Development and validation of a nomogram to predict medication risk based on a knowledge, attitude and practice (KAP) survey of residents in Shanxi Province, China.

Objective: Unsafe medication practices and medication errors are a major cause of harm in healthcare systems around the world. This study aimed to explore the factors that influence the risk of medication and provide medication risk evaluation model for adults in Shanxi province, China. Methods: The data was obtained from the provincial questionnaire from May to December 2022, relying on the random distribution of questionnaires and online questionnaires by four hospitals in Shanxi Province. Multiple linear regression analysis was used to explore the factors affecting the KAP score of residents. Univariate and multivariate logistic regression was used to determine the independent risk factors, and the nomogram was verified by receiver operating characteristic curve, calibration and decision curve analysis. Results: A total of 3,388 questionnaires were collected, including 3,272 valid questionnaires. The average scores of drugs KAP were 63.2 ± 23.04, 33.05 ± 9.60, 23.67 ± 6.75 and 33.16 ± 10.87, respectively. On the evaluation criteria of the questionnaire, knowledge was scored "fair", attitude and practice were scored "good". Sex, monthly income, place of residence, insurance status, education level, and employment were regarded as independent risk factors for medication and a nomogram was established by them. Conclusion: Males, low-income, and low-educated people are important factors affecting the risk of medication. The application of the model can help residents understand the risk of their own medication behavior and reduce the harm of medication.

Factors associated with blood lead levels in children in Shenyang, China: a cross-sectional study.

BACKGROUND: Although blood lead levels (BLLs) in children are gradually decreasing, low-concentration lead exposure can still exert adverse effects. We studied the factors that affect BLLs in children in Shenyang, China. METHODS: We conducted a cross-sectional study by administering structured questionnaires on family demographics and food intake. The concentrations of lead in venous blood were determined by graphite furnace atomic absorption spectrometry. RESULTS: A total of 273 children aged 1-6 years were enrolled. The geometric mean (geometric standard deviation) of BLLs was 24.94 (12.70) µg/L in boys and 23.75 (11.34) µg/L in girls. The prevalence of BLLs of ≥35 µg/L was 22.7% and was mainly observed in children aged under 3 years. Often hand washing before meals was protective against BLLs ≥20 µg/L (adjusted OR: 0.427, 95%CI: 0.238-0.767, p = 0.004). Consumption of puffed grains and eggs had an adjusted OR (95%CI) for BLLs ≥20 µg/L of 1.714 (1.012-2.901) (p = 0.045) and 1.787 (1.000-3.192) (p = 0.050), respectively. CONCLUSIONS: BLLs of children in Shenyang are still higher than in developed countries. Consumption of puffed grains and eggs is associated with higher BLLs. Often hand washing before meals may be protective against high BLLs.

Analysis of current γ knife stability testing status in medical institutions / 中国职业医学

@#Abstract: Objective To follow up and evaluate the stability testing status of γ stereotactic radiotherapy system (hereinafter γ knife WS 582-2017 Specifications for Testing of Quality Control in X and γ referred to ) in medical institutions based on the RayStereotactic Radiotherapy System WS 582-2017 Methods (hereinafter referred to ). A total of 43 medical institutions using γ knife and 54 medical physics personnel were recruited as the research subjects by random sampling method. Based on the - - standard tracking evaluation method, we followed up the evaluation of γ knife stability testing based on WS 582 2017. Results - Only 66.7% of the 54 subjects preformed WS 582 2017 in their daily work. Only 30.2% (all were tertiary hospital) of 43 medical institutions were equipped with complete quality control and testing equipment. The implementation rate of γ knife stability test was 67.4%, and it was not carried out in strict accordance with the test events and test cycle requirements - specified in the WS 582 2017. There were incomplete test events, incomplete records or test cycles that did not meet the Conclusion standard requirements in γ knife stability test. Medical institutions did not carry out γ knife stability tests in strict - accordance with the projects and cycle required by the WS 582 2017. The reasons are related to medical institutions are not equipped with complete testing equipment, the personnel are lack of understanding of relevant national standards, the poor publicity and implementation of the standards, the lack of standardized training channels and inadequate health supervision.

Association of prenatal factors and cord blood lead levels in China: A nested cohort cross-sectional study.

BACKGROUND: Lead exposure all over the world has gradually declined. As fetuses are more prone to lead exposure, even to low levels of lead exposure, it is important to monitor blood lead levels (BLLs) in pregnancy. METHODS: We obtained data on BLLs in the third trimester of pregnancy from medical records and measured cord BLLs obtained from 121 mother-child pairs in Shenyang, China from September 2019 to February 2020. We also estimated relationships between socio-demographic, lifestyle and dietary factors during pregnancy as well as cord BLLs to identify the source of lead exposure during pregnancy. BLLs was estimated by atomic absorption spectrometry through graphite furnace ionization techniques. The data which obtained by questionnaires during pregnancy included maternal sociodemographic, lifestyle, dietary factors. We have established three multivariate logistic regression models in which the dichotomous BLLs was used as the dependent variable (cord BLLs ≥20 µg/L vs <20 µg/L). RESULTS: The median and geometric mean of cord BLLs were 22.90 µg/L, 21.88 µg/L and BLLs in the third trimester of pregnancy were 25.29 µg/L, 24.66 µg/L, respectively. BLLs showed significant correlations between cord and the third trimester of pregnancy (r = 0.277, P = 0.012). Pregnant women who had not been exposed to passive smoking had lower OR (95 %) [0.43(0.19-0.94)] for cord BLLs ≥20 µg/L than pregnant women who had. Intake of docosahexaenoic acid (DHA) during third trimester of pregnancy presented an OR (95 %) [0.23(0.08-0.61)] for cord BLLs ≥20 µg/L. Consuming more whole grains (>3 times/week) and beverage (≥1 times/week) showed an OR (95%CI) for cord BLLs ≥20 µg/L of 0.09(0.02-0.53) and 0.19(0.06-0.69), respectively. CONCLUSION: This study showed the cord BLLs of Chinese are still higher than most developed countries. Passive smoking is a risk factor for cord BLLs ≥20 µg/L and supplement of DHA, whole grains and beverage consumption during pregnancy may act as a beneficial factor against having cord BLLs ≥20 µg/L.

The Association Between Environmental Lead Exposure and Recurrent Respiratory Infections in Children Aged 3-7 Years in Shenyang, China.

OBJECTIVE: To investigate the lead exposure levels, and the effect of blood lead level (BLL) on recurrent respiratory infections in children aged 3-7 years in Shenyang. METHODS: A case-control study including 78 children with recurrent respiratory infections and 141 controls was performed. Venous blood was obtained for BLL, and a questionnaire was completed. RESULTS: The BLL was significantly higher in children with recurrent respiratory infections than that in the control group [Median (IQR): 2.56 (1.29-6.19) vs 1.99 (0.90-5.92) µg/dL, P=0.029]. Children with BLL ≥1.95 µg/dL were more likely to be suffering from recurrent respiratory infections (OR=2.328, 95%CI=1.228-4.413) than those with BLL <1.95 µg/dL. CONCLUSIONS: High lead level can increase the risk of respiratory infections in preschool children.