Statement of Withdrawal: Statistical analysis of an endemic disease from a capture–recapture experiment

There are a number of statistical techniques for analysing epidemic outbreaks. However, many diseases are endemic within populations and the analysis of such diseases are complicated by changing population demography. Motivated by the spread of cowpox among rodent populations, a combined mathematical model for population and disease dynamics is introduced. An MCMC algorithm is then constructed to make statistical inference for the model based on data being obtained from a capture–recapture experiment. The statistical analysis is used to identify the key elements in the spread of the cowpox virus.     

Optimal cut-off for rare events and unbalanced misclassification costs

This paper develops a method for handling two-class classification problems with highly unbalanced class sizes and misclassification costs. When the class sizes are highly unbalanced and the minority class represents a rare event, conventional classification methods tend to strongly favour the majority class, resulting in very low detection of the minority class. A method is proposed to determine the optimal cut-off for asymmetric misclassification costs and for unbalanced class sizes. Monte Carlo simulations show that this proposal performs better than the method based on the notion of classification accuracy. Finally, the proposed method is applied to empirical data on Italian small and medium enterprises to classify them into default and non-default groups.     

Risk Assessment for Hospital-Acquired Diseases: A Risk-Theory Approach

We introduce a new approach to hospital-acquired disease risk assessment from public health databases. In a spirit similar to actuarial risk theory, we define an adjustment coefficient that can quantify the risk associated with a hospital department, allowing comparisons of similar departments. The adjustment coefficient characterizes the tail of the distribution of the total patient length of stay in a department before the first disease event occurs. We show that this coefficient is the solution of a Lundberg-like equation, and we provide a nonparametric estimation procedure for this measure, based on a Cramér-Lundberg approximation for the tail of the distribution. Using simulations, we provide evidence of the robustness of the approximation to various individual risk models. In addition, we illustrate the relevance of this approach by evaluating the risk associated with a standard patient safety indicator in 20 hospitals of southeastern France.     

医疗保险对老年人身体机能健康和心理健康的影响及其机制研究

随着我国人口老龄化不断加剧,切实保障好老年人健康格外紧迫。基于此,文章采用中国健康与养老追踪调查数据从身体机能健康和心理健康两个维度实证考察了医疗保险对老年人健康的影响及其作用机制。研究发现,医疗保险能够显著提高老年人身体机能健康和心理健康。机制研究表明,医疗保险能够显著提高老年人医疗服务利用、降低老年人慢性病发生率进而影响到老年人健康。因此,进一步扩大老年人医疗保险覆盖面、提高医疗保障水平、促进医疗服务公平性和可及性,是我国人口老龄化不断加剧状况下保障老年人健康的重要途径。     

关于我国农民工职业病维权困境的思考——从“开胸验肺”事件谈起

农民工张海超为确诊个人患有尘肺病不惜冒生命危险“开胸验肺”,这一事件引发了社会对农民工职业病维权问题的关注。我国农民工职业病维权面临着工伤认定程序漫长和维权成本高等困境。究其原因主要是法律不健全,职业病鉴定机构监管的缺失以及社会保障缺失。若要化解农民工职业病维权困境,必须健全相关法律,完善工伤保险制度并加强政府主导作用,只有这样才可切实保障农民工职业病患者权益。     

ASSOCIATIONS BETWEEN AIR POLLUTION AND HOSPITAL VISITS FOR CARDIOVASCULAR DISEASES IN THE ELDERLY IN SYDNEY USING BAYESIAN STATISTICAL METHODS

Using generalized linear models (GLMs), Jalaludin  et al. (2006;  J. Exposure Analysis and Epidemiology   16 , 225–237) studied the association between the daily number of visits to emergency departments for cardiovascular disease by the elderly (65+) and five measures of ambient air pollution. Bayesian methods provide an alternative approach to classical time series modelling and are starting to be more widely used. This paper considers Bayesian methods using the dataset used by Jalaludin  et al.  (2006) , and compares the results from Bayesian methods with those obtained by Jalaludin  et al.  (2006) using GLM methods.     

Incorporating human sexuality content into a positive youth development framework: Implications for community prevention

As approaches to positive youth development (PYD) gain momentum, the issue of sexuality – a critical component of human development – is being subsumed by ideological debates. In the current political climate, sexuality education is often relegated to biological and/or values-based approaches, neglecting essential relational and collective aspects of sexuality. Through the explication of sexuality as an important component of youth's social ecology, this paper provides a conceptual link between the goals of the Sexuality Information and Education Council of the United States' (SIECUS) Guidelines for comprehensive sexuality education and those of PYD. We argue that sexuality, as a normative part of human development, culture, identity, and relationships, be approached from an asset-based perspective, rather than a deficit-based perspective. We propose a framework that illustrates how aspects of sexuality are embedded within PYD contexts, and demonstrates how a sexuality education program rooted in SIECUS guidelines can further PYD goals across community contexts.     

Mate Availability and Women's Sexual Experiences in China

Data from the 1999-2000 Chinese Health and Family Life Survey were merged with community-level data from the 1982, 1990, and 2000 Chinese censuses to examine the relationship between the local sex ratio (number of men per 100 women) and sexual outcomes among women (N = 1,369). Consistent with hypotheses derived from demographic-opportunity theory, multilevel logistic regression analyses showed that women are more likely to be sexually active, to have had premarital sexual intercourse, to have been forced to have sex, and to test positive for a sexually transmitted infection when there is a relative abundance of age-matched men in their local community. Education, birth cohort, and geographic location also emerged as significant predictors of women's sexual experiences.     

吉林省四平地区老年人健康影响因素及对策探析

为了解吉林省四平地区老年人的健康状况及其影响因素,制定有效的防治对策,采用现场体检及问卷调查的方式,对该地区1 059位60岁及以上老年人的健康现状进行调查。老年人健康状况不容乐观,慢性病患病率较高。其中慢性病患病率位于前五位的依次为心脏病、高血压、糖尿病、骨关节病、脑血管病。老年人健康影响因素包括吸烟、饮酒、饮食、睡眠、锻炼身体等。提出注重健康影响因素、提高老年人健康水平的具体对策。     

Diabetes education program for people with type 2 diabetes: An international perspective

BackgroundIn the Palestinian community, lifestyle changes, rapid urbanization and socioeconomic development, stress, smoking, and changes in food habits has increased the risk of non-communicable diseases especially diabetes mellitus. Diabetes complications can be prevented if the glycemic status of patients with diabetes is maintained within a nearly normal range. Therefore, patient education is critical in controlling blood glucose levels within the normal range.ObjectiveThis study aimed at measuring the effect of diabetes educational intervention program for patients suffering from type 2 diabetes attending the Diabetes Clinic in Tulkarim Directorate of Health.MethodsA short duration observational study involving pre- and post-test educational intervention program was carried out on a relatively small number of type 2 diabetes patients at the Diabetes Clinic in Tulkarim Directorate of Health. In total, 215 patients attended a group-based 4 h educational intervention session about diabetes. The program included explaining diabetes mellitus-symptoms, risk factors, types, treatment and complications and main aspects of self-care of the disease (foot care, eye care, and blood glucose monitoring), main aspects of dietary management, weight reduction, blood pressure, smoking cessation, periodic investigations, home monitoring and importance of physical activity. Knowledge evaluation questionnaire were evaluated pre- and post-study. Anthropometric measurements such as body weight (WT), body mass index (BMI) and laboratory tests such as fasting blood glucose (FBG), hemoglobin A1C (HbA1c), cholesterol (Chol), and triglycerides (TG) were measured both at the beginning and at the end of the study. Significance of the results was assessed by paired t-test at 95% confidence interval.ResultsThe participant’s mean age was 51.07 that ranged between 31 and 70 years. For a total of 215 participants, 41.4% were males and 58.6% were females. The mean weight before educational intervention was 80.81 ± 14.95 kg (82.6 kg for males and 79.5 kg for females) that decreased to 78.9 ± 14.33 kg (81.1 kg for males and 77.3 kg for females) after educational intervention program. The BMI also decreased significantly after educational intervention. The mean fasting blood sugar was 188.65 ± 71.45 mg/dL before educational intervention that decreased to 177.7 ± 66.11 mg/dL after the educational intervention (p = 0.049). The mean glycosylated hemoglobin was 8.57 ± 1.21 before educational intervention that decreased to 7.95 ± 1.42 after educational intervention. The mean value of cholesterol before educational intervention was 183.27 ± 37.74 mg/dL that decreased to 169.57 ± 34.23 mg/dL after educational intervention. The mean triglycerides value decreased after educational intervention from 209.85 ± 171.04 mg/dL to 183.28 ± 152.4 mg/dL (p = 0.025). The mean score of knowledge questionnaire before educational intervention was 60.6 ± 20.65 that increased to 78.1 ± 13.4 after conducting educational intervention.ConclusionsDiabetes education was found to be effective on BMI, FBG, HbA1c, Chol, TG, and knowledge.RecommendationsDiabetes education is a cornerstone in the management and care of diabetes and should be an integral part of health planning involving patient’s family, diabetes care team, community, and decision makers in the education process.