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《Vaccine》2021,39(30):4153-4159
BackgroundWhile pertussis is notifiable in most countries, notifications typically underestimate the true pertussis burden. We explored the incidence of pertussis in general practice in Australia.MethodsUsing MedicineInsight, a large longitudinal electronic medical record database of general practice (primary care) encounters which includes >1.5 million patients, we first defined a cohort of active patients and then used free-text search algorithms to identify patients with pertussis-related encounters. We defined and identified pertussis-related encounters in four patient categories: pertussis-associated (category 1), potential pertussis (category 2), epidemiologically-linked pertussis (category 3), and symptoms consistent with pertussis (category 4). Incident pertussis-related encounter rates per 100,000 active patients were calculated from Jan 2008 to Aug 2015.ResultsEstimated mean annual pertussis incidence increased as definitions were expanded, from 94.3 (category 1 patients only) to 148.8 (categories 1+2+3 patients combined) per 100,000 active patients per year. Monthly time-series corresponding to the first three categories were highly correlated (Pearson’s r > 90% for each pair), but each was poorly correlated with category 4. For categories 1+2+3, the highest incidence was among 0–4 and 5–9 year olds. Incidence was 30% higher in females than males (i.e. 184.5 vs 139.8 per 100,00 active patients for categories 1–3 patients combined). Pertussis-associated incidence (category 1) was similar to national pertussis notification rates. Categories 2 and 3 added 25% and 33%, respectively, on average relative to category 1 incidence. The estimated incidence from categories 1+2+3 together were on average 64% higher than national pertussis notification rates.ConclusionWe provide comprehensive estimates of pertussis-related incidence in general practice (primary care), well in excess of notified pertussis incidence in Australia. This highlights the utility of MedicineInsight data in providing a greater understanding of the burden of medically-attended pertussis infections. 相似文献
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Little is known about the variables that account for why parents underestimate the pain of their child. In the present experiment, the joint impact of parental catastrophizing about their child's pain and children's facial pain expressions was examined upon pain estimates of their child undergoing a pressure pain test. In line with previous research, parents underestimated their children's pain. Interestingly, it was found that pain was estimated as higher when the child showed more facial pain expressions and when parents catastrophized more about their child's pain. An intriguing finding was that catastrophizing about their child's pain was related to less parent–child incongruence in pain ratings. The discussion addresses the possible functions of catastrophizing of parents about their children's pain, and delineates avenues for future research. 相似文献
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Analysis of the underestimation of induced abortions in a survey of the general population in France
Dr S. Houzard N. Bajos J. Warszwawski C. de Guibert-Lantoine M. Kaminski H. Leridon 《The European journal of contraception & reproductive health care》2013,18(1):52-60
Introduction A pilot study has been conducted in France to estimate the extent of underreporting of induced abortion and the factors linked to underreporting.Methods A representative random sample of 300 women aged between 18 and 44 years of age who had been pregnant during the previous 2 years and 100 women who had not was selected from the telephone directory. Interviews were conducted by telephone.Results The annual incidence of induced abortion for the 18–44-year-old age group was 6.9 per 1000 (95% confidence interval 2.2–11.6), while the rate derived from national statistics was 15 per 1000. Five women who reported a therapeutic abortion in their lifetime had confused induced abortion and therapeutic abortion.There was no significant difference in the proportion of women reporting induced abortion in their lifetime between those answering with another adult present and those who were alone when answering (13.1% versus 11.1%, p = 0.8). There was also no significant difference according to the sex of the interviewer (10.0% for men versus 12.2% for women, p = 0.6).Conclusion The results suggest that the context in which the questions were asked does not affect the validity of the answers and that there is a problem in the comprehension of the terminology used. Extensive rewriting and reformulation of the questions is required to minimize the underreporting of induced abortion. 相似文献
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Individuals with social phobia often have specific concerns about how they sound, as well as how they look, in social situations. Additionally, clients with social phobia experience negative self-imagery during anxiety provoking social situations. Their negative self-imagery encompasses a range of modalities including auditory aspects of performance [Hackmann, A., Clark, D. M., & McManus, F. (2000). Recurrent images and early memories in social phobia. Behaviour Research and Therapy, 38, 601–610.]. Other research has shown that clients with social phobia underestimate their social performance, at least in part due to them basing their judgements on negative self-imagery [Hirsch, C. R., Clark, D. M., Mathews, A., & Williams, R. (2003). Self-images play a causal role in social phobia. Behaviour Research and Therapy, 41, 901–921.]. This is the first study to assess underestimation of auditory performance in clients with social phobia and whether auditory feedback (adapted from video feedback) reduces this underestimation. Clients with social phobia and community controls recited a short story onto minidisk and then rated their performance. They then received auditory feedback. An assessor who was not informed about group allocation rated minidisk recordings of performance. Clients with social phobia rated their performance more negatively and underestimated auditory performance (in comparison to the assessor) to a greater extent than controls. Auditory feedback partially corrected this underestimation of auditory performance. 相似文献
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P. H. Cox J. G. M. Klijn M. Pillay M. Bontebal D. H. W. Schönfeld 《European journal of nuclear medicine and molecular imaging》1990,17(1-2):94-95
The evaluation of the risk of radiation damage to the unborn child as the result of the administration of radionuclides remains a subject for discussion (Mountford 1989). Lack of information concerning the biodistribution of radiopharmaceuticals in the early stages of pregnancy, before organogenesis has occurred, has greatly restricted the objective assessment of fetal doses. Recent observations on the biodistribution of a therapeutic dose of sodium iodide 131 in a patient with an unsuspected early pregnancy lead us to suspect that current dose estimates with respect to uterine exposure (ARSAC 1988) may seriously underestimate the actual exposure of the developing fetus. 相似文献
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Isabelle Deshaies Louise Provencher Simon Jacob Gary Côté Jean Robert Christine Desbiens Brigitte Poirier Jean-Charles Hogue 《Breast (Edinburgh, Scotland)》2011,20(1):50-55
Previous studies have shown that 4-54% of breast lesions reported on core biopsies as atypical ductal hyperplasia (ADH) are upgraded on further excision to ductal carcinoma in situ (DCIS) or invasive carcinoma. We evaluated the rate of upgrading ADH to carcinoma at surgery for ADH diagnosed by percutaneous biopsy, and examined characteristics associated with malignancy. We identified 13,488 consecutive biopsies conducted at one center over a nine-year period. A total of 422 biopsies with ADH in 415 patients were included. DCIS or invasive carcinoma was found in 132 cases (31.3% upgrading). Multivariate model revealed that ipsilateral breast symptoms, mammographic lesion other than microcalcifications alone, 14G core needle biopsy, papilloma co-diagnosis, severe ADH and pathologists with lower volume of ADH diagnosis were factors statistically associated with malignancy. However, no subgroups were identified for safe clinical-only follow-up. Surgery is recommended in all cases of ADH diagnosed by percutaneous breast biopsy. 相似文献
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《Vaccine》2017,35(33):4162-4166
OjectiveDespite vaccination, pertussis has remained endemic, sometimes leading to severe disease. We aimed to quantify the completeness of reporting (CoR) of pertussis hospitalizations and deaths in the Netherlands.Study designCoR was estimated using capture-recapture analyses. Hospitalizations (2007–2014) from the National Registration Hospital Care (hospital data) were matched to the notifiable Infectious Disease case registry (notifications) providing (month and) year of birth, gender and postal code. Deaths (1996–2014) from Statistics Netherlands (death registry) were matched to notifications using gender, age, year of death and notification date. Cases <2 years (y) and ≥2y were analysed separately. Chao’s estimator estimated the total population, which was used to calculate CoR.ResultsUsing strict matching criteria, we found 461 matches among 876 (hospital data) and 757 (notifications) hospitalizations <2y. The population estimate of hospitalized infants was 1446, resulting in CoR between 52% and 61%. For hospitalizations ≥2y (246; hospital data and 264; notifications) 43 matches were found, with a population estimate of 1512 and CoR between 16.5% and 22%.Among thirteen (death registry) and eight (notifications) deaths <2y, seven cases overlapped. The population estimate was 16. CoR of the two sources was 50–81%. With two (death registry) and eight (notifications) deaths ≥2y without overlap, the population estimate was 26 and CoR 8–31%.ConclusionResults showed substantial underestimation of pertussis hospitalizations and deaths. This has to be taken into account in evaluation of current and future immunization programs. 相似文献
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Alessandro Villa Fabio Chiesa Tiberio Massa Daniele Friedman Giuseppe Canavese Paola Baccini Massimo Calabrese Alberto Tagliafico 《Clinical breast cancer》2013,13(6):450-454
BackgroundThis study aimed to establish if women with a diagnosis of flat epithelial atypia (FEA) without residual microcalcifications at stereotactic vacuum-assisted breast biopsy (VABB) could be managed with mammographic follow-up (FU) instead of surgery and to compare 9-gauge and 11-gauge devices.Patients and MethodsFrom October 2003 to January 2011, 2382 VABB procedures were performed (1373 with 11-gauge and 1009 with 9-gauge). We found 121 cases of pure FEA that were surgically treated: 57 with a 9-gauge device (group 1) and 64 with an 11-gauge device (group 2). The underestimation rate (UR) of malignancy for patients without and those with residual microcalcifications for each VABB device was calculated. Differences between groups were analyzed with the Fischer exact test.ResultsThe overall UR of FEA was 4% (2 of 57) with the 9-gauge device and 8% (5 of 64) with the 11-gauge device. With a 9-gauge device, the UR for patients without residual microcalcifications was 0% (0 of 46), and the UR for patients with residual microcalcifications was 18% (2 of 11). With an 11-gauge device, the UR for patients without residual microcalcifications was 0% (0 of 39), the UR for patients with residual microcalcifications at post-biopsy mammograms was 16% (5 of 25). With a 9-gauge device, 80% (46 of 57) of patients did not have residual microcalcifications after VABB. With an 11-gauge device, 60% (39 of 64) of patients had no residual microcalcifications after VABB. Differences between the 9-gauge and 11-gauge devices were statistically significant (P < .05).ConclusionWomen with FEA without residual microcalcifications after VABB can be managed conservatively. Nine-gauge VABB is associated with a lower percentage of residual microcalcifications compared with an 11-gauge device, but it is safe to follow patients with FEA if all calcifications are removed with the core biopsy. 相似文献