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| 1 | 2012至2016年中国放宽独生子女政策与剖宫产率及出生结局的趋势分析:基于近700万医院出生个案的观察性研究显示文摘目的研究放宽独生子女政策和降低剖宫产率政策会如何影响中国剖宫产率和围产儿及孕产妇死亡率。研究设计观察性研究。研究地点全国危重孕产妇医院监测系统。研究对象2012--2016年,全国危重孕产妇医院监测系统的438家医院中,妊娠28周及以上或出生体重≥1000g的6838582例围产儿。主要结局指标使用修改的Robson分类定义产科风险。主要结局指标包括:产次、产妇年龄和Robson分类的分布变化;每个风险类别中,剖宫产率随时间变化的原始和调整趋势(使用稳健方差估计的泊松回归);同期围产儿及孕产妇死亡率随时间变化的趋势。结果剖宫产率在20122016年稳步下降(原始相对风险0.91,95%可信区间为0.89~0.93),在2016年总的剖宫产率达到41.1%。放宽独生子女政策伴随着经产妇生育比例的上升(从2012年的34.1%到2016年的46.7%),有既往剖宫产史的妇女的分娩量几乎翻了一番(从9.8%到17.7%)。在控制了这些影响因素后,剖宫产率随时间下降的趋势更大(调整后的相对风险0.82,95%可信区间为0.81~0.84)。初产妇的剖宫产率明显下降(0.75,95%可信区间为0.73~0.77),但无既往剖宫产史的经产妇的剖宫产率也有所下降(0.65,95%可信区间为0.62~0.77)。下降幅度最明显的是2012年剖宫产率最高的医院,这与政府针对剖宫产率最高的医院实行的政策是一致的。同期围产儿死亡率从每千出生10.1降至7.2(0.87,95%可信区间为0.83~0.91),而孕产妇死亡率没有变化。结论中国是唯一一个成功扭转剖宫产率上升趋势的国家。放宽独生子女政策相关的产科风险变化将增加剖宫产需求,考虑这一因素,中国的成功显得尤为显著。中国的经验表明,当政策能全面、系统地控制导致剖宫产过度使用的因素,再结合临床实践中各种激励措施,就能够改变剖宫产持续上升的趋势。 | 梁娟 牟祎 李小洪 唐雯 王艳萍 刘铮 黄小娜 Robert W Scherpbier 郭素芳 李明蓉 代礼 邓奎 邓长飞 李琪 康乐妮 朱军 Carine Ronsmans | 2018 | 英国医学杂志中文版2018，21，7： | 47 |
| 2 | 儿童心理行为发育问题预警征象筛查表的信度效度评估显示文摘目的对国家卫生和计划生育委员会组织研发的“儿童心理行为发育问题预警征象”(简称“预警征”)筛查表开展信度和效度评估,验证预警征筛查表对儿童心理行为发育问题早期筛查的实效性。方法采取分层随机抽样方法,从全国11个省市抽取低危人群1513名,高危人群597名,累计2110名0~6岁儿童进行国家卫生和计划生育委员会组织研发的预警征的信度和效度评估。其中信度评估包括重测信度、测试者间信度评估。以年龄与发育进程问卷(ASQ)和盖瑟尔发育量表(GESELL)为校标量表,通过检验预警征与效标量表测定结果的相关性和一致性,评估校标效度。结果不同年龄点预警征筛查阳性率为10.8%(21/141)-26.2%(51/137),每例研究对象筛查所需时间中位数为1min(四分位间距0.6min)。重测信度及测试者信度的相关系数均达到0.7及以上,表明预警征筛查结果的稳定性较好。在效度评估上,预警征与ASQ测评结果高度一致,一致性Kappa值为0.63。以GESELL为效标,预警征筛查发现可疑发育偏异儿童的灵敏度为82.2%,特异度为77.7%,总体Youden指数为0.6。结论预警征筛查的信度和效度已达到了心理学筛查量表评估的基本要求,并且筛查花费时间少、内容简洁,可用于广大基层开展儿童早期心理行为发育偏异的早期筛查工作。 | 黄小娜 张悦 冯围围 王惠珊 曹彬 张波 杨玉凤 王惠梅 郑毅 金星明 贾美香 邹小兵 赵春霞 Robert Scherpbier 静进 | 2017 | 中华儿科杂志2017，55，6： | 27 |
| 3 | 山西和贵州贫困地区儿童多维贫困测量及现状分析显示文摘目的探讨适合中国农村地区0~35月龄儿童的多维贫困测量方法,并了解部分贫困地区儿童贫困状况。方法资料来自2013年7—9月于山西和贵州贫困地区开展的横断面调查,选取其中资料完整的1 754名<3岁儿童及其看护人进行分析。多维儿童贫困测量维度包括水和卫生设施、营养、健康、早期教育、保护、参与。用多重交叠剥夺分析法分析多维贫困,家庭收入法分析收入贫困。结果多维贫困率为53.08%,收入贫困率为47.04%。水和卫生设施维度剥夺比例最高,为90.25%,其他维度剥夺比例依次为早期教育52.96%、保护46.69%、健康35.58%、参与25.66%、营养15.30%。水和卫生设施维度和早期教育维度对儿童贫困的贡献最大,分别为26.53%和22.06%。贵州儿童贫困率明显高于山西,小月龄、少数民族、母亲文化程度低、家中人口多、家中经济条件差的儿童群体贫困率更高。结论调查地区婴幼儿面临严重的多维度贫困,单纯经济导向的扶贫难以改善他们的福利状况;多维贫困测量方法有利于识别和定位儿童贫困,制定特异性策略来改善儿童福利,促进儿童早期发展。 | 魏乾伟 王晓莉 郝波 张敬旭 罗树生 赵春霞 郭素芳 Scherpbier Robert | 2018 | 中国公共卫生2018，34，2： | 7 |
| 4 | Implementing the communication for development strategy to improve knowledge and coverage of measles vaccination in western Chinese immunization programs:a before-and-after evaluation显示文摘Background:Communication for Development(C4D)is a strategy promoted by the United Nations Children’s Fund to foster positive and measurable changes at the individual,family,community,social,and policy levels of society.In western China,C4D activities have previously been conducted as part of province-level immunization programs.In this study,we evaluated the association of C4D with changes in parental knowledge of immunization services,measles disease,and measles vaccine,and changes in their children’s measles vaccine coverage.Methods:From April 2013 to April 2014,C4D activities were implemented as part of provincial immunization programs in the Inner Mongolia,Guangxi,Chongqing,Guizhou,Tibet,Shaanxi,Gansu,Ningxia,and Qinghai provinces.We used a before-and-after study design and employed face-to-face interviews to assess changes in parental knowledge and vaccination coverage.Results:We surveyed 2107 households at baseline and 2070 households after 1 year of C4D activities.Following C4D,95%of caregivers were aware of the vaccination record check requirement for entry into kindergarten and primary school;80%of caregivers were aware that migrant children were eligible for free vaccination;more than 70%of caregivers knew that measles is a respiratory infectious disease;and 90%of caregivers knew the symptoms of measles.Caregivers’willingness to take their children to the clinic for vaccination increased from 51.3%at baseline to 67.4%in the post-C4D survey.Coverage of one-dose measles-containing vaccine(MCV)increased from 83.8%at baseline to 90.1%after C4D.One-dose MCV coverage was greater than 95%in the Guangxi,Shaanxi,and Gansu provinces.Two-dose MCV coverage increased from 68.5 to 77.6%.House-to-house communication was the most popular C4D activity among caregivers(91.6%favoring),followed by posters and educational talks(64.8 and 49.9%favoring).Conclusions:C4D is associated with increased caregiver knowledge about measles,increased willingness to seek immunization services for their children,and increased measles vaccination coverage.Tailored communication strategies based on insights gained from these analyses may be able to increase vaccination coverage in hard-to-reach areas.C4D should be considered for larger scale implementation in China. | Ming Lu Yao-Zhu Chu Wen-Zhou Yu Robert Scherpbier Yu-Qing Zhou Xu Zhu Qi-Ru Su Meng-Juan Duan Xuan Zhang Fu-Qiang Cui Hua-Qing Wang Yi-Biao Zhou Qing-Wu Jiang | 2017 | Infectious Diseases of Poverty2017，6，1： | 3 |
| 5 | The effect on reliability of adding a separate written assessment component to an objective structured clinical examination显示文摘 | Verhoeven BH Hamers JG Scherpbier AJ | 2000 | Med Educ2000，34，7： | 1 |
| 6 | Effect of the learning climate of residency programs on faculty's teaching performance as evaluated by residents显示文摘 | Lombarts K M J M H Heineman M J Scherpbier A J J A | 2014 | PLOS One2014，9，86： | 1 |
| 7 | A qualitative analysis of the transition from theory to practice in undergraduate training in a PBL-medieal school显示文摘 | Prince KJ VauDe Wiel M Scherpbier AJ | 2005 | Adv Health Sci Educ Theory Pract2005，5，2： | 1 |
| 8 | Feedback by simu-lated patients in undergraduate medical education:a systematicreview of the literature显示文摘 | Bokken L Linssen T Scherpbier A | 2009 | Med Educ2009，43，3： | 1 |
| 9 | Buruli ulcer: Myco- bacterial ulcerans infection, Geneva 显示文摘 | ASIEDU K RAVIGLIONE M SCHERPBIER R | 2000 | World Health Organization2000，，： | 1 |
| 10 | Feedback by simulated patients in undergraduate medical education: a systematic review of the literature显示文摘 | Bokken L Linssen T Scherpbier A | 2009 | Med Educ2009，43，3： | 1 |
| 11 | Rescuing a Patient in De- teriorating Situations ( RAPIDS ) : A simulation - based education program on recognizing, responding and reporting of physiological signs of deterioration 显示文摘 | Liaw SY Rethans JJ Scherpbier A | 2011 | Resuscitation2011，82，9： | 1 |
| 12 | Feedback by simulated patients in undergraduate medical education:A systematic review of the literature显示文摘 | Bokken L Linssen T Scherpbier A | | 0，，3： | 1 |
| 13 | Clinical teachers and problem-based learning:a phenomenological study显示文摘 | Dornan T Scherpbier A | | 0，，02： | 1 |
| 14 | Nurses' roles in in-formed consent in a hierarchical and communal context显示文摘 | Susilo AP Van Dalen J Scherpbier A | 2013 | NursEthics2013，20，4： | 1 |
| 15 | Factors influencing intercultural doctor-patient communication: A realist review显示文摘 | Paternone E Scherpbier AJ Scheele F | 2015 | Patient Educ Couns2015，98，4： | 1 |
| 16 | Therapeutic immune reconstitution in HIV-1 infected children is independent of their age and pretreatment immune status 显示文摘 | van Rossum AMC Scherpbier HJ van Lochem EG | 2001 | AIDS2001，15，17： | 1 |
| 17 | Update of training models in Endourology:a qualitative systematic review of the literature between January 1980 and April 2008显示文摘 | Schout BM Hendrikx JM Scherpbier A J | | 0，，06： | 1 |
| 18 | Clin- icalteachers and problem-based learning: a phenomeno- logicalstudy 显示文摘 | Tim Dornan Albert Scherpbier Nigel King etc | 2005 | Medical Education2005，39，2： | 1 |
| 19 | A qualitative analysis of the transition from theory to practice in undergradu- ate training in a PBL - medical school 显示文摘 | Prince KJ VanDe wiel M scherpbier AJ | 2005 | Adv Heal th sci Educ Theory Pract2005，5，2： | 1 |
| 20 | Pre-clinical patient contacts and the application of biomedicaland clinical knowledge显示文摘 | Diemers AD van de Wiel MW Scherpbier AJ | 2011 | Med Educ2011，45，： | 1 |
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