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Aim: To analyze the level of knowledge, attitudes, practices, and risk perception regarding COVID-19 among Chinese residents 1.5 years after the pandemic. Subject and methods: A cross-sectional study was carried out with both online and paper questionnaires. We included a variety of covariates that were characteristic-related factors such as age, gender, education level, and retirement status, as well as those closely associated with risk perception regarding COVID-19. Results: Participants (n = 3588), 53.49 ± 18.88 years old, from two provinces of China, of which 44.7% were male and 52.03% had a high school or greater level of education, answered the questions. More than 90% of participants had adequate background knowledge about COVID-19 and agreed or even strongly agreed with many attitude items related to the government's role in diagnosis, treatment, and dealing with COVID-19 infections. About three fifths of the participants reported fear of contracting COVID-19, but only a minority (18.63%) felt they were more susceptible than others. Respondents aged 45 years or younger were more likely to fear contracting the virus than those older than 45 years (adjusted OR = 1.464, 95% CI 1.196 to 1.794, P = 0.0002). High education level (adjusted OR = 1.503, 95% CI 1.187 to 1.904, P = 0.0007) and non-retired status (adjusted OR = 1.679, 95% CI 1.354 to 2.083, P < 0.0001) were associated with a higher perception of susceptibility to infection than others. Moreover, respondents who were not retired had a significantly reduced practice score (adjusted OR = 1.554, 95% CI 1.261 to 1.916, P < 0.0001). Age, retirement status, and education level were also associated with knowledge, attitude, and practice level. Conclusion: Our findings suggest that the public generally has trust in the COVID-19 vaccine and the government with regard to COVID-19 in China. We recommend that high-risk groups of communities, such as elders and patients with chronic diseases, be given greater consideration in the outbreaks. Health education campaigns combined with workplace preventive intervention should be aimed at improving COVID-19 knowledge and beliefs in order to encourage more optimistic attitudes and to maintain safe practices. [ABSTRACT FROM AUTHOR]

Background: According to the World Population Outlook (2019), people over 65, usually accompanied by various chronic diseases, will make up 16% of the population in 2050. Therefore, the health problems of middle-aged and elderly people are becoming the focus of current global attention. Some scholars have found that the health of middle-aged and elderly people is related to the childhood socio-economic environment. Methods: Using the China Health and Retirement Longitudinal Study (CHARLS) data, this paper innovatively constructed four measurement dimensions of health (namely, self-rated health, physical health, emotional health, and mental health). Moreover, logistic regression was used to explore the impact of childhood socio-economic environment (such as parent's education level, work experience, etc.) on the health status of middle-aged and elderly people. Results: Compared with a poor childhood social-economic environment, a good childhood socio-economic environment is more advantageous to the self-rated health of middle-aged and elderly people, especially a childhood socio-economic environment close to the medium level; the psychological health of middle-aged and elderly people who have experienced an adverse childhood socio-economic environment was better than those who did not; the childhood socio-economic environment has no apparent impact on the cognitive situation of middle-aged and elderly people. Conclusions: Some policy implications can be drawn. For example, the government should vigorously introduce policies to help migrant workers' children receive education in cities and provide special education guarantees for migrant workers' children. Societies and families should also pay more attention to the childhood socio-economic environment. [ABSTRACT FROM AUTHOR]

Background: Limited data regarding the effects of school-based obesity prevention programs focusing on the changes in obesity-related knowledge and behaviors in China are available. The objective of this paper was to evaluate the effects of a school-based comprehensive lifestyle intervention among Chinese kids against obesity (CLICK-Obesity) in primary schools in Nanjing. Methods: We designed a cluster randomized controlled trial in eight randomly selected urban primary schools among 4th graders between May 2011 to April 2012 in Jianye, an urban district of Nanjing. Each school was randomly assigned to either the intervention or control group (four schools in each group). Mixed regression models and generalized estimating equations (GEE) were used to adjust for individual-level covariates under cluster randomization. Results: In this study, 1178 students (96.2%; 665 boys and 513 girls, 544 in control and 634 in intervention) participated in the baseline survey with mean age 10.2 ± 0.5 years. At the end of one-year intervention, 1125 students (91.8%; 628 boys and 497 girls, 513 in control and 612 in intervention) were reassessed. Notably, we found that the intervention group improved the knowledge and awareness of obesity-related risk factors, presented a lower increase of consumption of red/white meat (with a mean difference of −180.9 g/week, 95% CI: −350.6 to −11.2, p = 0.040), a larger increase in the time spent playing ball (with a mean difference of 24.2 min/week, 95% CI: −5.3 to 53.7, p = 0.090), and a significant reduction in screen time (with a mean difference of −71.0 min/week, 95% CI: −125.3 to −16.6, p = 0.020) compared to the control group after cluster (school) adjustment. Conclusion: The school-based integrated intervention was successful to modify unhealthy lifestyle behaviors and had a potential effect on childhood obesity prevention in urban China. However, the long-term effects and cost-effectiveness need to be evaluated in through further study. [ABSTRACT FROM AUTHOR]

Objectives: With the rapid development and spread of information technology, mobile healthcare (M-healthcare) is emerging as a feasible option for improved monitoring and treatment of patients with chronic diseases such as diabetes, particularly for those with limited access to medical institutions. Our study group has developed and evaluated an M-healthcare system that provides remote guidance for diabetic patients. This paper introduces the diabetic M-healthcare system and describes progress in implementation for remote and mobile healthcare in China. We provide evidence that this system improves diabetic patient management and can contribute to the establishment of a new model for patient-centered mobile healthcare. Target audience: The main groups that this paper is aimed at are doctors, nurses, nutritionists, and sportspersons engaged in the design of mobile medical systems, and computer engineers involved in the construction of intelligent medical software systems. Scope: The present article has as its scope designing the M-healthcare clinical follow-up system, identifying the advantages that the M-healthcare system has in comparison with traditional medical treatment, the clinical application effect of the M-healthcare system, and the development status of remote/mobile medical research in China and abroad. [ABSTRACT FROM AUTHOR]

Objective: To determine whether sense of coherence acts as a mediator between perceived stress and depression in newly diagnosed breast cancer patients. Methods: A single face-to-face interview was administered to characterize sociodemographic, clinical, and psychological characteristics; perceived stress scale (PSS), sense of coherence scale (SOC) and Hamilton depression scale (HAMD). Part of the characterize sociodemographic information was extracted from the women's medical charts. The interview was with 1100 patients newly diagnosed with breast cancer from breast wards in Zhengzhou, Henan Province, China; 1046 respondents completed this survey from May 2018 to March 2019. A data analysis was conducted based on correlation analysis, multiple linear regression, and structural equation model. Results: The total score of the sense of coherence was negatively correlated with perceived stress (r = −0.595, p < 0.01) and depression (r = −0.821, p < 0.01), and the total scores of perceived stress and depression were positively correlated (r = 0.755, p < 0.01). As indicated from the structural equation model, sense of coherence had a partial mediation effect between perceived stress and depression, with the mediator effect of 0.566, taking up 63.1% of the total effect. Conclusions: Sense of coherence acted as a mediator between perceived stress and depression in newly diagnosed breast cancer patients, demonstrating that medical staff should actively assess patients' sense of coherence level to provide personalized interventions for patients. [ABSTRACT FROM AUTHOR]

Objective: This study investigates the current situation and influencing factors of the nursing practice environment in Shenzhen, China, and provides suggestions for improving it. Background: Nursing shortage is an urgent global problem and also of concern in China. Studies have shown that better work environments are related to high job satisfaction and better patient outcomes. Methods: The 37-item Practice Environment Scale was used to assess the nursing practice environment. Respondents were 1116 nurses from five general tertiary hospitals in Shenzhen. Results: The mean satisfaction score for the nursing practice environment was 3.63 ± 0.72 (where 5 is the highest possible score). Position, being a specialist nurse, choice of nursing major, educational attainment, and night shifts significantly affected nurses' working environment satisfaction. Conclusion: The practice environment of nurses was satisfactory. We recommend reducing the workload and encouraging nurses to complete specialist training, and supporting nurses to expand their roles in hospitals and society to improve the nursing practice environment. [ABSTRACT FROM AUTHOR]

Aim: Neighborhood walking environment is an environmental issue affecting human health-related behaviors in China and worldwide. High school is a special period in China, during which students need to prepare for the college entrance examination and are physically inactive. Therefore, the influence of environment on high school students' physical activities is particularly prominent. The purpose of this study was to examine the relationship between neighborhood environment walkability and physical activity in Chinese youth. Subject and methods: We conducted a retrospective questionnaire study on 3424 freshmen from Tsinghua University in Beijing, China. The mean age at the moment of completing the questionnaire was 18.74 years (SD = 0.95) and the mean body mass index (BMI) was 21.37 kg/m2 (SD = 2.86). Participants were asked to look back on their usual weekly physical activity and perceived neighborhood environment during high school. Neighborhood environment was measured using the Neighbourhood Environment Walkability Scale for Youth (NEWS-Y). Physical activity data by the Global Physical Activity Questionnaire (GPAQ) were collected. The data were analyzed using multiple linear regression. Results: The mean scale total score of NEWS-Y was 14.66 (SD = 1.30). Participants on average engaged in 754.46 (SD = 844.69), 479.79 (SD = 687.24), 920.47 (SD = 994.92), and 2172.72 (SD = 1736.21) MET-minutes/week of travel physical activity (travel PA), moderate physical activity (MPA), vigorous physical activity (VPA), and total physical activity (total PA), respectively. A one scale score increases in neighborhood walkable environmental was associated with an increase in travel PA and MPA by 42.64 (P < 0.001) and 31.11 (P < 0.01) MET-minutes/week, respectively. Conclusion: A possibly positive correlation between neighborhood environment walkability and physical activity was found. Future studies are warranted to replicate this study's findings, as well as provide evidence for potential policies to make neighborhood environment conducive to physical activity. [ABSTRACT FROM AUTHOR]

Aim: Job stress is an important concept in current organizational behavior and relevant studies. We explored how two types of job stress impact on presenteeism from a dual-path. Subject and methods: This cross-sectional study conducted a literature research and questionnaire survey to explore the influence of job stress on presenteeism among healthcare workers based on a dataset composed of 1516 valid samples from 12 hospitals across China. Structural equation modeling and mediation analysis in SPSS were used to test the roles played by public service motivation and health in the influence of job stress on presenteeism. Results: In the final structural model equation, challenge stress had a significant positive impact on public service motivation (β = 0.08; P < 0.05) but a negative impact on health (β = −0.20; P < 0.01), and an insignificant negative effect on presenteeism (β = −0.00; P > 0.05). Hindrance stress was significantly negatively correlated with public service motivation (β = −0.20; P < 0.001) and health (β = −0.27; P < 0.001) and positively correlated with presenteeism (β = 0.09; P < 0.01). The mediating role of public service motivation was insignificant for challenge stress but significant for hindrance stress, while both paths were significant when mediated by health. Conclusions: First, job stress has a significant influence on presenteeism. Second, different types of job stress have different effects on presenteeism and hindrance stress plays a more salient role. Third, health plays a significant mediating role compared with public service motivation. The government and health industry should pay attention to healthcare workers' working status to improve the quality of healthcare service from the supply side. [ABSTRACT FROM AUTHOR]

Purpose: Medical waste is rising on policy agendas as a serious public health and environmental issue. The aim of this study was to assess current practices of medical waste management, which include waste generation, collection, storage, segregation, disposal, and use of protective equipment, in village clinics in rural China. Methods: Based on survey results from 236 randomly selected village clinics in 21 counties from three provinces of China, we used descriptive statistics to determine the medical waste management of village clinics in sample area. Results: We found that the generation rate of medical waste in sampled village clinics was approximately 0.65 kg per day or 0.17 kg/patient per day on average. Given the large number of primary healthcare facilities and population in rural areas of China, the total quantity of medical waste generated in these facilities is noteworthy. However, we also found poor compliance levels with the national regulations regarding medical waste management practices. A large proportion of medical waste was still not packed in required containers, and almost all village clinics did not segregate correctly. Moreover, a significant portion of village clinics used improper disposal methods and lacked the necessary protective equipment. Medical staff in these facilities pointed out four main difficulties in complying with national regulations: a lack of funding, equipment, designated areas, and management personnel specifically delegated for medical waste management. Conclusion: These findings suggest that Chinese policymakers and health administrators should pay more attention to rural areas in addressing potentially hazardous medical waste management practices by investing financial support as well as developing specific guidelines tailored to resource-strained rural primary healthcare facilities. [ABSTRACT FROM AUTHOR]

Aim: To investigate the attack rate of active tuberculosis (TB) cases and detection rate of latent tuberculosis infection (LTBI) cases, and to identify possible factors contributed to the outbreak in a high school. Subject and methods: We analyzed the investigation data of 35 teachers and 108 students, including active TB cases and their close contacts. The symptoms inquiry, tuberculin skin test (TST), and chest X-ray/CT scan were conducted in the close contact screening. We did variable-number-of-tandem-repeat genotyping and whole-genome sequencing of isolates. Results: The time interval between the onset of symptoms and diagnosis was 36 days. The total attack rate of active TB was 7.69% (11/143), with a class attack rate of 27.78% (10/36) among students. The genetic differences between any two available isolates were less than 5 SNPs. Approximately 15.38% (22/143) of persons were LTBI cases, and the total detection rates of LTBI for students and teachers were 7.40% (8/108) and 40% (14/35), respectively. Being in the same class as the index case resulted in a significantly higher risk of being diagnosed with active TB (P = 0.0001, RR = 18.51, 95%CI (2.44,140.42)) and either LTBI and MTB infection (RR = 14.40, RR = 16.46, respectively) compared with that of students in a non-index class. Conclusion: The case-finding delay should be reduced to prevent the spread in classes and schools. Effective surveillance and regulated screening for student contacts should be strengthened in schools to detect infections early. [ABSTRACT FROM AUTHOR]

Background: After 40 years of reform and opening up, China's social and economic conditions have undergone tremendous changes. For individuals who have experienced this historical period, the socioeconomic transition has brought different effects on their health status. This research examines the issue and provides evidence that government policies need to be improved. Methods: This study adopted data from the 2015 China Health and Retirement Longitudinal Study (CHARLS). We set the education level, occupation, and family income during old age as the socioeconomic status for the early, middle, and late stages of life. Based on specific criteria, we classified the population as disadvantaged and advantaged, considering eight changing trajectories of socioeconomic status. We used multiple regression analysis to examine how the eight trajectories affect individuals' physical and mental health. Results: After controlling for social demography and health behavior variables, we found that, compared with those in the advantaged group long term, people who were in the disadvantaged group suffered from a significantly negative impact of their socioeconomic status on physical and mental health. The health status of those who moved upward in socioeconomic status was substantially better than those who remained in the same status. Conclusion: This study confirms that early disadvantaged socioeconomic status has a long-term adverse effect on health. However, the negative impact can be mitigated by improving one's occupation during middle age or family income during old age throughout China's socioeconomic transitions. Therefore, increasing upward social mobility at any stage helps eliminate health inequalities. [ABSTRACT FROM AUTHOR]

Purpose: To identify the profile of a pediatric low-vision population and investigate the differences between low-vision services in urban and rural areas. Methods: A retrospective study was conducted of the records of 286 consecutive children presenting at the Low Vision Clinic of the Eye and ENT Hospital of Fudan University from January 2009 to December 2018. The data retrieved included age, sex, education, family history, rural vs. urban residence, cause of visual impairment, and low-vision aids dispensed. Results: Of the 286 children (65.0% boys and 35.0% girls), over half (178, 62.2%) were from urban areas. The age range of the patients was 3–15 years (mean 9.54 ± 4.11). The four major causes of visual impairment were congenital cataract (70, 24.5%), optic atrophy (37, 12.9%), congenital glaucoma (34, 11.9%), and macular dystrophy (31, 10.8%). Low-vision aids were prescribed for 203 children (71.0%), with binocular telescopes (69, 25.0%) and stand magnifiers (66, 23.9%) being the most common. The urban children enjoyed higher rates of low-vision services than the rural children, with more low-vision aids (192, 94.6%) prescribed for the former. Conclusions: Congenital and hereditary diseases constituted the major causes of low vision in the study population. In contrast to their urban counterparts, the rural children experienced inadequate low-vision rehabilitation. Our findings suggest that policymakers need to better address gender inequalities and urban–rural disparities in low-vision services and that the coverage of low-vision services, especially in rural areas, should be enhanced in China. [ABSTRACT FROM AUTHOR]

Objective: To measure the economic risk of diseases in Chinese middle-aged and elderly patients with diabetes. Methods: The economic risk of diseases in Chinese middle-aged and elderly patients with diabetes was comprehensively analyzed using the family economic risk of diseases, catastrophic health expenditure, and relative risk of the disease. Results: The proportions of families with low, medium, and high family economic risk of diseases were 64.73%, 8.56%, and 26.71%, respectively. When the defining criteria are 15%, 25%, and 40%, the incidences of catastrophic health expenditure were 66.71%, 60.07%, and 54.59%, respectively. The health expenditure of diabetic patients was 1.80 times that of non-diabetic patients when the difference in patients' income was eliminated. Conclusion: In general, Chinese middle-aged and elderly patients with diabetes face a large economic risk of diseases, which will seriously hinder the improvement of their family life quality. The sociodemographic characteristics related to diabetics will aggravate the patient's economic risk, such as smoking, drinking, and low household income. Moreover, diabetes patients with different basic medical insurance have different economic risk of diseases. [ABSTRACT FROM AUTHOR]

Background: Colorectal cancer (CRC) is the third most prevalent type of cancer in the world. Its prognosis is closely related to the disease stage at the time of diagnosis. Early detection of symptomless CRC or precursor lesions through population screening could reduce CRC mortality. However, screening programs are only effective if enough people are willing to participate. The incidence of CRC has a significantly increasing trend in China. Objective: Evaluation of the necessity of screening colonoscopy for community fecal occult blood-positive patients and exploration of the differences in the epidemiology of colorectal adenomas (CRA) and CRC of community screening patients and patients with different symptoms. Methods: We selected the 40–79 years age group of healthy people in the community of the Fengxian District of Shanghai who had two consecutive fecal occult blood and screening colonoscopies completed in our hospital between June 1, 2014 and October 31, 2014 as the screening group. Patients in the same age group with different symptoms (such as abdominal pain, bloody stool, diarrhea, change in bowel habits, weight loss, anemia, etc.) who had completed colonoscopy in our hospital during the same period comprised up the control group. Differences in the detection rates of colorectal polyps and CRC in the two groups and differences in the detection rates of CRA and early CRC between the two groups were compared. Results: There were 2251 patients in the colonoscopy screening group and 1836 patients in the control group. The colorectal polyps detection rates of the two groups were 19.46% (438/2251) and 21.95% (403/1836), respectively, and the difference was not statistically significant (p = 0.052). The CRC detection rates of the two groups were 0.8% (18/2251) and 2.02% (37/1836), respectively, the difference of which was statistically significant (p = 0.001). The detection rates of CRA were 17.73% (399/2251) and 19.88% (365/1836), respectively, which was not statistically significantly different (p = 0.083). Finally, the detection rates of early CRC were 0.36% (8/2251) and 0.44% (8/1836), respectively, which was not statistically significantly different in the two groups (p = 0.803). Conclusion: The detection rates of CRA among community screening patients and patients with different symptoms were not different. However, the detection rate of CRC in community screening patients was lower than that of the patients with different symptoms. Therefore community colonoscopy screening of fecal occult blood-positive asymptomatic healthy people is necessary, as it can help with the early detection and treatment of CRA. [ABSTRACT FROM AUTHOR]

Objectives: Active smoking during pregnancy may increase the risk of gestational diabetes mellitus (GDM), but little is known about the potential association between passive smoking and risk of GDM. The present study investigated the association between passive smoking at home and/or in the workplace and risk of GDM among non-smoking Chinese women. Methods: A population-based study including 995 pregnant women taking antenatal care from December 2015 to May 2016 was conducted. Screening was carried out after 24 gestational weeks, during which women were offered a 75-g 2-h oral glucose tolerance test (OGTT). Basic information and self-reported passive smoking were collected by a questionnaire. Passive smoking was classified as passive smoking at home, passive smoking in the workplace, or passive smoking at home and in the workplace. They were further classified by time period, total exposure time, and amount. Logistic regression was used to estimate both crude and adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Results: The prevalence of passive smoking was 78.3%. Compared with women who were non-exposed to passive smoking, a passive smoker has an increased risk of GDM with an adjusted OR (95% CI) of 1.60 (1.09, 2.33). In addition, there was a strong association between passive smoking exposure at home and GDM (adjusted OR 1.59; 95% CI 1.13, 2.24), and significant dose–response relationships in total exposure time and amount of passive smoking at home were observed. However, there is no obvious evidence for the link between passive smoking in the workplace and GDM risk (adjusted OR 1.25; 95% CI 0.87, 1.80). Conclusions: Passive smoking at home was associated with an increased risk of GDM among non-smoking Chinese women. These findings emphasize the importance of preventing passive smoking, especially at home. [ABSTRACT FROM AUTHOR]

Aims: The study aimed to develop consensus on the components of continuity of care for stroke patients in the cultural context of China. Subjects and methods: Thirteen experts were recruited purposefully to finish this study. A Delphi approach was adopted to reach consensus on the components of continuity of care, and 75% agreement was used as cutoff. Results: Three rounds of consultation were completed. Consensus (75% agreement) was obtained on 45 of the 49 statements. The final agreed list of statements represented three domains: the structure, process and outcome of continuity of care. Conclusions: It represents the first attempt to develop consensus on the components of continuity of care for Chinese patients with stroke. According to the established framework and components of continuity of care, health professionals can successfully implement continuity of care for stroke patients and improve the quality of care. [ABSTRACT FROM AUTHOR]

Background: Sleep is an important predictor of health and quality of life. This study examined the association between sleep problems and sleep duration with self-rated poor health and grip strength among respondents aged 50 years and above in India and China.Methods: The data for this study were derived from the first wave of WHO’s Study on Global Aging and Adult Health (SAGE), a nationally representative panel survey conducted in six LMICs. Grip strength and poor self-rated health were the main outcome variables, while sleep problems and sleep duration were the main predictors. Multivariate logistic regression models and ordinary least squares regression models were used to understand the association between sleep problems and sleep duration with poor self-rated health and grip strength.Results: Sleep problems and sleep duration were strongly and significantly associated with poor self-rated health and grip strength in India and China. Compared to older adults with no sleep problems, the odds ratio for poor self-rated health among older adults with sleep problems was 4.86 (95% CI = 4.12, 5.73, p < 0.01) and 5.06 (95% CI = 3.93, 6.51, p < 0.01) higher for India and China, respectively. The likelihood of reporting poor health was higher among older adults who got ≤ 6 or 10+ h of sleep in both India and China. A negative and significant association was found between longer sleep duration and grip strength only in China (β = −1.19, 95% CI = −1.78, −0.60, p < 0.01).Conclusion: We observed a significant association between sleep problems and sleep duration with poor self-rated health and grip strength. Results suggested that sleep problems are important factors in determining the health of older adults in low- and middle-income countries. [ABSTRACT FROM AUTHOR]

Background: The prevalence of gout varied in different populations and it appeared to be increasing in the past decades. Gout is a serious health issue and is an independent risk factor for heart failure and metabolic. Therefore, we have used the method of meta-analysis to systematically evaluate the prevalence of gout in mainland China and have provided relevantly informative data for gout prevention and control. Methods: Relevant articles from 2000 to 2016 October were identified by searching four electronic databases: PubMed, Chinese WanFang, CNKI, and Chongqing VIP. All of the calculations were performed using the MetaAnalyst beta 3.13 and R3.3 software. Results: In all, 30 eligible articles (1 in English and 29 in Chinese) were included with a total sample size of 146,081. The pooled prevalence of gout was 1.1% (95% CI: 0.8%, 1.5%). Subgroup analysis showed the following results: 1.7 and 0.5% for male and female; 1.3 and 1.0% for inland and coast, respectively; 1.4, 1.0 and 0.7% for urban, city and rural areas; 1.0 and 1.6% for community and hospital; 1.2, 1.7, and 0.8% for eastern, central and western region; 1.0, 1.1 and 1.3% for 2000-2005, 2006-2009 and 2010-2016, respectively. Conclusion: The prevalence of gout in mainland China is an ascendant trend that differs according to sex and region. [ABSTRACT FROM AUTHOR]

Aim: The multicultural study aimed at examining alcohol consumption change or drinking change of English, French and Chinese speaking immigrants in Ottawa and Gatineau, Canada, and identifying demographic factors that impact the change. Subjects and methods: In all, 810 immigrants of three language sub-groups were recruited by purposive-sampling. Using self-reports, respondents answered questions regarding drinking change and demography in the Multicultural Lifestyle Change Questionnaire in either the English, French or Chinese versions. Data on drinking were analyzed statistically. Results: The immigrants of different gender, language and category sub-groups exhibited different drinking rates, drinking rates before immigration, drinking rates after immigration, drinking change rates and drinking belief change rates. Drinking change (drinking behavior change + drinking belief change) was correlated positively with mother tongue and negatively with gender. Drinking behavior change was negatively correlated with gender and category of immigration. Mother tongue and gender significantly impacted drinking change. Gender significantly impacted drinking behavior change. Conclusion: The immigrants of different sub-groups in Canada experienced different drinking change. Mother tongue and gender were main impacting factors. Culture and acculturation were important contributing factors. Data of immigrant drinking change may provide evidence for drinking policy-making and policy-revising in Canada. [ABSTRACT FROM AUTHOR]

Aim: There are uncertainties regarding the modification effects of season and temperature on the relationship between air pollution and mortality. This study aims to examine the effects of season and temperature on mortality associated with particulate matter less than 10 μm in diameter (PM) in Tianjin, China. Methods: Time-series analysis was used to explore the modification effects of season and temperature on the association between PM and cause-specific mortality in Tianjin between 2006 and 2009. The causes studied were overall non-accidental mortality and subcategories of cardiovascular, respiratory, cardiopulmonary, stroke, and ischemic heart diseases (IHD). Results: The association between PM and mortality showed a strong seasonal pattern and the effects of PM on cause-specific mortalities were strongest for high temperature days. Generally, the adverse effects were stronger in summer than for other seasons, except for respiratory mortality. In the summer period, a 10 μg/m increase in PM at 0-1 days was associated with an increase in mortality for non-accidental (0.95 %, 95 % confidence interval [CI]: 0.45, 1.45), cardiovascular (1.40 %, 95 %CI: 0.77, 2.03), cardiopulmonary (1.37 %, 95 %CI: 0.77, 1.98), IHD (1.55 %, 95 %CI: 0.73, 2.37), and stroke (1.27 %, 95 % CI: 0.37, 2.12) causes. The overall increase in mortality per 10 μg/m increase in PM was 0.42 % (95 %CI: 0.26, 0.58) for non-accidental, 0.41 % (95 %CI: 0.21, 0.62) for cardiovascular, 0.46 % (95 %CI: 0.26,0.65) for cardiopulmonary, 0.57 % (95 %CI: 0.30, 0.84) for IHD, and 0.32 % (95 %CI: 0.03,0.61) for stroke. At high temperatures (≥23.8 °C), a 10 μg/m increase in PMat 0-1 days was associated with an increase in mortality of 0.90 % (95 %CI: 0.61,1.19) for non-accidental, 1.01 % for cardiovascular, 1.40 % (95 %CI: 0.55, 2.27) for respiratory, 1.06 % (95 %CI: 0.71, 1.41) for cardiopulmonary, 1.47 % (95 %CI: 1.00, 1.94) for IHD, and 0.75 % (95 %CI: 0.24, 1.28) for stroke. In addition, the PM effects of high temperature days were stronger for those aged 65 years and over. Conclusion: Season and temperature could modify the adverse effects of PM. An increase in hot summer days caused by climate change may enhance the risks of air pollution on human health. More attention should be paid to older populations, especially in summer and days with high temperatures. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the long-term efficacy and potential risk of psychiatric side effects of varenicline for smoking cessation compared with placebo or nicotine replacement therapy. Subject and methods: Systematic search of electronic databases (MEDLINE, EMBASE, Cochrane Central Register, SCI) up to March 2011. Two reviewers independently determined the eligibility of randomized controlled trials comparing varenicline with placebo, or nicotine replacement therapy with follow-up of at least 12 months. Information was independently extracted by 2 reviewers. Results: Ten trials involving 6,375 smokers were included in the meta-analysis. The pooled risk ratios (RR) for continuous abstinence was 2.83 (95% CI: 2.20-3.63) at 52 weeks for varenicline (1 mg, twice per day) versus placebo. Varenicline seemed to be more effective in smokers with chronic obstructive pulmonary disease (RR, 3.33) than smokers with cardiovascular diseases (RR, 2.64) or health smokers (RR, 2.52), non-Asian smokers than Asian smokers (2.98 vs. 1.94), elder smokers than younger smokers (2.87 vs. 2.52), female smokers than male smokers (2.98 vs. 1.94). The five predominant reported adverse events for varenicline compared to placebo were vomiting, nausea, abnormal dreams, constipation, and dysgeusia. There was no sufficient evidence that varenicline was associated with an increased risk of psychiatric side effects (RR, 1.45, 95% CI: 0.90-2.32). Conclusion: Varenicline therapy compared with placebo is associated with a favorable effect on smoking cessation at the end of 52 weeks. However, the psychiatric adverse events related with varenicline should be further studied with larger qualified study. People with preexisting mental illnesses should be prudently treated with varenicline. [ABSTRACT FROM AUTHOR]