Alcohol drinking rates of male between 7th and 11th graders in Japan decreased gradually based on nationwide repeated cross-sectional surveys from 1996 to 2008

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.

Smoking rate trends of male 7th and 11th graders in Japan based on repeated, nationwide, cross-sectional surveys every 4 years from 1996 to 2008

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.

A Cross-sectional Survey Assessing Carriage of Streptococcus pneumoniae in a Healthy Population in Xinjiang Uygur Autonomous Region of China

The carriage rate and serotype distribution of Streptococcus pneumoniae（S.pneumoniae）in a healthy population in China remains unclear.In this study,we collected the oropharyngeal swabs from513 individuals in Xinjiang,China.Real-time PCR targeting the lytA gene and 12 serotypes were assessed to identify S.pneumoniae carriage.

Awareness of and attitudes towards infertility and its treatment： a cross-sectional survey of men in a United States primary care population

Previous studies have described racial and socioeconomic disparities in the treatment of infertility. Patient factors such as attitudes and awareness may be contributing factors. Since primary care is often the setting that serves as an entry into other areas of medicine, we sought to evaluate men＇s attitudes and awareness of male infertility in the primary care setting. To do this, we performed a cross-sectional survey of men＇s attitudes toward men＇s health issues in 210 men from two primary care clinic waiting rooms in Atlanta, Georgia. The survey was self-administered with closed-ended question items and was approximately 20 min in length. Of the 310 men approached, 210 agreed to participate and returned completed surveys. Overall, 52% of men said they were ＂very＂ or ＂somewhat＂ familiar with infertility and 25% were familiar with treatments for infertility. Some men had heard of surgery （21%） and medication （35%） as treatments for male infertility. Awareness and familiarity with the condition was greater in high socioeconomic status men （i.e. college graduates or those with income 〉$100 k per year） but did not differ by race on multivariate analysis. Attitudes toward infertility varied by race with non-Caucasian men being more likely to indicate that infertility is a serious condition, to be concerned about infertility, and to believe it decreases a man＇s quality-of-life. Therefore, a lack of awareness, but not negative attitudes, may contribute to previously-described disparities in the treatment of infertility.

Knowledge,attitude and behaviour to evidence-based practice among psychiatric nurses:A cross-sectional survey

Objective To identify the status of knowledge,attitude,and behaviour toward evidence-based practice(EBP)among Chinese psychiatric nurses,and to examine the influencing factors of EBP behaviour.Methods We utilised a cross-sectional design.A total of 923 psychiatric nurses from 168 hospitals in 27 provinces in the mainland of China participated in our survey.The EBP questionnaire,the barriers to research utilisation scale and the facilitators to research utilisation scale were used for data collection via WeChat group from July 2018 to April 2019.Multiple regression analysis was used to analyse the influencing factors of psychiatric nurses’evidence-based practice behaviour.Results The score of Chinese psychiatric nurses’EBP attitude,behaviour and knowledge were 4.81±1.34,4.11±1.36 and 3.53±1.29,respectively.Multiple regression analysis showed that nurses’EBP behaviour was mainly determined by knowledge and attitude,which together explained 61.8%of the variance.The two top barriers were the dimensions of presentation and research.Facilitators include managerial support,employing nurses with research skills as models and providing advanced education on evidence-based nursing.Conclusion Psychiatric nurses have positive attitudes toward EBP,but their level of knowledge and behaviour is insufficient.Heavy workload,insufficient time,and a lack of knowledge and skills is the main barrier.Managerial support,employing nurses with research skills as models and providing advanced education are the main facilitators.

Attention and Intervention of Oncologists on Oxaliplatin-induced Adverse Reactions in China' Mainland:A Cross-sectional Internet-based Survey

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.

Intervention for oxaliplatin-induced hypersensitivity in China:a cross-sectional internet-based survey

Objective This cross-sectional study aimed at investigating the intervention status and the influence of oncologists on oxaliplatin-induced hypersensitivity reactions(OIHR).Methods Snowball sampling was used to send questionnaires to oncologists in various provinces and cities in China,via the internet,to collect data on their socio-demographic characteristics,the occurrence of OIHR,and the current status of interventions.One-way ANOVA and T-test of geographic samples were used to explore the relationship between the incidence of OIHR and intervention measures.Results A total of 401 valid questionnaires were collected,most respondents were 30–40 years old,and most oncologists had 5 years of working experience.The proportions of glucocorticoid and H1 receptor antagonist use for OIHR prevention were 67.83%and 38.65%,respectively.The proportion of oncologists with longer working years and higher professional titles who used glucocorticoids for OIHR prevention was higher,and the observed OIHR incidence was lower.Pretreatment with glucocorticoids may be an effective preventive measure and can reduce the incidence of the OXA allergic reactions(P<0.05).Conclusion The risk awareness of junior oncologists to OIHR prevention should be strengthened,and clinical efficacy evaluation of glucocorticoids in OIHR prevention should be further promoted.

Study protocol:A cross-sectional study on psychology and behavior investigation of Chinese residents,PBICR

Objective:This study protocol identifies the basic research route and framework of psychological and behavioral surveys among Chinese residents,aims establishing a database through a multicenter,large-sample cross-sectional survey in China to provide strong data support for research development in various fields and a more comprehensive and systematic understanding of the physical and mental health status of the public.Method:The study was conducted from June 20,2022 to August 31,2022,using stratified sampling and quota sampling methods,a total of 148 cities,202 districts and counties,390 townships/towns/sub-districts,and 780 communities/villages(excluding Hong Kong,Macao,and Taiwan)from 23 provinces,5 autonomous regions,and 4 municipalities directly under the central government in China were selected.The questionnaire was distributed one-on-one and face-to-face to the public by trained investigators,and the questionnaire included eight aspects:personal basic information,personal health status,family basic information,social environment in which they were located,psychological level scale,behavioral level scale,other scales,and attitude towards social hot issues.Data analysis will be performed after questionnaire return.Results:Data collection is ongoing.These findings will support physical and mental health research and strategy development in China and even globally,guiding policy-makers and health care organizations to reform their programs to ensure the best interests of residents and their families.

Association between knowledge and risk for cardiovascular disease among older adults: A cross-sectional study in China

Objectives:This study aimed to describe cardiovascular risk and cardiovascular disease(CVD)knowledge among older adults,and further explore the association between knowledge and risk.Methods:In this cross-sectional study,we enrolled 1120 older adults who received physical examination in health centers.The participants were interviewed to obtain their behavioral risk factors related to CVD and clinical characteristics.A risk prediction chart was used to predict participants'cardiovascular risk based on clinical characteristics and behavioral risk factors.Participants'CVD knowledge was collected with a pretested knowledge questionnaire.Results:Among the 1120 participants,240(21.4%)had low cardiovascular risk,353(31.5%)had moderate cardiovascular risk,527(47%)had high and very high cardiovascular risk.The knowledge level about CVD among 0.8%of the 1120 participants was good while that of 56.9%was poor.Lower CVD knowledge level,older age,lower income,and lower educational level were the independent factors of higher cardiovascular risk level.Conclusions:This study highlights the need to reduce the cardiovascular risk among older adults.CVD knowledge should be considered when developing health interventions.

Healthcare Staff Perceptions of Patient Safety Culture in Nursing Home Settings—A Cross-Sectional Study

In nursing homes, knowledge about patient safety culture is still limited. This study investigates staff perceptions of patient safety culture in Norwegian nursing homes, measured with the Nursing Home Survey on Patient Safety Culture (NHSOPSC). 466 (69%) staff from 12 different nursing homes participated. The total percentages of positive responses for each patient safety culture dimension and differences in perceptions according to staff’s educational background and position were calculated. Multiple linear regression analysis was used to test if the NHSOPSC dimensions predicted participants’ ratings of the question “Please give this nursing home an overall rating on patient safety”. The proportion of positive responses was high, with six of ten dimensions having an average percentage above 70%. “Supervisor expectations and actions promoting patient safety” (88%), “feedback and communication about incidents” (87%), and a “non-punitive response to mistakes” (78%) had high average scores, while “staffing” (46%) and “training and skills” (56%) had the lowest average scores. Managers reported higher scores on all dimensions, except for “compliance with procedures” compared with other staff groups. Educational level had less influence on staff’s perceptions of patient safety culture than management position. The ten NHSOPSC dimensions explained 47.2% of the variance for the overall rating question “Please give this nursing home an overall rating on patient safety” (F [10, 384] = 34.39, p < 0.001). “Management and organizational learning” had the strongest unique contribution (28.1%). This study suggests that staff working at the bedside have confidence in their nursing managers’ attention to patient safety issues and that a non-punitive environment is prevalent in Norwegian nursing homes.

Assessment of the triglyceride glucose index in adult patients with chronic diarrhea and constipation

BACKGROUND Accumulating evidence suggests that the gut microbiome is involved in the pathogenesis of insulin resistance(IR).However,the link between two of the most prevalent bowel disorders,chronic diarrhea and constipation,and the triglyceride glucose(TyG)index,a marker of IR,has not yet been investigated.AIM To investigate the potential association between TyG and the incidence of chronic diarrhea and constipation.METHODS This cross-sectional study enrolled 2400 participants from the National Health and Nutrition Examination Survey database from 2009-2010.TyG was used as an exposure variable,with chronic diarrhea and constipation as determined by the Bristol Stool Form Scale used as the outcome variables.A demographic investigation based on TyG quartile subgroups was performed.The application of multivariate logistic regression models and weighted generalized additive models revealed potential correlations between TyG,chronic diarrhea,and constipation.Subgroup analyses were performed to examine the stability of any potential associations.RESULTS In the chosen sample,chronic diarrhea had a prevalence of 8.00%,while chronic constipation had a prevalence of 8.04%.In multiple logistic regression,a more prominent positive association was found between TyG and chronic diarrhea,particularly in model 1(OR=1.45;95%CI:1.17-1.79,P=0.0007)and model 2(OR=1.40;95%CI:1.12-1.76,P=0.0033).No definite association was observed between the TyG levels and chronic constipation.The weighted generalized additive model findings suggested a more substantial positive association with chronic diarrhea when TyG was less than 9.63(OR=1.89;95%CI:1.05-3.41,P=0.0344),and another positive association with chronic constipation when it was greater than 8.2(OR=1.74;95%CI:1.02-2.95,P=0.0415).The results of the subgroup analyses further strengthen the extrapolation of these results to a wide range of populations.CONCLUSION Higher TyG levels were positively associated with abnormal bowel health.

Violence study of healthcare workers and systems in the Caribbean:ViSHWaS-Caribbean study

BACKGROUND Violence against healthcare workers(HCWs)in the Caribbean continues to prevail yet remains underreported.Our aim is to determine the cause,traits,and consequences of violence on HCWs in the Caribbean.AIM To determine the cause,traits,and consequences of violence on HCWs in the Caribbean.METHODS This research adopted an online cross-sectional survey approach,spanning over eight weeks(between June 6th and August 9th,2022).The survey was generated using Research Electronic Data Capture forms and followed a snowballing strategy to contact individuals using emails,social media,text messages,etc.Logistic regression analysis was performed to evaluate the variables that influence violence,including gender,age,years of experience,institution type,and night shift frequency.RESULTS The survey was completed by 225 HCWs.Females comprised 61%.Over 51%of respondents belonged to the 21 to 35 age group.Dominica(n=61),Haiti(n=50),and Grenada(n=31)had the most responses.Most HCWs(49%)worked for government academic institutions,followed by community hospitals(23%).Medical students(32%),followed by attending physicians(22%),and others(16%)comprised the most common cadre of respondents.About 39%of the participants reported experiencing violence themselves,and 18%reported violence against colleague(s).Verbal violence(48%),emotional abuse(24%),and physical misconduct(14%)were the most common types of violence.Nearly 63%of respondents identified patients or their relatives as the most frequent aggressors.Univariate logistic regression analyses demonstrated that female gender(OR=2.08;95%CI:1.16-3.76,P=0.014)and higher frequency of night shifts(OR=2.22;95%CI:1.08-4.58,P=0.030)were associated with significantly higher odds of experiencing violence.More than 50%of HCWs felt less motivated and had decreased job satisfaction post-violent conduct.CONCLUSION A large proportion of HCWS in the Caribbean are exposed to violence,yet the phenomenon remains underreported.As a result,HCWs’job satisfaction has diminished.

Factors associated with recommendation behaviors of four non-National Immunization Program vaccines:a cross-sectional survey among public health workers in China

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.

Primary Care Practitioners’ Views on the Use of Proton Pump Inhibitors Associated with Alginate-Antacids for Better Gastroesophageal Reflux Disease Symptom Control: Results of a National Survey in Spain

Background: Gastroesophageal reflux disease (GERD) is a prevalent disease in Western countries. Despite effective treatment modalities, in some patients total symptom control is not achieved in clinical practice. A cross-sectional study was designed to assess primary care practitioners’ views on the effectiveness of proton pump inhibitors (PPI) as monotherapy in the control of the most common symptoms of GERD (heartburn and regurgitation), as well as to determine the level of implementation of the “combined therapy” (PPI + alginate-antacids). Methods: A questionnaire on different aspects of the management of GERD was completed by 1491 primary care physicians. The questionnaire was composed of 11 close-ended questions with one-choice answer, with a total of 52 items, covering the main data from patients presenting with GERD. Results: Treatment with PPI alone was mostly considered insufficient for the control of GERD symptoms. The combined treatment of PPI + alginate-antacids was used for 37% and 21% of physicians for treating heart-burn and regurgitation, respectively. A better control of symptoms, an increase in the onset of action and to reduce nocturnal acid breakthrough were the most frequently argued reasons for the use of PPI + alginate-antacids. A high percentage of participants believed that treatment with PPI alone was insufficient for the control of symptoms and 39.8% of physicians reported the persistence of heartburn, 38.6% the persistence of regurgitation and 43.2% the persistence of epigastric discomfort in more than 25% of their patients treated with PPI as monotherapy. The most common schedule for the use of the antacid medication was on demand. Conclusions: Spanish primary care physicians consider that a high proportion of GERD patients continue to suffer from symptoms during PPI treatment alone. Ondemand “combined therapy” (PPI + antacid) is considered an efficient option to control reflux symptoms still troublesome in patients with PPI treatment alone.

Sleep Duration and Factors Related to Sleep Loss in 3-14-Year-Old Children in Beijing： A Cross-Sectional Survey

Background： It is known that short sleep duration adversely affects children＇s behavior and physical development. This study aimed to investigate the status of sleep duration in 3-14-year-old children in Beijing and explore the related factors of sleep loss with them. Methods： In this study, a cross-sectional study of random stratified cluster sampling was conducted on 3-14-year-old children and adolescents in Beijing. According to the proportion of children in each district and school, the final cohort included a total of 11 kindergartens, 7 primary schools, and 8 junior high schools from 7 districts of Beijing. Children of sampled classes were included, and their parents were invited to fill a series of questionnaires including the simplified Chinese version of Pediatric Sleep Questionnaire, Sleep Questionnaire Scale, and Hong Kong-Children Sleep Questionnaire about the performance of the last 6 months. Results： Out of the total 11,420 questionnaires, 9198 questionnaires were valid and effective with the response rate of 80.54%. The age of the investigated children was 8.8 ± 3.8 years, including 4736 males and 4462 females. The daily sleep duration of children in Beijing was 9.7 ± 0.7 h. The prevalence of sleep loss （〈9 h/day） of children in Beijing was 11.8%. The daily sleep duration of children aged 〈6, 6 ≤ age 〈11, and ≥11 years was 9.7 ± 0.6 h, 9.6 ± 0.6 h, and 9.5 ± 0.8 h, respectively. The sleep duration reduced significantly in children aged ≥11 years as compared to younger children in Beijing which was mainly contributed by the variation tendency of sleep duration on weekdays. The multivariate logistic regression analysis identified factors associated with sleep loss （P 〈 0.05）： male （odds ratio [OR] = 1.32, 95% confidence interval [CI ]： 1.15-1.51 ）, age ≥11 years （OR = 2.37, 95% CI： 1.92-2.93）, overweight （OR = 1.34, 95% CI： 1.17-1.54）, family history of snoring （OR - 1.35, 95% CI： 1.13-1.61 ） and activities before bedtime with watching TV （OR = 1.24, 95% CI： 1.08 1.43）, sports （OR = 1.22, 95% C/： 1.01-1.48）, playing cellphone （OR = 1.91,95% CI： 1.31-2.73） and surfing the Internet （OR = 1.27, 95% CI： 1.06-1.52） and among them age 〉11 years and playing cellphone betbre bedtime had greater impact on children＇s short sleep duration than that of other factors. Conclusions： Sleep loss was common among 3-14-year-old children in Beijing. Sleep duration decreased with age, especially among children over 11 years old. Factors associated with sleep loss covered sociodemographic characteristics, family sleep habits and routine activities before bedtime, and among those variables, age ≥11 years and playing with cellphones before bedtime had a greater impact on sleep duration, indicating that existing sleep loss in 3-14-year-old children could be, at least partly, improved by paying more attention to children aged of l I years or entering Grade 5 and Grade 6 and to children with a family history of snoring; by reducing the use of electronic products betbre bedtime, especially cellphones; by managing weight and keeping fit; and by improving the bedtime routine.

Antimicrobial stewardship program in China’s tertiary hospitals in 2018:a nationwide cross-sectional online survey

In the present study,we aimed to assess the development of the antimicrobial stewardship(AMS)program in China’s tertiary hospitals to identify the potential challenges for the AMS program and provide references and benchmarks for strategic policymaking.A nationwide cross-sectional study was conducted online by sending questionnaires to tertiary hospitals under China Antimicrobial Resistance Surveillance System(CARSS).The questionnaire included 5 sections regarding structure,technical support,antimicrobial use management,antimicrobial use surveillance,and education.Descriptive statistics were used for data analysis.Of the 1044 tertiary hospitals under CARSS,13.4%(140)hospitals participated in the study.Among them,99.3%(139/140)set up the AMS program.The hospital president(82.1%,115/140)and medical service department(59.3%,83/140)were responsible for AMS outcomes in most hospitals.Structured antimicrobial formulary restriction management was adopted by 99.3%(139/140)hospitals.Infectious disease department,infection control department,and microbiological laboratories were established in 87.1%(122/140),99.3%(139/140)and 100%(140/140)hospitals,respectively.Up to 85.6%(124/140)hospitals applied clinical pathways,and 33.6%(47/140)hospitals implemented hospital-specific guidelines for infectious diseases.Outpatient prescription auditing,inpatient prescription auditing,and prophylactic antimicrobial prescription auditing of aseptic operation were performed in 99.3%(139/140),98.6%(138/140)and 95.7%(134/140)hospitals,respectively.Up to 97.1%(136/140)hospitals participated in antimicrobial use surveillance network,and 99.3%(139/140)hospitals established the specialized management of carbapenem and tigecycline.Staff education and public education were provided with various ways and frequencies in 100%(140/140)and 90.0%(126/140)hospitals,respectively.AMS programs in China’s tertiary hospitals were primarily headed by hospital presidents and involved collaboration among various disciplines and administrative departments.More efforts should be put to further promote and strengthen the development of hospital-specific guidelines and the establishment of a progress and outcome evaluation system.

Behavioral Risk Profile of Men Who Have Sex with Men in Beijing, China： Results from a Cross-sectional Survey with Randomized Response Techniques

Background：Human immunodeficiency virus （HIV） is spreading rapidly among men who have sex with men （MSM） in China.Anonymous questionnaires or direct interviews have been frequently used to study their behavior.The aim of the study was to describe the behavioral risk profile of the MSM in Beijing using the randomized response techniques （RRTs）.Methods：A cross-sectional survey of sexual behavior among a sample of MSM was conducted in two HIV counseling and testing clinics in Beijing.The survey was carried out with an anonymous questionnaire containing sensitive questions on sexual behavior.To obtain the honest responses to the sensitive questions,three distinctive RRTs were used in the questionnaire：（1） Additive randomized response model for quantitative questions,（2） randomized response model for multiple choice questions,and （3） Simmons randomized response model for binomial questions.Formulae for the point estimate,variance,and confidence interval （CI） were provided for each specific model.Results：Using RRTs in a sample of 659 participants,the mean age at first homosexual encounter was estimated to be 21.7 years （95% CI：21.2-22.2）,and each had sex with about three （2.9,95% CI：2.4-3.4） male partners on average in the past month.The estimated rate for consistent condom use was 56.4% （95% CI：50.1-62.8%）.In addition,condom was estimated to be used among 80.0% （95% CI：74.1-85.9%） of the population during last anal sex with a male partner.Conclusions：Our study employed RRTs in a survey containing questions on sexual behavior among MSM,and the results showed that RRT might be a useful tool to obtain truthful feedback on sensitive information such as sexual behavior from the respondents,especially in traditional Chinese cultural settings.

Treatment of epilepsy in China Formal or informal?

Antiepileptic drugs are the preferred treatment approach for epileptic patients. However, informal treatment is important for intractable epilepsy. In this study, 500 epileptic patients were recruited from the General Hospital of Beijing Military Area Command of Chinese PLA during the period of October 2009 to January 2012. These involved patients that had been medically treated for at least 1 year. Information on the initial treatment and changes to treatment regimens for each patient was collected through questionnaires. The survey results showed that 52.3% of the epileptic patients searched for treatment after the first seizure, and the mean numbers of seizures was 12.8; 59.8% of the epileptic patients were diagnosed at the first visit, and the mean onset time was 17 months after the first seizure. After diagnosis, patients were treated for an average of 20 days, and the median time was 1 day. Formal anti-epileptic drugs were selected as the first treatment regimen by 67.8% of patients, and 77.5% of these drugs were monotherapies. The mean and median numbers of seizure were respectively 36.9 and 3.0 times before the first regimen was changed. The regimen was changed within the first 6 months by 46.6% of patients, and after the first and second years of treatment, the proportions increased to 54.0% and 71.8%, respectively. In total, 78.5% of the regi- mens were changed to informal treatments. The informal treatment of epilepsy in China is common, being initiated by either patients or physicians. Enhancing epileptic treatment services in hospital, improving physicians＇ professional quality, and strengthening health propaganda may promote the normalization of drug treatment of epilepsy in China.

Prevalence of diarrhoea and risk factors among children under five years old in Mbour,Senegal:a cross-sectional study

Background:Diarrhoeal diseases remain an important cause of mortality and morbidity among children,particularly in low-and middle-income countries.In Senegal,diarrhoea is responsible for 15%of all deaths in children under the age of five and is the third leading cause of childhood deaths.For targeted planning and implementation of prevention strategies,a context-specific understanding of the determinants of diarrhoeal diseases is needed.The aim of this study was to identify risk factors of diarrhoeal diseases in children under the age of five in Mbour,Senegal.Methods:Between February and March 2014,a cross-sectional survey was conducted in four zones of Mbour to estimate the burden of diarrhoeal diseases(i.e.diarrhoea episodes in the 2 weeks preceding the survey)and associated risk factors.The zones covered urban central,peri-central,north peripheral and south peripheral areas.Overall,596 households were surveyed by a questionnaire,yielding information on sociodemographic,environmental and hygiene behavioural factors.Univariable and multivariable logistic regression analyses were used to identify risk factors associated with the occurrence of diarrhoea.Results:The reported prevalence of diarrhoea among children under the age of five during the 2 weeks preceding the survey was 26%.Without adjustment,the highest diarrhoea prevalence rates were observed in the peri-central(44.8%)and urban central zones(36.3%).Multivariable regression revealed significant associations between diarrhoeal diseases and unemployment of mothers(adjusted odds ratio[aOR]=1.62,95%confidence interval[CI]:1.18-2.23),use of open bags for storing household waste(aOR=1.75,95%CI:1.00-3.02),evacuation of household waste in public streets(aOR=2.07,95%CI:1.20-3.55),no treatment of stored drinking water(aOR=1.69,95%CI:1.11-2.56)and use of shared toilets(aOR=1.69,95%CI:1.11-2.56).Conclusion:We found a high prevalence of diarrhoea in children under the age of five in Mbour,with the highest prevalence occurring in the central and peri-central areas.These findings underscore the need for public health interventions to alleviate the burden of diarrhoea among vulnerable groups.Promotion of solid waste disposal and reduction of wastewater exposure should be implemented without delay.

Epidemiology of School-Related Injuries in Belgium. A Better Knowledge for a Better Prevention

The landmark Convention on the Rights of the Child states that children around the World have right to safe environment. In Belgium, as in many countries, children spend, on average, 4.5 weekdays at school, during nearly 8 hours per day. Studies have shown that, the risk of school-related injury exceeds the risk during leisure time. Literature reports that school accidents account for 10 to 30% of all accidents among pupils. Despite that, few papers treat of the school-related injuries. Consequently, based on 1540 accidents forms from an insurance company, injury places, mechanisms involved, body parts injured and nature of injuries were described. Head injuries, upper and lower limbs injuries were investigated in more details. Pearson’s chi-square test was used to assess the relationships between the variables and multivariate logistic regression models were used to study the three specific types of injuries cited above. Gender ratio (M/F) was equal to 1.6 with 25.9% of children under 6 years, 29.4% of 6 - 9 years, 26.9% of 10 - 12 years and 17.8% from 13 years or more. The major places of injuries were the playground (56.9%) and the physical education (19.7%). Falls were observed in 52.1% of cases and contacts were reported in 24.3%. The head injuries account for 40.6%, the upper limbs for 32.0% and the lower limbs injuries for 20.2%. The bruises and the scratches were observed in 23.8% and the wounds in 21.5%. Fractures were reported in 16.1%. In conclusion, having a routine access to the data from the insurance companies could be an important source of information for an injury surveillance system in which the school injuries will be included. Taking into account this data will require an awareness of all the concerned persons about the relevance of such a system and a harmonization of the accidental forms.