A pilot intervention study on bullying prevention among junior high school students in Shantou, China.

BACKGROUND: Bullying is common among adolescents and can have an adverse effect on victims. This study aims to implement and evaluate an educational intervention on bullying prevention among junior high school students in Shantou, China. METHODS: The four-session educational intervention was designed based on the knowledge-attitude-practice model and conducted from September to December 2018, with one session implemented a month. The intervention methods included holding bullying-themed class meetings, distributing bullying educational leaflets at school, and playing anti-bullying videos in class. The post-intervention assessment was measured at the end of session 4. The chi-square tests were used to examine the changes from baseline to after intervention in the intervention and control group. RESULTS: The results showed that the intervention group's awareness of bullying (percentage of the students who knew bullying very well, male: before vs. after intervention: 16.3% vs. 37.6%, P < 0.001; female: before vs. after intervention: 11.8% vs. 38.8%, P < 0.01), and the female students' acceptance of anti-bullying education (before vs. after intervention: 89.3% vs. 97.6%, P < 0.05) was improved after intervention. The incidence of cyber victimization (male: 32.3% vs. 18.5%, P < 0.05; female: 22.4 to 7.0%, P < 0.01) was also reduced in the intervention group, with the reduction in the incidence of social (19.4% vs. 8.7%, P < 0.05), verbal (40.9% vs. 27.2%, P < 0.05) victimization, and peer (36.6% vs. 20.7%, P < 0.05) and social bullying (11.8% vs. 2.2%, P < 0.01) among male students after intervention. CONCLUSIONS: This educational intervention was the first important step to develop effective intervention strategies for bullying prevention among junior high school students in China.

[Investigation and analysis of factors that affect the health of children in the plastic recycling and regeneration processing region].

OBJECTIVE: To investigate the main influential factors for the health of children in the plastic waste recovery and recycling area. METHODS: A cross-sectional survey was performed among children aged 9∼17 years from three natural villages engaged in plastic waste recovery and recycling and four control villages engaged in planting. The health status of children was investigated by random household survey using a face-to-face questionnaire, and the main influential factors were analyzed accordingly. RESULTS: The incidence rates of respiratory symptoms (cough and expectoration, nasal congestion, and sore throat) (78.4%, 69/88) and digestive diseases (gastrointestinal disease and liver disease) (14.8%, 13/88) in the waste processing area were significantly higher than those in the control area (64.0%, 71/111; 6.3%, 7/111) (P < 0.05). CONCLUSION: Multivariate logistic regression analysis indicated that skin diseases are related to whether plastic can be smelt around the residential area.

[Investigation of current demands for professional continuing medical education in ophthalmic nurses].

OBJECTIVE: To investigate the current demands for professional continuing medical education (CME) in ophthalmic nurses and their influential factors, and to provide evidence for properly setting the curriculum of professional CME for nurses. METHODS: Qualitative and quantitative analysis was performed on 60 nurses in an ophthalmic hospital by questionnaire survey and group interview. RESULTS: Of the nurses surveyed, 49 (81.7%) thought the training time of professional CME needs to be adjusted, 40 (66.7%) referred to the training pattern, and 53 (88.3%) the training contents. The demanded courses of training mainly included professional nursing knowledge, professional nursing skills, and ophthalmic knowledge. Most nurses considered the influential factors for training were unreasonable training time and lack of applicability of some courses. CONCLUSION: To improve the quality of professional CME for ophthalmic nurses, the training curriculum should be designed in consideration of ophthalmic characteristics, different work experiences of nurses, and different nursing positions, the training time should be arranged properly, and various training patterns should be adopted flexibly.

An Intervention to Reduce Bicycle Injuries among Middle School Students in Rural China.

This study aimed to evaluate the effectiveness of an intervention to reduce bicycle injuries among rural middle school students in China. A one-year cluster-randomized controlled trial was conducted with seventh grade students from six middle schools in two towns in rural Chaoshan, China. The two towns were randomly assigned to either the intervention or control group. Road safety education materials, two lectures on road safety, and a series of health education activities were delivered to 1312 students in the intervention group over one year, and the content of the intervention included traffic safety knowledge, methods of preventing bicycle injury and management of bicycle injuries. Questionnaires weere administered to the two groups before and after the intervention to measure the incidence, cognitions, and behaviors related to bicycle injuries. The pre-intervention incidence of bicycle injuries exhibited no significant difference between the two groups, while the difference reached significance after the intervention (χ² = 13.409, p < 0.001). In the intervention group, the incidence decreased significantly after the intervention (χ² = 8.137, p = 0.004), while no significant change was observed in the control group. Publicity and education intervention measures have certain short-term effects on the prevention of bicycle injuries among rural middle school students; we should approach intervention measures according to the characteristics of traffic injuries in different areas.

Exploring Associations between Problematic Internet Use, Depressive Symptoms and Sleep Disturbance among Southern Chinese Adolescents.

The primary aim of this study was to examine associations between problematic Internet use, depression and sleep disturbance, and explore whether there were differential effects of problematic Internet use and depression on sleep disturbance. A total of 1772 adolescents who participated in the Shantou Adolescent Mental Health Survey were recruited in 2012 in Shantou, China. The Chinese version of the Internet Addiction Test (IAT) was used to evaluate the prevalence and severity of Internet addiction. The Chinese version of the Pittsburgh Sleep Quality Index (PSQI), a 10-item version of the Center for Epidemiologic Studies Depression Scale (CESD-10), and other socio-demographic measures were also completed. Multiple regression analysis was used to test the mediating effect of problematic Internet use and depression on sleep disturbance. Among the participants, 17.2% of adolescents met the criteria for problematic Internet use, 40.0% were also classified as suffering from sleep disturbance, and 54.4% of students had depressive symptoms. Problematic Internet use was significantly associated with depressive symptoms and sleep disturbance. The correlation between depressive symptoms and sleep disturbance was highly significant. Both problematic Internet use (ß = 0.014; Sobel test Z = 12.7, p < 0.001) and depression (ß = 0.232; Sobel test Z = 3.39, p < 0.001) had partially mediating effects on sleep disturbance and depression was of greater importance for sleep disturbance than problematic Internet use. There is a high prevalence of problematic Internet use, depression and sleep disturbance among high school students in southern China, and problematic Internet use and depressive symptoms are strongly associated with sleep disturbance. This study provides evidence that problematic Internet use and depression have partially mediating effects on sleep disturbance. These results are important for clinicians and policy makers with useful information for prevention and intervention efforts.

The association between meteorological factors and road traffic injuries: a case analysis from Shantou city, China.

Few studies examined the associations of meteorological factors with road traffic injuries (RTIs). The purpose of the present study was to quantify the contributions of meteorological factors to RTI cases treated at a tertiary level hospital in Shantou city, China. A time-series diagram was employed to illustrate the time trends and seasonal variation of RTIs, and correlation analysis and multiple linear regression analysis were conducted to investigate the relationships between meteorological parameters and RTIs. RTIs followed a seasonal pattern as more cases occurred during summer and winter months. RTIs are positively correlated with temperature and sunshine duration, while negatively associated with wind speed. Temperature, sunshine hour and wind speed were included in the final linear model with regression coefficients of 0.65 (t = 2.36, P = 0.019), 2.23 (t = 2.72, P = 0.007) and -27.66 (t = -5.67, P < 0.001), respectively, accounting for 19.93% of the total variation of RTI cases. The findings can help us better understand the associations between meteorological factors and RTIs, and with potential contributions to the development and implementation of regional level evidence-based weather-responsive traffic management system in the future.

Bridging the gap between science and policy: an international survey of scientists and policy makers in China and Canada.

BACKGROUND: Bridging the gap between science and policy is an important task in evidence-informed policy making. The objective of this study is to prioritize ways to bridge the gap. METHODS: The study was based on an online survey of high-ranking scientists and policy makers who have a senior position in universities and governments in the health sector in China and Canada. The sampling frame comprised of universities with schools of public health and medicine and various levels of government in health and public health. Participants included university presidents and professors, and government deputy ministers, directors general and directors working in the health field. Fourteen strategies were presented to the participants for ranking as current ways and ideal ways in the future to bridge the gap between science and policy. RESULTS: Over a 3-month survey period, there were 121 participants in China and 86 in Canada with response rates of 30.0 and 15.9 %, respectively. The top strategies selected by respondents included focus on policy (conducting research that focuses on policy questions), science-policy forums, and policy briefs, both as current ways and ideal ways to bridge the gap between science and policy. Conferences were considered a priority strategy as a current way, but not an ideal way in the future. Canadian participants were more in favor of using information technology (web-based portals and email updates) than their Chinese counterparts. Among Canadian participants, two strategies that were ranked low as current ways (collaboration in study design and collaboration in analysis) became a priority as ideal ways. This could signal a change in thinking in shifting the focus from the "back end" or "downstream" (knowledge dissemination) of the knowledge transfer process to the "front end" or "upstream" (knowledge generation). CONCLUSIONS: Our international study has confirmed a number of previously reported priority strategies to bridge the gap between science and policy. More importantly, our study has contributed to the future work on evidence-based policy making by comparing the responses from China and Canada and the current and ideal way for the future. Our study shows that the concept and strategies of bridging the gap between science and policy are not static but varying in space and evolving over time.

Impact of extreme high temperature on mortality and regional level definition of heat wave: a multi-city study in China.

BACKGROUND: Few multi-city studies have been conducted to explore the regional level definition of heat wave and examine the association between extreme high temperature and mortality in developing countries. OBJECTIVES: The purpose of the present study was to investigate the impact of extreme high temperature on mortality and to explore the local definition of heat wave in five Chinese cities. METHODS: We first used a distributed lag non-linear model to characterize the effects of daily mean temperature on non-accidental mortality. We then employed a generalized additive model to explore the city-specific definition of heat wave. Finally, we performed a comparative analysis to evaluate the effectiveness of the definition. RESULTS: For each city, we found a positive non-linear association between extreme high temperature and mortality, with the highest effects appearing within 3 days of extreme heat event onset. Specifically, we defined individual heat waves of Beijing and Tianjin as being two or more consecutive days with daily mean temperatures exceeding 30.2 °C and 29.5 °C, respectively, and Nanjing, Shanghai and Changsha heat waves as ≥3 consecutive days with daily mean temperatures higher than 32.9 °C, 32.3 °C and 34.5 °C, respectively. Comparative analysis generally supported the definition. CONCLUSIONS: We found extreme high temperatures were associated with increased mortality, after a short lag period, when temperatures exceeded obvious threshold levels. The city-specific definition of heat wave developed in our study may provide guidance for the establishment and implementation of early heat-health response systems for local government to deal with the projected negative health outcomes due to heat waves.

Impact of ambient humidity on child health: a systematic review.

BACKGROUND AND OBJECTIVES: Changes in relative humidity, along with other meteorological factors, accompany ongoing climate change and play a significant role in weather-related health outcomes, particularly among children. The purpose of this review is to improve our understanding of the relationship between ambient humidity and child health, and to propose directions for future research. METHODS: A comprehensive search of electronic databases (PubMed, Medline, Web of Science, ScienceDirect, OvidSP and EBSCO host) and review of reference lists, to supplement relevant studies, were conducted in March 2013. All identified records were selected based on explicit inclusion criteria. We extracted data from the included studies using a pre-designed data extraction form, and then performed a quality assessment. Various heterogeneities precluded a formal quantitative meta-analysis, therefore, evidence was compiled using descriptive summaries. RESULTS: Out of a total of 3797 identified records, 37 papers were selected for inclusion in this review. Among the 37 studies, 35% were focused on allergic diseases and 32% on respiratory system diseases. Quality assessment revealed 78% of the studies had reporting quality scores above 70%, and all findings demonstrated that ambient humidity generally plays an important role in the incidence and prevalence of climate-sensitive diseases among children. CONCLUSIONS: With climate change, there is a significant impact of ambient humidity on child health, especially for climate-sensitive infectious diseases, diarrhoeal diseases, respiratory system diseases, and pediatric allergic diseases. However, some inconsistencies in the direction and magnitude of the effects are observed.

A descriptive epidemiological study on the patterns of occupational injuries in a coastal area and a mountain area in Southern China.

OBJECTIVES: This study compared patterns of occupational injuries in two different areas, coastal (industrial) and mountain (agricultural), in Southern China to provide information for development of occupational injury prevention measures in China. DESIGN: Descriptive epidemiological study. SETTING: Data were obtained from the Hospital Injury Surveillance System based on hospital data collected from 1 April 2006 to 31 March 2008. PARTICIPANTS: Cases of occupational injury, defined as injury that occurred when the activity indicated was work. OUTCOME MEASURES: Distribution and differences of patterns of occupational injuries between the two areas. RESULTS: Men were more likely than women to experience occupational injuries, and there was no difference in the two areas (p=0.112). In the coastal area, occupational injury occurred more in the 21-30-year age group, but in the mountain area, it was the 41-50-year age group (p<0.001). Occupational injuries in the two areas differed by location of hometown, education and occupation (all p<0.001). Occupational injuries peaked differently in the month of the year in the two areas (p<0.001). Industrial and construction areas were the most frequent locations where occupational injuries occurred (p<0.001). Most occupational injuries were unintentional and not serious, and patients could go home after treatment. The two areas also differed in external causes and consequences of occupational injuries. CONCLUSIONS: The differing patterns of occupational injuries in the coastal and mountain areas in Southern China suggest that different preventive measures should be developed. Results are relevant to other developing countries that have industrial and agricultural areas.

[Determinants of bicycle injury among school-aged children in rural China: a qualitative study].

OBJECTIVE: To investigate the causes of bicycle injuries among middle school students in rural areas and attitudes of students, their parents and teachers toward bicycle injuries. METHODS: 103 respondents in 14 groups were interviewed using focus group discussion outline. Data were taped and interpreted by two experienced researchers using the QSR NVivo 8.0 software. RESULTS: Disobeying the traffic rules, riding bicycle carelessly and fast speed when riding bicycle were the first leading causes of bicycle injuries among middle school students. The relative importance of disobeying traffic rules, inattentive riding the bicycles and fast speed were 1.00, 0.80 and 0.78 respectively. Students, their parents and teachers held different attitudes toward the determinants of child bicycle injuries. The three groups considered the most importance objective cause was 'poor road condition (23 person-time)'. Fast riding speed was the most important subjective cause (students and parents were 14 and 8 person-time during the interview) but teachers thought that disobeying traffic rules was the most important one (by 14 person-time). CONCLUSION: Residents in rural China had low awareness of child bicycle injuries. There is a need to improve the awareness of road safety among rural residents. Future intervention strategies should be tailored to address main determinants to reduce the incidence of road traffic injuries among children.

Attitudes of students, parents, and teachers toward glasses use in rural China.

OBJECTIVE: To use focus groups to understand barriers to glasses use among children in rural China. METHODS: Separate focus groups were conducted between December 17, 2007, and August 5, 2008, for the following 3 groups at each of 3 schools in rural China: children aged 14 to 18 years with myopia of less than -0.5 diopters in both eyes, those children's parents, and those children's teachers. Participants were also asked to rank their responses to questions about glasses use. The focus group transcripts were coded independently by 2 investigators using qualitative data management software. RESULTS: Respondents of all 3 types indicated that glasses purchase and wear should be delayed in children with early myopia and might be harmful to the eyes. Parents and students reported being uncertain about children's actual myopia status and whether glasses should be worn. Parents ranked their most common reason for not buying glasses as being "too busy with work," whereas "too expensive" ranked low. Inconvenience was ranked as an important reason for not wearing glasses among all 3 student groups. "Accuracy of lens power" was the first-ranked requirement for glasses among all student groups, whereas "new and attractive styles" was ranked last by all. All 3 types of respondents believed that wearing glasses or failing to wear them might worsen myopia. CONCLUSIONS: Educational programs are needed to address significant knowledge gaps in families and schools about glasses use in rural China. Cost and the need for attractive styles may not be significant barriers to use in this setting, raising the possibility of paying for such programs through cost recovery.

Height, stunting, and refractive error among rural Chinese schoolchildren: the See Well to Learn Well project.

PURPOSE: To evaluate the hypothesis that changes in nutritional status could be partly responsible for observed increases in myopia prevalence among Chinese children. DESIGN: Cross-sectional cohort study. METHODS: Rural Chinese secondary school children participating in a study of interventions to promote spectacle use were randomly sampled (20% of children with uncorrected vision >6/12 bilaterally, and 100% of remaining children) and underwent cycloplegic refraction with subjective refinement and measurement of height and weight. Stunting was defined according to the World Health Organization standard population. RESULTS: Among 3226 children in the sample, 2905 (90.0%) took part. Among 1477 children undergoing refraction, 1371 (92.8%) had height and weight measurements. These children had a mean age of 14.5 +/- 1.4 years, 59.8% were girls, and mean spherical equivalent refraction was -1.93 +/- 1.82 diopters. Stunting was present in 87 children (6.4%). While height was inversely associated with refractive error (RE) (taller children were more myopic) among boys (r = -0.147, P = .001), this disappeared when adjusting for age, and no such association was observed among girls. Neither girls nor boys with stunting differed significantly in refraction from children without stunting, and neither stunting nor height was associated with RE when adjusting for age, height, and parental education. The power of this study to have detected a 0.75 diopters difference in RE between children with and without stunting was 0.96. CONCLUSION: Results from this cross-sectional study are not consistent with the hypothesis that nutritional status is a determinant of RE in this setting.