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Background: The use of reproductive health (RH) services is important to promote RH. However, little is known about RH services in rural areas, especially in low- and middle-income countries. China is the most populous country in the world, and 40.4% of its population is rural. Our study determined the utilization of and factors associated with RH services in rural China. Methods: A cross-sectional study of 978 20- to 39-year-old women was performed in four villages of four cities in Hunan Province. A researcher-created structured questionnaire was used to collect the data. The data were entered into EpiData v3.0 and analysed using SPSS v18.0. Statistical significance was defined as a two-sided P-value of less than 0.05. Descriptive statistics were used to examine the socio-demographic factors and the use of RH services by the sample population. Chi-square tests were used to assess associations between categorical variables. Logistic regression analyses were performed to examine factors that correlated with the use of RH services. Results: The top three services used were antenatal examinations (90.2%), postpartum visits (73.0%) and free folic acid supplements (71.6%). Age, monthly household income, employment, spousal education level, and artificial abortion history were associated with RH service utilization (P < 0.05). The most desired RH service was cervical/breast cancer prevention services (58.9%). The most preferred method participants used to obtain information on RH services was the internet. Conclusions: The utilization rate for RH services in rural China needs improvement. Future efforts should target high-risk populations of women by providing them with RH-related information and cultivating positive attitudes towards RH services. Plain language summary: Reproductive health (RH) services are recognized worldwide as a cost-effective strategy to promote RH. However, little is known about RH services in rural areas, especially in low- and middle-income countries. China is the most populous country in the world, and 40.4% of its population is rural. Due to the implementation of China's universal two-child policy, women between 20 and 39 years old are likely to experience more RH problems related to childbirth. Our study investigated the utilization of and factors associated with RH services in rural China. The top three services used among the 978 participants were antenatal examinations (90.2%), postpartum visits (73.0%) and free folic acid supplements (71.6%). Age, monthly household income, employment, spousal education level, and artificial abortion history were associated with RH service utilization. The participants most desired services pertained to the prevention of cervical/breast cancer, and the most preferred methods used to obtain information related to RH services was the internet. In conclusion, the utilization of RH services requires improvement, and future efforts should target high-risk populations of women by providing them with RH-related information and cultivating positive attitudes towards RH services. [ABSTRACT FROM AUTHOR]

Aims: Evidence concerning the impact of ambient particulate matter (PM) on mental health is just emerging and inconsistent. Air pollution with high PM levels has been frequently reported in China, however, no Chinese study has determined the association between PM exposures and anxiety hospitalizations. We examined the potential association between PM concentrations and anxiety admissions in 26 Chinese cities from January 2014 to December 2015.Methods: A time-stratified case-crossover design was employed in the study. Anxiety hospitalizations were identified according to ICD-10 from the electronic hospitalization summary reports system in China. Conditional logistic regression was applied to estimate the relation between PM levels and anxiety admissions, stratified by age and sex.Results: Positive associations between PM2.5/PM10 and admitted anxiety cases were observed. PM2.5 had the largest effect estimate at lag 5 days, with a per 10 μg/m3 increase corresponding to a 0.63% (95% CI, 0.26-1.00) increase in anxiety admissions. PM10's largest effect estimate was observed at lag 3 days, increasing 0.37% (95% CI, 0.12-0.62) anxiety admissions per 10 μg/m3. Females were more sensitive to PM2.5/PM10 concentrations than males, however, the effect modification by age was not significant. A marginally significant distinction in anxiety hospitalizations was found in patients with and without CVDs when they were exposed to PM2.5.Conclusions: Our findings indicate that short-term exposure to increased concentrations of PM2.5/PM10 exacerbates risks of anxiety hospitalizations in 26 Chinese cities. We observed effect modification by sex, with significantly stronger associations in female patients. This study offers the promise that reducing PM air pollution could probably reduce the huge disease burden from anxiety disorders. [ABSTRACT FROM AUTHOR]