Strategies that facilitate participation in family activities of children and adolescents with profound intellectual and multiple disabilities: parents’ and personal assistants’ experiences

Abstract

Purpose: Participation throughout one’s life plays a significant role for development and emotional well-being. For this reason, there is a need to identify ways to facilitate participation in family activities for children and adolescents with profound intellectual and multiple disabilities (PIMD). Methods: The study design was qualitative and explorative, based on semi structured interviews with 11 parents and 9 personal assistants of children with PIMD. Results: The interviews revealed participation-facilitating strategies relating to the children’s/adolescent’s proximal environment, such as “Availability and acceptability of the activity”, “Good knowledge about the child” and a “A positive attitude of people close to the child”, as well as strategies related to the children/adolescents themselves: “Sense of belonging”, “Possible for the child/adolescent to understand”, “Opportunities to influence” and “Feeling of being needed”. Conclusions: Children and adolescents with PIMD are dependent on support obtained through their environment. The identified strategies, individually adapted through awareness and knowledge by the parents and the personal assistants, provide important evidence to assist our understanding in gaining understanding about how to improve participation in family activities of children and adolescents with PIMD.

• Implications for Rehabilitation

• Participation-facilitating strategies related to the child/adolescent and his or her proximal environments are identified to improve participation in children and adolescents with profound intellectual and multiple disabilities (PIMD).

• Examples of strategies for the child’s/adolescents’ proximal environment include “good knowledge about the child/adolescent”, and, for the child/adolescent, include creating “sense of belonging” and “opportunities to influence”.

• Identifying and making these strategies explicit may assist in enhancing the participation of children and adolescents with PIMD in family activities.

• People in the child’s/adolescent’s proximal environment need to set the scene for participation.

     

Utilization of antithrombotic therapy for stroke prevention in atrial fibrillation: a cross‐sectional baseline analysis in general practice

What is known and objective: Antithrombotics for stroke prevention in atrial fibrillation (AF) are reportedly underutilised. Since the burden of care lies within general practice, attention must be paid to identifying and addressing practice gaps in this setting. The objective of this study was to determine the contemporary utilisation of antithrombotic therapy for stroke prevention in AF within Australian general practice (GP). Methods: Data pertaining to AF patients’ (aged ≥65 years) were collected from GP surgeries in New South Wales, Australia, using purpose‐designed data collection forms; extracted data comprised patients’ medical histories, current pharmacotherapy, and relevant characteristics. Results and Discussion: Data pertaining to 393 patients (mean age 78·0 ± 7·0 years) were reviewed. Overall, most (98·5%) patients received antithrombotic therapy. Among the 387 patients using antithrombotics, most (94·1%) received mono‐therapy. “Warfarin ± antiplatelet” was most frequently used (81·7%); 77·5% used “warfarin” as a monotherapy, followed by “dabigatran ± clopidogrel” (11·6%), “aspirin” (5·9%) and “clopidogrel” alone (0·8%). High stroke risk and low bleeding risk were associated with increased use of “warfarin ± antiplatelet” therapy. Older patients (≥80 years) were more likely to receive ‘nil therapy’ (P = 0·04), and less likely to receive dual and triple antithrombotic therapy. Conclusion: We found an encouraging improvement compared to previous studies in the utilisation of antithrombotic therapy for stroke prevention in AF within general practice. Warfarin is now utilised as the mainstay therapy, followed by aspirin, although the novel oral anticoagulants are entering the spectrum of therapies used. Consideration needs to be given to the potential impact of the newer agents and their scope of use.     

Parents’ experiences of participation in physical activities for children with cerebral palsy – protecting and pushing towards independence

Purpose: To explore how parents of children with cerebral palsy (CP) experience their child’s participation in physical activities and to identify facilitators and barriers for being physically active and reducing sedentary behaviour. Methods: Twenty-five parents of sixteen children, aged 8–11 years old with CP, with varying gross motor, cognitive and communicative functions and with different cultural backgrounds, participated in focus group or individual interviews. Content analysis was used for analysis. Results: Five subcategories addressing children’s participation in physical activity were found: “Belonging and taking space in the family”, “Important persons facilitating and hindering”, “Friends important but hard to get”, “Good for the body but challenging” and “Availability and opting out possibilities”. The subcategories built the main category “Protecting and pushing towards independence”, expressing the challenges parents experienced when their child wanted to be physically active. Conclusions: Parents desire competent persons to be available for support in participation in physical activities. They want support in finding friends for their child to be physically active with. Family culture and attitudes affect their child’s motivation for being physically active and should be taken into account when designing interventions for increased participation in physical activities and for reduced sedentary behaviour in children with disabilities.

• Implications for Rehabilitation

• Friends and competent adults facilitate participation in physical activities and reduce sedentary behaviour.

• Information on accessible and tailored physical activities is an important facilitator for participation in physical activities.

• Service planning and design of interventions may be facilitated by taking the individual family culture into account.

     

The lived experience of parents enabling participation of their child with a physical disability at home,at school and in the community

Purpose: The aim of this study was to provide an in-depth exploration and understanding of parents’ thoughts, feelings and concerns they experience while reflecting on their actions, challenges and needs in enabling their child’s participation at home, at school and in the community. Method: A naturalistic inquiry with thirteen Dutch parents using interpretative phenomenological analysis. Results: Analysis revealed three super-ordinate themes: “Parents’ experiences and concerns about systems, laws and regulations”, “Parents’ experiences and thoughts about physical and/or social environment” and “Parents’ experiences and feelings of finding and/or enabling an activity”. Parents’ often expressed feelings of disappointment derived from being misunderstood, from dealing with the complexity of systems, from hindrance of participation of their children by the social and the physical environment, and from the lack of leisure activities for their child. It is primarily restrictions in the physical and social environments that urge them to take actions, to experience challenges and think of needs. Conclusions: In-depth exploration and understanding of parents’ articulated matters must be shared and taken seriously by policymakers and service providers. Parents’ knowledge and experiences should be of major relevance to improve paediatric rehabilitation and other services for children with a physical disability.

• Implications for Rehabilitation

• To achieve tailored pediatric rehabilitation, involvement and needs of parents in enhancing their child’s participation ought to be acknowledged.

• Active use of parents’ experiences and knowledge regarding the participation of their child on different levels of decision making may improve daily services in pediatric rehabilitation.

• Aiming for optimal participation of a child with a physical disability at home, at school and in the community, the focus of pediatric rehabilitation needs to shift towards enabling, social and physical, environments.

     

Enhanced independence: experiences after regaining grip function in people with tetraplegia

Abstract

Purpose: To explore how surgical reconstruction of grip affects everyday life for patients with tetraplegia, with special emphasis on patients perspective of their perceived changes. Design: Qualitative method. Subjects: Eleven people (aged 22–73) with tetraplegia who had undergone surgical reconstruction to restore grip function. Methods: Qualitative interviews were conducted 7–17 months after surgery and analysed using Grounded theory. Results: The core concept describing the participants experienced gains after grip reconstructive surgery was “enhanced independence”. It was associated with changes in both practical and psychological aspects of independence. Practical aspects identified were: “perform more activities”, “smoother everyday life”, “renewed ability to participate in social activities”, “less dependence on assistance” and “less restricted by physical environment”. Psychological aspects of independence included “regained privacy”, “increased manageability”, “regained identity”, “recapture a part of the body” and “share positive experiences with relatives and friends”. Encompassing all categories was the concept “self-efficacy in hand control”. It was seen as a result included in the enhanced independency core but also as an important factor for the development of all the other categories. Conclusion: Participants in this study experienced enhanced independence after grip reconstructive surgery and rehabilitation. The enhanced independence included both practical and physical aspects and it influenced all domains using the International Classification of Function, Disability and Health model; body function and structure, activities, participation, personal factors and environmental factors.

• Implications for Rehabilitation

• Patients with tetraplegia experience grip reconstruction as a useful intervention, an enhanced independence, related to their improved hand control.

• The increased hand control impacted not only physical aspects but also practical and psychological aspects. It also influenced social and community participation and the interference the environment had on the person.

• Self-efficacy was both a result of the intervention and a catalyst allowing the subcategories to develop. Therefore, self-efficacy in hand control seems to be an important factor to focus on during the rehabilitation process.

     

A Survey of Swedish Mothers' Views on Breastfeeding and Experiences of Social and Professional Support

The purpose of this cross-sectional study was to investigate conditions for breastfeeding among 452 mothers. Three different groups of women, participating in the Swedish health care system, were asked to complete a questionnaire about breastfeeding and related issues: 1) pregnant women attending the pregnancy care centres (n= 186), 2) women staying at the maternity wards after delivery (n= 171) and 3) women with two-month-old child attending the child health stations (n= 95). We found that the majority of the mothers were in favour of breastfeeding and intended to or had begun to breastfeed their infants. The main problems were “sore nipples”, “children who cannot take the breast” and “insufficient milk production”. Negative experiences of previous breastfeeding and overwhelming demands were motives for weaning. The personnel within the health care system were shown to be important for the mothers as regards advice and support. However, we found that certain routines could be revised to strengthen the mothers' attitude towards breastfeeding: 1) Information on and discussions about breastfeeding occurred infrequently at the pregnancy care centres. 2) Water or formulated milk was often given to the newborn baby at the maternity wards and 3) the participation of the fathers was limited. Continuous surveillance of the routines and education of the health care staff would be desirable to enable them to give the mothers the right breastfeeding support and advice at the right time.     

Parent Pain Responses as Predictors of Daily Activities and Mood in Children with Juvenile Idiopathic Arthritis: The Utility of Electronic Diaries

The present study used electronic diaries to examine how parent responses to their child's pain predict daily adjustment of children with juvenile idiopathic arthritis (JIA). Nine school-aged children with JIA along with one of their parents completed thrice-daily assessments of pain-related variables, activity participation, and mood using handheld computers (Palm® pilots) for 14 days, yielding a potential of 42 child and parent assessments for each dyad. Children provided information on current pain level, mood, and participation in social, physical, and school activities. Parents independently rated their own mood as well as their behavioral responses to their child's pain at the same time points using a separate handheld computer. Results of multilevel modeling analyses demonstrated that use of “protective” pain responses by parents significantly predicted decreases in child activity and positive mood, with an even stronger inverse relationship between protective pain response and positive mood observed in children with higher than average disease severity. Protective pain responses were not found to be significantly predictive of daily negative mood in children. The use of “distracting” responses by parents significantly predicted less child activity restrictions but only in children having higher disease severity. There also was an unexpected trend in which parent use of more distracting pain responses tended to be associated with lower child positive mood. These preliminary findings suggest the importance of the parent in influencing adjustment in children with JIA and lend support to the incorporation of parents into comprehensive pain management approaches. The potential benefits of using electronic daily diaries as a strategy to examine pain and adjustment in children with JIA pain are discussed.     

Activity and Occupational Demands of Type Two Diabetes: The Voice of Mexican-American Older Adults

ABSTRACT

Type two diabetes mellitus has become a worldwide epidemic that directly or indirectly has impacted people everywhere. High incidence of diabetes in older adult Mexican-Americans poses serious, complex issues. Aim: The purpose of the study was to illuminate the cultural perspectives of highly motivated first-generation, bilingual Mexican-American older adults with T2DM, who accepted the activity and occupational demands and chose to follow the diabetes self-care regimen. Method: Emergent themes were extracted from focus groups using a phenomenological approach. Results: Themes were (1) “We had reasons”; (2) “Everyone had a different learning curve.”; (3) “Cultural issues made changing lifestyle difficult”; (4) and “Sharing helps us.” Conclusions: The inquiry revealed the shared perceptions and cultural nuances that may challenge Mexican-American people with diabetes, who try to adapt to lifestyle changes and occupational demands. Culturally-sensitive activity-based interventions that might facilitate self-care mastery were suggested. Future research is needed to facilitate OT reimbursement for self-care at the secondary prevention level.     

Department of law and ethics

Abstract

Angela Holder ends her Journal of Pediatrics article, “Parents, Courts, and Refusal of Treatment” with the summary sentence, “In cases involving high risks or choices of therapy … courts do seem to al- low parents latitude to make their own decisions” (1). On the other hand, Henry Hyde has said “… a question of life or death for a born person ought to belong to nobody. … The Constitution ought The relevant history of the Baby Doe debate is brief enough. At to protect that child. …” (2).     

Psycho-social factors associated with relapse to drug addiction in Bangladesh

Background: Relapse to drug use after successful treatment and rehabilitation is a common problem globally. This study aimed to identify the psychological and social factors associated with relapse of drug addiction in Bangladesh.

Methods: We conducted a cross-sectional study among 60 individuals (30 relapsed and 30 non-relapsed cases) with a history of drug addiction in four drug treatment and detoxification center in Bangladesh from May to December 2010. Data were collected from all the participants using a pre-tested, semi-structured questionnaire. A 4-point Likert format was used for scoring the questionnaire. Logistic regression models were performed to identify factors associated with relapse to drug addiction.

Results: All participants were male, aged between 18 and 41 years with mean (SD) age of 27.63 (4.23) years. The “negative emotion” factor had strong contribution on relapse, while “peer pressure,” “self-efficacy,” and “lack of assertiveness” contributed to relapse moderately. The “parental discord” and “relation with parents” factors showed no relationship with relapse. The thought/belief, feeling/emotion, and behavior/action patterns related to relapse were identified, and the covert or very internal affairs of relapse components were revealed.

Conclusion: Psychological factors were associated with an increased likelihood of relapse than social factors. These findings may help clinicians identify substance abuse patients likely to relapse and develop treatment and policy guidelines for prevention of relapse to drug addiction in Bangladesh.     

Therapeutic patient education for stroke survivors: Non-pharmacological management. A literature review

ObjectivesFocus on the different therapeutic patient education (TPE) programs for stroke survivors found in the literature. Verify their content and efficacy.MethodA literature review was conducted by searching for entries from 1966 to 2011 in the Medline and Cochrane Library databases. The references for the accepted articles were taken into consideration and the articles corresponding to the criteria inclusion but not present within the initial search were selected. The keywords used were “self care”, “self management”, “patient education” and “stroke”. Given the multiplicity of symptoms that may be addressed in TPE programs, and following expert advice, the symptoms were grouped after expanding the bibliographic search using the following, additional keywords: “dysphagia”; “swallowing disorder”; “urinary incontinence”; “caregiver”; “fall prevention”; “falling”; “injury”; “shoulder pain”; “physical activity”; “exercise”; “aphasia” and “cognitive impairment”.ResultsWe found 30 article abstracts. In the end, we only accepted seven articles on general TPE programs that were well structured and detailed enough. The TPE programs found in the literature were often of questionable methodological quality. The multiplicity of symptoms led to very general TPE programs that covered all possible stroke after-effects. The purpose of these programs was to reduce stress and anxiety, to improve quality of life and to alleviate psychosocial after-effects. A change in caregiver and patient behavior was observed at times. We expanded the bibliographic search to include scientific arguments that could help implement TPE programs for more specific targets.ConclusionTPE programs for stroke survivors could be improved by standardizing and assessing programs that focus on a specific problem caused by the various possible after-effects of strokes. In order to promote education for stroke survivors, specific training for health care professionals and appropriate funding are necessary.     

Questioning Style and Pimping in Clinical Education: A Quantitative Score Derived from a Survey of Internal Medicine Teaching Faculty

Construct: Pimping is a controversial pedagogical technique in medicine, and there is a tension between pimping being considered as “value adding” in some circumstances versus always unacceptable. Consequently, faculty differ in their attitudes toward pimping, and such differences may be measurable and used to inform future research regarding the impact of pimping on learner outcomes. Background: Despite renewed attention in medical education on creating a supportive learning environment, there is a dearth of prior research on pimping. We sought to characterize faculty who are more aggressive in their questioning style (i.e., those with a “pimper” phenotype) from those who are less threatening. Approach: This study was conducted between December 2015 and September 2016 at Johns Hopkins University. We created a 13-item questionnaire assessing faculty perceptions on pimping as a pedagogical technique. We surveyed all medicine faculty (n?=?150) who had attended on inpatient teaching services at two university-affiliated hospitals over the prior 2?years. Then, using responses to the faculty survey, we developed a numeric “pimping score” designed to characterize faculty into “pimper” (those with scores in the upper quartile of the range) and “nonpimper” phenotypes. Results: The response rate was 84%. Although almost half of the faculty reported that being pimped helped them in their own learning (45%), fewer reported that pimping was effective in their own teaching practice (20%). The pimping score was normally distributed across a range of 13–42, with a mean of 24 and a 75th percentile cutoff of 28 or greater. Younger faculty, male participants, specialists, and those reporting lower quality of life had higher pimping score values, all p?<?.05. Faculty who openly endorsed favorable views about the educational value of pimping had sevenfold higher odds of being characterized as “pimpers” using our numeric pimping score (p?≤?.001). Conclusions: The establishment of a quantitative pimping score may have relevance for training programs concerned about the learning environment in clinical settings and may inform future research on the impact of pimping on learning outcomes.     

Patients’ view on health-related aspects of functioning and disability of joint contractures: a qualitative interview study based on the International Classification of Functioning,Disability and Health (ICF)

Abstract

Purpose: The aim of this study was to identify health-relevant aspects of functioning and disability of persons aged 65 years or older with joint contractures, to link the findings to corresponding ICF categories and to describe the patients’ perspective. Methods: We conducted 43 qualitative, semi-structured, face-to-face interviews with affected persons in two different locations (Witten, Munich) and in three different settings. Data were analyzed using the “meaning condensation procedure” and then linked to ICF categories. Results: From all interviews a total of 2499 single meaning-concepts were extracted which were linked to 324 different ICF categories. The participants in all settings mainly reported problems related to “Mobility of a single joint (b710)”, “Sensation of pain (b280)” and problems related to “Walking (d450)”. Almost all participants reported “Products and technology for personal indoor and outdoor mobility and transportation (e120)” as a relevant environmental factor. Conclusions: From the patients’ perspective, joint contractures have an impact on multifaceted aspects of functioning and disability, mainly body functions, environmental factors and activities and participation. The results of this study will contribute to the development of a standard instrument for measuring functioning, disability and health-relevant aspects for patients with joint contractures.

• Implications for Rehabilitation

• Joint contractures are a major cause for the development of disability in older people.

• Patients’ perspectives and their personal experiences have to be considered when assessing the impact of joint contractures.

• The International Classification of Functioning, Disability and Health (ICF) is an appropriate framework for describing the patients’ multifaceted experience of joint contractures.

     

Parenting stress in mothers with cystic fibrosis*

Aim: To assess the parenting experience of mothers with cystic fibrosis (CF) and to compare with normative data. Methods: Cross-sectional study with a validated generic parental stress questionnaire (PSQ). This PSQ differentiates four components of parental stress: main factor “parental stress”, compounding factor “role restrictions”, protective factors “support from spouse”, and “social support”. Cut-off scores categorise results as “normal”, “borderline” or “concerning”. Sample: Seventy-three women were informed by their local CF centre. Of these, 36 enrolled and had a first-born child aged 1–12 years (consistent with reference values of the PSQ). Of these, 31 (86%) returned the PSQ. Mean age of mothers was 32.6 years?±?6.9 years, mean age of first-born child was 5.2 years?±?3.4 years. Most of the mothers had one biological child, five women had two children and one had three children. Results: Parental stress scores were normally distributed, the same applies for contributing factors and for the two protective factors. Favourable scores were twice as frequent as concerning scores. Mothers of younger children scored slightly better than mothers of school-aged children. Conclusion: In line with the only comparable study, mothers with CF seem to be a remarkably resilient group who mostly cope well with parental stress even in the face of a progressive, chronic disease requiring time-consuming treatment.

• Implications for Rehabilitation

• Today, motherhood is increasingly becoming an option in fertile women with cystic fibrosis.

• The additional burden of parenting seems to be rewarded by fulfilling essential personal goals.

• CF clinics should routinely address a possible wish for a child and to discuss it, openly.

     

Culturally‐grounded mother–daughter communication‐focused intervention for Thai female adolescents

Teenage pregnancy‐prevention interventions have fallen short in significantly decreasing risk of pregnancy for Thai populations. The “breaking the voice” (“rak luk khun tong pood”) culture‐appropriate teenage pregnancy‐prevention program was developed using community‐based research. Qualitative analyses of focus group data identified salient factors related to sexual communication and behavior. The integration of focus group results with theoretical constructs guided the development of an intervention to reduce risky sexual behavior by increasing communication between mothers and their adolescent daughters. A total of 157 mother–daughter dyads from congested areas in Bangkok participated in pilot testing of the intervention by the use of a survey. The findings indicated a significant increase in the frequency of and number of sexual risk communication (P < .05). There was a significant increase in perceived power in relationship control, ability to prevent sexual risk, assertiveness, and ability to decrease sexual risk among daughters (P < .05). “Breaking the voice” represents a female‐focused and culturally‐relevant intervention to combat teenage pregnancy.     

Skill training preferences and technology use in persons with neck and low back pain

Background: Neck pain (NP) and low back pain (LBP) are highly prevalent. Exercise therapy helps, but effect sizes and therapy compliance remain low. Client-centred therapy and technology use may play a role to improve therapy outcomes. To offer technology supported rehabilitation matching patient’s goals, training preferences for rehabilitation and technology familiarity need to be known.

Purpose: This study aims to (1) inventory training preferences and motives, (2) evaluate whether these change during rehabilitation, and (3) evaluate familiarity with using technologies, in persons with NP/LBP.

Method: Semi-structured interviews were conducted with regard to training preferences and usage of mainstream technological devices.

Results: Persons with NP (n?=?40) preferred to train on “lifting”, “prolonged sitting” and “driving a car”. Persons with LBP (n?=?40) preferred to train on “household activities”, “lifting” and “prolonged walking”. Motives were predominantly “ability to work” and “ability to do free time occupations”. Preferences shifted in ranking but remained the same during rehabilitation. Participants were familiar with the surveyed technologies.

Conclusion: Persons with NP or LBP prefer to train on exercises supporting the improvement of everyday life skills. They use technologies in their professional and personal life, which may lower the threshold for the adoption of rehabilitation technologies.

• Implications for rehabilitation

• Persons with neck pain (NP) and persons with low back pain (LBP) prefer to train on specific activities that limit their functional ability during daily tasks. The underlying motives linked to preferred training activities are predominantly “being able to work” and “being able to perform free time occupations”.

• Persons with NP and persons with LBP are accustomed to the use of mainstream technologies and the integration of these technologies in rehabilitation settings seems feasible.

• In order to enable technology supported rehabilitation that is client-centred, technologies need to offer an extensive number of exercises that support (components of) patient training preferences.

     

Exam Success at Undergraduate and Graduate-Entry Medical Schools: Is Learning Style or Learning Approach More Important? A Critical Review Exploring Links Between Academic Success,Learning Styles,and Learning Approaches Among School-Leaver Entry (“Traditional”) and Graduate-Entry (“Nontraditional”) Medical Students

Phenomenon: The literature on learning styles over many years has been replete with debate and disagreement. Researchers have yet to elucidate exactly which underlying constructs are measured by the many learning styles questionnaires available. Some academics question whether learning styles exist at all. When it comes to establishing the value of learning styles for medical students, a further issue emerges. The demographics of medical students in the United Kingdom have changed in recent years, so past studies may not be applicable to students today. We wanted to answer a very simple, practical question: what can the literature on learning styles tell us that we can use to help today's medical students succeed academically at medical school? Approach: We conducted a literature review to synthesise the available evidence on how two different aspects of learning—the way in which students like to receive information in a learning environment (termed learning “styles”) and the motivations that drive their learning (termed learning “approaches”)—can impact on medical students' academic achievement. Findings: Our review confirms that although learning “styles” do not correlate with exam performance, learning “approaches” do: those with “strategic” and “deep” approaches to learning (i.e., motivated to do well and motivated to learn deeply respectively) perform consistently better in medical school examinations. Changes in medical school entrant demographics in the past decade have not altered these correlations. Optimistically, our review reveals that students' learning approaches can change and more adaptive approaches may be learned. Insights: For educators wishing to help medical students succeed academically, current evidence demonstrates that helping students develop their own positive learning approach using “growth mind-set” is a more effective (and more feasible) than attempting to alter students' learning styles. This conclusion holds true for both “traditional” and graduate-entry medical students.     

2021年2月全球新型冠状病毒肺炎疫情风险评估

  目的  评估2021年2月新型冠状病毒肺炎（COVID-19）疫情全球流行情况及对我国的输入风险。  方法  根据美国约翰斯·霍普金斯大学公开发布的每日COVID-19疫情数据,结合牛津大学发布的政策严格性指数,采用流行病学描述方法,通过总体概述、世界卫生组织（WHO）各区及重点国家疫情趋势综合评估和周边十四国疫情与防控政策综合分析,对全球COVID-19疫情风险进行综合、全面与及时的评估。对于各国评估结果,用“全球重点关注国家”“各WHO分区一般关注国家”和“周边特别关注国家”予以表示。  结果  与2021年1月相比,2021年2月全球新增确诊病例降低了43.8%,全球新增死亡病例降低了25.9%,欧洲区新增确诊和死亡病例均最多,其次是美洲区（北）和美洲区（南）,均是需要重点关注的地区。全球每新增1000万确诊病例用时整体呈现增加趋势,每新增50万死亡病例用时保持不变。 我国周边十四国中需要特别关注的国家为俄罗斯。  结论  全球COVID-19肺炎疫情仍在继续蔓延,尽管全球新增确诊病例增长率呈现整体下降趋势,但对于重点关注国家仍要进行持续监测,并及时采取适当的防控政策,完善防疫主体之间的沟通交流机制,对疫情采取及时有效的防控措施。