广东省陆丰市2003年流行性乙型脑炎疫情分析及控制效果评价

广东省陆丰市2003年6月6—30日发生了流行性乙型脑炎(乙脑)流行。经采取应急接种和开展以灭蚊为主的爱国卫生运动等综合防制措施后，疫情很快得到控制。     

Prepubertal children with short stature have a different perception of their well-being and stature than their parents

The well-being of children with short stature has commonly been assessed by questioning the children's parents and teachers. Few studies have included questionnaires completed by the children themselves. The aim of this study was to compare how short children and their parent perceive the height and well-being of the child. A total of 80 prepubertal children who were investigated for short stature at the Children's Hospital, Göteborg, Sweden were included in the study. The Silhouette Apperception Technique (SAT) was used to estimate the perception by the child and his/her parents of the child's present stature, as well as their expectations of the child's final stature. The mean ratings of the parents' and children's perception of the child's present stature indicate that both children and parents tend to overestimate it. The mean rating of the children's expectations of final height suggests that the children have high and unrealistic expectations of achieving a tall stature. A visual analogue (VA) scale was used to assess aspects of well-being. Although the children in this study did not seem to have a negative perception of their own well-being, their parents rated the children's well-being lower. The correlation between the ratings of parents and children were comparatively low on both the SAT and the VA scale, indicating that conclusions about how children perceive their height and well-being cannot be based solely on the opinions of proxy respondents such as parents.This work was supported by grants from the Swedish Medical Research Council (6465, 7509), the Lundgren Foundation, the First of May Flower Campaign for Children's Health, and Pharmacia AB. The authors are grateful to Ms Birgitta Svensson for valuable computer support.     

Investigation of common symptoms of cancer and reliability analysis

Objective:To identify cancer distribution and treatment requirements,a questionnaire on cancer patients was conducted.It was our objective to validate a series of symptoms commonly used in traditional Chinese medicine (TCM).Methods:The M.D.Anderson Symptom Assessment Inventory (MDASI) was used with 10 more TCM items added.Questions regarding TCM application requested in cancer care were also asked.A multi-center,cross-sectional study was conducted in 340 patients from 4 hospitals in Beijing and Dalian.SPSS and Excel software were adopted for statistical analysis.The questionnaire was self-evaluated with the Cronbach's alpha score.Results:The most common symptoms were fatigue 89.4%,sleep disturbance 74.4%,dry mouth 72.9%,poor appetite 72.9%,and difficulty remembering 71.2%.These symptoms affected work (89.8%),mood (82.6%), and activity (76.8%),resulting in poor quality of life.Eighty percent of the patients wanted to regulate the body with TCM.Almost 100% of the patients were interested in acquiring knowledge regarding the integrated traditional Chinese medicine (TCM) and Western medicine (WM) in the treatment and rehabilitation of cancer.Cronbach's alpha score indicated that there was acceptable internal consistency within both the MDASI and TCM items,0.86 for MDASI,0.78 for TCM,and 0.90 for MDASI- TCM (23 items).Conclusions:Fatigue,sleep disturbance,dry mouth,poor appetite,and difficulty remembering are the most common symptoms in cancer patients.These greatly affect the quality of life for these patients.Patients expressed a strong desire for TCM holistic regulation.The MDASI and its TCM-adapted model could be a critical tool for the quantitative study of TCM symptoms.     

Development and validation of a learning needs assessment scale: a continuing professional education tool for multiple sclerosis specialist nurses

Aim. To develop and validate a learning needs assessment scale. Background. Learning needs analysis is a central component of continuing professional development but there is a lack of psychometrically developed learning needs assessment tools. Self‐assessment questionnaires are emerging as a key method. The development of a learning needs analysis scale for multiple sclerosis specialist nurses is described. Design. A psychometric approach comprising the three phases of the development and testing of the scale are outlined. Method. Phase 1: Item identification using a literature review; postal survey of stakeholders (n = 320), 20 nurse interviews; four nurse focus groups; five telephone interviews with people with MS. Phase 2: Refinement of draft scale and establishing face and content validity testing using an expert panel. Phase 3: Testing of draft scale using data from a postal survey (n = 47 MS specialist nurses) to assess the feasibility and effectiveness of scale, internal consistency and construct validity. Test–retest reliability was assessed using data from 17 MS specialist nurse respondents to calculate intra‐class correlation coefficients. Results. The data from the different study phases informed scale refinement. The validity and reliability of the scale was confirmed through testing. Conclusion. The study provides an example of how a robust learning needs assessment scale may be developed for a specialist area of nursing practice to be used in conjunction with more subjective approaches. Relevance to clinical practice. High quality nursing care depends upon a competent nursing workforce that engages in continuing professional development. This study provides an example of a psychometrically developed learning needs assessment scale to inform continuing professional development needs of nurses working in a specialist area of practice.     

Visual analog scales can assess the severity of rhinitis graded according to ARIA guidelines

BACKGROUND: The allergic rhinitis and its impact on asthma (ARIA) guidelines provide a new classification of allergic rhinitis, but a quantitative analysis for severity assessment is lacking. OBJECTIVE: To study whether a visual analog scale (VAS) for global rhinitis symptoms could be used to assess the disease severity according to ARIA. METHODS: Three thousand fifty-two allergic rhinitis patients seen in primary care were tested. Fifty three per cent had an objective diagnosis of allergy and 58% of the patients were treated. Patients were categorized according to ARIA guidelines. The severity of nasal symptoms was assessed using a VAS. Quality of life was measured using the rhinoconjunctivitis quality of life questionnaire (RQLQ). RESULTS: Severity had more impact on VAS levels than duration: mild intermittent rhinitis (3.5, 2.4-5.0 cm), mild persistent rhinitis (4.5, 3.2-5.6 cm), moderate/severe intermittent rhinitis (6.7, 5.3-7.7 cm) and moderate/severe persistent rhinitis (7.2, 6.1-8.2 cm). The receiver operating characteristic curve results showed that patients with a VAS of under 5 cm could be classified as 'mild' rhinitis (negative predictive value: 93.5%) and those with a VAS of over 6 cm as 'moderate/severe' rhinitis (positive predictive value: 73.6%). Receiver operating characteristic curves and a logistic regression showed that current treatment and allergy diagnosis have no effect on the assessment of rhinitis severity using VAS. Visual analog scale and the RQLQ global score were significantly correlated (rho = 0.46; P < 0.0001). CONCLUSION: A simple and quantitative method (VAS) can be used for the quantitative evaluation of severity of allergic rhinitis.     

Positron emission tomography/computed tomography in the management of Hodgkin and B-cell non-Hodgkin lymphoma: An update

¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is now an integral part of lymphoma staging and management. Because of its greater accuracy compared with CT alone, PET/CT is currently routinely performed for staging and for response assessment at the end of treatment in the vast majority of FDG-avid lymphomas and is the cornerstone of response classification for these lymphomas according to the Lugano classification. Interim PET/CT, typically performed after 2 to 4 of 6 to 8 chemotherapy/chemoimmunotherapy cycles with or without radiation, is commonly performed for prognostication and potential treatment escalation or de-escalation early in the course of therapy, a concept known as response-adapted or risk-adapted treatment. Quantitative PET is an area of growing interest. Metrics, such as the standardized uptake value, changes (Δ) in the standardized uptake value, metabolic tumor volume, and total lesion glycolysis, are being investigated as more reproducible and potentially more accurate predictors of response and prognosis. Despite the progress made in standardizing the use of PET/CT in lymphoma, challenges remain, particularly with respect to its limited positive predictive value, emphasizing the need for more specific molecular probes. This review highlights the most relevant applications of PET/CT in Hodgkin and B-cell non-Hodgkin lymphoma, its strengths and limitations, as well as recent efforts at implementing PET/CT-based metrics as promising tools for precision medicine.     

Material and social deprivation and health and social services utilisation in Québec: a local-scale evaluation system

Very few studies have employed local-scale analyses to evaluate how well primary health care and social services reach the most socially and economically deprived individuals. This paper describes a project, conducted in close partnership with decision-makers and practitioners at selected local community service centres (in French, CLSCs) in Quebec, Canada, that developed a system for assessing primary care and social services utilisation by applying deprivation levels defined at the local scale (i.e., according to the distribution of deprivation in individual CLSC service areas). More than 25 years ago, Québec started setting up a province-wide network of publicly financed CLSCs whose mission was to offer first-line health and social services at the local level. Now approximately one Quebecer in four receives at least one service a year from a CLSC. The evaluation system presented in this article is built on deprivation profiles for each CLSC service area and comprises maps, relative indices of service utilisation, and an interpretation framework that facilitates the integration of new data into the decision-making and services planning processes. Study results show that deprivation levels, when defined using local perspectives, correspond more closely to decision-makers' perceptions, that relative indices are sensitive to key determinants of services provision and utilisation, and that the interpretation framework is useful for reassessing intervention strategies.     

大学生体育生活方式与心理健康状况相关研究

目的:了解大学生体育生活方式与心理健康状况之间的关系,探索通过优化体育生活方式改良大学生心理健康状况的方法。方法:对在校大学生370例进行症状自评量表(SCL-90)和锻炼态度量表问卷调查,并进行体育生活方式调查问卷。结果:370例中喜好体育锻炼、平均每天用于体育锻炼时间多、喜欢体能耐力主导类、朋友相对少或所在班级管理干部关注体育锻炼的学生易养成体育锻炼习惯;体育锻炼态度中的行为态度是影响大学生心理健康状况的指标;爱好体育锻炼的学生心理健康状况相对较好。多人集体和单人对抗性项目对大学生心理健康状况有正向作用,体能速度主导类项目有负向作用;技巧类项目对心理健康水平有负面影响,而足球有正面的作用。农村学生心理健康欠佳,城镇学生相对较好。结论:应重视学生心理健康状况的城乡差异,和体育兴趣爱好对心理健康状况的影响。体育做为高校一项重要的教育过程对优化大学生的心理健康,培养良好的生活方式,树立终身体育的行为意识起重要的作用。     

社区综合康复治疗对颈椎病的效果分析

〔摘 要〕 目的：探讨社区综合康复治疗对颈椎病的效果。 方法：选取佛山市禅城区人民医院向阳院区 2017 年 1 月至 2019年9月期间收治的118例颈椎病患者,采用随机数字表法将其分为对照组与观察组,各59例。对照组施以常规治疗模式, 观察组施以社区综合康复治疗模式,对两组患者的临床治疗效果、满意度情况、治疗前及治疗 1 个月后的视觉模拟评分法 （VAS）评分、颈椎病临床评价量表（CASCS）评分情况进行观察比较。 结果：观察组患者治疗总有效率为 96.61 %,高于 对照组的 83.05 %,差异具有统计学意义（P ＜ 0.05）。观察组患者的总满意度为 98.30 %,高于对照组的 83.05 %,差异具 有统计学意义（P ＜ 0.05）。治疗前两组患者的 VAS、CASCS 评分比较,差异无统计学意义（P ＞ 0.05）;治疗 1 个月后观 察组患者的 VAS 评分低于对照组,CASCS 评分高于对照组,差异具有统计学意义（P ＜ 0.05）。 结论：社区综合康复治疗 对颈椎病具有良好的效果与较高的价值,不仅能够提升治疗总有效率与满意度,同时还能提升 CASCS 评分,降低 VAS 评分。