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Objective@#To explore the relationship between prepregnancy body mass index, weight gain during pregnancy with preschool obesity and body composition in offspring, so as to provide evidence for gestational weight gain and childhood obesity prevention.@*Methods@#A total of 1 333 preschool children were recruited from 3 kindergartens in Tianjin from September to December 2020. Structured questionnaire was used to collect children s lifestyle information. Height, weight and body fat mass of children were assessed, and body fat percentage (FM%), fat mass index (FMI) and non fat mass index (FFMI) were calculated. Maternal medical records were collected and the mothers were grouped according to their prepregnancy weight status and weight gain during pregnancy. χ 2 test, t test, linear regression model and Logistic regression were used to analyze the differences of obesity and body composition among different groups.@*Results@#The prevalence of overweight and obesity in preschoolers was 12.7% and 7.7%. After adjusting maternal age and delivery, gestational age, gender, age and lifestyle of children, the correlation between maternal pre pregnancy BMI,gestational weight gain with obesity and body composition indexes of children in preschool age was statistically significant ( P <0.05). For mothers with normal weight before pregnancy, excessive weight gain during pregnancy increased risk of high FM% and high FMI in offspring ( OR=1.81, 1.68, P <0.05). There was no significant correlation between maternal weight gain during pregnancy with offspring obesity and body composition among mothers with prepregnant overweight or obesity.@*Conclusion@#Maternal weight status before pregnancy and weight gain during pregnancy are correlated with obesity and body composition in the preschool age of offspring. It is suggested that mothers should maintain appropriate weight status before and during pregnancy.
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Objective To understand the general self-efficacy level of patients with tuberculosis(TB patients) and its influencing factors, provide evidence for improving the general self-efficacy of TB patients.Methods All TB inpatients in a comprehensive pulmonary hospital were conducted face-to-face survey through a general questionnaire and general self-efficacy scale, self-efficacy level of TB patients and its influencing factors were analyzed.Results Mean scale of general self-efficacy of 402 TB patients was (20.4±4.2), of which only 14 cases(3.5%)showed a high level self-efficacy.163(40.5%), 225(56.0%), and 14(3.5%)patients were with low(10~),medium(20~), and high(30~) self-efficacy scale.The general self-efficacy level of TB patients was influenced by the course of disease(P<0.001), residence(P=0.012), whether or not attended the lecture on tuberculosis education(P=0.034), whether or not conducted physical exercise(P=0.053,stepwise multiple linear regression analysis: P=0.017), working status(P=0.027), No.of hospitalization due to TB(P=0.002), family economic situation(P=0.027), and education level(P=0.020).Conclusion TB patients' self-efficacy level is low, and the general self-efficacy level and its influencing factors should be assessed by health care workers during the follow-up for patients, individualized nursing intervention for improving the TB patients' self-efficacy level should be developed.
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OBJECTIVE@#To evaluate the status of ethical awareness of medical journals in China. @*METHODS@#We surveyed editorial awareness based on 88 medical journals by using self-made questionnaire. Five aspects were selected by literature and systematic analysis: Instruction for authors, the first review stage, the peer-review stage, the editing stage, as well as education and training, which covered 11 indexes in the system. Weight values of indexes were gained by scoring of senior editors, and analytic hierarchy process, TOPSIS method, and weight rank-sun ratio were used to evaluate the status of editorial awareness. @*RESULTS@#Of the 88 biomedical journals, 56 (63.6%) had no ethical requirement in the instruction for authors in 2010, 14 (15.9%) were at high level of ethical awareness, 45 (51.1%) were at medium level, and 29(33.0%) were at low level. There were significant differences in the scores of instruction for authors and peer-review stage among the journals administrated by different authorities (H(C)=10.175, H=7.305, P<0.05). There were significant differences in the scores of instruction for authors, the first review stage, the peer-review stage, and the editing stage among the journals covered by different databases (H(C)=11.951, 7.661, 6.146, or 8.085, P<0.05), meanwhile, there was significant difference in the multi-level results of comprehensive evaluation for different databases covered journals (H(C)=6.109, P<0.05). The results from 3 comprehensive approaches were positively correlated. @*CONCLUSION@#Ethical awareness of medical journals in China should be improved. Comprehensive approach is more reliable and practical than that of single approach.
Subject(s)
China , Editorial Policies , Periodicals as Topic , Ethics , Surveys and QuestionnairesABSTRACT
Comprehensive evaluation methods are generally used to assess the population data. When we need to estimate the sample data in special situations, the impacts brought by the sampling error should be considered. Due to lack of the accurate measurement for the sensitivity and stability in the comprehensive evaluation methods, sampling errors usually cannot be estimated in the sampling research. Monte Carlo simulation was used in this article to solve the probability of the ordering results, and the matlab programs were presented. Based on the simulated results, we change the conventional “absolute conclusion” of comprehensive evaluation methods to “probability results” for the sample data, and put forward a new sorting and ranking method for the results of comprehensive evaluation.
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The TOPSIS method is a static comprehensive evaluation method for wide range applications. However, it encounters the reverse order problem in practical applications. Moreover, its evaluation value Ci only reflects the relative proximity of each evaluation object inside but not to the degree of closeness to the ideal optimal solution. The evaluation value is also limited to distinguish between the ranges of merit ranking. Since TOPSIS method has the wide range of applications, it is necessary to overcome the drawbacks of TOPSIS method. This article proposes a new improved TOPSIS method, which shows strict isotonicity and is more sensitive than the traditional TOPSIS method. The medical application based on this improved TOPSIS method is introduced.
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Aged , Humans , Decision Support Techniques , Evaluation Studies as Topic , Fuzzy Logic , Health Services for the Aged , Models, Theoretical , Quality of LifeABSTRACT
The quality of medical care shows characteristics of dynamic state with changes in time. However, many of appraisal and evaluation projects usually keep on the status of "past" or "present". Most of these models are static evaluation approach. In this study, besides the "past" and "present" status, we took one step further to unveil the future development trends of the medical therapeutical effects. Based on the index value and index increment, a dynamic TOPSIS method is presented. This method pays attention to both transverse and lengthwise information and can not only perform the evaluation on each time section but also can make the final dynamic evaluation. We applied this new method to the evaluation of quality of medical care, which was proved to be effective.
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Humans , Models, Theoretical , Quality Assurance, Health Care , MethodsABSTRACT
OBJECTIVE@#To compare the efficacy of proximal femoral nail anti-rotation (PFNA) versus dynamic hip screw (DHS) in the treatment of trochanteric fractures in adults.@*METHODS@#Reports of studies using randomized controlled trials (RCT) to compare PFNA with DHS in the management of intertrochanteric fractures were retrieved (up to December 5, 2011) from the Cochrane Library, MEDLINE, Elsevier, the Chinese Biomedical Database, Wanfang Data,and manually. Methodological quality of the trials was critically assessed, and relevant data were extracted. Statistical software Revman? 5.0 was used for data-analysis.@*RESULTS@#Thirteen RCTs involving 958 cases were included in the Meta-analysis. The results showed that, compared with DHS, PFNA significantly decreased the duration of surgery [WMD = -21.38, 95%CI (-33.05,-9.26), P<0.05], intra-operative blood loss [WMD = -176.36, 95%CI (-232.20, -120.52), P<0.05], the rate of post-operative complication [RR=0.46, 95%CI (0.31, 0.70), P<0.05], the rate of post-operative fixation failure[RR=0.27, 95%CI(0.11,0.62), P<0.05].@*CONCLUSION@#PFNA for intertrochanteric fractures is superior to DHS in regards to the mean duration of surgery, mean intra-operative blood loss, the rate of post-operative complication, and the rate of post-operative fixation failure. But there is not enough evidence to show any difference between PFNA and DHS in regards to the mean duration of hospital, the mean duration of fracture healing, the rate of post-operative fracture, the rate of post-operative coxa vara, the rate of postoperative superficial wound infection, the rate of other post-operative complications or the Harris score after surgery.