2004-2020年北京市通州区6～22岁学生人群法定报告传染病疫情监测分析

目的 分析2004—2020年北京市通州区6～22岁学生人群法定报告传染病发病趋势和流行特征,为开展传染病防控提供数据参考。方法 收集2004—2020年中国疾病预防控制信息系统中通州区年龄为6～22岁且人群分类为学生的法定报告传染病监测数据,描述发病率、构成比、发病顺位,利用joinpoint软件计算年度变化百分比（APC%）分析发病率趋势,以P<0.05为差异有统计学意义。结果 2004—2020年北京市通州区共报告6～22岁学生人群法定传染病18 807例,无死亡病例,报告发病率为953.16/10万。其中甲类传染病无报告;乙类报告发病率为184.99/10万;丙类报告发病率为768.17/10万。乙类发病率呈下降趋势（APC=-7.18,P<0.001）,丙类发病率变化趋势平稳（APC=3.82,P=0.20）。乙类传染病发病率小学生、初中生、高中生、大学生人群均呈下降趋势（P<0.05）;丙类传染病发病率小学生呈上升趋势（APC=6.97,P=0.02）,大学生人群呈下降趋势（APC=-10.03,P=0.01）,初中生、高中生发病率变化趋势平稳（P>...     

吉林省2013-2015年托幼儿童法定传染病监测结果分析

了解2013-2015年吉林省托幼儿童传染病的发病规律和流行特征,为制定托幼机构法定传染病防控措施提供科学依据.方法 运用描述流行病学方法,对2013-2015年传染病报告信息管理系统报告的吉林省托幼儿童传染病疫情资料进行统计分析.结果 2013-2015年吉林省托幼儿童报告乙、丙类法定传染病15种14 650例,年均发病率为1 065.87/10万.发病前3位的病种为手足口病、猩红热、流行性腮腺炎,累计发病数分别为9 876,2 916,1 429例,占报告总病数的97.09%,其中免疫规划类传染病报告病例(1 537例)占报告总病例数的10.49%.报告发病高峰为6-7月,占报告总发病数的43.32%;高发地区为延边州(1 738.44/10万)、通化市(1 626.89//10万)、白山市(766.75/10万).结论 手足口病、猩红热、流行性腮腺炎为吉林省托幼儿童传染病防控重点.     

2009-2018年内蒙古阿拉善盟学生及托幼儿童法定传染病流行特征分析

目的 分析内蒙古阿拉善盟学生及托幼儿童法定传染病流行特征,为做好防控工作提供科学依据。方法 从中国疾病预防控制信息系统中获取当地2009-2018年人群分类为学生、托幼儿童全部法定传染病报告病例,采用描述性流行病学方法分析其发病特征,对不同年份、人群类型的发病水平进行比较。结果 2009年1月1日至2018年12月31日期间,阿拉善盟共报告托幼儿童、学生法定传染病共计15种2970例,年平均报告发病率524.24/10万,无死亡病例。未报告甲类传染病,乙类传染病报告10种553例,年平均发病率97.61 /10万;丙类传染病报告5种2417例,年平均发病率426.63/10万。10年间累计报告病例占同期法定传染病报告总数的22.20%。累计报告病例居前5位的病种分别是手足口病、流行性腮腺炎、猩红热、流行性感冒、风疹,占全部报告病例数的93.16%。发病率最高的年龄组为4岁组,男女平均性别比为1.28。呼吸道传染病、消化道传染病、血源及性传播传染病、虫媒及自然疫源性传染病占总报告病例数的42.86%、54.07%、3.0%和0.07%。肠道传染病以3~5岁组发病数最高（1182例,2010.73/10万）,呼吸道传染病以6~12岁组发病数最高（632例,438.84/10万）,血源及性传播疾病以19~24岁组最高（31例,14.37/10万）,虫媒及自然疫源性疾病均分布在13~15岁组。结论 阿拉善盟托幼儿童和学生法定传染病报告占总报告病例数的比率较高,必须落实综合防控措施,有效预防学校托幼机构传染病的发生和流行。     

上海市松江区新桥镇2007—2016年间法定传染病流行特征分析

目的 了解上海市郊松江区新桥镇最近10年间法定传染病的发病情况和流行态势。方法 根据《中华人民共和国传染病防治法》的规定,利用上海市法定传染病疫情统计网络直报信息系统,运用回顾性流行病学研究方法对松江区新桥镇2007—2016年间报告的法定传染病数据进行分析研究。结果 2007—2016年间,上海市松江区新桥镇法定乙类传染病累计报告1 592例（27.82%,92.61/10万）。其中2007年（71.41/10万）至2010年（45.55/10万）间发病率逐年降低,此后呈上升趋势,至2015年达到137.58/10万。丙类法定传染病累计报告4 131例（72.18%,240.32/10万）,其中2007年发病率最低（26.53/10万）,此后逐年升高,2013年下降明显,2014年再次升至最高（421.93/10万）,此后略有下降。结论 上海市松江区近10年来传染病总体发病率呈曲折上升趋势,乙类传染病发病率较为平稳,传染病的死亡主要集中在乙型病毒性肝炎。手足口病发病数开始增多对丙类传染病构成比例及传染病总发病率产生有一定影响。     

洛阳市涧西区2004～2007年0～14岁法定传染病流行病学分析

目的了解0~14岁儿童传染病发病趋势,为防治措施提供依据。方法统计洛阳市涧西区2004~2007年0~14岁传染病报告资料,对报告的传染病进行分类,计算发病率和分析发病趋势。结果4年间0~14岁法定传染病共发生13种,前5位有6种2851例,占总数的96.09%,乙类传染病发病率479.80/10万,丙类发病率1046.00/10万,丙类高于乙类(χ2=405.20,P<0.01)。儿童传染病主要病种为细菌性痢疾、猩红热、腮腺炎、感染性腹泻。结论做好儿童基础免疫和小学生的加强免疫及综合防治工作是控制传染病发病的最有效措施。     

2008 - 2017年张家港市法定传染病疫情分析

目的 分析张家港市近10年法定传染病的发病特点及流行特征,为今后制定防控策略和措施提供科学依据。方法 收集2008 - 2017年法定传染病疫情资料,运用描述流行病学方法进行统计分析。结果 2008 - 2017年全市无甲类传染病报告,共报告乙丙类传染病23种42 879例,报告发病率273.57/10万;死亡91例,报告死亡率0.58/10万。其中乙类传染病17种16 496例,报告发病率105.05/10万;死亡90例,报告死亡率0.57/10万,丙类6种26 383例,报告发病率168.01/10万;死亡1例,报告死亡率0.01/10万。2008 - 2017年乙类传染病发病率呈逐年稳步下降趋势,丙类传染病发病率呈上升趋势。结论 该市丙类传染病呈上升趋势,今后的传染病防控重点应在继续加强乙类传染病如梅毒、肺结核、病毒性肝炎防治的同时,进一步加大对丙类传染病如手足口病的防控力度。     

2004～2009年无锡市滨湖区传染病疫情分析

[目的]探讨无锡市滨湖区法定传染病的疫情动态和流行特征。[方法]对国家疾病监测信息报告管理系统中滨湖区2004～2009年法定传染病疫情数据进行分析。[结果]2004～2009年共报告法定传染病21种10521例,年均发病率为248.72/10万。乙类传染病发病率呈下降趋势,丙类传染病发病率呈上升趋势;年均发病率（/10万）,血源及性传播传染病、肠道传染病、呼吸道传染病分别为97.20、92.14、58.68;淋病、肺结核、手足口病、病毒性肝炎分别为57.70、38.76、38.65、30.09。乙型肝炎、淋病、肺结核发病率呈逐年下降趋势,艾滋病、梅毒发病数近两年呈上升趋势,手足口病近两年发病率有上升趋势。[结论]滨湖区法定报告传染病总发病率处于一般水平。年发病率乙类传染病呈下降趋势,丙类传染病呈上升趋势。     

巢湖市2004～2011年法定传染病流行特征分析

目的分析探讨实行传染病网络直报以来,巢湖市法定报告传染病发病趋势及流行特征,为制定防控措施提供参考依据。方法通过《疾病监测信息报告管理系统》收集巢湖市2004～2011年甲、乙、丙类传染病监测资料,用描述流行病学的方法进行统计分析。结果 2004～2011年,巢湖市共报告法定传染病29种71 636例,发病率在143.582/10万～304.596/10万之间,年平均发病率为207.484/10万,不同年份发病率差异有统计学意义（χ2=2868.73,P〈0.01）。甲类1种4例,乙类19种50 672例,丙类9种20 960例;乙丙类传染病年平均发病率分别为146.765/10万、60.708/10万。结论巢湖市传染病发病水平呈逐步上升趋势。乙类传染病中肺结核和乙肝发病较多,血源及性传播疾病发病率明显上升;丙类传染病中手足口病发病明显上升。应进一步加强多发病和重点疾病防控工作。     

2008—2013年泰州市海陵区法定传染病疫情报告分析

目的了解泰州市海陵区近6年来的法定传染病发病趋势及传染病类别构成,分析流行特征和规律,为制定防治策略和措施提供科学依据。方法采用χ2趋势检验及描述流行病学研究方法对2008—2013年泰州市海陵区医疗卫生机构报告的法定传染病疫情资料进行统计分析。结果 2008—2013年间共报告乙丙类法定传染病15种12062例,其中,乙类传染病报告13种共6233例,丙类传染病报告6种共5829例,无甲类传染病报告。乙类传染病中,梅毒、病毒性肝炎、肺结核、淋病、痢疾为主要的前5位病种,占总报告数的89.36%,报告发病率呈现出下降的趋势（χ2=495.75,P〈0.01）。丙类法定传染病中,手足口病、流感、流腮、其他感染性腹泻病、风疹为主要的前5位病种,占总报告数的98.44%,报告发病率呈上升趋势（χ2=7.21,P〈0.01）。6年来,血源及性传播传染病占报告发病总数的30.95%,报告发病率呈下降的趋势（χ2=184.03,P〈0.01）;肠道传染病占报告发病总数的45.01%,呈现出上升的趋势（χ2=24.26,P〈0.01）;呼吸道传染病占报告发病总数的23.62%,呈下降的趋势（χ2=400.38,P〈0.01）;自然疫源及虫媒传染病累计报告发病28例,占报告发病总数的0.23%。结论2008—2013年间,泰州市海陵区乙类传染病报告发病率呈现出下降的趋势,梅毒、病毒性肝炎、肺结核居报告的前三位,丙类传染病呈上升趋势,手足口病、流感、流腮居报告的前三位。不同类别传染病发病趋势中,肠道传染病呈现出上升的趋势。应及时调整防控策略,加强手足口病、梅毒等主要病种的综合防治工作。     

遵义市2007-2011年托幼机构传染病流行病学特征

分析2007-2011年遵义市托幼机构传染病流行病学特征,为制定幼托机构传染病的防控措施提供科学依据.方法 利用2007-2011年遵义市托幼机构法定传染病的发病资料进行统计分析.结果 2007-2011年遵义市托幼机构共报告法定传染病19种,病例6 872例,年均发病率为926.89/10万,5 a间传染病发病率呈上升趋势(x2=703.179,P<0.01).其中乙类传染病13种,病例548例(7.97%),年均发病率为73.91/10万;丙类传染病6种,病例6324例(92.03%),年均发病率为852.97/10万.发病数居前5位的病种依次是手足口病(3585例)、流行性腮腺炎(2414例)、其他感染性腹泻(193例)、痢疾(158例)、风疹(100例).3-7月和9-12月是发病高峰期.结论 遵义市托幼机构传染病发病率呈逐年上升趋势,手足口病和流行腮腺炎是防控重点.     

Turkish and German patients' recall of diagnosis and therapy before and following informed consent

Objective. Adequate patient knowledge is essential for good compliance, effective doctor–patient communications and is the basis for informed consent. The purpose of the study was to examine differences in recall of informed consent procedures between patients with different ethnicity and to identify potential explanatory factors.

Design. We analyzed 579 patients, attending and released from a gynecology department in Berlin, Germany, between March 1997 and October 1998. To assess actual understanding of disclosure information, Turkish and German patients' perceptions were compared with documented data of their diagnoses and therapy.

Results. Overall, patients correctly identified 69% of their diagnosis and 76% of their therapy. On discharge overall patients' recall decreased significantly. Whereas German patients' knowledge increased, Turkish patients showed significant decreases in diagnosis and therapy recall.

Conclusion. The results reflect socio‐demographic differences between ethnic groups and indicate deficiency of the informed consent process for patients belonging to an ethnic minority.

Fragestellung. Ein ausreichend gutes und adäquates Wissen der Patienten ist wichtig für eine gute Compliance, eine effektive Arzt‐Patienten‐Beziehung und stellt die Basis für den sogenannten informed consent dar. Zielstellung der Studie war die Feststellung von Unterschieden im Wissensstand von Patientinnen verschiedener Ethnizität vor und nach der Aufklärung auf einer gynäkologisch‐operativen Station und die Identifizierung von Erklärungsfaktoren für eventuelle Differenzen.

Patientinnenkollektiv und Methodik. Es wurden 579 Patientinnen in die Studie einbezogen, die zwischen März 1997 und Oktober 1998 auf einer gynäkologischen Station in Berlin behandelt und mit einem Fragebogen befragt wurden. Zur Feststellung des jeweiligen aktuellen Informationsstandes wurden die Angaben der deutschen und der türkischstämmigen Patientinnen mit den dokumentierten Daten zu Diagnose und Therapie in den Krankenakten verglichen.

Ergebnisse. Insgesamt konnten 69% aller Patientinnen ihre Diagnose und 76% die Therapie richtig wiedergeben. Der Kenntnisstand am Ende des stationären Aufenthaltes war insgesamt signifikant schlechter als am Anfang. Während die deutschen Patientinnen besser Bescheid wussten, zeigten die türkischstämmigen Patientinnen signifikante Defizite hinsichtlich ihres Wissens über ihre Diagnose und Therapie.

Zusammenfassung. Die Ergebnisse reflektieren soziodemographische Unterschiede zwischen ethnischen Gruppen und zeigen Defizite im Informationsprozess vor und während des Klinikaufenthaltes insbesondere bei den Migrantinnen auf.     

Bullying and ostracism in youth with and without ADHD: implications for risk and resilience

Objective: This study compared bullying experiences, psychosocial adjustment, and resiliency in youth with and without ADHD.

Method: Participants included 73 youth ages 12–17 with and without ADHD. Participants and their caregivers completed the Bullying and Ostracism Screening Scale, Pediatric Symptom Checklist, and Fitness and Flourish Scale.

Results: There were no significant group differences in youth self-report for rates of bullying experiences or psychosocial adjustment. In contrast, caregivers reported significantly higher levels of victimization experiences (bullying and ostracism) and psychosocial maladjustment for youth with ADHD. Youth who reported increased victimization experiences also reported significantly more internalizing symptoms and lower levels of resilience, irrespective of ADHD diagnosis.

Conclusion. The diagnosis of ADHD did not confer increased risk for bullying or ostracism according to youth self-report. In contrast, caregivers of youth with ADHD reported increased risk for victimization and higher rates of psychosocial maladjustment. Potential reasons for these inter-rater differences are discussed.     

Serum Homocysteine and Cysteine Levels and Anthropometric Changes: A Longitudinal Study among Brazilian Children and Adolescents

Objective: This article aimed to identify the influence of high serum homocysteine (Hcy) and cysteine (Cys) levels, alone or in conjunction, on changes in anthropometric parameters in children and adolescents over a 12-month follow-up period.

Methods: This is a cohort study involving 483 boys and girls 7–15 years of age. The outcome variables were body mass index (BMI)-for-age and waist circumference (WC) and the principal exposure variables were serum Hcy and Cys levels, alone or in conjunction. A generalized estimating equation (GEE) approach was used to identify longitudinal changes in the outcome variables.

Results: Irrespective of age, sex, socioeconomic conditions, dietary intake, or the practice of physical activity, the children and adolescents in the fifth quintile of distribution of Hcy levels had a z-score increase of 0.50 (p < 0.01) and a 3.62 cm increase (p < 0.01) in mean BMI-for-age and WC, respectively, over the period of the study. In individuals with Cys values above the fifth quintile, a z-score increase of 0.59 (p < 0.01) and a 5 cm increase (p < 0.01) were found in BMI-for-age and WC, respectively. When serum Hcy and Cys levels were both above the fifth quintile of distribution, a z-score increase of 0.87 (p < 0.01) and a 6.57 cm increase (p < 0.01) were found in mean BMI-for-age and WC, respectively, over the 12-month follow-up.

Conclusion: High serum Hcy and Cys levels contributed to an increase in BMI-for-age and WC in children and adolescents over a 12-month follow-up period, with these increases being even greater when these 2 biochemical parameters were simultaneously high.     

Agriculture and musculoskeletal disorders in low- and middle-income countries

Objectives: To systematically explore and summarize the risk factors of work-related musculoskeletal disorders (WMSDs) among the agricultural workers in low- and middle-income countries (LMIC). In addition, to identify and analyze the methodological flaws in the reviewed studies.

Methods: A comprehensive electronic literature search was conducted using PubMed, Medline, SCOPUS, CINAHL, Science Direct, Embase, Wiley Online Library, Google Scholar, and Web of Science databases. Three-phased screening process was undertaken to eliminate irrelevant publications. Assessment of methodological quality was done using a standardized assessment tool.

Results: Eighteen cross-sectional studies were included in the narrative synthesis. Based on the median score of 38%, nine publications were classified as having higher methodological quality. Eight countries were represented in this review, mainly the South East Asia countries. Majority of the participants were rice farmers. Most common risk factors associated with WMSDs were physical factors (n = 10), followed by individual (n = 6) and psychosocial (n = 5) risk factors. A majority of the studies investigated the risk factors for spinal region. Several methodological weaknesses were noticed in the studies concerning outcome definition, assessment of potential confounders, generalizability, selection bias, information bias, and statistical analysis. Extensive heterogeneity across the studies prevented statistical pooling.

Conclusions: The common anatomical region evaluated was the spine and the most reported risk factors were physical risk factors. Future researches in the LMIC should focus on conducting longitudinal studies that could infer temporality. Researchers should give more attention in defining the study population, evaluating the exposure and outcome in an unbiased way, and in executing reliable statistical analysis.     

Short-term and long-term efficacy of classical ketogenic diet and modified Atkins diet in children and adolescents with epilepsy: A systematic review and meta-analysis

Objectives: Classical ketogenic diet (KD) and modified Atkins diet (MAD) are two types of KD commonly used for the treatment of intractable epilepsy throughout the world. Studies have shown the efficacy of these diets. However, no systematic review and meta-analysis study has to date compared the efficacy of KD and MAD in a time trend. Therefore, the objectives of the present study were to compare the short-term and long-term efficacy of classical KD and MAD in children and adolescents with epilepsy and to determine the efficacy of classical KD and MAD at multiple time points and in a time trend.

Methods: Main electronic literature databases, including MEDLINE/PubMed, Web of Science, Scopus, and EMBASE, were searched in November 2016. Rate difference and random effects model were used to compare the efficacy of the classical KD and MAD.

Results: Overall, 70 studies were eligible for inclusion. Meta-analysis revealed a non-significant trend toward a higher efficacy of MAD at month-3 and month-6 (P?>?0.05). In the classical KD group, the percentage of responder patients achieving ≥50% seizure reduction was 62, 60, 52, 42, and 46% at month-1, 3, 6, 12 and 24 and for the MAD group was 55, 47, 42, and 29% at month-1, 3, 6, and 12, respectively.

Discussion: Classical KD does not differ substantially from MAD in ≥50% and ≥90% reduction of seizure frequency at month-3 and month-6. Overall, the number of patients achieving seizure freedom increases over time.     

Adolescent Obesity and Its Association with Diet Quality and Cardiovascular Risk Factors

Objective: This study aimed to evaluate the adolescent obesity and its association with Mediterranean Diet Quality Index (KIDMED) and cardiovascular risk factors in adolescents.

Method: This cross sectional study included 95 adolescents aged between 10 and 18 who visited a Primary Health Service Center in Turkey. Participants’ biochemical parameters, anthropometric measurements and blood pressures were measured. The level of adherence to Mediterranean Diet was evaluated by a clinical questionnaire, the Mediterranean Diet Quality Index for children and adolescents (KIDMED).

Results: Overweight adolescents had significantly higher systolic blood pressure, diastolic blood pressure, total cholesterol, very low-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, hemoglobin A1c, C-reactive protein, alanine aminotransferase, than normal-weight adolescents. Overweight/obese subjects also had significantly lower HDL cholesterol than normal-weight subjects. Results indicated that 60.0% of the adolescents had a low quality diet, 34.7% had a mid-quality/needs-improvement diet, and 5.3% had an optimal quality diet. No association was found between diet quality and obesity and cardiovascular risk factors.

Conclusion: Overweight and obese children are strongly associated with multiple cardiovascular risk factors. To avoid health problems arising from obesity, adolescents should refer to global solutions. Mediterranean diet is a good measure against adverse cardiovascular risk factors in adolescence.     

Fruit and Vegetable Consumption and Their Association With the Indicators of Iron and Inflammation Status Among Adolescent Girls

Background: The objective of this study was to identify an association among dietary components, iron, and inflammatory status among adolescent girls.

Method: Dietary information for 85 adolescent girls was collected through food frequency questionnaires. Biomarkers of iron and inflammatory status were analyzed.

Results: We found that 28.2% of adolescent girls had anemia and 65.9% girls were iron-deficient. Girls who did not consume guava had 3.8-fold (95% confidence interval =1.1–9.4; p?=?0.020) increased the risk of having low serum iron levels. Girls who consumed amaranth had significantly (p?=?0.024) higher serum hepcidin levels (n?=?44; 129.7?±?81.40?pg/mL vs n?=?41; 94.6?±?55.8?pg/mL) as well as ferritin levels (n?=?44; 19.7?±?16.4?µg/L vs n?=?41; 14.0?±?10.2?µg/L). Overall consumption of fruits and green leafy vegetables among girls significantly affects their iron status.

Conclusions: Regular consumption of vitamin C–rich fruits and green leafy vegetable intake are imperative for improvement of iron status among adolescent girls.     

Anthropometric Evaluation and Functional Assessment of Patients with Pulmonary Hypertension and its Relationship with Pulmonary Circulation Parameters and Functional Performance

Objective: The objective of this study was to investigate the anthropometric and functional status in patients with pulmonary hypertension (PH) and its relationship with pulmonary circulation parameters and functional performance.

Methods: The study is cross-sectional with 34 subjects, who were evaluated in terms of anthropometric measurements, physical performance, pulmonary circulation, and regular physical activity.

Results: Subjects had a mean age of 47.0 ± 14.5 years, mean IMC 28.5 ± 7.7 kg/m² among adults, and 27.65 ± 2.68 kg/m² among elderly, with high body fat and preserved muscle mass. The sample presented the parameters of pulmonary circulation expected for PH patients and adequate performance in the physical capacity test. By linear regression analysis there was observed a negative relationship between body fat and regular physical activity.

Conclusion: The evaluated subjects had an excess of body weight and fat, with preserved muscle mass, which does not appear to interfere in the pulmonary circulation parameters. However, elevated body fat appears to impair regular their physical activity.