Background:Depression and anxiety are highly prevalent among adolescents and have multiple negative effects on their physical and mental health.While exercise can reduce the symptoms of depression and anxiety,the rela...Background:Depression and anxiety are highly prevalent among adolescents and have multiple negative effects on their physical and mental health.While exercise can reduce the symptoms of depression and anxiety,the rela-tionship between mental disorders among American university students has been rarely reported.Accordingly,this study aimed to explore the association between exercise,depression and anxiety among American university students in the 2018–2019 academic year.Methods:In this cross-sectional study,the association between exercise,depression and anxiety was investigated in a large representative sample of American university students.In the 2018–2019 academic year,university students aged 18+years old from 79 institutions participated in this school-based study.The questionnaire included measurements of demographic characteristics,exercise,and validated screen instructions for depression(PHQ-9)and anxiety(GAD-7).The multivariable logistic regression model was applied to explore the association between exercise,depression and anxiety.Results:A total of 62026 indivi-duals(31.9%males)participated in this survey,and the prevalence of exercising at least 5 h each day was 24.6%.The prevalence of depression and anxiety was 25.7%and 22.3%,respectively.In the multivariable logistic regres-sion model,compared to exercise at least 5 h daily,participants whose exercise less than 1 h daily(OR=1.31[1.29,1.33],p<0.05),2 to 3 h daily(OR=1.13[1.11,1.15],p<0.05),3 to 4 h daily(OR=1.04[1.02,1.06],p<0.05),were correlated with greater odds of depression,while exercise less than 1 h daily(OR=1.23[1.21,1.25],p<0.05),2 to 3 h daily(OR=1.10[1.08,1.12],p<0.05)were significantly correlated with great-er odds of anxiety.Conclusion:Higher levels of exercise are associated with lower risk of depression and anxiety among American university students.Community and school interventions should focus on increasing exercise participation in university populations to promote both physical and mental health.展开更多
BACKGROUND Advances in minimally invasive surgery and improved post-operative pain management make it possible to consider performing even major foot/ankle operations as day-case.This could have significant benefits f...BACKGROUND Advances in minimally invasive surgery and improved post-operative pain management make it possible to consider performing even major foot/ankle operations as day-case.This could have significant benefits for patients and the health service.However there are theoretical concerns about post-operative complications and patient satisfaction due to pain.AIM To scope the current practice of foot and ankle surgeons on day-case surgery for major foot and ankle procedures in the United Kingdom(UK).METHODS An online survey(19 questions)was sent to UK foot and ankle surgeons via the British Orthopaedic Foot&Ankle Society membership list in August 2021.Major foot and ankle procedures were defined as surgery that is usually performed as an inpatient in majority of centres and day-case as same day discharge,with day surgery as the intended treatment pathway.RESULTS 132 people responded to the survey invitation with 80%working in Acute NHS Trusts.Currently 45%of respondents perform less than 100 day-case surgeries per year for these procedures.78%felt that there was scope to perform more procedures as day-case at their centre.Post-operative pain(34%)and patient satisfaction(10%)was not highly measured within their centres.Lack of adequate physiotherapy input pre/post-operatively(23%)and lack of out of hours support(21%)were the top perceived barriers to performing more major foot and ankle procedures as day-case.CONCLUSION There is consensus among UK surgeons to do more major foot/ankle procedures as day-case.Out of hours support and physiotherapy input pre/post-op were perceived as the main barriers.Despite theoretical concerns about post-operative pain and satisfaction this was only measured by a third of those surveyed.There is a need for nationally agreed protocols to optimise the delivery of and measurement of outcomes in this type of surgery.At a local level,the provision of physiotherapy and out of hours support should be explored at sites where this is a perceived barrier.展开更多
Objective: The aim of the present study was to investigate Chinese nurses' perception of risk factors for phlebitis.Methods: A convenience sample of hospital nurses was recruited in Beijing, China. Data were colle...Objective: The aim of the present study was to investigate Chinese nurses' perception of risk factors for phlebitis.Methods: A convenience sample of hospital nurses was recruited in Beijing, China. Data were collected using a demographic information questionnaire and a questionnaire measuring nurses' perception of risk factors for infusion phlebitis.Results: It was found that knowledge of risk factors for infusion phlebitis was incomplete, even among experienced nurses in the study participants. A high rate of incorrect answers to questions about the p H of fluid(89.9%), gauze or polyurethane catheter dressings(79.1%), and steel needles for drug infusion(76.3%) was observed.Conclusions: These findings suggest that nurses should be trained about the risk factors for infusion phlebitis.展开更多
Early drinking is considered to result in making tolerant of alcohol consumption and a higher prevalence of alcohol related disorders in the later. We focused generational impacts on drinking rate among high school st...Early drinking is considered to result in making tolerant of alcohol consumption and a higher prevalence of alcohol related disorders in the later. We focused generational impacts on drinking rate among high school students based on multiple nationwide data. The surveys were nationwide, cross-sectional random sampling surveys given every 4 years from the Japanese Youth Tobacco and Alcohol Surveys, 1996 to 2008. Participants were male 53,925 high school students from 7th grade to 11th grade. We divided to the three follow-up groups every 4 years from 1996 to 2004 for male junior high school students in 7th grades and the end periods were 4 years later in 11th grades. Outcome measures in this study were life time drinking, current drinking within 30 days and weekly drinking. All drinking rates decreased each at 7th and at 11th grade. The increments in these drinking rates from 7th grade to 11th grade in males decreased gradually in recent follow-up groups. Generational impacts should be considered by using follow-up groups to study drinking behaviors among students.展开更多
Objective To determine the factors influencing insomnia and construct early insomnia warning tools for rescuers to informbest practices for early screening and intervention.Methods Cluster sampling was used to conduct...Objective To determine the factors influencing insomnia and construct early insomnia warning tools for rescuers to informbest practices for early screening and intervention.Methods Cluster sampling was used to conduct a cross-sectional survey of 1,133 rescuers from one unit in Beijing,China.Logistic regression modeling and R software were used to analyze insomniarelated factors and construct a PRISM model,respectively.Results The positive rate of insomnia among rescuers was 2.74%.Accounting for participants’age,education,systolic pressure,smoking,per capita family monthly income,psychological resilience,and cognitive emotion regulation,logistic regression analysis revealed that,compared with families with an average monthly income less than 3,000 yuan,the odds ratio(OR)values and the[95%confidence interval(CI)]for participants of the following categories were as follows:average monthly family income greater than 5,000 yuan:2.998(1.307–6.879),smoking:4.124(1.954–8.706),and psychological resilience:0.960(0.933–0.988).The ROC curve area of the PRISM model(AUC)=0.7650,specificity=0.7169,and sensitivity=0.7419.Conclusion Insomnia was related to the participants’per capita family monthly income,smoking habits,and psychological resilience on rescue workers.The PRISM model’s good diagnostic value advises its use to screen rescuer early sleep quality.Further,advisable interventions to optimize sleep quality and battle effectiveness include psychological resilience training and smoking cessation.展开更多
The continuous awareness campaigns about Colorectal Cancer (CRC) directed towards the Lebanese population in order to foster preventive medicine are on the rise. The impact has been positive and reported in previous r...The continuous awareness campaigns about Colorectal Cancer (CRC) directed towards the Lebanese population in order to foster preventive medicine are on the rise. The impact has been positive and reported in previous research, although the number of victims is still high. This paper aims to perform a recent cross-sectional study of Lebanese residents’ CRC awareness by comparing the findings of two studies carried out in the years 2016 and 2018. The samples of the current study include 1140 (2016) and 993 (2018) participants who completed a simple structured questionnaire directed to assess their knowledge of colon cancer and the behavioral intentions of obtaining CRC screening. Upon comparing results, the percentage of those who know about CRC has increased significantly from 40.4% in 2016 to 78.7% in 2018, the proportion of respondents who believed that family history is the major risk factor for CRC did increase significantly from 47.7% in 2016 to 90.8% in 2018. Likewise, the proportions of respondents who believed that overweight, age, and stress are among the major risk factors for CRC increased from 26.9%, 26.7% and 11.3% in 2016 to 86.2%, 52.1% and 21.51% in 2018, respectively. On the other hand, the proportions for the risk factors related to alcohol and smoking have dropped from 37.7% and 37.3% to 27.4% and 24.2%, respectively. Moreover, the most important source of information for CRC was friends (18.4% in 2016 versus 73.8% in 2018), followed by family (18.7% in 2016 versus 56.7% in 2018), and then physicians (18.9% in 2016 and 40.2% in 2018). In fact, the efforts of the non-governmental organization (NGO) SAID (118 different major activities in the span of 3 years) did make a significant difference in what relates to CRC awareness among the Lebanese population. These findings are used to encourage and support other NGOs to adopt targeted new awareness campaigns which have proven successful, and to present evidence based on facts to government officials in the Ministry of Health to support and possibly sponsor national awareness campaigns and preventive efforts to mitigate CRC levels.展开更多
Backgrounds: Smoking in childhood has become an important public health concern. Previous studies have reported on secular trends in childhood smoking rates and compared with smoking rates at fixed ages. They also des...Backgrounds: Smoking in childhood has become an important public health concern. Previous studies have reported on secular trends in childhood smoking rates and compared with smoking rates at fixed ages. They also described secular trends regarding the prevalence of smoking at fixed ages. The variations in smoking rate of young children and adolescents by follow-up groups have not been studied by follow-up groups at a national level. Objective: We looked at trends and generational impacts on smoking rate by using follow-up groups of male Japanese high school students to quantitatively assess differences in trends, based on multiple nationwide data from the Japanese Youth Tobacco and Drinking Surveys gathered every 4 years between 1996 and 2008. Methods: The surveys were nationwide, cross-sectional random sampling surveys given every 4 years from 1996 to 2008, using the single-stage cluster sampling methodology. The cluster unit of the sampling was school. The survey targeted junior and senior high school students from schools selected through Japan using the National School Directory. Students enrolled in the sampled schools were subjects of the study. Participants were 53,925 high school students from 7th grade to 11th grade in 1996, 2000, 2004 and 2008. We divided the three follow-up groups every 4 years from 1996 to 2004 for male junior high school students in 7th grades, age 13. The end periods were 4 years later when they had become 11th graders, age 17, from 2000 to 2008. Main outcome measures in this study were life time smoking, current smoking within 30 days and daily smoking at 7th or 11th grade and the trend of the smoking rates between 7th to 11th grades. Results: Life time smoking rate, current smoking rate and daily smoking rate in Japanese high school students decreased at 7th grade from 1996 to 2004. They also decreased at 11th grade from 2000 to 2008. However, the slopes differed among their follow-up groups. The increments in their smoking rates from 7th grade to 11th grade in male high school students were smaller in recent follow-up groups both in 2000 and in 2004 than in follow-up groups in 1996. Then, those increments in follow-up groups between in 2000 and in 2004 were similar in lifetime smoking rate and current smoking rate. Conclusions: We have shown that monitoring trends by follow-up group are important in studying smoking for public health. Values of smoking rates from a young age to adolescence by follow-up group should be examined. Values of smoking rate and regular changes in smoking rate are important because smoking rate changes dynamically during adolescence. Not only trends in smoking rates at fixed ages, but also generational impacts should be considered by using follow-up groups to study smoking behaviors among students. We need to continue careful monitoring of follow-up group smoking prevalence. When long-term health promotions are planned or assessed, policy makers need to look at changes in follow-up groups.展开更多
Background: Six in ten sexually active adolescent women in Uganda have an unmet need for contraception yet there is limited data on what is driving its use. This study aimed to determine the associations between socio...Background: Six in ten sexually active adolescent women in Uganda have an unmet need for contraception yet there is limited data on what is driving its use. This study aimed to determine the associations between sociodemographic factors and modern contraceptive ever-use among adolescents in Uganda. Methods: A crossectional study was conducted among 337 adolescents aged 13 - 19 years who had ever had sex in Wakiso (urban) and Kamuli (rural) districts in Uganda. The outcome of interest was the ever-use of modern contraceptives. Generalized linear models with a Poisson link were used to examine the associations between sociodemographic factors and contraceptive ever use. Results: The weighted prevalence of ever-use of modern contraceptives was 30.9%. Contraceptive ever use was more likely among the older adolescents (adjusted Odds Ratio) aOR 1.31 (95% CI = 1.06 - 1.55), married aOR 1.67 (95% CI = 1.09 - 2.58) and the less educated were aOR 1.79 (95% CI = 1.14 - 2.83) compared to their counterparts. Adolescents living in the urban district (Wakiso) aOR 0.67 (95% CI = 0.49 - 0.92) were less likely to use modern contraceptives. In stratified analysis, the urban poor were more likely to use modern contraceptives (moderate aPR 0.35 95%CI (0.17 - 0.68) ** or high socioeconomic status aPR 0.62, 95%CI (0.28 - 1.37). Conclusions: The study shows low contraceptive ever-use among adolescents. Adolescents with low education and those from rural settings were more likely to ever-use modern contraceptives. Having good knowledge of contraception and discussing sex with parents promoted contraceptives ever-use. We recommend further studies assessing barriers to contraceptive use among adolescents in Uganda.展开更多
Objective: To investigate the patient safety culture regarding intravenous therapy in parts of tertiary hospitals in Guangzhou, China.Methods: A cross-sectional survey was conducted. A total of 333 medical staffs memb...Objective: To investigate the patient safety culture regarding intravenous therapy in parts of tertiary hospitals in Guangzhou, China.Methods: A cross-sectional survey was conducted. A total of 333 medical staffs members from eight hospitals in Guangzhou were included in our study using convenience sampling. An evaluation about the patient safety culture regarding intravenous therapy was conducted.Results: The summarized results show that the total and level one items' scores are greater than 4.3 points(the full mark is 5 points). The lowest scoring of the five level one items is for the hospital's security resources(4.53±0.526), and the highest is for the hospital's safety management commitment(4.65±0.445). Among the 25 secondary entries, the four lowest-scoring entries are "doctors who can master the knowledge of drug efficacy and adverse reactions"(4.44±0.622), "doctors who can master the knowledge of the choice of medicine"(4.45±0.621), "a guarantee of sufficient human resources"(4.46±0.647), and "doctors who can master the knowledge related to the observation and complications with the treatment of intravenous therapy operation"(4.435±0.634).Conclusions: The patient safety culture regarding intravenous treatment in parts of tertiary hospitals in Guangzhou is promising, but there are still shortcomings, including the need to increase relevant resources, such as equipment facilities, training resources, and especially human input.展开更多
Helicobacter pylori(H.pylori)infection is one of the most common chronic bacterial infections all over the world.University students are a group with strong comprehensive ability.Their cognition and behavior can exert...Helicobacter pylori(H.pylori)infection is one of the most common chronic bacterial infections all over the world.University students are a group with strong comprehensive ability.Their cognition and behavior can exert great impact on society.However,up to now,reports on the awareness and attitudes regarding H.pylori infection among university students are scarce.This study aimed to survey dietary,habits,knowledge,and attitudes towards H.pylori infection.A total of 5794 participants,including undergraduates,postgraduates,and doctoral students,were recruited from the top 100 universities in China.A selfconstructed questionnaire was used to assess the knowledge and attitudes of students toward H.pylori infection and its impact.In our study,most of the population preferred dining in the canteen(69.6%),whereas 20.6% chose restaurants or takeaway.Up to 24.1% of the respondents had at least one lifestyle habit associated with H.pylori colonization.Almost half had at least one digestive symptom related to H.pylori infection.Most students were aware of its association with gastritis(84.4%)and peptic ulcer(86.6%).However,only half of them were aware of its association with gastric cancer(57.9%).Furthermore,only 14.1% of the respondents had been tested for H.pylori,and 25.1% of them tested positive.The H.pylori-detection rate was higher in Hunan province compared with Guangdong and Jilin provinces.Regarding knowledge of H.pylori,65.4% of the respondents had known about it,and 24.3% correctly answered all questions.When comparing the acquisition of H.pylori knowledge between tested and untested students,32.5% of the tested participants answered all questions correctly,which was significantly higher than the untested group(13.1%).There was no significant difference between genders in H.pylori knowledge and detection.University students are highly educated population.If they were fully aware of the harm of H.pylori infection,their parents,friends,and even future families would benefit,thus reducing the incidence of H.pylori infection,as well as gastric cancer and healthcare finances.This survey not only investigated but also spread the awareness of H.pylori among university students,which is of great medical,economic and sociological importance.展开更多
Background Many cancer patients seek adjunctive therapies to biomedical cancer treatments at some point of their disease trajectory.While acupuncture is increasingly recommended by leading oncological associations,lim...Background Many cancer patients seek adjunctive therapies to biomedical cancer treatments at some point of their disease trajectory.While acupuncture is increasingly recommended by leading oncological associations,limited evidence exists concerning the evidence-informed practice and adherence to current guidelines of traditional complementary and integrative medicine(TCIM)practitioners treating cancer patients.Methods An international online-survey assessed the demographical data,clinical practice,and sources of information used by TCIM practitioners in Austria,Germany,United States of America,Australia,and New Zealand.Results In total,404 respondents completed the survey,of which 254(62.9%)treated cancer patients.Most practitioners were acupuncturists and herbalists(57.1%),had(16.8±9.9)years of clinical experience and see a median of 2(1,4)cancer patients per week.Breast cancer(61.8%)is the most common cancer type seen in TCIM clinics.Adjunctive TCIM treatments are frequently concurrent with the patient’s cancer specific treatment(39.9%),which is also reflected by the main goal of a TCIM treatment to alleviate side effects(52.4%).However,only 28.0%of the respondents are in contact with the treating oncologist.According to the respondents,pain is most effectively treated using acupuncture,while herbal medicine is best for cancer-related fatigue.TCIM practitioners mostly use certified courses(33.1%)or online databases(28.3%)but often believe that experts are more reliable to inform their practice(37.0%)than research publications(32.7%).Conclusion Acupuncturists and herbalists commonly treat cancer patients.Most practitioners use TCIM as an adjunct to biomedicine as supportive care and use it largely in accordance with current oncological guidelines.展开更多
Background Immunization is a crucial preventive measure to safeguard children under five years old against a range of diseases.In China,the coverage rate of non-National Immunization Program(non-NIP)vaccines can be im...Background Immunization is a crucial preventive measure to safeguard children under five years old against a range of diseases.In China,the coverage rate of non-National Immunization Program(non-NIP)vaccines can be improved by leveraging the recommendation from public health workers.Hence,understanding the influencing factors of recommendation behaviors assume paramount importance.This study aims to investigate influencing factors of public health workers’recommendation behaviors towards non-NIP vaccines,with a particular emphasis on financial incentives.Methods A cross-sectional survey was conducted using a multi-stage sampling method in 2019 from August to October.627 public health workers were recruited from 148 community healthcare centers in ten provincial-level administrative divisions in China.An anonymous questionnaire was used to collect demographic information,attitudes towards vaccination,and recommendation behaviors towards non-NIP vaccines,includingHaemophilus influenzae type b(Hib)vaccine,pneumococcal conjugate vaccine,varicella vaccine,and rotavirus vaccine.Descriptive analysis and multivariate logistic regression analysis were adopted in this study.Results Of the 610 public health workers with complete survey data,53.8%,57.4%,84.1%,and 54.1%often recommended Hib vaccine,pneumococcal pneumonia vaccine(PCV),varicella vaccine,and rotavirus vaccine,respectively.Logistic regression revealed that gender(Hib vaccine:OR=0.4,95%CI:0.2-0.8;PCV:OR=0.4,95%CI:0.2-0.8;rotavirus vaccine:OR=0.3,95%CI:0.2-0.6),financial incentives for non-NIP vaccination(Hib vaccine:OR=1.9,95%CI:1.1-3.6;PCV:OR=2.1,95%CI:1.1-3.9;rotavirus vaccine:OR=2.0,95%CI:1.1-3.8)and perception of vaccine safety(Hib vaccine:OR=2.7,95%CI:1.1-7.0;PCV:OR=3.2,95%CI:1.2-8.0;rotavirus vaccine:OR=3.0,95%CI:1.2-7.7)were associated with public health workers’recommendation towards Hib vaccine,PCV and rotavirus vaccine.Conclusions The findings highlighted public health workers’recommendation behaviors of non-NIP vaccines in China and revealed strong association between vaccine recommendation and financial incentives.This highlights the importance of financial incentives in public health workers’recommendation toward non-NIP vaccines in China.Proper incentives are recommended for public health workers to encourage effective health promotion in immunization practices.展开更多
BACKGROUND Colorectal polyps(CPs)are frequently occurring abnormal growths in the colorectum,and are a primary precursor of colorectal cancer(CRC).The triglyceride-glucose(TyG)index is a novel marker that assesses met...BACKGROUND Colorectal polyps(CPs)are frequently occurring abnormal growths in the colorectum,and are a primary precursor of colorectal cancer(CRC).The triglyceride-glucose(TyG)index is a novel marker that assesses metabolic health and insulin resistance,and has been linked to gastrointestinal cancers.AIM To investigate the potential association between the TyG index and CPs,as the relation between them has not been documented.METHODS A total of 2537 persons undergoing a routine health physical examination and colonoscopy at The First People's Hospital of Kunshan,Jiangsu Province,China,between January 2020 and December 2022 were included in this retrospective cross-sectional study.After excluding individuals who did not meet the eligibility criteria,descriptive statistics were used to compare characteristics between patients with and without CPs.Logistic regression analyses were conducted to determine the associations between the TyG index and the prevalence of CPs.The TyG index was calculated using the following formula:Ln[triglyceride(mg/dL)×glucose(mg/dL)/2].The presence and types of CPs was determined based on data from colonoscopy reports and pathology reports.RESULTS A nonlinear relation between the TyG index and the prevalence of CPs was identified,and exhibited a curvilinear pattern with a cut-off point of 2.31.A significant association was observed before the turning point,with an odds ratio(95% confidence interval)of 1.70(1.40,2.06),P<0.0001.However,the association between the TyG index and CPs was not significant after the cut-off point,with an odds ratio(95% confidence interval)of 0.57(0.27,1.23),P=0.1521.CONCLUSION Our study revealed a curvilinear association between the TyG index and CPs in Chinese individuals,suggesting its potential utility in developing colonoscopy screening strategies for preventing CRC.展开更多
BACKGROUND Dietary fiber(DF)intake may have a protective effect against type 2 diabetes(T2D);however,its relationship with diabetic kidney disease(DKD)remains unclear.AIM To investigate the potential association betwe...BACKGROUND Dietary fiber(DF)intake may have a protective effect against type 2 diabetes(T2D);however,its relationship with diabetic kidney disease(DKD)remains unclear.AIM To investigate the potential association between DF intake and the prevalence of DKD in individuals diagnosed with T2D.METHODS This cross-sectional study used data from the National Health and Nutrition Examination Survey collected between 2005 and 2018.DF intake was assessed through 24-h dietary recall interviews,and DKD diagnosis in individuals with T2D was based on predefined criteria,including albuminuria,impaired glomerular filtration rate,or a combination of both.Logistic regression analysis was used to assess the association between DF intake and DKD,and comprehensive subgroup and sensitivity analyses were performed.RESULTS Among the 6032 participants,38.4%had DKD.With lower DF intake-T1(≤6.4 g/1000 kcal/day)-as a reference,the adjusted odds ratio for DF and DKD for levels T2(6.5-10.0 g/1000 kcal/day)and T3(≥10.1 g/1000 kcal/day)were 0.97(95%CI:0.84-1.12,P=0.674)and 0.79(95%CI:0.68-0.92,P=0.002),respectively.The subgroup analysis yielded consistent results across various demographic and health-related subgroups,with no statistically significant interactions(all P>0.05).CONCLUSION In United States adults with T2D,increased DF intake may be related to reduced DKD incidence.Further research is required to confirm these findings.展开更多
Objective:To study the prevalence of anemia,the proportion of hemoglobin(Hb)levels,the treatment methods,and the influencing factors of Hb levels in maintenance hemodialysis(MHD)and peritoneal dialysis patients.Method...Objective:To study the prevalence of anemia,the proportion of hemoglobin(Hb)levels,the treatment methods,and the influencing factors of Hb levels in maintenance hemodialysis(MHD)and peritoneal dialysis patients.Methods:In this study,602 patients with maintenance hemodialysis and continuous ambulatory peritoneal dialysis were enrolled from December 2020 to December 2022 in our hospital,and their medical records were collected and summarized.The main contents included the patient’s gender,age,primary disease,dialysis duration,dialysis method,the use of erythropoietic stimulating agents(ESA),intravenous iron,and laboratory tests.A Hb index exceeding 110 g/L was set as the standard for the prevalence of anemia.Results:The rate of anemia in patients undergoing blood purification was 83%.The proportion of ESA use was 84.1%,and the proportion of iron use was 76.7%,of which the proportion of intravenous iron used was 17.0%,and the proportion of folic acid used was 28.3%.Conclusion:The incidence of anemia in MHD patients was relatively high,with a low proportion of patients reaching the standard Hb levels.Risk factors include albumin(ALB)levels,iron storage,white blood cells,C-reactive protein,cholesterol,etc.Nutritional support,iron supplementation,and prevention of micro-inflammatory reactions can effectively promote the improvement of Hb indicators in dialysis patients to prevent anemia.展开更多
Background Stroke is the leading cause of mortality in China,with limited evidence of in-hospital burden obtained from nationwide surveys.We aimed to monitor and track the temporal trends and rural-urban disparities i...Background Stroke is the leading cause of mortality in China,with limited evidence of in-hospital burden obtained from nationwide surveys.We aimed to monitor and track the temporal trends and rural-urban disparities in cerebrovascular risk factors,management and outcomes from 2005 to 2015.Methods We used a two-stage random sampling survey to create a nationally representative sample of patients admitted for ischaemic stroke in 2005,2010 and 2015.We sampled participating hospitals with an economic-geographical region-stratified random-sampling approach first and then obtained patients with a systematic sampling approach.We weighed our survey data to estimate the national-level results and assess changes from 2005 to 2015.Results We analysed 28277 ischaemic stroke admissions from 189 participating hospitals.From 2005 to 2015,the estimated national hospital admission rate for ischaemic stroke per 100000 people increased(from 75.9 to 402.7,Ptrend<0.001),and the prevalence of risk factors,including hypertension,diabetes,dyslipidaemia and current smoking,increased.The composite score of diagnostic tests for stroke aetiology assessment(from 0.22 to 0.36,Ptrend<0.001)and secondary prevention treatments(from 0.46 to 0.70,Ptrend<0.001)were improved.A temporal decrease was found in discharge against medical advice(DAMA)(from 15.2%(95%CI 13.7%to 16.7%)to 8.6%(8.1%to 9.0%);adjusted Ptrend=0.046),and decreases in in-hospital mortality(0.7%in 2015 vs 1.8%in 2005;adjusted OR(aOR)0.52;95%CI 0.32 to 0.85)and the composite outcome of in-hospital mortality or DAMA(8.4%in 2015 vs 13.9%in 2005;aOR 0.65;95%CI 0.47 to 0.89)were observed.Disparities between rural and urban hospitals narrowed;however,disparities persisted in in-hospital management(brain MRI:rural-urban difference from−14.4%to−11.2%;cerebrovascular assessment:from−20.3%to−16.7%;clopidogrel:from−2.1%to−10.3%;anticoagulant for atrial fibrillation:from−10.9%to−8.2%)and in-hospital outcomes(DAMA:from 2.7%to 5.0%;composite outcome of in-hospital mortality or DAMA:from 2.4%to 4.6%).Conclusions From 2005 to 2015,improvements in hospital admission and in-hospital management for ischaemic stroke in China were found.A temporal improvement in DAMA and improvements in in-hospital mortality and the composite outcome of in-hospital mortality or DAMA were observed.Disparities between rural and urban hospitals generally narrowed but persisted.展开更多
Background:Understanding factors influencing adolescents’ sport/exercise participation(S/EP) is vital to developing effective interventions,but currently,evidence from less developed countries is limited.The purpose ...Background:Understanding factors influencing adolescents’ sport/exercise participation(S/EP) is vital to developing effective interventions,but currently,evidence from less developed countries is limited.The purpose of this study was to examine correlates of S/EP across individual,interpersonal,and environmental levels in a nationally representative sample of Thai adolescents.Methods:Data from 4617 Thai adolescents aged 14-17 years old were obtained from recruited schools across Thailand.Data on S/EP(outcome variable),and psychosocial,home,and community environment covariates were collected from individual adolescents using the Thailand Physical Activity Children Survey,Student Questionnaire.School environmental data were collected at the school level using a School Built Environment Audit.Hierarchical regressions taking into account school clustering effects were applied for data analysis.Results:At the individual level,age and body mass index were independently and strongly correlated with S/EP.Adolescents with high preference for physical activity(PA)(odd ratio(OR)=1.71,p <0.001) and at least a moderate level of self-efficacy(OR=1.33,p=0.001) were more likely to have high S/EP.At the interpersonal level,adolescents whose parents joined their sports/exercise at least 1-2 times/week(OR=1.36,p=0.003) received>3 types of parental support(OR=1.43,p=0.005) and who received siblings’(OR=1.26,p=0.004) and friends’(OR=1.99,p <0.001) support had a greater chance of high S/EP.At the environmental level,adolescents’ S/EP was greater when there were at least 3-4 pieces of home sport/exercise equipment(OR=2.77,p=0.003),grass areas at school(OR=1.56,p <0.001),and at least 1-2 PA facilities in the community(OR=1.30,p=0.009).Conclusion:Multiple factors at different levels within an ecological framework influencing Thai adolescents’ S/EP were generally similar to those found in developed countries,despite some differences.For those interested in promoting and supporting Thai adolescents’ engagement in sports/exercise,further exploration of the influence of self-efficacy and attitude toward PA is required at the individual level;parental and peer support at the interpersonal level;and home sport equipment,school grass areas,and neighborhood PA facilities at the environment level.展开更多
Objective:The objective of this study is to evaluate the acceptance of pregnant women with regards to coronavirus disease 2019 (COVID-19) vaccination during pregnancy and to identify any significant changes in their a...Objective:The objective of this study is to evaluate the acceptance of pregnant women with regards to coronavirus disease 2019 (COVID-19) vaccination during pregnancy and to identify any significant changes in their anxiety and knowledge on COVID-19 compared to our previous study.Methods:This cross-sectional survey was performed in the antenatal clinics of United Christian Hospital and Tseung Kwan O Hospital of Hong Kong,China.Questionnaires were distributed to pregnant women for self-completion when attending follow-up from August to October 2021.Apart from basic demographic data,the questionnaire comprised of questions including knowledge on COVID-19 and its vaccines in pregnancy as well as attitudes and behaviors of pregnant women and their partners toward COVID-19.Continuous variables were analyzed by Student’s test and Levene’s test was used to confirm normal distribution and homogeneity of variance for continuous variables,whereas categorical variables were analyzed by the Chi-squared test or Fisher’s exact test as appropriate.AP value of <0.05 was considered to be statistically significant.Results:A total of 816 completed questionnaires were included for analysis.Pregnant women were less worried about COVID-19 in the current survey as compared to the last survey (393/816,48.2%vs.518/623,83.1%,P<0.001).Fewer pregnant women believed that pregnancy were more susceptible to contract SARS-CoV-2 as compared to the last survey (265/816,32.5%vs.261/623,41.9%,P<0.001).They have significant knowledge gap and concerns about COVID-19 vaccines.Nearly half of the participants believed that pregnant women cannot have COVID-19 vaccination (402/816,49.3%) and it is unsafe to fetus (365/816,44.7%).Around a third of women perceived that they were more prone to the side effects and complications of COVID-19 vaccines than the general population (312/816,38.2%) and did not recognize that maternal COVID-19 vaccination could effect transferral of antibodies to the fetus to promote postnatal passive immunity (295/816,36.2%).Most of them had not been vaccinated (715/816,87.6%) and only (12/715) 1.7% of them would consider vaccination during pregnancy.Conclusion:Despite the local and international recommendations for pregnant women to be vaccinated,the uptake of COVID-19 vaccines during pregnancy remained extremely low.Efforts should be made to effectively provide information about the safety and benefits of COVID-19 vaccines during pregnancy.There is an urgent need to booster vaccination rates in pregnant women to avoid excessive adverse pregnancy outcomes related to COVID-19.展开更多
Objective:Psoriasis is a chronic inflammatory systemic disease that severely impacts patients’ quality of life (QoL) and psychological health.While biologics have been shown to be effective in treating psoriatic lesi...Objective:Psoriasis is a chronic inflammatory systemic disease that severely impacts patients’ quality of life (QoL) and psychological health.While biologics have been shown to be effective in treating psoriatic lesions,thus improving QoL,real-life data regarding such effects remain scant.We administered a repeated cross-sectional survey to assess the effects of 8 weeks of biologics treatment on the QoL and mental health status of patients with moderate-to-severe plaque psoriasis.Methods:From March to May 2022,patients with moderate-to-severe plaque psoriasis were enrolled and treated with biologics in the outpatient clinic at the Dermatology Hospital of Southern Medical University.Assessments were performed before treatment and after 4 and 8 weeks of treatment with biologics.Psoriasis severity,QoL,and mental health status were evaluated using the Psoriasis Area and Severity Index (PASI),Dermatology Life Quality Index (DLQI),36-Item Short-form Health Survey (SF-36),and Hospital Anxiety and Depression Scale (HADS).A multivariate generalized estimating equations (GEE) analysis was used to account for repeated measures and to determine the effects of treatment duration and type of biological agent on relevant indicators.Results:Among the 78 enrolled patients,the ranges of pretreatment scores were 4.6 to 46.8 for the PASI,1 to 30 for the DLQI,31.5 to 100.0 for the physical component score (PCS) of the SF-36,16.6 to 100.0 for the mental component score (MCS) of the SF-36,0 to 15 for the HADS-A,and 0 to 17 for the HADS-D.After 8 weeks of biologics treatment,98.7% (77/78) of patients had obtained PASI 75.All assessed scores changed over time (GEE,P < 0.001).Moreover,there were group-by-time interaction effects for the DLQI score (GEE,P = 0.023) and PCS (GEE,P = 0.029).The HADS-A and HADS-D scores were both decreased at week 8 compared with pretreatment values.Correlation analyses revealed that higher DLQI scores were associated with lower levels of QoL and higher levels of anxiety or depression.Conclusion:Biologics are not only effective in the treatment of skin lesions but also exert beneficial effects upon the QoL and mental health of patients with psoriasis as determined in the short-term assessments conducted in this study.展开更多
Objective This cross-sectional study aimed to investigate the current attention and intervention of oncologists on oxaliplatin(OXA)-induced adverse reactions(ADRs).Methods In 31 provinces or administrative regions acr...Objective This cross-sectional study aimed to investigate the current attention and intervention of oncologists on oxaliplatin(OXA)-induced adverse reactions(ADRs).Methods In 31 provinces or administrative regions across China,401 oncologists were surveyed through a self-designed questionnaire.The survey queried the basic information of respondents,clinical use of OXA,OXA-induced ADRs,and relative interventions.Chi-square tests and multiple logistic regression were used to explore the sociodemographic factors influencing the safety perception of OXA and the relevant interventions.Results The survey showed that the age of respondents was mainly distributed between 30 and 40 years and the working period for most oncologists was no more than 5 years.Oncologists with long working years were more willing to conduct patient education and inquire about ADRs than those with short working years.The rate of ADRs reported by oncologists with intermediate professional titles was significantly higher than that reported by oncologists with junior and senior professional titles.Conclusion Our findings indicate that oncologists in China's Mainland are concerned about OXA-induced ADRs,but the reporting of ADRs still needs to be strengthened.Therefore,training and educational programs are urgently needed to improve the risk management of OXA-induced ADRs among oncologists.展开更多
文摘Background:Depression and anxiety are highly prevalent among adolescents and have multiple negative effects on their physical and mental health.While exercise can reduce the symptoms of depression and anxiety,the rela-tionship between mental disorders among American university students has been rarely reported.Accordingly,this study aimed to explore the association between exercise,depression and anxiety among American university students in the 2018–2019 academic year.Methods:In this cross-sectional study,the association between exercise,depression and anxiety was investigated in a large representative sample of American university students.In the 2018–2019 academic year,university students aged 18+years old from 79 institutions participated in this school-based study.The questionnaire included measurements of demographic characteristics,exercise,and validated screen instructions for depression(PHQ-9)and anxiety(GAD-7).The multivariable logistic regression model was applied to explore the association between exercise,depression and anxiety.Results:A total of 62026 indivi-duals(31.9%males)participated in this survey,and the prevalence of exercising at least 5 h each day was 24.6%.The prevalence of depression and anxiety was 25.7%and 22.3%,respectively.In the multivariable logistic regres-sion model,compared to exercise at least 5 h daily,participants whose exercise less than 1 h daily(OR=1.31[1.29,1.33],p<0.05),2 to 3 h daily(OR=1.13[1.11,1.15],p<0.05),3 to 4 h daily(OR=1.04[1.02,1.06],p<0.05),were correlated with greater odds of depression,while exercise less than 1 h daily(OR=1.23[1.21,1.25],p<0.05),2 to 3 h daily(OR=1.10[1.08,1.12],p<0.05)were significantly correlated with great-er odds of anxiety.Conclusion:Higher levels of exercise are associated with lower risk of depression and anxiety among American university students.Community and school interventions should focus on increasing exercise participation in university populations to promote both physical and mental health.
文摘BACKGROUND Advances in minimally invasive surgery and improved post-operative pain management make it possible to consider performing even major foot/ankle operations as day-case.This could have significant benefits for patients and the health service.However there are theoretical concerns about post-operative complications and patient satisfaction due to pain.AIM To scope the current practice of foot and ankle surgeons on day-case surgery for major foot and ankle procedures in the United Kingdom(UK).METHODS An online survey(19 questions)was sent to UK foot and ankle surgeons via the British Orthopaedic Foot&Ankle Society membership list in August 2021.Major foot and ankle procedures were defined as surgery that is usually performed as an inpatient in majority of centres and day-case as same day discharge,with day surgery as the intended treatment pathway.RESULTS 132 people responded to the survey invitation with 80%working in Acute NHS Trusts.Currently 45%of respondents perform less than 100 day-case surgeries per year for these procedures.78%felt that there was scope to perform more procedures as day-case at their centre.Post-operative pain(34%)and patient satisfaction(10%)was not highly measured within their centres.Lack of adequate physiotherapy input pre/post-operatively(23%)and lack of out of hours support(21%)were the top perceived barriers to performing more major foot and ankle procedures as day-case.CONCLUSION There is consensus among UK surgeons to do more major foot/ankle procedures as day-case.Out of hours support and physiotherapy input pre/post-op were perceived as the main barriers.Despite theoretical concerns about post-operative pain and satisfaction this was only measured by a third of those surveyed.There is a need for nationally agreed protocols to optimise the delivery of and measurement of outcomes in this type of surgery.At a local level,the provision of physiotherapy and out of hours support should be explored at sites where this is a perceived barrier.
文摘Objective: The aim of the present study was to investigate Chinese nurses' perception of risk factors for phlebitis.Methods: A convenience sample of hospital nurses was recruited in Beijing, China. Data were collected using a demographic information questionnaire and a questionnaire measuring nurses' perception of risk factors for infusion phlebitis.Results: It was found that knowledge of risk factors for infusion phlebitis was incomplete, even among experienced nurses in the study participants. A high rate of incorrect answers to questions about the p H of fluid(89.9%), gauze or polyurethane catheter dressings(79.1%), and steel needles for drug infusion(76.3%) was observed.Conclusions: These findings suggest that nurses should be trained about the risk factors for infusion phlebitis.
文摘Early drinking is considered to result in making tolerant of alcohol consumption and a higher prevalence of alcohol related disorders in the later. We focused generational impacts on drinking rate among high school students based on multiple nationwide data. The surveys were nationwide, cross-sectional random sampling surveys given every 4 years from the Japanese Youth Tobacco and Alcohol Surveys, 1996 to 2008. Participants were male 53,925 high school students from 7th grade to 11th grade. We divided to the three follow-up groups every 4 years from 1996 to 2004 for male junior high school students in 7th grades and the end periods were 4 years later in 11th grades. Outcome measures in this study were life time drinking, current drinking within 30 days and weekly drinking. All drinking rates decreased each at 7th and at 11th grade. The increments in these drinking rates from 7th grade to 11th grade in males decreased gradually in recent follow-up groups. Generational impacts should be considered by using follow-up groups to study drinking behaviors among students.
基金Beijing Science and Technology"Capital Characteristics"Project[Z181100001718007]Translational Medicine Project of PLA General Hospital[2017TM-023]+1 种基金Expansion of Military Medical and Health Achievements[17WKS25]National Science and Technology Support Program[No.2013BAI08B01]。
文摘Objective To determine the factors influencing insomnia and construct early insomnia warning tools for rescuers to informbest practices for early screening and intervention.Methods Cluster sampling was used to conduct a cross-sectional survey of 1,133 rescuers from one unit in Beijing,China.Logistic regression modeling and R software were used to analyze insomniarelated factors and construct a PRISM model,respectively.Results The positive rate of insomnia among rescuers was 2.74%.Accounting for participants’age,education,systolic pressure,smoking,per capita family monthly income,psychological resilience,and cognitive emotion regulation,logistic regression analysis revealed that,compared with families with an average monthly income less than 3,000 yuan,the odds ratio(OR)values and the[95%confidence interval(CI)]for participants of the following categories were as follows:average monthly family income greater than 5,000 yuan:2.998(1.307–6.879),smoking:4.124(1.954–8.706),and psychological resilience:0.960(0.933–0.988).The ROC curve area of the PRISM model(AUC)=0.7650,specificity=0.7169,and sensitivity=0.7419.Conclusion Insomnia was related to the participants’per capita family monthly income,smoking habits,and psychological resilience on rescue workers.The PRISM model’s good diagnostic value advises its use to screen rescuer early sleep quality.Further,advisable interventions to optimize sleep quality and battle effectiveness include psychological resilience training and smoking cessation.
文摘The continuous awareness campaigns about Colorectal Cancer (CRC) directed towards the Lebanese population in order to foster preventive medicine are on the rise. The impact has been positive and reported in previous research, although the number of victims is still high. This paper aims to perform a recent cross-sectional study of Lebanese residents’ CRC awareness by comparing the findings of two studies carried out in the years 2016 and 2018. The samples of the current study include 1140 (2016) and 993 (2018) participants who completed a simple structured questionnaire directed to assess their knowledge of colon cancer and the behavioral intentions of obtaining CRC screening. Upon comparing results, the percentage of those who know about CRC has increased significantly from 40.4% in 2016 to 78.7% in 2018, the proportion of respondents who believed that family history is the major risk factor for CRC did increase significantly from 47.7% in 2016 to 90.8% in 2018. Likewise, the proportions of respondents who believed that overweight, age, and stress are among the major risk factors for CRC increased from 26.9%, 26.7% and 11.3% in 2016 to 86.2%, 52.1% and 21.51% in 2018, respectively. On the other hand, the proportions for the risk factors related to alcohol and smoking have dropped from 37.7% and 37.3% to 27.4% and 24.2%, respectively. Moreover, the most important source of information for CRC was friends (18.4% in 2016 versus 73.8% in 2018), followed by family (18.7% in 2016 versus 56.7% in 2018), and then physicians (18.9% in 2016 and 40.2% in 2018). In fact, the efforts of the non-governmental organization (NGO) SAID (118 different major activities in the span of 3 years) did make a significant difference in what relates to CRC awareness among the Lebanese population. These findings are used to encourage and support other NGOs to adopt targeted new awareness campaigns which have proven successful, and to present evidence based on facts to government officials in the Ministry of Health to support and possibly sponsor national awareness campaigns and preventive efforts to mitigate CRC levels.
文摘Backgrounds: Smoking in childhood has become an important public health concern. Previous studies have reported on secular trends in childhood smoking rates and compared with smoking rates at fixed ages. They also described secular trends regarding the prevalence of smoking at fixed ages. The variations in smoking rate of young children and adolescents by follow-up groups have not been studied by follow-up groups at a national level. Objective: We looked at trends and generational impacts on smoking rate by using follow-up groups of male Japanese high school students to quantitatively assess differences in trends, based on multiple nationwide data from the Japanese Youth Tobacco and Drinking Surveys gathered every 4 years between 1996 and 2008. Methods: The surveys were nationwide, cross-sectional random sampling surveys given every 4 years from 1996 to 2008, using the single-stage cluster sampling methodology. The cluster unit of the sampling was school. The survey targeted junior and senior high school students from schools selected through Japan using the National School Directory. Students enrolled in the sampled schools were subjects of the study. Participants were 53,925 high school students from 7th grade to 11th grade in 1996, 2000, 2004 and 2008. We divided the three follow-up groups every 4 years from 1996 to 2004 for male junior high school students in 7th grades, age 13. The end periods were 4 years later when they had become 11th graders, age 17, from 2000 to 2008. Main outcome measures in this study were life time smoking, current smoking within 30 days and daily smoking at 7th or 11th grade and the trend of the smoking rates between 7th to 11th grades. Results: Life time smoking rate, current smoking rate and daily smoking rate in Japanese high school students decreased at 7th grade from 1996 to 2004. They also decreased at 11th grade from 2000 to 2008. However, the slopes differed among their follow-up groups. The increments in their smoking rates from 7th grade to 11th grade in male high school students were smaller in recent follow-up groups both in 2000 and in 2004 than in follow-up groups in 1996. Then, those increments in follow-up groups between in 2000 and in 2004 were similar in lifetime smoking rate and current smoking rate. Conclusions: We have shown that monitoring trends by follow-up group are important in studying smoking for public health. Values of smoking rates from a young age to adolescence by follow-up group should be examined. Values of smoking rate and regular changes in smoking rate are important because smoking rate changes dynamically during adolescence. Not only trends in smoking rates at fixed ages, but also generational impacts should be considered by using follow-up groups to study smoking behaviors among students. We need to continue careful monitoring of follow-up group smoking prevalence. When long-term health promotions are planned or assessed, policy makers need to look at changes in follow-up groups.
文摘Background: Six in ten sexually active adolescent women in Uganda have an unmet need for contraception yet there is limited data on what is driving its use. This study aimed to determine the associations between sociodemographic factors and modern contraceptive ever-use among adolescents in Uganda. Methods: A crossectional study was conducted among 337 adolescents aged 13 - 19 years who had ever had sex in Wakiso (urban) and Kamuli (rural) districts in Uganda. The outcome of interest was the ever-use of modern contraceptives. Generalized linear models with a Poisson link were used to examine the associations between sociodemographic factors and contraceptive ever use. Results: The weighted prevalence of ever-use of modern contraceptives was 30.9%. Contraceptive ever use was more likely among the older adolescents (adjusted Odds Ratio) aOR 1.31 (95% CI = 1.06 - 1.55), married aOR 1.67 (95% CI = 1.09 - 2.58) and the less educated were aOR 1.79 (95% CI = 1.14 - 2.83) compared to their counterparts. Adolescents living in the urban district (Wakiso) aOR 0.67 (95% CI = 0.49 - 0.92) were less likely to use modern contraceptives. In stratified analysis, the urban poor were more likely to use modern contraceptives (moderate aPR 0.35 95%CI (0.17 - 0.68) ** or high socioeconomic status aPR 0.62, 95%CI (0.28 - 1.37). Conclusions: The study shows low contraceptive ever-use among adolescents. Adolescents with low education and those from rural settings were more likely to ever-use modern contraceptives. Having good knowledge of contraception and discussing sex with parents promoted contraceptives ever-use. We recommend further studies assessing barriers to contraceptive use among adolescents in Uganda.
文摘Objective: To investigate the patient safety culture regarding intravenous therapy in parts of tertiary hospitals in Guangzhou, China.Methods: A cross-sectional survey was conducted. A total of 333 medical staffs members from eight hospitals in Guangzhou were included in our study using convenience sampling. An evaluation about the patient safety culture regarding intravenous therapy was conducted.Results: The summarized results show that the total and level one items' scores are greater than 4.3 points(the full mark is 5 points). The lowest scoring of the five level one items is for the hospital's security resources(4.53±0.526), and the highest is for the hospital's safety management commitment(4.65±0.445). Among the 25 secondary entries, the four lowest-scoring entries are "doctors who can master the knowledge of drug efficacy and adverse reactions"(4.44±0.622), "doctors who can master the knowledge of the choice of medicine"(4.45±0.621), "a guarantee of sufficient human resources"(4.46±0.647), and "doctors who can master the knowledge related to the observation and complications with the treatment of intravenous therapy operation"(4.435±0.634).Conclusions: The patient safety culture regarding intravenous treatment in parts of tertiary hospitals in Guangzhou is promising, but there are still shortcomings, including the need to increase relevant resources, such as equipment facilities, training resources, and especially human input.
基金funded by the Development and Reform Commission of Hunan Province to Yuqian Zhou(Grant No.2021-212-17).
文摘Helicobacter pylori(H.pylori)infection is one of the most common chronic bacterial infections all over the world.University students are a group with strong comprehensive ability.Their cognition and behavior can exert great impact on society.However,up to now,reports on the awareness and attitudes regarding H.pylori infection among university students are scarce.This study aimed to survey dietary,habits,knowledge,and attitudes towards H.pylori infection.A total of 5794 participants,including undergraduates,postgraduates,and doctoral students,were recruited from the top 100 universities in China.A selfconstructed questionnaire was used to assess the knowledge and attitudes of students toward H.pylori infection and its impact.In our study,most of the population preferred dining in the canteen(69.6%),whereas 20.6% chose restaurants or takeaway.Up to 24.1% of the respondents had at least one lifestyle habit associated with H.pylori colonization.Almost half had at least one digestive symptom related to H.pylori infection.Most students were aware of its association with gastritis(84.4%)and peptic ulcer(86.6%).However,only half of them were aware of its association with gastric cancer(57.9%).Furthermore,only 14.1% of the respondents had been tested for H.pylori,and 25.1% of them tested positive.The H.pylori-detection rate was higher in Hunan province compared with Guangdong and Jilin provinces.Regarding knowledge of H.pylori,65.4% of the respondents had known about it,and 24.3% correctly answered all questions.When comparing the acquisition of H.pylori knowledge between tested and untested students,32.5% of the tested participants answered all questions correctly,which was significantly higher than the untested group(13.1%).There was no significant difference between genders in H.pylori knowledge and detection.University students are highly educated population.If they were fully aware of the harm of H.pylori infection,their parents,friends,and even future families would benefit,thus reducing the incidence of H.pylori infection,as well as gastric cancer and healthcare finances.This survey not only investigated but also spread the awareness of H.pylori among university students,which is of great medical,economic and sociological importance.
文摘Background Many cancer patients seek adjunctive therapies to biomedical cancer treatments at some point of their disease trajectory.While acupuncture is increasingly recommended by leading oncological associations,limited evidence exists concerning the evidence-informed practice and adherence to current guidelines of traditional complementary and integrative medicine(TCIM)practitioners treating cancer patients.Methods An international online-survey assessed the demographical data,clinical practice,and sources of information used by TCIM practitioners in Austria,Germany,United States of America,Australia,and New Zealand.Results In total,404 respondents completed the survey,of which 254(62.9%)treated cancer patients.Most practitioners were acupuncturists and herbalists(57.1%),had(16.8±9.9)years of clinical experience and see a median of 2(1,4)cancer patients per week.Breast cancer(61.8%)is the most common cancer type seen in TCIM clinics.Adjunctive TCIM treatments are frequently concurrent with the patient’s cancer specific treatment(39.9%),which is also reflected by the main goal of a TCIM treatment to alleviate side effects(52.4%).However,only 28.0%of the respondents are in contact with the treating oncologist.According to the respondents,pain is most effectively treated using acupuncture,while herbal medicine is best for cancer-related fatigue.TCIM practitioners mostly use certified courses(33.1%)or online databases(28.3%)but often believe that experts are more reliable to inform their practice(37.0%)than research publications(32.7%).Conclusion Acupuncturists and herbalists commonly treat cancer patients.Most practitioners use TCIM as an adjunct to biomedicine as supportive care and use it largely in accordance with current oncological guidelines.
基金This work was supported by the Bill&Melinda Gates Foundation(INV034554)。
文摘Background Immunization is a crucial preventive measure to safeguard children under five years old against a range of diseases.In China,the coverage rate of non-National Immunization Program(non-NIP)vaccines can be improved by leveraging the recommendation from public health workers.Hence,understanding the influencing factors of recommendation behaviors assume paramount importance.This study aims to investigate influencing factors of public health workers’recommendation behaviors towards non-NIP vaccines,with a particular emphasis on financial incentives.Methods A cross-sectional survey was conducted using a multi-stage sampling method in 2019 from August to October.627 public health workers were recruited from 148 community healthcare centers in ten provincial-level administrative divisions in China.An anonymous questionnaire was used to collect demographic information,attitudes towards vaccination,and recommendation behaviors towards non-NIP vaccines,includingHaemophilus influenzae type b(Hib)vaccine,pneumococcal conjugate vaccine,varicella vaccine,and rotavirus vaccine.Descriptive analysis and multivariate logistic regression analysis were adopted in this study.Results Of the 610 public health workers with complete survey data,53.8%,57.4%,84.1%,and 54.1%often recommended Hib vaccine,pneumococcal pneumonia vaccine(PCV),varicella vaccine,and rotavirus vaccine,respectively.Logistic regression revealed that gender(Hib vaccine:OR=0.4,95%CI:0.2-0.8;PCV:OR=0.4,95%CI:0.2-0.8;rotavirus vaccine:OR=0.3,95%CI:0.2-0.6),financial incentives for non-NIP vaccination(Hib vaccine:OR=1.9,95%CI:1.1-3.6;PCV:OR=2.1,95%CI:1.1-3.9;rotavirus vaccine:OR=2.0,95%CI:1.1-3.8)and perception of vaccine safety(Hib vaccine:OR=2.7,95%CI:1.1-7.0;PCV:OR=3.2,95%CI:1.2-8.0;rotavirus vaccine:OR=3.0,95%CI:1.2-7.7)were associated with public health workers’recommendation towards Hib vaccine,PCV and rotavirus vaccine.Conclusions The findings highlighted public health workers’recommendation behaviors of non-NIP vaccines in China and revealed strong association between vaccine recommendation and financial incentives.This highlights the importance of financial incentives in public health workers’recommendation toward non-NIP vaccines in China.Proper incentives are recommended for public health workers to encourage effective health promotion in immunization practices.
基金Supported by Suzhou Municipal Science and Technology Program of China,No.SKJY2021012.
文摘BACKGROUND Colorectal polyps(CPs)are frequently occurring abnormal growths in the colorectum,and are a primary precursor of colorectal cancer(CRC).The triglyceride-glucose(TyG)index is a novel marker that assesses metabolic health and insulin resistance,and has been linked to gastrointestinal cancers.AIM To investigate the potential association between the TyG index and CPs,as the relation between them has not been documented.METHODS A total of 2537 persons undergoing a routine health physical examination and colonoscopy at The First People's Hospital of Kunshan,Jiangsu Province,China,between January 2020 and December 2022 were included in this retrospective cross-sectional study.After excluding individuals who did not meet the eligibility criteria,descriptive statistics were used to compare characteristics between patients with and without CPs.Logistic regression analyses were conducted to determine the associations between the TyG index and the prevalence of CPs.The TyG index was calculated using the following formula:Ln[triglyceride(mg/dL)×glucose(mg/dL)/2].The presence and types of CPs was determined based on data from colonoscopy reports and pathology reports.RESULTS A nonlinear relation between the TyG index and the prevalence of CPs was identified,and exhibited a curvilinear pattern with a cut-off point of 2.31.A significant association was observed before the turning point,with an odds ratio(95% confidence interval)of 1.70(1.40,2.06),P<0.0001.However,the association between the TyG index and CPs was not significant after the cut-off point,with an odds ratio(95% confidence interval)of 0.57(0.27,1.23),P=0.1521.CONCLUSION Our study revealed a curvilinear association between the TyG index and CPs in Chinese individuals,suggesting its potential utility in developing colonoscopy screening strategies for preventing CRC.
文摘BACKGROUND Dietary fiber(DF)intake may have a protective effect against type 2 diabetes(T2D);however,its relationship with diabetic kidney disease(DKD)remains unclear.AIM To investigate the potential association between DF intake and the prevalence of DKD in individuals diagnosed with T2D.METHODS This cross-sectional study used data from the National Health and Nutrition Examination Survey collected between 2005 and 2018.DF intake was assessed through 24-h dietary recall interviews,and DKD diagnosis in individuals with T2D was based on predefined criteria,including albuminuria,impaired glomerular filtration rate,or a combination of both.Logistic regression analysis was used to assess the association between DF intake and DKD,and comprehensive subgroup and sensitivity analyses were performed.RESULTS Among the 6032 participants,38.4%had DKD.With lower DF intake-T1(≤6.4 g/1000 kcal/day)-as a reference,the adjusted odds ratio for DF and DKD for levels T2(6.5-10.0 g/1000 kcal/day)and T3(≥10.1 g/1000 kcal/day)were 0.97(95%CI:0.84-1.12,P=0.674)and 0.79(95%CI:0.68-0.92,P=0.002),respectively.The subgroup analysis yielded consistent results across various demographic and health-related subgroups,with no statistically significant interactions(all P>0.05).CONCLUSION In United States adults with T2D,increased DF intake may be related to reduced DKD incidence.Further research is required to confirm these findings.
文摘Objective:To study the prevalence of anemia,the proportion of hemoglobin(Hb)levels,the treatment methods,and the influencing factors of Hb levels in maintenance hemodialysis(MHD)and peritoneal dialysis patients.Methods:In this study,602 patients with maintenance hemodialysis and continuous ambulatory peritoneal dialysis were enrolled from December 2020 to December 2022 in our hospital,and their medical records were collected and summarized.The main contents included the patient’s gender,age,primary disease,dialysis duration,dialysis method,the use of erythropoietic stimulating agents(ESA),intravenous iron,and laboratory tests.A Hb index exceeding 110 g/L was set as the standard for the prevalence of anemia.Results:The rate of anemia in patients undergoing blood purification was 83%.The proportion of ESA use was 84.1%,and the proportion of iron use was 76.7%,of which the proportion of intravenous iron used was 17.0%,and the proportion of folic acid used was 28.3%.Conclusion:The incidence of anemia in MHD patients was relatively high,with a low proportion of patients reaching the standard Hb levels.Risk factors include albumin(ALB)levels,iron storage,white blood cells,C-reactive protein,cholesterol,etc.Nutritional support,iron supplementation,and prevention of micro-inflammatory reactions can effectively promote the improvement of Hb indicators in dialysis patients to prevent anemia.
基金Ministry of Science and Technology of the People’s Republic of China(National Key R&D Programme of China,2017YFC1310901,2016YFC0901002,2017YFC1307905,2015BAI12B00)National Natural Science Foundation of China(No.81801152,92046016)+1 种基金Beijing Natural Science Foundation(Z200016),Beijing Talents Project(2018000021223ZK03)Youth Programme(QML20180501)and Sanofi funding.
文摘Background Stroke is the leading cause of mortality in China,with limited evidence of in-hospital burden obtained from nationwide surveys.We aimed to monitor and track the temporal trends and rural-urban disparities in cerebrovascular risk factors,management and outcomes from 2005 to 2015.Methods We used a two-stage random sampling survey to create a nationally representative sample of patients admitted for ischaemic stroke in 2005,2010 and 2015.We sampled participating hospitals with an economic-geographical region-stratified random-sampling approach first and then obtained patients with a systematic sampling approach.We weighed our survey data to estimate the national-level results and assess changes from 2005 to 2015.Results We analysed 28277 ischaemic stroke admissions from 189 participating hospitals.From 2005 to 2015,the estimated national hospital admission rate for ischaemic stroke per 100000 people increased(from 75.9 to 402.7,Ptrend<0.001),and the prevalence of risk factors,including hypertension,diabetes,dyslipidaemia and current smoking,increased.The composite score of diagnostic tests for stroke aetiology assessment(from 0.22 to 0.36,Ptrend<0.001)and secondary prevention treatments(from 0.46 to 0.70,Ptrend<0.001)were improved.A temporal decrease was found in discharge against medical advice(DAMA)(from 15.2%(95%CI 13.7%to 16.7%)to 8.6%(8.1%to 9.0%);adjusted Ptrend=0.046),and decreases in in-hospital mortality(0.7%in 2015 vs 1.8%in 2005;adjusted OR(aOR)0.52;95%CI 0.32 to 0.85)and the composite outcome of in-hospital mortality or DAMA(8.4%in 2015 vs 13.9%in 2005;aOR 0.65;95%CI 0.47 to 0.89)were observed.Disparities between rural and urban hospitals narrowed;however,disparities persisted in in-hospital management(brain MRI:rural-urban difference from−14.4%to−11.2%;cerebrovascular assessment:from−20.3%to−16.7%;clopidogrel:from−2.1%to−10.3%;anticoagulant for atrial fibrillation:from−10.9%to−8.2%)and in-hospital outcomes(DAMA:from 2.7%to 5.0%;composite outcome of in-hospital mortality or DAMA:from 2.4%to 4.6%).Conclusions From 2005 to 2015,improvements in hospital admission and in-hospital management for ischaemic stroke in China were found.A temporal improvement in DAMA and improvements in in-hospital mortality and the composite outcome of in-hospital mortality or DAMA were observed.Disparities between rural and urban hospitals generally narrowed but persisted.
基金the Thai Health Promotion Foundation for research funding。
文摘Background:Understanding factors influencing adolescents’ sport/exercise participation(S/EP) is vital to developing effective interventions,but currently,evidence from less developed countries is limited.The purpose of this study was to examine correlates of S/EP across individual,interpersonal,and environmental levels in a nationally representative sample of Thai adolescents.Methods:Data from 4617 Thai adolescents aged 14-17 years old were obtained from recruited schools across Thailand.Data on S/EP(outcome variable),and psychosocial,home,and community environment covariates were collected from individual adolescents using the Thailand Physical Activity Children Survey,Student Questionnaire.School environmental data were collected at the school level using a School Built Environment Audit.Hierarchical regressions taking into account school clustering effects were applied for data analysis.Results:At the individual level,age and body mass index were independently and strongly correlated with S/EP.Adolescents with high preference for physical activity(PA)(odd ratio(OR)=1.71,p <0.001) and at least a moderate level of self-efficacy(OR=1.33,p=0.001) were more likely to have high S/EP.At the interpersonal level,adolescents whose parents joined their sports/exercise at least 1-2 times/week(OR=1.36,p=0.003) received>3 types of parental support(OR=1.43,p=0.005) and who received siblings’(OR=1.26,p=0.004) and friends’(OR=1.99,p <0.001) support had a greater chance of high S/EP.At the environmental level,adolescents’ S/EP was greater when there were at least 3-4 pieces of home sport/exercise equipment(OR=2.77,p=0.003),grass areas at school(OR=1.56,p <0.001),and at least 1-2 PA facilities in the community(OR=1.30,p=0.009).Conclusion:Multiple factors at different levels within an ecological framework influencing Thai adolescents’ S/EP were generally similar to those found in developed countries,despite some differences.For those interested in promoting and supporting Thai adolescents’ engagement in sports/exercise,further exploration of the influence of self-efficacy and attitude toward PA is required at the individual level;parental and peer support at the interpersonal level;and home sport equipment,school grass areas,and neighborhood PA facilities at the environment level.
文摘Objective:The objective of this study is to evaluate the acceptance of pregnant women with regards to coronavirus disease 2019 (COVID-19) vaccination during pregnancy and to identify any significant changes in their anxiety and knowledge on COVID-19 compared to our previous study.Methods:This cross-sectional survey was performed in the antenatal clinics of United Christian Hospital and Tseung Kwan O Hospital of Hong Kong,China.Questionnaires were distributed to pregnant women for self-completion when attending follow-up from August to October 2021.Apart from basic demographic data,the questionnaire comprised of questions including knowledge on COVID-19 and its vaccines in pregnancy as well as attitudes and behaviors of pregnant women and their partners toward COVID-19.Continuous variables were analyzed by Student’s test and Levene’s test was used to confirm normal distribution and homogeneity of variance for continuous variables,whereas categorical variables were analyzed by the Chi-squared test or Fisher’s exact test as appropriate.AP value of <0.05 was considered to be statistically significant.Results:A total of 816 completed questionnaires were included for analysis.Pregnant women were less worried about COVID-19 in the current survey as compared to the last survey (393/816,48.2%vs.518/623,83.1%,P<0.001).Fewer pregnant women believed that pregnancy were more susceptible to contract SARS-CoV-2 as compared to the last survey (265/816,32.5%vs.261/623,41.9%,P<0.001).They have significant knowledge gap and concerns about COVID-19 vaccines.Nearly half of the participants believed that pregnant women cannot have COVID-19 vaccination (402/816,49.3%) and it is unsafe to fetus (365/816,44.7%).Around a third of women perceived that they were more prone to the side effects and complications of COVID-19 vaccines than the general population (312/816,38.2%) and did not recognize that maternal COVID-19 vaccination could effect transferral of antibodies to the fetus to promote postnatal passive immunity (295/816,36.2%).Most of them had not been vaccinated (715/816,87.6%) and only (12/715) 1.7% of them would consider vaccination during pregnancy.Conclusion:Despite the local and international recommendations for pregnant women to be vaccinated,the uptake of COVID-19 vaccines during pregnancy remained extremely low.Efforts should be made to effectively provide information about the safety and benefits of COVID-19 vaccines during pregnancy.There is an urgent need to booster vaccination rates in pregnant women to avoid excessive adverse pregnancy outcomes related to COVID-19.
文摘Objective:Psoriasis is a chronic inflammatory systemic disease that severely impacts patients’ quality of life (QoL) and psychological health.While biologics have been shown to be effective in treating psoriatic lesions,thus improving QoL,real-life data regarding such effects remain scant.We administered a repeated cross-sectional survey to assess the effects of 8 weeks of biologics treatment on the QoL and mental health status of patients with moderate-to-severe plaque psoriasis.Methods:From March to May 2022,patients with moderate-to-severe plaque psoriasis were enrolled and treated with biologics in the outpatient clinic at the Dermatology Hospital of Southern Medical University.Assessments were performed before treatment and after 4 and 8 weeks of treatment with biologics.Psoriasis severity,QoL,and mental health status were evaluated using the Psoriasis Area and Severity Index (PASI),Dermatology Life Quality Index (DLQI),36-Item Short-form Health Survey (SF-36),and Hospital Anxiety and Depression Scale (HADS).A multivariate generalized estimating equations (GEE) analysis was used to account for repeated measures and to determine the effects of treatment duration and type of biological agent on relevant indicators.Results:Among the 78 enrolled patients,the ranges of pretreatment scores were 4.6 to 46.8 for the PASI,1 to 30 for the DLQI,31.5 to 100.0 for the physical component score (PCS) of the SF-36,16.6 to 100.0 for the mental component score (MCS) of the SF-36,0 to 15 for the HADS-A,and 0 to 17 for the HADS-D.After 8 weeks of biologics treatment,98.7% (77/78) of patients had obtained PASI 75.All assessed scores changed over time (GEE,P < 0.001).Moreover,there were group-by-time interaction effects for the DLQI score (GEE,P = 0.023) and PCS (GEE,P = 0.029).The HADS-A and HADS-D scores were both decreased at week 8 compared with pretreatment values.Correlation analyses revealed that higher DLQI scores were associated with lower levels of QoL and higher levels of anxiety or depression.Conclusion:Biologics are not only effective in the treatment of skin lesions but also exert beneficial effects upon the QoL and mental health of patients with psoriasis as determined in the short-term assessments conducted in this study.
基金supported by the Clinical Toxicology Foundation of the Chinese Society of Toxicology(No.CST2020CT107)the Research Project of the Drug Clinical Evaluation Professional Committee of the China Pharmaceutical Association(No.CPA-Z06-ZC-2021-004).
文摘Objective This cross-sectional study aimed to investigate the current attention and intervention of oncologists on oxaliplatin(OXA)-induced adverse reactions(ADRs).Methods In 31 provinces or administrative regions across China,401 oncologists were surveyed through a self-designed questionnaire.The survey queried the basic information of respondents,clinical use of OXA,OXA-induced ADRs,and relative interventions.Chi-square tests and multiple logistic regression were used to explore the sociodemographic factors influencing the safety perception of OXA and the relevant interventions.Results The survey showed that the age of respondents was mainly distributed between 30 and 40 years and the working period for most oncologists was no more than 5 years.Oncologists with long working years were more willing to conduct patient education and inquire about ADRs than those with short working years.The rate of ADRs reported by oncologists with intermediate professional titles was significantly higher than that reported by oncologists with junior and senior professional titles.Conclusion Our findings indicate that oncologists in China's Mainland are concerned about OXA-induced ADRs,but the reporting of ADRs still needs to be strengthened.Therefore,training and educational programs are urgently needed to improve the risk management of OXA-induced ADRs among oncologists.
