Middle school food environments and racial/ethnic differences in sugar-sweetened beverage consumption: Findings from the Healthy Choices study

Background

Prior studies have demonstrated disproportionate clustering of fast food outlets around schools.

Purpose

The purpose of this study is to determine if racial/ethnic differences in middle school student self-reported sugar-sweetened beverage (SSB) consumption is explained by differential distributions of food outlets surrounding their schools.

Methods

Baseline (2005) data were analyzed from 18,281 middle school students in 47 Massachusetts schools participating in Healthy Choices, an obesity prevention program. Linear mixed effects models were used to examine the association of individual race/ethnicity and daily SSB consumption and the potential mediating effect of the density of food outlets (the number of fast food outlets and convenience stores in a 1500 m buffer area surrounding the school) on this association adjusting for individual and school demographics.

Results

More SSB consumption was reported by students of all racial/ethnic minority groups compared to their White peers except Asians. The density of fast food restaurants and convenience stores was not associated with individual SSB consumption (β = 0.001, p = 0.875) nor did it mediate the association of race/ethnicity and SSB consumption.

Conclusions

Racial and ethnic differences in SSB consumption among MA middle school students cannot be fully explained by the location of fast food restaurants and convenience stores.     

深圳市先天性心脏病流行病学特征研究

目的:研究深圳市2010 ～ 2011年胎儿及早期新生儿先天性心脏病(CHD)的流行病学特征.方法:利用深圳市2010 ～2011年出生缺陷监测数据,把CHD病例分为单发和合并其他系统畸形两类,计算主要病种的发生率、产前诊断率,并分析患儿的转归、社会人口学特征以及多发CHD的伴发畸形情况.结果:深圳市2010 ～2011年包括怀孕以来的先天性心脏病儿总发生率为58.97/万;单发的心脏畸形占86.93％,合并其他系统畸形的心脏畸形组占13.07％,以合并染色体异常、神经系统和总唇裂畸形为主,以产后确诊为主,足月儿的动脉导管未闭、室间隔缺损、房间隔缺损为主要类型;以主动脉缩窄、右室双出口、单心室、右心发育不良等严重先天性心脏畸形的产前诊断率较高;与单发先天性心脏病组相比,合并其他系统畸形组产妇高龄、流动人口比例较高,28周前终止妊娠、死胎、婴儿死亡的比例较高,转归较差.结论:深圳市胎儿及早期新生儿先天性心脏病总发生率水平低于广东省医院出生缺陷监测水平,先天性心脏病分型较复杂,以合并其他系统畸形的严重先天性心脏病预后较差,提示应重视CHD的病因学研究和预防工作.     

Five types of OECD healthcare systems: Empirical results of a deductive classification

This article classifies 30 OECD healthcare systems according to a deductively generated typology by Rothgang and Wendt [1]. This typology distinguishes three core dimensions of the healthcare system: regulation, financing, and service provision, and three types of actors: state, societal, and private actors. We argue that there is a hierarchical relationship between the three dimensions, led by regulation, followed by financing and finally service provision, where the superior dimension restricts the nature of the subordinate dimensions. This hierarchy rule limits the number of theoretically plausible types to ten. To test our argument, we classify 30 OECD healthcare systems, mainly using OECD Health Data and WHO country reports. The classification results in five system types: the National Health Service, the National Health Insurance, the Social Health Insurance, the Etatist Social Health Insurance, and the Private Health System. All five types belong to the group of healthcare system types considered theoretically plausible. Merely Slovenia does not comply with our assumption of a hierarchy among dimensions and typical actors due to its singular transformation history.     

类风湿关节炎中医证候分析

从病因病机、证候分类、证候分布、证候微观分析等方面,对类风湿关节炎中医证候分布规律进行分析,指出为了应该努力开展系统性研究,制定统一诊断、分型及分期标准,开展大样本临床调查,使类风湿关节炎证候分析拥有科学的依据和对照标准。     

我国国际疾病分类领域作者合著现象分析——基于社会网络分析视角

目的运用社会网络分析法探讨国内国际疾病分类领域作者合著现象.方法利用UCINET软件从网络密度、点度中心性、中间中心性、接近中心性和凝聚子群5个角度进行分析.结果作者合著网络密度为0.0021,网络中主成分节点占所有节点总数的3.46％,点度中心性值最高的节点是林洁中,而中间中心性和接近中心性值最高的节点均为郭蕴青,1851个作者构成44个2-丛.结论 目前国内该领域作者合著关系不紧密,但在一定程度上林洁中、梁耀、李建炜、范炜、郭蕴青、刘爱民等作者属于该领域的核心成员或意见领袖.从整体角度来看,该网络目前尚未形成明显的小团体现象,组织结构比较松散、孤立.     

National hospital data for intussusception: Data linkage and retrospective analysis to assess quality and use in vaccine safety surveillance

ObjectivesTo assess the quality of national Hospital Episode Statistics (HES) data for intussusception, and evaluate this routinely collected database for rotavirus vaccine safety surveillance by estimating pre-vaccination trends in intussusception hospitalisation.MethodsData linkage was performed between HES and prospective intussusception data from the British Paediatric Surveillance Unit (BPSU), followed by capture–recapture analysis to verify HES data quality. Inclusion criteria were infants aged less than 12 months and admitted for intussusception to National Health Service (NHS) hospitals in England from March 2008 to March 2009. To estimate pre-vaccination incidence rates of intussusception, we performed a retrospective analysis of HES data. Infants aged less than 12 months and admitted for intussusception to NHS hospitals in England between 1995 and 2009 were included.ResultsData linkage between 254 cases of intussusception identified in HES data and 190 cases reported via the BPSU resulted in 163 cases common to both data sources. Of remaining 91 cases in HES, 37 had confirmed intussusception. HES data accuracy was 78.7% (200 confirmed/254 cases) and completeness for intussusception was 86% (163 matched/190 BPSU cases) compared to 81.5% (163 matched/200 HES cases) for BPSU. A total of 233 (95% CI: 227.4 to 238.8) intussusception cases were estimated for the infant population (2008 to 2009). For retrospective analysis, of 6462 intussusception admissions in HES data (1995 to 2009), 1594 (24.7%) were duplicate admissions. A declining trend in intussusception incidence was observed in the infant population, from 86/100,000 in 1997 to 34/100,000 in 2009 (60% reduction, P < 0.001). Cosinor modelling showed an excess of cases among infants in winter and spring (P < 0.001, n = 4957, 1995 to 2009).ConclusionNational hospital data capture the majority of admissions for intussusception and should be considered for the post-implementation surveillance of rotavirus vaccine safety in England.     

多排CT分型在高龄粗隆间骨折治疗中的应用

利用多排CT对股骨粗隆间骨折进行分型,根据分型指导高龄粗隆间骨折的临床治疗。自2011.01—2014.01对110例高龄股骨粗隆间骨折根据多排CT分型,分别行股骨近端防旋髓内钉固定及髋关节置换术治疗,评价CT分型对手术治疗的指导意义。110例获得随访,平均22（10~36）个月,术后2年髋关节功能Harris评分：优80例,良22例,可5例,差3例,优良率92.7%。多排CT分型在高龄股骨粗隆间骨折的临床治疗中,具有指导意义,提高了手术疗效,减少了骨折及手术并发症。