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Previous studies suggest that the implementation of universal precaution (UP) plays a role in reducing HIV stigma. In this study we investigate the efficacy of a stigma reduction intervention on UP compliance and explore whether UP compliance could potentially influence HIV stigma reduction in medical settings. A randomized controlled intervention trial was conducted in two provinces of China with 1760 healthcare service providers recruited from 40 county-level hospitals. Longitudinal analyses included data collection at baseline, 6-, and 12-month follow-up assessments. Using a hierarchical modeling approach, we estimated the intervention effect for each provider's UP compliance and its potential mediating role on HIV stigma with the bootstrapping method. A significant intervention effect on UP compliance was observed at both the 6- and 12-month follow-up assessments. The intervention effect on provider avoidance intent was partially mediated by the provider's own UP compliance at the two follow-up points. This study provides evidence that UP compliance should be part of HIV stigma reduction programs, especially in resource-restrained countries. Findings suggest that a protected work environment may be necessary but not sufficient to address HIV stigma in medical settings. [ABSTRACT FROM AUTHOR]

The diagnostic criteria of gestational diabetes mellitus has being changed continuously. Based on the hyperglycemia and adverse pregnancy outcome study, most international academic organizations including World Health Orgnization and Ministry Heath of China published new criteria, while there are still some arguments. After introduced the development of the diagnostic criteria and risk factors, the article presented the study of metformin in gestational diabetes the offspring followup and proposed to adopt comprehensive intervention to face the challenges to our clinical management in China [ABSTRACT FROM AUTHOR]

With a rising HIV/AIDS epidemic, it has become especially important for health service providers in China to understand and correctly adhere to universal precautions. Using qualitative interview data, perspectives from both health administrators and service providers working at all levels of China’s health care system were examined. Service providers admitted selective adherence and non-adherence to universal precautions in their daily medical practice, and gave their explanations for such behaviors. Lack of time to put on protective gear, gear’s interference with medical procedures, lack of administrative support, heavy workload in hospitals, inaccurate risk assessment, and beliefs that compliance with universal precautions is unnecessary, time consuming and costly were mentioned as reasons behind noncompliance. Effective universal precaution interventions need to target both administrators and providers, and address both structural barriers and individual attitudinal and behavioral factors. [ABSTRACT FROM AUTHOR]

Occupational stress is one of the major occupational health problems in industrialized countries. In Europe, the United States, Japan, and other countries, occupational stress has been included in the prevention and control of occupational hazards in the workplace. This problem has also become a major risk factor affecting the physical and mental health of the working population in China. Over the last three decades, China had carried out a lot of research on occupational stress and made significant progress, but there is still a big gap between China and industrialized countries in terms of theoretical research on occupational stress, development of measurement tools, research topics and methods, formulation of regulations and standards, and practice of prevention and control. Articles in this key issue report the research on the core scale of occupational stress measurement for the Chinese working population, the scale scoring norm of manufacturing and medical personnel, the research on the relationship between positive psychology variables, and occupational stress and its role in the relationship between occupational stress and health outcomes.

Objective: To evaluate the effect of comprehensive intervention combined with clinical preventive services and lifestyle adjustment on high-risk populations of cardiovascular disease. Methods: In 2015, 4 towns (streets) in Tongxiang City, of Zhejiang Province including Heshan Town, Longxiang Street, Wutong Street, and Fengming Street, were selected by using the typical sampling. The towns (streets) were allocated to the intervention group (Heshan Town and Longxiang Street) and the control group (Wutong Street and Fengming Street) by using the cluster random sampling. In each town (street), hypertension patients aged 50 to 74 years old who were taking community medicine management and with a 10-year cardiovascular disease risk ≥10% were recruited as subjects. There were 1 823 subjects in the intervention group and 1 883 in the control group. The intervention group was given a 1-year comprehensive intervention combining clinical preventive services and lifestyle adjustment, while the control group received routine chronic disease management. After the intervention, the final questionnaire investigation was conducted and health physical examination data were obtained. The death, acute coronary heart disease events and stroke incidence were the primary outcomes, and cardiovascular disease-related knowledge and behavior, clinical preventive services utilization, physical changes, blood fat index and 10-year cardiovascular disease risk were the secondary outcomes. The difference-in-difference model was used to evaluate the effects of interventions. Results: The age of subjects in the intervention and control group was (68.76±3.75) and (67.90±4.56) years old, respectively. After 1-year intervention, the incidence of mortality, acute coronary events and stroke in intervention group was 1.65% (30 cases), 0.27% (5 cases) and 2.69% (49 cases), respectively, which showed no statistical difference compared to the control group [1.33% (25 cases), 0.32% (6 cases) and 2.07% (39 cases)]. After adjusting for the age, gender, education, marital status, self-assessed family income level and situation of taking antihypertensive drugs, the difference-in-difference model showed that the body mass index and diastolic blood pressure in the intervention group decreased by 0.33 kg/m(2) and 1.49 mmHg (1 mmHg=0.133 kPa). Compared with the control group, daily vegetable consumption proportion, the awareness rates of aspirin, stains, salt intake, and oil intake increased by 4.76%, 26.22%, 29.56%, 10.80%, and 15.17%, respectively ( P< 0.05). Conclusion: After the 1-year comprehensive intervention, there was no significant change in primary outcomes among high-risk populations of cardiovascular disease. In secondary outcomes, body mass index and diastolic blood pressure declined and cardiovascular disease-related knowledge awareness increased.

Objective: To investigate control of an outbreak due to orthopedic infections caused by Enterobacteriaceae producing IMP carbapenemases., Methods: The sporadic orthopedic infections with Enterobacteriaceae producing carbapenemase (CPE) were retrospectively analyzed in a Chinese tertiary care hospital from November 2010 to September 2012., Results: The CPE were isolated from four distinct orthopedic patients, three patients infected with Enterobacter cloacae while the other with Klebsiella oxytoca. All strains were resistant to almost all the conventional antimicrobial. The strains produced IMP-4 type detected in the two early patients, while other strains could produce IMP-8 type. All of the four patients had ever undergoing invasive surgical procedure, and three of them were given fluoroquinolones for anti-infection treatment while the other patients was treated with meropenem. Ultimately, all patients were cured and discharged, without outbreak of nosocomial infection caused by CPE., Conclusion: Our study shows that strict infection control plays an important role in limiting dissemination of Enterobacteriaceae producing IMP carbapenemase. In addition, reasonable supporting treatment and disinfection protection seems to be more effective for the infection of strains., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

Objective: To evaluate the effect of comprehensive control and prevention for chronic diseases in demonstration plot of Chongqing., Methods: Residents were enrolled through multi-stage stratified random sampling method from 17 districts or counties which had successfully established demonstration plots and 21 districts or counties which had not established demonstration plots (non-demonstration plot for short) yet on May, 2012. Questionnaire was designed to survey awareness of health knowledge, health behaviors and utilization of health supportive tools. The results were analyzed by SPSS 15.0 software., Results: We investigated 15 108 residents, 6156 of which were in demonstration plot and others (8951) were not. The findings revealed the percentage of the people who were aware the national action of health lifestyle in demonstration plot and in non-demonstration plot were 44.4% (2734/6157) and 40.2% (3598/8951), respectively, and the awareness of the hypertension risk of too much sodium were 72.4% (4458/6156) and 67.5% (6042/8951), respectively, and the awareness of the cardinal vascular disease (CVD) risk of obesity and overweight were 77.2% (4753/6157) and 69.6% (6230/8951), respectively. About the residents' health behaviors in demonstration plot and in non-demonstration plot, the utilization rates of salt restriction scoop or pot were 23.5% (1447/6157) and 17.9% (1602/8951), and the utilization rates of oil restriction pot were 16.7% (1028/6157) and 11.8% (1064/8951), respectively. Totally, 33 of the 37 indexes were shown higher in demonstration plot than that in non-demonstration plot (P < 0.05)., Conclusion: The chronic diseases comprehensive control and prevention in demonstration plot was more effective, and the remarkable improvement of health knowledge and behaviors level had been achieved in demonstration plot.

Objective: To compare infection control (IC) knowledge, attitudes and practice of dentists across eight countries., Methods: Self-administered infection control surveys were completed by 1,874 clinicians in eight countries. Practitioner's knowledge, attitudes, and practice of infection control were examined using over 100 variables. Chi-squared statistics (α = 0.05) were used to compare respondents from different national groups., Results: Immunizations rates varied significantly across the eight countries (p < 0.01) with Asian countries having a lower rate of immunization against HBV than the United States practitioners. Perceived risk of acquiring HIV varied significantly across the study groups (p < 0.01); China had the lowest portion (75%). Dentists in the US reported 92% surface barrier use; only 15% in China reported use. Only 58% of practitioners in Pakistan reportedly used disposable exam gloves; 97% of US practitioners regularly use these gloves. For all groups assessed, including the United States, little over 50% of practitioners understood and practiced Universal/Standard (UP/SP) precautions effectively., Conclusion: Analyses from this study suggest that the dental IC knowledge and practice varied widely across the eight countries of interest. Many of the countries were found to have barriers to access IC materials. Results indicate that all eight countries could use improved education standards for universal precautions., Clinical Significance: Knowledge, attitudes and practice of dental safety vary in different parts of the world. This study compares the compliance rates in dental safety among countries and pegs them to the level of practice in the United States. This study also provides evidence-based data on the needs in the regions surveyed and could be used to implement remedial educational measures in improving safe practices.

Aims: The study was to assess HIV/AIDS knowledge, attitudes and perceived vulnerability with potential factors., Background: HIV/AIDS is a public health catastrophe in China. Nurses are expected to care for nurture, comfort and advocate for all patients regardless of their condition. However, in the area of HIV/AIDS, nurses suffer as a result of expectations put on them by their professional roles., Design: This was a descriptive, cross-sectional design that used a survey approach., Method: Data were collected from Summer 2003-Winter 2004., Results: Nurses reported significant perceived severity of risk from occupational exposure. Many nurses were frequently exposed to being stuck by needles (86%) and being splashed by body fluids and more than half of them (59.7%) were concerned about contracting HIV/AIDS. Nurses who had experience of finger pricks worried about potentially contacting HIV and being unaware of it (odds ratio= 0.444, p = 0.004). Nurses demonstrated a lack of knowledge and training in infectious diseases which may be a result of the fact that the study location is not considered a 'concentrated area' for infectious disease transmission; therefore, the need for the infectious diseases training has not been considered urgent., Conclusions: A well-designed educational programme on occupational hazards and risk behaviour should be implemented to educate nurses in suburban cities and the general public. Hospital administrators should implement on-site continuing education on HIV/AIDS throughout China. Armed with better knowledge of both transmission routes and precautions, nurses can protect themselves while providing care to patients., Relevance to Clinical Practice: Nurses in China urgently need psychosocial and physical supports from families, friends, communities and their working environments while combating HIV epidemic. With good support system, nurses will better educate patients and their family members on how to prevent transmission not only of HIV/AIDS but of a wide range of other infectious diseases as well., (© 2010 Blackwell Publishing Ltd.)

Objective: To analyze the prevalence trend, prevalence characteristics and influence factors of Japanese B Encephalitis (JE) in Henan province., Methods: The data that of 64 401 JE patients in Henan from 1980 to 2008 were statistically analyzed by SPSS12.0 and EXCEL2003 software. Luoshan, Xinan, Xihua, Deng county and Hua county were chosen as monitoring sites. The mosquito specimens were gathered with the artificial hour method and the mosquito curtain method, the mosquito density was calculated one time each ten day period from May to July. At the same time, 30-40 newborn pig blood samples were gathered each ten-day period and the pig serum JE IgG antibody was detected by ELISA method., Results: The Cumulative incidence of JE was 64 401 cases in Henan province from 1998 to 2008, the range of incidence rate was from 0.34/100 000 (315/93 599 969) to 6.72/100 000 (5246/78 076 567); The average incidence of JE was 4.39/100 000 (3530/80 381 469) from 1980 to 1994; The average incidence of JE was 0.86/100 000 (811/94 217 549) from 1995 to 2008; In 2008, the incidence rate reached the lowest point for 0.34/100 000 (315/93 599 969); The incidence occurred mainly in July-September, accounting for 89.40% of the total cases (57 572/64 401); the patients were concentrated mainly in 5 cities, which were Xinyang, Nanyang, Zhumadian, Zhoukou, Luoyang, accounting for 81.02% (52 175/64 401). The 0 - 14 years old age group was the dominant group (79.01%, 50 884/64 401). In Luoyang city, incidence of >/= 15 years old group was significantly increased (57.83%, 2120/3666), the constitution of JE incidence were significantly different between 0 - 14 years old group and >/= 15 years old age group (chi(2) = 2705.32, P < 0.05) in Henan province and Luoyang city. The different density of the mosquitoes and the different positive-times for 50% of the antibodies of JE in piglets on the monitor sites showed the intensity of JE disease., Conclusion: The incidence of JE showed a decreasing trend, seasonal, regional characteristics and age distribution difference in Henan province. The monitoring of host animal pig JE antibody level and the medium mosquito density may forecast the JE prevalence tendency. To control the incidence in the younger groups in Henan province, older age group in Luoyang city and high-incidence areas, it is important to strengthen the monitoring and forecasting measures to prevent JE in Henan province.

Objectives: To compare knowledge, attitudes and practice of standard methods in infection control by dentists in eight countries using a standardised questionnaire., Methods: Self-administered questionnaires on dental infection control and safety (IC&S) knowledge, attitudes and practice were distributed to a convenience sample of dentists in India, Pakistan, Thailand, Philippines, Taiwan, China, South Korea and the United States of America., Results: Knowledge and practice of infection control among the Asian dentists lagged behind the levels of US dentists. Availability and affordability of equipment and materials were some of the reasons for the practice of infection control and safety. Attitude towards universal/standard precautions in controlling bloodborne pathogens was comparable between groups surveyed. Tested knowledge and practice of infection control was acceptable but the attitude and understanding of universal/standard precautions was ambiguous among both Asian and USA dental practitioners. Education in dental infection control should focus on improving the attitudes of practitioners towards universal precautions., Conclusions: Knowledge and practice of dental IC&S was high among the USA respondents. Immunisation and IC & S should be stressed in Asia. Information obtained through this study could be used to plan and implement policies in improving dental infection control and occupational safety in individual countries.

Objective: To investigate the sanitary working status in the districts for locating residents after earthquake in Dujiangyan municipality., Methods: Some immediate measures were taken after the earthquake including water source surveillance, restoring immunization system and epidemic surveillance. A questionnaire survey was also conducted to collect information in 107 locating districts of 18 towns., Results: Generally, the sanitary working status was good. Temporary sheds in most districts were Tents (75.70%, 81/107) and simple sheds (19.63%, 21/107), and 69.16% (74/107) districts could use water supply and 94.39% (101/107) arrange specialized persons to disinfect the environment and kill pests. The fly density was 2 per eye-view. The proportions for the correct responds to health knowledge, action adopted and attitude of residents were all above 90%. According to the epidemic surveillance system and mobile syndrome surveillance system in disaster area, there was no increasing trend for the incidences of contagious diseases., Conclusion: 20 days after earthquake, the whole situation of disease prevention in disaster area is stable.

Objective: To realize the epidemiological and drug-resistance characteristics of dysentery during 1990 to 2003 in Beijing., Methods: The group's characteristics of dysentery were described and analysed by using descriptive study method. Drug sensitivity tests were performed with Kirby-Bauer method recommended by WHO, and data were analyzed with SPSS statistic software., Results: Average incidence rate was 222.24 /100 000 and incidence rate was high in children and in urban areas. The period of high incidence was found in July 16 to August 3. The equation of index-curve forecast model was gained as Y = e (5.816-0.5845x. It showed some value in predicting the tendency of dysentery. Shigella was sensitive to quinolones and cephalosporins, and there was no significant differences between the middle and high grade in these two kinds of antibiotics., Conclusion: It should be taken as a measurement for the period of high incidence of dysentery.

Background: Although the human immunodeficiency virus (HIV) epidemic in China is expanding rapidly, the principles of universal precautions (UP) are not widely disseminated in Chinese hospitals. Lack of training about occupational prevention of bloodborne pathogens (BBP) may place student nurses at risk when they are in clinical practice., Aim: To examine the impact of structured training on prevention of occupational exposure to BBP on knowledge, behaviour, and incidence of medical sharp injuries among student nurses in Changsha, China., Methods: A quasi-experimental study evaluated changes in knowledge, self-reported UP behaviours, observed adherence to UP, and needle stick/sharp injuries during a 4-month follow-up period. The study population consisted of 106 student nurses in two classes. One class served as the experimental group, while the other served as a control group. Students in the experimental group participated in a structured training intervention consisting of lectures and demonstrations., Results: At 4 months, the group that received the BBP training scored significantly higher than the standard education group on both knowledge (P < 0.001) and behaviour (P = 0.002). Although students in the experimental group were not observed to practise UP significantly more frequently than those in the control group, they were less likely to experience needle stick/sharp injuries (OR = 0.29; 95% CI 0.11, 0.74; P = 0.004)., Conclusion: Structured training in prevention of occupational exposure to BBP improved knowledge and behaviour and reduced the number of needle stick/sharp injuries among Chinese student nurses, compared with students who did not receive the training. Training in the techniques of UP could play a role in reducing the risk for occupational exposure to BBP among Chinese future nurses. In view of the accelerating HIV epidemic, implementation and evaluation of such training programmes are urgently needed.

A study evaluated a training-of-trainers strategy to update HIV/AIDS knowledge and improve attitudes and behavior among health professionals and the public. A survey was carried out among health workers and villagers. An initial workshop was given to 55 staff from several health institutions. Trainees were provided limited funds to conduct secondary workshops at local levels. They were requested to diffuse knowledge to patients during routine health visits. A follow-up survey was conducted 18 months later in counties in which workshops were not held. Knowledge, attitudes, and behavior were compared both at the baseline and follow-up surveys, and before and after the intervention. Nearly 95% (94.8%, or 13,782) of health workers in Fuyang Prefecture were trained secondarily at local levels. Knowledge was significantly higher in intervention (88.5-99.8%) compared with nonintervention (37.4-53.7%) counties, and after intervention (22.2-66.6%), respectively (p < .01). Attitudes toward people with HIV/AIDS improved significantly in intervention counties. Condom use during last sexual intercourse increased from 11.0% to 33.5% in health workers (p < .01) and from 8.7% to 18.5% among villagers (p <.01). The strategy wascost effective for improving knowledge and attitudes and promoting condom use.

Purpose: To evaluate the effect of an educational training program for hospital nurses on universal precautions in Changsha, Hunan Province, People's Republic of China., Method: Using a quasi-experimental design, 50 of 100 randomly selected hospital nurses were randomly assigned to receive an educational intervention. Questionnaires were administered to the 100 nurses prior to and 4 months after the training., Findings: Knowledge, practice, and behaviors related to universal precautions and the prevalence of hepatitis B immunization improved among nurses in the group who received training. No significant change in the frequency of glove use was found. Underreporting of sharps injuries to hospital authorities continued in both groups., Conclusion: Although educational training significantly improved Chinese nurses' knowledge, practice, and behavior related to universal precautions, there remains room for improvement in glove use and needlestick injury reporting.

Objective: To study the changes of risk factors of cardiovascular disease in the rural community population after intervention., Methods: The Beijing Fangshan cardiovascular prevention program was a community-based comprehensive intervention study which was launched from 1991 and ended in 2000 in five communities including three as intervention communities (IC) and two as control communities (CC) in Fangshan, Beijing suburb. The intervention measures were focused on health education and hypertension control. The changes of risk factors of cardiovascular disease in IC and CC were analyzed using random sample in the year 1991, 1995 and 1999, respectively. The risk factors include systolic and diastolic blood pressure (SBP and DBP), body mass index(BMI), serum total cholesterol(TC), triglyceride(TG), high-density lipoprotein cholesterol(HDL), smoking, and drinking., Results: From the year 1991 to 1999, the risk factors of cardiovascular disease such as SBP, DBP, smoking rate and drinking rate were reduced in the population of IC. For male in IC, the decline of SBP, DBP, smoking rate, and drinking rate were 1.6 mmHg, 1.1 mmHg, 14.5% (P < 0.01) and 3.7%, respectively. For female of IC, SBP and DBP declined 4.8 mmHg (P < 0.01) and 3.2 mmHg (P < 0.01), respectively. SBP, DBP and smoking rate in the population of CC had a little reduction while BMI, TC and TG increased in both IC and CC. During the period of 1991 to 1999, most cardiovascular risk factors in the population of IC had net reduction compared to that of CC., Conclusions: Except for BMI and lipids, rural community intervention, as focused on health education and hypertension control, has resulted in the reduction of most risk factors of cardiovascular disease.