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.     

Patient-reported recall of smoking cessation interventions from a health professional

Objective

To determine the prevalence and characteristics of current cigarette smokers who report receiving health care provider interventions (‘5A's’: ask, advise, assess, assist, arrange) for smoking cessation.

Methods

Data came from the 2009–2010 National Adult Tobacco Survey, a telephone survey of United States adults aged ≥ 18 years. Among current cigarette smokers who reported visiting a health professional in the past year (n = 16,542), estimates were calculated overall and by sex, age, race/ethnicity, education, income, health insurance coverage, and sexual orientation.

Results

Among smokers who visited a health professional (75.2%), 87.9% were asked if they used tobacco, 65.8% were advised to quit, and 42.6% were asked if they wanted to quit. Among those wanting to quit, 78.2% were offered assistance and 17.5% had follow-up arranged. Receipt of the ‘ask’ component was lower among males and uninsured individuals. Receipt of the ‘advise’ and ‘assess’ components was lower among those aged 18–24 and uninsured individuals. Receipt of the ‘assist’ component was lower among non-Hispanic blacks. No differences were observed for the ‘arrange’ component.

Conclusions

Many current smokers report receiving health care provider interventions for smoking cessation. Continued efforts to educate, encourage, and support all health professionals to provide effective, comprehensive tobacco cessation interventions to their patients may be beneficial.     

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.     

2011年医院感染现患率调查分析

目的 了解医院感染现患率,完善医院感染预防控制措施.方法 采用横断面调查的方法,对2011年8月24日的住院患者进行医院感染现患率调查及统计分析.结果 调查住院患者518例,发现医院感染32例,医院感染现患率为6.2％;医院感染现患率前3位的科室依次为ICU 100.0％、神经外科29.4％、心脏监护病房20.0％;医院感染部位前3位的依次为下呼吸道44.1％、上呼吸道17.6％、手术切口14.7％;医院感染易感因素前3位依次为气管切开29.4％、使用抗菌药物20.6％、手术17.6％、使用呼吸机17.6％;调查发现医院感染32例,有25例送检标本,标本送检率78.1％,阳性标本18例,检出阳性率72.0％;医院感染病原菌检出构成比前3位依次为金黄色葡萄球菌、铜绿假单胞菌、真菌,分别占22.7％、16.6％、16.6％.结论 加强重点科室医院感染管理,合理使用抗菌药物,减少侵入性操作是控制医院感染的重要措施.     

新碘盐标准实施前后全市居民盐碘、尿碘含量调查

目的了解广东省新碘盐标准实施前后惠州市防治碘缺乏病措施落实情况,为今后防治工作提供指导和理论依据。方法按《全国碘缺乏病监测方案》要求,2009-2012年对惠州市惠城区、惠阳区、博罗县、惠东县和龙门县等5县区采集居民家中碘盐、饮用水,以及在辖区内小学采集8～10岁儿童尿样。结果新碘盐标准实施前后全市盐碘、尿碘含量均符合国家《碘缺乏病消除标准》。结论进一步完善惠州地区科学补碘工作,持续消除碘缺乏病。     

Cultural adaptation of the Latin American version of the World Health Organization Composite International Diagnostic Interview (WHO-CIDI) (v 3.0) for use in Spain

Objective

To develop a Spanish version of the WHO-Composite International Diagnostic Interview (WHO-CIDI) applicable to Spain, through cultural adaptation of its most recent Latin American (LA v 20.0) version.

Methods

A 1-week training course on the WHO-CIDI was provided by certified trainers. An expert panel reviewed the LA version, identified words or expressions that needed to be adapted to the cultural or linguistic norms for Spain, and proposed alternative expressions that were agreed on through consensus. The entire process was supervised and approved by a member of the WHO-CIDI Editorial Committee. The changes were incorporated into a Computer Assisted Personal Interview (CAPI) format and the feasibility and administration time were pilot tested in a convenience sample of 32 volunteers.

Results

A total of 372 questions were slightly modified (almost 7% of approximately 5000 questions in the survey) and incorporated into the CAPI version of the WHO-CIDI. Most of the changes were minor — but important — linguistic adaptations, and others were related to specific Spanish institutions and currency. In the pilot study, the instrument's mean completion administration time was 2 h and 10 min, with an interquartile range from 1.5 to nearly 3 h. All the changes made were tested and officially approved.

Conclusions

The Latin American version of the WHO-CIDI was successfully adapted and pilot-tested in its computerized format and is now ready for use in Spain.     

青藏高原少数民族聚居农牧区儿童监护人预防接种认知和行为研究

目的 了解青海省少数民族聚居农牧区儿童监护人对预防接种知识的认知和行为态度,为制定免疫规划传播策略提供依据.方法 采用多阶段整群抽样方法,对703名儿童监护入进行问卷调查.结果 少数民族聚居的农牧区儿童监护人对预防接种知识了解不够,自主接种意识薄弱.不同民族儿童监护人在预防接种知识的掌握和主动开展疫苗接种方面差异有统计学意义.医务人员和电视广播是儿童监护人获取信息的主要渠道,且也希望今后继续通过这两种途径获得.结论 针对不同人群制定不同的传播策略,重点通过医务人员和广播电视途径开展免疫规划知识宣传,提高公众参与免疫规划服务的主动性.     

佛山市南海区大沥地区中小学教师健康检查结果

目的了解佛山市南海区大沥镇中小学教师身体健康状况,分析中小学教师健康状况的影响因素,并提出健康干预措施和策略。方法采用整群抽样的方法选择佛山市南海区大沥镇全部公立中小学,按照是否从事一线教学工作将研究对象分为研究组和对照组,由专职医生对所有研究对象进行身体健康状况检查,包括：体格检查（身高、体重、体重指数等）、常规内科检查、实验室检查（血常规、生化检查）。结果教师组慢性咽炎和鼻炎的检出率高于对照组的行政管理人员（P〈0．01）;收缩压和舒张压的测量值在专职教师和行政管理人员之间的差异均无统计学意义（P〉0．05）;心电图检查发现,教师组异常率为30．8％,对照组心电图异常率为26．5％,两组间差异无统计学意义（P〉0．05）;教师组肥胖患者占4．2％;对照组肥胖患者占5．4％,两组体重指数的分布之间差异无统计学意义（P〉0．05）。结论中小学教师鼻炎、慢性咽炎等慢性病的患病率较高,身体健康状况不容乐观,应定期健康检查,加强健康干预,提高健康水平。