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2021 Vol. 37, No. 2

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Special Report –
Health education and associated factors among migrant population in China, 2017
WANG Lu-yao, YIN Qin, ZHU Kai
2021, 37(2): 193-197. doi: 10.11847/zgggws1125696
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  Objective  To investigate the status and main influencing factors of health education among migrant population in China and to provide evidences for promoting health literacy of migrant population.  Methods  From the dataset of China's National Migrant Population Dynamic Survey conducted in May 2017, we extracted the information on 154 586 migrants aged 15 years or older and living in a resettlement destination for more than 6 months. Statistical analysis on the collected data was performed using SPSS 20.0 software.  Results  Among the migrants studied, 112 989 (73.1%) reported ever receiving health education during past one year. The number (percentage) of the migrants reporting ever received high, moderate, and low informative health education were 84 236 (54.5%), 26 486 (17.1%), and 43 864 (28.4%), respectively. The topics of health education ever received by the migrants included smoking control (reported by 51.5% of the migrants), maternal and child health/eugenics (51.2%), reproductive health and contraception (50.5%), self-rescue in public emergency (42.3%), prevention of sexually transmitted disease/acquired immunodeficiency syndrome (39.7%), chronic disease prevention (37.4%), mental health (35.8%), tuberculosis prevention (33.7%), and occupational disease prevention (33.4%). The health education media reported by the migrants involved promotional materials such as paper and film (listed by 85.6% of the migrants), billboards/electronic display (74.8%), public health consultation (45.3%), health lecture (44.6%), community messaging/WeChat/networks (40.2%), and personal face-to-face consultation (30.1%). The results of multivariate ordinal logistic regression revealed that the migrants with following characteristics were more likely to have high informative health education: aged 30 – 49 years, with the education of junior high school and above, married, with an average monthly family income of 3 000 – 11 999 RMB, living in current resettlement destination for 2 – 5 years, and immigrating to regions in central or western China; while, the migrants aged 50 years and above, with a rural registered residence, having an occupation other than employer, employee or self-employed, having a cross province migration, and immigrating to regions in northeastern China were more likely to have low informative health education.  Conclusion  The health education is generally at a low level and mainly influenced by age, education, marital status, type of registered residence, employment, monthly family income, years of current migration, and resettlement region among migrant population in China.
Utilization of public health services and its influencing factors among migrant people with hypertension or diabetes in China
SONG Yue-ping, ZHANG Guang-ying
2021, 37(2): 198-202. doi: 10.11847/zgggws1123492
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  Objective   To examine the status and influencing factors of basic public health services (BPHS) utilization among migrant people with hypertension or diabetes in China and to provide evidences for promoting the utilization of BPHS among migrant population with chronic diseases.   Methods   We extracted the data on 9 272 migrant people with hypertension or type 2 diabetic mellitus (T2DM) from the Dynamic Monitoring Survey on Migrant Population – 2017 sponsored by the National Health and Family Planning Committee. Probit regression model was adopted to analyze influencing factors of BPHS utilization among the migrant population.   Results   Among the 169 989 migrant people aged 15 years and above, the prevalence rate of the two chronic diseases was 5.34% (4.74% for hypertension and 1.23% for T2DM). The rate of BPHS utilization was only 36.4% among the migrant people with hypertension or T2TM. The results of Probit regression model analysis indicated that among the migrants suffering from both hypertension and T2DM, those being female and aged 55 years and above were more likely to utilize BPHS; while, those with non-agricultural household registration, residing in northeastern regions, without health records being established or not being sure about the establishment of their health records, receiving no health education on chronic disease, and living at a residence at least 15 minutes away from a nearest medical institutions were less likely to utilize BPHS. The results also revealed that for the migrant hypertension patients, 55 years and above, being minority ethnics, living in central or western regions were more likely to utilize BPHS; but those without health records being established or not being sure about the establishment of their health records and those not receiving or being not sure about having received health education on chronic disease were less likely to utilize BPHS; for the migrant T2DM patients, those living in central or western regions were more likely to utilize BPHS, while those without health records being established or not being sure about the establishment of their health records and those not receiving health education on chronic disease were less likely to utilize BPHS.   Conclusion   The utilization rate of basic public health services is low and mainly influenced by gender, age, ethnic, type of household registration, establishment of health record, health education on chronic disease, and the time required from residence to nearest medical institution among migrant people with hypertension or type 2 diabetic mellitus in China.
Status and influencing factors of receiving health education and personal health record establishment among elderly migrant population in China
WANG Xiao-hui, LI Jian-bo, YANG Yang
2021, 37(2): 203-208. doi: 10.11847/zgggws1128961
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  Objective  To explore the status quo and influencing factors of receiving health education and personal health record establishment among elderly migrant population in China and to provide evidences for promoting utilization of basic health services in the population.  Methods  From the dataset of National Dynamic Surveillance on Health and Family Planning for Migrant Population conducted across China during May – August 2017, we extracted the data on health education and personal health record establishment for 8 090 migrant people aged 60 years and above; multivariate logistic regression model was adopted to analyze influencing factors of receiving health education and personal health record establishment in the migrant population.  Results  Of the elderly migrant people surveyed, 4 818 (59.56%) had received health education and 2 575 (31.83%) had their health records being established. The results of multivariate logistic regression analysis indicated that the elderly migrant people with following characteristics were more likely to ever receive health education: with middle school education, having an average monthly household income of 3 000 yuan (RMB) or more, living in the central or western region, participating in medical insurance, having a migration of cross-county but within a municipality, and being uncertain of residing in an immigration region; while, the elderly migrant people of being female, aged 65 years and above, and residing in rural regions were less likely to ever receive health education; the results also revealed that the elderly migrant people of being female, aged 70 years and above, having an average monthly household income of 3 000–6 000 yuan, having a self-purchased house, living in the central or western region, participating in medical insurance, and having a migration of cross-county but within a municipality were more likely to have their health records being established.  Conclusion  The accessibility of health education and the establishment of health records for the elderly migrant population in China were both at a low level. Gender, age, monthly household income, living region, medical insurance and range of migration are common factors influencing health education acceptance and personal health record establishment for the elderly migrant population in China.
Infectious disease-related health literacy and its influencing factors among migrant populations in China: a cross-sectional analysis
GUO Jing, GUO Yu-meng, ZHU Lin,
2021, 37(2): 209-213. doi: 10.11847/zgggws1131104
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  Objective   To examine infectious disease-related health literacy and its influencing factors among adult migrant people in China and to provide references for developing health education programs for the population.   Methods   From the dataset of National Dynamic Migrant Population Survey conducted in May 2016 across China, we extracted health literacy-related information for 8 554 migrant people aged 15 – 69 years and analyzed infectious disease-related health literacy and its influencing factors in the population.   Results   Of all the migrants surveyed, 5 015 (58.63%) were assessed with infectious disease-related health literacy and 5 462 (63.85%) with scientific view of health. The self-reported proportions of ever receiving topic- specific health education were 64.12% for reproduction and contraception/prenatal and postnatal care, 51.13% for nutrition, 50.68% for sexually transmitted disease/AIDS prevention, 49.70% for smoking control, 35.00% for chronic disease prevention, 34.99% for occupational disease prevention, 29.48% for tuberculosis prevention, 21.48% for coping with haze and smog pollution, and 15.38% for prevention and treatment of mental disorders; for all the migrants, 78.76% reported acquiring health-related information via publicity materials, 78.24% via publicity columns, 42.60% via lectures, 27.41% via face-to-face consultations, 23.51% via electronic display screens, 17.56% via applications/short message service/WeChat, 16.07% via doctor′s lecture courses, and 9.59% via website consultations, respectively. Unconditional multivariate logistic regression analysis demonstrated that the migrant people with following characteristics were more likely to have infectious disease-related health literacy: with the education of junior high school and above, with the knowledge about health record but without their health records being established, with their health records being established, ever receiving health education on at least 5 topics, ever receiving health education via at least 4 dissemination ways, and with scientific view of health; while, the migrant people having bought homes in places of their household registration were less likely to have infectious disease-related health literacy.   Conclusion   The infectious disease-related health literacy is at a relatively high level and mainly influenced by education level, place of housing purchase, health record establishment, contents and dissemination ways of health education, and whether with scientific view of health among adult migrant people in China.
Supply and utilization of health service among migrant population in China: a comparative study
WEI Yi
2021, 37(2): 219-223. doi: 10.11847/zgggws1125803
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  Objective  To compare regional differences in health service supply to and utilization of migrant populations in China and to provide references for the accessibility and equalization of health services for migrant population.  Methods  The data on 200 937 migrant people aged 15 – 59 years were extracted from a dynamic surveillance on migrant populations conducted in 32 provincial regions across China during 2014. Differences in supply and utilization of health education, medical insurance and hospitalization among migrant populations in the eastern, central, western and northeastern regions were analyzed and compared.  Results  For the migrant populations in the four geographic regions, the relative rate (RR) of content-, site-, and route-specific health education supply per capita were highest for the migrant population in western region (RR = 1.16, 1.13, and 1.13), but the lowest for those in northeastern (RR = 0.83, 0.80, and 0.83). The highest coverage of medical insurance for urban and rural residents (RR = 1.54), urban workers (RR = 1.50), private individuals (RR = 1.21), employment injury (RR = 1.54), and maternity (RR = 1.54) were observed in the migrant population in eastern region; while, the lowest coverage of the 5 items of medical insurance were observed in the migrant population in northeastern region, with the RR of 0.44, 0.55, 0.83, 0.46, and 0.42, respectively. The coverage of free medical care was the highest in the migrant population in western region (RR = 1.20) and the lowest in those in northeastern region (RR = 0.73). The hospitalization rate was the highest for the migrant population in eastern and western regions (RR = 1.06) and the rate was the lowest for the migrant population in northeastern region (RR = 0.62).  Conclusion  For the migrant populations in different geographical regions in China, those in western region had higher quality of health education per capita; the migrant population in eastern region had a higher coverage of medical insurance and those in eastern and western region had a higher hospitalization rate; but the migrant population in northeastern regions had lower quality of health education per capita and lower rate of medical insurance coverage and hospitalization.
Community education for self-help in public emergency and its influencing factors among migrant population in the Yangtze River Delta
YANG Zhen, JIANG Cheng-hua
2021, 37(2): 224-227. doi: 10.11847/zgggws1130557
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  Objective   To describe the characteristics and influencing factors of community education for self-help in public emergency among migrants in the Yangtze River Delta and to provide references for improving relevant community education programs in the population.   Methods  From the China Migrants Dynamic Survey conducted in 2017 across the country, we extracted the information on 24 181 migrants at ages of 18 – 59 years and living in the Yangtze River Delta at least one year and analyzed the data statistically with SPSS 19.0.   Results   The proportion of the migrants receiving education on self-help in public emergency in communities was 30.6% and the proportion was significantly lower than the average (45.0%) reported by the migrants in other regions of China (χ2 = 1695.135, P < 0.01). Compared with those in other regions, the migrants in the Yangtze River Delta were characterized by significantly higher ratios of cross-provincial migrating (χ2 = 5541.645, P < 0.01), migrating from rural areas (χ2 = 1461.138, P < 0.01), with high comprehensive education (χ2 =77.441, P < 0.01) but lower ratios of with their the health records being established (χ2 = 2008.472, P < 0.01) and insufficient involvement in community activities (χ2 = 166.126, P < 0.01); while, the gender ratio of the migrants was not significantly different from that of migrants in other regions (χ2 = 0.282, P > 0.01). The results of multivariate logistic regression analysis indicated that among the migrants in the Yangtze River Delta, those with cross-provincial migrating, without health records being established, being female, and with insufficient involvement in community activities were less likely to receive the education on self-help in public emergency in communities and the region of resettlement and education background were not significant factors influencing the acceptability of the education.   Conclusion   Among the migrants in Yangtze River Delta, the proportion of receiving education on self-help in public emergency in communities was low and the influencing factors for the acceptability of the education were different from those among the migrants in other regions; the situation may result from differentiated information communication adopted by the providers of the education in the region.
Effect of online health education on health literacy among migrant population: a structural equation model analysis
GUO Jing, ZHU Lin, GUO Yu-meng,
2021, 37(2): 228-232. doi: 10.11847/zgggws1129620
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  Objective   To examine the influence of online health education on health literacy among migrant population and to provide references for conducting online health education in migrant population.   Methods   From the dataset of National Dynamic Migrant Population Survey conducted in May 2016 across China, we extracted health literacy-related information for 8 554 migrant people aged 15 – 69 years. Structural equation model was used to analyze the effect and influence path of online health education on health literacy in the migrant population.   Results   Among the migrant people surveyed, the health literacy rate was 37.16% and in terms of health knowledge, healthy lifestyles and basic health-related skills, the health literacy rate were 38.93%, 42.89%, and 33.28%, respectively. The proportion of the migrant people ever receiving online health education was relatively low; only 17.56% and 9.59% of the migrant people reported acquiring health education through WeChat/official account/application and website. Compared to the migrant people not receiving online health education, the migrant people acquiring health education through WeChat/official account/application and website had significantly higher health literacy rate for health knowledge (44.27% vs. 37.79% and 51.95% vs. 37.55%), basic health related skills (51.46% vs. 41.07% and 56.95% vs. 41.40%), and healthy lifestyles (39.48% vs. 31.96% and 45.73% vs. 31.96%) (P < 0.01 for all). The results of structure equation model analysis demonstrated that acquiring online health education exerted a positive and direct impact on the improvement of health literacy for health knowledge and basic health related skills (\begin{document}${\hat \gamma _{\rm{1}}}$\end{document} = 0.119, \begin{document}${\hat \gamma _{\rm{2}}}$\end{document} = 0.040; both P < 0.05); the results also revealed that knowledge-based health literacy plays an intermediary role on the improvement of health literacy for basic health related skills and healthy lifestyles (\begin{document}${\hat \gamma _{\rm{3}}}$\end{document} = 0.115, \begin{document}${\hat \gamma _{\rm{4}}}$\end{document} = 0.113; both P < 0.01).  Conclusion   Without time and space limitation, online health education is advantageous in promoting health literacy among migrant population in China.
Status and influencing factors of health education in ethnic minority migrant population in China
DU Jie, TIAN Shi-jing, WANG Na,
2021, 37(2): 233-237. doi: 10.11847/zgggws1126041
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  Objective  To examine the status quo and influencing factors of health education among ethnic minority migrant population in China and to provide references for promoting the equalization of basic public health services in the population.  Methods  Relevant data on 14 226 ethnic minority migrant people aged ≥ 15 years were from the National Dynamic Surveillance on Health and Family Planning of Migrant Population carried out during May – August 2017. SPSS 25.0 statistical software was used to analyze the status quo and influencing factors of health education in the population.  Results  Of all the people surveyed, 75.4% (10 724) had received health education on various topics; the proportions of the people ever receiving the education on various health issues were 53.9% for reproductive health and contraception, 53.2% for tobacco control, 53.1% for maternal and child health care and eugenics, 47.9% for the prevention and control of sexual transmitted disease/human immunodeficiency virus infection/acquired immunodeficiency syndrome (STD/HIV/AIDS), 43.3% for self-help in a public emergency, 41.6% for chronic disease prevention and control, 40.4% for tuberculosis prevention and control, 37.9% for mental health, and 34.9% for occupational disease prevention, respectively. The ways of acquiring related information reported by the people ever receiving health education were as following: publicity materials such as paper, film and television (reported by 84.3% of the people), bulletin board/public electronic display screens (71.9%), health knowledge lecture (47.0%), public health consultation (46.2%), community-delivered short massage /WeChat/website (38.2%) and personalized face-to-face consultation (32.4%). Unconditioned multivariate logistic regression analysis revealed that the people with following characteristics were more likely to have health education: being Zhuang or Uygur ethnic, with the education of junior high school and above, married, with a stable employment, employed by a collective/state-run/joint venture enterprise, immigrating to central or western regions, having medical insurance, with established health records in local region, and with a self-rated good or generally good health; while the people of ≥ 45 years were less likely to receive health education.  Conclusion  The health education among ethnic minority migrant population is at a low level and less comprehensive. Main impact factors for acceptance of health education in ethnic minority migrant population include age, nationality, education level, marital status, employment status, nature of employer, region of immigration, medical insurance, establishment of health record in local residence, and self-rated health.
Utilization of mother-to-child transmission prevention service and its influencing factors among migrant pregnant women with syphilis infection in Zhejiang province
SUN Yu, SHI Xie-li, QIU Li-qian,
2021, 37(2): 238-243. doi: 10.11847/zgggws1123437
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  Objective  To examine the utilization of mother-to-child transmission prevention service and its influencing factors among migrant pregnant women with syphilis infection in Zhejiang province and to provide a reference for optimizing the strategies on prevention of mother-to-child transmission (PMTCT) of syphilis.  Methods  We extracted the data on 3 738 migrant pregnant women with syphilis infection registered in Zhejiang province between January 1, 2013 to December 31, 2017 from national direct network report system for PMTCT of AIDS, syphilis and hepatitis B. The status and associated factors of anti-syphilis treatment and standardized therapy among the pregnant women were analyzed.  Results  Among all the pregnant women, 3 081 (82.4%) had anti-syphilis treatment and of the women with the treatment, 2 083 (66.1%) received standardized therapy. Multivariate logistic regression analysis revealed that the pregnant women being ethnic minorities, unmarried, having early pregnancy detection, with co-infection of human immunodeficiency virus (HIV) or hepatitis B virus (HBV), and having one or more parities were less likely to have anti-syphilis treatment; for the women with anti-syphilis treatment, those aged 30 years and above were more likely to have standardized therapy, while those unmarried or having one or more parities were less likely to have standardized therapy.  Conclusion  The anti-syphilis treatment, especially standardized therapy, needs to be improved and both the anti-syphilis treatment and standardized therapy are mainly influenced by marital status and the parity number among the migrant pregnant women with syphilis in Zhejiang province.
Epidemiological Research
Willingness and behavior of HIV testing among college students in Beijing city: a multi-dimensional analysis
CHEN Tian-qi, HUANG Ya-yang, BU Kai,
2021, 37(2): 244-250. doi: 10.11847/zgggws1125765
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  Objective  To investigate the cognition, willingness, and behavior of human immunodeficiency virus (HIV) testing among college students in Beijing city and to provide evidences for promoting voluntary HIV testing and developing effective AIDS prevention and control measures in the students.  Methods  With convenient sampling/snowball sampling and a questionnaire self-designed based on health belief model theory, we conducted an online anonymous survey in Beijing city among 16 – 30 years old undergraduate and graduate students (n = 2 562) in 5 universities with the implementation of the United States Centers for Disease Control and Prevention Global AIDS Program – China Cooperation (GAP) in 2015.  Results  The response rate of the survey was 87.0%. Of the 2 230 students with valid information, only 3.8% (86) reported ever having an HIV testing; 86.0% (1 917) considered that the inclusion of HIV testing in regular physical examination is acceptable and the proportion was significantly lower in the male respondents than in the female respondents (82.3% vs. 87.9%, P < 0.01); 39.0% (869) were aware of rapid HIV testing and the awareness rate was significantly higher in the male respondents than in the female respondents (46.8% vs. 34.9%, P < 0.01). The respondents ever receiving an HIV testing had a higher score for perceived HIV susceptibility but lower scores for perceived severity of HIV infection, benefits and barriers of HIV testing compared to those never receiving the testing. In terms of barriers for participation in HIV testing, both the respondents with and without HIV testing reported the highest score for the item of cognition on the necessity of HIV testing and the susceptibility of HIV infection.  Conclusion  The acceptance rate was high but the participation rate was low for HIV testing and being not aware of HIV testing was a main reason for the low rate of HIV voluntary counseling and testing among the undergraduate and graduate students in Beijing city. The results suggest that health education on HIV/AIDS should be promoted among the students.
Heterogeneity of psychotic-like experiences and related factors among adolescents
WANG Dong-fang, HUANG Yu-jie, SUN Meng,
2021, 37(2): 251-255. doi: 10.11847/zgggws1124617
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  Objective  To investigate whether there exists a heterogeneity in psychotic-like experiences (PLEs) and related factors of the heterogeneity among adolescents.  Methods  Community Assessment of Psychic Experiences (CAPE) was administered among 5 127 students recruited with convenient sampling in Hunan province during 2015 – 2016. Latent profile analysis (LPA) was adopted to explore the heterogeneity of PLEs in the adolescents.  Results  Among the 4 508 adolescents, the PLEs could be categorized into low, medium, and high frequency types. Compared to the characteristics of respondents with low frequency PLEs, the high frequency PLEs of the respondents was related to following factors: age (odds ratio [OR] = 1.56, 95% confidence interval [95% CI]: 1.27 – 1.92), being female (OR = 1.64, 95% CI: 1.25 – 2.14), from urban regions (OR = 2.04, 95% CI: 1.52 – 2.74), being Han nationality (OR = 1.40, 95% CI: 1.06 – 1.85), in a family without steady income (OR = 2.52, 95% CI: 1.66 – 3.85), in a single parent family (OR = 1.56, 95% CI: 1.17 – 2.07), and with family history of mental illness (OR = 3.31, 95% CI: 1.93 – 5.68).  Conclusion  There exists a significant heterogeneity in PLEs among adolescents and age, gender, and familial status should be considered when conducting early intervention on PLEs in the adolescents.
Development and reliability and validity evaluation of an online partner-seeking sexual behavior attitude scale
WANG Ying, LIU Hui-jun
2021, 37(2): 256-259. doi: 10.11847/zgggws1126633
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  Objective  To develop an online partner-seeking sexual behavior attitude scale (OSSA) and to evaluate the validity and reliability of the scale among rural older unmarried men.  Methods  Literature analysis, in-depth interview, and expert consultation were performed to develop the OSSA. Totally 744 unmarried men aged 28 years and above were recruited among rural populations in 20 central and western provinces and among rural-to-urban migrants in 3 cities in China and surveyed with the OSSA during January – September 2017. Item analysis, exploratory factor analysis, confirmatory factor analysis, and reliability and validity testing were used to verify the reliability and validity of the OSSA.  Results  The developed OSSA was composed of 10 items in 3 dimensions including risk perception (3 items), functional cognition (3 items), and trust perception (4 items). The cumulative variance contribution of the 3 domains is 63.628% based on exploratory factor analysis. Confirmatory factor analysis resulted in following parameter estimations of the OSSA: 0.975 for goodness of fit index, 0.945 for adjusted goodness of fit index, 0.955 for standard fit index, 0.919 for relative fit index, 0.978 for incremental fit index, 0.977 for comparative fit index, 0.959 for Tucker-Lewis index, 0.530 for reduced norm fit index, and 0.543 for reduced comparison fit index; and the estimations indicated a good fitting of the OSSA′s measurements to the empirical data. The Cronbach′s α coefficient for the whole scale was 0.737 and that for the three dimensions were 0.735, 0.739, and 0.661, respectively, indicating a good reliability of the OSSA. The correlation coefficients between the score of each dimension and that of the whole scale ranged 0.526 – 0.802 (P < 0.01 for all) and the correlation coefficients between the score of each item and its dimension score were between 0.626 – 0.840 (P < 0.01 for all); those coefficients demonstrated that the OSSA is of good construct validity and content validity. Among the participants surveyed with the OSSA, the overall score and dimension scores for risk perception and function cognition differed significantly by sexual behavior and cohabitation experience (P < 0.01 for all); the overall score and dimension score for function cognition varied significantly by age, education, occupation, migration (only for overall score), average monthly income (only for function cognition), and love affair experience (P < 0.01 for all); while, the dimension score for trust perception differed significantly only by education (P < 0.01); the results indicated a good discriminant validity of the OSSA.  Conclusion  The preliminarily developed online partner-seeking sexual behavior attitude scale is of good reliability and validity and could be applied in the studies on the attitude towards online sexuall partner-seeking among older unmarried men in China.
Prevalence and influencing factors of asthma and wheezing among preschool children in Urumqi city: a cross-sectional survey
WANG Ting-ting, SHI Hao-nan, LIU Qian,
2021, 37(2): 260-264. doi: 10.11847/zgggws1125733
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  Objective  To explore parents-reported indoor environment influencing factors of wheezing and asthma among preschool children in Urumqi city of Xinjiang Uygur Autonomous Region and to provide evidences for prevention and control of respiratory diseases in the children.  Methods  Using stratified random cluster sampling, we conducted a self-administered questionnaire survey among 4 000 parents of 2 – 7 years old children in 20 kindergartens in two districts of Urumqi city during April – August 2019. The preschoolers′ information on wheezing and asthma symptoms and exposure to personal and environmental factors correlated with the symptoms were collected with a self-designed questionnaire.  Results  For the 3 678 preschool children with valid data, the parents-reported prevalence of asthma and wheezing were 2.5% and 5.5% respectively. Multivariate logistic regression analysis revealed following risk factors for asthma: family asthma history (odds ratio [OR] = 6.227, 95% confidence interval [95% CI]: 3.130 – 12.391), home decoration when a child being one year old and younger (OR = 2.434, 95% CI: 1.048 – 5.655), furry pets keeping in a child′s home (OR = 2.091, 95% CI: 1.008 – 4.338), and being an ethnicity other than Han (OR = 1.760, 95% CI: 1.070 – 2.895); the analysis also demonstrated that family asthma history (OR = 6.056, 95% CI: 3.042 – 12.056), furry pets keeping in a child′s home (OR = 2.193, 95% CI: 1.061 – 4.534), and and being an ethnicity other than Han (OR = 1.749, 95% CI: 1.061 – 2.882) were risk factors for wheezing.  Conclusion  In addition to genetic factors, home decoration is a risk factor for asthma and keeping furry pets is a risk factor for asthma and wheezing among preschool children in Urumqi city.
Association of household sanitation with diarrhea among small children in ethnic minority regions of central and western China
ZHU Xian, LIU Cheng-lu, XU Chang,
2021, 37(2): 265-269. doi: 10.11847/zgggws1127176
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  Objective  To examine the status of household sanitation, prevalence and impact factors of diarrhea in small children in rural ethnic minority regions of central and western China for providing evidences to child diarrhea prevention.  Methods  Using probability-proportional-to-size sampling, we recruited 1 355 children aged ≤ 5 years in 90 villages in Henan province (Henan), Sichuan Yi Autonomous Prefecture (Sichuan) and Tibet Autonomous Region (Tibet) and conducted a face-to-face questionnaire survey among the caregivers of the children during August – October 2016.  Results  Valid information were collected from caregivers of 1 348 children averagely aged 22.34 ± 15.56 months. The overall two-week prevalence rate of diarrhea was 17.58% for all the children and the two-week prevalence rate for the children in Henan, Sichuan, and Tibet were 6.63%, 25.42%, and 15.17%, respectively, with a significant difference (χ2 = 71.096, P < 0.001). The diarrhea prevalence rate differed significantly by daily care and household sanitation among the children of different nationalities and living in various regions (P < 0.05). Multivariate logistic regression analysis revealed following main risk factors for child diarrhea prevalence: aged < 24 months (0 – 5 months: odds ratio [OR] = 4.096, 95% confidence interval [95% CI]: 1.140 – 14.721; 6 – 12 months: OR = 4.875, 95% CI: 1.389 – 17.110; 12 – 23 months: OR = 6.969, 95% CI: 2.059 – 23.583); consuming unboiled drinking water (OR = 1.678, 95% CI = 1.024 – 2.749); and consuming domestic water from an unprotected water source (OR = 1.786, 95% CI: 1.067 – 2.991).  Conclusion  Among the small children in rural regions of central and western China, diarrhea is prevalent and there are obvious disparities in diarrhea prevalence among the children of different nationalities and living in various regions. Household hygienic condition of drinking water and domestic water need to be improved for the prevention of diarrhea in the children, especially in those less than two years old.
Association between puberty timing and mental sub-health and its gender differences in junior middle school students
ZHAO Zhi-ya, XU Hui-qiong, WANG Shan-shan,
2021, 37(2): 270-274. doi: 10.11847/zgggws1126346
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Abstract:
  Objective  To describe the distribution of mental sub-health in junior middle school students, and to explore the association between puberty timing and mental sub-health and gender difference in the association.  Methods  Totally 8 560 junior middle school students were recruited with stratified cluster sampling in 4 cities across China for a self-administered anonymous questionnaire survey conducted between October and December 2015. Puberty timing of the students were assessed with scores of Pubertal Development Scale (PDS) and mental sub-health status was assessed with the Multidimensional Sub-Health Questionnaire for Adolescents (MSQA).  Results  Among the 8 013 students with valid response, the detection rate of mental sub-health was 15.81%, with a significantly higher rate among the girl students than among the boy students (17.54% vs. 14.09%, χ2 = 17.86; P < 0.001); the detection rate of emotional symptoms was 17.08% and the rate of girl students was significantly higher than that of body students (22.14% vs. 17.08%, χ2 = 32.54; P < 0.001); and the detection rate of behavioral problems and social adaptation symptoms were 23.11% and 12.25% and there were no significant gender difference in the rates (both P > 0.05). Multivariable logistic regression analysis revealed that the early puberty timing in both the boy and girl students was associated with high levels of mental sub-health and emotional symptoms, behavioral symptoms and social adaptation problems. There was no association between delayed puberty timing and mental sub-health in boy students but delayed puberty timing was associated with the alleviated mental sub-health in girl students (odds ratio [OR] = 0.73, P < 0.01). In boy students, perceived delayed puberty timing was associated with high levels of mental sub-health (OR = 1.58), emotional symptoms (OR = 1.68), behavioral symptoms (OR = 1.58), and social adaptation problems (OR = 1.50) (all P < 0.01); while in the girl students, perceived delayed puberty timing was associated with increased behavioral symptoms (OR = 1.31, P < 0.01).  Conclusion  Puberty timing is significantly related to mental sub-health in junior middle school students and the association differs by gender. Attention should be paid to advanced or delayed puberty timing among junior middle school students for the promotion of mental health in the students.
Neck/shoulder, upper back pain and its work-related factors: a cross-sectional study among female employees in public institutions in Beijing
LIU Jing-nan, ZHENG Ru, JIANG Xue-wen,
2021, 37(2): 275-279. doi: 10.11847/zgggws1126099
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Abstract:
  Objective  To explore the prevalence and work-related factors of neck/shoulder pain (NSP) and upper back pain among female employees in public institutions in Beijing.  Methods  The data on 4 654 female staff in public institutions were extracted from "Terminal Evaluation on Healthy Beijing People: A Ten-Year Health Promotion Action" conducted during June – August 2018. Information on NSP/upper back pain and work-related factors in the female staff were collected and analyzed.  Results  Of all the female employees, 67.0% reported NSP/upper back pain. The results of non-ordinal multivariate logistic regression analysis demonstrated that for the female employees, having overtime work was a risk factor of various degrees of NSP/upper back pain; at middle age, with higher education, having annual income of 50 000 – 100 000 yuan RMB, engaged in heavy physical labor were significant risk factors for moderate or severe NSP/upper back pain (all P < 0.05); while, dissemination of health promotion materials in workplaces was a protective factor against moderate and severe NSP/upper back pain, with the odds ratios of 0.675 (95% confidence interval [95% CI]: 0.522 – 0.873) and 0.434 (95% CI: 0.311 – 0.606).  Conclusion  Neck/shoulder pain and upper back pain are prevalent among female employees in public institutions in Beijing and relevant interventions on the illness should be promoted to improve health condition of the occupational population.
Impact of infant formula sales promotion – recommendation and trial use on breastfeeding practice among mothers of 0 – 6 months infants in poverty-stricken rural areas of China
ZHANG Li-fang, MU Ming, NIE Wei,
2021, 37(2): 280-285. doi: 10.11847/zgggws1126429
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Abstract:
  Objective  To explore the impact and influence mechanisms of infant formula recommendation and trial use on breastfeeding practice among mothers of infants aged 0 – 6 months in poverty-stricken rural areas of China.  Methods  We randomly selected 447 households with 0 – 6 months old infants in 123 villages in two national-level poverty-stricken counties locating at Qinba mountainous region and conducted a survey among mothers of the infants of the households selected in March – April 2019. Information about breastfeeding of the infants, maternal exposure to infant formula sales promotion, maternal nutrition health knowledge, maternal attitude towards breastfeeding and breastfeeding self-efficacy were collected with a self-designed questionnaire, Iowa Infant Feeding Attitude Scale (IIFAS), and The Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). Logit regression and multivariate linear regression were used in analyses.  Results  The logit regression analysis demonstrated that receiving infant formula samples for sales promotion (odds ratio [OR] = 0.60, 95% confidence interval [95% CI]: 0.38 – 0.93; P = 0.02) was a hindering factor for basic breastfeeding and feeding a newborn first time with infant formula (OR = 0.54, 95% CI: 0.31 – 0.95, P = 0.03) was a hindering factor for breastfeeding; the analysis did not indicate significant correlation between exposed to infant formula sales promotion (advertisements or advices for infant formula use from others) and breastfeeding practice (both P > 0.1). Exposure to infant formula advertisements was related with higher score for nutrition health knowledge (β = 0.33, P = 0.01) and higher score for breastfeeding attitude (β = 1.04, P = 0.04); while exposure to advices for infant formula use and receiving infant formula samples for sales promotion were not associated with scores for nutrition health knowledge and breastfeeding attitude (both P > 0.1), but receiving infant formula samples for sales promotion was correlated with significantly reduced breastfeeding self-efficacy (β = – 3.22, P = 0.03).  Conclusion  In poverty-stricken rural areas in Qinba mountainous region, the mothers of infants aged 0 – 6 months have no sufficient feeding skills; the usage of infant formula for sales promotion could increase maternal dependence on infant formula but reduce breastfeeding self-efficacy and thus decrease breastfeeding rate among the mothers.
Cognition on and consumption intention of genetically modified food among consumers in Shanxi province
SHEN Lu-lu, CHENG Jing-min, LI Li
2021, 37(2): 286-289. doi: 10.11847/zgggws1124199
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Abstract:
  Objective  To examine genetically modified food (GMF)-related cognition, intention of consumption, and information resource among consumers in Shanxi province fro providing references for production and consumption of GMF.  Methods  We recruited 2 500 residents in 34 counties/districts of 5 municipalities in Shanxi province using stratified multistage random sampling and conducted a face-to-face questionnaire survey from December 2016 to March 2017.  Results  The response rate of the survey was 88.6%. Univariate analysis showed that respondents′ cognition on GMF differed significantly by age (χ2 = 57.674, P < 0.01), education (χ2 = 69.910, P < 0.01), marital status (χ2 = 40.325, P < 0.01), occupation (χ2 = 89.480, P < 0.01), family size (χ2 = 6.316, P < 0.05), and Engel′s coefficient (χ2 = 10.629, P < 0.05). Multivariate analyses indicated that education, occupation and Engel′s coefficient were significant influencing factors for cognition on GMF of the respondents. The respondents′ intention of GMF consumption was significantly impacted by perceptions on GMF′s safety (χ2 = 48.706, P < 0.01), nutritional content (χ2 = 48.706, P < 0.01) and price (χ2 = 71.894, P < 0.01). Television programs, mobile phones and the internet were main ways for the respondents to obtain GMF-related knowledge.  Conclusion  The cognition on GMF is at a low level among consumers, especially among those with low education, in Shanxi province, suggesting that targeted education programs on GMF need to be promoted among the public.
Diagnosis, control and prevention of chronic obstructive pulmonary disease among middle-aged and elderly residents in Anhui province
ZHA Zhen-qiu, HE Yu-zhuo, XU Wei,
2021, 37(2): 290-292. doi: 10.11847/zgggws1128159
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Abstract:
  Objective  To investigate current situation of diagnosis, control and prevention of chronic obstructive pulmonary disease (COPD) among middle-aged and elderly residents in Anhui province for providing evidences to COPD prevention and control.  Methods  Using stratified multistage cluster random sampling, we recruited 2 996 residents aged ≥ 40 years at 5 COPD surveillance sites across Anhui province and conducted a questionnaire survey and physical examination among the participants during January – June, 2015. For the diagnosis of COPD, lung function measurement before and after bronchial dilation test were performed among 2 815 participants without relevant contraindications.  Results  Totally 272 COPD patients were diagnosed among all participants undergoing lung function testing. Among the COPD patients diagnosed, the prevalence rates of previously diagnosed diseases were 15.5% for chronic bronchitis, 4.1% for emphysema, 6.3% for asthma, 0.4% for previously diagnosed COPD, and 18.2% for other chronic respiratory diseases; among the patients with previously diagnosed chronic bronchitis, emphysema, asthma, and chronic respiratory diseases, the detection rate of COPD were 33.1%, 55.0%, 33.3%, and 31.8%; the COPD detection rate was positively correlated with previous history of chronic bronchitis, emphysema, asthma, and chronic respiratory diseases, with the correlation coefficients of 0.17, 0.13, 0.11, and 0.18 (all P < 0.001) and the Kappa values of 0.16, 0.06, 0.08, and 0.17, respectively. Of all the participants, only 2.0% (51) reported previous lung function testing; 28.3% (843) and 25.2% (758) were current and daily smokers and the prevalence rate of current and daily smoking were significantly higher among the participants with chronic respiratory diseases (42.0% vs. 27.3% and 39.2% vs. 24.2%), respiratory disease symptoms (34.2% vs. 27.5% and 33.2% vs. 24.2%), and COPD detected in lung function testing (53.6% vs. 25.4% and 48.4% vs. 22.6%) compared with the participants without those diseases or symptoms (all P < 0.001).  Conclusion  Among middle-aged and elderly residents in Anhui province, the missed diagnosis of COPD is prevalent; the rate of having lung function testing is low; and the smoking rate is high among the residents with chronic respiratory diseases and symptoms.
Experimental Study
Effect and mechanism of long-chain noncoding RNA HOTAIR targeting micRNA-138 on inflammatory response and oxidative stress induced by LPS in septic rats
LIU Qin, CHEN Yan, HU Guo-xin,
2021, 37(2): 293-297. doi: 10.11847/zgggws1124218
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Abstract:
  Objective  To investigated the effect and mechanism of long-chain noncoding RNA (lncRNA) HOX transcript antisense RNA (HOTAIR) targeting microRNA-138 (miRNA-138) and mediating Toll-like receptors 4 (TLR4)-dependent signaling pathway on inflammatory response and oxidative stress induced by lipopolysaccharide (LPS) in septic rats.  Methods  Sixty male Sprague-Dawley rats were randomly divided into four groups according to body weight (10 in each group): control group, model group, short-hairpin RNA (shRNA) control group and short hairpin RNA targeting HOTAIR (shHOTAIR) group. LPS (5 mg/kg) was injected intraperitoneally to establish a rat sepsis model. The expression of HOTAIR and miRNA-138 were detected by real-time reverse-transcriptase PCR (RT-PCR). Hematoxylin-eosin staining was used to observe the pathological changes of liver and lung tissues in rats of each group. The expressions of tumor necrosis factor-alpha (TNF-α), interleukin 6, 4, 10 (IL-6, IL-4, IL-10), superoxide dismutase (SOD), malondialdehyde (MDA), glutathione (GSH), and the phosphorylation of TLR4 and nuclear factor kappa B (NF-kB/p65) were detected using kit assays.  Results  Compared with those of the control group, the HOTAIR was overexpressed but miRNA-138 was underexpressed in lung tissues of model rats (both P < 0.05); obvious pathological changes were observed in liver and lung tissues of the model rats. Compared with those of the model rats, the pathological changes of the liver and lung tissues of the rats with shHOTAIR treatment were significantly alleviated. Compared with those of the control rats, serum TNF-α, IL-6 and MDA of the model rats increased significantly, while serum IL-4, IL-10, SOD and GSH decreased significantly (P < 0.05 for all); in comparison with those of the model rats, serum TNF-α, IL-6 and MDA of the rats of shHOTAIR group decreased significantly, but serum IL-4, IL-10, SOD and GSH increased significantly (all P < 0.05).  Conclusion  HOTAIR inhibits inflammatory response and oxidative stress induced by LPS in septic rats by targeting miR-138 and mediating TLR4-dependent signaling pathway.
Effects of mono (2-ethylhexyl) phthalate on cholesterol metabolism in HepG2 cells
TAN Qing, JIANG Xue-xia, HE Zhen,
2021, 37(2): 298-302. doi: 10.11847/zgggws1125827
Abstract(2589) HTML (1122) PDF 686KB(30)
Abstract:
  Objective  To investigate the effect of mono (2-ethylhexyl) phthalate (MEHP) on cholesterol content in hepatocytes and to provide evidences to researches on the mechanism of hepatic toxicity of MEHP.  Methods  HepG2 cells were treated with MEHP at various dosages (0.8, 4.0, 20.0, and 100.0 μmol/L for intra-hepacellular and extra-hepacellular total cholesterol [TC] and free cholesterol [FC] test; 0.01, 1.00, 10.00, and 100.00 μmol/L for tests of endonuclear sterol regulatory element binding protein 2 [SREBP-2] and cellular cholesterol metabolism-related proteins), Dulbecco′s modified Eagle′s medium (DMEM) as negative control and 1 mmol/L oleic acid (OA) for 24 and 48 hours, respectively. CHOD-PAP-POD enzymatic method was used to detect intra-hepacellular and extra-hepacellular TC and FC; the expression of SREBP-2 was measured with immunocytochemistry; protein expressions of hydroxymethylglutaryl coenzyme A reductase (HMGCR), low density lipoprotein receptor (LDLR) and cholesterol acyltransferase (ACAT1) were determined with Western blot.  Results  After 24 hours′ treatment of 100 μmol/L MEHP, the intracellular FC (0.508 ± 0.069 mmol/g) was significantly higher than that of the negative control cells (P < 0.05); the endonuclear nSREBP-2 expressions increased obviously in all MEHP-treated cells and in positive control cells compared with that of the negative control cells. After 48 hours′ treatment, the intracellular FC returned to normal levels (P > 0.05); while, the intra-hepacellular expressions of nSREBP-2 and HMGCR decreased significantly in all MEHP exposed HepG2 cells in comparison with those in the negative control cells (all P < 0.05).  Conclusion  MEHP has a certain interference effect on cholesterol metabolism in hepatocytes, but the effect is reversible.
Survey and Report
Evaluation on performance of urban employee basic medical insurance in Heilongjiang province
PAN Lin, YANG Shi-ya, QI Xin-ye,
2021, 37(2): 303-306. doi: 10.11847/zgggws1125522
Abstract(2348) HTML (1349) PDF 509KB(46)
Abstract:
  Objective  To evaluate the fairness in health financing, health service utilization and economic protection capacity of urban employee basic medical insurance (UEBMI) in Heilongjiang province and to provide evidences for improving the performance of the medical insurance system.  Methods  We collected the data on operation effect of UEBMI in Heilongjiang province from statistics published by National Bureau of Statistics and other governmental agencies and the dataset of three waves of national health service survey conducted in 2003, 2008 and 2013. We adopted burden contribution rate, fairness index, concentration index (CI), and catastrophic health expenditure (CHE) in analyses on the fairness in the operation of the health insurance system.  Results  In the province, the family health financing contribution index decreased from 0.293 9 to 0.252 6 after the implementation of UEBMI, indicating a decline in the equity of family health financing among the workers; the utilization of outpatient and hospitalization medical service were not balanced generally among workers with various income levels, with the horizontal fairness index of 0.024 0 and 0.088 0 for outpatient and hospitalization service utilization in 2013. The CHE increased from 9.79% in 2003 to 21.63% in 2013 among the urban workers surveyed.  Conclusion  The fairness in health financing, health service utilization and economic protection capacity need to be improved for the operation of urban employee basic medical insurance in Heilongjiang province.
Epidemiological characteristics and containment efficiency of imported COVID-19 cases from abroad in Liaoning province
CHEN Tao, NA Jun, TIAN Jiang, LIU Ru,
2021, 37(2): 307-310. doi: 10.11847/zgggws1132464
Abstract(1068) HTML (344) PDF 625KB(39)
Abstract:
  Objective  To analyze epidemiological characteristics and containment efficiency of imported cases of coronavirus disease 2019 (COVID-19) in Liaoning province and to provide evidences for the prevention and control of imported COVID-19 cases.  Methods  From China Information System for Disease Prevention and Control, we collected the data on all reported COVID-19 cases imported from abroad into Liaoning province from January 29 to July 12, 2020. The demographics, spatial temporal distribution, clinical characteristics and treatment outcomes of the cases were analyzed in combination with the results of field surveys on the cases.  Results  The first imported COVID-19 case was reported in Liaoning province on January 29, 2020 and till July 12 of the year, a total of 72 cases were reported, including 33 confirmed cases (45.83%) and 39 asymptomatic infected cases (54.17%). The majority (28, 84.85%) of confirmed cases were common cases and only 5 (15.15%) of the cases were mild cases; no severe, critical or fatal case were reported. In the province, there were 9 municipalities with the reported COVID-19 cases imported from aboard and Shenyang and Dalian were the two municipalities with much more number (36 [50.00%] and 21 [29.17%]) of the reported cases. Among the reported cases, 54 (75.00%) were at the ages of 14 to 49 years; 31 (43.06 %) were international students; 10 (13.89 %) were engaged in commercial service and another 10 were retirees. The reported cases entered China from 18 counties and 22.22%, 20.83%, and 15.28% were from the United States, the Russian Federation, and the United Kingdom, respectively. For all the cases, the shortest cure time was 2.38 days and the longest was 40.64 day; the mean cure time was 13.53 ± 7.81 days for the confirmed cases, while the mean time of medical treatment or observation was 13.82 ± 3.27 days for the asymptomatic cases.  Conclusion  The imported COVID-19 cases from abroad in Liaoning province were mainly asymptomatic or common cases with younger ages and all the them were cured; the cases were mainly international students and business service personnel from the United States, the Russian Federation. The implemented strategies for the containment of the imported COVID-19 cases were reasonable and effective.
Self-assessed practice about medical risk and its influencing factors among medical staff in township hospitals in Guizhou province
YANG Xing, YANG Xi, QU Fang
2021, 37(2): 311-314. doi: 10.11847/zgggws1124451
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Abstract:
  Objective  To examine self-assessed practice about medical risk and its influencing factors among medical staff in township hospitals in Guizhou province for providing references to medical risk management in rural grassroots medical institutions.  Methods  We conducted a self-administered questionnaire survey among 1 310 medical personnel participating a training program from township hospitals in 88 prefectures/counties/districts across Guizhou province in December 2018. Information on personal practice about medical risk, evaluation on institutional medical risk management, and job satisfaction were collected and analyzed; multivariate linear regression was used to explore influencing factors of self-assessment on practice about medical risk.  Results  For the 1 193 eligible respondents, the average score for personal practice about medical risk was 24.28 ± 3.20 in a scale with the maximum score of 30 for excellent practice. Univariate analysis showed that the score for personal practice about medical risk differed significantly by age, job category, professional title, working years, frequency of participating in trainings on medical risk management, whether having been involved in medical disputes, and job satisfaction among the respondents (P < 0.05 for all). Multivariate linear regression analysis showed that the score for personal practice about medical risk was inversely correlated with professional title (β′ = 0.057), the frequency of taking a part in relevant training program (β′ = 0.192), job satisfaction (β′ = 0.082), and related to the involvement in medical disputes (β′ = 0.084) (all P < 0.05).  Conclusion  The self-assessed practice about medical risk is at a good level and mainly influenced by professional title, relevant training and job satisfaction among medical staff in township hospitals in Guizhou province. The results suggest that the relevant trainings should be promoted among the new employees and the staff with poor job involvement and ever experiencing a medical dispute.
Development and application of outpatient medical record system-based electronic prescription on health education for outpatients
HU Xiao-su, HU He-jing, ZHANG Wen-li,
2021, 37(2): 315-318. doi: 10.11847/zgggws1132255
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Abstract:
  Objective  To explore the development and preliminary application of an electronic prescription on health education for outpatients.  Methods  We carried out a panel study in a tertiary hospital in Beijing from December 2019 through August 2010. First, we compiled electronic disease-specific health education prescriptions and implanted those prescriptions into an outpatient medical record system of the hospital. Then, we conducted questionnaire surveys among 1 163 outpatients as the control group before the implantation of the prescriptions and 1 096 outpatients as the observation group after the implantation of the prescriptions.  Results  The proportions of the outpatients acquiring health education via face-to-face communication and written materials were significantly high in observation group than in control group (both P < 0.01). Compared to those of control group, the outpatients of observation group reported significantly higher ratios of receiving specific guidance other than medication on daily diet, life style, mental health, cognition of pathogenic mechanism, and general health (all P < 0.01). Significantly higher proportions of the outpatients of observation group than those of the control group reported practicing health behaviors including smoking cessation, reducing salt use, limiting oil consumption, oral health promotion, mental health promotion, reasonable medication, and disease self-management (P < 0.01 for all). Significantly higher access of health education information and increase in health literacy were reported by the outpatients of observation group in comparison to those of control group (both P < 0.01).  Conclusion  The medical record system-based electric health education prescription is effective in promotion of health attitude and behavior and disease self- management among clinic outpatients.
Prevalence and influencing factors of social isolation among community elderly in Tangshan city
LI Ya-na, HAN Ying, LIU Yao, WANG Xue,
2021, 37(2): 319-322. doi: 10.11847/zgggws1124142
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Abstract:
  Objective  To investigate the status quo and influencing factors of social isolation among community elderly and to provide evidences for improving the quality of life of the elderly.  Methods  Using convenient sampling, we recruited 1 526 residents aged 60 years and above in 6 communities of Tangshan city, Hebei province for face-to-face interviews conducted from December 2017 to August 2018. A self-designed questionnaire, the Abbreviated Lubben Social Network Scale (LSNS-6), Emotional Balance Scale, Social Support Rating Scale and Montreal Cognitive Assessment Scale were used in the survey.  Results  For all the participants averagely aged 71.08 ± 7.729 years, the mean score of LSNS-6 was 16.16 ± 5.447 and 371 (24.3%) were assessed as being with social isolation (LSNS-6 score of ≤ 12). Univariate analysis revealed following significant influencing factors of social isolation: demographic characteristics (age, education, marital status, number of children), health condition (chronic illness, physiological perception, cognitive function), psychological status (emotional balance, negative life event, interpersonal well-being), family environment (family structure and grandparenting) and social environment (social support and community function) (P < 0.05 for all). Multivariate linear regression analysis demonstrated that age, education, number of children, having three or more chronic diseases, cognitive function, emotional balance, grandparenting, social support, and community function were of significant influence on social isolation among the participants (all P < 0.05).  Conclusion  Multiple factors have significant impact upon social isolation among elderly community residents in Tangshan city and strengthening familial and social support can reduce the risk of social isolation in the elderly.
Association of semen metal concentration and estrogen receptor alpha gene with semen quality in human
PAN Hai-bin, YUAN Guan-xiang, ZHANG Jin,
2021, 37(2): 323-327. doi: 10.11847/zgggws1125935
Abstract(2150) HTML (893) PDF 540KB(35)
Abstract:
  Objective  To investigate the association of semen metal concentration and estrogen receptor alpha gene (ESR1) with semen quality in human and to provide epidemiological evidences for researches on mechanism of metal's effect on semen quality.  Methods  A hospital-based case-control study was conducted among 91 cases and 91 controls with abnormal and normal semen quality recruited from the attendees having semen examination in a reproductive medicine center of a tertiary grade A hospital in Shenzhen city from September 2016 to November 2017. A questionnaire interview and laboratory detection on concentrations of 11 metals and ESR1 expression in semen were carried out in the participants.  Results  Compared to the controls, the cases had significantly higher median seminal concentration (μg/L) of chromium (Cr: 2.12 vs. 1.64), manganese (Mn: 9.61 vs. 8.18), copper (Cu: 107.00 vs. 91.40), and thallium (Tl: 0.23 vs. 0.19) (all P < 0.01). The relative mRNA expression level of ESR1 gene in the semen of the cases (– 0.66 ± 4.85) and the controls (0.63 ± 3.96) was significantly different (t = – 1.974, P < 0.05). The results of unconditional multivariate logistic regression demonstrated that after adjusting for age, body mass index (BMI) and abstinence time, in contrast to those with the lowest quartile concentrations, the participants with the highest quartile concentration of Cr, Mn and Cu were at increased risk of abnormal semen quality, with the odds ratio (OR) (95% confidence interval [95% CI]) of 3.16 (1.32 – 7.58), 3.58 (1.45 – 8.83) and 3.17 (1.32 – 7.64), respectively; the participants with the third and the highest quartile concentration of Tl were also at increased risk of abnormal semen quality, with the OR (95% CI) of 2.77 (1.15 – 6.70) and 3.96 (1.55 – 10.08) compared to the participants with the lowest quartile concentration. The participants with a low ESR1 gene expression in semen had an increased risk of abnormal semen quality (OR = 1.89, 95% CI: 1.04 – 3.46) in comparison with those with a high ESR1 gene expression. The results of multivariate linear regression analysis revealed that in comparison to the lowest quartile concentration, the highest quartile seminal concentration of Tl was reversely correlated with ESR1 gene expression (b = – 2.49, 95% CI: – 4.44 – – 0.54) after adjusting for age, BMI and abstinence time. Mediation analysis indicated that ESR1 gene expression contributed to a significant proportion of the correlation between Tl and semen quality, accounting for 18.6% of the total effect.  Conclusion  High metal concentration of Cr, Mn, Cu, and Tl and low expression of ESR1 gene in semen are risk factors for abnormal semen quality. The adverse effect of Tl on semen quality is partially mediated by ESR1 gene expression.
Impact of ambient temperature on other infectious diarrhea incidence and its attributable risk in Shaoxing city
WANG Hai-tao, ZHAO Zhe, JIANG Bao-fa
2021, 37(2): 328-332. doi: 10.11847/zgggws1124062
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Abstract:
  Objective  To examine the impact of ambient temperature on other infectious diarrhea incidence (OIDI) and the impact′s attributable risk of OIDI in Shaoxing city, Zhejiang province for providing evidences to the prevention and control of the disease.  Methods  Daily data on OIDI and meteorological factors in Shaoxing city were collected for the period from January 2014 through December 2016. The impact of daily average ambient temperature (DAAT) on OIDI was analyzed using the distributed lag non-linear model (DLNM). Fraction and number of OIDI attributable to DAAT were estimated based on the results of DLNM analysis.  Results  A total of 42 480 of OIDI were reported during the 3-year period in the city. Both high and low DAAT were associated with an increased risk of OIDI. The DAAT of 3.6 ℃ was associated to the highest lag 30 day cumulative effect on OIDI, with a cumulative relative risk (RR) of 4.820 (95% confidence interval [95% CI]: 2.857 – 8.132). The total number of OIDI attributed to the influence of DAAT was 15 335 (95% CI: 11 896 – 17 533), accounting for 36.10% (95% CI: 28.23% – 41.66%) of all OIDI. The fraction of attributable risk of OIDI for low DAAT was 5.09% (95% CI: 4.29% – 5.60%), higher than that (2.61% [95% CI: 0.89% – 3.86%]) for high DAAT. The females and the people ≥ 15 years old were vulnerable populations of OIDI associated with high DAAT.  Conclusion  Both high and low daily average ambient temperature could increase the risk of other infectious diarrhea incidence and the attributable risk of infectious diarrhea for low daily average ambient temperature is greater than that for high average ambient temperature but females and the people aged 15 years and above are vulnerable to other infectious diarrhea incidence associated with high average ambient temperature.
Mental health and its influencing factors among empty-nest elderly in rural China
LI Yue
2021, 37(2): 333-336. doi: 10.11847/zgggws1126709
Abstract(4556) HTML (1242) PDF 507KB(160)
Abstract:
  Objective  To examine mental health status and its influencing factors among empty-nest elderly in rural China and to provide evidences for promoting mental health among the rural empty-nest elderly.  Methods  The data on 1 892 empty-nest elderly aged ≥ 60 years in rural regions of China were extracted from the fourth wave of China Family Panel Study (CFPS) conducted in 2016. Mental health condition of the elderly was assessed with Center for Epidemiologic Studies Depression Scale (CES-D). Unconditional multivariate logistic analysis was used to evaluate mental health of the participants by demographics, physical health, social economic condition, and psychosocial factors.  Results  The results of univariate analysis indicated following significant impact factors on mental health of the empty-nest elderly: gender, marriage status, physical health, chronic diseases, self-care ability, exercise, education, relationship with children, frequency of contact with children, and support from neighborhoods (P < 0.05 for all). The results of unconditional multivariate logistic analysis demonstrated that unmarried (odd ratio [OR] = 1.742) and low self-care ability (OR = 2.431) were significant risk factors but good physical health (OR = 0.226), high education in comparison with illiteracy or semiliterate (primary school: OR = 0.477, junior high school and above: OR = 0.428) and not having poor relationship with children (general relationship: OR = 0.321, close relationship: OR = 0.171) were protective factors of mental health for the empty-nest elderly (P < 0.05 for all).  Conclusion  For the promotion of mental health among rural empty-nest elderly, more attention should be paid to those being female, the living alone, in poor physical health, having chronic diseases, with low self-care ability, not doing physical exercise, with low education, having poor relationship with children, less frequently contacting with children, and with less support from neighborhood.
Effect of daily mean temperature on circulatory disease mortality among residents in Shenzhen city
LIAN Ting-yu, FU Ying-bin, LIU Gang,
2021, 37(2): 337-342. doi: 10.11847/zgggws1126144
Abstract(1879) HTML (1717) PDF 820KB(44)
Abstract:
  Objective  To explore the effect of daily mean temperature on circulatory disease mortality in urban residents and to provide evidences for reducing temperature-related mortality risk of circulatory diseases.  Methods  The data on circulatory disease mortality among permanent residents of Shenzhen city from January 2013 through December 2017 were collected from death registry system and that on meteorology of the same period were collected simultaneously. The distributed lag non-linear model (DLNM) was used to analyze delayed and cumulative effect of daily mean temperature on age-, sex-, and major cause-specific circulatory disease mortality. The median daily temperature of 24.7 ℃ was used in estimations of relative risk (RR) of mortality related to temperature variation (up or down) of one degree Celsius.  Results  No significant correlations were observed between extreme high temperature and total and age- or sex-specific circulatory disease mortality and the mortality of cerebrovascular disease and ischemic heart disease during the period. Extreme low temperature was correlated with significantly increased total mortality of circulatory diseases (RR = 1.603, 95% confidence interval [95% CI]: 1.123 – 2.288), the circulatory disease mortality in the population over 65 years old (RR = 1.706, 95% CI: 1.080 – 2.696) and male population (RR = 1.800, 95% CI: 1.163, 2.785), and the mortality of cerebrovascular diseases (RR = 1.985, 95% CI: 1.170 – 3.434); but the associations of extreme low temperature with the mortality of female population, population under 65 years old, and the mortality of ischemic heart disease were not significant.  Conclusion  Extreme low temperature can increase circulatory disease mortality in a time lag manner among the residents of Shenzhen city; male population and population over 65 years are vulnerable to the affect of extreme low temperature.
Income of maternal health care workers in Beijing and Shanghai: a comparison study
MA Dong-ping, YIN Wen-qiang, ZHENG Wen-gui,
2021, 37(2): 343-345. doi: 10.11847/zgggws1123240
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Abstract:
  Objective  To compare the income level of maternal health care workers with other occupations in Beijing and Shanghai and the disparity in the workers’ income between the two cities for exploring suitable income of maternal health care workers.  Methods  We collected the data on income of maternal health care workers, medical professionals, and officers and that on house price in Beijing and Shanghai from literatures and statistical yearbooks published from 2000 through 2017. The amount of income and house price were adjusted to the level in year 2017 for the analysis on the suitability of the income for the maternal health care workers.  Results  The average annual income per capita was 105 422.4 yuan (RMB) and 108 498.8 yuan for the maternal health care workers in Beijing and Shanghai in 2017 and the income suitability index was 37.0% and 37.6% for the workers in Beijing and Shanghai, respectively.  Conclusion  The income of maternal health care workers in Beijing and Shanghai are both at a relatively low level and the income suitability for the maternal health care workers in Beijing is lower than that for the workers in Shanghai based on quantitative evaluation.
Under-five mortality in Guangdong province, 2015 – 2018
LUO Can, WANG Xiong-hu, ZHU Ying-xian,
2021, 37(2): 346-349. doi: 10.11847/zgggws1126336
Abstract(2754) HTML (979) PDF 664KB(64)
Abstract:
  Objective  To investigate the under-5 mortality rate (U5MR) in Guangdong province and to analyze the variation in causes of U5MR for developing interventions for decreasing U5MR.  Methods  The data on 20 057 deaths of children under 5 years old registered in Guangdong province from 2015 through 2018 were collected and analyzed statistically.  Results  The neonatal mortality rate (NMR), infant mortality rate (IMR), and U5MR were 1.37‰, 2.06‰, and 2.73‰, respectively. The top five causes of the neonatal mortalities were preterm labor or low birth weight (21.97%), birth asphyxia (21.97%), other diseases of newborn (12.40%), other congenital anomalies (7.08%), and congenital heart disease (5.70%). During the 4-year period, the top five causes of the neonatal mortality and under five mortality were the same roughly, but the rank order of the top five causes of the mortalities varied slightly. The region-specific U5MR differed among the 21 municipalities of the province and the ratio of deaths with unclear diagnosis increased yearly.  Conclusion  The under-5 mortality rate was at a low level in Guangdong province during 2015 – 2018 at the national level, indicating that maternal and child healthcare measures are effective.
Incident characteristics of public health emergencies in Anhui province, 2010 – 2018
CHEN Fang, GONG Lei, HOU Sai,
2021, 37(2): 350-353. doi: 10.11847/zgggws1124932
Abstract(2518) HTML (3106) PDF 552KB(94)
Abstract:
  Objective  To describe incident characteristics of public health emergencies (PHE) in Anhui province for providing evidences to improvements in PHE prevention and control strategies.  Methods  The cleared data on PHE in Anhui province from January 1st, 2010 to December 31st, 2018 were extracted from National Information System for Disease Control and Prevention and the incident characteristics of the registered PHE was analyzed.  Results  Totally 331 PHE were reported during the period in the province, of which, 281 and 49 were classified as minor and moderate events and only one was categorized as a major emergency. The PHE involved 10 774 disease cases and resulted in 107 deaths. For all the PHE and disease cases, 62.8% and 72.6% were contributed to infectious disease epidemics and 74.8% of all the deaths were contributed to poisonings. Among all the PHE contributed to infectious disease epidemics, 55.8% were caused by respiratory infectious diseases and 69.3% of the all poisoning-related PHE were food poisonings. The PHE reported in every month of a year from 2010 to 2018 but more PHE contributed to infectious disease epidemics were reported during March – June and October – December and more PHE contributed to poisoning were reported during July – September in a year. The reported PHE occurred in all the 16 municipalities/prefectures but 49.6% of the PHE occurred in 3 of the 16 municipalities/prefectures of the province. More than one half (51.1%) of the reported PHE and one-third (70.0%) of PHE-related disease cases, but only 0.9% of the PHE-related deaths occurred in schools or childcare facilities; for all the PHE occurred in schools or childcare facilities, 91.1% were caused by infectious disease epidemics.  Conclusion  Public health emergencies were mainly caused by infectious disease epidemics but the majority of public health emergency-related deaths were due to poisoning, and schools and childcare facilities were the sites at a higher risk of public health emergency incidence in Anhui province during years from 2010 to 2018.
Effect of health management follow-up service on medication compliance among hypertension outpatients
ZHANG Ling-ling, LIANG Li-ming, SUN Hua-jun,
2021, 37(2): 354-357. doi: 10.11847/zgggws1125164
Abstract(1770) HTML (647) PDF 539KB(29)
Abstract:
  Objective  To examine the effect of health management follow-up service on medication compliance among hypertension outpatients and to provide evidences for standardizing health management and improving medication compliance in hypertension patients.  Methods  Using stratified random sampling, we recruited 3 108 adult attendees (≥ 35 years) at 16 community healthcare centers in 4 districts of Tianjin city during May 2015 and conducted a questionnaire survey among 612 primary hypertension patients identified from the attendees recruited. Propensity score matching (PSM) method was used to analyze the effect of health management follow-up service on medication compliance in the hypertension patients.  Results  Of all the patients surveyed, 462 (75.5%) reported taking antihypertensive medicine prescribed by doctors regularly. Of the 152 patients matched by PSM, 71.1% reported prescription-based regular antihypertensive medication. The patients receiving health management follow-up service reported a significantly higher ratio of regularly taking antihypertensive medicine compared to those not having health management follow-up service (81.6% vs. 60.5%, χ2 = 8.189, P = 0.007).  Conclusion  Health management follow-up service can improve the compliance antihypertensive medication in hypertension outpatients.
Intermediary role of social participation on relationship between daily life ability and mental health status in elderly people
MA Lan, GUO Li-fang, LI Yue,
2021, 37(2): 358-360. doi: 10.11847/zgggws1126239
Abstract(1040) HTML (455) PDF 625KB(40)
Abstract:
  Objective  To examine correlations among daily life ability, mental health status and social participation in community elderly, and to explore mediating effect of social participation on the association between daily life ability and mental health status.  Methods  With stratified simple random sampling, we recruited 6 160 community residents aged ≥ 60 years in 28 prefecture-level regions across Henan province for a questionnaire survey during January – February 2018. Correlation analysis and hierarchical regression analysis were performed with SPSS 22.0.  Results  For the 6 094 valid respondents, the average scores were 91.69 ± 17.33 for daily life ability, 0.50 ± 0.76 for mental health status, and 2.27 ± 3.60 for social participation, respectively. The elderly′s daily life ability was positively correlated with their social participation (r = 0.680, P < 0.01) and mental health (r = 0.431, P < 0.01); the social participation was positively associated with mental health (r = 0.305, P < 0.01). Social participation had a partial mediating effect on the correlation between daily life ability and mental health, with a mediating effect ratio of 48.12%.  Conclusion  There are significant correlations among community elderly′s daily life ability, social participation, and mental health; the elderly′s daily life ability could affect their mental health directly and indirectly through the mediating role of social participation.
Overview
Definition and standard of integrated management on chronic diseases under integrated service concept
LIU Wan-qi, YANG Jin-xia, XIE Pian-pian,
2021, 37(2): 361-365. doi: 10.11847/zgggws1124266
Abstract(3361) HTML (1691) PDF 710KB(126)
Abstract:
Integrative service has become a "magic weapon" advocated by international organizations to improve service efficiency and reduce service costs in various fields because of its good cost-economic and social benefits. Integrated service has been recognized and respected by scholars at home and abroad, and is also of great value in the field of hygiene and health. From the point of view of the characteristics of chronic diseases, the management of chronic diseases needs the guidance of integrated service concept, and strives towards the direction of integrated management. To this end, on the basis of theoretical and practical research, the study defines the definition, connotation and standard of integrated management of chronic diseases, and provides theoretical basis, practical basis and guidance for the comprehensive implementation of integrated management of chronic diseases in China.
Application of single nucleotide polymorphism in mosquito population genetics and mosquito-borne disease control
WEI Yong, WANG Jia-tian, ZHENG Xue-li
2021, 37(2): 366-370. doi: 10.11847/zgggws1124530
Abstract(2862) HTML (5985) PDF 536KB(69)
Abstract:
With the spread of mosquitoes around the world, mosquito-borne diseases used to be relatively confined in the past have become more and more common. Dengue fever, Chikungunya fever, Japanese encephalitis, West Nile virus disease, yellow fever, and Zika virus infection are several common and emerging viral diseases transmitted by mosquitoes. The local mosquito species and population genetic characteristics have a potential impact on the outbreak of local mosquito-borne diseases, so mosquito identification and population genetic research are particularly important in prevention and control of the diseases. Single nucleotide polymorphism (SNP) markers are the third generation genetic markers. Because of their characteristics of wide distribution, genetic stability and easy detection on a large scale, they have become the new generation DNA markers having been studied by most researches and have become the most promising molecular markers.
Advances and challenges in researches on precision public health
YANG Ying-ying, FU Chuan-xi
2021, 37(2): 371-374. doi: 10.11847/zgggws1127292
Abstract(3041) HTML (1114) PDF 566KB(201)
Abstract:
In recent years, precision public health has rapidly emerged in international medical community. Precision public health is centered on the population, through the cross-application of tools including genomics, bioinformatics, big data and artificial intelligence, to define the risk of disease occurrence in population, determine feasible interventions to accurately predict and prevent the occurrence and development of disease, and promote population health. Precision public health is widely used in dealing with infectious diseases, chronic diseases, rare diseases and public health emergencies. However, there are still some current challenges in breaking the "data barriers", protecting data privacy, and the lack of standardized diagnostic specifications. This article summarizes the definition, influencing factors, application and challenges of precision public health.
Multigenerational and cross-generational effect of environmental endocrine disruptors on reproductive system in male animals
LIANG Jing-jia, GU Ai-hua
2021, 37(2): 375-380. doi: 10.11847/zgggws1127217
Abstract(2493) HTML (1218) PDF 508KB(40)
Abstract:
Environmental endocrine disruptors (EDCs) are exogenous chemical compounds interfering with the activity of endogenous hormones, and can cause harm to development of tissues including reproductive system. After parents exposed to EDCs for a certain period of time, the offspring may be also affected by the chemical compounds, which is called multi-generation and cross-generation effects. Most recent researches are related to the multi-generation and cross-generation effects of maternal exposure and some studies also suggest that paternal exposure may have adverse effects on male offspring. EDCs have been found having certain reproductive toxicity to male animals, but its reproductive effect on male offspring after paternal exposure is undefined. This study reviews researches on reproductive toxicity of bisphenol A, phthalates, dioxin-like compounds and atrazine to male animals, as well as the reproduction-related multigenerational and cross-generational effects of paternal exposure to those chemicals on male offsprings.
Progress in studies on biomarkers related to heat stroke
XIAO Wen-jing, WANG Wu-chao, ZHOU Qian-yun,
2021, 37(2): 381-384. doi: 10.11847/zgggws1124009
Abstract(3309) HTML (3787) PDF 468KB(65)
Abstract:
With the process of global warming and the intensity and frequency of heat wave attacks, the incidence and mortality of heat stroke are increasing year by year, which may become an emergency event of public health. The biomarkers predicting the occurrence and development of heat stroke will help to understand heat radiation diseases more conveniently and effectively, and further develop prevention and control measures. This study reviews the biomarkers used in heat stroke diagnosis in recent years, and discusses the latest progress in their clinical application.