农村感染艾滋病病毒人群相关知信行调查

目的描述献血员集中地区农村现存艾滋病病毒感染人群的相关知识、态度和行为。方法采用整群抽样方法,在安徽省北部地区既往卖血人员比较集中的村,对25~55岁的村民进行调查,包括问卷调查和艾滋病病毒抗体实验室检测。结果在216名艾滋病病毒阳性人员中,有157人(72.7%)听说过艾滋病,其中,有23人(14.7%)认为自己可能感染了艾滋病,116人(73.9%)认为艾滋病能通过性生活传播,98人(62.4%)认为安全套能预防性生活传播艾滋病,86人(54.8%)认为感染了艾滋病的人不应该过性生活。这些指标男性均高于女性。平均每周性生活1.34次(男1.39次,女1.34次)。共有12人(6.3%)自报曾用过安全套,但在近1年中只有8人(4.2%)使用过安全套,其中只有2人坚持每次都用。有6人(2.9%)在近1年内同男(女)朋友有性关系(男4人,女2人),性生活总数为67次(男53次,女14次),其中男性报告有3次使用了安全套(5.7%),女性未使用安全套,合计使用安全套比例为4.5%。有12名(12.1%)男村民自报有“访问小姐”行为;有10人在城市“访问过小姐”。6人自报“访问小姐”12个,共发生性关系14次。其中有5次使用了安全套。结论献血员集中地区农村艾滋病病毒阳性人群对自我感染艾滋病病毒的危险性认识不足,缺乏基本的艾滋病知识,存在不利于预防艾滋病的态度和行为。安全套使用率太低,艾滋病的性传播危险性很大。外出打工和“访问小姐”两种行为的并存可能会将艾滋病从农村卖血地区传播到一些城市地区。需要加强基本的艾滋病健康教育活动和安全性行为干预活动。     

1996～2001年北京市城区居民吸烟知、信、行变化趋势分析

目的了解北京市城区居民吸烟危害知识、态度、行为变化趋势,为控烟工作提供参考依据。方法采用三阶段整群随机抽样方法,对北京市城区15~69岁常驻居民进行问卷调查,获得16735份有效问卷,率值根据2000年普查结果采用后权重法进行标化处理。结果知晓吸烟易得冠心病率波动在29.41%~39.06%,吸烟易得高血压率21.37%~33.46%;46.61%~61.97%的人赞同禁止烟草广告,31.34%~47.15%的人赞同提高香烟价格;总吸烟率由1996年的34.56%下降到2001年的28.49%,现在吸烟率从30.30%下降到25.07%,戒烟率从4.30%下降到3.28%。结论北京市吸烟干预工作取得一定效果,但吸烟危害健康知识传播尚有待于进一步加强,尤其是对青少年和吸烟者。     

Development of a dietary screening questionnaire to predict excessive weight gain in pregnancy

Excessive gestational weight gain (GWG) is a risk factor for several adverse pregnancy outcomes, including macrosomia. Diet is one of the few modifiable risk factors identified. However, most dietary assessment methods are impractical for use in maternal care. This study evaluated whether a short dietary screening questionnaire could be used as a predictor of excessive GWG in a cohort of Icelandic women. The dietary data were collected in gestational weeks 11–14, using a 40‐item food frequency screening questionnaire. The dietary data were transformed into 13 predefined dietary risk factors for an inadequate diet. Stepwise backward elimination was used to identify a reduced set of factors that best predicted excessive GWG. This set of variables was then used to calculate a combined dietary risk score (range 0–5). Information regarding outcomes, GWG (n = 1,326) and birth weight (n = 1,651), was extracted from maternal hospital records. In total, 36% had excessive GWG (Icelandic criteria), and 5% of infants were macrosomic (≥4,500 g). A high dietary risk score (characterized by a nonvaried diet, nonadequate frequency of consumption of fruits/vegetables, dairy, and whole grain intake, and excessive intake of sugar/artificially sweetened beverages and dairy) was associated with a higher risk of excessive GWG. Women with a high (≥4) versus low (≤2) risk score had higher risk of excessive GWG (relative risk = 1.23, 95% confidence interval, CI [1.002, 1.50]) and higher odds of delivering a macrosomic offspring (odds ratio = 2.20, 95% CI [1.14, 4.25]). The results indicate that asking simple questions about women's dietary intake early in pregnancy could identify women who should be prioritized for further dietary counselling and support.     

双克隆型多发性骨髓瘤3例并文献复习

目的:探讨双克隆型多发性骨髓瘤(multiple myeloma,MM)的临床特征.方法:分析我院诊断的3例双克隆型MM,并进行文献复习.结果:病例1患者抗SSA强阳性(++),SSB(+),抗Ro-52强阳性(++),被诊断为IgG-KAP并IgA-LAM型MM合并干燥综合征.经VAD方案化疗后IgG-KAP型M蛋白消失,出院后给以TCD方案维持治疗,目前病情平稳.病例2患者被诊断为IgG-KAP并游离KAP型MM,给予VAD方案化疗后IgG降至正常水平,出院后给以TCD方案维持治疗,目前病情平稳;病例3患者诊断为IgG-KAP并IgA-KAP型MM,合并肾功能不全及高钙血症,给予TCD方案并结合透析治疗,1个月后死于肾功能衰竭;结论:双克隆型MM罕见,临床表现多样,预后可能较差,尚需更多的病例以总结其临床特征.     

Reliability and validity of the Chinese version of the New Brief Job Stress Questionnaire (New BJSQ) among workers in China

This study aimed to develop the Chinese version of the New Brief Job Stress Questionnaire (New BJSQ) and investigate its reliability and validity. The survey was administered at two time-points separated by a two-week interval among Chinese workers. The Chinese version of the New BJSQ was developed according to the international guidelines. Cronbach’s alpha, intra-class correlation coefficients (ICCs), and Pearson correlation coefficient were calculated to assess the reliability. A variance explained by the first factor was calculated to examine factor-based validity, and confirmatory factor analysis was performed (CFA) to determine the construct validity. Baseline and follow-up analyses included 516 and 52 workers, respectively. In most scales, sufficient internal consistency and test-retest reliability were observed, and principal component analyses demonstrated that the first factor explained more than 50% proportion of the variance. CFA showed that the four-factor model (Job demands, Task-level job resources, Workgroup-level job resources, and Organizational-level job resources) demonstrated a moderate fit, similar to the original version. The Chinese version of New BJSQ showed good reliability and moderate validity. Future studies should explore content and construct validities and the factor structure of the Chinese version of the New BJSQ in more detail.     

Development and validation in Ecuador of the EPD Questionnaire,a diabetes‐specific patient‐reported experience and outcome measure: A mixed‐methods study

IntroductionThe global prevalence of diabetes in 2019 in adults was estimated to be 9.3%. This study developed in Ecuador, for the first time, instruments to assess patient‐reported outcomes and experiences.MethodsThe Experiences of the Person with Diabetes (EPD) Questionnaire is a diabetes‐specific instrument. A mixed‐methods study was conducted. First, a qualitative item development phase that included four focus groups and six semi‐structured interviews with patients was conducted in different rural and urban areas of Ecuador to obtain information on culture, beliefs, demographics, diet and social perspectives. A second quantitative phase for psychometric validation was carried out in primary care settings of rural and urban areas of Ecuador.ResultsForty‐two and four hundred and eighty‐nine participants were included in each phase, respectively. The item development phase resulted in a questionnaire of 44 items (23 for perceived outcomes and 21 for experiences). In the validation study, most participants were women (58%) and from urban areas (57%). Exploratory factor analysis revealed three dimensions for each instrument. Outcomes instrument dimensions were symptoms and burnout, worries and fears and social limitations. Experiences instrument dimensions were information, patient‐centred care and care delivery. Cronbach''s α values of the total score and dimensions were high, ranging between .81 and .93 in both instruments. Confirmatory factor analysis showed an acceptable fit of the data.ConclusionThe EPD Questionnaire is probably the first instrument developed to assess patient‐reported experiences and perceived outcomes in a middle‐income country that included patients to capture all dimensions relevant for the intended population. Its psychometric properties are robust and could provide valuable information for clinicians and policymakers in the region.Patient or Public ContributionThe development of these instruments has taken into consideration patients and the public since their conception. A qualitative approach gathered relevant information related to the cultural, social and economic burden of different populations in Ecuador. Before validation, a pilot test was carried out with users of the National Health Services to obtain their perspectives and insights of the developed instrument. Finally, during the data analysis, we have given special consideration to social variables such as rural and urban populations.     

What Do People Know about Food,Nutrition and Health?—General Nutrition Knowledge in the Austrian Population

Background: Only limited information is available on the nutrition knowledge of the general Austrian population and how this relates to the nutrition knowledge of health professionals (medical doctors, pharmacists, nutritionist, dieticians) and school teachers. Methods: Adolescents and adults at the age of 14–75 years (n = 1000), medical doctors (n = 307), pharmacists (n = 295), nutritionists (n = 124), dieticians (n = 160) and school teachers (n = 873) completed an online survey using a German version of the General Nutrition Knowledge Questionnaire-Revised (GNKQ-R) including self-reported data on sex, age, BMI, and health status. Adolescent and adult participants were recruited by a research agency to be representative for the Austrian population for age, sex, and education. A convenience sample was used for health professionals (medical doctors, pharmacists, nutritionist, dieticians) and school teachers. All participants completed a computer-assisted web-based interviewing (CAWI) survey. Results: Total scores for nutrition knowledge of the general population (61.4%) were significantly lower than scores from all other groups (medical doctors 81.3%, pharmacists 83.0%, dieticians 87.5%, nutritionists 85.6%, school teachers 74.5%). The main drivers for better nutritional knowledge were female sex, higher age, and higher level of education, while BMI classification and self-reported health status had no impact. In regard to single questions, the most striking result was the misclassification of sugar as the nutrient with the most calories by 41.4% of the general population while only 29.0% correctly identified fat to be the nutrient with the most calories. Conclusions: The nutritional knowledge of the general population should be significantly improved in order to lay a basis for better dietary behavior. In view of the relatively low scores of teachers, their nutrition education should be improved in order to enable transfer of sound education in schools.     

Reproducibility of the German and Slovakian Versions of the Dietary Habits and Nutrition Beliefs Questionnaire (KomPAN)

Purpose. The aim of this study was to assess the reproducibility and reliability of the KomPAN questionnaire among two groups of university students from Germany and Slovakia. Methods. A total of 422 individuals (mean age 21.4 years, SD 4.0), including 197 from Slovakia (men 26.2%) and 225 from Germany (men 22.3%), were tested using the self-administered (SA-Q) version of the KomPAN questionnaire and then retested two weeks later. A cross-classification analysis, kappa coefficients, Cronbach’s ɑ coefficients, and a test-retest result comparison were conducted separately for each group of students to assess the reproducibility and reliability of the questionnaire. Results. The cross-classification values were higher than 46.2% among the German students and higher than 55.8% among the Slovakian students. The kappa coefficients ranged from 0.21 to 0.90 in the German students and from 0.38 to 0.94 in the Slovakian students. Cronbach’s ɑ ranged from 0.58 to 0.78. Conclusion. The questionnaire displayed a moderate to very good reproducibility, which was slightly higher in the Slovakian group than in the German group. Therefore, the questionnaire can be recommended for further analysis and comparison of the dietary habits among Germans and Slovakians on a larger scale.