Search

China’s fast economic growth contributes to the rapid development of its urbanization process, and also renders a series of industrial accidents, which often cause loss of life, damage to property and environment, thus requiring the associated risk analysis and safety control measures to be implemented in advance. However, incompleteness of historical failure data before the occurrence of accidents makes it difficult to use traditional risk analysis approaches such as probabilistic risk analysis in many cases. This paper aims to develop a new methodology capable of assessing regional industrial safety (RIS) in an uncertain environment. A hierarchical structure for modelling the risks influencing RIS is first constructed. The hybrid of evidential reasoning (ER) and Analytical Hierarchy Process (AHP) is then used to assess the risks in a complementary way, in which AHP is hired to evaluate the weight of each risk factor and ER is employed to synthesise the safety evaluations of the investigated region(s) against the risk factors from the bottom to the top level in the hierarchy. The successful application of the hybrid approach in a real case analysis of RIS in several major districts of Beijing (capital of China) demonstrates its feasibility as well as provides risk analysts and safety engineers with useful insights on effective solutions to comprehensive risk assessment of RIS in metropolitan cities. The contribution of this paper is made by the findings on the comparison of risk levels of RIS at different regions against various risk factors so that best practices from the good performer(s) can be used to improve the safety of the others. [ABSTRACT FROM AUTHOR]

The changing population age structure has a significant influence on the economy, society, and numerous other aspects of a country. This paper has innovatively applied the method of compositional data forecasting for the prediction of population age changes of the young (aged 0–14), the middle-aged (aged 15–64), and the elderly (aged older than 65) in China, India, and Vietnam by 2030 based on data from 1960 to 2016. To select the best-suited forecasting model, an array of data transformation approaches and forecasting models have been extensively employed, and a large number of comparisons have been made between the aforementioned methods. The best-suited model for each country is identified considering the root mean squared error and mean absolute percent error values from the compositional data. As noted in this study, first and foremost, it is predicted that by the year 2030, China will witness the disappearance of population dividend and get mired in an aging problem far more severe than that of India or Vietnam. Second, Vietnam’s trend of change in population age structure resembles that of China, but the country will sustain its good health as a whole. Finally, the working population of India demonstrates a strong rising trend, indicating that the age structure of the Indian population still remains relatively “young”. Meanwhile, the continuous rise in the proportion of elderly population and the gradual leveling off growth of the young population have nevertheless become serious problems in the world. The present paper attempts to offer crucial insights into the Asian population size, labor market and urbanization, and, moreover, provides suggestions for a sustainable global demographic development. [ABSTRACT FROM AUTHOR]

Accidents, bad weathers, traffic congestions, etc. led to the uncertainties of travel times in real-life road networks, which greatly affected the quality of individual’s life and the reliability of transportation system. This paper addressed the school bus routing problem in such a stochastic and time-dependent road environment. Firstly, the problem was set based on a single-school configuration, and the students were picked up at their homes, which was in line with the current situation of school bus systems in China. Thus, it could be regarded as an independent problem of school bus route generation in random dynamic networks, which could be solved as a variant of extended Vehicle Routing Problem. However, due to the fluctuation and uncertainty of link travel times, the arrival time at each stop including the destination was varying. Therefore, the selection of optimal path connecting the current service node with the next one was treated as a sub-problem in this study, where the reliability of travel times in the stochastic and time-varying network was highly concerned by such time-rigid commuters. To this end, a Robust Optimal Schedule Times model with a hard time windows constraint was built to generate a most cost-reliable route for school buses. By the use of Robust Optimization method, it was intended to minimize the worst-case total cost which combined the cost of earlier schedule delays with the disutility of travel times. It was also proved that the proposed model could be converted into solving a conventional problem in deterministic dynamic networks for a reduction of computation complexity, which provided the potential of applying to the practical problems. Finally, the validity of the proposed model and its performance evaluation was analyzed through a small-scale computational instance, where all the link travel times in the simulated network were attributed to both time-varying and stochastic. Then, a mathematical programming solver was used to find the exact optimal solution. The results indicated that the model was valid, and the necessity of considering the stochastic and time-dependent nature of transportation networks was also confirmed in the case study. [ABSTRACT FROM AUTHOR]

Aiming to solve the safety problems of high-speed railway operation and management, one new method is urgently needed to construct on the basis of the rough set theory and the uncertainty measurement theory. The method should carefully consider every factor of high-speed railway operation that realizes the measurement indexes of its safety operation. After analyzing the factors that influence high-speed railway safety operation in detail, a rough measurement model is finally constructed to describe the operation process. Based on the above considerations, this paper redistricts the safety influence factors of high-speed railway operation as 16 measurement indexes which include staff index, vehicle index, equipment index and environment. And the paper also provides another reasonable and effective theoretical method to solve the safety problems of multiple attribute measurement in high-speed railway operation. As while as analyzing the operation data of 10 pivotal railway lines in China, this paper respectively uses the rough set-based measurement model and value function model (one model for calculating the safety value) for calculating the operation safety value. The calculation result shows that the curve of safety value with the proposed method has smaller error and greater stability than the value function method’s, which verifies the feasibility and effectiveness. [ABSTRACT FROM AUTHOR]

Colorectal Cancer (CRC) is becoming a major threat to people’s life in China. Screening methods adopted by many other countries as effective counter-cancer methods have not been explicitly explored for people there. Thus, we present a Markov model with detailed precancerous adenoma states and then evaluate various screening strategies in this paper. Different from current researches, our model considers the population’s heterogeneous risk of developing adenomas and observation-based screening strategies. Furthermore, we also give a new cost-effectiveness metric. After calibrating, the model is simulated using the Monte Carlo method. Numerical results show that there are threshold values of compliance rates below which strategy with every ten-year colonoscopy becomes the most cost-effective method; otherwise, an observation-based screening strategy is the most cost-effective. We also find that strategy with single colonoscopy for adenoma-free individuals and every three-year colonoscopy for those with adenoma is recommended when the observation-based strategy is not considered. Our findings give an explicit and complete instruction in CRC screening protocol in average-risk Chinese. [ABSTRACT FROM AUTHOR]

Background: Hypochondriac symptoms are commonly reported in health science students. With their incomplete medical knowledge, they may compare their own bodily symptoms with disease symptoms during the process of learning, which can lead to mental distress and the need for repeated medical reassurance. Objective: To estimate the prevalence of hypochondriac symptoms in Chinese health science students. Methods: A systematic literature search was conducted on PubMed, Web of Science, Embase, China National Knowledge Infrastructure, China Biology Medicine disc, and Wanfang Data on July 1, 2018. Additionally, the references of the retrieved papers were searched. Cross-sectional studies published in either English or Chinese that reported the prevalence of hypochondriac symptoms in health science students were included. The selection process was executed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis, and study quality was assessed with the checklist recommended by the Agency for Healthcare Research and Quality for cross-sectional studies. A random-effects model according to the DerSimonian-Laird method was used to calculate the pooled prevalence. Results: Seven cross-sectional studies involving 6,217 Chinese health science students were included. The pooled prevalence of hypochondriac symptoms among health science students was 28.0% (95% CI = 19.0%–38.0%). The symptoms were a little more common in females (30.0%, 95% CI = 19.0%–42.0%) than in males (29.0%, 95% CI = 16.0%–42.0%), but the difference was not significant. No significant differences were found between participants grouped by study year. Only three studies explored the coping styles of students with hypochondriasis, and these revealed a high tendency toward help-seeking behaviors. Conclusion: Our systematic review and meta-analysis showed a high prevalence of hypochondriac symptoms among health science students, indicating that it is a noteworthy phenomenon. We suggest that counseling and other support services are necessary for health science students. [ABSTRACT FROM AUTHOR]

To balance the supply and demand in China's beef market, beef consumption must be scientifically and effectively forecasted. Beef consumption is affected by many factors and is characterized by gray uncertainty. Therefore, gray theory can be used to forecast the beef consumption, In this paper, the structural defects and unreasonable parameter design of the traditional gray model are analyzed. Then, a new gray model termed, EGM(1,1,r), is built, and the modeling conditions and error checking methods of EGM(1,1,r) are studied. Then, EGM(1,1,r) is used to simulate and forecast China’s beef consumption. The results show that both the simulation and prediction precisions of the new model are better than those of other gray models. Finally, the new model is used to forecast China’s beef consumption for the period from 2019–2025. The findings will serve as an important reference for the Chinese government in formulating policies to ensure the balance between the supply and demand for Chinese beef. [ABSTRACT FROM AUTHOR]

While numerous papers have illuminated the worthiness of research collaboration, relatively few have addressed its prerequisites. In our study, seven prerequisites for research collaboration were extracted from the existing literature, and 460 student researchers were surveyed for their perceptions of the prerequisites’ importance. Focusing on voluntary research collaborations rather than brokered ones, it was found that socially oriented prerequisites such as reciprocal interactions, accountability, trust, and equality are perceived of more importance than prerequisites of psychical proximity, networking channels, and funds and material supplies (substance- and entity-related prerequisites). With latent regression analyses, we also found that Chinese and older, more experienced researchers are inclined to stress the importance of equality. Researchers of different cohorts prioritise substance- and entity-related prerequisites disparately. Specifically, Chinese researchers emphasise the necessity of funds, while researchers from first-tier universities place more value on networking channels. Disciplinary differences for the prerequisite of proximity were also discovered. Based on these results, discussion and implications were referred. Further suggestions on research collaboration studies are rendered. [ABSTRACT FROM AUTHOR]

Background: Around the world, regulatory bodies have taken the lead in determining the competencies required to become a physician. As a first step in addressing this project, it was decided to develop a set of core competencies that were unique to China and that might serve as a basis for medical education. The purpose of this paper was to construct a competency model for clinical physicians in China. Methods: Data was collected using a cross-sectional survey of 6247 clinicians from seven administrative regions (31 provinces, autonomous regions and municipalities directly under the central government) in China. The total sample was randomly divided into two sub-samples, an initial sample (Sample 1) and a replication sample (Sample 2). Independent exploratory factor analysis was conducted in each sample and the results were compared to determine the stability. After that the confirmatory factor analysis was used to ascertain the competency model for physicians. The reliability, convergent and discriminant validity of competency-based instrument were also examined. Results: 76 items with 8 dimensions were identified, accounting for 68.41% of the construct’s total variance in the initial sample and 67.47% in the replication sample. For the two samples, the overall scale reliability (Cronbach’s alpha) was both 0.985 with dimensions from 0.905 to 0.954 for the initial sample and from 0.902 to 0.955 for the replication sample after deleting the items. In confirmatory factor analysis, the result showed that all items had acceptable goodness of fit index. RMSEA and SRMR were less than 0.08 (RMSEA = 0.046, SRMR = 0.040), while GFI, NFI, IFI, and CFI were higher than 0.9 (GFI = 0.905, NFI = 0.903, IFI = 0.909, CFI = 0.909), leading to acceptable construct validity. All construct reliability values of the factors were higher than 0.70, and all average variance extracted values exceeded 0.50. Thus, we considered the reliability and validity of the 8 dimensions were acceptable. Conclusions: The instrument was shown to be both valid and reliable for measuring clinical physicians’ competency in China. The results of the competency-based instrument can be used by ministry of health and administrators of hospitals to assess physicians’ competencies, encourage and guide them to modify their behaviors according to the evaluation criteria, and also cultivate physicians with strong clinical practice, innovation and independent scientific research ability. Through these measurements and understandings, the overall level of clinical physicians will be increased in China. [ABSTRACT FROM AUTHOR]

Background: About 1 million people worldwide commit suicide each year, and college students with suicidal ideation are at high risk of suicide. The prevalence of suicidal ideation in college students has been estimated extensively, but quantitative syntheses of overall prevalence are scarce, especially in China. Accurate estimates of prevalence are important for making public policy. In this paper, we aimed to determine the prevalence of suicidal ideation in Chinese college students. Objective and Methods: Databases including PubMed, Web of Knowledge, Chinese Web of Knowledge, Wangfang (Chinese database) and Weipu (Chinese database) were systematically reviewed to identify articles published between 2004 to July 2013, in either English or Chinese, reporting prevalence estimates of suicidal ideation among Chinese college students. The strategy also included a secondary search of reference lists of records retrieved from databases. Then the prevalence estimates were summarized using a random effects model. The effects of moderator variables on the prevalence estimates were assessed using a meta-regression model. Results: A total of 41 studies involving 160339 college students were identified, and the prevalence ranged from 1.24% to 26.00%. The overall pooled prevalence of suicidal ideation among Chinese college students was 10.72% (95%CI: 8.41% to 13.28%). We noted substantial heterogeneity in prevalence estimates. Subgroup analyses showed that prevalence of suicidal ideation in females is higher than in males. Conclusions: The prevalence of suicidal ideation in Chinese college students is relatively high, although the suicide rate is lower compared with the entire society, suggesting the need for local surveys to inform the development of health services for college students. [ABSTRACT FROM AUTHOR]

Lane change violations are a major cause of traffic conflicts and accidents at urban intersections and one of many road-safety issues in China. This study aims to explore the socio-psychological factors underlying drivers’ motivation for lane change violation behavior at urban intersections and examines how these factors predict this violation behavior. A self-reported questionnaire is designed by applying the construct of the theory of planned behavior (TPB) to collect data. Five hundred-six valid responses are received from the questionnaire survey conducted on the Internet in China. The data are then analyzed using structural equation modeling (SEM). The results of the analysis show that behavioral intention is the strongest predictor of self-reported lane change violation behavior at urban intersections. Perceived behavioral control has both direct and indirect effects on self-reported lane change violation behavior. Furthermore, attitude, subjective norms and perceived behavioral control are found to have significant correlations with drivers’ intention of lane change violations at urban intersections. The results of this study could provide a reference for designing more effective interventions to modify drivers’ lane change violation behavior at urban intersections. [ABSTRACT FROM AUTHOR]

China's rapid urbanization and high traffic accident frequency have received many researchers’ attention. It is important to reveal how urban infrastructures and other risk factors affects the traffic accident frequency. A growing amount of research has examined the local risk factors impact on traffic accident frequency at certain time. Some studies considered these spatial influences but overlooked the temporal correlation/heterogeneity of traffic accidents and related risk factors. This study explores risk factors’ influence on urban traffic accidents frequency while considering both the spatial and temporal correlation/heterogeneity of traffic accidents. The study area is split into 100 equally sized rectangle traffic analysis zones (TAZs), and the urban traffic accident frequency and attributes in each TAZ are extracted. The linear regression model, spatial lag model (SLM), spatial error model (SEM) and time-fixed effects error model (T-FEEM) are established and compared respectively. The proposed methodologies are illustrated using ten-month traffic accident data from the urban area of Guiyang City, China. The results reveal that the time-fixed effects error model, which considers both spatial and temporal correlation/heterogeneity of traffic accidents, is superior to other models. More traffic accidents will happen in those TAZs that have more hospitals or schools. Moreover, hospitals have a greater influence on traffic accidents than schools. Because of the location in the margin of the city, those TAZs that have passenger stations have more traffic accidents. This study provides policy makers with more detailed characterization about the impact of related risk factors on traffic accident frequencies, and it is suggested that not only the spatial correlation/heterogeneity but also the temporal correlation/heterogeneity should be taken into account in guiding traffic accident control of urban area. [ABSTRACT FROM AUTHOR]

The analysis of traffic collisions is essential for urban safety and the sustainable development of the urban environment. Reducing the road traffic injuries and the financial losses caused by collisions is the most important goal of traffic management. In addition, traffic collisions are a major cause of traffic congestion, which is a serious issue that affects everyone in the society. Therefore, traffic collision analysis is essential for all parties, including drivers, pedestrians, and traffic officers, to understand the road risks at a finer spatio-temporal scale. However, traffic collisions in the urban context are dynamic and complex. Thus, it is important to detect how the collision hotspots evolve over time through spatio-temporal clustering analysis. In addition, traffic collisions are not isolated events in space. The characteristics of the traffic collisions and their surrounding locations also present an influence of the clusters. This work tries to explore the spatio-temporal clustering patterns of traffic collisions by combining a set of network-constrained methods. These methods were tested using the traffic collision data in Jianghan District of Wuhan, China. The results demonstrated that these methods offer different perspectives of the spatio-temporal clustering patterns. The weighted network kernel density estimation provides an intuitive way to incorporate attribute information. The network cross K-function shows that there are varying clustering tendencies between traffic collisions and different types of POIs. The proposed network differential Local Moran’s I and network local indicators of mobility association provide straightforward and quantitative measures of the hotspot changes. This case study shows that these methods could help researchers, practitioners, and policy-makers to better understand the spatio-temporal clustering patterns of traffic collisions. [ABSTRACT FROM AUTHOR]

Background: Postpartum Family Visits (PFVs) have been advocated as a way to improve health outcomes for puerperal women and their newborns. This study aimed to identify individual factors associated with the utilization of PFVs in rural Jiangsu Province, China. Methods: We employed responses of the household survey in Jiangsu province, part of the National Health Service Survey (NHSS), a nationally representative survey in China. The data analysis framework was designed based on Andersen’s behavioral model. The outcome variables included nonuse and deficient use of PFVs, and the explanatory variables were organized into three hierarchical levels: predisposing, enabling and need factors. Univariate analysis and multivariate logistic regression analysis were conducted to examine the impact of the three hierarchical levels on PFVs utilization. Results: A total of 884 rural women who had a childbearing history in the prior five years answered PFVs questions. About 23.4% of them had never received any PFVs, and 40.4% received <3 visits. In the results of multivariate logistic regression, educational level (OR = 0.43, 95% CI: 0.24–0.77), income (OR = 0.62, 95% CI: 0.43–0.88), the distance from the nearest hospital (OR = 1.49, 95% CI: 1.07–2.07) and parity (OR = 2.17, 95% CI: 1.54–3.05) had significant relationship with nonuse. Factors significantly associated with deficient use of PFVs included employment (OR = 0.62, 95% CI: 0.39–0.98), the distance from the nearest hospital (OR = 1.73, 95% CI: 1.26–2.36), level of delivery institution (OR = 1.57, 95% CI: 1.14–2.17), and parity (OR = 1.45, 95% CI: 1.03–2.05). Conclusion: The study found lower Social Economic Status (SES), long distance with primary health institutions, and the increased need for services stemming from multi-parity reduced the likelihood of nonuse or deficient use of PFVs in rural areas. Multiparous, low SES women and those living far away from primary health institutions should be paid more attention to assure the coverage of postpartum care. [ABSTRACT FROM AUTHOR]

Background: Offering free glasses can be important to increase children’s wear. We sought to assess whether “Upgrade glasses” could avoid reduced glasses sales when offering free glasses to children in China. Methods: In this cluster-randomized, controlled trial, children with uncorrected visual acuity (VA)< = 6/12 in either eye correctable to >6/12 in both eyes at 138 randomly-selected primary schools in 9 counties in Guangdong and Yunnan provinces, China, were randomized by school to one of four groups: glasses prescription only (Control); Free Glasses; Free Glasses + offer of $15 Upgrade Glasses; Free Glasses + offer of $30 Upgrade Glasses. Spectacle purchase (main outcome) was assessed 6 months after randomization. Results: Among 10,234 children screened, 882 (8.62%, mean age 10.6 years, 45.5% boys) were eligible and randomized: 257 (29.1%) at 37 schools to Control; 253 (28.7%) at 32 schools to Free Glasses; 187 (21.2%) at 31 schools to Free Glasses + $15 Upgrade; and 185 (21.0%) at 27 schools to Free Glasses +$30 Upgrade. Baseline ownership among these children needing glasses was 11.8% (104/882), and 867 (98.3%) children completed follow-up. Glasses purchase was significantly less likely when free glasses were given: Control: 59/250 = 23.6%; Free glasses: 32/252 = 12.7%, P = 0.010. Offering Upgrade Glasses eliminated this difference: Free + $15 Upgrade: 39/183 = 21.3%, multiple regression relative risk (RR) 0.90 (0.56–1.43), P = 0.65; Free + $30 Upgrade: 38/182 = 20.9%, RR 0.91 (0.59, 1.42), P = 0.69. Conclusions: Upgrade glasses can prevent reductions in glasses purchase when free spectacles are provided, providing important program income. Trial registration: ClinicalTrials.gov Identifier: . Registered on 31 August 2014. [ABSTRACT FROM AUTHOR]

Background: Intimate partner violence (IPV) is the most common form of violence against women worldwide. IPV during pregnancy is an important risk factor for adverse health outcomes for women and their offspring. However, the prevalence of IPV during pregnancy is not well understood in China. The objective of this study was to estimate the pooled prevalence of IPV during pregnancy in China using a systematic review and meta-analysis. Methods: Systematic literature searches were conducted in PubMed, Web of Science, CNKI, Wanfang, Weipu and CBM databases to identify relevant articles published from the inception of each database to January 31, 2016 that reported data on the prevalence of IPV during pregnancy in China. The Risk of Bias Tool for prevalence studies was used to assess the risk of bias in individual studies. Owing to significant between-study heterogeneity, a random-effects model was used to calculate the pooled prevalence and corresponding 95% confidence interval, and then univariate meta-regression analyses were performed to investigate the sources of heterogeneity. Subgroup analysis was conducted to explore the risk factors associated with IPV during pregnancy. Results: Thirteen studies with a total of 30,665 individuals were included in this study. The overall pooled prevalence of IPV during pregnancy was 7.7% (95% CI: 5.6–10.1%) with significant heterogeneity (I2 = 97.8%, p < 0.001). The results of the univariate meta-regression analyses showed that only the variable “sample source” explained part of the heterogeneity in this study (p < 0.05). The characteristics “number of children” and “unplanned pregnancy” were determined as risk factors for experiencing violence during pregnancy. Conclusions: The prevalence of IPV during pregnancy in China is considerable and one of the highest reported in Asia, which suggests that issues of violence against women during pregnancy should be included in efforts to improve the health of pregnant women and their offspring. In addition, a nationwide epidemiological study is needed to confirm the prevalence estimates and identify more risk factors for IPV during pregnancy. [ABSTRACT FROM AUTHOR]

Objective: The School-based Education Program to Reduce Salt Intake in Children and Their Families study was a cluster randomized control trial among grade five students in 28 primary schools and their families in Changzhi, China. It achieved a significant effect in lowering systolic blood pressure (SBP) in all family adults by 2.3 mmHg and in elderlies (aged > = 60 years) by 9.5 mmHg. The aim of this study was to assess the cost-effectiveness of this salt reduction program. Methods: Costs of the intervention were assessed using an ingredients approach to identify resource use. A trial-based incremental cost-effectiveness ratio (ICER) was estimated based on the observed effectiveness in lowering SBP. A Markov model was used to estimate the long-term cost-effectiveness of the intervention, and then based on population data, extrapolated to a scenario where the program is scaled up nationwide. Findings were presented in terms of an incremental cost per quality-adjusted life year (QALY). The perspective was that of the health sector. Results: The intervention cost Int$19.04 per family and yielded an ICER of Int$2.74 (90% CI: 1.17–12.30) per mmHg reduction of SBP in all participants (combining children and adult participants together) compared with control group. If scaled up nationwide for 10 years and assumed deterioration in treatment effect of 50% over this period, it would reach 165 million families and estimated to avert 42,720 acute myocardial infarction deaths and 107,512 stroke deaths in China. This would represent a gain of 635,816 QALYs over 10-year time frame, translating into Int$1,358 per QALY gained. Conclusion: Based on WHO-CHOICE criteria, our analysis demonstrated that the proposed salt reduction strategy is highly cost-effective, and if scaled up nationwide, the benefits could be substantial. Trial registration: ClinicalTrials.gov [ABSTRACT FROM AUTHOR]

Objective: To estimate the long-term cost-effectiveness of dapagliflozin versus acarbose as monotherapy in treatment-naïve patients with type 2 diabetes mellitus (T2DM) in China. Methods: The Cardiff Diabetes Model, an economic model designed to evaluate the cost-effectiveness of comparator therapies in diabetes was used to simulate disease progression and estimate the long-term effect of treatments on patients. Systematic literature reviews, hospital surveys, meta-analysis and indirect treatment comparison were conducted to obtain model-required patient profiles, clinical data and costs. Health insurance costs (2015¥) were estimated over 40 years from a healthcare payer perspective. Univariate and probabilistic sensitivity analyses were performed. Results: The model predicted that dapagliflozin had lower incidences of cardiovascular events, hypoglycemia and mortality events, was associated with a mean incremental benefit of 0.25 quality-adjusted life-years (QALYs) and with a lower cost of ¥8,439 compared with acarbose. This resulted in a cost saving of ¥33,786 per QALY gained with dapagliflozin. Sensitivity analyses determined that the results are robust. Conclusion: Dapagliflozin is dominant compared with acarbose as monotherapy for Chinese T2DM patients, with a little QALY gain and lower costs. Dapagliflozin offers a well-tolerated and cost-effective alternative medication for treatment-naive patients in China, and may have a direct impact in reducing the disease burden of T2DM. [ABSTRACT FROM AUTHOR]

Objectives: Road traffic crashes that involve very high numbers of fatalities and injuries arouse public concern wherever they occur. In China, there are two categories of such crashes: a crash that results in 10–30 fatalities, 50–100 serious injuries or a total cost of 50–100 million RMB ($US8-16m) is a “serious road traffic crash” (SRTC), while a crash that is even more severe or costly is a “particularly serious road traffic crash” (PSRTC). The aim of this study is to identify the main factors affecting different types of these crashes (single-vehicle, head-on, rear-end and side impact) with the ultimate goal of informing prevention activities and policies. Methods: Detailed descriptions of the SRTCs and PSRTCs that occurred from 2007 to 2014 were collected from the database “In-depth Investigation and Analysis System for Major Road Traffic Crashes” (IIASMRTC), which is maintained by the Traffic Management Research Institute of the Ministry of Public Security of China (TMRI). 18 main risk factors, which were categorized into four areas (participant, vehicle, road and environment-related) were chosen as potential independent variables for the multinomial logistic regression analysis. Comparisons were made among the single-vehicle, head-on, rear-end and side impact crashes in terms of factors affecting crash occurrence. Findings: Five risk factors were significant for the six multinomial logistic regression models, which were location, vertical alignment, roadside safety rating, driver distraction and overloading of cargo. It was indicated that intersections were more likely to have side impact SRTCs and PSRTCs, especially with poor visibility at night. Overloaded freight vehicles were more likely to be involved in a rear-end crash than other freight vehicles. Driver distraction is an important risk factor for head-on crashes, while vertical alignment and roadside safety rating are positively associated with single-vehicle crashes. Conclusion: Based on the findings, promising measures were proposed to prevent each type of SRTC and PSRTC, which governmental or regulatory agencies could employ to plan strategies to reduce SRTCs and PSRTCs and support lifesaving policies. [ABSTRACT FROM AUTHOR]

The purpose of this study was to construct and validate a “Perceived Physical Literacy Instrument” (PPLI) for physical education teachers. Based on literature review and focus group interviews, an 18-item instrument was developed for the initial tests. This self-report measure, using a 5-point Likert scale, formed the PPLI and was administered to 336 physical education teachers in Hong Kong. The sample was randomly split, and exploratory and confirmatory factor analyses resulted in a 9-item, 3-factor scale. Exploratory factor analysis (EFA) item loadings ranged from 0.69 to 0.87, and Cronbach’s alpha ranged from 0.73 to 0.76. Confirmatory factor analysis (CFA) showed that the construct demonstrated good fit to the model. The PPLI thus appeared to be reliable and valid to measure the perceived physical literacy of physical education teachers. It is argued that the instrument can be used for both research and applied purposes and potential uses for the instrument in physical education, medical and health settings are discussed. [ABSTRACT FROM AUTHOR]

Objective: Team-based learning (TBL) is an increasingly popular teaching method in medical education. However, TBL hasn’t been well-studied in the ophthalmology clerkship context. This study was to examine the impact of modified TBL in such context and to assess the student evaluations of TBL. Methods: Ninety-nine students of an 8-year clinical medicine program from Zhongshan Ophthalmic Centre, Sun Yat-sen University, were randomly divided into four sequential units and assigned to six teams with the same faculty. The one-week ophthalmology clerkship module included traditional lectures, gross anatomy and a TBL module. The effects of the TBL module on student performance were measured by the Individual Readiness Assurance Test (IRAT), the Group Readiness Assurance Test (GRAT), the Group Application Problem (GAP) and final examination scores (FESs). Students’ evaluations of TBL were measured by a 16-item questionnaire. IRAT and GRAT scores were compared using a paired t-test. One-way analysis of variance (ANOVA) and subgroup analysis compared the effects among quartiles that were stratified by the Basic Ophthalmology Levels (BOLs). The BOLs were evaluated before the ophthalmology clerkship. Results: In TBL classes, the GRAT scores were significantly higher than the IRAT scores in both the full example and the BOL-stratified groups. It highlighted the advantages of TBL compared to the individual learning. Quartile-stratified ANOVA comparisons showed significant differences at FES scores (P < 0.01). In terms to IRAT, GRAT and GAP scores, there was no significant result. Moreover, IRAT scores only significantly differed between the first and fourth groups. The FES scores of the first three groups are significantly higher than the fourth group. Gender-specific differences were significant in FES but not the IRAT. Overall, 57.65% of student respondents agreed that TBL was helpful. Male students tended to rate TBL higher than female students. Conclusion: The application of modified TBL to the ophthalmology clerkship curriculum improved students’ performance and increased students’ engagement and satisfaction. TBL should be further optimized and developed to enhance the educational outcomes among multi-BOLs medical students. [ABSTRACT FROM AUTHOR]

Background: Our objective is to compare the cost-utility of icotinib and gefitinib for the second-line treatment of advanced non-small cell lung cancer (NSCLC) from the perspective of the Chinese healthcare system. Methods: Model technology was applied to assess the data of randomized clinical trials and the direct medical costs from the perspective of the Chinese healthcare system. Five-year quality-adjusted life years (QALYs) and incremental cost-utility ratios (ICURs) were calculated. One-way and probabilistic sensitivity analyses (PSA) were performed. Results: Our model suggested that the median progression-free survival (PFS) was 4.2 months in the icotinib group and 3.5 months in the gefitinib group while they were 4.6 months and 3.4 months, respectively, in the trials. The 5-year QALYs was 0.279 in the icotinib group and 0.269 in the gefitinib group, and the according medical costs were $10662.82 and $13127.57. The ICUR/QALY of icotinib versus gefitinib presented negative in this study. The most sensitive parameter to the ICUR was utility of PFS, ranging from $-1,259,991.25 to $-182,296.61; accordingly the icotinib treatment consistently represented a dominant cost-utility strategy. Conclusions: The icotinib strategy, as a second-line therapy for advanced NSCLC patients in China, is the preferred strategy relative to gefitinib because of the dominant cost-utility. In addition, icotinib shows a good curative effect and safety, resulting in a strong demand for the Chinese market. [ABSTRACT FROM AUTHOR]

This study examined the psychometric properties of the Connor-Davidson Resilience Scale (CD-RISC) with a Chinese military population with the aim of finding a suitable instrument to quantify resilience in Chinese military service members. The confirmatory factor analysis results did not support the factorial structure of the original or the Chinese community version of the CD-RISC, but the exploratory factor analysis results revealed a three-factor model (composed of Competency, Toughness, and Adaptability) that seemed to fit. Moreover, the repeat confirmatory factory analysis replicated the three-factor model. Additionally, the CD-RISC with a Chinese military sample exhibited appropriate psychometric properties, including internal consistency, test-retest reliability, and structural and concurrent validity. The revised CD-RISC with a Chinese military sample provides insight into the resilience measurement framework and could be a reliable and valid measurement for evaluating resilience in a Chinese military population. [ABSTRACT FROM AUTHOR]

Background: The epidemiology of Functional abdominal bloating (FAB) and its impact on health-related quality of life (HRQoL) in Chinese people remains unclear. Methods: Randomised, stratified, multi-stage sampling methodology was used to select a representative sample of the general population from five cities in China (n = 16,078). All respondents completed the modified Rome II questionnaire; 20% were asked to complete the 36-item Short Form (SF-36). The associated factors of FAB were analyzed. The effects of FAB on HRQoL were estimated with gender stratification using propensity score techniques in 20% subsample. Results: Overall, 643 individuals (4.00%) had FAB and it was more prevalent in males than in females (4.87% vs. 3.04%, P<0.001). For males, self-reported history of dyspepsia was most strongly associated with FAB (OR = 2.78; 95% CI: 1.59, 4.72). However, the most strongly associated factor was self-reported health status for females (moderate health vs. good health: OR = 2.06, 95% CI: 1.07, 3.96. P = 0.030; poor health vs. good health: OR = 5.71, 95% CI: 2.06, 15.09). Concerning HRQoL, FAB was found to be related to two domains: role limitation due to physical problems (P = 0.030) and bodily pain (P<0.001) in females. While, in males, there were significant differences in multiple domains between those with and without FAB. Conclusion: The prevalence of FAB in China was lower than previous reports. Males who had ever been diagnosed with dyspepsia and females who were in a poor self-reported health status were correlated with a higher prevalence of FAB. FAB affected only physical health in females, but impaired both physical and mental health in males. [ABSTRACT FROM AUTHOR]