Development and validation of a prediction model for early screening of people at high risk for colorectal cancer

BACKGROUND Colorectal cancer(CRC)is a serious threat worldwide.Although early screening is suggested to be the most effective method to prevent and control CRC,the current situation of early screening for CRC is still not optimistic.In China,the incidence of CRC in the Yangtze River Delta region is increasing dramatically,but few studies have been conducted.Therefore,it is necessary to develop a simple and efficient early screening model for CRC.AIM To develop and validate an early-screening nomogram model to identify individuals at high risk of CRC.METHODS Data of 64448 participants obtained from Ningbo Hospital,China between 2014 and 2017 were retrospectively analyzed.The cohort comprised 64448 individuals,of which,530 were excluded due to missing or incorrect data.Of 63918,7607(11.9%)individuals were considered to be high risk for CRC,and 56311(88.1%)were not.The participants were randomly allocated to a training set(44743)or validation set(19175).The discriminatory ability,predictive accuracy,and clinical utility of the model were evaluated by constructing and analyzing receiver operating characteristic(ROC)curves and calibration curves and by decision curve analysis.Finally,the model was validated internally using a bootstrap resampling technique.RESULTS Seven variables,including demographic,lifestyle,and family history information,were examined.Multifactorial logistic regression analysis revealed that age[odds ratio(OR):1.03,95%confidence interval(CI):1.02-1.03,P<0.001],body mass index(BMI)(OR:1.07,95%CI:1.06-1.08,P<0.001),waist circumference(WC)(OR:1.03,95%CI:1.02-1.03 P<0.001),lifestyle(OR:0.45,95%CI:0.42-0.48,P<0.001),and family history(OR:4.28,95%CI:4.04-4.54,P<0.001)were the most significant predictors of high-risk CRC.Healthy lifestyle was a protective factor,whereas family history was the most significant risk factor.The area under the curve was 0.734(95%CI:0.723-0.745)for the final validation set ROC curve and 0.735(95%CI:0.728-0.742)for the training set ROC curve.The calibration curve demonstrated a high correlation between the CRC high-risk population predicted by the nomogram model and the actual CRC high-risk population.CONCLUSION The early-screening nomogram model for CRC prediction in high-risk populations developed in this study based on age,BMI,WC,lifestyle,and family history exhibited high accuracy.

Correlation between psychological traits and the use of smart medical services in young and middle-aged adults: An observational study

BACKGROUND Psychological problems affect economic development.However,there is a huge gap between mental health service resources and mental health service needs.Existing mental health service technology and platforms cannot meet all the diverse mental health needs of people.Smart medicine is a new medical system based online that can effectively improve the quality and efficiency of medical services and make mental health services accessible.AIM To explore the level of intelligent medical use among young and middle-aged people and its correlation with psychological factors.METHODS Convenience sampling was used to select 200 young and middle-aged patients with medical experience at the Third People's Hospital of Chengdu between January 2022 and January 2023 as the research subjects.The general condition Questionnaire,Eysenck Personality Questionnaire,Symptom Checklist-90,General Health Questionnaire,and Smart Medical Service Use Intention Questionnaire were used to collect data.Pearson’s correlation was used to analyze the correlation between the participants’willingness to use smart medical services and their personality characteristics,psychological symptoms,and mental health.RESULTS The results revealed that the mental health of young and middle-aged people was poor,and some had psycho-logical problems such as anxiety,depression,and physical discomfort.Familiarity,acceptance,and usage of smart healthcare in this population are at a medium level,and these levels correlate with psychological characteristics.Acceptance was positively correlated with E,and negatively correlated with P,anxiety,fear,anxiety/insomnia,and social dysfunction.The degree of use was negatively correlated with P,obsessive-compulsive symptoms,depression,anxiety,hostility,paranoia,and somatic symptoms.CONCLUSION The familiarity,acceptance,and usage of smart medical services among the middle-aged and young groups are related to various psychological characteristics.

Investigation of the Oral Health Status of Patients Based on Rehabilitation Nursing

Objective: To investigate the current situation of knowledge, attitude, and practice (KAP) of oral health among rehabilitation nursing patients, and provide some reference for implementing oral health intervention measures for rehabilitation nursing patients. Method: A total of 231 nursing patients in the rehabilitation department of a tertiary hospital in this city from January 2023 to October 2023 were selected as the research subjects. Their oral health knowledge, attitudes, and behaviors were investigated, and the oral health behavior habits of patients with different genders, education levels, and disease situations were compared. Result: The total awareness rate of oral health knowledge among patients was 73.16%, and the average score of oral health knowledge was 6.58 ± 1.25 points. The overall positive rate of oral health attitude among patients is 55.70%, and the average score of oral health attitude is 5.01 ± 1.04 points. The average score for oral health behavior is 16.87 ± 5.23 points. Only 8.48%, 3.3%, 1.3%, 2.6%, and 0.87% of patients seek timely medical treatment for bleeding tooth roots, gum swelling and pain, gum bleeding, tooth pain, and dental calculus, respectively;Only 5.19% of people change their toothbrush every 3 months, and only 10.39% use the vertical brush method to brush their teeth. The scores of oral health knowledge, attitudes, and behaviors of patients are related to age, educational level, disease type, and smoking situation. The oral health knowledge and attitude scores of elderly patients were lower than those of younger patients, and the difference was statistically significant (P P P P P < 0.05). Conclusion: The oral health status of rehabilitation nursing patients is not optimistic, with a moderate level of oral health knowledge, weak awareness of oral health, and a low qualification rate of oral health behaviors. Strengthening oral health education for rehabilitation nursing patients and incorporating oral health care procedures into rehabilitation nursing procedures is of great significance.

Research and Exploration of Ideological and Political Education in the Course of Pathophysiology

Course based ideological and political education (CIPE) is an important way to improve the quality of ideological and political work and talent cultivation. This study explores for the first time the implementation of ideological and political education in the teaching of pathophysiology courses, and also analyzes the evaluation of student psychological status and the importance of mental health education in the implementation of IPE courses. A survey was conducted on 211 students at Yangtze University to understand their motivation and behavior towards learning ideological, political, and pathophysiological courses. In addition, a questionnaire survey was used to explore the relationship between pathophysiology and ideological and political courses, as well as the importance of their satisfaction with the implementation of ideological and political courses in pathophysiology and mental health education. The research results indicate that factors such as educational background and gender differences affect the learning of CIPE. Graduate students are more interested in ideological and political courses, while female students find it difficult to study pathophysiology;In addition, the results of one-way ANOVA indicate that the implementation effect of IPE in pathophysiology courses depends on the level of interest in IPE and pathophysiology courses, the level of consideration for the importance of professional courses, the professional gains after studying pathophysiology, and the level of understanding of the relationship between IPE and CIPE. 81.04% of students believe that in the CIPE process, telling stories by teachers themselves is the most popular way of communication and education. This reflects the importance of mental health education from the perspective of CIPE. In addition, this study also indicates that PBL and flipped classroom teaching models are popular teaching models in CIPE. This study is beneficial for promoting the improvement and implementation of CIPE and mental health education in higher education curricula, thus providing valuable insights for educational decision-makers.

Adjuvant therapy for hormone receptor-positive breast cancer: Perspective from a survey on breast cancer physicians' acceptance of practice-changing data

A cross-sectional online survey was conducted.A high proportion of the Chinese breast cancer(BC)physician respondents(n=77)would prescribe extended adjuvant endocrine therapy(AET)with aromatase inhibitors(AI)beyond 5 years for postmenopausal females with BC,especially those with higher risk.Respondents with≥15 years of clinical experience were more likely to prescribe a longer duration of AET for low-risk patients.Half of the respondents considered intermittent letrozole as an acceptable option.Most respondents would prescribe adjuvant chemotherapy to genomic high-intermediate risk[Oncotype DX recurrence score(RS)21-25]females aged≤50 years regardless of the clinical risk classification.

Development of a new 17-item Asthenopia Survey Questionnaire using Rasch analysis

AIM:To develop the 17-item Asthenopia Survey Questionnaire(ASQ)-17 by Rasch analysis,and to generate a predictiveness score.METHODS:Totally 739 participants were recruited and 680 were involved in the result analysis in this prospective,cross-sectional study.Three rounds of Rasch analysis were used to analyze the psychometric characteristics of items and options.RESULTS:Phase 1 assessed the original ASQ-19,adjusted the item scoring mode to a four-point Likert response rating scale and combined the 18th and 19th items into a new item.Phase 2 deleted the 11th item.Phases 3 and 4 assessed the new ASQ-17.All the evaluation indexes of ASQ-17 were acceptable.The Infit and Outfit MnSq values of items were 0.67-1.48,the variance explained by the principal component and the unexplained variance explained by the first contrast were 53.90%-59.40%and 1.50-1.80 in three dimensions.The curve peaks of scores in each dimension were separated and in the same order.The PSR and PSI values were 2.80 and 0.89,respectively.The mean scores of dimensions A(9.5±4.1 vs 3.5±3.2),B(7.3±3.3 vs 2.5±2.7),C(4.3±2.2 vs 1.4±2.0)and total(21.1±8.1 vs 7.4±7.0)in asthenopia participants were significantly higher than those without asthenopia(all P<0.001).The area under the curve in two groups was 0.899(P<0.001).Youden’s index was up to the maximum value of 0.784 when the cut-off value was 12.5.CONCLUSION:ASQ-17 has stronger option sorting and suitability than ASQ-19.It is an effective assessment tool for asthenopia with an optimal cut-off threshold value of 12.5,which is suitable for diagnosis and curative effect evaluation.

Ground level utility of Access, Watch, Reserve classification: Insights from a tertiary care center in North India

BACKGROUND The overuse and misuse of antimicrobials contribute significantly to antimicrobial resistance(AMR),which is a global public health concern.India has particularly high rates of AMR,posing a threat to effective treatment.The World Health Or-ganization(WHO)Access,Watch,Reserve(AWaRe)classification system was introduced to address this issue and guide appropriate antibiotic prescribing.However,there is a lack of studies examining the prescribing patterns of antimi-crobials using the AWaRe classification,especially in North India.Therefore,this study aimed to assess the prescribing patterns of antimicrobials using the WHO AWaRe classification in a tertiary care centre in North India.Ophthalmology,Obstetrics and Gynecology).Metronidazole and ceftriaxone were the most prescribed antibiotics.According to the AWaRe classification,57.61%of antibiotics fell under the Access category,38.27%in Watch,and 4.11%in Reserve.Most Access antibiotics were prescribed within the Medicine department,and the same department also exhibited a higher frequency of Watch antibiotics prescriptions.The questionnaire survey showed that only a third of participants were aware of the AWaRe classification,and there was a lack of knowledge regarding AMR and the potential impact of AWaRe usage.RESULTS The research was carried out in accordance with the methodology presented in Figure 1.A total of n=123 patients were enrolled in this study,with each of them receiving antibiotic prescriptions.The majority of these prescriptions were issued to inpatients(75.4%),and both the Medicine and Surgical departments were equally represented,accounting for 49.6%and 50.4%,respectively.Among the healthcare providers responsible for prescribing antibiotics,72%were Junior Residents,18.7%were Senior Residents,and 9.3%were Consultants.These findings have been summarized in Table 1.The prescriptions included 27 different antibiotics,with metronidazole being the most prescribed(19%)followed by ceftriaxone(17%).The mean number of antibiotics used per patient was 1.84±0.83.The mean duration of antibiotics prescribed was 6.63±3.83 days.The maximum number of antibiotics prescribed per patient was five.According to the AWaRe classification,57.61%of antibiotics fell under the Access,38.27%in Watch,and 4.11%in Reserve categories,suggesting appropriate antibiotic selection according to these criteria.The distribution of antibiotics prescribed according to the WHO AWaRe categories is presented in Figure 2.The difference in prescribing frequencies amongst departments can be noted.Most of the antibiotics prescribed in the Access category were from the Medicine department(75.4%),followed by Surgery(24.6%).For Watch antibiotics,Medicine had a higher proportion(63.4%)compared to Surgery(36.6%).In terms of seniority,Junior Residents prescribed the highest number of antibiotics for both Access and Watch categories in Medicine and Surgery departments.Senior residents and Consultants prescribed a lower number of antibiotics in all categories and departments.Only a few antibiotics were prescribed in the Reserve category,with most prescriptions being from the Medicine department.The study also evaluated the Knowledge and Awareness of Healthcare professionals towards the WHO AWaRe classi-fication through a questionnaire survey.A total of 93 participants responded to the survey.Among them,most parti-cipants were Junior Residents(69.9%),followed by Senior Residents(25.8%)and Faculty(4.3%).When enquired if they knew about the WHO AWaRe classification only 33.3%of the participants responded positively.Of those who were aware of the AWaRe classification,the most common source of information was the internet(31.2%),followed by the antimicrobial policy of their institution(15.1%)as seen in Table 2.The survey results on the knowledge and awareness of AMR among healthcare professionals are also presented in Tables 3 and 4.Out of the 93 participants,68(73.1%)agreed that the emergence of AMR is inevitable,while only 13(14.0%)disagreed that AWaRe usage will result in the inability to treat serious infections.Additionally,58(62.4%)agreed that it will lead to lengthier hospital stays,43(46.2%)agreed that the success of chemotherapy and major surgery will be hampered,and the majority also agreed that its use will lead to increased cost of treatment and increased mortality rates.Regarding the utilization of AWaRe in the hospital summarized in Tables 4 and 5,35.5%of the participants agreed that it should be used,while only 2.2%disagreed.Additionally,34.4%agreed that AWaRe reduces adverse effects of inappro-priate prescription.However,37.6%of the participants considered that AWaRe threatens a clinician's autonomy and 30.1%thought that its use can delay treatment.Additionally,the DDD of each drug was also evaluated.The usage of various antimicrobial drugs in a hospital setting,along with their daily doses and DDD according to the WHO's Anatomical Therapeutic Chemical classification system was calculated.Some of the important findings include high usage rates of ceftriaxone and metronidazole,and relatively low usage rates of drugs like colistin and clindamycin.Additionally,some drugs had wider ranges than others.Comparison of WHO defined DDD with Daily Drug dose(Mean)in the studied prescriptions is represented in the Clustered Bar chart in Figure 3.Finally,the Mean Daily Drug Dose for prescribed drugs was compared with WHO defined DDD for each drug using a Student’s T test.The mean daily drug dose of amoxy/clav was significantly higher than the WHO DDD(1.8 vs 1.50,P=0.014),while the mean daily drug dose of metronidazole and doxycycline were significantly lower than the WHO DDD(P<0.001 and P=0.008,respectively).The mean daily drug dose of piperacillin/tazobactam,amikacin,clindamycin,and levofloxacin did not show significant differences compared to the WHO DDD(P>0.05).CONCLUSION This research indicates an appropriate proportion of prescriptions falling under the Access category(57.61%),suggesting appropriate antibiotic selection,a significant proportion also belongs to the Watch category(38.27%),emphasizing the need for greater caution to prevent the escalation of AMR.There is a moderate level of awareness among healthcare professionals about AMR and the steps being taken to tackle it,highlighting the gap in implementation of policies and need for more steps to be taken in spreading the knowledge about the subject.However,there is a significant difference between the WHO DDD and the prescribed daily dose in the analysed prescriptions suggesting overuse and underuse of antibiotics.

COVID-19 Downgraded Already Impaired Mental Health of Medical Undergraduates during the Pandemic Years

Background: Measures to contain the COVID-19 transmission reached teaching routines of universities worldwide with possible mental health consequences for anxiety. This study assessed prevalence and risk factors for stress, depression, and anxiety (SDA) in medical students during quarantine by COVID-19. Methods: A cross-sectional observational study of medical students by means of the DASS-21 questionnaire. Risk factors for SDA were assessed based on epidemiologic questions related to COVID-19. Receiver Operating Characteristics (ROC) curves were calculated for each predictor, as well as sensitivity and specificity. Results: This survey reached 1009 responses. A prevalence of 77.5% for some SDA disorder was found, 63% being severe. Previous diagnosis of psychiatric disorder was a factor of risk for anxiety (OR 2.78 CI95% 1.44 - 14.25, p = 0.044), as well as for depression (OR 3.37 CI95% 1.98 - 6.02, p Conclusion: Psychiatric conditions as well as chronic illnesses were risk factors for high prevalence of anxiety, depression and stress during the COVID-19 pandemic among medical students.

A Study on the Utility of an Electroencephalogram-Based Stress Analysis Method for Seaside and Road Space

Modern society is called the stress society, there has been a growing interest in comfortable living space. Therefore, a lot of studies using biological information have been done to quantitatively assess the effects on the human body in recent years. This study verified quantitatively difference between healing effect and stress reduction effect of sea space and general street space using an inexpensive EEG (Electroencephalogram) machine. The purpose of this study is to verify quantitatively healing effect and stress reduction effect of sea space using the EEG measurement from the psychological analysis by questionnaire survey and the SD (Semantic Differential) method. As a result, EEG and questionnaire results, psychological analysis results can be seen to match, and the effectiveness of the EEG measurement was confirmed.

Development of Tourism Resources of Baimai Spring Park in Jinan City and Its Path Optimization

Tourism is gradually becoming one of the pillar industries of China s economy. Tourism resources are the premise and foundation of tourism development. It is of great significance to study the exploitation of tourism resources to promote the development of tourism. Jinan is famous for water, and Baimai Spring Park is a collection of springs in one place, with rich tourism resources. Coupled with the local government s attention to tourism, Baimai Spring Park, as a representative, has accumulated a rich tourism market foundation. With the support of policies, unique spring ecological and cultural resources and increasingly perfect location conditions, the high-quality development of tourism resources in Baimai Spring Park is particularly urgent. In this study, the present situation and problems of development of tourism resources in Baimai Spring Park were analyzed by questionnaire survey method, and corresponding optimization suggestions were put forward.

Study on the Perceived Value of Zhanjiang Residents to Mangrove Cuisine

Taking mangrove cuisine in Zhanjiang as an example,this paper investigates the residents’perceived value of mangrove cuisine through questionnaire survey.The results show that the overall satisfaction of residents on the mangrove cuisine in Zhanjiang is high.The highest satisfaction of residents on the perceived value of mangrove cuisine is the historical and cultural heritage,and the lowest satisfaction is the local characteristics.The main factor affecting the satisfaction is the utility value.Based on the analysis of the present situation and existing problems of mangrove cuisine resources in Zhanjiang,this paper puts forward some countermeasures and suggestions for the sustainable development of mangrove food in Zhanjiang in terms of strengthening government support,increasing public participation awareness,increasing publicity channels,enhancing popularity and reputation,and paying attention to the inheritance of characteristic food culture.

On Students'Oral Communicative Ability of Dialogue

The present study presents a detailed report implemented to solve the problem that some of my students do not like the dialogue practice I assign them in class.It is hypothesized that the students' oral communication is increased by better-designed dialogue practice.This hypothesis is verified by a four-week practice of well-organized oral work activities.

Multi-center investigation of breast reconstruction after mastectomy from Chinese Society of Breast Surgery:A survey based on 31 tertiary hospitals(CSBrS-004)

Objective:Multi-center data on the current status and trends of breast reconstruction after mastectomy in China are lacking.Herein,we conducted a cross-sectional survey to investigate the current clinical practice pattern of postmastectomy breast reconstruction among Chinese female patients with breast cancer.Methods:A standardized questionnaire used to collect information on breast reconstruction among females diagnosed with breast cancer was distributed by 31 members of the Chinese Society of Breast Surgery between January 1,2018 and December 31,2018.Information was collected on tumor characteristics,treatment,mesh application,nipple-areola complex(NAC)preservation,postoperative complications,bilateral reconstruction,patient satisfaction and local recurrence.The overall rate of breast reconstruction was assessed,and the characteristics were compared across patient groups with different reconstruction approaches.Results:A total of 1,554 patients underwent breast reconstruction after total mastectomy,with a reconstruction rate of 9.6%.Among them,1,190 were implant-based,and 262 underwent autologous reconstructions,while 102 cases underwent a combination of both.Patients who underwent implant-based reconstruction were younger than those who received autologous reconstruction(40.1±4.6 vs.45.0±5.9,P=0.004).Compared to patients with autologous reconstruction,mesh application(25.5%vs.6.5%),NAC preservation(51.8%vs.40.5%)and reconstruction failure(1.8%vs.0)were more frequently reported among those with implant-based reconstruction.There was no significant difference in general satisfaction across three reconstruction approaches,though patients with autologous reconstruction reported the highest aesthetic satisfaction among the three groups(P=0.044).Conclusions:Implant-based breast reconstruction remains the dominant choice among patients,while autologous reconstruction was associated with higher aesthetic satisfaction.Our multi-center investigation based on the findings of the tertiary hospitals of Chinese Society of Breast Surgery may guide a future series of clinical studies on breast reconstruction in China.

Analysis of adversity quotient of nursing students in Macao:A crosssection and correlation study

Objectives: To investigate the adversity quotient (AQ) of Macao undergraduate nursing students and analyse its influencing factors.Methods:A cross-section design was used,and a convenience sample of nursing students(n=158 valid)was selected from a tertiary institute in Macao.In addition to demographic questions,the Chinese versions of the Adversity Quotient Scale,the Emotional Intelligence(EI)Scale,the Simplified Coping Style Questionnaire and the Parenting Styles Scale were used to assess the students'characteristics.Results:The average AQ score of the students was 116.72±11.39.AQ scores were negatively correlated with coping-negative,and maternal style(excessive interference,excessive protection)(r=-0.332,P<0.001;r=-0.167,P=0.036).Coping-negative entered the regression equation(F=19.154,P<0.001).The female nursing students had higher scores in ownership dimension of AQ than their male counterparts(31.98±3.26 vs.29.21±3.08,t=-4.442,P<0.001).Conclusions:The average AQ scores of Macao undergraduate nursing students were moderate.The female nursing students are more likely to attribute the cause of adversity to themselves,and specific psychosocial and cultural issues may be at play.There is a necessity for Macao nursing students to improve their ability to overcome setbacks.Special attention should be paid to the cultivation of students'positive coping styles.

Downtown Retailing Development Under Suburbanization——A Case Study of Beijing

The role of retailing has diminished in the center of cities of Western countries since its heyday in the 1920s. This trend was caused by violent transformations in the economic, social and locational contexts which involve resi- dential suburbanization, as well as new forms of commercial development out of town. As far as transforming China is concerned, the downtown retailing center has also come to turning point of development in the context of suburbaniza- tion. Based on the survey of Beijing residents’ shopping behavior, the present research tends to making clear the actual change and development problem of downtown retailing center. Combining with the macro retailing environment, re- lated influencing factors are further discussed too. Study results show that downtown retailing still plays an important part in resident’s shopping activity. However, with rapid urban sprawl, retailing in urban center has been greatly threatened by booming out-of-town commerce. In the course of such spatial change, the suburbanization of resident, the prevalence of new commercial forms and the change of consumers’ life style all have exerted their own pressure on downtown retailing. But for the special socioeconomic background of development and the support of government policy, it will still keep its vitality of retailing for a long period of time.

Associated factors of professional identity among nursing undergraduates during COVID-19:A cross-sectional study

Objectives Professional identity plays an important role in the long-term development of nurses,and it will change when public health emergency occurs.The objective of this study is to investigate the factors associated with the professional identity of nursing undergraduates in the epidemic of COVID-19.Methods A cross-sectional survey design with convenience sampling was used.A total of 3,875 nursing undergraduates were recruited from seven universities across China from March to April 2020.A general information questionnaire was used to collect students’information,and the Professional Identity Questionnaire for Nurse Students was used to survey their professional identity during the early and later stages of the first wave of the COVID-19 epidemic.Results The score of professional identity in the later stage(59.49±12.41)was higher than that in the early stage(56.96±12.61).The stepwise regression indicated that several factors were associated with professional identity,including gender,residential area,major,impact of the epidemic on intention to work after graduation,reasons for choosing nursing major and students’scores of professional identity in early stage.Conclusions Nursing educators can utilize the positive impact of responding to public health emergencies to increase the professional identity of students.Meanwhile,educators should give those students with lower professional identity more targeted education to cultivate their professional identity after the occurrence of public health emergencies.

Farmers′ Perception to Farmland Conversion: A Questionnaire Survey in Xining City, Qinghai Province, China

China is experiencing a fast process of farmland conversion which is conducted mainly by local governments to fuel economic development.Social tension is aroused and policy makers take great concerns on coordinating interests among different stakeholders,especially for increasing farmers′ interest.The purpose of this study is to get some insights related to land acquisition institution by exploring farmers′ perception to farmland conversion.Participatory Rural Appraisal(PRA) was applied for the investigation in peri-urban area,of Xining City,Qinghai Province,China.The total of 519 householders from 15 villages completed valid questionnaire survey from July to November,2012.The results indicate that farmland conversion has several impacts on farmers′ life.Most farmers are gradually adapting to city life.Higher living expenses and more income are perceived by farmers with average score of 4.21 and 2.69,respectively.The average scores of 2.38 and 2.46 are for improvement of life security and more job opportunities.Farmers expect to get some stable ways of compensation in addition to lump-sum compensation in cash.Stable subsidies every year and obtaining same number of land received strong proposal.And these two options are cited by 49.6% and 43.9% of respondents.Farmland conversion brings about cleaner living condition and more amenities,but lower air visibility and drier air.Results reflect landless farmers′ economic and life pressures and various demands.Local government should pay more attention to increase farmers′ income and improve rural security system.

How to improve patient satisfaction during midazolam sedation for gastrointestinal endoscopy?

To determine the procedure-related factors that affect sedation satisfaction and to make a suggestion to improve it.METHODSWe prospectively enrolled a total of 456 patients who underwent outpatient endoscopy procedures with midazolam sedation between March 2014 and August 2014. All patients completed both pre- and post-endoscopy questionnaires about sedation expectations and satisfaction.RESULTSThe study cohort included 167 (36.6%) patients who underwent esophagogastroduodenoscopy (EGD), 167 (36.6%) who underwent colonoscopy, and 122 (26.8%) who underwent a combined procedure (EGD and colonoscopy). Over 80% of all patients were satisfied with sedation using midazolam. In univariate and multivariate analyses, total procedure time in the EGD group, younger age (≤ 50 years), and longer colonoscopy withdrawal time in the colonoscopy group were related to decreased satisfaction with sedation. However, in active monitoring and intervention group, there was no decrease in grade of satisfaction despite longer procedure time due to more procedures during colonoscopy. Younger age (≤ 50 years), longer inter-procedure time gap, and colonoscopy withdrawal time were related to decreased satisfaction in the combined EGD and colonoscopy group.CONCLUSIONMidazolam is still a safe and effective sedative for gastrointestinal endoscopy. Satisfaction with sedation depends on several factors including age (≤ 50 years) and procedure time duration. To improve patient satisfaction with sedation, active monitoring of sedation status by the endoscopist should be considered for patients who require long procedure time.

HIV/AIDS related perception and behavior: A comparative study among college students of different majors in China

Objective:In order to carry out proper education and intervention of AIDS based on different features and demands of different majors,this study aimed to compare the difference of college students from six majors in China in the aspects of AIDS-related knowledge,attitudes and behaviors.Methods:A questionnaire survey was carried out among 18,644 students in 30 colleges/universities from 9 provinces of China,who were recruited through stratified cluster sampling.AIDS-related knowledge,attitude,condom-use intention,self-efficacy and sexual behavior of these students were investigated.Results:AIDS-related knowledge level of students majoring in education was the lowest while that of medical students was the highest as well as highest self-efficacy of condom use.Students of music or fine arts had the strongest intention to use condoms,while the students majoring in education had the weakest.The sexually active percentages of male students from different majors ranked as follows:music or fine arts(29.5%),minority nationality(12.2%),science&tech(10.9%),medicine(10.6%),educationmajor(10.0%),and liberal arts(8.2%).Among female students,the rank was music or fine arts(11.0%),science&tech(6.2%),education-major school(4.5%),minority nationality(4.5%),liberal arts(4.1%),and medicine(2.8%).Conclusion:It is urgent to enhance proper AIDS-related education and intervention based on the features and demands of students from different majors or universities,for example,to enhance comprehensive AIDS prevention education among students major in education and to increase behavioral skills to prevent sexually transmitted diseases among students from colleges or faculty of music or fine arts.

Abusive supervision and turnover intention: Mediating effects of psychological empowerment of nurses

Objective: This study aims to determine the mediating effects of psychological empowerment on abusive supervision and turnover intention as perceived by nurses to provide information to change the status of nurse turnover.Methods: A cross-sectional survey (a questionnaire examining perceptions of abusive supervision,measurement of psychological empowerment,and questionnaire for turnover intention) was used to collect data.A total of 1127 clinical nurses,who were recruited through convenience sampling,participated in the survey.Results: Nurses' average perceived abusive supervision,psychological empowerment,and turnover intention scores were 1.62 ± 0.95,3.24 ± 0.83,and 14.17 ± 3.78,respectively.Psychological empowerment was found to mediate the relationship between abusive supervision and turnover intention (P< 0.01).Turnover intention tends to be stronger and psychological empowerment reduced when nurse managers adopt an abusive leadership style.Conclusions: Nurses' psychological empowerment is an intermediary variable that predicts the relationship between abusive supervision and turnover intention.Nurse managers should manage abusive supervision to increase nurses' psychological empowerment and decrease turnover intention.