Dietary attitudes and behaviours of women in China after the 2008 Wenchuan earthquake in three seismically different zones.

BACKGROUND AND OBJECTIVES: The sudden occurrence of the 2008 Wenchuan Earthquake not only devastated people's health, but also may have impacted on the psychological and dietary attitudes and behaviours of the survivors. Although the influence of natural disaster on people's health has been extensively investigated, there is a lack of information about the effects on people's dietary attitudes and behaviours. Our aim was to evaluate the influence of the Wenchuan earthquake on the dietary attitudes and behaviours of adult women from different zones of China in July 2008. METHODS AND STUDY DESIGN: 736 women, aged 18-55 years old, were randomly selected and interviewed after the earthquake. Women were selected from three zones: the earthquake zone (n=206), the shaking zone (n=326), and the non-seismic zone (n=204). RESULTS: Although nutrition knowledge mean scores of women in the three zones were relatively low, the women in the earthquake zone became more vigilant about the nutritional value and acceptability of food than women in the other two zones. Nevertheless, women in the earthquake zone also developed some arguably untoward, if understandable, behaviour after the disaster. They increased their consumption and tendency to stock instant food and snack items. That said, these findings were modulated by other factors such as age, residence, Body Mass Index (BMI), and nutrition knowledge itself, as were post-earthquake eating behaviours, as judged by the ordinal logistic regression analyses performed. CONCLUSIONS: The major Wenchuan earthquake was associated with differentials in dietary attitudes and behaviours among women by seismic zone.

Effectiveness of a school-based nutrition and food safety education program among primary and junior high school students in Chongqing, China.

BACKGROUND: Health behavioral patterns, especially eating patterns, established in childhood often carry over into adulthood, and some of the unhealthy ones are later associated with adult morbidity and mortality. Recently, a few nutrition and food safety education programs have been implemented in primary and junior high schools in China. PURPOSE: This study aims to examine the effectiveness of a school-based nutrition and food safety education program among primary and junior high school students in China. METHODS: A mixed study design incorporating an intervention study and a quantitative survey was conducted for this research. With stratified cluster sampling, students from the 5(th) and 6(th) grade in one primary school and the 7(th) and 8(th) grade in one junior high school in Chongqing, China, were all selected and separated randomly into an intervention group (n = 501) and a control group (n = 522). Effectiveness evaluation investigations were performed at the initial time and nine-month follow-up (n = 472), respectively. Effectiveness of pre-/post-intervention and nine-month follow-up changes in scores of nutrition knowledge and food safety was assessed using a two-tailed t-test and analysis of variance. RESULTS: Nutrition knowledge scores for the intervention group were mean 9.03, SD±2.75 at the baseline, and 14.70±3.28 after intervention. There was a significant improvement (t = 29.78, p < 0.01). The nine-month follow-up knowledge scores of the intervention group were 12.35±2.89, which were lower than the immediately after the intervention group (t = 12.40, p<0.01), but higher than those of the baseline level (t = 18.04, p < 0.01). Food safety scores of the post-intervention were higher (p < 0.01) than that of the control group in both pre-intervention and nine-month follow-up. The control group had no significant change in the pre-post intervention. CONCLUSIONS: It is feasible and effective to improve nutrition and food safety knowledge among primary and junior high school students through school-based nutrition and food safety education programs.

Meta-analysis of oral contraceptive use and risks of all-cause and cause-specific death.

BACKGROUND: Whether ever use of oral contraceptives (OCs) is associated with mortality remains unclear. OBJECTIVES: To evaluate the association between ever use of OCs and mortality. SEARCH STRATEGY: On November 2, 2014, PubMed and Embase were searched for human studies, using the terms "contraceptive," "contraceptives," "death," and "mortality." SELECTION CRITERIA: Prospective cohort studies were included that provided risk estimates on OC use and mortality, and were reported in English or Chinese. DATA COLLECTION AND ANALYSIS: A random-effects model was used to pool data. Random-effects meta-regression was used to determine whether duration of OC use and time since last OC use were associated with mortality. MAIN RESULTS: Nine studies were included. Ever use of OCs was not associated with mortality from all causes (hazard ratio [HR] 0.94; 95% CI 0.87-1.02) or breast cancer (HR 1.00; 95% CI 0.95-1.06). Neither the duration of OC use nor the time since last OC use was associated with all-cause or breast cancer mortality. In an analysis of a small number of studies, ever users were at decreased risk of mortality from ovarian cancer (HR 0.58; 95% CI 0.35-0.94). CONCLUSIONS: There is no significant association between ever use of OCs and mortality from all causes or breast cancer.

The Willingness-to-Pay for General Practitioners in Contractual Service and Influencing Factors among Empty Nesters in Chongqing, China.

BACKGROUND: In 2012, a pilot health policy of contractual service relations between general practitioners and patients was implemented in China. Due to the decline in body and cognitive function, as well as the lack of family care and narrow social support networks, the demand of health services among the elderly is much higher than that among the general population. This study aims to probe into the empty nesters' willingness-to-pay for general practitioners using a contractual service policy, investigating empty nesters' payment levels for the service, and analyze the main factors affecting the willingness of empty-nesters' general practitioners using contractual service supply cost. METHODS: This cross-sectional study adopted a multistage stratified sampling method to survey 865, city empty nesters (six communities in three districts of one city) aged 60-85 years. A condition value method was used to infer the distribution of the willingness-to-pay; Cox's proportional hazards regression model was used to analyze the influencing factors of willingness-to-pay. RESULTS: More than seventy percent (76.6%) of the empty nesters in this city were willing to pay general practitioners using contract service in Chongqing. The level of willingness-to-pay for the surveyed empty nesters was 34.1 yuan per year. The median value was 22.1 yuan per year, which was below the Chongqing urban and rural cooperative medical insurance individual funding level (60 yuan per year) in 2013. Cox's proportional hazards regression model analysis showed that the higher the education level was, the worse the self-reported health status would be, accompanied by higher family per capita income, higher satisfaction of community health service, and higher willingness-to-pay empty nesters using a contract service. Women had a higher willingness-to-pay than men. CONCLUSIONS: The willingness-to-pay for general practitioners by contractual service is high among city empty nesters in Chongqing, thus, individual financing is feasible. However, people are willing to pay less than half of the current personal financing of cooperative medical insurance of urban and rural residents. Education level, family per capita income, and self-reported health status are the main factors affecting the cost sharing intention for general practitioners using contract service supply. According to the existing situation of different empty nesters, it is important to perfect the design of general practitioners using a contractual service policy system, according to differentiated personal financing levels.