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The purpose of this research was to create a function for mapping the cancer-specific instrument (FACT-G) to a preference-based measure (EQ-5D-3 L) utility index for health-related quality of life, with utility scores generated using the Chinese value set. A cross-sectional study among 243 Chinese patients with cancer was conducted through EQ-5D-3 L and FACT-G questionnaires survey. The EQ-5D-3 L utility index values were predicted based on OLS, GLM, CLAD, and Tobit model regression approaches. The performance and predictive power of each model were also evaluated using r2 and adj- r2, MAE, RMSE, ICC, and MID. Linear equating was used to avoid regression of the OLS model to mean. The model was validated using a 10-fold cross-validation method. Among all regression models for the FACT-G, the OLS 5 model predicted mean EQ-5D-3 L values the best, in terms of model goodness of fit (r2 = 0.6230, MAE = 0.0448, RMSE = 0.0624). The OLS model proved to be the most accurate for the mean, and the linear equating scores were much closer to the observed scores. Our results suggest that the best algorithm for FACT-G mapping to EQ-5D-3 L utility index is OLS model, based on the survey of Chinese patients with cancer.

BackgroundEarly somatic embryogenesis (SE) has been recognized as an important tool for plants to propagate in vitro. However, our knowledge about the proteins involved in early SE including the callus dedifferentiation is still limited, especially in the economic woody tree – Eucalyptus.ResultsWe performed the data-independent acquisition (DIA) mass-spectrometry (MS) to study the proteins involved in early SE of two Eucalyptus species - E. camaldulensis (high regeneratively potential) and E. grandis x urophylla (low regenerative potential). Initially, the data-dependent acquisition MS produced 44,451 peptides and 9,142 proteins. While the DIA MS identified 35,207 peptides and 7,077 proteins in the stem and tissue-culture induced callus of the two Eucalyptus species. MSstat identified 2,078 and 2,807 differentially expressed proteins (DEPs) in early SE of E. camaldulensis and E. grandis x urophylla, respectively. They shared 760 upregulated and 420 downregulated proteins, including 4 transcription factors, 31 ribosomal proteins, 1 histone, 3 zinc finger proteins (ZFPs), ARF19, WOX8 and PIN1. Further, 27 and 4 DEPs were found to be involved in “photosynthesis” (ko00195) and “two-component system” (ko02020), respectively. Notably, SERK, WRKY, ZFP and ABC transporter proteins were analyzed to be related with high SE potential. By combining the miRNA and RNA-Seq results, some miRNA-mRNA/protein regulation networks might be involved in early SE of Eucalyptus, like miR160~TPP2, miR164~UXS2, miR169~COX11 and miR535~ Eucgr.E01067.ConclusionsThis is the first study of proteome profiles in early SE of Eucalyptus. The findings will improve our understanding of molecular changes and regulatory networks in early SE of Eucalyptus.

Aim: To explore the expression profiles and functions of circRNAs in hepatocellular carcinoma (HCC). Materials & methods: We obtained circRNA expression profiles through RNA sequencing. Expression levels of circRNAs were confirmed by quantitative real-time PCR. The effects on HCC progression were determined using Cell Counting Kit 8, clone formation and transwell assays. Results: We identified 114 upregulated and 144 downregulated circRNAs in HCC tissues. The results of quantitative real-time PCR showed that circGNAO1, circRNF180 and circMERTK were significantly downregulated in HCC tissues, whereas circSNX6 was significantly upregulated. CircRNF180 was associated with microvascular invasion. Overexpression of circRNF180 inhibits the proliferation, colony formation, migration and invasion of HCC cells. Conclusion: CircRNF180 may function as a tumor suppressor and could serve as a potential biomarker and therapeutic target in HCC.

This study investigated the effect of berberine (BBR) on growth performance and composition and function of cecal microbiota in yellow-feathered broilers. A total of 360 1-day-old female broilers were assigned to 3 dietary treatments, each with 6 replicates of 20 birds. The dietary treatments consisted of a basal diet as negative control (NC), basal plus 200 mg/kg oxytetracycline calcium and 250 mg/kg nasiheptide as an antibiotic positive control (PC), and basal plus 250 mg/kg BBR. On day 21, 42, and 63, one chicken from each replicate was randomly selected for blood collection and cecal sampling. The 16S rRNA sequencing technology was used to analyze the community composition and function of cecal microbiota. Dietary supplementation with antibiotics or BBR increased the final body weight (BW) at day 63 and the average daily gain (ADG) during 1 to 21 d compared with the NC (P

The karst geo-ecosystems are fragile environments. The largest karst region in the world is located in southwestern China, within which the Guangxi province is one of the main areas. Chinese fir (Cunninghamia lanceolata (Lamb.) Hook.), an evergreen species, is an important fast-growing timber tree in southern China. In the present study, we examined the genetic diversity and spatial genetic differentiation of Chinese fir in sampling localities around the karst landform region of Guangxi by genotyping 330 individuals from 11 sampling localities with 22 novel polymorphic microsatellite loci. High levels of gene flow have homogenized Chinese fir in Rongshui, Nandan, and Tiane sites, which are speculated to be the primary center of gene exchange and diversity for Chinese fir around the karst landform in Guangxi. Significant isolation by distance pattern was found among nine sampling localities. A moderate level of genetic differentiation (FST = 0.089, Dest = 0.139) between sampling localities was detected. Structure analysis divided Chinese fir into three subgroups (K = 3). With higher differentiation and less genetic variation than in the central population, marginal populations of Cangwu and Pubei were identified in the south of the karst landform. An effective conservation strategy focusing on the maintenance of genetic variation for marginal populations of the species was proposed.

The age of the population is shifting toward the elderly range, which may lead to an increased risk of mild cognitive impairment (MCI). The aims of this study are to evaluate the cognitive function in elderly people using the Montreal Cognitive Assessment (MoCA), to identify the relationship between cognitive function and different characteristics, and to evaluate the efficacy of the intervention after six months of cognitive training. In this study, we included 2886 subjects aged ≧60 years in the baseline survey, and 140 subjects with MCI who participated in the baseline survey were randomly divided into an intervention group (N = 70) and a control group (N = 70). The control group was not provided any intervention measures, and the intervention group was administered cognitive training. The education level, monthly income, sleep time, exercise time, reading times, and time spent engaging in community activities and performing housework were positively correlated with MoCA scores, but age was negatively correlated with MoCA scores. The total MoCA score of the intervention group increased from 19.77 ± 2.24 points to 21.09 ± 2.20 points after six months of cognitive training, but the score of the control group decreased from 20.41 ± 2.10 points to 19.17 ± 2.57 points. The two-way repeated-measures ANOVA revealed a very significant effect of the interaction between time and cognitive training on the total MoCA score. Seventeen participants in the intervention group improved to normal levels, and no participants progressed to dementia after six months of cognitive training. Thus, the efficacy of the intervention was statistically significant. Our study concludes that older age is associated with a cognitive decline. Factors that are more likely to protect against cognitive decline included a higher education level and monthly income, sufficient sleep time, regular physical exercise and reading, frequently engaging in community activities, and continuing to perform housework. Moreover, the cognitive training intervention is effective and may help to decrease the deterioration of cognitive function in patients with MCI, and the interaction between intervention time and cognitive training significantly improves cognitive function.

ObjectiveThis study aimed to develop a function for mapping the cancer-specific instrument (FACT–G) to a preference-based measure (EQ-5D-3L) utility index for HRQoL, in which the utility scores were generated using the Chinese value set.MethodThe data are based on a cross-sectional survey of 243 patients in China with different cancer types. Cancer patients who completed the EQ-5D-3L and the FACT-G questionnaire, and patient demographics and clinical characteristics were included in this study. Regression models were used to predict the EQ-5D-3L utility index values based on four subscale scores of the FACT-G using the ordinary least squares (OLS) model, generalized linear models (GLM), censored least absolute deviations (CLAD), Tobit model, and two-part model (TPM) regression approaches. The performance and predictive power of each model were also evaluated using r2 and adj- r2, mean absolute error (MAE) and root mean squared error (RMSE). Linear equating is a mapping technique that avoids regression to the mean.ResultsThe introduction of the square term and the interaction term improves the accuracy of the model. The social well-being subscale of the FACT-G was not associated with the EQ-5D-3L utility index, whereas, the physical, emotional, functional well-being, and FACT-G total scores were derived when mapping the FACT-G to the EQ-5D-3L utility index. For the FACT-G, the OLS model was the best at predicting mean EQ-5D-3L values among all the regression models and has 70% explanatory power for the observed EQ-5D-3L variation. Nevertheless, the OLS model overpredicted utilities for poorer health states and underestimated utilities for those with better health. The result of the OLS model, GLM, and CLAD models were similar to the MAE, MSE, and RMSE. The results showed that the mean prediction accuracy of the OLS models was higher than that of the other models, and the OLS model's linear equating predicted values were much closer to the observed values.ConclusionThe algorithm based on Chinese population development for mapping the FACT-G into the EQ-5D-3L utility index can be realized. We also recommend that OLS models be used to assess the economic evaluation of patients' health-related quality of life when the population is in moderate to good health for further cost-utility analysis in China.

ObjectiveThis study aimed to develop a function for mapping the cancer-specific instrument (FACT–G) to a preference-based measure (EQ-5D-3L) utility index for HRQoL, in which the utility scores were generated using the Chinese value set.MethodThe data are based on a cross-sectional survey of 243 patients in China with different cancer types. Cancer patients who completed the EQ-5D-3 L and the FACT-G questionnaire, and patient demographics and clinical characteristics were included in this study. Regression models were used to predict the EQ-5D-3L utility index values based on four subscale scores of the FACT-G using the ordinary least squares (OLS) model, generalized linear models (GLM), censored least absolute deviations (CLAD), Tobit model, and two-part model (TPM) regression approaches. The performance and predictive power of each model were also evaluated using r2 and adj- r2, mean absolute error (MAE) and root mean squared error (RMSE).ResultsThe introduction of the square term and the interaction term improves the accuracy of the model. The social well-being subscale of the FACT-G was not associated with the EQ-5D-3L utility index, whereas, the physical, emotional, functional well-being, and FACT-G total scores were derived when mapping the FACT-G to the EQ-5D-3L utility index. For the FACT-G, the OLS model was the best at predicting mean EQ-5D-3L values among all the regression models and has 70% explanatory power for the observed EQ-5D-3L variation. Nevertheless, the OLS model overpredicted utilities for poorer health states and underestimated utilities for those with better health. The result of the OLS model, GLM, and CLAD models were similar to the MAE, MSE, and RMSE.ConclusionThe algorithm based on Chinese population development for mapping the FACT-G into the EQ-5D-3L utility index can be realized. We also recommend that OLS models be used to assess the economic evaluation of patients' health-related quality of life when the population is in moderate to good health for further cost-utility analysis in China.

Chinese fir [ Cunninghamia lanceolate (Lamb.) Hook] is one of the most important indigenous timber tree species in China. The aim of the present work is to characterize simple sequence repeat (SSR) loci derived from the specific length amplified fragment sequencing (SLAF) data of the genome and to investigate the number of pollen donors for per cone was with novel SSR markers of low-frequency null alleles. A total of 58855 SLAF-SSR with frequency of 42.04 SSR/Mbp were identified in about 1.40 Gb Chinese fir genome. Dinucleotide repeat SSR contributed to 66.4% of the total SSR from SLAF data. The AT/AT and ATG/CAT motifs were predominant in the category of din- and trinucleotide repeat SSR. Low frequencies of null alleles (

Background Information and communication technology (ICT) has been widely used in medical education as well as biomedical and population based research, however, the use of ICT in China is still insufficient. This study aimed to investigate the use, perceptions and attitudes of ICT use in biomedical and population based research among faculty members in medical universities in southern China. Methods A cross-sectional study was conducted among faculty members working in the health sciences discipline in 6 major universities in southern China. A self-completed online questionnaire was used for data collection. Findings Of 270 faculty members enrolled, 206 faculties (76%) used ICT in their work and 54% were female. Few faculty members took an online course or were trained on ICT use before. The ICT- using group was more experienced than the ICT-free group (P= 0.047). The most frequently used ICT tools were mobile phone, the Internet, non-mobile computer system, WeChat (similar to Facebook - a popular social communication tool in China) and QQ (a popular chat tool in China). The use of non-mobile computer systems, WeChat and QQ in ICT-using group was more frequent than in ICT-free group (P

The present study aims to determine the association between bus drivers' socio-demographic characteristics, personality traits, mental health and traffic violations. This case-control study included 596 bus drivers who were recruited during October 2014 to May 2016, including 295 drivers with traffic violations and 301 drivers without traffic violations. The bus drivers' personality traits and mental health were assessed by the Eysenck Personality Questionnaire (EPQ) and the Symptom Checklist (SCL-90-R). Drivers aged 26-35 years were 72% less likely to be involved in traffic violations compared to drivers aged ≤25 years (OR:0.284,95%CI:0.137-0.586). Drivers with ≤2 years driving experience were associated with almost a three-fold increased risk of traffic violations compared to ≥21 years driving experience (OR:3.174,95%CI:1.097-9.187). The OR value decreased with the increase of annual income (OR:4.631,95%CI:2.667-8.042;OR:3.569,95%CI:2.038-6.251;OR:3.781,95%CI:1.999-7.151). Occasionally drinking drivers and regularly drinking drivers, compared to nondrinking drivers, exhibited a higher risk of traffic violations (OR:2.487,95%CI:1.521-4.065;OR:3.271,95%CI:1.387-7.716).Extroversion and neuroticism were identified as significant factors associated with traffic violations (OR:1.262,95%CI:1.145-1.393;OR:1.159,95%CI:1.060-1.267).Somatization increased eleven-fold risk of bus drivers' traffic violations (OR:11.185,95%CI:4.563-27.419). The results revealed that bus drivers' traffic violations were mainly affected by specific socio-demographic characteristics, personality traits and mental health, which increase the risk of traffic violations.

Background The psychological status of drivers is related to adverse driving behaviors. Although there are several studies on the mental health and traffic accidents among bus drivers, related studies on the association between mental health and individual characteristics are scarce. Methods Our report is on a cross-sectional study of bus drivers that took place between October 2014 and May 2016. A total of 596 bus drivers who worked for transportation companies and underwent occupational physical examinations at The Guangxi Zhuang Autonomous Region workers' Hospital during the study period were included. Demographic characteristics were collected by a self-designed demographic questionnaire. The Eysenck Personality Questionnaire (EPQ) and the Symptom Checklist 90-Revised (SCL-90-R) were used to evaluate the personality and mental health of bus drivers, and the results of the scales were compared with Chinese norms. The structural equation model was used to analyze the correlation among demographic characteristics, personality characteristics, and mental health. Results Except for the lie dimension, the average scores of the driver's personality dimension were higher than the Chinese norm, and the means of somatization and phobia scores of bus drivers were also higher; obsessions-compulsions, interpersonal sensitivity, and depression scores were lower than those for the Chinese norms. The structural equations modeling revealed that the total effects coefficient of demographic characteristics on mental health was 0.68, and that of personality was 0.60. There were direct influences between demographic characteristics and personality characteristics, demographic characteristics and mental health, and personality characteristics and mental health; the standardized path coefficients were 0.60, 0.50, and 0.30, respectively. Smoking, drinking, and neuroticism were the main factors affecting the mental health of bus drivers; and the standardized path coefficients were 0.56, 0.54, and 0.90 respectively. Conclusions In this study, bus drivers were significantly more extroverted, psychotic, and neurotic than the general population; and they were more likely to suffer from somatization and phobia. The mental health of bus drivers was associated with some demographic and personality characteristics in the study. These findings provide a theoretical basis for the selection of bus drivers and intervention measures for drivers with high-risk driving tendencies, which is conducive to better guide road traffic safety construction and reduce the occurrence of road traffic injuries.

Background: Secondhand Smoke (SHS) exposure is a leading cause of childhood illness and premature death. Pediatricians play an important role in helping parents to quit smoking and reducing children’s SHS exposure. This study examined Chinese pediatricians’ attitudes and practices regarding children’s exposure to SHS and clinical efforts against SHS exposure. Methods: A cross-sectional survey of pediatricians was conducted in thirteen conveniently selected hospitals in southern China, during September to December 2013. Five hundred and four pediatricians completed self-administered questionnaires with a response rate of 92%. χ2 tests were used to compare categorical variables differences between smokers and non-smokers and other categorical variables. Results: Pediatricians thought that the key barriers to encouraging parents to quit smoking were: lack of professional training (94%), lack of time (84%), resistance to discussions about smoking (77%). 94% of the pediatricians agreed that smoking in enclosed public places should be prohibited and more than 70% agreed that smoking should not be allowed in any indoor places and in cars. Most of the pediatricians thought that their current knowledge on helping people to quit smoking and SHS exposure reduction counseling was insufficient. Conclusions: Many Chinese pediatricians did not have adequate knowledge about smoking and SHS, and many lacked confidence about giving cessation or SHS exposure reduction counseling to smoking parents. Lack of professional training and time were the most important barriers to help parents quit smoking among the Chinese pediatricians. Intensified efforts are called for to provide the necessary professional training and increase pediatricians’ participation in the training.

Background The demand to use information and communications technology (ICT) in education and research has grown fast among researchers and educators working in global health. However, access to ICT resources and the capacity to use them in global health research remains limited among developing country faculty members. In order to address the global health needs and to design an ICT-related training course, we herein explored the Chinese health science faculty members’ perceptions and learning needs for ICT use. Methods Nine focus groups discussions (FGDs) were conducted during December 2015 to March 2016, involving 63 faculty members working in areas of health sciences from six universities in China. All FGDs were audio recorded and analysed thematically. Results The findings suggest that the understandings of ICT were not clear among many researchers; some thought that the concept of ICT was too wide and ambiguous. Most participants were able to cite examples of ICT application in their research and teaching activities. Positive attitudes and high needs of ICT use and training were common among most participants. Recommendations for ICT training included customised training programmes focusing on a specific specialty, maintaining a balance between theories and practical applications, more emphasis on the application of ICT, and skills in finding the required information from the bulk information available in the internet. Suggestions regarding the format and offering of training included short training programmes, flexible timing, lectures with practicum opportunities, and free of charge or with very minimal cost to the participants. Two participants suggested the linking of ICT-related training courses with faculty members’ year-end assessment and promotion. Conclusions This study among health sciences faculty members in China demonstrated a high level of need and interest in learning about ICT use in research and training. The results have important implications for the design and implementation of ICT-related educational programmes in China and other developing countries.

Children’s exposure to secondhand smoke (SHS) at home has numerous adverse health effects. This study evaluated the effects of a pediatric in-patient department-based pilot smoking cessation intervention for household members to reduce children’s SHS exposure and encourage smoking cessation. A pre-post test design study was designed to assess the effectiveness of a telephone counseling intervention on household members of hospitalized children in pediatric departments. Data were collected with a standardized Chinese language questionnaire. At the three-month follow-up survey, the proportions of household members who reported adopting complete smoking restriction at home (55%), did not smoke at home at all (37%), did not allow others to smoke in the car (70%), or did not allow others to smoke around the child (57%) were significantly higher than the self-reported responses at the baseline survey. The proportions of household members who reported smoking at home (49%) and in the car (22%) were significantly lower than the baseline survey. Overall, 7% of the participants had reported quitting smoking after three months. Pediatric in-patient department-based telephone counseling for smoking cessation was found to be acceptable to Chinese parents. The intervention encouraged few parents to quit smoking, but encouraged more parents to take measures to reduce children’s SHS exposure.

Background Secondhand smoke (SHS) exposure of children due to parental tobacco use is a particularly prevalent health issue and is associated with adverse health outcomes. Following the US Clinical Practice guidelines, pediatricians in the United States deliver 5A’s (ask, advise, assess, assist, and arrange) counseling to smoking parents which has proven to be effective. We examined Chinese pediatricians’ adherence to the clinical practice guidelines for smoking cessation (i.e. 5A’s counseling practices) with smoking parents, and identified factors associated with these practices. Methods A cross-sectional paper-and-pencil survey of pediatricians was conducted in twelve conveniently selected southern Chinese hospitals. Factors associated with any of the 5A’s smoking cessation counseling practices were identified by logistic regression. Results Of respondents (504/550), only 26 % routinely provided 5A’s smoking cessation counseling to smoking parents. More than 80 % of pediatricians didn’t receive formal training in smoking cessation and had not read China smoking cessation guidelines; 24 % reported being “very confident” in discussing smoking or SHS reduction with parents. Pediatricians who had never smoked (OR: 2.29, CI:1.02-5.12), received training in smoking cessation (OR: 2.50, CI:1.40-4.48), had read China smoking cessation guidelines (OR: 2.17, CI:1.10-4.26), and felt very (OR: 7.12, CI:2.45-20.70) or somewhat (OR: 3.05, CI:1.11-8.37) confident in delivering cessation counseling were more likely to practice 5A’s. Pediatricians who reported “it is hard to find a time to talk with parents” (OR: 0.32, CI: 0.11-0.92) or “lack of a standard of care requiring pediatricians to provide smoking cessation or SHS exposure reduction intervention” (OR: 0.45, CI: 0.21-0.98) as a barrier were less likely to follow the 5A’s guidelines. Conclusions Smoking cessation counseling to address parental smoking is infrequent among Chinese pediatricians. There is a need to develop and test intervention strategies to improve the delivery of 5A’s smoking cessation counseling to parental smokers.

This study aimed to assess the relationships between road traffic injury severity and individual characteristics in Liuzhou, a city in southern China. Data for this study were collected from the Guangxi Public Security Bureau Traffic Police Corps. Multivariate ordinal logistic regression analysis was used. Of all 14,595 individuals involved in accidents, males, motor vehicle drivers, motorcyclists, and those aged 21-45 years accounted for the great proportion of all injuries. Children, the elderly, pedestrians, farmers and migrant workers, unemployed people, and novice drivers were at higher risk of serious injury in crashes. These findings suggest that individual characteristics (age, modes of transport, profession, driving experience) are strongly related to injury severity. To address road traffic related mortality and injuries, there is a need to develop policy strategies, strengthen road supervision, and improve public consciousness of road safety.

Background: Rapid development of information and communications technology (ICT) during the last decade has transformed biomedical and population-based research and has become an essential part of many types of research and educational programs. However, access to these ICT resources and the capacity to use them in global health research are often lacking in low- and middle-income country (LMIC) institutions. Objective: The aim of our study was to assess the practical issues (ie, perceptions and learning needs) of ICT use among health sciences graduate students at 6 major medical universities of southern China. Methods: Ten focus group discussions (FGDs) were conducted from December 2015 to March 2016, involving 74 health sciences graduate students studying at 6 major medical universities in southern China. The sampling method was opportunistic, accounting for the graduate program enrolled and the academic year. All FGDs were audio recorded and thematic content analysis was performed. Results: Researchers had different views and arguments about the use of ICT which are summarized under six themes: (1) ICT use in routine research, (2) ICT-related training experiences, (3) understanding about the pros and cons of Web-based training, (4) attitudes toward the design of ICT training curriculum, (5) potential challenges to promoting ICT courses, and (6) related marketing strategies for ICT training curriculum. Many graduate students used ICT on a daily basis in their research to stay up-to-date on current development in their area of research or study or practice. The participants were very willing to participate in ICT courses that were relevant to their academic majors and would count credits. Suggestion for an ICT curriculum included (1) both organized training course or short lecture series, depending on the background and specialty of the students, (2) a mixture of lecture and Web-based activities, and (3) inclusion of topics that are career focused. Conclusions: The findings of this study suggest that a need exists for a specialized curriculum related to ICT use in health research for health sciences graduate students in China. The results have important implications for the design and implementation of ICT-related educational program in China or other developing countries. [JMIR Med Educ 2017;3(1):e11]

Background Assisting smoking parents to quit smoking and eliminating the secondhand smoke (SHS) exposure of their children is a global health priority. Engaging healthcare workers in developing countries to address this priority has been a challenge. This study intends to explore issues around current practice related to SHS exposure assessment and counseling and identify barriers to SHS exposure reduction counseling in the Chinese pediatric setting. Methods We conducted qualitative interviews (11 focus groups discussions (FGDs) with pediatricians, 6 FGDs with pediatric nurses and 11 in-depth interviews (IDIs) with hospital administrators) among 101 health-care professionals (HCP) from 5 hospitals in four major cities of Guangxi Province, China. All FGDs/ IDIs were audio recorded and analysed thematically. Results The findings suggest that few Chinese pediatricians routinely address the SHS exposure of children in their usual practice. All HCPs felt the need for clinical interventions to promote SHS exposure reduction for children. Primary barriers to SHS exposure reduction counseling in the Chinese pediatric setting included: lack of skills and training in tobacco use reduction and cessation counseling; time constraints and heavy workloads, uncertainty about the usefulness of smoking cessation interventions and lack of hospital-wide systems requiring pediatricians to record tobacco use or SHS exposure information. Ideas for overcoming these barriers were building capacity of pediatricians, collaboration with international organization to initiate training, engaging top level leaders in the effort and ensuring financial resources to support the program. Conclusions This study among hospital administrators and service providers in China demonstrated a high level of interest in delivering SHS exposure reduction interventions in the pediatric setting. The findings can inform the creation and delivery of clinical interventions in China to promote SHS exposure reduction to children in the pediatric setting. Electronic supplementary material The online version of this article (doi:10.1186/1471-2431-14-266) contains supplementary material, which is available to authorized users.

(1) Background: The home environment is a major source of Environmental Tobacco Smoke (ETS) exposure among children especially in early childhood. ETS exposure is an important health risk among children and can cause severe and chronic diseases, such as asthma, bronchitis, and premature death. However, ETS exposure at home has often been neglected in the Chinese families. Identification of factors that facilitate or otherwise hamper the adoption of home smoking ban will help in the design and implementation of evidence-based intervention programs. This study identifies factors correlated with home smoking bans in Chinese families with children. (2) Methods: A cross-sectional survey of parents living in Nanning city, Guangxi Province, China with at least one smoker and a child in the household was conducted between September, 2013 and January, 2014. A Chi-square test was used to compare categorical variables differences between the parents who had home smoking bans and those with no home smoking ban. Multiple logistic regression analyses were used to identify factors correlated with home smoking bans. (3) Results: 969 completed questionnaires were collected with a response rate of 92.29% (969/1050). Of the respondents (n = 969), 14.34% had complete home smoking bans. Factors that were associated with home smoking bans were: having no other smokers in the family (OR = 2.173), attaining education up to high school (OR = 2.471), believing that paternal smoking would increase the risk of lower respiratory tract illnesses (OR = 2.755), perceiving the fact that smoking cigarettes in the presence of the child will hurt the child’s health (OR = 1.547), believing that adopting a no smoking policy at home is very important (OR = 2.816), and being confident to prevent others to smoke at home (OR = 1.950). Additionally, parents who perceived difficulty in adopting a no smoking policy at home would not have a home smoking ban (OR = 0.523). (4) Conclusions: A home smoking ban is not widely adopted by families of hospitalized children in Guangxi Province, China. To protect the health of children, there is a need to develop and test interventions to promote home smoking bans. Factors identified as predictors of home smoking ban should be considered in the design of interventions.

Background Pediatricians play an important role in promoting smoking cessation among the parents of young children as more behavioral counseling and cessation treatment are made available in the Chinese healthcare system. However, beliefs about the effectiveness of these interventions can influence pediatricians’ recommendations to their patients. This study examined pediatricians’ beliefs regarding effectiveness of counseling and medications for smoking cessation. Methods A cross-sectional survey of pediatricians was conducted in thirteen conveniently selected southern Chinese hospitals, during September to December 2013. A self-administered questionnaire was used for data collection. We used chi square tests and multinomial logistic regression analysis to identify factors associated with beliefs regarding effectiveness of counseling and medications for smoking cessation. Results Beliefs of the respondents (504/550; 92% response rate) were divided regarding the effectiveness of counseling and medications for smoking cessation. Sixty percent believed that physician counseling is effective for smoking cessation; 53% believed pharmacological products (or medications) are effective. Factors that were associated with positive beliefs towards the effectiveness of counseling included: believing about the professional responsibility to discuss smoking cessation, being confident in discussing smoking cessation or SHS exposure reduction with patients’ parents, believing that health professionals should routinely ask about their patients smoking habits, believing that health professionals should routinely advise their smoking patients to quit smoking, possessing adequate knowledge in quitting smoking, and being able to assess smokers different stages of readiness to quit. Most of the above factors were also associated with the belief that medication is effective for smoking cessation. Conclusions A substantial proportion of Chinese pediatricians believed that cessation counseling and medications are not effective, which is not supported by current evidence in the field. Several factors including individual, practice level and health system level characteristics were associated with their belief. Training efforts are needed to influence pediatricians’ beliefs regarding the effectiveness of cessation counseling and medications.

Questionnaire used in the online survey. (DOC 78 kb)

Questionnaire used in the online survey. (DOC 78 kb)