Prevalence and risk factors of physical inactivity among middle-aged and older Chinese in Shenzhen: a cross-sectional study.

OBJECTIVE: Investigations on physical inactivity are common around the world; however, little is known about the status of physical inactivity in mainland China. The aim of this study was to examine the prevalence and risk factors associated with physical inactivity in Shenzhen in Southern China. DESIGN: A community-based, cross-sectional study. SETTING: A multistage-stratified, random cluster survey was conducted in Xixiang Street, Bao'an District of Shenzhen in Southeast China. PARTICIPANTS: 3920 adults aged 40 years or more were recruited to the study and completed the International Physical Activity Questionnaire Short Form between 1 March 2015 and 30 July 2016. MAIN OUTCOME MEASURES: Physical inactivity was defined as engaging in physical activity levels insufficient to reach the current guidelines. Bivariate and multivariate analyses were undertaken to assess the prevalence and risk factors associated with physical inactivity. RESULTS: The prevalence of physical inactivity was 63.1% for all participants, 63.9% for women and 61.9% for men, respectively. Participants who were older (OR=1.31, 95% CI 1.11 to 1.54), who were female (OR=1.22, 95% CI 1.04 to 1.43), who had higher education experience (OR=1.38, 95% CI 1.19 to 1.61), who are under economic pressure (OR=2.17, 95% CI 1.48 to 3.17), who ever smoked a cigarette (OR=1.44, 95% CI 1.13 to 1.82) and drank alcohol (OR=1.42, 95% CI 1.14 to 1.77), and participants in the lowest body mass index category (OR=1.40, 95% CI 1.03 to 1.89), were more likely to report physical inactivity. CONCLUSIONS: These findings indicate that physical inactivity is prevalent in Southern China. Interventions and programmes aimed at increasing physical activity among middle-aged and older Chinese adults may also be tailored to participants under economic pressure and those with unhealthy behaviours such as smoking and drinking.

Association of smoking with risk of stroke in middle-aged and older Chinese: Evidence from the China National Stroke Prevention Project.

Although the impacts of smoking on health are well established, it is unclear on how they affect the Chinese population aged ≥40 years. This study aimed to investigate the association between smoking and risk of stroke in middle-aged and older Chinese adults, based on the data from the China National Stroke Prevention Project.A community-based cross-sectional study with 12,704 (5681 men, 7023 women) Chinese adults aged ≥40 years was conducted to examine the association of smoking with stroke. Multivariable logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs).Among the study population, a total of 524 stroke survivors were identified. The age-adjusted prevalence of stroke was 4.06% for both sexes, 2.95% for women, and 5.38% for men. The multivariate-adjusted ORs (95% CI) of stroke associated with current cigarette smoking and former cigarette smoking were 1.67 (1.24-2.25) and 1.93 (1.29-2.87), respectively. Compared with those who were never-smokers, the multivariate-adjusted OR of stroke (95% CI) were 1.48 (0.96 to -2.29), 1.75 (1.20-2.56), and 2.37 (1.20 to -4.68) for those who smoked 1 to 10, 11 to 20, and ≥21 cigarettes per day; and 0.51 (0.19 to -1.42), 1.90 (1.36 to -2.67), and 2.01 (1.17 to -3.46) for those who smoked 1 to 19, 20 to 39, and ≥40 years, respectively (both P < .001 for linear trends). Among former smokers, the multivariable-adjusted ORs of stroke by duration of smoking cessation (compared with never smokers) for <5, 5 to 19, and ≥20 years were 3.47 (1.42-8.49), 3.37 (1.95-5.80), and 0.95 (0.49-1.84), respectively (P = .009 for linear trend). The increased odds of stroke with smoking were more evident among participants who were men, >60 years old, or without family history of stroke than their counterparts.This study suggests the increased odds of stroke in current cigarette smokers with a graded increase in prevalent risk that depended on how many cigarettes and how many years were smoked. Moreover, quitting smoking appears to decrease this excess risk substantially.

Author Correction: Prevalence and risk factors associated with stroke in middle-aged and older Chinese: A community-based cross-sectional study.

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Improper wound treatment and delay of rabies post-exposure prophylaxis of animal bite victims in China: Prevalence and determinants.

BACKGROUND: Rabies is invariably a fatal disease. Appropriate wound treatment and prompt rabies post-exposure prophylaxis (PEP) are of great importance to rabies prevention. The objective of this study was to investigate the prevalence and influencing factors of improper wound treatment and delay of rabies PEP after an animal bite in Wuhan, China. METHODOLOGY: This cross-sectional study was conducted among animal bite victims visiting rabies prevention clinics (RPCs). We selected respondents by a multistage sampling technique. A face-to-face interview was conducted to investigate whether the wound was treated properly and the time disparity between injury and attendance to the RPCs. Determinants of improper wound treatment and delay of rabies PEP were identified by a stepwise multivariate logistic regression analysis. PRINCIPAL FINDINGS: In total, 1,015 animal bite victims (564 women and 451 men) responded to the questionnaire, and the response rate was 93.98%. Overall, 81.2% of animal bite victims treated their wounds improperly after suspected rabies exposure, and 35.3% of animal bite victims delayed the initiation of PEP. Males (OR = 1.871, 95% CI: 1.318-2.656), residents without college education (OR = 1.698, 95% CI: 1.203-2.396), participants liking to play with animals (OR = 1.554, 95% CI: 1.089-2.216), and people who knew the fatality of rabies (OR = 1.577, 95% CI: 1.096-2.270), were more likely to treat wounds improperly after an animal bite. Patients aged 15-44 years (OR = 2.324, 95% CI: 1.457-3.707), who were bitten or scratched by a domestic animal (OR = 1.696, 95% CI: 1.103-2.608) and people who knew the incubation period of rabies (OR = 1.844, 95% CI: 1.279-2.659) were inclined to delay the initiation of PEP. CONCLUSIONS: Our investigation shows that improper wound treatment and delayed PEP is common among animal bite victims, although RPCs is in close proximity and PEP is affordable. The lack of knowledge and poor awareness might be the main reason for improper PEP. Educational programs and awareness raising campaigns should be a priority to prevent rabies, especially targeting males, the less educated and those aged 15-44 years.

Prevalence and risk factors associated with stroke in middle-aged and older Chinese: A community-based cross-sectional study.

Although the prevalence of stroke and its risk factors has been widely reported in some Western countries, information on essential stroke parameters is lacking in China, the most populous nation. A community-based cross-sectional study with 8,018 Chinese adults aged ≥40 years was used to determine the prevalence of stroke and associated risk factors. Within the screened population, the prevalence of stroke was 2.21% for both sexes, 1.60% for females, and 3.18% for males. Prevalence increased with age in both sexes (P < 0.0001). In a multivariable model, factors significantly associated with stroke were increasing age (odds ratio [OR] = 1.87, 95% CI: 1.58-2.24), male gender (OR = 2.03, 95% CI: 1.42-2.90), family history of stroke (OR = 4.33, 95% CI: 2.89-6.49), history of hyperlipidemia (OR = 1.87, 95% CI 1.31-2.68), history of hypertension (OR = 1.47, 95% CI 1.02-2.12), and physical inactivity (OR = 1.74, 95% CI: 1.16-2.59). The findings indicate that stroke prevalence in middle-aged and older Chinese adults is higher in males than in females, and increases with age in both sexes. Population-based public health intervention programs and policies targeting hyperlipidemia and hypertension control and encouragement of physical activity should be highly prioritized for middle-aged and older adults in Shenzhen, China.

Association of coffee consumption with risk of colorectal cancer: a meta-analysis of prospective cohort studies.

A meta-analysis was performed to assess the association of coffee consumption with colorectal cancer and to investigate the shape of the association. Relevant prospective cohort studies were identified by a comprehensive search of the PubMed, Embase and Web of Science databases from their inception through August 2015. Either a random-effects model or fixed-effects model was used to compute the pooled risk estimates when appropriate. Linear and nonlinear dose-response meta-analyses were also performed. Nineteen prospective cohort studies involving 2,046,575 participants and 22,629 patients with colorectal cancer were included. The risk of colon cancer was decreased by 7% for every 4 cups per day of coffee (RR=0.93, 95%CI, 0.88-0.99; P=0.199). There was a threshold approximately five cups of coffee per day, and the inverse association for colorectal cancer appeared to be stronger at a higher range of intake. However, a nonlinear association of rectal cancer with coffee consumption was not observed (P for nonlinearity = 0.214). In conclusion, coffee consumption is significantly associated with a decreased risk of colorectal cancer at ≥ 5 cups per day of coffee consumption. The findings support the recommendations of including coffee as a healthy beverage for the prevention of colorectal cancer.

Chinese Version of the EQ-5D Preference Weights: Applicability in a Chinese General Population.

OBJECTIVES: This study aimed to test the reliability, validity and sensitivity of Chinese version of the EQ-5D preference weights in Chinese general people, examine the differences between the China value set and the UK, Japan and Korea value sets, and provide methods for evaluating and comparing the EQ-5D value sets of different countries. METHODS: A random sample of 2984 community residents (15 years or older) were interviewed using a questionnaire including the EQ-5D scale. Level of agreement, convergent validity, known-groups validity and sensitivity of the EQ-5D China, United Kingdom (UK), Japan and Korea value sets were determined. RESULTS: The mean EQ-5D index scores were significantly (P<0.05) different among the UK (0.964), Japan (0.981), Korea (0.987), and China (0.985) weights. High level of agreement (intraclass correlations coefficients > 0.75) and convergent validity (Pearson's correlation coefficients > 0.95) were found between each paired schemes. The EQ-5D index scores discriminated equally well for the four versions between levels of 10 known-groups (P< 0.05). The effect size and the relative efficiency statistics showed that the China weights had better sensitivity. CONCLUSIONS: The China EQ-5D preference weights show equivalent psychometric properties with those from the UK, Japan and Korea weights while slightly more sensitive to known group differences than those from the Japan and Korea weights. Considering both psychometric and sociocultural issues, the China scheme should be a priority as an EQ-5D based measure of the health related quality of life in Chinese general population.

Patients' Willingness on Community Health Centers as Gatekeepers and Associated Factors in Shenzhen, China: A Cross-sectional Study.

The gate-keeping function of primary healthcare facilities has not been fully implemented in China. This study was aiming at assessing the willingness on community health centers (CHCs) as gatekeepers among a sample of patients and investigating the influencing factors.A cross-sectional survey was conducted in 2013. A total of 7761 patients aged 18 to 90 years from 8 CHCs in Shenzhen (China) were interviewed using a structured questionnaire. Descriptive and multivariable logistic regression analyses were used to analyze the characteristics of patients, their willingness on the gatekeeper policy, and identify the associated factors.On willingness of patients to select CHCs as gatekeepers, 70.03% of respondents were willing, 18.95% were neutral, and 9.02% were unwilling. Multivariable analysis indicated that female patients (odds ratio [OR] = 1.15, 95% confidence interval [CI]: 1.02-1.30); patients with health insurance (OR = 1.21, 95% CI: 1.07-1.36); patients who lives near CHC (OR = 1.89, 95% CI: 1.17-3.05); and patients who were more familiar with the gatekeeper policy (OR = 2.09, 95% CI: 1.85-2.36), had higher level of willingness on the policy. Conversely, reporting with good health status was independently associated with the decreased willingness on gatekeeper policy (OR = 0.69, 95% CI: 0.53-0.90).The findings indicated that patients' willingness on CHCs as gatekeepers is high. More priority measures, such as expanding medical insurance coverage of patients, strengthening the propaganda of gatekeeper policy, and increasing the access to community health service, are warranted to be taken. This will help to further improve the patients' willingness on CHCs as gatekeepers. It is thus feasible to implement the gatekeeper policy among patients in China.