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Background: The organizational climate that fosters and supports the implementation of evidence is a key factor influencing the effective implementation of evidence-based practice (EBP). Nurses, being the largest group of medical staff, play a crucial role in EBP implementation. The perception of the climate for EBP implementation among nurses in their organizations is unknown, especially among Chinese nurses. Aims: To clarify the implementation climate of EBP among Chinese nurses and identify the factors associated with the implementation and development of evidence-based nursing practices. Methods: This study employed a descriptive cross-sectional study design. From March 2023 to April 2023, a sample of nurses (n = 1260) from two Tertiary care hospitals in central China were selected and surveyed by self-designed social-demographic questionnaire and Implementation Climate Scale. Multiple linear stepwise regression analysis was conducted to determine the predictors of implementation climate. Results: The nurses achieved a mean ICS score of 59.10 ± 11.22, with mean scores exceeding 3 points for each sub-dimension and item. In the results of multiple linear regression, income satisfaction, implementation of evidence-based nursing practice project(s) within the unit, experience of evidence-based nursing practice during working life, and specific training or courses in evidence-based nursing practice were predictors of ICS. Of these, income satisfaction was the most significant predictor. These factors could explain 17.5% of the total variance in implementation climate. Conclusion: The climate for implementing EBP in Chinese nursing organizations was relatively strong. Nursing managers can enhance the climate for implementing EBP in their organizations by actively improving salary and enhancing EBP-related trainings and practices. Relevance to clinical practice: Understanding nurses' perceptions of the EBP implementation climate in their organizations can help to identify specific barriers and facilitators to the development of EBP and facilitate its successful implementation. Patient or public contribution: Clinical nurses were involved in data collection and completed the questionnaires on EBP implementation climate. What does this paper contribute to the wider global clinical community?: The number of studies on the organization and implementation climate of evidence-based nursing practice is limited, especially in China. According to the results of this study, nurses exhibited a positive perception and recognition of the organized EBP implementation climate. Income satisfaction, implementation of evidence-based nursing practice project(s) within the unit, experience of evidence-based nursing practice during the working life and specific training or courses undertaken in evidence-based nursing practice were factors of nurses' perception of implementation climate. Organizational managers should actively provide comprehensive resource support to enhance the implementation climate of evidence-based nursing practice. [ABSTRACT FROM AUTHOR]

Background: Shexian Dryland Stone Terraced System (SDSTS) in the Taihang Mountains was formally recognized as Globally Important Agricultural Heritage Systems (GIAHS) by Food and Agriculture Organization on May 20, 2022. People there have been relying on the terraced fields for centuries, using various plants, including medicinal plants. However, little information was reported about the flora in SDSTS, nor medicinal plants. Thus, the present study aims to identify and document medicinal plants traditionally used by the local people living around the SDSTS and associated ethnobotanical knowledge. Methods: We conducted investigations in Shexian County, Hebei Province, North China, where SDSTS is distributed. Then, Wangjinzhuang, a community located in the core zone of SDSTS, was chosen as the case site. We selected the informants through purposive and snowball sampling. The data were collected through semi-structured interviews, participant observation, and key informant interviews. The medicinal plants traditionally used by the local people were documented and analyzed. We examined and confirmed the botanical identification based on voucher specimens and by cross-checking the descriptions with the series of books, scientific papers on medicinal plants, and the plant databases. Results: The local people have rich traditional knowledge to collect and use medicinal plants in SDSTS. Records of 123 medicinal plant species belonging to 51 families were obtained from SDSTS. Asteraceae was represented by 16 species, followed by Fabaceae, Lamiaceae and Ranunculaceae. (They all have 8 species.) The majority of the reported plant species were commonly processed into decoctions. And 180 diseases affecting humans were reported to be treated with traditional medicinal plants from SDSTS. Conclusion: It is the first ethnobotanical study on medicinal plants in China-Nationally Important Agricultural Heritage Systems, and in globally important agricultural heritage systems as well. Medicinal plants are crucial for people living in Shexian County. It is necessary to recognize and respect traditional knowledge peculiar to the mountainous region of northern China, especially for those involved in the human–nature interaction and the role of knowledge in agrobiodiversity conservation and rural development that local residents have persisted for centuries. [ABSTRACT FROM AUTHOR]

Background: Standardized coding of plays an important role in radiology reports' secondary use such as data analytics, data-driven decision support, and personalized medicine. RadLex, a standard radiological lexicon, can reduce subjective variability and improve clarity in radiology reports. RadLex coding of radiology reports is widely used in many countries, but translation and localization of RadLex in China are far from being established. Although automatic RadLex coding is a common way for non-standard radiology reports, the high-accuracy cross-language RadLex coding is hardly achieved due to the limitation of up-to-date auto-translation and text similarity algorithms and still requires further research.Methods: We present an effective approach that combines a hybrid translation and a Multilayer Perceptron weighting text similarity ensemble algorithm for automatic RadLex coding of Chinese structured radiology reports. Firstly, a hybrid way to integrate Google neural machine translation and dictionary translation helps to optimize the translation of Chinese radiology phrases to English. The dictionary is made up of 21,863 Chinese-English radiological term pairs extracted from several free medical dictionaries. Secondly, four typical text similarity algorithms are introduced, which are Levenshtein distance, Jaccard similarity coefficient, Word2vec Continuous bag-of-words model, and WordNet Wup similarity algorithms. Lastly, the Multilayer Perceptron model has been used to synthesize the contextual, lexical, character and syntactical information of four text similarity algorithms to promote precision, in which four similarity scores of two terms are taken as input and the output presents whether the two terms are synonyms.Results: The results show the effectiveness of the approach with an F1-score of 90.15%, a precision of 91.78% and a recall of 88.59%. The hybrid translation algorithm has no negative effect on the final coding, F1-score has increased by 21.44% and 8.12% compared with the GNMT algorithm and dictionary translation. Compared with the single similarity, the result of the MLP weighting similarity algorithm is satisfactory that has a 4.48% increase compared with the best single similarity algorithm, WordNet Wup.Conclusions: The paper proposed an innovative automatic cross-language RadLex coding approach to solve the standardization of Chinese structured radiology reports, that can be taken as a reference to automatic cross-language coding. [ABSTRACT FROM AUTHOR]

Background: Most studies of associations between parental support behaviours for physical activity (PA) and children's moderate-to-vigorous physical activity (MVPA) have been conducted in developed countries, and they have focused on maternal or parental support behaviours. Children's MVPA time (i.e., weekdays vs. weekends) has not been adequately differentiated. This paper investigated the associations of paternal and maternal support behaviours for PA with the proportion of children who met the MVPA recommendations on weekdays and weekends in China.Methods: Cross-sectional data of 517 father-child dyads and 1422 mother-child dyads were analysed. The children recorded PA diaries on 7 consecutive days to assess their MVPA time. The father or mother completed a questionnaire concerning their support for children's PA. Multivariate logistic regression was used to investigate the independent effects of paternal and maternal support behaviours for PA on whether children met the MVPA recommendations for weekdays, weekends, and the whole week.Results: Significantly fewer children met the MVPA recommendations on weekends (37.8%) than on weekdays (62.8%). Higher paternal (odds ratio [OR] = 1.098, 95% confidence interval [CI]: 1.009-1.195) and maternal (OR = 1.076, 95% CI: 1.021-1.134) total support behaviour scores were associated with higher odds of children meeting the MVPA recommendations on weekends, after controlling for covariates. Paternal PA knowledge-sharing with the child was positively associated with children meeting the MVPA recommendations on weekends (OR = 1.319, 95% CI: 1.055-1.649); it tended to be associated with children meeting the MVPA recommendations on weekdays and throughout the week, although these associations were not statistically significant. Maternal reservation of PA time for the child was positively associated with a higher likelihood of children meeting the MVPA recommendations on weekdays (OR = 1.160, 95% CI: 1.025-1.313), weekends (OR = 1.241, 95% CI: 1.097-1.403), and throughout the week (OR = 1.214, 95% CI: 1.076-1.369).Conclusions: Paternal and maternal support behaviours for PA should be enhanced on weekends to increase children's MVPA. Fathers should share PA knowledge with children and mothers should reserve PA time for children every day. [ABSTRACT FROM AUTHOR]

Background: Text Matching (TM) is a fundamental task of natural language processing widely used in many application systems such as information retrieval, automatic question answering, machine translation, dialogue system, reading comprehension, etc. In recent years, a large number of deep learning neural networks have been applied to TM, and have refreshed benchmarks of TM repeatedly. Among the deep learning neural networks, convolutional neural network (CNN) is one of the most popular networks, which suffers from difficulties in dealing with small samples and keeping relative structures of features. In this paper, we propose a novel deep learning architecture based on capsule network for TM, called CapsTM, where capsule network is a new type of neural network architecture proposed to address some of the short comings of CNN and shows great potential in many tasks.Methods: CapsTM is a five-layer neural network, including an input layer, a representation layer, an aggregation layer, a capsule layer and a prediction layer. In CapsTM, two pieces of text are first individually converted into sequences of embeddings and are further transformed by a highway network in the input layer. Then, Bidirectional Long Short-Term Memory (BiLSTM) is used to represent each piece of text and attention-based interaction matrix is used to represent interactive information of the two pieces of text in the representation layer. Subsequently, the two kinds of representations are fused together by BiLSTM in the aggregation layer, and are further represented with capsules (vectors) in the capsule layer. Finally, the prediction layer is a connected network used for classification. CapsTM is an extension of ESIM by adding a capsule layer before the prediction layer.Results: We construct a corpus of Chinese medical question matching, which contains 36,360 question pairs. This corpus is randomly split into three parts: a training set of 32,360 question pairs, a development set of 2000 question pairs and a test set of 2000 question pairs. On this corpus, we conduct a series of experiments to evaluate the proposed CapsTM and compare it with other state-of-the-art methods. CapsTM achieves the highest F-score of 0.8666.Conclusion: The experimental results demonstrate that CapsTM is effective for Chinese medical question matching and outperforms other state-of-the-art methods for comparison. [ABSTRACT FROM AUTHOR]

Background: The strategy of successful ageing is an important means to deal with the challenges of the current ageing society. This paper aims to explore the effects of different intensities of physical activity on the successful ageing of the elderly.Methods: Our data were from wave 4 of the China Health and Retirement Longitudinal Survey (CHARLS), involving 9026 residents aged 60 years and older. The intensity of physical activity was divided into three levels: vigorous, moderate and mild. The concept of successful ageing adopted a four-dimensional model of life satisfaction added to the theoretical model of Rowe and Kahn's. Propensity score matching (PSM) with controlling nine confounding factors were used to analyse the effects of different intensities of physical activity.Results: The percentage of successful ageing was 1.88% among all subjects. Among them, 30.26, 29.57 and 29.40% of the elderly often participated in vigorous, moderate and mild physical activity, respectively. The results of PSM showed that participation in moderate activity increased the probability of successful ageing of the elderly by 0.76-0.78% (P < 0.001), while participation in vigorous and mild physical activity had no significant effect on successful ageing (P > 0.05). Moderate physical activity had statistically significant effects on four components of successful aging, including major disease, physical function, life satisfaction, and social participation (P < 0.05).Conclusion: Moderate-intensity physical activity was most beneficial to the successful ageing of the elderly and should be promoted in the elderly population. [ABSTRACT FROM AUTHOR]

Objective: To predict the trend of AIDS in specific age groups and to determine the objective population for AIDS screening, this study explored the three transmission routes and characterized each patient group using the APC model based on the whole, local, and immigrant populations in Zhejiang, China.Methods: The data recruited in this paper was obtained from the national Comprehensive AIDS Prevention and Control Information System - Antiviral Therapy Management database and the Chinese Disease Prevention and Control Information System and the Statistical Yearbook of Zhejiang, China. An APC model was used to estimate the impact of age, period, and cohort on the incidence of AIDS, as well as to predict the AIDS incidence in specific age groups based on different sexes with different transmission routes.Results: The AIDS incidence peaked in males aged 20-35 years; the incidence of males was higher than that of females due to the impact of period; obvious cohort effect was observed among the immigrants. In the whole and local populations, the incidences of males in all age groups and females in both the 35-year-old group and the whole age group were predicted to increase sharply in 5 years. In the immigrant population, the AIDS incidences in both sexes in all age groups were expected to increase significantly in 5 years. Under the influence of period, the incidence of AIDS via homosexual transmission in the whole population and the local population increased and remained stable after 2015. At the same time, the incidence of AIDS transmitted by homosexual and heterosexual routes in the immigrants also showed an increasing trend.Conclusions: The results elucidate that there are sex differences in AIDS incidence, and the incidence of AIDS through various transmission routes in all groups is predicted to exhibit an upward trend in the 5 years to come. Effective intervention strategies should be developed and implemented by the public health departments in Zhejiang to control the epidemic of AIDS. [ABSTRACT FROM AUTHOR]

Background: This paper tries to describe prevalence and patterns of antibiotics prescription and bacteria detection and sensitivity to antibiotics in rural China and implications for future antibiotic stewardship. Methods: The study was implemented in one village clinic and one township health center in each of four rural residential areas in Anhui Province, China. It used mixed-methods comprising non-participative observations, exit-survey and microbiological study. Observations were conducted to record clinical diagnosis and antibiotic prescription. Semi-structured questionnaire survey was used to collect patient's sociodemographic information and symptoms. Sputum and throat swabs were collected for bacterial culture and susceptibility testing. Results: A total of 1068 (51.0% male vs 49.0% female) patients completed the study with diagnosis of respiratory tract infection (326,30.5%), bronchitis/tracheitis (249,23.3%), pharyngitis (119,11.1%) and others (374, 35.0%). They provided 683 sputum and 385 throat swab specimens. Antibiotics were prescribed for 88% of the RTI patients. Of all the specimens tested, 329 (31%) were isolated with bacteria. The most frequently detected bacteria were K. pneumonia (24% in all specimens), H. influenza (16%), H. parainfluenzae (15%), P. aeruginosa (6%), S.aureus (5%), M. catarrhalis (3%) and S. pneumoniae (2%). Conclusions: The study establishes the feasibility of conducting microbiological testing outside Tier 2 and 3 hospitals in rural China. It reveals that prescription of antibiotics, especially broad-spectrum and combined antibiotics, is still very common and there is a clear need for stewardship programs aimed at both reducing the number of prescriptions and promoting single and narrow-spectrum antibiotics. [ABSTRACT FROM AUTHOR]

Background: China's healthcare reform programme continues to receive much attention. Central to these discussions has been how the various financial incentives underpinning reform efforts are negatively impacting on the healthcare workforce. Research continues to document these trends, however, qualitative analysis of how these incentives impact on the motivation of healthcare workers remains underdeveloped. Furthermore, the application of motivational theories to make sense of healthcare worker experiences has yet to be undertaken. Methods: The purpose of our paper is to present a comparative case study account of healthcare worker motivation across urban China. It draws on semi structured interviews (n = 89) with a range of staff and organisations across three provinces. In doing so, the paper analyses how healthcare worker motivation is influenced by a variety of financial incentives; how motivation is influenced by the opportunities for career development; and how motivation is influenced by the day to day pressures of meeting patient expectations. Results: The experience of healthcare workers in China highlights how a reliance on financial incentives has challenged their ability to maintain the values and ethos of public service. Our findings suggest greater attention needs to be paid to the motivating factors of improved income and career development. Further work is also needed to nurture and develop the motivation of healthcare workers through the building of trust between fellow workers, patients, and the public. Conclusions: Through the analysis of healthcare worker motivation, our paper presents a number of ways China can improve its current healthcare reform efforts. It draws on the experience of other countries in calling for policy makers to support alternative approaches to healthcare reform that build on multiple channels of motivation to support healthcare workers. [ABSTRACT FROM AUTHOR]

Background: The social Q&A community quickly becomes a popular platform for consumers to find health information because of its convenience and interactivity.Methods: Based on the 10,861 depression questions collected in the Zhihu, the largest Q&A platform in China, we divided the healthy information needs description into nine categories with Latent Dirichlet Allocation (LDA). We also divided the healthy information needs type into Physiological, affective and cognitive needs based on the Wilson model.Results: The results show that the largest categories are depression symptom and social activities while the less concerned health information is prevention and medical insurance. More attention is paid to cognitive needs. We also find there is no strong correlation between attention and needs type.Conclusions: The purpose of this paper is to refine the consumer health information needs types to better understand the consumer health information characteristic in China. [ABSTRACT FROM AUTHOR]

Background: Many studies have demonstrated the benefits of the addition of growth hormone (GH) to the controlled ovarian stimulation protocol in vitro fertilization (IVF) cycles in poor-respond patients, but the effect of GH on patients with poor embryonic development remain unclear. This paper was designed to investigate the efficacy of GH co-treatment during IVF for the patients with poor embryonic development.Method: A randomized controlled trial including 158 patients with poor embryo development was conducted between July 2017 and February 2019. One hundred and seven patients were randomized for GH treatment (GH group) and 51 patients for untreated (control group). The primary end-points were the clinical pregnancy and live birth rates in the two groups. The oocyte competence were assessed through calculating the mitochondrial DNA (mtDNA) copy number in corresponding cumulus granulosa cells (CGCs). Quantitative PCR were used for calculation of mtDNA copy number.Results: Relative to the control group, GH co-treatment resulted in a significantly higher number of retrieved oocytes (10.29 ± 5.92 versus 8.16 ± 4.17, P = 0.023) and cleaved embryos (6.73 ± 4.25 versus 5.29 ± 3.23, P = 0.036). The implantation rate, clinical pregnancy rates per cycle, and live birth rate per cycle were higher in the GH group than in the control group (36.00% versus 17.86%, P = 0.005; 43.93% versus 19.61%, P = 0.005; 41.12% versus 17.65%, P = 0.006). CGCs of the GH group had significantly higher mtDNA copy numbers than CGCs of the control group (252 versus 204, P < 0.001).Conclusions: These data provided further evidence to indicate that GH supplementation may support more live births during IVF, in patients with poor embryonic development. It also appears that oocytes generated under GH co-treatment have a better developmental competence.Trial Registration: ChiCTR1900021992 posted March 19, 2019 (retrospectively registered). [ABSTRACT FROM AUTHOR]

Background: Due to their relative isolation, the previous studies of Monpa plant use were only conducted in north-east India. In October 2013, Mêdog County was no longer remote, thanks to completion of a highway into the county. This study of plant species used by the Monpa had three research objectives. These were (i) to identify and record local names and uses of plants in Mêdog County, (ii) to assess which of these were uses of endemic or near-endemic species within this part of the Indo-Burma biodiversity hotspot, and (iii) to assess how plant uses reflect socio-economic change in Mêdog County? Methods: Field surveys were conducted in 12 villages of four townships in Mêdog County, Tibet, China. Two field visits were made. The first field trip was in November 2017 and the second field trip was in May 2018. We interviewed 64 key informants between 21 and 84 years old. Most of them were the village leaders and other local people who are knowledgeable about plants. After transect walks with knowledgeable local people, we used free listing, key informant interviews, and semi-structured interviews during the field work. Plants traditionally used by the Monpa were documented. Utilization frequency was used to assess the significance of each species, and the Cultural Importance index was used to estimate the cultural significance of the species in common. We also used the informant consensus factor (FIC) to determine the homogeneity of the informants' knowledge of medicinal plants. Results: One hundred ninety-four plant species belonging to 82 families and 158 genera were recorded and collected. One hundred twenty-two species, primarily fruits, were food plants. Forty-five species were used as traditional medicines. This included highly valued species collected in alpine areas (Paris polyphylla) and brought to villages in Mêdog, which are at a lower altitude (between 728 and 1759 m a.s.l). Seven edible plant species were also used as herbal medicines. We also recorded 39 species used for other purposes in Monpa daily life. These included nine species that were used to make agricultural tools, five species for dyes and mordants, four species for timber, three species for fuelwood, four species for religious ritual use, three species for washing, two species for incense, two species for thatching, two species for fiber (rope and paper), two "calendar plants" were used to indicate seasons for agricultural purposes, two fish poison plant species, and one species were used as a tobacco substitute. Based on taxonomic insights and from studies elsewhere, we suggested that fiber species were under-reported (c. 14 species were used vs. one species reported used). Even though these plant species are rich and diverse, the use of endemic or near-endemic species was rarely recorded in previous studies. These species included Arenga micrantha (used for starch), Hornstedtia tibetica (fruits), Castanopsis clarkei (edible nuts) and Gnetum pendulum (edible nuts), Ophiorrhiza medogensis (vegetables), Derris scabricaulis (fish poison), Radermachera yunnanensis (agricultural tools), Litsea tibetana (seed oil), Dendrocalamus tibeticus (wine strainers and implements for administering medicine), Zanthoxylum motuoense (spices), Cinnamomum contractum (tobacco substitutes), Morus wittiorum (medicines), and Garcinia nujiangensis (funeral rituals). Despite the absence of roads until 2013 and the impression of "isolation," Monpa knowledge of plant use reflects three categories of change. Firstly, oral histories of plants used in Bhutan were also encountered by Monpa people after their migration from Bhutan to south-eastern Tibet. Secondly, a "slow change" through centuries of exchange of knowledge (for example of Chinese and Tibetan medical systems), seeds of introduced crops (finger millet (indigenous to Africa), maize (from Meso-America)), and experimentation and use of introduced medicinal plants (such as Datura stramonium, which originates from North America). Thirdly, "fast change" over the past decade. This is reflected in changes in traditional architecture and in rising commercial trade in selected plant resources such as Dendrobium orchid stems and Paris polyphylla rhizomes which are in demand in China's Traditional Chinese Medicine (TCM) markets). Conclusions: Monpa people in the south-eastern Tibet have detailed knowledge of the diverse plant resources. But that traditional knowledge is now faced with a crisis because of the modern socio-economic change. In addition, Monpa knowledge of plants reflects slower changes in knowledge as well. For example, Monpa ethnomedicine has been influenced by traditional Tibetan and Chinese medicine over a longer period in time. Overall, this study provides a deeper understanding of the Monpa peoples' knowledge on wild plants, including endemic and near-endemic species whose uses have not been previously recorded. Several of these narrowly distributed species, such as the fish poison Derris scabricaulis, could be the focus of further studies. Some wild edible plants may also have interesting dietary constituents which need in-depth studies. These detailed studies could enable the Monpa people to benefit from the use of their traditional plant-derived culture and therefore support the biodiversity conservation. [ABSTRACT FROM AUTHOR]

Background: Traditional Chinese medicine (TCM) is a highly important complement to modern medicine and is widely practiced in China and in many other countries. The work of Chinese medicine is subject to the two factors of the inheritance and development of clinical experience of famous Chinese medicine practitioners and the difficulty in improving the service capacity of basic Chinese medicine practitioners. Heterogeneous information networks (HINs) are a kind of graphical model for integrating and modeling real-world information. Through HINs, we can integrate and model the large-scale heterogeneous TCM data into structured graph data and use this as a basis for analysis.Methods: Mining categorizations from TCM data is an important task for precision medicine. In this paper, we propose a novel structured learning model to solve the problem of formula regularity, a pivotal task in prescription optimization. We integrate clustering with ranking in a heterogeneous information network.Results: The results from experiments on the Pharmacopoeia of the People's Republic of China (ChP) demonstrate the effectiveness and accuracy of the proposed model for discovering useful categorizations of formulas.Conclusions: We use heterogeneous information networks to model TCM data and propose a TCM-HIN. Combining the heterogeneous graph with the probability graph, we proposed the TCM-Clus algorithm, which combines clustering with ranking and classifies traditional Chinese medicine prescriptions. The results of the categorizations can help Chinese medicine practitioners to make clinical decision. [ABSTRACT FROM AUTHOR]

Background: Conservation of biodiversity is primary important of today's critically vulnerable environment. Efficient conservation can be possible only with the long-term participation and understanding of the communities. Ritual beliefs of the indigenous people are one of the important tools to understand the local communities and aid the nature conservation. In this paper, we documented contemporary ritual practices and ritual plant uses among the Naxi people and discussed the importance of traditional knowledge on ritual practice in the conservation of plants in the mountains presenting a case study of the Dongba culture. Methods: This study was carried out from July in 2013 to July in 2014. To document and analyze the present state of the ritual plant used by the Naxi people we conducted an ethnobotanical survey. We interviewed local people including Dongba priests using the semi-structured questionnaire. During the field study, we participated in the local religious activities to witness the use of different plants in ritual activities of the Naxi people. We interviewed twenty-two key informants and eleven of them were male. All the specimens of documented species were collected and deposited at the herbarium of Kunming Institute of Botany. Results: The survey results revealed the Naxi people possessed sound knowledge of the traditional ritual plants and great diversity of plants used in many of Naxi rituals and festivals. From the survey, we documented 32 ritual plant species belonging to 24 genera of 17 families used in various ritual activities. The ritual plants were grouped into two categories, namely those burned as incense, and those used for decoration. The incense plants like Olea europaea subsp. cuspidata and Pistacia weinmanniifolia were probably promising natural aromatic resource. Plants of genus Quercus were the most frequently used species. The places for ritual activities were diverse, such as the incense burners inside and outside the house and sacred trees at the Baishuitai. Local people except the young generation had an abundant of traditional knowledge. Conclusions: Our study shows the live ritual activities and the beliefs of the residents are keeping the plant diversity and the entire forest preserved as sacred mountains. Our study emphasizes traditional belief and an alternative view of conservation that is not led mainly by governmental policies, as local practices and ritual plants uses play as constant reminders to the Naxi on nature conservation. However, further research is recommended for in-depth understanding the role of traditional belief in biodiversity conservation. [ABSTRACT FROM AUTHOR]

Background: This paper investigates the properties and performance of the two generic measures, EQ-5D and SF-12, for Health-Related Quality of Life (HRQoL) assessments of pregnant women living with HIV in Kunming City, Yiliang County, Daguan County, Longchuan County, Tengchong County, Longling County and Fengqing County in Yunnan Province, China.Methods: As part of a screening programme for the prevention of mother-to-child transmission of HIV (PMTCT), a retrospective cross-sectional survey was conducted in the seven Maternal and Infant Health Care centers in Yunnan Province, China, between April and June of 2016. The demographic and HIV infection-related information used in the study was collected through questionnaires designed by the study's staff. HRQoL information was collected using two generic scales: EQ-5D and SF-12.Results: A total sample of one hundred and one pregnant women with a mean age of 30.4 ± 5.1 years was investigated. Average time elapsed since infection diagnoses was 5.8 ± 3.4 years. Only one infant (1.0%) was HIV positive, and 56 (55.4%) infants were HIV negative. The HIV status of 44 (43.6%) infants was unknown. The relationship between the EQ-5D functional dimensions and the PCS-12 and the relationship between the EQ-5D anxiety/depression dimension and the MCS-12 were stronger. Those whose PCS-12 and MCS-12 scores were at the median or lower were classified as being in worse health, while those over the median were classified as being in better health. Respondents who reported no problem on each of the EQ-5D dimensions was divided according to the median SF-12 component scores. Those who scored at the median or lower than the median were classified as being in worse health, while those higher than the median were classified as being in better health. The VAS scores were also significantly different than the median split of the SF-12 scores for these subjects.Conclusion: EQ-5D and SF-12 showed a discrimination ability in measuring the HRQoL of pregnant women living with HIV. The construct validity was identified for EQ-5D and SF-12 in the study. The respective constructs of EQ-5D and EQ-VAS may not overlap. Pregnant women living with HIV in the study gave more weight to their mental health when they provided a total health rating in EQ-VAS. EQ-VAS could explain the limitations of the EQ-5D dimension scores with ceiling effects in the survey. The results of our study could help to determine the suitable HRQoL instruments for pregnant women living with HIV and provide evidence for the proper comparison of EQ-5D and SF-12. [ABSTRACT FROM AUTHOR]

Background: In the past 20 years, the trends of ischemic heart disease (IHD) mortality in China have been described in divergent claims. This research analyzes mortality trends for IHD by using the data from 102 continuous Disease Surveillance Points (DSP) from 1991 to 2009.Method: The 102 continuous DSP covered 7.3 million people during the period 1991-2000, and then were expanded to a population of 52 million in the same areas for 2004-2009. The data were adjusted by using garbage code redistribution and underreporting rate, mapped from international classification of diseases ICD-9 to ICD-10. The mortality rates for IHD were further adjusted by the crude death proportion multiplied by the total number of deaths in the mortality envelope, which was calculated by using logrt = a + bt. Age-standard death rates (ASDRs) were computed using China's 2010 census population structure. Trend in IHD was calculated from ASDRs by using a joinpoint regression model.Results: The IHD ASDRs increased in total in regions with an average annual percentage change (AAPC) 4.96%, especially for the Southwest (AAPC = 7.97%) and Northeast areas (AAPC = 7.10%), and for male and female subjects (with 5% AAPC) as well. In rural areas, the year 2000 was a cut-off point for mortality rate with annual percentage change increasing from 3.52% in 1991-2000 to 9.02% in 2000-2009, which was much higher than in urban areas (AAPC = 1.05%). And the proportion of deaths increased in older adults, and more male deaths occurred before age 60 compared to female deaths.Conclusion: By observing a wide range of areas across China from 1991 to 2009, this paper concludes that the ASDR trend for IHD increased. These trends reflect changes in the Chinese standard of living and lifestyle with diets higher in fat, higher blood lipids and increased body weight. [ABSTRACT FROM AUTHOR]

Background: Geographical distribution of healthcare resources is an important dimension of healthcare access. Little work has been published on healthcare resource allocation patterns in China, despite public equity concerns. Methods: Using national data from 2043 counties, this paper investigates the geographic distribution of hospital beds at the county level in China. We performed Gini coefficient analysis to measure inequalities and ordinary least squares regression with fixed provincial effects and additional spatial specifications to assess key determinants. Results: We found that provinces in west China have the least equitable resource distribution. We also found that the distribution of hospital beds is highly spatially clustered. Finally, we found that both county-level savings and government revenue show a strong positive relationship with county level hospital bed density. Conclusions: We argue for more widespread use of disaggregated, geographical data in health policy-making in China to support the rational allocation of healthcare resources, thus promoting efficiency and equity. [ABSTRACT FROM AUTHOR]

Background: Multiple sclerosis (MS) is a rare chronically debilitating disease. There are few reports on the burden of disease of MS and prevalence in China. The authors intended to estimate disease burden and prevalence of MS in Shandong Province using available epidemiologic data.Methods: Prevalence was calculated using DISMOD II software based on incidence extrapolated from hospitalization data, case fatality and remission rate from literature as input indexes. Disability-adjusted life year (DALY) was computed with epidemiologic indexes estimated by DISMOD II program.Results: The prevalence of MS was estimated to be 3.7(95 % CI: 1.65-5.8) and 6.7(95 % CI: 2.7-9.56) cases per 100,000 people for males and for females, respectively. The mean age at onset of MS was 36.0(43.0 ± 30.0 years in males and 33.7(43.4 ± 29.7) years in females. Duration of the disease was estimated to be 34.0 (31.6 ± 21.0) years for males and 39.5(34.9 ± 21.8) years for females. The disease burden in disability-adjusted life years was 3316, comprised of 903 (27.2 %) years of life lost (YLL) and 2413 (72.8 %) years lived with disability (YLD).Conclusions: Our study highlighted that population in Shandong Province had a high prevalence of MS and the patients had a heavy disease burden. It also revealed that the results obtained in this paper would be useful to provide a reference for establishing specific healthcare policies for this rare disease in Shandong Province. [ABSTRACT FROM AUTHOR]

Background: Chronic rhinosinusitis (CRS) is defined as a condition of inflammation in the paranasal sinus mucosa persisting for more than 12 weeks. We previously reported that the prevalence of CRS was about 8 % in China. Here, we aim to investigate the occupational and environmental risk factors associated with CRS.Methods: Data were collected from seven Chinese cities: Urumqi, Changchun, Beijing, Wuhan, Chengdu, Huaian and Guangzhou. CRS was diagnosed according to the European Position Paper on Rhinosinusitis and Nasal Polyps (EP(3)OS) document. Participants were asked to complete a standardized questionnaire, which was developed by the Global Allergy and Asthma European Network (GA(2)LEN) project and covered sociodemographic characteristics, CRS-related symptoms and occupational and environmental exposures. We evaluated the association between CRS and various occupational and environmental factors using odds ratios (ORs) and 95 % confidence intervals (95 % CIs).Results: The total study population consisted of 10,633 subjects, 850 (7.99 %) of whom were defined as having CRS according to the EP(3)OS criteria. We found that there were significant associations between occupational and environmental factors and CRS. Specifically, having a clearance-related job, occupational exposure to dust, occupational exposure to poisonous gas, a pet at home or carpet at home or at the workplace were risk factors for CRS. Additionally, the method used to keep warm in winter, the duration of time spent using air conditioning in summer and the frequency of exposure to mouldy or damp environments were significantly different in subjects with and without CRS.Conclusions: Our data showed that some occupational and environmental exposures are strongly associated with CRS, which aids in understanding the epidemiology of CRS. [ABSTRACT FROM AUTHOR]

Background: China has the biggest population in the world, and has been experiencing the largest migration in history, and its rapid urbanization has profound and lasting impacts on local and national public health. Under these conditions, a systems understanding on the correlation among urbanization, environmental change and public health and to devise solutions at national, local and individual levels are in urgent need.Methods: In this paper, we provide a comprehensive review of recent studies which have examined the relationship between urbanization, urban environmental changes and human health in China. Based on the review, coupled with a systems understanding, we summarize the challenges and opportunities for promoting the health and wellbeing of the whole nation at national, local, and individual levels.Results: Urbanization and urban expansion result in urban environmental changes, as well as residents' lifestyle change, which can lead independently and synergistically to human health problems. China has undergone an epidemiological transition, shifting from infectious to chronic diseases in a much shorter time frame than many other countries. Environmental risk factors, particularly air and water pollution, are a major contributing source of morbidity and mortality in China. Furthermore, aging population, food support system, and disparity of public service between the migrant worker and local residents are important contributions to China's urban health.Conclusions: At the national level, the central government could improve current environmental policies, food safety laws, and make adjustments to the health care system and to demographic policy. At the local level, local government could incorporate healthy life considerations in urban planning procedures, make improvements to the local food supply, and enforce environmental monitoring and management. At the individual level, urban residents can be exposed to education regarding health behaviour choices while being encouraged to take responsibility for their health and to participate in environmental monitoring and management. [ABSTRACT FROM AUTHOR]

Background: With regard to the global childhood obesity epidemic, it is imperative that effective lifestyle interventions are devised to combat childhood obesity. This paper describes the development and implementation of a comprehensive (a combination of diet and physical activity (PA)), social cognitive behaviour modification intervention using accelerometry and a dietary diary to tackle child overweight and obesity. The comprehensive intervention effect was evaluated in a comparison with diet only, PA only and a no-treatment control group.Methods: A pilot study was conducted with a non-randomized cluster design. Four hundred thirty-eight overweight and obese children aged 7-12 years from ten primary schools in Beijing were recruited to receive a one-year intervention. Participants were allocated into one of four groups: the comprehensive intervention group; the PA only group (Happy 10 program); the diet only group (nutrition education program); and a control group. The effects of intervention on adiposity, blood pressure, and biochemical indicators were assessed by examining 2-way interactions (time × intervention) in linear mixed models. Means and 95 % confidence intervals (CI) for the adjusted changes between post-intervention and baseline relative to changes in the control group were calculated and reported as effect sizes.Results: The percentage of body fat in the comprehensive intervention group showed a significant relative decrease (adjusted change: -1.01 %, 95 % CI: (-1.81, -0.20) %) compared with the PA only, diet only or control groups (P < 0.001). Systolic blood pressure significantly decreased in the comprehensive intervention group (adjusted change: -4.37 mmHg, 95 % CI: (-8.42, -0.33) mmHg), as did diastolic blood pressure (adjusted change: -5.50 mmHg, 95 % CI (-8.81, -2.19) mmHg) (P < 0.05). Compared with the other two intervention groups and the control group, positive adjusted changes in fasting glucose in the comprehensive group were found, although not for the biochemical lipid metabolism indicators. Positive but non-significant adjusted changes in body mass index and waist circumference were observed.Conclusions: Compared with the diet or PA only intervention groups, the current comprehensive program had superior positive effects on body fat percentage and blood pressure but not on the biochemical lipid metabolism indicators in Chinese overweight and obese children. Future randomized controlled trials and long-term follow-up studies are required to elaborate the findings of the current intervention.Trial Registration: ClinicalTrials.gov identifier: NCT02228434. [ABSTRACT FROM AUTHOR]

Background: This paper is based on an ethnobotanical investigation that focused on the traditional medicinal plants used by local Maonan people to treat human diseases in Maonan concentration regions. The Maonan people have relied on traditional medicine since ancient times, especially medicinal plants. The aim of this study is to document medicinal plants used by the Maonans and to report the status of medicinal plants and associated traditional knowledge. Methods: Ethnobotanical data were collected from June 2012 to September 2014 in Huanjiang Maonan Autonomous County, northern Guangxi, southwest China. In total, 118 knowledgeable informants were interviewed. Following statistically sampling method, eighteen villages from 5 townships were selected to conduct field investigations. Information was collected through the approache of participatory observation, semi-structured interviews, ranking exercises, key informant interviews, focus group discussions, and participatory rural appraisals. Results: A total of 368 medicinal plant species were investigated and documented together with their medicinal uses by the Maonans, most of which were obtained from the wild ecosystems. The plants were used to treat 95 human diseases. Grinding was a widely used method to prepare traditional herbal medicines. There were significant relationships between gender and age, and between gender and informants' knowledge of medicinal plant use. Deforestation for agricultural purposes was identified as the most destructive factor of medicinal plants, followed by drought and over-harvest. Conclusions: The species diversity of medicinal plants used by the Maonans in the study area was very rich. Medicinal plants played a significant role in healing various human disorders in the Maonan communities. However, the conflicts between traditional inheriting system and recent socio-economic changes (and other factors) resulted in the reduction or loss of both medicinal plants and associated indigenous knowledge. Thus, conservation efforts and policies, and innovation of inheriting system are necessary for protecting the medicinal plants and associated indigenous knowledge. Awareness is also needed to be raised among local Maonans focusing on sustainable utilization and management of both medicinal plants and traditional knowledge. [ABSTRACT FROM AUTHOR]

Background: Cancer has become a global health problem. China still suffers continuous increasing cancer mortality. To study the trend of cancer mortality in rural China, this paper established an Age-Period-Cohort model to discuss the age effect, period effect and cohort effect on cancer mortality in rural China. Methods: The data were collected from the “China Health Statistical Yearbook” from 1990 to 2010. Collected data were analyzed by Age-Period-Cohort model and Intrinsic Estimation method. Results: The age effect on the total cancer mortality represented a V trend. Compared with Group 0–4, Group 5–9 showed 71.87% lower cancer mortality risk. Compared with Group 5–9, Group 75–79 showed 38 times higher cancer mortality risk. The period effect on the total cancer mortality risk weakened firstly but then increased. It increased by 35.70% from 1990 to 2010, showing an annual average growth of 1.79%. The cohort effect on the total cancer mortality risk weakened by totally 84.94% from 1906–1910 to 2005–2010. Three “deterioration periods” and three “improvement periods” were witnessed during this period. The malignant cancer mortality varied similarly with the total cancer mortality, while benign cancer mortality and other cancer mortality represented different variation laws. Conclusions: Although the total cancer mortality risk is increasing at an accelerated rate, cancer mortality risk in recent born year is decreasing, indicating very important impact of social change on the cancer mortality in rural China. [ABSTRACT FROM AUTHOR]

Background: Indigo-dyed textiles have been central to the cultural identity of Landian Yao (literally "blue clothes Yao") people in Southwest China for centuries, driving a significant local market for naturally dyed indigo cloth. In the past two decades, local indigo production for traditional textiles has declined for several reasons: Firstly, the younger generation of Landian Yao has shifted to using western style jeans and T-shirts. Secondly, due to its labor-intensive nature. In contrast, at a global scale, including in China, there has been a revival of interest in natural indigo use. This is due to a growing awareness in the fashion industry about human and environmental health issues related to synthetic dye production. Ironically, this new awareness comes at a time when traditional knowledge of indigo dyeing is being lost in many places in China, with weaving and use of natural dyes now limited to some remote areas. In this study, we recorded indigo dyeing processes used by Landian Yao people and documented the plant species used for indigo dyeing. Methods: Field surveys were conducted to the study area from September 2015 to November 2016, supplemented by follow-up visits in July 2018 and November 2018. We interviewed 46 key informants between 36 and 82 years old who still continued traditional indigo dyeing practices. Most were elderly people. Semi-structured interviews were used. During the field study, we kept a detailed account of the methods used by Landian Yao dyers. The data were then analyzed by using utilization frequency to determine the best traditional recipe of indigo dye extraction. All the specimens of documented species were collected and deposited at the herbarium of Kunming Institute of Botany. Results: Our results showed that indigo dyeing was divided into two main steps: (1) indigo pigment extraction and (2) dyeing cloth. The general procedures of indigo dye extraction included building or buying a dye vat, fermentation, removal of the leaves of indigo producing plant species, addition of lime, oxygenation, followed by collection, and the storage of the indigo paste. The procedures of dyeing cloth included preparing the dye solutions, dyeing cloth, washing, and air drying. It is notable that Landian Yao dyers formerly only performed the dyeing process on the goat days in the lunar calendar from June to October. After comparing the range of local indigo extraction methods, our results showed that the following was best of these traditional recipes: a indigo-yielding plant material to tap water ratio of 30 kg: 200 l, lime 3 kg, a fermentation time of 2–3 d, aeration by agitation for up to 60 min, and a precipitation time of 2–3 h. Our results show that 17 plant species in 11 families were recorded in the indigo dyeing process. With the exception of the indigo sources, only Dioscorea cirrhosa Lour. and Artemisia argyi H.Lév. & Vaniot were previously recorded in dyeing processes. Other species given in this paper are recorded for the first time in terms of their use in the indigo dyeing process. In the study area, Landian Yao men were in charge of indigo dye extraction, and the women were responsible for dyeing cloth. Conclusions: The Landian Yao has completely mastered the traditional indigo dyeing craft and are one of the well-deserved identity blues. Indigo production from plants using traditional methods is a slow process compared to synthetic dyes and is not suitable for modern and rapid industrial production. Therefore, our study records the detailed information of traditional indigo dyeing to protect and inherit it. Strobilanthes cusia (Nees) Kuntze is the main indigo source in Landian Yao that is widely used in the world and can be commercially exploited as an indigo plant. For commercial and environment benefits, we suggest that producing natural indigo for the commercial market is a good choice. [ABSTRACT FROM AUTHOR]