The geographic distribution of un-immunized children in Ontario,Canada: Hotspot detection using Bayesian spatial analysis

BackgroundIn Ontario, Canada, little is currently known about the extent to which un-immunized children may cluster geographically. Our objectives were to: describe the geographic distribution of fully un-immunized children; identify geographic clusters (hotspots) of un-immunized children; and to characterize the contribution of spatial effects and covariates on hotspots, where found.MethodsOur analytic cohort consisted of Ontario students aged 7–17 years in the 2016–2017 school year. We defined students as un-immunized if they had zero doses of any vaccine and a non-medical exemption recorded in Ontario’s registry. We calculated unadjusted proportions of un-immunized students by Census Subdivision (CSD) and then used a sequential approach to identify hotspots starting first with hotspot identification at the CSD level and then probed identified hotspots further by Dissemination Area (DA) and including covariates. Hotspots were identified using the Besag-York-Mollie Bayesian spatial model and were defined as areas with >95% probability of having two times the proportion of un-immunized students, relative to the province overall.ResultsWe identified 15,208 (0.94%) un-immunized children within our cohort consisting of more than 1.61 million students. Unadjusted proportions of un-immunized students varied greatly by geography, ranging from 0% to 21.5% by CSD. We identified 16 hotspot CSDs which clustered in five distinct areas, all of which were located in southern Ontario. The contribution of covariates and spatial effects on the risk of having un-immunized students varied greatly across hotspot areas.ConclusionsAlthough the provincial proportion (0.94%) of un-immunized students is small, geographical clustering of such students is evident in Ontario and in some areas presents an important risk for future outbreaks. Further qualitative work within these hotspot areas would be a helpful next step to better characterize the factors associated with vaccine refusal in these communities.     

Human papillomavirus (HPV) vaccination in the transition between adolescence and adulthood

PurposeYoung adulthood is characterized by changes in health care decision-making, insurance coverage, and sexual risk. Although the human papillomavirus (HPV) vaccine is now approved for adults up to age 45, and catch-up vaccination is currently recommended up through age 26, vaccination rates remain low in young adults. This study explored perspectives on HPV vaccination among young adults receiving care at the student health center of a large public university.MethodsWe conducted semi-structured interviews (n = 27) and four focus groups with female and male undergraduate and graduate students (n = 18) and semi-structured interviews with health care providers (n = 6). Interviews and focus groups explored perceived risk of HPV infection, benefits of the HPV vaccine, and motivations for and barriers to HPV vaccination.ResultsMany young adults cited their parents’ views and recommendations from medical providers as influential on their decision-making process. Students perceived that cervical cancer prevention was a main benefit of the HPV vaccine and sexual activity was a risk factor for HPV infection. Students often lacked knowledge about the vaccine’s benefits for males and expressed some concerns about the safety and side effects of a vaccine perceived as new. Logistical barriers to vaccination included uncertainty over vaccination status and insurance coverage for the vaccine, and concerns about balancing the vaccine schedule with school obligations. Providers’ vaccine recommendations were impacted by health system factors, including clinical infrastructure, processes for recommending and documenting vaccination, and office visit priorities. Suggested vaccination promotion strategies included improving the timing and messaging of outreach efforts on campus and bolstering clinical infrastructure.ConclusionsAlthough college may be an opportune time to reach young adults for HPV vaccination, obstacles including navigating parental influence and independent decision-making, lack of awareness of vaccination status, and numerous logistical and system-level barriers may impede vaccination during this time.     

不同性别大学生健康危险行为现状及影响因素研究*

目的 了解大学生健康危险行为现状及影响因素,促进大学生健康发展。方法 采用分层随机抽样的方法,对5所高校的2510名大学生进行问卷调查,利用SPSS 25.0统计软件进行统计描述、x2检验和logistic回归分析。结果 男生健康危险行为发生率均高于女生:饮酒（81.99%/34.57%）、通宵上网（47.24%/28.22%）、吸烟（31.28%/2.25%）、参与赌博（22.99%/9.41%）。多因素结果显示,男女生健康危险行为的共同危险因素有宗教信仰、恋爱、睡眠障碍、父母感情不好（OR>1,P<0.05）;共同保护因素有师范类院校、医学类院校、住校（OR<1,P<0.05）;男生健康危险行为的危险因素还有消费水平高、担任干部、生源地为农村（OR>1,P<0.05）;年级高是男生通宵上网的保护因素（OR=0.824,P=0.011）,吸烟的危险因素（OR=1.271,P=0.005）。结论 大学生饮酒、通宵上网、吸烟、参与赌博的发生率较高,性别差异大,影响因素来自个体、学校、家庭层面,应从以上层面对重点人群进行健康教育,积极引导大学生形成健康的行为方式。     

贵阳市高校教师颈椎慢性疼痛现状及影响因素分析

目的 了解贵阳市高校教师颈椎慢性疼痛情况,为高校教师颈椎慢性疼痛方面的医疗卫生服务提供参考依据。 方法 采取单纯随机抽样方法抽出7所公办本科高校,再整群随机抽取部分学院的教师,采用问卷对抽中的教师进行面对面调查。 结果 共调查963名高校教师,检出颈椎慢性疼痛患者360例,颈椎慢性疼痛患病率37.4%。男性患病率为29.9%,女性患病率为42.9%,女性患病率高于男性（〖XC五号.EPSP〗=16.927,P<0.001）。高校教师颈椎慢性疼痛患者的平均疼痛时间3年,女性较男性疼痛时间要长（Z=-2.936,P=0.003）;疼痛最主要类型为酸、胀痛。颈椎疼痛对80%以上的高校教师的日常、睡眠、心情都有轻度以上的影响。多因素分析结果显示,伏案时间（OR=1.247,95%CI:1.035~1.502）和每周运动天数较少:<1天（OR=2.808,95%CI:1.859~4.243）、1~2天（OR=1.750,95%CI:1.207~2.537）、3~4天（OR=1.636,95%CI:1.133~2.363）是高校教师患颈椎慢性疼痛的独立危险因素。 结论 贵阳市高校教师群体颈椎慢性疼痛患病率较高、呈年轻化趋势,疼痛病史较长,女性较男性严重;颈椎慢性疼痛影响患者的睡眠和心情。应关注高校教师颈椎慢性疼痛的防控。     

基于大学生群体的三种手机成瘾量表信效度及应用的比较研究

目的 比较三种手机成瘾量表在大学生手机成瘾测量中的一致性。方法 选取合肥市3所本科高校的1004名大学生,采用手机成瘾指数量表（MPAI）、智能手机依赖量表（SAS）、智能手机依赖量表简版（SAS-SV）同时进行手机成瘾倾向的测量,采用匹兹堡睡眠质量指数量表（PSQI）进行睡眠质量的测量,对122位学生在首次测评两周后进行重测。用Pearson相关系数描述三个量表得分之间的相关性;用符合率和Kappa系数衡量手机成瘾判定结果的一致性;用t检验、方差分析、logistic回归进行手机成瘾与大学生基本特征、相关因素的关联分析。结果 MPAI与SAS、MPAI与SAS-SV、SAS与SAS-SV得分之间的Pearson相关系数分别为0.72、0.74、0.95（P＜0.010）。MPAI与SAS-SV判定手机成瘾结果的符合率为64.6％,Kappa值为0.32（P＜0.001）。t检验显示,性别、专业属性与量表得分之间,三个量表结果一致;方差分析显示年级与量表得分之间,SAS与MPAI、SAS-SV的结果不一致。Logistic回归分析显示,性别、年级、专业属性与手机成瘾之间,MPAI、SAS-SV结果一致;睡眠与手机成瘾之间,MPAI、SAS-SV结果不一致。结论 三种量表的信效度均较好;量表得分的相关性较高,但MPAI和SAS-SV判定手机成瘾的一致性较差;在手机成瘾相关因素分析上,量表间存在不一致的现象。     

西藏自治区在校大学生心理健康状况调查研究

目的探讨西藏自治区在校大学生心理健康状况的现状。方法用临床症状自评量表（SCL-90）对全区大学生进行调查研究。结果①女生心理健康状况比男生差，恐怖因子男女之间存在显著差异（t=-3．700 P〈0．05）；②农村大学生心理健康状况比城镇大学生差，其中焦虑、精神病性达到显著性水平（t=-2．761 P〈0．05；t=-2．799 P〈0．05）；③汉族学生心理健康状况比藏族学生差，人际关系敏感、抑郁、精神病性3个方面差异显著（t=-2．856 P〈0．05；t=-3．312，〈0．05；t=-2．733 P〈0．05）。结论加强大学生的心理卫生保健，有利于减少心理问题，促进人格的健康发展。     

在校大学生艾滋病认知状况的调查研究

目的：了解高校大学生对艾滋病的认知状况,以便为制定有针对性的健康教育和综合防治措施提供科学依据。方法：采用现场不记名方式于2000年11月对西安五所高校大学生进行了问卷调查,用EpiInfo5.0统计软件进行统计分析。结果：70．5％的被调查者清楚艾滋病的全称。49．1％的人能正确回答艾滋病的三种主要传播途径,25．6％的人还认为蚊虫叮咬可传播艾滋病,对此知识的掌握年龄大者,已婚者,受教育程度高的和医学生掌握程度优于年龄小的,未婚者,教育程度低的和非医学生。结论：高校大学生对艾滋病有关知识了解甚少,他们又处在感染的高危人群,这种低知识水平的现状,与我国面临的艾滋病流行趋势极不适应,提示令后艾滋病知识的健康教育应在大学生尤其应在低年级学生中加强。     

大学生心理健康状况及其影响因素的研究

目的：调查大学生心理健康状况及其影响因素。方法：采用问卷调查,进行单因素分析和多元线性回归分析,筛选影响心理健康的因素。结果：有心理问题者占１０．４％,有严重心理问题者占３．７％。影响大学生心理健康的因素有研究对象年级、母亲文化程度、父母关系、家族居住地区。结论：大学生中存在心理问题应引起家长、学校和社会的关注。