Structural equation modeling analysis of determinants of barriers to breast self-examination among Eastern Chinese women.

BACKGROUND: This study aimed to establish a structural equation model to determine the associations among knowledge of breast cancer, beliefs about breast self-examination (BSE), BSE practice, socio-economic status (SES), and barriers to BSE among Eastern Chinese women. METHODS: An online cross-sectional correlational survey of 2026 women from Eastern China was undertaken by a self-administered questionnaire in 2020. Structural equation modeling was utilized for examining the interrelationships between BSE barriers and other variables. RESULTS: Our results suggested that BSE barriers were significantly and negatively related to SES, BSE beliefs, and BSE practices (ß = -0.176, p < 0.001 and ß = -0.118, p < 0.001 and ß = -0.435, p < 0.001, respectively). Among them, participants' BSE practices had the strongest effects on BSE barriers, while the effect of breast cancer knowledge on BSE barriers was in an opposite direction (ß = 0.177, p < 0.001). CONCLUSIONS: BSE barriers were influenced by SES, breast cancer knowledge, BSE beliefs and BSE practices. Our results warn that breast cancer prevention education should strengthen knowledge of practical methods rather than general knowledge. Therefore, intervention strategies designed to develop BSE and breast cancer prevention should take into account multiple factors, in particular finding more effective ways for the public to turn knowledge into a motivator rather than a barrier.

Ecological sustainability assessment of building glass industry in China based on the point of view of raw material emergy and chemical composition.

Severe environmental destruction is being driven by excessive resource consumption in the industrial production process. Therefore, there is a necessity to evaluate the sustainability of the production system. In this study, the emergy method has been adopted to assess the flat building glass production in China based on raw material and chemical composition. A series of problems including key contributors, primary sustainable indexes, unit emergy value (UEVs), sensitivity ratios, and waste impact was studied. The results illustrate that (1) the nonrenewable resources and imported resources showed the dominant impacts. (2) Silica sand and sandstone were the foremost items for the raw material angle emergy. (3) Excessive EIR, serious ELR, and tiny ESI were the main contributors to the unsustainability of the evaluated system. (4) Four UEVs were revealed, which are 1.69E + 12sej/kg, 1.80E + 12sej/kg, 1.60E + 12sej/kg, and 1.71E + 12sej/kg, respectively. (5) The nonrenewable resources showed the biggest fluctuation (7.09%), followed by imported resources (1.62%) in view of the raw material perspective; for the chemical composition, the nonrenewable resources were 7.15%, and imported resources were 1.49%, respectively. (6) Waste gas emissions were found as the major emergy contributor to the economic loss. Furthermore, positive solutions were discussed for improving the sustainability of glass production, including the proportion increase of renewable energy, recycling material replacement, and promotion of energy-saving equipment.

Socioeconomic status index is an independent determinant of breast cancer screening practices: Evidence from Eastern China.

BACKGROUND: Breast cancer is the most prevalent malignancy affecting Chinese women, and early routine screening is incredibly important for its prevention and control. This study aimed to investigate the role of socioeconomic status (SES) in female breast cancer screening practices using the composite SES index. METHODS: This cross-sectional study involved 1816 women in Eastern China. Data were collected using an online self-administered questionnaire from January 2020 to May 2021. We used principal component analysis to construct the composite SES index using educational level, annual household income, and occupation. Logistic regression was used to analyze the association between the SES index and breast cancer screening utilization. RESULTS: Of the participants, 19.27% reported having performed breast self-examination, 12.89% reported having undergone clinical breast examination, and 3.52% reported having received mammography. The SES has a significant influence on the patronage of female breast cancer screening in Eastern China. The composite SES index was found to have a positive and significant association with breast cancer screening practices. An interaction was found between the SES index and patient characteristics, such as health awareness, marital status, and location of residence. In addition, the SES index had a positive effect on breast cancer-related knowledge. CONCLUSIONS: Socioeconomic inequalities existed in Eastern China and were related to breast cancer screening patronage. The composite SES index was identified as a significant determinant of breast cancer screening practices. Our results highlighted the negative impacts of socioeconomic inequities on female breast cancer screening utilization. This suggests that reducing socioeconomic inequalities in breast cancer screening requires more focused interventions and concerted outreach activities for groups with lower education levels, lower income, or lower occupational classes.

Early intravenous tranexamic acid intervention reduces post-traumatic hidden blood loss in elderly patients with intertrochanteric fracture: a randomized controlled trial.

PURPOSE: Elderly patients with intertrochanteric fractures exhibit post-traumatic hidden blood loss (HBL). This study aimed to evaluate the efficacy and safety of reducing post-traumatic HBL via early intravenous (IV) tranexamic acid (TXA) intervention in elderly patients with intertrochanteric fracture. METHODS: A prospective randomized controlled study was conducted with 125 patients (age ≥ 65 years, injury time ≤ 6 h) who presented with intertrochanteric fracture from September 2018 and September 2019. Patients in the TXA group (n = 63) received 1 g of IV TXA at admission, whereas those in the normal saline (NS) group (n = 62) received an equal volume of saline. Hemoglobin (Hgb) and hematocrit (Hct) were recorded at post-traumatic admission (PTA) and on post-traumatic days (PTDs) 1-3. HBL was calculated using the Gross formula. Lower extremity venous ultrasound was performed to detect venous thrombosis. RESULTS: Hgb on PTDs 2 and 3 was statistically higher in the TXA group than in the NS group. Hct and HBL on PTDs 1-3 were significantly less in the TXA group compared to the NS group. Preoperative transfusion rate was significantly lower in the TXA group compared with the NS group. There was no difference between the two groups with regard to the rates of complications. CONCLUSION: Early IV TXA intervention could reduce post-traumatic HBL and pre-operative transfusion rate in elderly patients with intertrochanteric fractures without increasing the risk of venous thrombosis.