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This cross-sectional survey was conducted to understand parents' perceptions regarding air pollution and its effect on children's respiratory health in Nanchang, China, to offer baseline information useful to the government of the People's Republic of China. Data collected from 1,056 residents (response rate = 93.7%) was analyzed using descriptive analysis, chi-square test, nonparametric rank-sum test, Spearman rank correlation coefficient, and linear trend test. The results showed that most parents would worry more about their children's health if air quality became worse, especially in families with high education and income. The top three respiratory conditions associated with poor air quality among children were cough (90.5%), upper respiratory infection (72.9%), and bronchitis (47.2%). Parents believed motor vehicle emissions (95.9%), secondhand smoke (95.4%), and dust (92.9%) to be the risk factors largely responsible for respiratory illnesses among children. Furthermore, most respondents supported government intervention to improve air quality with several suggestions: controlling industrial pollution (69.9%), increasing public transportation and reducing private cars (51.0%), and controlling and reducing waste incineration (45.6%)., Introduction People in China are becoming more aware of the quality of their life, opting to live in a comfortable environment and to lead a healthy lifestyle. This shift is [...]

Background: Studies assessing the impacts of China's New-type Rural Cooperative Medical Scheme (NCMS) reform of 2003 among rural elderly have been limited.Method: Multistage stratified cluster sampling household surveys of 1838, 1924, 1879, 1888, 1890 and 1896 households from 27 villages in Jiangxi province were conducted in 2003/2004, 2006, 2008, 2010, 2012 and 2014. Data from older adults age 65 and above were analyzed. Weighted logistic regression was applied to find factors of elderly hospitalization services.Results: Since 2003, hospitalization rates for elderly increased, while rates of patients leaving against medical advice and patients avoiding the hospital decreased (P < 0.05). Factors associated with a higher likelihood of reporting hospitalization in the past year for elderly were the per-capita financial level V in 2012 for NCMS (Adjusted Odds Ratios [aOR]: 2.295), the level VI in 2014 (aOR: 3.045) versus the level I in 2003 and chronic disease (aOR: 2.089) versus not having a chronic disease. Lower rate of elderly left against medical advice was associated with the financial level V in 2012 (aOR: 0.099) versus the level I. The higher rate of hospital avoidance was associated with chronic disease status (aOR: 5.759) versus not having a chronic disease, while the lower rate was associated with the financial level VI in 2014 (aOR: 0.143) versus the level I. Among reporting reasons for elderly hospital avoidance, the cost-related reasons just dropped slightly over the years.Conclusions: NCMS improved access to health services for older adults. The utilization of hospitalization services for rural elderly increased gradually, but cost-related barriers remained the primary reporting barrier to accessing hospitalization services. [ABSTRACT FROM AUTHOR]

Background This study assessed the prevalence of chronic disease among rural residents in Jiangxi, China, analyzed influencing factors and provided scientific rationale for chronic disease prevention and control. Methods Multi-stage stratified cluster random sampling was used to get a representative sample of rural residents in three counties across five time points from 2003 to 2012. Multivariate logistic regression and χ2 analysis were performed to analyze the influencing factors. Results The average prevalence of chronic disease across the five surveys was 7.9%. A declining trend in chronic disease prevalence from 9.1% in the baseline year to 6.9% in 2012 was observed. Multivariate logistic regression analysis showed that age, gender, occupation, education, marital status and employment were related to the prevalence of chronic disease. Conclusion The prevalence of chronic disease among rural residents in Jiangxi Province was lower than the national level, and declined over the course of the study. Strengthening health services and interventions for women, farmers, those who are divorced or widowed, the unemployed, and those with a low level of education or low income will help to improve the health status of the population. [ABSTRACT FROM PUBLISHER]

Background: To introduce a model of community health service organization (as implemented in urban areas) to less developed rural areas in China and evaluate the impact of this model on health care utilization. Methods: The intervention involved developing leadership at county level, training rural health practitioners, providing clinical management guidelines and standards, encouraging clinic improvements and providing access to subsidies for public health work. We chose 7 townships and 49 administrative villages in Chongyi County as the intervention sites; 3 townships and 9 administrative villages in Luxi County as the comparison sites. Officers from county health bureaus and postgraduates from School of Public Health, Nanchang University visited each township hospital and village clinic in field together and made observations and interviewed clinic staff. Results: There was little change in health facilities or workforce in the two areas. However, there was an increase in the use of public health services at township and village level in the intervention sites in Chongyi. In these, the proportion of clinics which had developed a child health (under the age of 3) management system, maternal postpartum visit and chronic disease management increased from 53%, 51% and 47% to 78%, 73%, and 71% respectively. There was no significant change in the comparison sites. Conclusions: The trial demonstrated that it was feasible to implement a model of community health service delivery that was adapted to depressed rural areas because it required little organizational change, additional funding or personnel. The model had a positive impact on the provision of public health programs, a finding which has implications for efforts to improve access to primary health care in rural China. [ABSTRACT FROM AUTHOR]

Background: In 2003 China began to implement the New-type rural Cooperative Medical System (NCMS). This provided enhanced funding for hospital-based medical services among farmers. We examined self-reported utilization data for evidence of changes following the new policy., Methods: We conducted a multistage stratified random cluster sampling method for Jiangxi Province, China. Data were collected via five surveys in 2003-4, 2006, 2008, 2010, and 2012. The study compared the rates of hospitalization, early discharge, and hospital avoidance as descriptive indices after weighting the data. Weighted multiple logistic regression analysis was used. Multi-stage cross-sectional analysis was used to explore the reasons for early discharge and for avoiding the hospital during illness., Results: We found that the rates of hospitalization, early discharge and hospital avoidance showed upward, downward and downward changes respectively. The logistic regression analysis showed that, controlling for other factors, the financing level significantly affected the changes of the three indexes (p<0.05). The proportion of finance-related early discharge and hospital avoidance dropped significantly (p<0.05)., Conclusions: NCMS improved the utilization of in-hospital services step by step as time went on, and greatly alleviated cost-related barriers to accessing health services. Even so, because costs continue to restrict access to services we should continue the NCMS policy and improve its guarantee levels., (© The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: To study the effects of environmental exposure to rare earth elements (REEs) on health in children., Methods: The level of physical growth and development, function of immune system, intelligence were chosen as the health-response indexes of children. Indicators for physical growth and development were measured. IgA, IgG, IgM and complement C3, C4 in blood serum were determined with turbidimeter measure, IgE were determined by chemiluminescence immunoassay (CLIA), lymphocyle subset CD3, CD4, CD8, CD4/CD8 and NK were determined by flowcytometry. Intelligence quotient (IQ) were examined with Drawing A Man Test in the children aged 7-10 years randomly sampled in the area containing rare earth (RE) ore and the control area in Xunwucounty, Jiangxi. Blood REEs were determined by inductively coupled plasma source mass pectrometry (ICP-MS)., Results: All 15 kinds of REEs were detected in each sample, the quantity of blood REEs of the children were lower in exposure group than in control group and in the rare earth area [(2.10 +/- 0.88)ng/g] was 1.73 times as that of the children in the control area [(1.26 +/- 1.35) ng/g]. The difference is significant (P < 0.01). The humoral immunity would be changed in the body of the children exposed to REEs, the quantity of IgM was lower in exposure group than in control group. The measuring result of T lymph subgroup of the children indicates: CD3, CD4, CD4/CD8 changed a lot. The percent of CD3, CD8 were significantly lower and CD4/CD8 was significantly higher in exposure group than in control group. The score of IQ was lower significantly in the exposure group than in the control. The percentage of high IQ decreased, the percentage of low IQ increased. Multiple regression analysis showed the variable of blood REEs in exposure to REEs group or those in the control group were introduced into the Vital capacity, blood pressure and IgM regression model. The distance from home to the RE area and either RE put in home influenced the score of children's IQ., Conclusion: The children aged 7-10 years in RE ore area may have higher REEs burden in the body, and exposure to REEs could have adverse influences in children.