The association between second-hand smoke exposure and depressive symptoms among pregnant women

Tobacco smoking and depression are strongly associated, but the possible association between second-hand smoke (SHS) exposure and depression is unclear. This study aimed to examine the possible relation between SHS exposure and depressive symptoms among pregnant women. A cross-sectional survey was conducted in Shenzhen, China, using a multistage sampling method. The univariable and multivariable logistic regression models were used to explore the associations between SHS exposure and depressive symptoms. Among 2176 pregnant women, 10.5% and 2.0% were classified as having probable and severe depressive symptoms. Both binary and multinomial logistic regression revealed that there were significantly increased risks of severe depressive symptoms corresponding to SHS exposure in homes or regular SHS exposure in workplaces using no exposure as reference. In addition, greater frequency of SHS exposure was significantly associated with the increased risk of severe depressive symptoms. Our findings suggest that SHS exposure is positively associated with depressive symptoms in a dose-response manner among the pregnant women.

Research on the influencing factors of reverse logistics carbon footprint under sustainable development

With the concerns of ecological and circular economy along with sustainable development, reverse logistics has attracted the attention of enterprise. How to achieve sustainable development of reverse logistics has important practical significance of enhancing low carbon competitiveness. In this paper, the system boundary of reverse logistics carbon footprint is presented. Following the measurement of reverse logistics carbon footprint and reverse logistics carbon capacity is provided. The influencing factors of reverse logistics carbon footprint are classified into five parts such as intensity of reverse logistics, energy structure, energy efficiency, reverse logistics output, and product remanufacturing rate. The quantitative research methodology using ADF test, Johansen co-integration test, and impulse response is utilized to interpret the relationship between reverse logistics carbon footprint and the influencing factors more accurately. This research finds that energy efficiency, energy structure, and product remanufacturing rate are more capable of inhibiting reverse logistics carbon footprint. The statistical approaches will help practitioners in this field to structure their reverse logistics activities and also help academics in developing better decision models to reduce reverse logistics carbon footprint.

Factors influencing adsorption and desorption of trimethoprim on marine sediments: mechanisms and kinetics

Adsorption-desorption behavior of ionic antibiotics in natural aquatic environment is complex, especially in coastal or estuary area where influencing factors such as pH and salinity usually varied in a wide range. In this study, batch-type and stirred flow chamber (SFC) experiments were carried out to simulate the sorption-desorption behavior of trimethoprim (TMP) in seawater-sediment system. Equilibrium and kinetic modeling were carried out to determine the rate and extent of TMP sorption on two marine sediments with different properties. Sediment BHB (K _d , 6.40 L kg^-1) has a greater sorption capacity compared with sediment LZB (K _d , 3.40 L kg^-1), which is related to the higher content of organic carbon and clay of sediment BHB. Adsorption of TMP varied in the pH range of 6.9 to 8.1 with maximum adsorption at pH 7.4. Increasing salinity and presence of phosphate and nitrate led to decreased TMP sorption. Attenuated total reflection Fourier transform infrared (ATR-FTIR) analysis demonstrated the formation of hydrogen bond between TMP and marine sediments. Adsorption of TMP on marine sediments was a non-equilibrium process that can be described with second-order kinetic model. Our analysis suggested that chemical non-equilibrium was the rate controlling process and intraparticle diffusion was also involved in TMP adsorption. A moderate desorption percentage (16.4-22.8% for LZB and 32.5-42.0%for BHB) was observed. Overall, the results showed that environmental factors and time-dependent processes need to be considered in modeling the fate and transport of TMP in coastal/estuarine waters.

Is environmental sustainability a strategic priority for logistics service providers?

Despite an increasing number of third-party logistics service providers (3PLs) regard environmental sustainability as a key area of management, there is still great uncertainty on how 3PLs implement environmental strategies and on how they translate green efforts into practice. Through a multiple case study analysis, this paper explores the environmental strategies of a sample of medium-sized 3PLs operating in Italy and the UK, in terms of environmental organizational culture, initiatives, and influencing factors. Our analysis shows that, notwithstanding environmental sustainability is generally recognised as a strategic priority, a certain degree of diversity in the deployment of environmental strategies still exists. This paper is original since the extant literature on green strategies of 3PLs provides findings predominantly from a single country perspective and mainly investigates large/multinational organizations. It also provides indications to help managers of medium-sized 3PLs in positioning their business. This is particularly meaningful in the 3PL industry, where medium-sized organizations significantly contribute to the generated turnover and market value.

Spatiotemporal analysis of tuberculosis incidence and its associated factors in mainland China

Spatiotemporal analysis is an important tool to monitor changes of tuberculosis (TB) epidemiology, identify high-risk regions and guide resource allocation. However, there are limited data on the contributing factors of TB incidence. This study aimed to investigate the spatiotemporal pattern of TB incidence and its associated factors in mainland China during 2005-2013. Global Moran's I test, Getis-Ord Gi index and heat maps were used to examine the spatial clustering and seasonal patterns. Generalized Linear Mixed Model was applied to identify factors associated with TB incidence. TB incidence presented high geographical variations with two main hot spots, while a generally consistent seasonal pattern was observed with a peak in late winter. Furthermore, we found province-level TB incidence increased with the proportion of the elderly but decreased with Gross Demographic Product per capita and the male:female ratio. Meteorological factors also influenced TB incidence. TB showed obvious spatial clustering in mainland China and both the demographic and socio-economic factors and meteorological measures were associated with TB incidence. These results provide the related information to identify the high-risk districts and the evidence for the government to develop corresponding control measures.

Policies, Socioeconomic, Institutional and Biophysical Factors Influencing the Change from Rice to Sugarcane in Nong Bua Lamphu Province, Thailand

For the past decade, Thailand pursued a strategy of promoting biofuel crop production, including sugarcane, to meet the ever increasing energy demand and to increase the income of farmers. This study analyzed the influence of policy instruments implemented to promote the sugarcane cultivation, farm household socioeconomic levels, biophysical, and institutional factors driving the conversion of rice fields into sugarcane farms. Primary information was collected from 230 farm households through a structured questionnaire. Relevant policy documents published by the responsible government agencies were the main sources of secondary information collected for policy analysis. The analyses revealed that farmers in the study area converted 25-75% of their rice fields into sugarcane farms as a result of implementation of policy instruments that made sugarcane financially far more attractive than rice. The results of the regression analysis showed that eight variables were found significant and positively influenced the conversion of rice fields into sugarcane farms. These were access to extension services, information, sugarcane loading stations, and ground water for irrigation, and duration of experience in sugarcane farming as well as household head's age and education. Irrespective of landholding size, the majority of farmers were not concerned about food security. In view of the finding, if feasible, in the form of additional price supports and commercial cane sugar index-based pricing strategies to promote sugarcane production should benefit all concerned farmers. Likewise, attention should be paid to deliver essential extension and marketing services in an effective way, particularly to those farmers who are not receiving such services.

Improving local health workers' knowledge of malaria in the elimination phase-determinants and strategies: a cross-sectional study in rural China

BACKGROUND

The current stage of malaria elimination in China requires experienced local health workers with sufficient knowledge of malaria who help to keep the public health system vigilant about a possible resurgence. However, the influencing factors of local health workers' knowledge level are not fully comprehended. This study aims to explore the factors with heavy impact on local health worker's knowledge of malaria and propose corresponding suggestions.

METHODS

Underpinned by stratified sampling method, a cross-sectional survey was carried out between November 2014 and April 2016. Chi square test was performed to identify the factors with potential influence on health workers' knowledge level of malaria. Bivariate logistic regression was employed to explore the relationship between the predictors and local health workers' knowledge level of malaria. Layered Chi square test was used to calculate the homogeneity of the interaction between training approaches and the percentage of participants with high-level knowledge.

RESULTS

The endemic type of county and type of organization played the most significant role in influencing local health workers' knowledge level regarding malaria in the sample population. The participants from Type 1 and Type 2 counties were 4.3 times (4.336 and 4.328, respectively) more likely to have high-level knowledge of malaria than those who work in Type 3 counties. The probability of having high-level knowledge amongst the participants from county-level facilities (county hospitals and CDCs) were more than 2.2 times higher than those who work in villages. Other socio-demographic factors, such as education and work experience, also affected one's knowledge regarding malaria. Amongst the six most-used training approaches, electronic material (OR = 2.356, 95% CI 1.112-4.989), thematic series (OR = 1.784, 95% CI 0.907-3.508) and supervision (OR = 2.788, 95% CI 1.018-7.632) were proven with significant positive impact on local health workers' knowledge of malaria.

CONCLUSION

Village doctors and who served in Type 3 counties were identified as the ones in urgent need of effective training. Three types of training approaches, including electronic material, thematic series and supervision, were proven to be effective in improving local health workers' knowledge. Nevertheless, the coverage of these training approaches was still limited. This study suggests expanding the coverage of training, especially the three particular types of training, to local health workers, particularly to the target populations (village doctors and who served in Type 3 counties). Online training, small group discussion and targeted skill development may be the directions for the future development of training programmes.

Factors associated with liver dysfunction in patients with acute pancreatitis

AIM

To identify the factors associated with liver dysfunction in patients with acute pancreatitis (AP).

METHODS

One hundred and twenty-six patients with AP admitted to our hospital were selected from March 2014 to March 2015 and divided into three groups according to the severity of liver dysfunction: a mild group, a moderate group, and a liver failure group. Clinicla data of patients, including disease etiology, CT examination results, and biochemical indexes, were collected to calculate the modified computed tomography severity index (MCTSI) score, Ranson score and bedside index for severity in acute pancreatitis (BISAP) score, which were then compared among the three groups.

RESULTS

The percentages of patients with severe AP, moderately severe AP, and mild AP differed significantly maong the three groups (P < 0.05). Spearman correlation analysis showed a positive correlation between the severity of AP and that of liver dysfunction (r = 0.271, P = 0.017). Ranson, BISAP, and MCTSI scores differed significantly maong the three groups (P < 0.05). Biliary AP was the most common etiology, followed by alcoholic AP. There was no significant difference in the distribution of biliary AP, alcoholic AP, and hypertriglyceridemia among the three groups.

CONCLUSION

Liver dysfunction in AP patients is caused by many factors, and the severity of AP is positively related to the degree of abnormal liver function. BISAP scoring system can accurately predict the occurrence of liver dysfunction in patients with AP.

[Analysis of dietary pattern and diabetes mellitus influencing factors identified by classification tree model in adults of Fujian]

Objective: To find out the dietary patterns and explore the relationship between environmental factors (especially dietary patterns) and diabetes mellitus in the adults of Fujian. Methods: Multi-stage sampling method were used to survey residents aged ≥18 years by questionnaire, physical examination and laboratory detection in 10 disease surveillance points in Fujian. Factor analysis was used to identify the dietary patterns, while logistic regression model was applied to analyze relationship between dietary patterns and diabetes mellitus, and classification tree model was adopted to identify the influencing factors for diabetes mellitus. Results: There were four dietary patterns in the population, including meat, plant, high-quality protein, and fried food and beverages patterns. The result of logistic analysis showed that plant pattern, which has higher factor loading of fresh fruit-vegetables and cereal-tubers, was a protective factor for non-diabetes mellitus. The risk of diabetes mellitus in the population at T2 and T3 levels of factor score were 0.727 (95%CI:0.561-0.943) times and 0.736 (95%CI: 0.573-0.944) times higher, respectively, than those whose factor score was in lowest quartile. Thirteen influencing factors and eleven group at high-risk for diabetes mellitus were identified by classification tree model. The influencing factors were dyslipidemia, age, family history of diabetes, hypertension, physical activity, career, sex, sedentary time, abdominal adiposity, BMI, marital status, sleep time and high-quality protein pattern. Conclusion: There is a close association between dietary patterns and diabetes mellitus. It is necessary to promote healthy and reasonable diet, strengthen the monitoring and control of blood lipids, blood pressure and body weight, and have good lifestyle for the prevention and control of diabetes mellitus.

[The composition of gut microbiota in infant and its influencing factors]

Gut microbiota provide enzymes and additional biochemical metabolic pathways for the host, which together with the host genome and the external environment, influence the body function. The composition of gut microbiota in infant is closely related to health in later life. However, it is influenced by many factors, including delivery mode, feeding pattern, prenatal diet, pregnancy psychology and antepartum antibiotic treatment. Vaginal delivery and breastfeeding is beneficial for shaping gut microbiota, while cesarean section and formula feeding would reduce the amount of gut dominant bacteria. In addition, inappropriate diet during pregnancy, prenatal stress and antepartum antibiotic treatment alters bacterial colonization of the gut in infant.

[Survey of schistosomiasis KAP and influencing factors of behaviors among residents in Jiangsu Province]

OBJECTIVE

To understand the schistosomiasis control knowledge, attitude, and practice (KAP), and influencing factors of behaviors among residents in Jiangsu Province, so as to provide the evidence for making effective health education and health promotion models.

METHODS

The probability proportionate to size sampling (PPS) and multi-stage sampling methods were adopted to sample the research objects. A questionnaire survey of schistosomiasis control KAP was conducted in the residents of 16 to 69 years old in schistosomiasis endemic areas of Jiangsu Province, and the results were statistically analyzed.

RESULTS

The total awareness rate of the participants was 95.98% for schistosomiasis control knowledge. The correct rates of attitude and practice were 89.06% and 77.43%, respectively. The awareness/correct rates of knowledge, attitude and practice reduced in turns significantly (χ² =1 282.96, P < 0.01). The knowledge awareness rate of fishermen and boatmen was 90.98%, but their attitude correct rate was only 53.81% ( χ² =120.52, P < 0.01). The unconditional logistic regression analysis showed that with the education level increasing, their practice correct rate rose, and the participants with the college degree or above had a higher correct rate compared to illeterate ones (OR = 6.411, 95% CI: 4.896-8.395). The practice correct rate of the fisher-men and boatmen was only 5.1% of the rate of the farmers (OR = 0.051, 95% CI: 0.029-0.091).

CONCLUSIONS

The total awareness rate of basic knowledge of schistosomiasis prevention and control in the residents of Jiangsu Province has reached the requirements in the "National Schistosomiasis Control Long-term Planning Outline (2004-2015)", but the correct rate of behaviors is low. The education level, occupation and residential areas affect the health behaviors of schistosomiasis prevention and control. Therefore, it is necessary to carry out targeted health promotion activities to promote the formation of healthy lifestyle and behaviors.

Influencing factors of alexithymia in Chinese medical students: a cross-sectional study

BACKGROUND

A much higher prevalence of alexithymia has been reported in medical students compared with the general population, and alexithymia is a risk factor that increases vulnerability to mental disorders. Our aim was to evaluate the level of alexithymia in Chinese medical students and to explore its influencing factors.

METHODS

A cross-sectional study of 1,950 medical students at Shenyang Medical College was conducted in May 2014 to evaluate alexithymia in medical students using the Chinese version of the 20-item Toronto Alexithymia Scale (TAS-20). The reliability of the questionnaire was assessed by Cronbach's α coefficient and mean inter-item correlations. Confirmatory factor analysis (CFA) was used to evaluate construct validity. The relationships between alexithymia and influencing factors were examined using Student's t-test, analysis of variance, and multiple linear regression analysis. Statistical analysis was performed using SPSS 21.0.

RESULTS

Of the 1,950 medical students, 1,886 (96.7%) completed questionnaires. Overall, Cronbach's α coefficient of the TAS-20 questionnaire was 0.868. The results of CFA showed that the original three-factor structure produced an acceptable fit to the data. By univariate analysis, gender, grade (academic year of study), smoking behavior, alcohol use, physical activity, history of living with parents during childhood, and childhood trauma were influencing factors of TAS-20 scores (p < 0.05). Multiple linear regression analysis showed that gender, physical activity, grade, living with parents, and childhood trauma also had statistically significant association with total TAS-20 score (p < 0.05).

CONCLUSIONS

Gender, physical activity, grade, history of living with parents during childhood, and childhood trauma were all factors determining the level of alexithymia. To prevent alexithymia, it will be advisable to promote adequate physical activity and pay greater attention to male medical students and those who are in the final year of training.

Levels and distributions of organochlorine pesticides in the soil-groundwater system of vegetable planting area in Tianjin City, Northern China

To study the influence of long-term pesticide application on the distribution of organochlorine pesticides (OCPs) in the soil-groundwater system, 19 soil samples and 19 groundwater samples were collected from agricultural area with long-term pesticide application history in Northern China. Results showed that the composition of OCPs changed significantly from soil to groundwater. For example, ∑DDT, ∑HCH, and ∑heptachlor had high levels in the soil and low levels in the groundwater; in contrast, endrin had low level in the soil and high level in the groundwater. Further study showed that OCP distribution in the soil was significantly influenced by its residue time, soil organic carbon level, and small soil particle contents (i.d. <0.0002 mm). Correlation analysis also indicates that the distribution of OCPs in the groundwater was closely related to the levels of OCPs in the soil layer, which may act as a pollution source.

Unique characteristics of algal dissolved organic matter and their association with membrane fouling behavior: a review

Over the last several decades, the frequent occurrence of algal bloom in drinking water supplies, driven by increasing anthropogenic input and climate change, has posed serious problems for membrane filtration processes, resulting in reduced membrane permeability and increased energy consumption. It is essential to comprehensively understand the characteristics of algal dissolved organic matter (DOM) and the subsequent effects on the filtration processes for better insight into membrane fouling mitigation. Many studies have revealed that algal DOM has displayed unique characteristics distinguished from other sources of DOM with respect to the chemical composition, the structures, and the molecular weight distributions. Algal DOM is considered to be a major obstacle in understanding membrane fouling due to its complicated interactions among dissimilar algal DOM constituents as well as between algal DOM and membrane material matrices. The present review article summarizes (1) recent characterizing methods for algal DOM, (2) environmental factors affecting the characteristics of algal DOM, (3) the discrepancies between algal DOM and other sources of aquatic DOM, particularly terrestrial sources, and (4) potential fouling effects of algal DOM on membrane filtration processes and their associations with algal DOM characteristics. A broad understanding of algal DOM-driven membrane fouling can lead to breakthroughs in efficient membrane filtration processes to treat algal bloom water sources.

[Long-term treatment outcome and influencing factors of teeth receiving modified crown lengthening]

Objective: To observe the long-term clinical treatment outcome and the influencing factors of the outcome for the teeth receiving modified crown lengthening surgery combined with root canal treatment and post-core crown restoration. To summarize the clinical guidelines of modified crown lengthening surgery in selection of indications and for mulation of treatment planning. Methods: Fifty-seven patients with a total of 67 teeth receiving modified crown lengthening surgery combined with root canal treatment and post-core crown restoration for at least a 6 months' follow-up period between July 2004 and July 2013 were recruited in this retrospective study by phone call interviews. The patients' clinical outcomes were evaluated by the combination of clinical examination, radiograph and questionnaire regarding patient-reported outcome of the last follow up (≥9 months post modified crown lengthening surgery and ≥6 months after definite crown restorations). All of the treated teeth were classified into two groups, group A (teeth with good clinical treatment outcome) and group B (teeth with poor clinical treatment outcome), based on the defined criteria including patients' satisfaction with the function and esthetics of the teeth and absence of periodontal, endodontic and prosthodontic complications. The potential influencing factors of clinical treatment outcome were also determined by Logistic regression analysis. Results: Vertical root fracture in 1 tooth was found on its periapical film and the tooth was deemed hopeless. Thus, the survival rate is 99% (66/67) for the multidisciplinary treatment approach. Seventy-two percent (48/67) of the teeth achieved good clinical treatment outcome and 28% (19/67) of the teeth developed one or several complications. In group B (teeth with poor clinical treatment), 16 out of teeth exhibited periodontal complications with bleeding on probing (BOP) positive mostly found. Logistic regression analysis demonstrated that plaque control (OR=21.392, P=0.014), edge form (OR=7.610, P=0.011), and smoking experience (OR=7.315, P=0.018) were the risk factors influencing the clinical treatment outcome of modified crown lengthening surgery combined with root canal treatment and post-core restoration. Conclusions: Modified crown lengthening surgery combined with root canal treatment and post-core restoration has a good and stable clinical effect in the observational time of 6-114 months. Plaque control, smoking status and edge form of the tooth appeared to be the influencing factors of this multidisciplinary treatment approach.

Microalgae-based advanced municipal wastewater treatment for reuse in water bodies

Reuse of secondary municipal effluent from wastewater treatment plants in water bodies could effectively alleviate freshwater resource shortage. However, excessive nutrients must be efficiently removed to prevent eutrophication. Compared with other means of advanced wastewater treatment, microalgae-based processes display overwhelming advantages including efficient and simultaneous N and P removal, no requirement of additional chemicals, O₂ generation, CO₂ mitigation, and potential value-added products from harvested biomass. One particular challenge of microalgae-based advanced municipal wastewater treatment compared to treatment of other types of wastewater is that concentrations of nutrients and N:P ratios in secondary municipal effluent are much lower and imbalanced. Therefore, there should be comprehensive considerations on nutrient removal from this specific type of effluent. Removal of nutrients and organic substances, and other environmental benefits of microalgae-based advanced municipal wastewater treatment systems were summarized. Among the existing studies on microalgal advanced nutrient removal, much information on major parameters is absent, rendering performances between studies not really comparable. Mechanisms of microalgae-based nitrogen and phosphorus removal were respectively analyzed to better understand advanced nutrient removal from municipal secondary effluent. Factors influencing microalgae-based nutrient removal were divided into intrinsic, environmental, and operational categories; several factors were identified in each category, and their influences on microalgal nutrient removal were discussed. A multiplicative kinetic model was integrated to estimate microalgal growth-related nutrient removal based majorly on environmental and intrinsic factors. Limitations and prospects of future full-scale microalgae-based advanced municipal wastewater treatment were also suggested. The manuscript could offer much valuable information for future studies on microalgae-based advanced wastewater treatment and water reuse.

Aquatic transformation of phosphite under natural sunlight and simulated irradiation

The phototransformation of phosphite (HPO₃^2-, H₂PO₃^-, +3) from Lake Taihu water (THW) under natural sunlight was evaluated. No direct phosphite photoreaction was observed under sunlight. Suspended solids were shown to play important roles in the indirect photoreaction of phosphite in lake water. The phototransformation of phosphite followed pseudo-first-order reaction kinetics and the kinetics constants (k, d^-1) decreased as: 0.0324 (original THW), 0.0236 (sterilized THW), 0.0109 (filtered THW) and 0.0102 (sterilized filtered THW). Original THW with 1 mmol L^-1 NO₃^- added was used to simulate the phosphite removal in lakes with serious N pollution. The results showed that the phototransformation was accelerated (with k increased to 0.0386-0.0463 d^-1), and sterilization or filtration shown little effect to the transformation, as the half-lives of phosphite drew closer. Under simulated irradiation in NO₃^- system, increasing NO₃^- concentration or decreasing pH value promoted phototransformation. The addition of Fe³⁺ or Fe²⁺ accelerated photooxidation, while the addition of Mn²⁺ or Cd²⁺ inhibited phototransformation. Br^-, NO₂^- and HCO₃^- in environmental concentrations decreased phototransformation, and HCO₃^- showed the strongest inhibition. Suwannee River humic acid or Suwannee River fulvic acid strongly inhibited the photooxidation process, and the inhibiting effects varied with their structure. Phosphite photooxidation was strongly inhibited by adding isopropanol or sodium azide as reactive oxygen species (ROS) quenchers. Electron spin resonance analysis indicated that OH was a main oxidant produced in this system. The increased amount of phosphate coincided with the decreased amount of phosphite, which indicated that the transformation product of phosphite was phosphate. Phosphite is a considerable component of the P redox cycle in Lake Taihu.

Factors associated with older people's long-term care needs: a case study adopting the expanded version of the Anderson Model in China

Background

Alongside changes in society and the economy, the family’s function of taking care of older people is weakening and the formal care mode is becoming more accepted. Older Chinese people are facing diverse choices of long-term care (LTC) modes. Acknowledging this situation, to optimize older people’s arrangements for LTC services and improve quality of later life, this study sets out to explore and make theoretical sense of older people’s LTC needs and to identify the factors influencing their LTC needs.

Methods

Questionnaire data were collected from 1090 participants in four Chinese cities in 2014. A conceptual framework was established based on the Anderson Model (i.e., predisposing factors, enabling factors, and need factors), and further strengthened by adding several psychosocial factors (i.e. intergenerational relationships, unmet care service needs, and self-image). Multinomial logistic regression was adopted to explore the influencing factors of LTC needs. Participants choosing home-and-community-based care were regarded as the reference group.

Results

After controlling for predisposing, enabling, and need factors, those with better self-image (OR = 1.027, p = 0.021) and fewer unmet care service needs (OR = 0.936, p = 0.009) were identified as being more likely to choose family care; those with less close intergenerational relationships (OR = 0.676, p = 0.019), fewer unmet care service needs (OR = 0.912, p = 0.027), and better self-image (OR = 1.044, p = 0.026) were more likely to choose institutional care. Gender- and age-related differences in the determinants of LTC needs were observed.

Conclusions

The findings of this study suggest that professionals and service providers should pay more attention to the important role of psychosocial factors in affecting older people’s LTC needs and be more sensitive to gender- and age-related differences. Effective efforts to improve intergenerational relationships, to further develop care services for older people, and to foster a more positive image of aging should be emphasized.

Cardiac rehabilitation knowledge in patients with coronary heart disease in Baoding city of China: A cross-sectional study

OBJECTIVE

The purpose of this study is to assess the awareness on cardiac rehabilitation (CR) in patients with coronary heart disease (CHD).

METHODS

Inpatients diagnosed with coronary heart disease were recruited from 3 hospitals in this study. The study employed a cardiac structured questionnaire to assess respondents' level of awareness, and bivariate to analyze the sociodemographic factors that influence the awareness on CR.

RESULTS

Of all 500 participants, 66.40% were male and the mean age was 62.51  ±  9.96 years. The mean score of knowledge was 44.00  ±  17.00 (score range: 0-93), and the mean level of awareness was 47.31% (awareness range: 0-100%). The highest mean level of awareness was in the reexamination subscale (98%) and the lower were in the basic information about CR program, SP optimized medication and heart rate subscale. Bivariate analysis showed that higher age was associated with less knowledge. Patients with higher education level and better income status had better knowledge. And patients who lived in rural and had no jobs had less knowledge.

CONCLUSIONS

This study showed low levels of awareness on CR program in CHD patients in Baoding. Therefore, the need for health education is indicated in this study to improve the awareness on CR among CHD patients.

Vertical distribution of ambient aerosol extinctive properties during haze and haze-free periods based on the Micro-Pulse Lidar observation in Shanghai

Ambient aerosols make a significant contribution to the environment and climate through their optical properties. In this study, the aerosol extinction coefficient and Aerosol optical depth (AOD) retrieved using the Fernald Method from the ground-based Micro-Pulse Lidar (MPL) were used to investigate the characteristics of aerosols during haze and haze-free periods in Shanghai. There were 216 haze days including 145 dry haze days, 39 damp haze days and 32days of both dry and damp haze in Shanghai from March 2009 to February 2010. During the haze periods, aerosols were concentrated mainly below 600m resulting in the most severe pollution layer in Shanghai. In contrast to the aerosol optical properties during haze-free periods, aerosol extinction coefficients and AOD were larger in the lower altitude (below 1km) during haze periods. The lowest 1km contributed 53-72% of the Aerosol optical depth (AOD) below 6km for the haze periods and <41% of that for the haze-free periods except summer. According to the analysis of influencing factors, although atmospheric convection was strong in summer which led to reduce the extinction, the highest occurrence of haze with relatively low aerosol extinction most of time was in summer, which resulted from the factors such as higher relative humidity, temperature and more solar radiation causing hygroscopic growth of particles and formation of secondary aerosols; in spring and autumn, there was less haze occurrences because the boundary layer was relatively higher, which allowed pollutants to diffuse more easily, but spring was the second most frequency season of haze due to frequent dust transport from the north; in winter high concentrations of particles and low boundary layer height were not beneficial to the diffusion of pollutants near the surface and caused haze occurrence rather high with high aerosol extinction.

Analysis of Factors Influencing the Grading of Condition Severity and Zoning Management in an Emergency Triage System

BACKGROUND

To identify and analyze factors that influence the grading and zoning management model of emergency triage as a first step in the improvement of the system.

METHODS

Questionnaires were used to extract data from clinical histories of 286 patients who attended the Emergency Department of Binzhou Central Hospital (Binzhou City, Shandong Province, China) from September to November of 2015. Through logistic regression analysis, influencing factors for unreasonable (≥ 2h) emergency department retention times were identified.

RESULTS

Analysis of general characteristics of patients including gender, method of payment or assigned medical department did not result in any statistically significant differences between patients with a time to discharge longer than 2 h and those with a shorter time to discharge (P > 0.05). Older age, higher income, lower or higher education degree, admission time from 17:00-7:59, and lack of understanding of zoning management and of condition severity grading resulted in a retention time greater than or equal to 2 hours (P < 0.05). According to the Logistic regression model: age, income level, education degree, admission time, degree of understanding of zoning management and condition severity grading were all independent risk factors affecting the time to discharge from the emergency department (P <0.05).

CONCLUSION

Countermeasures need to be developed in order to minimize the influence of patients' factors and promote reasonable average retention times lower than 2 hours in the emergency department.

Spatial distribution of soil cadmium and its influencing factors in peri-urban farmland: a case study in the Jingyang District, Sichuan, China

Semi-agricultural ecosystems in peri-urban areas are susceptible to contamination. The spatial distribution and influencing factors of such pollution are unclear and poorly constrained in many areas worldwide. Therefore, studying the problems of soil pollution in peri-urban areas is critical for environmental management and agricultural production. In this paper, with cadmium (Cd) as the target pollutant, the spatiotemporal variations of soil cadmium pollution and the relative importance of the affecting factors were analyzed at a peri-urban area from the Jingyang District, Sichuan, China. Statistical results showed that the farmland in the study area could be considered moderately soil Cd-polluted, under the dual influence of natural factors and human activity. In particular, the soil Cd concentration in Tianyuan and Bajiaojing exceeded 0.5 mg kg^-1, for intensive industrial enterprises are distributed in these areas. Correspondingly, the geoaccumulation index also showed that the contamination of Cd in this area was moderately polluted. Moreover, the ecological risk index was 80% in the study area, indicating that the soil Cd pollution potential risk was moderate to high. High geological background values (soil Cd = 0.29 mg kg^-1), river migration, industrial enterprises, and traffic significantly influenced soil Cd pollution, with natural geological factors playing greater roles. The significant horizontal-spatial effective distances away from Shiting River, Deyang-Aba Highway, and chemical plants were 200, 400, and 100 m, respectively. These results will be useful in guiding farmland cultivation and pollution remediation effectively in the peri-urban areas.

Research Professionals' Perspectives, Barriers, and Recommendations Regarding Minority Participation in Clinical Trials

OBJECTIVE

This study aims to investigate research professionals' perspectives regarding minority participation in clinical trials.

METHODS

A web-based survey of research professionals at US institutions receiving NIH and/or AHRQ funding to conduct clinical research in 2013. Descriptive statistics, mean, standard deviation (SD), and the Wilcoxon rank-sum test were utilized for analysis.

RESULTS

Distributed were 13,041 surveys with 967 (7.4%) responses. Overall and race-stratified analyses included 633 and 521 surveys, respectively. A majority agreed that patients' race (mean, 3.4; SD = 1.0) and primary language (mean, 4.0; SD = 0.9) have an effect on enrollment. They had more success in enrolling those whose primary language was the same as their own (mean, 3.8; SD = 1.0), and that a language barrier and time spent arranging for interpreters had prevented them from offering a study to potential candidates (mean, 3.2; SD = 1.2). Non-Caucasian respondents were more likely to agree that "fear of unknown side effects" was a deterrent for minorities (p < 0.01), "minorities are more likely to be unavailable for follow-up phone calls" (p = 0.07), and "the unavailability of translated material discourages non-English speakers from participation" (p = 0.08). They also were more likely to be neutral or agree with being discouraged from enrolling minorities because of the possibility of their withdrawal or being less likely to be available for phone follow-ups and follow-up visits (all p < 0.01).

CONCLUSION

Despite a few subtle racial differences in research professionals' perspectives, a majority expressed no hesitation in enrolling minorities. Patients' race and primary language appeared to influence enrollment. A language barrier appeared to be the strongest barrier for research professionals.

Current status and historical variations of DDT-related contaminants in the sediments of Lake Chaohu in China and their influencing factors

The temporal-spatial distributions of DDT-related contaminants (DDXs), including DDT (dichlorodiphenyltrichloroethane), DDE (dichlorodiphenyldichloroethylene) and DDD (dichlorodiphenyldichloroethane), in the sediments of Lake Chaohu and their influencing factors were studied. p,p-DDE and p,p-DDD were found to be the two dominant components of DDXs in both surface and core sediments. The parent DDT compounds were still detectable in sediment cores after the late 1930s. Historical usage of technical DDT was identified as the primary source of DDXs in sediments, as indicated by DDT/(DDD + DDE) ratios of less than one. The residual levels of DDXs were higher in the surface and core sediments in the western lake area than in other lake areas, which might be due to the combined inflow effects of municipal sewage, industrial wastewater and agricultural runoff. The DDX residues in the sediment cores reached peak values in the late 1970s or early 1980s. There were significant positive relationships between DDX residues in sediment cores with annual DDT production and with fine particulate sizes (<4.5 μm). The relationship between the DDXs and TOC in sediment was complex, as indicated by the significant differences among the surface and core sediments. The algae-derived organic matter significantly influenced the amount of residue, composition and distribution of DDXs in the sediments. The DDD/DDE ratios responded well to the anaerobic conditions in the sediments that were caused by algal blooms after the late 1970s in the western lake area. This suggests that the algae-derived organic matter was an important factor and served as a biomarker of eutrophication and also affected the DDX residues and lifecycle in the lake ecosystem.

Adsorption-desorption of oxytetracycline on marine sediments: Kinetics and influencing factors

To reveal the kinetics and mechanisms of antibiotic adsorption/desorption processes, batch and stirred flow chamber (SFC) experiments were carried out with oxytetracycline (OTC) on two marine sediments. The OTC adsorption capacities of the marine sediments were relatively weak and related to their organic carbon (OC) and contents of fine particles. Sorption isotherms of OTC on marine sediment can be well described by both the Langmuir and Freundlich models. Langmuir adsorption maxima (q_max) and Freundlich distribution coefficients (K_f) increased with the decrease of salinity and pH, which indicated the importance of variable charged sites on sediment surfaces. A second order kinetic model successfully described adsorption and desorption kinetics of OTC and well reproduced the concentration change during stop-flow. The adsorption kinetic rates (k_a) for OTC under different experimental conditions ranged from 2.00 × 10^-4 to 1.97 × 10^-3 L (mg min)^-1. Results of SFC experiments indicated that diffusive mass transfer was the dominant mechanism of the time-dependent adsorption of OTC and its release from marine sediment was mildly hysteretic. The high desorption percentage (43-75% for LZB and 58-75% for BHB) implied that binding strength of OTC on two marine sediments was weak. In conclusion, marine sediment characteristics and environmental factors such as salinity, pH, and flow rate are critical factors determine extent of OTC sorption on marine sediment and need to be incorporated in modeling fate and transport of OTC in marine environment.

Knowledge about and sources of smoking-related knowledge, and influencing factors among male urban secondary school students in Chongqing, China

Objectives

This study examined smoking-related knowledge, sources of smoking-related knowledge and its influencing factor among male urban secondary school students.

Methods

We conducted a cross-sectional survey, using a self-administered questionnaire, among 1297 male secondary school students in municipal areas of Chongqing, China.

Results

Non-smokers had a better knowledge of smoking hazards than smokers. Less than 20% of students knew that smoking can cause heart disease, peptic ulcer, and cerebral stroke. Sources of smoking-related knowledge differed between smokers and non-smokers, respectively: TV (76.5 vs. 76.7%), teacher (70.1 vs. 62.4%), social network (66.6 vs. 73.1%), parents (57.0 vs. 59.2%), newspaper (55.4 vs. 61.6%), and friends (37.7 vs. 33.9%). Non-smokers’ hobbies of reading were significantly higher than smokers’ (χ² = 11.5845, p = 0.0007). Smokers’ hobbies of online games (χ² = 14.9106, p = 0.0001), and sports (χ² = 4.8609, p = 0.0275) were significantly higher than non-smokers’. Generalized estimating equations (GEE) found that students whose both father and mother smoke were unable to receive tobacco-related knowledge. GEE also found that students in high school, with affluent family economic condition and with an opposing attitude towards father smoking possessed a better smoking-related knowledge. However, male students with disagreement or neutral attitude towards friends smoking were negatively associated with the knowledge of smoking hazards.

Conclusions

The findings of the present study suggest that a significant proportion of male secondary school students in urban Chongqing lack specific knowledge about smoking-related diseases. Targeted educational programs for secondary school students in China are needed to promote tobacco control and tobacco use reduction and cessation among students.

Effect of comfortable nursing on quality of care in patients undergoing endoscopic retrograde cholangiopancreatography

AIM

To evaluate the effect of comfort nursing on quality of care in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP).

METHODS

One hundred and twenty patients who underwent ERCP treatment from June 2014 to December 2015 were randomly selected and divided into an experimental group (60 cases) to receive comfort nursing and a control group (60 cases) to receive routine care. Univariate and multivariate analyses were used to explore the difference in the quality of care between the two groups.

RESULTS

Univariate and multivariate analyses demonstrated that comfort nursing had a significant effect on preoperative sleep quality (RR = 0.623, 95%CI: 0.412-0.924), intraoperative changes in blood pressure (RR = 0.234, 95%CI: 0.134-0.524 ), degree of intraoperative patient compliance (RR = 0.423, 95%CI: 0.187-0.612), postoperative sleep quality (RR = 0.435, 95%CI: 0.287-0.698), and postoperative eating habits (RR = 0.179, 95%CI: 0.024-0.798), but had no effect on postoperative incidence of pancreatitis (RR = 0.512, 95%CI: 0.136-1.524).

CONCLUSION

comfort nursing can significantly improve preoperative and postoperative sleep quality, reduce intraoperative fluctuations in blood pressure, improve intraoperative patient compliance to increase the success rate of surgery, improve postoperative eating habits, and increase patients' satisfaction in patients undergoing ERCP.

Variations and factors that influence the formation of polychlorinated naphthalenes in cement kilns co-processing solid waste

Pilot studies of unintentionally produced pollutants should be performed before waste being co-processed in cement kilns. Polychlorinated naphthalene (PCN) formation and emission from cement kilns co-processing sorted municipal solid waste, sewage sludge, and waste acid, however, have not previously been studied. Here, PCNs were analyzed in stack gas samples and solid samples from different stages of three cement production runs. PCN destruction efficiencies were higher when waste was co-processed (93.1% and 88.7% in two tests) than when waste was not co-processed (39.1%), so co-processing waste would not increase PCN outputs. The PCN concentrations were higher in particle samples from the C1 preheater and stages at back end of kiln than in particle samples from other stages, suggesting that cyclone preheater and back end of kiln should be focused for controlling PCN emissions. Besides that, based on the variation of PCN concentrations and corresponding operating conditions in different stages, the temperature, feeding materials, and chlorine content were suggested as the main factors influencing PCN formation. The PCN homologue and congener profiles suggested chlorination and dechlorination were the main PCN formation and decomposition pathways, and congeners CN-23, CN-46, and CN-59 appear to be appropriate indicators of PCNs emitted from coal-burning sources.

[Catastrophic Health Expenditure before and after Compensations from the New Rural Cooperative Medical Scheme in Rural Zigong of Sichuan Province]

OBJECTIVES

To estimate catastrophic health expenditure (CHE) of rural families in Zigong, and to determine the main influencing factors of CHE.

METHODS

CHE was estimated using indicators such as occurrence and average deviations. The influencing factors of CHE were identified through binary logistic regression.

RESULTS

We found 6.37% catastrophic health payment headcount, 1.13% mean catastrophic payment gap, and 17.80% mean positive gap after compensations. Compensations from the new rural cooperative medical scheme (NCMS) led to a reduction of 74.81% catastrophic health payment headcount for hospitalization costs and 48.00% catastrophic health payment headcount for outpatient costs, respectively. The numbers of hospitalizations in a family, presence of patients with chronic diseases, per capita household income, and numbers of family members with a job were found to be predictors of CHE.

CONCLUSIONS

Rural families that have patients with chronic diseases are vulnerable to CHE.The government should develop policies to ease the financial burdens of the families with a high accumulated health expenditure over time.

Factors influencing first childbearing timing decisions among men: Path analysis

BACKGROUND

Factors that influence men's childbearing intentions have been relatively unexplored in the literature.

OBJECTIVE

This study aimed to determine the influencing factors about the first childbearing timing decisions of men.

MATERIALS AND METHODS

In this cross-sectional study, 300 men who were referred to private and governmental healthcare centers in Shahrood, Iran were randomly recruited from April to September 2014. Data were collected using a demographic questionnaire, the Quality of Life Questionnaire; ENRICH Marital Satisfaction Questionnaire, Synder's Hope Scale, and the Multidimensional Scale of Perceived Social Support.

RESULTS

After removing the statistically insignificant paths, men's age at marriage had the highest direct effect (β=0.86) on their first childbearing decision. Marital satisfaction (β=-0.09), social support (β=0.06), economic status (β=0.06), and quality of life (β=-0.08) were other effective factors on men's first childbearing decisions. Moreover, marital satisfaction and social support had significant indirect effects on men's childbearing decisions (β=-0.04 and -0.01, respectively).

CONCLUSION

Many factors, including personal factors (age at marriage and quality of life), family factors (marital satisfaction), and social factors (social support), can affect men's decision to have a child. Policymakers are hence required to develop strategies to promote the socioeconomic and family conditions of the couples and to encourage them to have as many children as they desire at an appropriate time.

Evaluation of performance and impacts of maternal and child health hospital services using Data Envelopment Analysis in Guangxi Zhuang Autonomous Region, China: a comparison study among poverty and non-poverty county level hospitals

BACKGROUND

As the core of the county-level Maternal and Child Health Hospitals (MCHH) in rural areas of China, the service efficiency affects the fairness and availability of healthcare services. This study aims to identify the determinants of hospital efficiency and explore how to improve the performance of MCHH in terms of productivity and efficiency.

METHODS

Data was collected from a sample of 32 county-level MCHHs of Guangxi in 2014. Firstly, we specified and measured the indicators of the inputs and outputs which represent hospital resources expended and its profiles respectively. Then we estimated the efficiency scores using Data Envelopment Analysis (DEA) for each hospital. Efficiency scores were decomposed into technical, scale and congestion components, and the potential output increases and/or input reductions were also estimated in this model, which would make relatively inefficient hospitals more efficient. In the second stage, the estimated efficiency scores are regressed against hospital external and internal environment factors using a Tobit model. We used DEAP (V2.1) and R for data analysis.

RESULTS

The average scores of technical efficiency, net technical efficiency (managerial efficiency) and scale efficiency of the hospitals were 0.875, 0.922 and 0.945, respectively. Half of the hospitals were efficient, and 9.4 % and 40.6 % were weakly efficient and inefficient, respectively. Among the low-productiveness hospitals, 61.1 % came from poor counties (Poor counties in this article are in the list of key poverty-stricken counties at the national level, published by The State Council Leading Group Office of Poverty Alleviation and Development, 2012). The total input indicated that redundant medical resources in poverty areas were significantly higher than those in non-poverty areas. The Tobit regression model showed that the technical efficiency was proportional to the total annual incomes, the number of discharge patients, and the number of outpatient and emergency visits, while it was inversely proportional to total expenditure and the actual number of open beds. Technical efficiency was not associated with number of health care workers.

CONCLUSION

The overall operational efficiency of the county-level MCHHs in Guangxi was low and needs to be improved. Regional economic differences affect the performances of hospitals. Health administrations should adjust and optimize the resource investments for the different areas. For the hospitals in poverty areas, policy-makers should not only consider the hardware facilities investment, but also the introduction of advanced techniques and high-level medical personnel to improve their technical efficiency.

Analysis on the situation of subjective well-being and its influencing factors in patients with ankylosing spondylitis

Background

To examine the subjective well-being (SWB) in patients with ankylosing spondylitis (AS) compared with the healthy controls, and to explore the associations between SWB and demographic characteristics, disease-specific variables in AS patients.

Methods

SWB was assessed with General Well-Being Schedule (GWBS) in 200 AS patients and 210 healthy controls. Comparisons among subgroups were performed to investigate how certain aspects operate as favorable or adverse factors in influencing SWB in the patients with AS.

Results

Both men and women with AS reported significantly impaired SWB on all scales of the GWBS except for the Control (O) scale. The results revealed that better sleep, lower disease activity and more family care predicted higher SWB. In AS patients, positive attitude towards therapy prospect was significantly associated with higher SWB. Therapy prospect refers to the hope of patients about the disease treatment.

Conclusions

Compared with general population, SWB might be affected by the onset of AS. There are significant associations between SWB and sleep quality, BASDAI, APGAR, therapy prospect.

Internet use of parents before attending a general pediatric outpatient clinic: does it change their information level and assessment of acute diseases?

Background

Before seeing a pediatrician, parents often look online to obtain child health information. We aimed to determine the influence of IUC (internet use regarding the reason for consultation) on their subjective information level, their assessment of acute diseases and the change in this assessment. Secondary objectives were to identify the most commonly used online resources and factors with an influence on IUC.

Methods

This cross-sectional observational study was conducted at a general pediatric outpatient clinic located in Vienna, Austria. An anonymous, voluntary and 14-items-containing questionnaire served to gather all data. A total number of 500 questionnaires were collected.

Results

Of the parents attending the outpatient clinic, 21 % use the internet before the appointment (= IUC). Most common online resources utilized for this purpose are websites run by doctors (61.3 %), the outpatient clinic’s homepage (56.3 %), Google (40 %), Wikipedia (32.5 %), health advisory services provided by doctors (28.7 %), health portals (21.3 %) and health forums and communities (18.8 %). The information level in terms of the reason for consultation is rated as good by 50.6 %, as average by 46.7 % and as insufficient by 2.7 % (internet users: 42.7 %, 55.3 %, 1.9 %). Acute diseases of the children are estimated to be mild by 58.4 %, to be moderate by 41.1 % and to be severe by 0.5 % (internet users: 54.9 %, 45.1 %, 0 %). After having used any source of information, this assessment is unchanged in 82.8 %, acute diseases are rated as more severe in 13.8 % and as less severe in 3.4 % (internet users: 79.2 %, 16.7 %, 4.2 %). Internet users and non-users do not differ with respect to their information level (p = 0.178), the assessment of acute diseases (p = 0.691) and the change in this assessment (p = 0.999). A higher education level of parents (mothers: p = 0.025, fathers: p = 0.037), a young age of their children (p = 0.012) and acute diseases of their children (p = 0.046) predispose to IUC.

Conclusions

Against the common perception that online health information might fuel panic-mongering, we could not determine a link between IUC and the assessment of acute diseases. The information level of internet users and non-users does not differ either. Further research is needed to clarify causes for high and low IUC.

Preliminary Analysis of Clinical Situations Involved in Quantification of Contrast-Enhanced Ultrasound in Crohn's Disease

To assess influencing factors for quantitative analysis of contrast-enhanced ultrasound (CEUS) in Crohn's disease (CD), dynamic CEUS examinations from 77 consecutive CD patients were recorded. Peak intensity (PI) values were calculated using the pre-installed quantification software of the ultrasound scanner. The influence of depth, pressure from the ultrasound probe and intraluminal gas was analyzed. The PI value of the anterior wall was lower than that of the posterior wall when the depth was ≤3.4 cm (17.9 dB vs. 21.3 dB; p < 0.05) or evident pressure was exerted (19.1 dB vs. 22.5 dB; p < 0.01). In the presence of intraluminal gas, the PI of the anterior wall was higher than that of the posterior wall (20.7 dB vs. 18.8 dB; p < 0.05). Nevertheless, no significant difference was found between the PI value of anterior and posterior walls when the depth was >3.4 cm (19.8 dB vs. 20.3 dB), moderate pressure was exerted (20.5 dB vs. 21.1 dB) or luminal gas was excluded between the two bowel walls (18.9 dB vs. 21.2 dB; p ≥ 0.05). The factors of depth, pressure from the ultrasound probe and intraluminal gas can affect the quantification results of CEUS. It is preferable to place the region of interest in the posterior wall when luminal gas is absent and in the anterior wall when luminal gas is present. In the latter case, more attention should be paid to reducing pressure by the ultrasound probe.

Significance of serum gastrin 17 in diagnosis of gastrointestinal diseases

Gastrin 17 (G17) is a polypeptide hormone secreted by gastrointestinal G cells, and it binds to cholecystokinin receptor (CCKR) to exert its biological function through signal transduction, stimulating the secretion of gastric acid and the growth of gastrointestinal mucosa. In recent years some studies suggest that G17 promotes cell proliferation and inhibits apoptosis. Since serum G17 can provide some clues to the function of gastric mucosa and the presence of gastric cancer and precancerous disease, it is of great significance in the diagnosis of gastrointestinal diseases. However, serum G17 is affected not only by gastric factors such as the lesion, the degree of atrophy, and Helicobacter pylori (H. pylori) infection, but also by extragastric and drug factors. In this article, we discuss the biological characteristics of G17, factors influencing serum G17 and the relationship between serum G17 and gastrointestinal diseases.

Influence of age, sex, body mass index, alcohol, and smoking on shear wave velocity (p-SWE) of the pancreas

Purpose

A variety of elastographic techniques have been developed to facilitate the non-invasive assessment of tissue properties. The goal of the study was to examine the influence of gender, age, BMI, alcohol consumption, and smoking in healthy volunteers.

Methods

Of the 263 participants who met all the study inclusion criteria, 234 had successful measurements. The examination was performed with the Siemens Acuson S3000 (Siemens Healthcare, Erlangen, Germany), using the 6C1 curved array transducer with the virtual touch tissue quantification (VTQ) method.

Results

The values determined with the curved array in the head of the pancreas were 1.44 ± 0.39 m/s for women and 1.19 ± 0.29 m/s for men; in the body, the results were 1.49 ± 0.37 m/s for women and 1.26 ± 0.30  m/s for men; in the tail, the corresponding values were 1.29 ± 0.36 m/s for women and 1.05 ± 0.30 m/s for men. Comparison of gender showed that men have significantly lower mean values than women. There were significantly higher values in all parts of the organ with the increasing age of the participants (p < 0.0001). For BMI, there was a significant correlation with the values only when considering the BMI in continuous form. Alcohol consumption and smoking did not have any significant effects.

Conclusions

ARFI-VTQ is qualified for use on pancreatic tissue. Further studies are required to examine the influence of other factors in larger populations.

Sources and seasonal variation of coliform bacteria abundance in groundwater around the slopes of Mount Meru, Arusha, Tanzania

The quality of the groundwater along the slopes of Mount Meru, Tanzania, is poorly understood. Water access and sanitation practices may pose health risks to communities. This study was undertaken to assess the sources, abundance and seasonal variation of coliform bacteria in groundwater and factors contributing to such variations along slopes of Mount Meru, Tanzania. Water samples collected from 67 randomly selected water sources (springs, shallow wells which ranged from 4 to 35 m deep and Boreholes above 40 m deep) during dry and wet seasons were analysed for total coliform (TC), faecal coliform (FC), Escherichia coli (E. coli) and faecal streptococci (FS), using the membrane filtration method. The fraction of springs and shallow wells contaminated was generally higher compared to the fraction of boreholes. The highest TC, FC, E. coli and FS counts were significantly higher (p < 0.05) during the wet than the dry season owing to rising of water table and leaching during rainy season. Water sources that were located within 10 m of pit latrines had the highest coliform counts relative to those located beyond 10 m. Similarly, the highest coliform counts were observed in all shallow wells that (i) had low well head above the ground, (ii) were not covered, (iii) had casing materials which were not concrete and (iv) utilised traditional pumping (bucket/pulley) systems. This was due to contaminated storm water access, inoculation of microbes by exposed buckets and inefficiency of the casing material. Furthermore, the counts decreased with depths of boreholes and shallow wells during the two seasons probably due to retention and die-off. It is recommended that groundwater in this area be treated against coliform contamination prior to utilisation as portable water.

Factors affecting adherence to treatment in inflammatory bowel disease

Inflammatory bowel disease (IBD) is a group of chronic inflammatory diseases of the intestine, which includes Crohn's disease (CD) and ulcerative colitis (UC). IBD is a kind of refractory disease. Currently, drugs including 5-ASA, corticosteroids, and immunosuppressant drugs as well as biological agents are the basic treatment. The vast majority of patients need these drugs to induce and maintain remission. The choice of treatment and patients' adherence are equally important, because the disease prognosis is related to the medication adherence. Although current treatments have been greatly optimized, little attention has been paid to many factors associated with non-adherence to IBD medications in China. This article reviews the domestic and foreign research on the factors influencing IBD medication adherence, with an aim to help medical personnel identify factors that influence treatment adherence and effectively manage this refractory disease.

Factors influencing Chinese university students' willingness to performing bystander cardiopulmonary resuscitation

BACKGROUND AND AIM

Low rates of bystander-initiated CPR are a major obstacle to improved survival rates, and the aim of this study is to elucidate the factors associated with university students' attitudes toward performing bystander CPR.

METHODS

Questionnaires were distributed to 18 universities across three metropolises in China. One question asking for respondents' attitudes toward performing bystander CPR was set as the dependent variable, and the logistic regression models were used to extract independent factors for respondents' attitudes toward performing bystander CPR.

RESULTS

2934 questionnaires were completed, with a response rate of 81.5%. Results suggested that predictors of willingness to perform bystander CPR were: previous experience of performing bystander CPR, higher self-perceived ability to perform bystander CPR properly after instruction, medicine and law discipline, male gender, not being the single child of their parents, higher participation in university societies, being used to taking decisive action immediately, less self-perceived life stress and higher self-perceived knowledge level of CPR.

CONCLUSIONS

Persons having previous experience of performing bystander CPR and those who thought they would have the ability to perform bystander CPR properly are predominantly associated with willingness to perform bystander CPR. Psychological and cultural factors need further study.

How do case managers spend time on their functions and activities?

BACKGROUND

Case management has been a widely accepted approach to practice in various care settings. This study aimed to explore how community aged care case managers allocated their time to case management functions, how frequently they performed specific case management activities, and what factors influenced the frequency of their activities.

METHODS

The study involved 154 survey participants, or 17.1% of the target case managers in the State of Victoria, Australia. Key information collected included participants' socio-demographic characteristics, proportions of time allocated to six core case management functions, and frequency ratings of 41 specific activities within seven case management functions. Ordinal regression analyses were performed to determine significant factors associated with participants' frequency ratings of their activities.

RESULTS

Participants allocated the largest proportion of time to care coordination (22.0%), and the smallest proportion of time to outcome evaluation (8.0%). Over 70% of the participants assigned high frequency ratings to 31 of the 41 case management activities. The remaining ten activities, including all four outcome evaluation activities, three needs assessment activities, one care planning activity, one care coordination activity, and one general functions-related activity were less commonly performed very frequently. The regression analyses indicated that some case manager and client factors were significantly associated with frequency ratings of nine of the ten activities aforementioned. The two main findings of the regression analyses were: First, emphasising achieving more case management goals was significantly associated with higher frequency of three outcome evaluation activities; second, longer work experience was significantly associated with higher frequency of one care coordination activity and one outcome evaluation activity.

CONCLUSIONS

The frequent performance of most case management activities and relative absence of factors influencing their frequency suggest a uniformity of practice in community aged care case managers' practice. What is not clear is whether the frequency of these activities (in particular less frequent performance of outcome evaluation activities) conforms to expectations.

Effect of regional difference on characteristics of gastric cancer

AIM: To analyze the difference in the characteristics of gastric cancer between patients from Nankai District, Tianjin and those from Longnan City of Gansu Province, and to explore the possible influencing factors.

METHODS: Clinical data for gastric cancer patients from the two regions were collected, including incidence, age, gender, family history, precancerous condition, Helicobacter pylori (H. pylori) infection, gastroscopy, pathology, treatment and so on. A retrospective study was then performed to analyze the difference in disease characteristics.

RESULTS: The incidence of gastric cancer (4.60% vs 5.77%), H. pylori detection rate (74.16% vs 55.60%), rate of H. pylori infection (50.70% vs 57.95%), onset age (63.09 years ± 9.46 years vs 54.46 years ± 8.87 years), and peak age of onset (60-69 years vs 50-59 years) differed significantly between patients from Nankai District of Tianjin and those from Longnan City of Gansu Province (P < 0.05), while the diagnosis rate of early gastric cancer (0.72% vs 0.58%) and the male to female ratio (1.23:1 vs 1.25:1) showed no significant difference between the two regions (P > 0.05). Most of the patients from Longnan City had family histories of cancer, atrophic gastritis and other precancerous conditions. The most common location of gastric cancer was gastric antrum, and the main pathological type was low differentiation adenocarcinoma in both regions, but their treatment and prognosis were different.

CONCLUSION: Regional differences were found in the incidence and characteristics of gastric cancer. Compared to Longnan region, the incidence of gastric cancer and H. pylori infection rate were lower in Nankai district, with a better prognosis due to good patient compliance and active treatment. For patients from Longnan city, the onset age of gastric cancer was younger, the occurrence of gastric cancer had a clear tendency of family history of cancer and most of the patients had precancerous diseases. The differences in the characteristics of gastric cancer may be closely related to factors such as environment, diet, H. pylori infection and patient compliance.

Factors influencing hospitalized patients' perception of individualized nursing care: a cross-sectional study

Background

Individualized care is a cornerstone of patient-centered nursing care. To foster individualized care, influencing factors should be known. The aim of this study was to identify the individual and organizational factors influencing hospitalized patients’ perception of individualized care.

Methods

A cross-sectional study was conducted of 606 patients from 20 wards from five hospitals across Germany. Individualized care and potential influencing factors were assessed via structured questionnaires. To identify influencing factors, we applied a hierarchical linear model with two levels.

Results

Self-rated health, length of ward stay, educational level and shared decision-making process about nursing care were perceived to influence individualized care. A higher rating of health and longer ward stay correlated with improved perceptions of individualized nursing care. In addition, an educational level of nine or fewer years and a perceived shared decision-making process about nursing care positively influenced the perception of nursing care as being tailored to individual needs.

Conclusions

Several factors influence patients’ perception of individualized care. However, only the decision-making process can be actively influenced by nurses. Therefore, nurses should be encouraged to promote shared decision-making regarding patients’ nursing care.

Trial number

DRKS00005174 (Date of registration: 2013/08/01).

Sonocatalytic degradation of Rhodamine B catalyzed by β-Bi2O3 particles under ultrasonic irradiation

β-Bi2O3 particles were synthesized by a polyacrylamide sol-gel method. The sonocatalytic activity of β-Bi2O3 particles was evaluated by degrading Rhodamine B (RhB) under the ultrasonic irradiation, revealing that β-Bi2O3 particles exhibit a good sonocatalytic activity. The effects of various experimental factors including ultrasonic frequency (f), solution temperature (T), catalyst dosage (Ccatalyst) and initial RhB concentration (CRhB) on the sonocatalysis efficiency were investigated. The optimum conditions for sonocatalytic degradation of RhB are obtained to be f=60 kHz, T=40 °C, Ccatalyst=3 g L(-1), and CRhB=5 mg L(-1). The percentage degradation of RhB after sonocatalysis for 90 min is 98.7%. Detected by the photoluminescence technique that of using terephthalic acid as a probe molecule, hydroxyl radicals (OH) are found to be produced on the irradiated by β-Bi2O3 particles. Based on the experimental results, OH radicals are suggested to be the major active species which are responsible for the degradation reaction.

A sera-epidemiological study on pertussis immunity levels among community populations and an analysis of the underlying factors in Tianjin China

BACKGROUND

The aim of this study is to characterize the sera-epidemiology of pertussis immunity levels among community populations and to identify the underlying factors. Moreover, our study will help resolve new issues encountered during the control and prevention of pertussis reemergence.

METHODS

The anti-pertussis antibody levels among community populations were examined using enzyme linked immunosorbent assays (ELISA) over three years. Comparative studies were carried out to assess the efficacy of different types of vaccines. Meanwhile, the duration of protection provided by DTaP within the under-7 age group was subjected to further analysis.

RESULTS

The average positive rate for anti-pertussis antibody was 49.15% across all community populations, among which the 4-12 age group showed a rate substantially lower than those of other groups (P<0.001). There was no statistically significant difference in anti-pertussis antibody levels (P=0.977) between people receiving three and four doses of the vaccine. The surveillance results showed that the positive antibody response rate elicited by component pertussis combo (DTcP) vaccines (84.44%) was strikingly higher than that elicited by acellular pertussis combo (DTaP) vaccines (37.22%, P<0.001). More specifically, when given 4 doses of DTcP vaccines, 66.67% of the people showed positive anti-pertussis toxin (PT) antibody levels, which was higher than the ratio of 9.87% (P<0.001) in the case of DTaP vaccines. The positive anti-pertussis antibody levels peaked at 73% within the first five months following vaccination and then gradually decreased to below 20% in four years. The positive rate was inversely correlated with the length of time after vaccination (r=-0.929, P=0.003).

CONCLUSIONS

The anti-pertussis antibody levels were not only relatively low among community populations, but also dropped excessively rapidly among vaccinated populations. Natural infection is an important contributor to the high pertussis immunity levels seen in adolescents and adults. The efficacy of DTaP remains to be improved.

Nursing of colostomy complications

Intestinal colostomy complications are common in patients after colostomy, seriously affecting postoperative quality of life. They not only cause difficulties to postoperative nursing and influence postoperative rehabilitation, but also increase the psychological and economic burden. Reducing the incidence of stoma complications and improving the quality of nursing care are of important significance for improving nursing satisfaction and quality of life. This review aims to elucidate the factors influencing complications after colostomy as well as the types, nursing measures and nursing mode for these complications.

The Health Literacy Status and Influencing Factors of Older Population in Xinjiang

BACKGROUND

This study was to investigate the health literacy and influencing factors of older population in pension institution of Xinjiang, China.

METHODS

Elderly people were selected from 44 pension institutions in Urumqi, Changji, Karamay and Shihezi and from September 2011 to June 2012 using random layer sampling method. The investigation was carried out by Chinese citizen health literacy questionnaire prepared by the China Health Education Center. Data were analyzed by Oneway ANOVA, multiple linear regression and Pearson correlation analysis.

RESULTS

A total of 1396 elderly people met the inclusion criteria and their average age was (77.37 ± 8.48) years. Their average health literacy score was (77.37 ± 8.48) points, which was at a low level. There was significant difference in health literacy score among the factors of age, gender, race, education, household income, marital status and occupation (P<0.05). The independent influencing factors of health literacy were education, race, occupation, household income, age and marital status (P < 0.05). Correlation analysis was conducted between the scores of health knowledge, health belief, health behavior, health skill and total scores of health literacy. Health knowledge scores and total scores had highest correlation (r=0.95), followed by health belief scores and total scores (r=0.81).

CONCLUSION

The correlation between health behavior scores and health skill scores was the lowest (r=0.33). The major factors that lead to low health literacy in elderly people are femininity, minority and low levels of education.

Uncertainty and perspectives in studies of atmospheric nitrogen deposition in China: A response to Liu et al. (2015)

In this paper, we have formally responded to the speculation in "Liu et al. suspect that Zhu et al. (2015) may have underestimated dissolved organic N but overestimated total particulate N in wet deposition in China" by Liu et al. (2015). Here, we first discussed the uncertainty and plausible reasons of atmospheric deposition in China, which have been reported in different studies. We disagree with their interpretation on some points. Firstly, the difficulties in quality control from sampling to analyzing are common to all studies regarding atmospheric deposition, including the studies cited by Liu et al. (2015). More importantly, their discussion did not fully consider the apparent influence of different scaling-up methods (from an observation site scale to a national scale) on estimations of atmospheric N deposition in China. Furthermore, we provided the optimal approaches to resolve these challenges discussed in order to promote the related studies of atmospheric N deposition in China in the future.

Photodegradation of methylmercury in Jialing River of Chongqing, China

Photodegradation (PD) of methylmercury (MMHg) is a key process of mercury (Hg) cycling in water systems, maintaining MMHg at a low level in water systems. However, we possess little knowledge of this important process in the Jialing River of Chongqing, China. In situ incubation experiments were thus performed to measure temporal patterns and influencing factors of MMHg PD in this river. The results showed that MMHg underwent a net demethylation process under solar radiation in the water column, which predominantly occurred in surface waters. For surface water, the highest PD rate constants were observed in spring (12×10(-3)±1.5×10(-3) m2/E), followed by summer (9.0×10(-3)±1.2×10(-3) m2/E), autumn (1.4×10(-3)±0.12×10(-3) m2/E), and winter (0.78×10(-3)±0.11×10(-3) m2/E). UV-A radiation (320-400 nm), UV-B radiation (280-320 nm), and photosynthetically active radiation (PAR, 400-700 nm) accounted for 43%-64%, 14%-31%, and 16%-45% of MMHg PD, respectively. PD rate constants varied substantially with the treatments that filtered the river water and amended it with chemicals (i.e., Cl-, NO3-, dissolved organic matter (DOM), Fe(III)), which reveals that suspended particulate matter and water components are important factors in affecting the PD process. For the entire water column, the PD rate constant determined for each wavelength range decreased rapidly with water depth. UV-A, UV-B, and PAR contributed 27%-46%, 6.2%-12%, and 42%-65% to the PD process, respectively. PD flux was estimated to be 4.7 μg/(m2·year) in the study site. Our results are very important to understand the cycling characteristics of MMHg in the Jialing River of Chongqing, China.

Sonocatalytic degradation of RhB over LuFeO3 particles under ultrasonic irradiation

LuFeO3 particles with an average particle size of ∼200 nm were synthesized via a polyacrylamide gel route. The sonocatalytic activity of LuFeO3 particles was evaluated by the degradation of Rhodamine B (RhB) under ultrasonic irradiation, revealing that they exhibit a good sonocatalytic activity. The effects of various experimental factors including ultrasonic frequency (f), reaction solution temperature (T), catalyst dosage (Ccatalyst), initial RhB concentration (CRhB), and pH value on the sonocatalysis efficiency were investigated. It is found that the former four factors have an important influence on the sonocatalytic degradation of RhB, where the best degradation conditions are obtained to be f=60 kHz, T=40 °C, Ccatalyst=4 g L(-1), and CRhB=5 mg L(-1). The pH value has a relatively small effect on the sonocatalytic degradation of RhB compared with other experimental factors. Hydroxyl (·OH) radicals were detected by fluorimetry using terephthalic acid as a probe molecule, revealing that they are produced over the ultrasonic-irradiated LuFeO3 particles. The addition of ethanol leads to a quenching of ·OH radicals and a simultaneous decrease in the RhB degradation. This indicates that ·OH radicals are the primary active species responsible for the dye degradation.

Forecasting of municipal solid waste quantity in a developing country using multivariate grey models

In order to plan, manage and use municipal solid waste (MSW) in a sustainable way, accurate forecasting of MSW generation and composition plays a key role. It is difficult to carry out the reliable estimates using the existing models due to the limited data available in the developing countries. This study aims to forecast MSW collected in Thailand with prediction interval in long term period by using the optimized multivariate grey model which is the mathematical approach. For multivariate models, the representative factors of residential and commercial sectors affecting waste collected are identified, classified and quantified based on statistics and mathematics of grey system theory. Results show that GMC (1, 5), the grey model with convolution integral, is the most accurate with the least error of 1.16% MAPE. MSW collected would increase 1.40% per year from 43,435-44,994 tonnes per day in 2013 to 55,177-56,735 tonnes per day in 2030. This model also illustrates that population density is the most important factor affecting MSW collected, followed by urbanization, proportion employment and household size, respectively. These mean that the representative factors of commercial sector may affect more MSW collected than that of residential sector. Results can help decision makers to develop the measures and policies of waste management in long term period.