Effect of a school-based educational intervention on HPV and HPV vaccine knowledge and willingness to be vaccinated among Chinese adolescents : a multi-center intervention follow-up study.

BACKGROUND: Middle school students are recommended as the primary target population for human papillomavirus (HPV) vaccination. This study aimed to assess HPV and HPV vaccine knowledge, and to evaluate the effect of a school-based educational intervention, immediately and one year later, on HPV knowledge and vaccine acceptability among adolescents in mainland China. METHODS: A school-based interventional follow-up study was conducted in seven representative cities in mainland China from May 2015 to May 2017. "Train-the-trainer" strategy was employed to educate school teachers in this study. Students aged 13 to 14 years old were assigned to intervention classes and control classes. All students were required to complete the baseline questionnaire. Students in the intervention classes were given a 45-minute lecture regarding HPV and HPV vaccine knowledge and were then asked to complete a post-education questionnaire. One year later, all students were asked to complete the post-education questionnaire again. RESULTS: Baseline HPV knowledge was low among Chinese adolescents, with only 12.6% and 15.7% of students having heard of HPV and HPV vaccines, respectively. After the intervention, the level of HPV-related knowledge increased immediately, and students with higher knowledge levels of HPV and HPV vaccines were more willing to get vaccinated. One year after the intervention, the knowledge of HPV and HPV vaccines was dramatically diminished. However, knowledge was significantly higher in intervention classes compared to control classes. CONCLUSIONS: Knowledge and awareness of HPV and vaccination are generally deficient among Chinese adolescents. School-based health education was very effective in improving awareness and positive attitudes about HPV and HPV vaccines within a short time. Integrating health education on HPV into the existing school-based sexual health curriculum could be an effective way to increase HPV vaccination coverage and help to eliminate preventable HPV-associated cancers in China.

Abstinence Following a Motivation-Skill-Desensitization-Mental Energy Intervention for Heroin Dependence: A Three-year Follow-up Result of a Randomized Controlled Trial.

The high rate of relapse among heroin users remains a significant public concern in China. In the present study, we utilized a Motivation-Skill-Desensitization-Mental Energy (MSDE) intervention and evaluated its effects on abstinence and mental health. Eighty-nine male heroin users in a drug rehabilitation center were enrolled in the study. The participants in the MSDE intervention group (n=46) received MSDE intervention, which included motivational interviewing, coping skills training, eye movement desensitization and reprocessing, and mindfulness-based psychotherapy. The participants in the control group (n=43) received a series of lectures on skills training. A significant increase in Contemplation Ladder score (P<0.001) and decreases in scores on the Obsessive Compulsive Drug Use Scale (P<0.001), Beck Depression Inventory (P<0.001), and Aggression Questionnaire (P=0.033) were found immediately after intervention. Compared to the control group, the MSDE intervention group reported significantly higher abstinence rates (P=0.027) and retention rates (P<0.001) at follow-up. Overall, the MSDE intervention, which uses a combined strategy for relapse prevention, could be a promising approach for preventing relapse among heroin users in China.

Knowledge of human papillomavirus vaccination and related factors among parents of young adolescents: a nationwide survey in China.

PURPOSE: To investigate the human papillomavirus (HPV) vaccine-related knowledge and factors associated with the knowledge among parents of young adolescents in China. METHODS: The study was based on data of a survey carried out in seven geographic regions of China. Parents of students in junior middle school were surveyed during parents' meetings. RESULTS: A total of 2895 parents were included in the analyses. Of parents, 38.3% responded with "yes" to more than three of the six knowledge questions, among whom only 4.5% of them correctly answered all six questions. Social benefit programs (41.3%), doctors and/or nurses (39.7%), and newspapers and/or magazines (36.5%) were selected as the top three sources of HPV-related knowledge. Mothers, parents who work in the health care sector, and parents with a higher annual income or with vaccination experience outside the expanded program on immunization showed a better knowledge base. Parents who consented to sex education for children or showed fear of cervical cancer were likely to have more HPV-related knowledge. In particular, the knowledge level of parents with prior consultation regarding HPV vaccines was higher. CONCLUSIONS: Parents of young adolescents in China possessed a low level of HPV vaccine-related knowledge. Findings highlight the need for tailored health education through different channels to improve HPV-related knowledge among parents.

Human papillomavirus vaccine awareness, acceptability, and decision-making factors among Chinese college students.

BACKGROUND: College students are recommended as the target groups for catch-up human papillomavirus (HPV) vaccination. Systematical exploration of awareness, acceptability, and decision-making factors of HPV vaccination among Chinese college students has been limited. MATERIALS AND METHODS: A multi-center survey was conducted in mainland China between November 2011 and May 2012. College students aged 18-22 years were stratified by their grade, gender, and major for sampling. Socio-demographic and HPV-related information such as knowledge, perceptions, acceptability, and attitudes were collected through a questionnaire. RESULTS: A total of 3,497 undergraduates completed the questionnaire, among which 1,686 were males. The acceptability of the HPV vaccine was high (70.8%). Undergraduates from high-level universities, at lower grade, or with greater prior knowledge of HPV vaccines showed higher acceptability of HPV vaccination (ptrend <0.001). Additionally, undergraduates with vaccination experience outside the National Expanded Program on Immunization (OR=1.29; 95%CI: 1.10-1.51) or fear of HPV-related diseases (OR=2.79; 95%CI: 2.28-3.41) were more willing to accept HPV vaccination. General knowledge of HPV vaccine was low among undergraduates, and safety was a major concern (71.05%). The majority of students wished to pay less than 300RMB for HPV vaccine and chose the Chinese Center for Disease Control and Prevention as the most appropriate venue for vaccination. CONCLUSIONS: Although most undergraduates demonstrate positive attitudes towards HPV vaccination, challenges pertaining to introduction exist in China. Corresponding proactive education and governmental subsidy to do so are urgently needed by this age-group population. Suggestions and potential strategies indicated may help shape the future HPV vaccination program in China.

Perceptions and acceptability of HPV vaccination among parents of young adolescents: a multicenter national survey in China.

Prophylactic HPV vaccines target young adolescents to prevent related cervical lesions and even genital warts prior to onset of sexual activity. Parental consent is often essential for success of vaccination program for this age group. We conducted a national multicenter study to explore the acceptability of HPV vaccination among parents of young adolescents and associated factors in relevant parent decision making in China. A total of 2899 parents of young adolescents (11-17 years) participated in the survey between November 28, 2011 and May 9, 2012, but four were excluded from analysis because of inconsistencies in their given information in the questionnaire. Mothers accounted for 62.8% of the parent participants. The mean age of the parents was 40.40 (standard deviation, 4.68) years. Only 36.2% of the parents accepted the vaccine for their children. Knowledge about HPV and HPV vaccine was a positive correlate with HPV vaccination acceptability (Ptrend=0.003). Grade of child (Ptrend=0.015), prior vaccination experience outside the National Expanded Program on Immunization (OR: 1.43; 95%CI: 1.19-1.72), fear of cervical cancer and/or genital warts (OR: 2.47; 95%CI: 2.00-3.05), and prior consultation regarding HPV vaccine information (OR: 2.35; 95%CI: 1.57-3.52) were also positively associated with higher HPV vaccine acceptability. The acceptability was lower in mothers (OR: 0.45; 95%CI: 0.37-0.54) and who had better education (Ptrend=0.009). 57.3% of the parents agreed that the most appropriate venue for HPV vaccination was the local center for disease prevention and control. In conclusion, our study indicates a low acceptability of HPV vaccination among parents of young adolescents in China. We understand there are many challenges in implementing HPV vaccination program. Our findings will serve as valuable references for future HPV vaccination policies and campaigns after HPV vaccines are approved in China.

[Prevalence and related factors of injury caused by agricultural machinery in the 3 provinces Shandong, Henan and Hebei of China].

OBJECTIVE: To study the prevalent characteristics and related factors of injuries caused by agricultural machinery in 3 provinces Shandong, Henan and Hebei in China. METHODS: A total of 1621 agricultural machinery operators aged between 18 and 60 years old from Shandong, Henan and Hebei provinces were selected by purposive-cluster sampling method in 2009. Demographic characteristics, injury history caused by agricultural machinery in the last year and the related social and psychological factors were collected by self-designed questionnaire. We used statistical description to report the injury prevalence, and adopted the univariate and multivariate analysis to explore the risk factors. RESULTS: The average incidence of injuries caused by agricultural machinery was 13.44% (213/1585) in the three provinces, of which 14.46% (202/1397) in males and 5.85% (11/188) in females (χ(2) = 10.56, P < 0.01). Most of injuries (155 cases, 72.77%) occurred between April and August. Being stuck by rolling starting handles (45 cases, 21.13%), being crushed by running or dropping machineries (32 cases, 15.02%), fall from machines (28 cases, 13.15%) ranked the top three causes of injuries. The main related machines were tractors and motor tricycles (133 cases, 62.44%). The leading types of injuries were scratch (115 cases, 53.99%), strain (68 cases, 31.92%) and fracture (37 cases, 17.37%). RESULTS: of multivariate logistic regression analysis showed that being male (OR = 3.18, 95%CI:1.65-6.15), educational level above high school(OR = 1.69, 95%CI:1.21-2.34), annual family income <2000 yuan (OR = 1.94, 95%CI:1.13-3.32), operating experience ≤ 5 years (OR = 1.70, 95%CI:1.13-2.55), daytime sleepiness (OR = 2.89, 95%CI:1.66-5.01), smoking during machinery operation (OR = 1.43, 95%CI:1.05-1.96), bearing debts (OR = 1.88, 95%CI:1.35-2.63) and suffering from other diseases (OR = 1.42, 95%CI:1.02-1.98) were risk factors of agricultural machinery injuries. CONCLUSION: The average incidence of injuries caused by agricultural machinery in the three provinces Shandong, Henan and Hebei, was rather high among agricultural machinery operators, especially in the males. Agricultural machinery injury has been an important issue endangering the health of rural labor force in recent years.

A novel use of neural network model to determine the effects of multibiomarker on early health damage among Chinese steel workers.

Coke-oven workers are exposed to many kinds of pollutants that can cause health damage even lead to carcinogenesis. Therefore, it is critical to identify biomarkers that predict early health damage in these exposed individuals in molecular epidemiological studies. We applied an artificial neural network (ANN) model to the identification of such predictors in a study of coke-oven workers. The study included 330 steel-factory workers who were exposed to different levels of polycyclic aromatic hydrocarbons (PAHs) in the workplace and their levels of early health damage were determined by cytokinesis-block micronuclei (CMN), heat shock protein 70 (Hsp70) expression, benzo(a)pyrene diolepoxide-albumin adduct (BPDE-AA), and olive tail moment (OTM). The ANN model was built to predict the early health damage index, and the receiver operating characteristic (ROC) curve was used to illustrate the judged criteria and the ANN model. Trend Chi-square modeling was also performed. We found that there were 55 subjects with early health damage among 330 workers based on the multibiomarker criteria using the 95 percentile of the control group as the cut-off value, while there were 22-35 positive subjects if screening by any single biomarker. The Cochran-Armitage trend test for these findings were statistically significant (Z = 3.21, P = 0.0013). Six variables were selected to simulate the ANN model. The area under ROC (AUROC) was 0.726 ± 0.037 (P < 0.001), and the predictors included workplace, cholesterol, waistline, and others. Therefore, collective using CMN frequency, Hsp70 level, BPDE-AA level, and OTM with equal weights to make an initial screening test for early health damage in coke-oven workers is feasible and superior to any single biomarker. The determinants of the effects of multibiomarker on early health damage screening can be identified by the ANN model and ROC curve method.

[Study on the status and risk factors of the first use illicit drugs among college students in Wuhan city].

OBJECTIVE: To investigate the status on the initial use of illicit drugs among the college students in Wuhan city,and to explore its related risk factors for developing strategies to reduce the rate. METHODS: College students were enrolled from universities by stratified randomization, and were asked to answer the self-report questionnaires anonymously. The related risk factors with initial illicit drugs were analyzed by univariate analyses and logistic regression analysis. RESULTS: The rate of initial illicit drugs use reached 2.0 % among 5677 studied college students in Wuhan city including 2.8 % male students ever once used illicitly with the rate as 5.5 % among senior college students. The overall rate of initial illicit drugs use among students who were under the conditions of insomniac, depression, smoking cigarettes, drinking alcohol,lack of parents' care and bad relationship with classmates were seen as 3.3 %, 3.8%, 18.0 %, 16.3%, 12.0%,16.0% respectively. The rate of initial illicit drugs use among those who were with very high or low family income were 4.0% and 3.1% respectively. CONCLUSION: There was high rate of initial illicit drug use among college students in Wuhan city and the major risk factors of the initial illicit drugs use would include smoke, drink, depression, bad relationship with classmates and being in higher grade. The problem of the initial illicit drugs was very serious among the college students in Wuhan city which called for special attention.

Elevated levels of urinary 8-hydroxy-2 -deoxyguanosine, lymphocytic micronuclei, and serum glutathione S-transferase in workers exposed to coke oven emissions.

To investigate associations among occupational exposure to coke oven emissions (COEs), oxidative stress, cytogenotoxic effects, change in the metabolizing enzyme glutathione S-transferase (GST), and internal levels of polycyclic aromatic hydrocarbons (PAHs) in coke oven workers, we recruited 47 male coke oven workers and 31 male control subjects from a coke oven plant in northern China. We measured the levels of 1-hydroxypyrene (1-OHP) and 8-hydroxy-2 -deoxyguanosine (8-OHdG) in urine, micronucleated binucleated cells (BNMNs) in peripheral blood lymphocyte, and GST in serum. Our results showed that the group exposed to COEs had significantly increased levels of 1-OHP [median 5.7; interquartile range (IQR), 1.4-12.0 micromol/mol creatinine] compared with the control group (3; 0.5-6.4 micromol/mol creatinine). In addition, the median levels (IQR) of 8-OHdG, BNMNs, and GST were markedly increased in the exposed [1.9 (1.4-15.4) micromol/mol creatinine; 6 (2-8) per thousand ; 22.1 (14.9-31.2) U/L, respectively] compared with controls [1.3 (1.0-4.0) micromol/mol creatinine, 2 (0-4) per thousand; and 13.1 (9.5-16.7) U/L, respectively]. These results appeared to be modified by smoking. However, multivariate logistic regression analysis revealed that exposure to COEs had the highest odds ratio among variables analyzed and that smoking was not a significant confounder of the levels of studied biomarkers. Overall, the present findings suggest that COE exposure led to increased internal PAH burden, genetic damage, oxidative stress, and GST activity. The consequences of the changes in these biomarkers, such as risk of cancer, warrant further investigations.

[Analysis of serum glutathione S-transferase and urinary 8-hydroxy-2-deoxyguanosine in coke oven workers].

OBJECTIVE: To investigate the application of serum glutathione S-transferase (GST) and urinary 8-hydroxy-2-deoxyguanosine (8-OHdG) as the monitoring biomarkers for coke oven workers exposed to polycyclic aromatic hydrocarbons (PAHs). METHODS: 47 male coke oven workers and 31 male control workers were investigated. Urinary 8-OHdG and serum GST were analyzed using high performance liquid chromatography (HPLC) with electrochemical detection and test kit. Urinary 1-hydroxypyrene (1-OHP) as internal exposure of PAHs was also determined simultaneously by alkaline hydrolysis and HPLC. RESULTS: The values of urinary 1-OHP, serum GST and urinary 8-OHdG were reported as median with interquartile range (P(25)-P(75)). Urinary 1-OHP [5.7 (1.4-12.0) micromol/mol Cr], serum GST [22.1 (14.9-31.2) U/ml], and urinary 8-OHdG [1.9 (1.4-15.4) micromol/mol Cr] in coke oven workers were significantly higher than in control workers [3.0 (0.5-6.4) micromol/mol Cr (P < 0.05), 13.1 (9.5-16.7) U/ml (P < 0.01), and 1.3 (1.0-4.0) micromol/mol Cr (P < 0.05) respectively]. Categorizing by smoking status, significant differences in urinary 1-OHP and serum GST were found only in smokers among coke oven workers compared to control workers (P < 0.01), and 8-OHdG levels only in non-smokers (P < 0.01). Additionally, there was significant correlation between urinary 1-OHP and serum GST activity (r(s) = 0.31, P < 0.01, n = 78). The multiple logistic regression analysis showed that coke oven workers were at the higher risk of having GST activities above 16.7 U/ml (OR = 13.2) and 8-OHdG levels above 1.8 micromol/mol creatinine (OR = 4.4). High body mass index was an independent factor to affect urinary 8-OHdG levels. CONCLUSIONS: The elevated serum GST activities and increased oxidative DNA damage were found in the coke oven workers. Occupational exposure and smoking interact on each other. Serum GST may be used as a biomarker for assessing the exposure of PAHs. Assay of urinary 8-OHdG may be useful for evaluating the risk of lung cancer in coke oven workers.

[Influence of smoking on the prevalence of chronic diseases among people with different income levels].

OBJECTIVE: To explore the influence of smoking on chronic diseases among people with various income levels in China. METHODS: Cross-sectional study on smoking behavior, chronic disease and income level was performed using database of the Second National Health Service Study (1998) provided by the Ministry of Health in China. RESULTS: Compared to never-smokers, smokers (including current smokers and former smokers) had a higher rate of having chronic diseases, after adjusted in age, income, educational level, employment status and type of jobs with corresponding countryside (OR = 1.185, 95% CI: 1.121 - 1.253 and town OR = 1.083, 95% CI: 1.010 - 1.161). Smoking had a more serious effect on having chronic illness in males from the countryside (former-smoker OR = 2.764, 95% CI: 2.471 - 3.092) than in town (former-smoker OR = 2.112, 95% CI: 1.844 - 2.419). Smokers at the lowest income level had a higher possibility of having chronic illness (town OR = 2.076, 95% CI: 1.551 - 2.780; countryside OR = 2.903, 95% CI: 2.248 - 3.749) than those at the highest income level (town OR = 1.785, 95% CI: 1.285 - 2.479 in the countryside OR = 2.466, 95% CI: 1.941 - 3.134). CONCLUSION: Smoking might cause more serious health problems to people at lower income level in China.