and cooperative research, and the importance of Internet in the epidemiological communication process. The integration between the epidemiological knowledge and the use of Internet to globalize knowledge is emphasized as one of the most important benefits this technology brings. However, it is indicated that this technology by itself is not the solution for functional problems in the health information system.     

Automated, laboratory-based system using the Internet for disease outbreak detection, the Netherlands

Rapid detection of outbreaks is recognized as crucial for effective control measures and has particular relevance with the recently increased concern about bioterrorism. Automated analysis of electronically collected laboratory data can result in rapid detection of widespread outbreaks or outbreaks of pathogens with common signs and symptoms. In the Netherlands, an automated outbreak detection system for all types of pathogens has been developed within an existing electronic laboratory-based surveillance system called ISIS. Features include the use of a flexible algorithm for daily analysis of data and presentation of signals on the Internet for interpretation by health professionals. By 2006, the outbreak detection system will analyze laboratory-reported data on all pathogens and will cover 35% of the Dutch population.     

Agreement between symptom surveys, physical examination procedures and electrodiagnostic findings for the carpal tunnel syndrome.

OBJECTIVES: The goal of this study was to evaluate the concordance between various clinical screening procedures for carpal tunnel syndrome. METHODS: The subject population consisted of 824 workers from 6 facilities. The evaluated procedures included bilateral sensory nerve conduction testing, physical examinations, and symptom surveys, including hand diagrams. The agreement between the outcomes of various combinations of these procedures was assessed by determining the kappa coefficient. RESULTS: There was relatively poor overlap between the reported symptoms, the physical examination findings, and the electrodiagnostic results consistent with carpal tunnel syndrome. Overall, only 23 out of 449 subjects (5%) with at least 1 positive finding met all 3 criteria (symptoms, physical examination findings, and electrophysiological results consistent with carpal tunnel syndrome) for the dominant hand. The screening procedures showed poor or no agreement with kappa values ranging between 0.00 and 0.18 for all the case definitions evaluated for carpal tunnel syndrome. CONCLUSIONS: The poor overlap between the various screening procedures warns against the use of electrodiagnostic findings alone without the symptom presentation being considered. The results of this study also point to a need for the further development and evaluation of methods for detecting carpal tunnel syndrome.     

Agreement between body mass index,calf circumference,arm circumference,habitual energy intake and the MNA in hospitalized elderly

Objectives  

This study aimed to assess the agreement between body mass index, calf circumference, arm circumference, habitual energy intake and the mini nutritional assessment (MNA) and then assess the accuracy of these parameters in relation to the MNA.     

南京市城区居民身高、体重和腰围自我报告值与客观测量值的一致性分析

目的 评价南京市城区居民身高、体重和腰围自我报告值与客观测量值的一致性。方法 采用多阶段抽样方法,抽取南京市建邺区11个社区年满18周岁的常住居民进行面对面问卷调查及体格检查。不同方法收集数据之间的一致性分析采用Kappa和Bland-Altman分析。结果 调查对象身高、体重、腰围和身体质量指数（body mass index,BMI）知晓率分别为91.1%、90.4%、54.5%和88.9%。调查对象自我报告高估身高值0.47 cm、低估腰围和BMI值分别为0.39 cm和0.14 kg/m²,差异均具有统计学意义（均有P<0.001）。BMI分组自我报告值与客观测量值的总体一致率为90.7%（kappa值=0.847）。Bland-Altman分析显示身高、体重、腰围和BMI自我报告与客观测量数据的差值超出95%一致性限范围的点均小于10%。结论 南京市城区居民身高、体重和腰围自我报告值与客观测量值的一致性良好。     

Exploring the relationship between macroeconomic conditions and problem drinking as captured by Google searches in the US

There is considerable policy interest in the impact of macroeconomic conditions on health-related behaviours and outcomes. This paper sheds new light on this issue by exploring the relationship between macroeconomic conditions and an indicator of problem drinking derived from state-level data on alcoholism-related Google searches conducted in the US over the period 2004–2011. We find the current recessionary period coincided with an almost 20% increase in alcoholism-related searches. Controlling for state and time-effects, a 5% rise in unemployment is followed in the next 12 months by an approximate 15% increase in searches. The use of Internet searches to inform on health-related behaviours and outcomes is in its infancy; but we suggest that the data provides important real-time information for policy-makers and can help to overcome the under-reporting in surveys of sensitive information.     

Agreement between maternal interview- and medical record-based gestational age.

Agreement between maternal interview- and medical record-based gestational age was assessed by using data from a case-control study of childhood strabismus. The sample consisted of 383 cases of strabismus and their age-matched controls, diagnosed between 1985 and 1986 in Baltimore, Maryland, who were under age 7 years when diagnosed. Medical record-based gestational age was derived, in order of priority, from early ultrasound examination, time from the last menstrual period, pediatric examination, and obstetric examination. The intraclass correlation coefficient, kappa, and mean difference were used to compare agreement between maternal interview- and medical record-based gestational age by maternal and pregnancy characteristics and characteristics related to study design. Overall, 86 percent of mothers were within 2 weeks of the gestational age reported in the medical record. The intraclass correlation coefficient comparing maternal and medical record-based gestational age was 0.83 (95% confidence interval 0.80-0.86). Agreement was positively associated with shorter length of recall, low birth order, and having a neonatal illness related to prematurity. Agreement was poor among mothers of healthy preterm infants. There was a weak positive association between recall and some sociodemographic covariates. There was greater misclassification of prematurity in the controls than in the cases. The results suggest that, in general, women recall gestational age well, which supports the use of gestational age derived from maternal interviews.     

Agreement between information from the Pregnant Card and the mother's memory of antenatal care

This cross-sectional study aimed to verify agreement between information given by mothers after delivery and data recorded on Pregnant Cards about antenatal care under the Brazilian Unified National Health System in the Metropolitan Region of Vitória, Espírito Santo State, Brazil. The study considered a population of 1,035 postpartum mothers interviewed in eight hospitals, where the cards were copied. The representativeness of the sample was guaranteed by stratification according to the proportion of births. Kappa and McNemar tests were carried out with the collected and processed information. Agreement levels regarding antenatal care were predominantly poor (kappa < 0.20). Mothers tend to: overestimate the number of antenatal visits (McNemar = 51.73; p-value = 0.001); affirm diseases during pregnancy, such as diabetes, anemia, hypertension and urinary infections; report the performance of laboratory tests; report the carrying out of clinical examinations. Results suggest the need to reflect on the type of data used for planning and implementing maternal and child public health polices, since data varies depending on the information source.     

Patients, physicians, and the Internet

The Internet will have a profound effect on the practice and business of medicine. Physicians, eager to provide high-quality care and forced by competition to offer online services, will introduce e-mail and patient-friendly Web sites to improve administrative services and manage common medical conditions. Patients will identify more health information online and will take more responsibility for their care. The doctor/patient relationship will be altered: Some aspects of electronic communication will enhance the bond, and others will threaten it. Patients will have access to vast information sources of variable validity. Many physician organizations are preparing for the electronic transformation, but most physicians are unprepared, and many are resistant.     

Agreement between laboratory tests and self-reports of alcohol, tobacco, caffeine, marijuana and other drug use in post-partum women

The agreement between self-reported consumption of several drugs and laboratory tests used to detect their use is examined. Post-partum women (N = 108) enrolled in a research study participated in a detailed interview covering alcohol and caffeine ingestion, tobacco smoking and use of marijuana and other psychoactive drugs. They also kept a 4-day record of their use of these substances. Blood and urine samples were taken and a physical exam done at the close of the record period. Laboratory tests to detect use of alcohol, tobacco, caffeine, marijuana and other drugs were carried out and the results compared to self-reported drug use in the interview and the record. The degree of agreement depended on the drug taken, the test used and the pattern of drug use in the sample. Sporadic or infrequent consumption related poorly to laboratory tests, especially those that were designed as screening tools. Regular consumption could be identified with greater accuracy. However, the group associations evident between self-reports of drug use and laboratory results were not sufficient to guarantee that subjects were correctly classified. Error in both self-report and the decision made from laboratory values must be taken into account in determining the confidence that should be placed in the data and the conclusions drawn from it.     

Agreement between women's and providers' assessment of hormonal contraceptive risk factors

OBJECTIVE: To measure agreement between women's self-administered risk factor questionnaire and their providers' evaluation of their medical eligibility for hormonal contraceptive use. METHODS: This was an anonymous cross-sectional study. Participants were women 15-45 years old who completed a 20-item self-administered questionnaire. Women were recruited from six public health family planning clinics in the Seattle Metropolitan area. A matching medical evaluation questionnaire was completed concurrently by each participant's health care provider. Using provider evaluation as the "gold standard" against which we compared self-reported medical history, we calculated participant-provider agreement with point estimates and 95% confidence interval (CI). RESULTS: Of 399 participant and provider pairs, participant-provider agreement was obtained for 392 participant pairs. The majority of the participants (90.3%) were 15-30 years old and 77.7% had used a hormonal contraceptive method for more than 1 year. The estimated proportion of the overall agreement was 96% (95% CI, 0.92-0.98). Women were more likely to report severe headaches (12.4% vs. 3.3%), possible pregnancy (7.3% vs. 3.5%) and smoking (6.2% vs. 2.1%) than providers, but less likely to report smoking more than 15 cigarettes per day (2.6% vs. 9.2%) and irregular menses (6.5% vs. 9.9%). CONCLUSION: Overall, a high proportion of the women in this study completed our medical history questionnaire in concordance with their health care providers' same-day medical evaluation. Agreement on critical medical eligibility criteria such as hypertension was well above 90%. For criteria on which there was disagreement, women were more likely to identify contraindications than were their providers.     

Agreement between administrative data and patients' self-reports of race/ethnicity

OBJECTIVES: We examined agreement of administrative data with self-reported race/ethnicity and identified correlates of agreement. METHODS: We used Veterans Affairs administrative data and VA 1999 Large Health survey race/ethnicity data. RESULTS: Relatively low rates of agreement (approximately 60%) between data sources were largely the result of administrative data from patients whose race/ethnicity was unknown, with least agreement for Native American, Asian, and Pacific Islander patients. After exclusion of patients with missing race/ethnicity, agreement improved except for Native Americans. Agreement did not increase substantially after inclusion of data from individuals indicating multiple race/ethnicities. Patients for whom there was better agreement between data sources tended to be less educated, non-solitary living, younger, and White; to have sufficient food; and to use more inpatient Department of Veterans Affairs (VA) care. CONCLUSIONS: Better reporting of race/ethnicity data will improve agreement between data sources. Previous studies using VA administrative data may have underestimated racial disparities.     

Agreement between self-reported and routinely collected health-care utilization data among seniors

OBJECTIVE: To examine the agreement between self-reported and routinely collected administrative health-care utilization data, and the factors associated with agreement between these two data sources. DATA SOURCES/STUDY SETTING: A representative sample of seniors living in an Ontario county within Canada was identified using the Ontario Ministry of Health's Registered Persons Data Base in 1992. Health professional billing information and hospitalization data were obtained from the Ontario Ministry of Health and Long-Term Care (OMH) and the Ontario Health Insurance Plan (OHIP). STUDY DESIGN: A cross-sectional survey was carried out to assess any contact and frequency of contacts with health professionals and hospital admissions. Similar information was obtained from routinely collected administrative data. The level of agreement was assessed using the proportion of absolute agreement, Cohen's kappa statistic (kappa), and the intraclass correlation coefficient (ICC). Logistic and linear regressions were used to identify factors that were associated with the magnitude and direction of disagreement respectively. DATA COLLECTION/EXTRACTION METHODS: Telephone interviews were conducted on 1,054 seniors, and complete data were available for 1,038 seniors. Each respondent's personal health number was used to electronically link survey data with health professional billing and hospitalization databases. PRINCIPAL FINDINGS: Substantial to almost perfect agreement was found for the contact utilization measures, while agreement on volume utilization measures varied from poor to almost perfect. In surveys, seniors overreported contact with general practitioners and physiotherapists or chiropractors, and underreported contact with other medical specialists. Seniors also underreported the number of contacts with general practitioners and other medical specialists. The odds of agreement decreased if respondents were male, aged 75 years and older, had incomes of less than $25,000, had poor/fair/good self-assessed health status, or had two or more chronic conditions. CONCLUSION: The findings of this study indicate that there are substantial discrepancies between self-reported and administrative data among older adults. Researchers seeking to examine health-care use among older adults need to consider these discrepancies in the interpretation of their results. Failure to recognize these discrepancies between survey and administrative data among older adults may lead to the establishment of inappropriate health-care policies.     

Agreement between women's histories of oral contraceptive use and physician records

The histories of oral contraceptive (OC) use provided by women participating in a study of hepatocellular adenoma (HCA) were compared with records obtained from their physicians. In the HCA study two memory aids were used to assist women in their recall: a calendar of significant events during a woman's lifetime to which she might relate her use of OCs and a book of colour photographs of the 90 OC preparations available up to the time of the study. Using the number of months of a woman's history which could be checked against physician records (mean for all women of 33 months) as the denominator, the highest proportion of concordance was for month-specific duration of OC use (90%) with lower agreement for duration and brand (62%) and duration, brand, and dose (54%). Agreement was better for cases than for controls.