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Objective To study the associations of pedestrian injuries with age, income and educational level in Shanghai and to analyze the relative disease burden. Methods Information on pedestrian-related cases and deaths were collected from 494 hospitals and mortality registry systems from 1992 to 2010, and a multistage cluster sampling survey conducted in 2006. Logistic regression model was used in the analyses. Results The age group of 5-9 had the highest mortality and morbidity among children. Mortality increased obviously among those aged 60 or above. Individuals with an educational level under the primary school and with the lower family average income were more likely to suffer pedestrian-related injuries. Multivariate Logistic analysis demonstrated that lower income and lower educational level increased the risk of pedestrian injuries with the odds ratio of 1.40 (95% CI: 1.15-1.71) and 1.70 (95% CI: 1.20-2-40), respectively. About 13.54% of the share of GDP for the healthcare, social security and welfare industries in Shanghai was occupied by the burden of pedestrian-related injuries in 2006. Conclusion Pedestrian-related injury has inverse association with victims' income and educational level. Children of 5-9 years old and adults over 60 with lower educational level and lower monthly income are the target persons to be intervened. [ABSTRACT FROM AUTHOR]

Background To evaluate and compare the effectiveness of the combined regimen (consisting of condoms and emergency contraception pills (ECP)) and using condoms only for the purpose of preventing pregnancy. Methods One-thousand-five-hundred-and-sixty-two (1,562) couples as volunteers enrolled at nine centers in Shanghai. Eight-hundred-and-twelve (812) were randomized to use male condoms and ECP (i.e., Levonorgestrel) as a back-up to condoms (the intervention group) and 750 to use male condoms only(the control group), according to their working unit. Participants were visited at admission and at the end of 1, 3, 6, 9, and 12 months. The cumulative life table rates were calculated for pregnancy and other reasons for discontinuation. Result The gross cumulative life table rates showed that the cumulative discontinuation rates for all reasons during the year of follow-up in the condoms plus emergency contraception group and the condoms only group were 7.76 ± 0.94 and 6.61 ± 0.91, respectively, per 100 women (X2 = 0.41, p = 0.5227). The cumulative gross pregnancy rate of the condoms plus emergency contraception group and the condoms only group were 2.17 ± 0.52 and 1.25 ± 0.41, respectively, per 100 women (X2 = 1.93, p = 0.1645).The Pear Index in the condoms plus emergency contraception group and the condoms only group were 2.21% and 1.26%, respectively. Conclusion Male condoms remain a highly effective contraceptive method for a period of one year while consistently and correctly used. In addition, the lowest pregnancy rate followed from perfect use condom. [ABSTRACT FROM AUTHOR]

Objective To study age and educational level and their relationship with fall-related injuries in Shanghai and to analyze the relevant costs. Methods Multistage cluster sampling was used for the selection of participants and standardized questionnaires were used for the information collection in 2006. Information on cases and deaths caused by fall-related injuries were obtained from 494 hospitals as well as from the mortality registry systems from 2001 till 2010. Results Of 45 857 participates, 674 suffered from fall-related injuries with the largest proportion among all injuries. The fall-related mortality increased from 10.63 per 100 000 in 2001 to 14.11 per 100 000 in 2010. The under-five mortality rate was the highest among children aged 0-14 years. Mortality increased dramatically among those aged 55 or above for the female and aged 60 or older for the male. Individuals with an educational level under the primary school were more likely to suffer fall-related injuries, accounting for 72.66% of all deaths and 49.24% of nonfatal cases respectively. The annual burden of fall-related injuries equated to 25.90% of the share of GDP for the healthcare, social security and welfare industries in 2006. Conclusion Fall-related injuries were inversely related to victims' educational level. Children under the age of 5, women over 55 years old and men over 60 years old with an educational level lower than the primary school are the most risky groups of populations for intervention measures. [ABSTRACT FROM AUTHOR]

Background In China, there is increasing concern because of the rapid increase in HIV infection recorded over recent years. Migrant workers are recognized as one of the groups most affected. In this study, HIV/AIDS-related knowledge, attitudes, and behavior among unmarried migrant workers in Shanghai are investigated, with the aim of providing critical information for policy makers and sex educators to reinforce sexual health services and sex health education targeting the behavior and sexual health of unmarried male migrants. Methods A cross-sectional survey was conducted among unmarried male migrant workers in Shanghai, China' largest city and housing the most migrants. A self-administered, anonymous questionnaire was used to collect information on knowledge, attitudes, and behavior associated with increased risk of HIV/AIDS. Results A total of 2254 subjects were questioned, with a response rate of 91.3%. Among those interviewed, 63.5% reported sexual activities. Misconceptions regarding HIV transmission, poor perception of HIV infection, and low use of condoms were not uncommon. Among those who had sexual intercourse, 73.7% had not used condoms in their last sexual intercourse, and 28.6% reported having engaged in sexual risk behavior (defined as having at least one non-regular partner). Multivariate logistic regression analyses identified several indicators of sexual risk behavior, including younger age at first sexual intercourse (OR: 0.67, 95% CI: 0.31-0.91 for older age at first sexual intercourse), more cities of migration (OR: 2.91, 95% CI: 2.17-3.81 for high level; OR:1.15, 95% CI: 1.06-1.29 for medium level), poor perception of acquiring HIV/AIDS (OR:1.52, 95% CI: 1.33-1.96 for unlikely; OR: 2.38, 95% CI: 1.61-3.70 for impossible), frequent exposure to pornography (OR: 0.33, 95% CI: 0.11- 0.43 for never; OR:0.69, 95% CI: 0.60-1.81 for less frequently), not knowing someone who had or had died of HIV/AIDS and related diseases (OR: 2.13, 95% CI: 1.70-2.53 for no), and having peers who engaged in sex with a non-regular sex partner (OR: 4.40, 95% CI: 3.37- 5.56 for yes). Conclusions Today, it is necessary to reinforce sex health education among unmarried migrants and sexual health services should target vulnerable migrant young people. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the impacts of reproductive tract infections (RTIs) intervention on RTIs-related knowledge, attitudes, practices and prevalence of married women at reproductive age. Methods: Four sub-districts from Xuhui district, Shanghai were selected by multistage cluster random sampling and residence committees were randomly assigned to either an intervention group or a control one. RTIs intervention was implemented in intervention group, while routine family planning program was conducted in control group. Results: Compared with control group, intervention group have improved the following targets: the increment of RTI knowledge score was higher than that in control group (OR=9.22, 95%CI:7.01–12.14); the increment score of individual health behaviors (6.31) was higher than that in control group (4.50) (OR=1.60, 95%CI: 1.21–2.10); the increase of condom use frequency in intervention group was higher than that in control group (4.12% vs 0.69%) (OR=1.84, 95%CI: 1.31–2.57); the decreased RTIs rate was higher than that in control group (7.45% vs 0.96%) (OR=0.68, 95%CI: 0.49–0.95). Conclusion: It is an effective way to conduct community-based intervention to increase women''s RTIs knowledge, improve RTIs-related attitudes, promote good individual health behaviors, so as to decrease RTIs prevalence. [Copyright &y& Elsevier]

Objective. The main objectives of the study are to analyze fatal traffic-injury trends in 1987–2003 in Shanghai and predict its prevalence in near future and provide scientific data for the local governmental decision on developing practical working methods on traffic-injury prevention and control.Methods. In this study, epidemiological method and Grey dynamic model GM (1,1) were introduced to analyze and forecast traffic-injury mortality rates respectively.Results. There was an apparent increasing trend of traffic-related injuries in Shanghai from 1987 to 2003 with the rate of growth in motorization. The average rates of annual increase are 3.59% in fatalities (from 7.78 per 100,000 population to 14.18 per 100,000 population) during the period. Pedestrians were the most common type of victims (29.6%), followed by bicyclists (25.1%), and motorcyclists (24.1%). Males accounted for the majority of all victims, over 69%. The population of high-school and lower high-school education level represented 66.4% victims of total road-traffic injuries. And if no special factors effect its development, the traffic fatalities would be up to 17.84 per 100,000 population in 2010, when calculating from equations we found and validated Y(t) = 359.90 × e0.027(t-1)-352.13, (t = 1, 2, .., N) for Shanghai.Conclusion. Our data indicate the risk of fatal traffic injuries has increased in recent years and will go on growing in the near future in Shanghai. The findings showed that Grey dynamic model GM (1,1) is eligible on the prediction and can be a tool for injuries forecasting, implementing effective policies, programs, and interventions for reducing traffic injuries in the big cities. [ABSTRACT FROM AUTHOR]

Highlights • Seatbelt wearing rate increased from 61% in October 2015 to 85% in December 2017 in Shanghai, China. • High-tech seatbelt enforcement and interventions conducted by an international consortium on road safety may have contributed to the increase. • Seatbelt wearing rate was higher among drivers than passengers, in central urban areas than peri-urban areas. • Further actions are needed to promote seatbelt use among passengers, particularly rear seat passengers. Abstract Objective Road traffic crashes impose a heavy burden in China's most populous city, Shanghai. Since early 2016, Shanghai police have started deploying high-resolution cameras and an object-detection algorithm in seatbelt enforcement. Around the same time, an international consortium on road safety launched a series of capacity trainings for law enforcement accompanied by infrastructure renovation and social marketing campaigns in Shanghai. Our objective is to assess the level and trend of seatbelt use in Shanghai over 2015-2017. Methods Ongoing observational studies evaluate seatbelt use within the city. Data are collected at eight randomly selected locations throughout the city, stratified by road type and geographic locations. Data collection covers most times of the day on both business days and weekends, providing a full representation of varying traffic models during both rush hours and non-rush hours. At each site, trained field workers observe seatbelt use of occupants in all passing motorized vehicles. A multivariate logistic regression model was developed to analyze the data. Findings From October 2015 to December 2017, six rounds of data collection were completed with a total sample size of 77,641 drivers and passengers of motor vehicles. The seatbelt use rate has steadily increased over time, from 60.8% (95% CI: 59.9%–61.7%) in round 1 to 84.9% (84.3%–85.4%) in round 6 (p-value < 0.01). The increase is substantial and statistically significant for both drivers and passengers (p-value < 0.01). Results from the multivariate logistic regression show an annual growth rate of seatbelt use of 8.8% (8.4%–9.1%); the wearing rate was 49.8% (49.0%–50.5%) lower among passengers than drivers; 3.5% (2.9%–4.1%) lower in peri-urban areas than central urban areas; 16.3% (14.3%–18.4%) higher among 18–24-year and 18.9% (17.0%–20.9%) higher among 25–59-year olds than other age groups. Conclusion and policy implications Seatbelt use in Shanghai has been boosted during a short period of time through a combined strategy that includes training of police, social marketing campaign, and the deployment of computer vision assisted enforcement. Large cities in China and other countries facing similar challenges with seatbelt wearing may learn from Shanghai's experience. [ABSTRACT FROM AUTHOR]