Interviewer BMI effects on under- and over-reporting of restrained eating: evidence from a national Dutch face-to-face survey and a postal follow-up

Objectives

To determine the effect of interviewer BMI on self-reported restrained eating in a face-to-face survey and to examine under- and over-reporting using the face-to face study and a postal follow-up.

Methods

A sample of 1,212 Dutch adults was assigned to 98 interviewers with different BMI who administered an eating questionnaire. To further evaluate misreporting a mail follow-up was conducted among 504 participants. Data were analyzed using two-level hierarchical models.

Results

Interviewer BMI had a positive effect on restrained eating. Normal weight and pre-obese interviewers obtained valid responses, underweight interviewers stimulated under-reporting whereas obese interviewers triggered over-reporting.

Conclusion

In face-to-face interviews self-reported dietary restraint is distorted by interviewer BMI. This result has implications for public health surveys, the more so given the expanding obesity epidemic.     

山西省职业暴露人群高致病性禽流感(H5N1)血清抗体水平调查

目的了解山西省职业暴露人群高致病性禽流感(H5N1)感染现状,探索高危人群的暴露情况与感染途径,为防控工作提供依据。方法现场问卷调查职业暴露人群,用单放射免疫扩散溶血实验检测高致病性禽流感(H5N1)的血清抗体水平。结果山西省的职业暴露人群以青壮年为主;主要暴露方式以加工(44.93%)、喂养+清扫禽舍(21.74%)和喂养+清扫禽舍+捕捉(15.94%)为主;接触病死禽时91.89%的人员采取了防护措施;研究显示山西职业暴露人群H5N1病毒的感染率为0.97%,曾经发生过高致病性禽流感疫情的县与未发生过疫情的县感染率差异无统计学意义(χ2=0.000,P=0.995)。结论山西省禽类职业暴露人群可能存在H5N1隐性感染,并提示无论是否发生过禽间疫情,均需加强监测与管理。     

Phenotypic and genetic spectrum of Danish patients with ABCA4-related retinopathy

Background: Pathogenic variations in the ABCA4 gene were originally recognized as genetic background for the autosomal recessive disorders Stargardt disease and fundus flavimaculatus, but have expanded to embrace a diversity of retinal diseases, giving rise to the new diagnostic term, ABCA4-related retinopathy. Diagnostic genotyping of ABCA4 is complicated by the large size of the gene and the existence of approximately 600 known pathogenic variations, along with numerous rare polymorphisms. A commercial diagnostic array-based assay has been developed targeting known mutations, however a conclusive genetic diagnosis must rely on a comprehensive genetic screening as the mutation spectrum of ABCA4-related retinopathies continues to expand. Material and methods: Among 161 patients with a Stargardt-related phenotype previously assessed with the commercial ABCA4 mutation microarray, we analyzed the ABCA4 gene with High-resolution melting (HRM) in patients in whom the array analysis identified either a heterozygous mutation (n?=?50) or no mutation (n?=?30). Results: The HRM method detected each of the already known mutations and polymorphisms. We identified the second ABCA4 mutation in 31 of 50 heterozygous patients (62%). Several novel mutations were identified of which four were identified multiple times. The recurrent novel mutations were subsequently assessed among the 30 patients with possible ABCA4-related diseases, previously found to be negative for known ABCA4 mutations by array analysis. In total, 30 different mutations were identified of which 21 have not been described before. Conclusion: Scandinavian patients with ABCA4-related retinopathy appear to have a distinct mutation spectrum, which can be identified in patients of diverse clinical phenotypes.     

The predictive value of subjective symptoms and clinical signs for the presence of treatment‐requiring exudative age‐related macular degeneration

Purpose: The introduction of vascular endothelial growth factor inhibitors for the treatment of exudative age‐related macular degeneration (AMD) has increased the referral rates of AMD patients with visual symptoms to treating centres considerably. However, a large proportion of the referred patients do not qualify for treatment implying that considerable resources could be saved if these patients could be identified on the basis of the clinical data available in the referring nonspecialized setting. Methods: A prospective observational study of 1682 consecutive patients referred with suspicion of exudative AMD qualifying for intravitreal angiostatic treatment. On the basis of the structured interviewing about symptoms, ophthalmoscopy, optical coherence tomography scanning, and fluorescein angiography, the patients were divided into two groups: one qualifying for and another not qualifying for treatment. Multiple logistic regression was used to identify independent parameters predicting the need for treatment. Results: The presence of metamorphopsia, dyschromatopsia, retinal haemorrhages and exudates, central retinal thickness, and the absence of micropsia were highly significant individual determinants of treatment‐requiring AMD. Sudden onset and worsening of symptoms and the presence of a central dark spot covaried with the occurrence of retinal haemorrhages, whereas reduced visual acuity and blurred vision covaried with the presence of both haemorrhages and exudates. Conclusion: Patients with treatment‐requiring AMD can be reliably identified by questioning about the presence of metamorphopsia and dyschromatopsia and the absence of micropsia, combined with ophthalmoscopical detection of retinal haemorrhages and exudates. This information may improve the triage of patients considered for referral.     

Choroidal thickness following extrafoveal photodynamic treatment with verteporfin in patients with central serous chorioretinopathy

Purpose: To evaluate the effect of verteporfin photodynamic treatment (PDT) on choroidal thickness in patients with central serous chorioretinopathy (CSC). Methods: Choroidal thickness was measured with enhanced depth imaging– optical coherence tomography (EDI–OCT) before and after verteporfin PDT (full‐dose verteporfin, half‐light dose) in 16 eyes in 16 patients with serous detachment of the fovea secondary to extrafoveal angiographic fluorescein leakage. Treatment was confined to the area of leakage, whereas choroidal thickness before and after treatment was assessed over a larger area of the fundus using OCT. Results: Complete resolution of the serous detachment was seen in all 16 eyes within 1 month of extrafoveal PDT, while choroidal thickness in the area where PDT was applied decreased from 407 μm [mean; 95% confidence interval (CI₉₅) 356–458 μm] to 349 μm (mean; CI₉₅ 300–399 μm; p < 0.0001), and subfoveal choroidal thickness was reduced from 421 μm (mean; CI₉₅ 352–489 μm) to 346 μm (mean; CI₉₅ 278–414 μm; p = 0.0001). Initially, subfoveal choroidal thickness was significantly increased in the treated eye compared with the healthy fellow eye (mean 324 μm; CI₉₅ 273–376 μm; p = 0.0003), but after treatment, the difference was not significant. Discussion: Photodynamic therapy of active CSC was followed by choroidal thickness reduction, not only locally but also at considerable distance from the treated area. Thus, the process that causes choroidal thickening in CSC appears to spread laterally within the choroid.     

Local retinal sensitivity in relation to specific retinopathy lesions in diabetic macular oedema

Purpose: To study microperimetric macular sensitivity in diabetic macular oedema (DMO) in relation to lesion characteristics obtained by optical coherence tomography (OCT), colour fundus photography, and fluorescein angiography (FA). Methods: The study comprised 20 eyes in 15 patients with nonproliferative diabetic retinopathy and recently diagnosed untreated DMO. Investigations included microperimetry, fluorescein angiography, colour fundus photography, and OCT. All measures and gradings were made for each of the nine fields of an early treatment diabetic retinopathy study macula template. Statistical analysis was made using Spearman’s nonparametric test including field and mean values within fields. Comparisons were made within the study population and with a normative microperimetry database. Results: Subnormal microperimetric sensitivity was associated with cystoid macular oedema, both in foveal petaloid (r = ?0.50, p = 0.02) and extrafoveal honeycomb patterns (r = ?0.8, p < 0.0001) and with outer nuclear layer cysts (r = ?0. 5, p = 0.024), inner nuclear layer cysts (r = ?0.31, p = 0.03), and hard exudate (r = ?0.38, p = 0.0026). There was no detectable effect of focal noncystoid oedema (r = ?0.16, p = 0. 48), diffuse noncystoid oedema (r = ?0.14, p = 0.55), capillary nonperfusion (r = ?0.33, p = 0.15), intraretinal haemorrhage (r = ?0.15, p = 0.53), or serous retinal detachment (r = ?0.11, p = 0.63). Foveal thickening was associated with locally reduced sensitivity (r = ?0.54, p = 0.01). Foveal sensitivity was positively correlated to the visual acuity, with a correlation of 0.44 and a borderline significance (p = 0.0509). Conclusions: Macular hard exudates and cystoid oedema were associated with locally reduced sensitivity. Thus, the lesions associated with reduced sensitivity for a white‐on‐white stimulus were such lesions that cause light to be blocked or scattered before it reaches the photoreceptors, suggesting that optical effects are a major cause of sensitivity loss.     

流动人口生殖健康公共服务的内涵及政策分析

对我国流动人口生殖健康公共服务的内涵及我国流动人口生殖健康公共服务的相关政策法规进行了分析,并且从人力资源、经费投入及相关政策法规3个方面,分析了当前我国流动人口生殖健康公共服务存在的问题,并提出了促进我国流动人口生殖健康公共服务供给的建议。