余杭区前列腺增生患病现状及相关治疗的调查

目的:探讨杭州市余杭区前列腺增生的患病现状及相关治疗情况。方法:选择浙江省杭州市余杭区10个社区580名中老年男性作为调查对象,将研究对象分成不同的年龄组进行研究。比较不同年龄段的IPSS评分、下尿路症状评分及下尿路症状的严重程度,对比不同年龄段的Q_(max)水平和前列腺体积,同时根据不同的诊断标准统计前列腺增生的患病率,并且调查相关的用药情况。结果:随着年龄的上升,男性人群的IPSS评分也随之上升,年龄80岁男性的平均IPSS评分高达(15.90±4.73)分;随着年龄的上升,下尿路症状中的尿道梗阻症状评分、膀胱刺激症状评分显著上升,且下尿路症状的严重程度逐渐提高;Q_(max)水平随着年龄的上升而降低,且Q_(max)水平15 m L/s的比例提高。不同诊断标准下的前列腺增生患病率存在差异性。用药情况中以5α-还原酶抑制剂类药物的使用率最高,α-肾上腺素能受体阻滞剂类药物、中成药的使用率也较高。结论:杭州市余杭区大部分中老年男性群体存在下尿路症状,且随着年龄的上升,下尿路症状越明显、前列腺增长的患病率越高,相关的用药情况基本合理。     

铜仁市受艾滋病影响儿童的生存现状调查

目的 了解铜仁市受艾滋病影响儿童生活、学习、就医及抚养情况,为开展关怀救助提供依据。方法 按照贵州省受艾滋病影响儿童专项调查方案,调查全市受艾滋病影响儿童生活、学习、就医及抚养人等情况。结果 调查受艾滋病影响儿童280人,艾滋病病毒感染18人,母婴传播94.4％（17/18）,性传播5.6％（1/18）。学龄儿童未上学的5.6％（11/196）,上学儿童学费减免的30.3％（56/185）。获得救助基金的儿童27.5％（77/280）,对现状感到满意的儿童40.4％（113/280）。农村抚养家庭占77.7％（150/193）,贫困家庭占38.3％（74/193）,有抚养人为艾滋病病毒感染者家庭占50.8%（98/193）,最高学历初中以下家庭占95.9％（185/193）。儿童医疗费用能被家庭负担起的5.7％（16/280）,近2周儿童生病去医院的65.4％（183/280）,在乡镇以下医疗机构就诊的66.1％（121/183）。 结论 铜仁市受艾滋病影响儿童生活质量偏低,幸福感不高,部分关怀救助措施覆盖不到位,应建立儿童生活学习和医疗救治长效关怀机制,加强心理支持,保障儿童健康成长。     

2014年郑州市凉粉类淀粉制品微生物污染状况抽样调查分析

目的 了解郑州市凉粉类淀粉制品中微生物污染状况,为预防食源性疾病提供依据。 方法 根据GB 4789.2-2010、GB 4789.3-2010、GB 4789.4-2010以及GB 4789.10-2010对凉粉类淀粉制品中菌落总数、大肠菌群、沙门氏菌以及金黄色葡萄球菌分别进行检测。 结果 按照GB 2713-2003《淀粉制品卫生标准》要求判断,260份样品菌落总数合格率为23.08%,大肠菌群检出率为75.00%;样品间菌落总数存在差异(P<0.01),大肠菌群含量差异也较大。沙门氏菌检出率为11.54%,金黄色葡萄球菌检出率为3.85%。 结论 郑州市凉粉类淀粉制品微生物污染问题较为普遍,应加强对该类食品的监管,以改善该类食品的卫生状况。     

流行病学调查研究中的质量控制

为了解疾病状态和探究疾病的危险因素,流行病学研究在实际工作中使用的越来越频繁。对于一项流行病学研究,真实可靠的结论来之不易。而调查研究的结果真实与否取决于整个研究过程中各个环节的质量控制,因此消除或尽量减少各种误差对最终得到正确的结果结论是至关重要的。在大规模、多中心的流行病学调查中,研究覆盖的地区多,涉及的人员广,更应注重研究的质量控制体系建立。本文就流行病学调查中的设计、实施、分析阶段中可能出现的误差,对各个环节的质量控制进行综述。     

Concordance of the Composite International Diagnostic Interview Version 3.0 (CIDI 3.0) with standardized clinical assessments in the WHO World Mental Health surveys

The DSM-IV diagnoses generated by the fully structured lay-administered Composite International Diagnostic Interview Version 3.0 (CIDI 3.0) in the WHO World Mental Health (WMH) surveys were compared to diagnoses based on follow-up interviews with the clinician-administered non-patient edition of the Structured Clinical Interview for DSM-IV (SCID) in probability subsamples of the WMH surveys in France, Italy, Spain, and the US. CIDI cases were oversampled. The clinical reappraisal samples were weighted to adjust for this oversampling. Separate samples were assessed for lifetime and 12-month prevalence. Moderate to good individual-level CIDI-SCID concordance was found for lifetime prevalence estimates of most disorders. The area under the ROC curve (AUC, a measure of classification accuracy that is not influenced by disorder prevalence) was 0.76 for the dichotomous classification of having any of the lifetime DSM-IV anxiety, mood and substance disorders assessed in the surveys and in the range 0.62-0.93 for individual disorders, with an inter-quartile range (IQR) of 0.71-0.86. Concordance increased when CIDI symptom-level data were added to predict SCID diagnoses in logistic regression equations. AUC for individual disorders in these equations was in the range 0.74-0.99, with an IQR of 0.87-0.96. CIDI lifetime prevalence estimates were generally conservative relative to SCID estimates. CIDI-SCID concordance for 12-month prevalence estimates could be studied powerfully only for two disorder classes, any anxiety disorder (AUC = 0.88) and any mood disorder (AUC = 0.83). As with lifetime prevalence, 12-month concordance improved when CIDI symptom-level data were added to predict SCID diagnoses. CIDI 12-month prevalence estimates were unbiased relative to SCID estimates. The validity of the CIDI is likely to be under-estimated in these comparisons due to the fact that the reliability of the SCID diagnoses, which is presumably less than perfect, sets a ceiling on maximum CIDI-SCID concordance.     

Brachytherapy practice across Canada: A survey of workforce and barriers

PurposeTo determine the current use of brachytherapy, characteristics of the brachytherapy workforce, and barriers to development and maintenance of brachytherapy programs across Canada.Methods and MaterialsA survey was designed to inquire about the use of brachytherapy and was sent to all Canadian radiation oncologists.ResultsOf the 116 respondents, we identified 80 radiation oncologists from 33 of 41 responding centers who currently or in the past have practiced brachytherapy. Responses were received from 30% overall and 80% of provinces. Approximately 58% of the respondents treat in one site with brachytherapy, whereas 12% treat in three or more sites. Gynecologic (GYN) and genitourinary are the most commonly treated sites (49% of respondents). For all sites, there was a large range in the number of patients treated with brachytherapy by each radiation oncologist per year (i.e., cervix: 1–50). Approximately 49% of the respondents have discontinued practicing brachytherapy for a certain site, most commonly head and neck (28%), GYN (25%), and bronchus (24%). The most common reasons include reassignment or lack of a local program. The most common reasons why brachytherapy is not used for sites other than GYN and prostate include lack of infrastructure and insufficient training of radiation oncologists rather than insufficient patient numbers or lack of evidence for a benefit of brachytherapy.ConclusionsWithin its limitations, our study suggests a mismatch between demand and availability of brachytherapy programs across Canada. In light of finite resources, a rational approach to investment in brachytherapy is needed and this must be based on a formal audit of brachytherapy demand and use.     

人工流产女青年精神心理压力评价与性知识知晓率调查分析

目的：调查分析人工流产女青年的精神心理压力及对性知识的了解情况,为降低这一人群的人工流产发生率提供建议与参考.方法：选取2011年6月至2012年12月在我院自愿进行人工流产术的464例25岁以下女青年为观察对象,选取同期在我院进行健康体检的500名女青年作为对照组.采用自拟调查问卷进行调查,对比两组在焦虑抑郁心理、男女生殖系统知识、性病防护知识、性行为态度与避孕习惯等方面的差异.结果：接受人工流产术的女青年焦虑自评量表（SAS）评分为（44.16±6.04）分,抑郁自评量表（SDS）评分为（45.48±8.39）分;对照组分别为（39.24±7.18）分和（40.67±9.04）分,二者间差异具有统计学意义（P＜0.05）.人流组女青年与对照组在对生殖系统知识及性病防护相关知识等方面的差异具有统计学意义（P＜0.01）;人流组与对照组女青年性行为态度与避孕习惯比较差异具有统计学意义（P＜0.01）.结论：人工流产女青年普遍存在一定的焦虑抑郁心理,生殖健康知识缺乏、性行为态度与避孕习惯差异是导致意外妊娠的主要原因.针对以上因素给予生殖健康教育有助于降低这一人群的人工流产发生率.     

Validity of vaccination cards and parental recall to estimate vaccination coverage: A systematic review of the literature

Immunization programs frequently rely on household vaccination cards, parental recall, or both to calculate vaccination coverage. This information is used at both the global and national level for planning and allocating performance-based funds. However, the validity of household-derived coverage sources has not yet been widely assessed or discussed. To advance knowledge on the validity of different sources of immunization coverage, we undertook a global review of literature. We assessed concordance, sensitivity, specificity, positive and negative predictive value, and coverage percentage point difference when subtracting household vaccination source from a medical provider source. Median coverage difference per paper ranged from −61 to +1 percentage points between card versus provider sources and −58 to +45 percentage points between recall versus provider source. When card and recall sources were combined, median coverage difference ranged from −40 to +56 percentage points. Overall, concordance, sensitivity, specificity, positive and negative predictive value showed poor agreement, providing evidence that household vaccination information may not be reliable, and should be interpreted with care. While only 5 papers (11%) included in this review were from low-middle income countries, low-middle income countries often rely more heavily on household vaccination information for decision making. Recommended actions include strengthening quality of child-level data and increasing investments to improve vaccination card availability and card marking. There is also an urgent need for additional validation studies of vaccine coverage in low and middle income countries.     

Correlates of seasonal flu vaccination among U.S. home health aides

Introduction

Home health aides (HAs) receive limited training and reach many older patient populations highly susceptible to influenza virus. We sought to examine socio-demographic correlates of seasonal flu vaccination receipt among HAs.

Methods

We analyzed data from the 2007 U.S. National Home Health Aide Survey, a nationally representative sample of HAs reporting on occupational status, job and demographic characteristics and receipt of seasonal flu vaccine (n = 3377).

Results

Seasonal flu vaccine receipt was low among all types of HAs (43.9%). After adjustment for socio-demographic indicators (i.e. age, gender, race and health insurance), home health, home care, hospice and personal care attendants were significantly less likely to report receiving seasonal flu vaccine as compared to licensed nursing assistants (adjusted odds ratio, AOR = 0.42, 95% CI [0.20–0.85]; 0.41, [0.17–0.99]; 0.50, [0.26–0.97], and 0.53, [0.26–0.99], respectively).

Conclusion

Targeted effective vaccination campaigns are needed to improve vaccination rates among home health aides.     

针灸穴位注射引起结核分枝杆菌感染的流行病学调查

目的 描述某诊所中医针灸和穴位注射引起结核分枝杆菌感染事件,为进一步探索传播途径提供基础依据.方法 开展病例搜索,通过实验室确诊病例,采用描述性流行病学方法,用SPSS软件进行统计分析.结果 2011年该诊所中医诊疗患者2509例,发生针灸穴位注射处局部结核感染病例46例,感染率为1.83％,其中6例感染后的患者不同时期出现肺部影像异常,表现为粟粒性肺结核,肺部出现影像异常的时间分别为肿块发生后的49、68、85、122、131、152 d;2011年1月发生首例感染患者,感染率逐月上升,9月份达到高峰,随后逐步下降,末例发生在12月份;1、2、12月份感染率最低,分别为0.61％、0.65％和0.88％,9月份感染率最高,为5.88％;实验室检测感染患者脓液标本6份,检出结核分枝杆菌4份,结核复合群2份.结论 中医针灸穴位注射引起结核感染事件,在国内外文献中未曾报道,故中医工作者应引起重视,避免发生类似事件.