南海区中小学生近视相关因素分析与预防策略

目的:了解南海区中小学生近视及相关因素,为今后近视防控工作提供依据。方法:多阶段整群随机抽样法、问卷调查法、现场检测法。结果:问卷调查显示40%学生表示学校从不调整或课桌椅不可调。超过40%学生未按要求每天坚持在校做眼保健操2次。50%学生放学后做作业时间超过3h。50%学生课外参加文化类补习班超过1 h。超过70%学生在过去一周里,使用移动电子设备时间平均每天超过0.5 h以上。以课桌椅分配不达标率最突出,达标率只有7.0%,黑板面照度达标率20.5%,黑板反射比达标率33.1%、教室采光后墙反射比达标率35.3%、课桌面照度达标率38.8%。结论:近视相关危险行为在学生中普遍存在,学校环境卫生监测指标不达标情况较为严重。提出如下建议:建立常规监测制度;推动学校教学环境建设;开展广泛宣传教育。营造各方参与、专家指导、学校教育、家庭关注、学生自主的良好氛围,扎实开展综合防控行动。

Effect of socio-demographic status on dental caries in pupils by using a multilevel hurdle model

Introduction: Dental caries is the most prevalent chronic disease among schoolchildren. We aimed to investigate the association between dental caries index and socio-demographic status in schoolchildren by using a multilevel hurdle model. Materials and Methods: A cross-sectional epidemiological study was carried out on 906 primary school pupils in Kerman, Iran in 2012. The subjects were selected through a stratified cluster random sampling. At first, the whole target area was stratified according to two geographic areas, the north and south area. Then each area was stratified according to gender. In the next step, several schools were considered as clusters, which were selected randomly in each geographic area and gender strata. All the schoolchildren in these schools were included in this study as samples. Twelve-year-old pupils were examined for dental caries. The dependent variable in this study was the dmft/DMFT index. Eight variables, including socio-demographic information, were collected. Multilevel negative binomial hurdle model was employed for data analysis. Results: The prevalence of caries-free pupils was 30.1% and the mean dmft/DMFT was 3.6 ± 2.2. Negative binomial part of the adjusted model showed that the dmft/DMFT adjusted rate for females was 1.36 (95% CI: 1.10-1.79) times higher than males. Also, the dmft/DMFT adjusted rate for overweight pupils was 0.86 (95% CI: 0.74-0.98) times lower than those with normal weight. Logistic part of the adjusted model showed that the posibility of caries-free state in overweight pupils was 1.95 (95% CI: 1.22-3.11) times higher than those with normal weight. In addition, pupils whose fathers and mothers were workers and housewives, respectively, and those with a high maternal age were at a greater risk for caries experience than others (p < 0.05). Conclusion: BMI, gender, parent’s job and mother’s age at delivery were factors effecting on dental caries in schoolchildren. These pupils need more attention to dental care.

Homeopathy for COVID-19 in primary care:A randomized,double-blind,placebo-controlled trial(COVID-Simile study)

Background:Different homeopathic approaches have been used as supportive care for coronavirus disease 2019(COVID-19)cases,but none has been tested in a clinical trial.Objectives:To investigate the effectiveness and safety of the homeopathic medicine,Natrum muriaticum LM2,for mild cases of COVID-19.Design,setting,participants,and interventions:A randomized,double-blind,two-armed,parallel,singlecenter,placebo-controlled clinical trial was conducted from June 2020 to April 2021 in S?o-Carlos,Brazil.Participants aged>18 years,with influenza-like symptoms and positive result from a real-time polymerase chain reaction test for severe acute respiratory syndrome coronavirus 2 were recruited and randomized(1:1)into two groups that received different treatments during a period of at-homeisolation.One group received the homeopathic medicine Natrum muriaticum,prepared with the second degree of the fifty-millesimal dynamization(LM2;Natrum muriaticum LM2),while the other group received a placebo.Outcome measures:The primary endpoint was time until recovery from COVID-19 influenza-like symptoms.Secondary measures included a survival analysis of the number and severity of COVID-19 symptoms(influenza-like symptoms plus anosmia and ageusia)from a symptom grading scale that was informed by the participant,hospital admissions,and adverse events.Kaplan-Meier curves were used to estimate time-to-event(survival)measures.Results:Data from 86 participants were analyzed(homeopathy,n=42;placebo,n=44).There was no difference in time to recovery between two groups among participants who were reporting influenzalike symptoms at the beginning of monitoring(homeopathy,n=41;placebo,n=41;P=0.56),nor in a sub-group that had at least 5 moderate to severe influenza-like symptoms at the beginning of monitoring(homeopathy,n=15;placebo,n=17;P=0.06).Secondary outcomes indicated that a 50%reduction in symptom score was achieved significantly earlier in the homeopathy group(homeopathy,n=24;placebo,n=25;P=0.04),among the participants with a basal symptom score≥5.Moreover,values of restricted mean survival time indicated that patients receiving homeopathy might have improved0.9 days faster during the first five days of follow-up(P=0.022).Hospitalization rates were 2.4%in the homeopathy group and 6.8%in the placebo group(P=0.62).Participants reported 3 adverse events in the homeopathy group and 6 in the placebo group.Conclusion:Results showed that Natrum muriaticum LM2 was safe to use for COVID-19,but there was no statistically significant difference in the primary endpoints of Natrum muriaticum LM2 and placebo for mild COVID-19 cases.Although some secondary measures do not support the null hypothesis,the wide confidence intervals suggest that further studies with larger sample sizes and more symptomatic participants are needed to test the effectiveness of homeopathic Natrum muriaticum LM2 for COVID-19.Trial registration:UMIN Clinical Trials Registry ID:JPRN-UMIN000040602.