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Aims and objectives To compare sexually active Chinese high school students in three major Asian cities with their non-sexually active counterparts in order to determine prevalence and associations with selected health outcomes. Background There have been limited studies to date on the association between sexual activity and substance use in Chinese high schools. While the role of the school nurse in the development of sexual health and harm reduction education in secondary schools has been well documented in international studies, this has received little attention in Asia. Design Cross-sectional survey. Methods This study was administered in 2003/2004 to 13,895 Grades 6 to 12 high school students in Hong Kong (3498), Macau (6286) and Taipei (4111). Descriptive analysis was conducted followed by univariate analysis comparing sexual behaviour with (1) substance use including alcohol, smoking, illicit drugs; (2) feeling depressed for greater than or equal to two weeks in last 12 months; contemplating suicide during the last 12 months; and (3) perception of poor health/academic performance. Results The students (8%) reported being sexually active had marked differences in selected health outcomes when compared with the nonsexually experienced students. More than 90% of the sexually active students had tried alcohol, with more than 50% being regular drinkers, more than 30% testifying to binge drinking and nearly 50% reported depression in the past 12 months. Substance use, poorer perception of health and academic performance were also significantly higher in the sexually experienced students relative to their nonexperienced counterparts. Conclusions Sexually experienced Chinese high school students surveyed were at higher risk of substance abuse, poorer psychological health and academic performance. Relevance to clinical practice Community and public health nursing needs to address Asian adolescent sexual health education needs, in particular provide culturally targeted interventions for associated substance abuse and psychological health within the context of high school sex education. [ABSTRACT FROM AUTHOR]

Aims To assess the impact of a set of comprehensive tobacco control policies implemented in Taiwan in 2009, including extensive smoke-free policy, advertisement ban, pictorial warning and price increase, on adolescent smoking prevalence. Design Five waves of cross-sectional surveys. Setting Taiwan, 2004-11. Participants Nationally representative sample of junior high schools aged 13-15 years, in a biennial survey, total sample size 101 100. Measures Core questionnaire of the Global Youth Tobacco Survey, including ever smoking, 30-day smoking and number of cigarettes smoked. The magnitude of prevalence change before and after the 2009 policy implementation was quantified by adjusted odds ratios estimated by piecewise logistic regression models. Findings The 30-day smoking prevalence demonstrated an upward trend [odds ratio ( OR) = 1.06, 95% confidence interval ( CI) = 1.02-1.10] between 2004 and 2008. Significant decline in 30-day smoking prevalence after the 2009 law implementation was observed ( OR = 0.84, 95% CI = 0.71-0.99). Those living in non-city areas demonstrated a greater magnitude of change. In addition to changes in prevalence, we observed some delay in the age starting smoking, reduction in smokers who smoke fewer than one cigarette per day, and decrease in smokers who did not buy cigarettes. The decline in smoking prevalence was contributed primarily by the reduction in experimenters. Conclusion The comprehensive tobacco control programme introduced in Taiwan in 2009 was associated with a reduction in adolescent smoking, particularly among those in earlier stages of smoking and those who resided in non-city areas. [ABSTRACT FROM AUTHOR]

BackgroundThe occurrence of asthma may be associated with dietary factors. ObjectiveTo examine the association between nutrient intake and physician-diagnosed asthma and allergic rhinitis. MethodsA stratified, multiple-staged sampling design was used to select study areas, in which household interviews were carried out to gather information on health status and 24-h food recall. Data from 1166 adolescents, 13–17 years of age, were analysed. ResultsIn univariate analysis, total calorie and energy-adjusted fat intake were associated with the prevalence of asthma, whereas vitamin A and vitamin C intake showed negative association with asthma. Multivariate logistic regression was used to adjust for sex and levels of urbanization; intake of saturated fats was associated with increased risk (OR = 2.02 for an increase of one SD, 95%CI 1.40–2.90), while monounsaturated fats were inversely related to asthma (OR = 0.65 for an increase of one SD, 95%CI 0.43–0.99). Vitamin C intake in the lowest quartile was associated with elevated risk for asthma with marginal significance (OR = 1.81, 95%CI 0.88–3.71, P = 0.10). None of the nutritional factors was associated with allergic rhinitis. ConclusionResults from this cross-sectional survey suggest that saturated and monounsaturated fats may have different effects on airway inflammation. [ABSTRACT FROM AUTHOR]

This 16-year (1986–2001) retrospective study enrolled 80 infantile patients (aged, 30–365 days old) with culture-proven bacterial meningitis. The most prevalent pathogens were Salmonellaspecies, Streptococcus (S.) agalactiae, Escherichia (E.) coli, and Haemophilus (H.) influenzae, accounting for about 59% of the episodes. Meningitis caused by Salmonella species, E. coli and H. influenzae occurs more often in the older infants, while that caused by S. agalactiae occurs more often in young infants. Our study revealed a decrease in the proportion of Salmonella meningitis from 27% in the first 8 years to 9% in the second 8 years with E. coli replacing Salmonella species as the leading pathogen of this disease during the second period. Overall mortality rate for both periods of time was 11%. However, if we take those with undesirable poor outcomes into account, 43% of patients could be considered treatment failures. The study also reveals a high prevalence of neurological complications when this disease is caused by H. influenzae, S. pneumoniae, and Salmonella species. Stepwise logistic regression analysis revealed that only initial changing levels of consciousness (P=0.006) were independently associated with treatment failure. The most frequent neurological complications associated with this disease included subdural empyema, hydrocephalus, cerebral infarctions, and seizures. Because therapeutic regimens may require attention to the eradication of bacterial pathogen but also the neurological complications, early diagnosis and choice of appropriate antibiotics are essential to increasing the possibility of survival. [Copyright &y& Elsevier]

To determine the epidemiologic trends, prognostic factors, and therapeutic results of neonatal bacterial meningitis, 60 neonatal patients with culture-proven neonatal bacterial meningitis were enrolled in this study. To compare changes over time, the appearance of disease among the patients was divided into two equal periods (1986-1993 and 1994-2001). Group B streptococci were the most common causative pathogens, accounting for approximately 32% of the episodes. Escherichia coli, the next most common pathogen, was more frequently observed in the second period. Seventy-seven percent of gram-negative bacilli isolates were resistant to ampicillin. Moreover, oxacillin-resistant Staphylococcus and ampicillin-resistant group B streptococci strains occurred in the second periods as late-onset neonatal bacterial meningitis. The overall mortality rates for the first and second study period were 17% and 8%, respectively. However, if individuals with poor outcomes were taken into account, 38% of patients were considered treatment failures. Significant prognostic factors included the presence of seizures, thrombocytopenia, and high cerebrospinal fluid protein and low cerebrospinal fluid glucose concentration. Although the mortality rate was significantly reduced in the second period, there has been increasing incidence of the emergence of resistant strains presenting a therapeutic challenge. The presentation in neonatal bacterial meningitis might be nonspecific, and blood culture results were negative in 45% of the episodes. Early diagnosis, choice of appropriate antibiotics, and correction of metabolic derangement are essential to improving outcomes. Chang C-J, Chang W-N, Huang L-T, Huang S-C, Chang Y-C, Hung P-L, Tasi C-Y, Lu C-H, Cheng B-C, Lee P-Y, Chang H-W. Neonatal bacterial meningitis in southern Taiwan. [Copyright &y& Elsevier]