[Analysis on the demand, access and related factors of cancer prevention and treatment knowledge among urban residents in China from 2015 to 2017].

Objective: To investigate the demand and access to the cancer prevention and treatment knowledge and related factors among urban residents in China from 2015 to 2017. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The self-designed questionnaire was used to collect the information of general demographic characteristics, the demand and access to cancer prevention and treatment knowledge, and the influencing factors of the attitude. The Chi-square test was used to analyze the difference of the demand of the cancer prevention knowledge among different groups and the corresponding factors of the cancer prevention and treatment knowledge were analyzed by using the logistic regression model. Results: The proportion of residents who need the cancer prevention and treatment knowledge was 79.5%. The demand rate of the inducement, symptom and diagnosis methods of cancer in the occupational population was highest, about 66.8%, 71.0% and 20.8%, respectively. The demand rate of treatment methods and cost in current cancer patients was the highest, about the 45.9% and 21.9%, respectively. The top three sources to acquire the cancer prevention and treatment knowledge were "broadcast or television" (69.5%), "books, newspapers, posters or brochures" (44.7%) and "family and friends" (33.8%). The multivariate analysis showed that compared with public institution personnel/civil servants, unmarried/cohabiting/divorced/widowed and others, annual household income less than 20 000 CNY, from the eastern region, people without cancer diagnosis and people with self-assessment of cancer risk, the demand rate of cancer prevention and treatment knowledge was higher in enterprise personnel/workers, married, annual household income between 60 000 CNY and 150 000 CNY, from the central region, people with cancer and people with unclear cancer risk (all P values <0.05). Conclusion: There was a high demand for the cancer prevention and treatment knowledge among urban residents in China from 2015 to 2017. The main access to the knowledge is from the radio or television. The occupation, marital status, annual household income, residential region, health status and risk of disease were the main factors of the demand of the cancer prevention and treatment knowledge.

[Etiology analysis and vestibular assessment of bilateral vestibular vestibulopathy].

Objective:To define clinical and laboratory characteristics of bilateral vestibulopathy(BVP) and to propose diagnostic criteria of this disorder based on clinical and laboratory vestibular function test findings.Method:Forty-two case series with a clinical suspicion of BVP were retrospectively analyzed, in an attempt to determine etiology. Presenting auditory-vestibular symptoms, bedside dynamic visual acuity tests and laboratory test were reviewed, including bithermal caloric test, rotatory chair tests, video head impulse test (vHIT), vestibular-evoked myogenic potentials (VEMP).Result:Among these 42 patients, dizziness was seen in 42 cases(100%), oscillopsia was seen in 21 cases(50%), hearing loss was seen in 30(71.4%). Eight cases(19%) had tinnitus. Twenty-five cases showed vestibular loss in dynamic visual acuity test (69.4%). Definite diagnosis of complete BVP was made in 36 patients when the patients showed abnormal findings on caloric test, rotatory chair test and vHIT in addition to the symptoms. Whereas probable diagnosis of partial BVP was obtained in 6 patients with abnormal caloric test and rotatory chair test but no pathological vHIT. VEMP (ocular or cervical) could be recorded in 20 patients. Fourteen cases were caused by ototoxic drugs while no causes could be determined in 6 cases among these 42 cases.Conclusion:The diagnosis of BVP is a challenge. Vestibular laboratory test battery which reflect full frequency function of VOR has great value to confirming the diagnosis and differentiate complete BVP to partial BVP. Diagnosis standard shall be made combining clinical history, characteristic symptoms and the results of auditory-vestibular function testing. Ototoxic drugs contribute most considering etiology.

[Preference on screening frequency and willingness-to-pay for multiple-cancer packaging screening programs in urban populations in China].

Objective: From an actual cancer screening service demanders' perspective, we tried to understand the preference on screening frequency and willingness-to-pay for the packaging screening program on common cancers and to evaluate its long-term sustainability in urban populations in China. Methods: From 2012 to 2014, a multi-center cross-sectional survey was conducted among the actual screening participants from 13 provinces covered by the Cancer Screening Program in Urban China (CanSPUC). By face-to-face interview, information regarding to preference to screening frequency, willingness-to-pay for packaging screening program, maximum amount on payment and related reasons for unwillingness were investigated. Results: A total of 31 029 participants were included in this survey, with an average age as (55.2±7.5) years and median annual income per family as 25 000 Chinese Yuan. People's preference to screening frequency varied under different assumptions ( " totally free" and "self-paid" ). When the packaging screening was assumed totally free, 93.9% of residents would prefer to take the screening program every 1 to 3 years. However, the corresponding proportion dropped to 67.3% when assuming a self-paid pattern. 76.7% of the participants had the willingness-to-pay for the packaging screening, but only 11.2% of them would like to pay more than 500 Chinese Yuan (the expenditure of the particular packaging screening were about 1 500 Chinese Yuan). The remaining 23.3% of residents showed no willingness-to-pay, and the main reasons were unaffordable expenditure (71.7%) and feeling'no need'(40.4%). Conclusions: People who participated in the CanSPUC program generally tended to choose high-frequency packaging screening program, indicating the high potential acceptance for scale-up packaging screening, while it needs cautious assessments and rational guidance to the public. Although about seven in ten of the residents were willing to pay, the payment amount was limited, revealing the necessity of strengthening individual's awareness of his or her key role in health self-management, and a reasonable payment proportion should be considered when establishing co-compensation mechanism.

Patterns of association of chronic medical conditions and major depression.

AIMS: Age and sex-related patterns of association between medical conditions and major depressive episodes (MDE) are important for understanding disease burden, anticipating clinical needs and for formulating etiological hypotheses. General population estimates are especially valuable because they are not distorted by help-seeking behaviours. However, even large population surveys often deliver inadequate precision to adequately describe such patterns. In this study, data from a set of national surveys were pooled to increase precision, supporting more precise characterisation of these associations. METHODS: The data were from a series of Canadian national surveys. These surveys used comparable sampling strategies and assessment methods for MDE. Chronic medical conditions were assessed using items asking about professionally diagnosed medical conditions. Individual-level meta-analysis methods were used to generate unadjusted, stratified and adjusted prevalence odds ratios for 11 chronic medical conditions. Random effects models were used in the meta-analysis. A procedure incorporating rescaled replicate bootstrap weights was used to produce 95% confidence intervals. RESULTS: Overall, conditions characterised by pain and inflammation tended to show stronger associations with MDE. The meta-analysis uncovered two previously undescribed patterns of association. Effect modification by age was observed in varying degrees for most conditions. This effect was most prominent for high blood pressure and cancer. Stronger associations were found in younger age categories. Migraine was an exception: the strength of association increased with age, especially in men. Second, especially for conditions predominantly affecting older age groups (arthritis, diabetes, back pain, cataracts, effects of stroke and heart disease) confounding by age was evident. For each condition, age adjustment resulted in strengthening of the associations. In addition to migraine, two conditions displayed distinctive patterns of association. Age adjusted odds ratios for thyroid disease reflected a weak association that was only significant in women. In epilepsy, a similar strength of association was found irrespective of age or sex. CONCLUSIONS: The prevalence of MDE is elevated in association with most chronic conditions, but especially those characterised by inflammation and pain. Effect modification by age may reflect greater challenges or difficulties encountered by young people attempting to cope with these conditions. This pattern, however, does not apply to migraine or epilepsy. Neurobiological changes associated with these conditions may offset coping-related effects, such that the association does not weaken with age. Prominent confounding by age for several conditions suggests that age adjustments are necessary in order to avoid underestimating the strength of these associations.

Socioeconomic status and the risk of major depression: the Canadian National Population Health Survey.

BACKGROUND: There are few longitudinal studies investigating the risk of major depression by socioeconomic status (SES). In this study, data from the longitudinal cohort of Canadian National Population Health Survey were used to estimate the risk of major depressive episode (MDE) over 6 years by SES levels. METHODS: The National Population Health Survey used a nationally representative sample of the Canadian general population. In this analysis, participants (n=9589) were followed from 2000/2001 (baseline) to 2006/2007. MDE was assessed using the Composite International Diagnostic Interview--Short Form for Major Depression. RESULTS: Low education level (OR=1.86, 95% CI 1.28 to 2.69) and financial strain (OR=1.65, 95% CI 1.19 to 2.28) were associated with an increased risk of MDE in participants who worked in the past 12 months. In those who did not work in the past 12 months, participants with low education were at a lower risk of MDE (OR=0.43, 95% CI 0.25 to 0.76), compared with those with high education. Financial strain was not associated with MDE in participants who did not work. Working men who reported low household income (12.9%) and participants who did not work and reported low personal income (5.4%) had a higher incidence of MDE than others. CONCLUSIONS: SES inequalities in the risk of MDE exist in the general population. However, the inequalities may depend on measures of SES, sex and employment status. These should be considered in interventions of reducing inequalities in MDE. MDE history is an important factor in studies examining inequalities in MDE.

Direct assessment of international consistency of standards for ground-level ozone: strategy and implementation toward metrological traceability network in Asia.

An international exercise to directly assess consistency of standards for ground-level ozone in East Asia was conducted as part of the East Asian Regional Experiment 2005 (EAREX 2005) in the framework of the Atmospheric Brown Clouds (ABC) project. Ten organizations collaboratively participated in the intercomparison. Four groups representing Japan, Korea, Hong Kong, and Taiwan made comparisons at the Gosan super observatory, Jeju Island, Korea, in March 2005, with ozone instruments calibrated to their national standards, and four Japanese groups made off-site comparisons with laboratory-level standards. All comparisons generally indicated good agreement with the standard reference photometer (SRP) 35, built by the National Institute of Standards and Technology (USA) and maintained by the National Institute for Environmental Studies (Japan). The assessment was expanded to measurement networks contributing to the World Meteorological Organization's Global Atmospheric Watch (WMO/GAW) program as part of off-site comparisons, and excellent agreement was achieved. These efforts contribute to propagating traceability of the national metrology standards among the atmospheric science community, to ensuring comparability of the existing ozone measurements, and to establishing an integrated network of air quality monitoring in Asia.

Indirect electrochemical treatment of saline dyestuff wastewater.

Dyestuff wastewater is always found to contain highly-concentrated sodium chloride. In many cases, biological processes are not available to dispose saline dyestuff wastewater. In this paper, both direct a nd indirect electrochemical oxidation of saline dyestuff wastewater were carried out and the accessibility of indirect electrochemical oxidation by electrochemically generated hypochlorite was investigated. It was found that the indirect electrochemical process removed COD by 87% and color by 100% in 50 minutes while the direct electrochemical process removed COD by 47% and color by 50% in 5 hours. The rate-limiting step for hypochlorite evolution at the anode was found to be diffusion-controlled. For the two processes, COD removal kinetics could be simplified as the pseudo first-order kinetics. The rate constants of COD removal were 0.038 min(-1) and 0.0018 min(-1) for the indirect and direct oxidation respectively. Current efficiency of the indirect process was I while that of the direct process was 0.16; cost efficiency of the two processes was 8,000 mg-COD (kWh)(-1) and 1,000 mg-COD (kWh)(-1) respectively. It can be concluded that the indirect electrochemical process is a promising method for the disposal of saline dyestuff wastewater.

Hazard rate estimation under random censoring with varying kernels and bandwidths.

We discuss the estimation of hazard rates under random censoring with the kernel method. Two practically relevant problems that occur when applying unmodified kernel estimators are boundary effects near the endpoints of the support of the hazard rate, and a substantial increase in the variance from left to right over the range of abscissae where the hazard rate is estimated. A new class of boundary kernels is proposed for the first problem. Explicit formulas for these kernels are developed, and it is shown that this boundary correction works well in practice. A data-adaptive varying bandwidth selection procedure is proposed for the second problem. This procedure generally will lead to increasing bandwidths near the left endpoint and toward the right endpoint, and will lead to smaller integrated mean squared error of the hazard rate estimator as compared to a fixed bandwidth method. A practically feasible method incorporating the new boundary kernels and local bandwidth choices is implemented and illustrated with survival data from a leukemia study.

Study on mutagenicity and identification of organic pollutants in wastewater of industrial area.

In this study, wastewater samples from three industrial wastewater channels and 12 related factories were collected. Nonvolatile organic chemicals were concentrated on H-103 resin and analysed by GC/MS/DS techniques. The mutagenicity of organic extracts from the samples was examined by using S. typhimurium assay (Ames test). The results of both Ames test and chemical analysis showed that the mutagenic compounds in the Loujia Channel mainly come from Dyestuff Factory, and that Pharmaceutical Factory is a main pollution source of mutagenic compounds for the Xindun Channel. Our experimental results also showed that it is necessary to examine the mutagenicity of industrial wastewater by using short term bioassay for evaluating long-term effect of industrial wastewater on human health.

An introduction to China's health care system.

The Chinese health care system was originally a highly centralized one. It had great success in improving the people's health. The county-township-village three-tier health care system has contributed much to rural primary health care, and has set an example of primary health care to the developing nations. In the 1980s, this system experienced transformations along with the changes of the country's administrative system and economic policy. The transformations are characterized by the disintegration of the rural cooperative medical service, by the decentralization of township hospitals from county to township governments, by official permission for private practice, by the implementation of the personal responsibility system in health institutions, by the health security reform, and by the development of health insurance in rural areas. The long-existing health administrative problems which were aggravated in the last decade are the rural-urban differences in resource allocation and the large proportion of people without health security. With the increase of medical service prices in recent years due to the inflation of the whole economy, it is believed that the cost of health care will create an economic burden to the low-income, fee-for-service paying individuals and will further affect the health of the population. In the process of the national economic reform, it is an important and difficult task for the health administrators to adjust the health care system promptly and properly. Only by continuously carrying forward good traditions, correcting mistakes and consistently persisting in health reform, can China further raise its health care to a new, prosperous stage.

Efficacy of mexiletine in ventricular arrhythmias among patients in Taiwan: assessment by 24-hour Holter electrocardiography.

The effects of mexiletine in 30 patients with symptomatic recurrent ventricular arrhythmias were assessed by 24-hour Holter electrocardiography and M-mode echocardiography. The mean daily dose of mexiletine was 534 mg (range, 300 to 900 mg) and the interval of Holter follow-up was 16.9 days (range, 10 to 25 days). Total ventricular premature beats were reduced by 85% or more in 21 patients; in 19 of these patients there was a reduction of one or more modified Lown grades of ventricular arrhythmias. The overall reduction in Lown grades in the 30 patients was from 3.3 +/- 0.8 to 1.5 +/- 1.4 (P less than 0.0001). No significant changes in heart rate before or after mexiletine therapy were noted. Left ventricular echocardiography showed no significant changes in percentage fractional shortening after treatment. Adverse effects included gastrointestinal intolerance in seven patients and neurogenic symptoms in three. During the follow-up period of 1 to 11 (mean, 3.2) months, ventricular arrhythmias recurred in three patients. It is concluded that oral mexiletine is moderately effective and safe in controlling symptomatic recurrent ventricular arrhythmias.