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LANCET期刊导读(Volume 380, Issue 9845)

发布者:鑫达医学翻译 发布时间:2012-09-09 8:50:52 阅读:

Lancet杂志, 第380卷,9845期. 2012年9月8日
题目:Prevalence and risk of violence against children with disabilities: a systematic review and meta-analysis of observational studies
残疾儿童暴力冲突发生率及风险分析:Meta分析
链接:http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60692-8/fulltext
内容概述:
全球范围内,儿童中重度残疾发病率极高。与同龄、健康儿童相比,残疾儿童受暴力冲突伤害的可能性更大。来自英国及瑞士的课题组对残疾儿童暴力冲的发生率及风险进行Meta分析。
文章纳入1990年1月至2010年8月期间发表的病例对照研究(case-control study)、横断面研究(cross-sectional study)或队列研究(cohort study)。最初纳入10663篇英文文献,最终获得符合标准的文献17篇。其中,16篇文献内对儿童残疾的发病率及风险进行了分析。结果发现,复合因素冲突发生率为26.7% (95% CI 13.8—42.1%),OR值(相对危险度)为3.68 (2.56—5.29) ;肢体冲突发生率为20.4% (13.4—28.5%),OR值(相对危险度)为3.56 (2.80—4.52);性暴力发生率为13.7% (9.2—18.9%),OR值(相对危险度)为2.88 (2.24—3.69)。
本Meta分析表明,残疾儿童更易卷入暴力冲突。但是由于缺乏严谨的临床试验设计,所以并不能对暴力冲突与残疾的因果关系进行评价。
点评:这篇Meta分析相信很多人看了后觉得技术含量并不高。而且,这篇文章并不能解释暴力冲突与儿童残疾的关系。Idea非常简单,无非就是借助了Meta分析罢了。相信很多人会做Meta分析,可为什么我们写的论文就不能发表到Lancet这种期刊呢?这个确实值得我们深入思考!
Summary
Background
Globally, at least 93 million children have moderate or severe disability. Children with disabilities are thought to have a substantially greater risk of being victims of violence than are their non-disabled peers. Establishment of reliable estimates of the scale of the problem is an essential first step in the development of effective prevention programmes. We therefore undertook a systematic review and meta-analysis to synthesise evidence for the prevalence and risk of violence against children with disabilities.
Methods
For this systematic review and meta-analysis, we searched 12 electronic databases to identify cross-sectional, case-control, or cohort studies reported between Jan 1, 1990, and Aug 17, 2010, with estimates of prevalence of violence against children (aged ≤18 years) with disabilities or their risk of being victims of violence compared with children without disabilities.
Findings
17 studies were selected from 10 663 references. Reports of 16 studies provided data suitable for meta-analysis of prevalence and 11 for risk. Pooled prevalence estimates were 26•7% (95% CI 13•8—42•1) for combined violence measures, 20•4% (13•4—28•5) for physical violence, and 13•7% (9•2—18•9) for sexual violence. Odds ratios for pooled risk estimates were 3•68 (2•56—5•29) for combined violence measures, 3•56 (2•80—4•52) for physical violence, and 2•88 (2•24—3•69) for sexual violence. Huge heterogeneity was identified across most estimates (I2>75%). Variations were not consistently explained with meta-regression analysis of the characteristics of the studies.
Interpretation
The results of this systematic review confirm that children with disabilities are more likely to be victims of violence than are their peers who are not disabled. However, the continued scarcity of robust evidence, due to a lack of well designed research studies, poor standards of measurement of disability and violence, and insufficient assessment of whether violence precedes the development of disability, leaves gaps in knowledge that need to be addressed.
 


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