Comparative performance of contact plate metod and swab method for surface microbial contamination on medical fabrics.

BACKGROUND: The contact plate method is widely accepted and used in various fields where hygiene and contamination levels are crucial. Evidence regarding the applicability of the contact plate method for sampling fabric microbial contamination levels in real medical environments was limited. This study aimed to assess the applicability of the contact plate method for detecting microbial contamination on medical fabrics in a real healthcare environment, thereby providing a benchmark for fabric microbial sampling methods. METHODS: In a level three obstetrics ward of a hospital, twenty-four privacy curtains adjacent to patient beds were selected for this study. The contact plate and swab method were used to collect microbial samples from the privacy curtains on the 1st, 7th, 14th, and 28th days after they were hung. The total colony count on each privacy curtain surface was calculated, and microbial identification was performed. RESULTS: After excluding the effects of time, room type, and curtain location on the detected microbial load, the linear mixed-effects model analysis showed that contact plate method yielded lower colony counts compared to swab method (P < 0.001). However, the contact plate method isolated more microbial species than swab method (P < 0.001). 291 pathogenic strains were isolated using the contact plate method and 133 pathogenic strains were isolated via the swab method. There was no difference between the two sampling methods in the detection of gram-negative bacteria (P = 0.089). Furthermore, the microbial load on curtains in double-occupancy rooms was lower than those in triple-occupancy rooms (P = 0.021), and the microbial load on curtains near windows was lower than that near doors (P = 0.004). CONCLUSION: Contact plate method is superior to swab method in strain isolation. Swab method is more suitable for evaluating the bacterial contamination of fabrics.

Comparative Analysis of Sampling Methods for Assessing Bacterial Contamination on Hospital Partition Curtains: Moistened Swabs versus RODAC Agar Plates.

BACKGROUND Partition curtains are one of the main sources of nosocomial infection in the hospital environment. However, there are no unified standards for monitoring medical textiles across different countries or regions. This study aimed to investigate the accuracy of 2 different sampling methods - swabbing vs RODAC (replicate organism detection and counting) agar plate - in terms of detection of bacterial contamination, and their suitability as monitoring methods for partition curtains and other medical textiles. MATERIAL AND METHODS A total of 24 partition curtains were selected by stratified random sampling. The swabbing technique and RODAC agar plates were the chosen sampling methods. The number of colony-forming units was calculated and colony morphologies and strains on the plates were observed and identified after culturing. RESULTS A total of 192 samples were collected. Of them, 161 pathogenic strains were isolated via the swabbing technique and 309 pathogenic strains were isolated using the RODAC agar plates. The swabbing technique had a higher proportion for gram-positive bacteria (P=0.0004), while RODAC agar plates had a higher proportion for gram-negative bacteria (P=0.72). The detection of bacterial contamination rates using the swabbing technique was superior to that of the RODAC agar plate method (P<0.001). CONCLUSIONS The swabbing technique offers more advantages in terms of detection of bacterial contamination rates and gram-positive bacteria, while the RODAC agar plate is more sensitive for detection of gram-negative bacteria.

Factors associated with self-medication in children and the decomposition of rural-urban disparities in China.

BACKGROUND: Self-medication in children is one of the greatest threats to children health in China. OBJECTIVES: The purpose of this study was to examine the potential factors associated with self-medication in children and explore rural-urban disparities. METHODS: A total of 2798 children enrolled in the study. Informed consent was obtained from each primary caregiver following a detail explanation about the purpose of the study. Multivariable logistic regression analysis and Oaxaca-Blinder decomposition analysis were used. RESULTS: The results showed that 38.2% primary caregivers of rural areas self-medicated their children, compared to 18.7% of those in urban areas. The urban primary caregivers with college or above education were more likely to self-medicate their children, while rural primary caregivers with college or above education were less likely to self-medicate their children. Children having unhealthy eating habits were more likely to have been self-medicated by their primary caregivers in urban and rural areas. Urban primary caregivers who spend more than 10 min from home to the nearest medical institution were more likely to self-medicate their children. In rural areas, children aged 3-6 years old, primary caregivers with monthly household income per capita of 1001-3000 Yuan, and children with chronic diseases are another set of enabling factors which impacted on self-medication. Unhealthy eating habits of children were the largest contributor to the rural-urban self-medication gap. CONCLUSIONS: Children's factors explained the largest portion of the rural-urban difference in self-medication among children. The evidence presented in this study suggests that public health policies addressing rural-urban differences in children' s factors could serve as an effective method for reducing rural-urban disparities in self-medication among children.

[The Effects of Social Support and Health Literacy on Depression among Rural Patients with Hypertension].

OBJECTIVE: To explore the effects of social support and health literacy on depression among hypertensive patients in rural areas and to provide reference for improving depression in hypertensive patients. METHODS: A multi-stage stratified sampling method was used to select 549 hypertensive patients in a rural area of Chengdu city for a questionnaire survey. Structural equation model was used to analyze the effects of social support and health literacy on depression in hypertensive patients. RESULTS: Social support ( ß=-0.116, 95% CI: (-0.198)-(-0.132)) and health literacy ( ß=-0.209, 95% CI: (-0.289)-(-0.132)) had a direct negative effect on depression, and social support had a direct positive effect on health literacy ( ß=0.146, 95% CI: 0.064-0.229). Health literacy was a mediator between social support and depression ( ß=-0.030, 95% CI: (-0.054)-(-0.013)). The gender, employment status and per capita annual income of the patients affected the incidence of depression ( P<0.05). CONCLUSIONS: Social support and health literacy are important predictors of depression among hypertensive patients. We should construct a good social support network, strengthen the publicity of health knowledge, and improve social support and health literacy to alleviate the depression in hypertensive patients. At the same time, more attention should be paid to women, people with low per capita annual income and working hypertensive patients.

Mediating Effect of Work Stress on the Associations Between Psychological Job Demands, Social Approval, and Workplace Violence Among Health Care Workers in Sichuan Province of China.

Objective: The aim of this study was to investigate the prevalence of workplace violence against health care workers, to explore the combined association of work stress, psychological job demands, and social approval with workplace violence and their respective mechanisms among health care workers. Methods: Using data from the Chinese Sixth National Health Service Survey (NHSS) in 2018 conducted among 1,371 health care workers in Sichuan province of China. A self-administered structured questionnaire was used to collect data on health care workers' socio-demographic and work-related characteristics, work stress, psychological job demands, social approval, and workplace violence. We used structural equation modeling (SEM) to test the hypothesized relationship among the variables. Results: The results showed that a total of 77.0% health care workers were exposed to workplace violence. Work stress was directly related to workplace violence (ß = 2.167, 95%CI: 1.707, 2.627), while psychological job demands and social approval had indirect associations with workplace violence via work stress [ß = 0.427, 95%CI: 0.297, 0.557; ß = -0.787, 95%CI: (-0.941)-(-0.633)]. Both psychological job demands (ß = 0.197, 95%CI: 0.139, 0.255) and social approval [ß = -0.346, 95%CI: (-0.399)-(-0.294)] had direct associations with work stress, while social approval had direct association with psychological job demands [ß = -0.085, 95%CI: (-0.136)-(-0.034)]. Psychological job demands mediated the relationship between social approval and work stress. Conclusion: Overall, decreasing workplace violence among health care workers requires to promote interventions to reduce work stress and psychological job demands by improving social approval.

Physical Comorbidity and Health Literacy Mediate the Relationship Between Social Support and Depression Among Patients With Hypertension.

Depression is a common comorbidity among patients with hypertension. Patients with hypertension and depression have worse health outcomes compared to those without depression. The combined effects of social support, physical comorbidity, and health literacy on depression among individuals with hypertension remain unclear. A survey was conducted between December 2017 and May 2018 to investigate the relationships among social support, physical comorbidity, health literacy, and depression in a population of patients with hypertension in rural areas of Sichuan province, China. Multiple linear regression was used to examine factors that influenced depression, and structural equation modeling (SEM) was used to examine the relationships among the four study variables. The mean scores of 549 patients with hypertension were 37.17 ± 6.84 for social support, 14.62 ± 6.26 for health literacy, and 3.56 ± 3.05 for depression; furthermore, 34.2% of participants had physical comorbidity. Gender and per capita annual family income were significantly associated with depression. Physical comorbidity was directly positively related to depression while health literacy was directly negatively related to depression. Social support had an indirect negative association with depression by the mediating effects of health literacy and physical comorbidity. Adequate social support and health literacy, and less physical comorbidity could potentially contribute to reducing depression. The study highlights the importance of social support in maintaining mental health among patients with hypertension. Strategies that target the enhancement of social support and health literacy should be prioritized to relieve depression among patients with hypertension. More attention should be paid to women, low-income individuals, and patients with physical comorbidities.

The changing modes of human immunodeficiency virus transmission and spatial variations among women in a minority prefecture in southwest China: An exploratory study.

Liangshan Yi Autonomous Prefecture in Southwest China has a high human immunodeficiency virus (HIV) prevalence rate. This study examined the changing modes of HIV transmission among women with new HIV infections and explored the spatial heterogeneities in the factors associated with heterosexual transmission in this minority region.The data consisting of women with new HIV infections from 2011 to 2014 were collected from multiple sources. New infections were identified by BED capture enzyme immunoassay. The Bayesian hierarchical model was used to estimate the proportion of women with new HIV infections via heterosexual transmission across all townships in the Prefecture. A geographically weighted regression (GWR) model was utilized to investigate spatial variations in the sociodemographic characteristics associated with the changing modes of HIV transmission.An analytical sample of 927 women with new HIV infections was constructed and utilized to investigate the changing mode of HIV transmission. The rate of heterosexual transmission among women with new HIV infections in 2011 was below 20%. However, by 2014 this rate dramatically increased to nearly 80%. Among sociodemographic characteristics, GWR results revealed significant ethnic differences in heterosexual HIV transmission between Yi women and women in other ethnic groups, with Yi women demonstrating a lower risk of infection through heterosexual transmission. However, such ethnic differences were observed only in 30% of the townships in the Prefecture. Moreover, having a primary education decreased the odds of heterosexual transmission, which was observed in about 56% of the townships. Also, being involved in occupations other than agriculture or animal husbandry and being single or married decreased the odds of HIV infection through heterosexual contact among women, which did not significantly vary across the Prefecture.Heterosexual transmission was the predominant mode of HIV transmission among women in the Prefecture, and this transformation was clearly marked by a fast-growing trend and a spatial diffusion pattern. Spatial variations also existed in sociodemographic factors that were associated with the changing modes of HIV transmission.

The Influence of Social Support and Care Burden on Depression among Caregivers of Patients with Severe Mental Illness in Rural Areas of Sichuan, China.

Depression is one of the most common psychological consequences of caregiving. Caring for patients with severe mental illness (SMI) adds significant challenges to family caregivers' mental health. The purpose of this study was to describe the prevalence of depression among caregivers of SMI patients in rural areas of Sichuan province of China, to examine the influence of social support and care burden on depression, and to explore the intermediary effect of care burden between social support and depression among caregivers of SMI patients. Data were collected from 256 primary caregivers of SMI patients in rural Sichuan Province in China. We used structural equation modeling (SEM) to test the hypothesized relationship among the variables. We found that a total of 53.5% of caregivers had depression. Both care burden (ß = 0.599, 95%CI: 0.392-0.776) and social support (ß = -0.307, 95%CI: (-0.494)-(-0.115)) were directly related to depression, while social support had a direct association with care burden (ß = -0.506, 95%CI: (-0.672)-(-0.341)). Care burden mediated the relationship between social support and depression. For the socio-demographic variables, gender, education level and per capita annual income of household had significant correlations with depression (p < 0.05). The results strongly demonstrated that social support and care burden were predictors of depression, especially social support. Policymakers should fully recognize the role of primary family caregivers in caring for SMI patients and promote interventions to decrease care burden and reduce caregivers' depression by improving social support and network. More attention should be given to female caregivers and caregivers with lower education and lower household income levels.

Factors associated with the choice of primary care facilities for initial treatment among rural and urban residents in Southwestern China.

OBJECTIVE: To explore influential factors contributing to the choice of primary care facilities (PCFs) for the initial treatment among rural and urban residents in Southwestern China. METHODS: A face-to-face survey was conducted on a multistage stratified random sample of 456 rural and 459 urban residents in Sichuan Province from January to August in 2014. A structured questionnaire was used to collect data on residents' characteristics, provider of initial treatment and principal reason for the choice. Multivariate logistic regression was performed to identify factors associated with choosing PCFs for the initial treatment. RESULTS: The result showed that 65.4% of the rural residents and 50.5% of the urban residents chose PCFs as their initial contact for medical care. Among both rural and urban residents, the principal reason for choosing medical institutions for the initial treatment was convenience (42.3% versus 40.5%, respectively), followed by high quality of medical care (26.5% versus 29.4%, respectively). Compared to rural residents, urban residents were more likely to value trust in doctors and high quality of medical care but were less likely to value the insurance designation status of the facilities. Logistic regression analysis showed that both rural and urban residents were less likely to choose PCFs for the initial treatment if they lived more than 15 minutes (by walk) from the nearest facilities (rural: OR = 0.15, 95%CI = 0.09-0.26; urban: OR = 0.19, 95%CI = 0.10-0.36), had fair (rural: OR = 0.49, 95%CI = 0.26-0.92; urban: OR = 0.31, 95%CI = 0.15-0.64) or poor (rural: OR = 0.14, 95%CI = 0.07-0.30; urban: OR = 0.22, 95%CI = 0.11-0.44) self-reported health status. Among rural residents, attending college or higher education (OR = 0.21, 95%CI = 0.08-0.59), being retired (OR = 0.90, 95%CI = 0.44-1.84) and earning a per capita annual income of household of 10,000-29,999 (OR = 0.24, 95%CI = 0.11-0.52) and 30,000-49,999 (OR = 0.26, 95%CI = 0.07-0.92) were associated with lower rates of seeking care at PCFs. CONCLUSION: Efforts should be made to improve the accessibility of PCFs and to upgrade the services capability of PCFs both in rural and urban areas in China. At the same time, resources should be prioritized to residents with poorer self-reported health status, and rural residents who retire or have better education and higher income levels should be taken into account.

MUC1 and maltose­binding protein recombinant fusion protein combined with Bacillus Calmette­Guerin induces MUC1­specific and nonspecific anti­tumor immunity in mice.

Human mucin 1 (MUC1) is a target for immunotherapy. The major problem associated with MUC1­based cancer vaccines is the weakness of the immunogenicity of MUC1. The present study aimed to develop an efficient cancer vaccine through generating a recombinant fusion protein consisting of MUC1 and maltose­binding protein (MBP) by inserting seven tandem repeats encoding the human MUC1 gene into the pMAL­c2 expression vector. Bacillus Calmette­Guerin (BCG) was used as an adjuvant. MUC1 was found to predominantly induce T helper type 2 (Th2) cell responses. MUC1/BCG and MUC1­MBP were found to generate T helper (Th) type 1 and 2 responses, while MUC1­MBP/BCG induced a Th1 immune profile and stimulated MUC1­specific cytotoxic T lymphocyte killing activity. MUC1­MBP, as well as MBP and BCG alone were found to induce natural killer (NK) cell activity, with MUC1­MBP/BCG observed to synergistically induce NK cell activity. Furthermore, MUC1­MBP/BCG significantly inhibited MUC1+ B16 cell growth in mice. These findings show that MBP augments the immunogenicity of MUC1 and that BCG enhances the efficacy of the MUC1­MBP vaccine. Thus, MUC1­MBP/BCG may have potential as a cancer vaccine for clinical application.

Expression of human full-length MUC1 inhibits the proliferation and migration of a B16 mouse melanoma cell line.

Mucin 1 (MUC1) is a large transmembrane glycoprotein that is aberrantly overexpressed in most adenocarcinomas and certain hematological malignancies. MUC1 is known to function as an oncogene with roles in both tumor formation and progression, making it a potential target for immunotherapy. B16-MUC1 cells with human full-length MUC1 are frequently used to study the antitumor activities of MUC1-based vaccines. However, we found that the growth of B16-MUC1 cells was significantly reduced in vitro. Therefore, in this study, we established two MUC1-positive clones, B16-MUC1 9-12 and B16-MUC1 9-23, and one empty vector control clone, B16-neo, to investigate the effects of MUC1 on the cancer-related characteristics of B16 cells in vitro and in vivo. Our results demonstrated that, compared with MUC1-negative cells, cells expressing MUC1 exhibited decreased cell proliferation, increased cell cycle arrest and reduced cell migratory and invasive capacities. We further investigated several MUC1-related molecules of the ß-catenin pathway, and found that the expression of MUC1 decreased the translocation of ß-catenin into the nucleus, reduced the activity of T cell factor (TCF) and blocked the expression of cyclin D1 and c-Myc. Moreover, when inoculated into BALB/c nude mice, cells expressing MUC1 developed smaller tumors compared with the control cells. These results demonstrate that MUC1 expression negatively affects the malignancy of B16 cells, and suggest that the regulatory mechanisms of MUC1 as an oncoprotein are more complex than previously appreciated.