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Purpose: The objectives are to explore the prevalence of DNR orders, the factors influencing them, and the association between DNR signing and health care utilization among advanced cancer patients., Methods: This was a retrospective cohort study. Data from cancer decedents in three hospitals in China from January 2016 to December 2017 during their last hospitalization before death were obtained from the electronic medical records system., Results: In total, 427 cancer patients were included; 59.0% had a DNR order. Patients who had solid tumors, lived in urban areas, had more than one comorbidity, and had more than five symptoms were more likely to have DNR orders. The cut-off of the timing of obtaining a DNR order was 3 days, as determined by the median number of days from the signing of a DNR order to patient death. Patients with early DNR orders (more than 3 days before death) were less likely to be transferred to the intensive care unit and undergo cardiopulmonary resuscitation, tracheal intubation, and ventilation, while they were more likely to be given morphine and psychological support compared with those with late (within 3 days before death) and no orders., Conclusions: Advanced cancer patients with solid tumors living in urban areas with more symptoms and comorbidities are relatively more likely to have DNR orders. Early DNR orders are associated with less aggressive procedures and more comfort measures. However, these orders are always signed late. Future studies are needed to better understand the timing of DNR orders.

Background: The Chinese government is piloting canteen services for older adults, but few studies have explored the influence of canteen services on the health of these older adults. This study aimed to investigate the impact of canteen services on older adults' general mental health, nutritional status, satisfaction with life, and social capital in rural areas., Methods: This study used a cross-sectional design. We selected 14 villages in Jinhua City, Zhejiang Province, China, including seven villages with canteen services and seven villages without canteen services. Participants were 284 senior older adults (aged 75~98), including 140 residing in villages with canteen services (Canteen Group [CG]) and 144 residing in villages without canteen services (Non-Canteen Group [NCG]). We also divided the CG into two sub-groups according to the funding sources (one receiving government support only, the other receiving government support plus enterprise donations). We used a self-designed questionnaire, including sociodemographics, diet-related items (e.g., satisfaction with the meals, diet expenditure, self-evaluation of meal nutrition), and the four scales including the Chinese version of the 12-item General Health Questionnaire (GHQ-12), the Chinese version of the Mini Nutritional Assessment Short-Form (MNA-SF), the Satisfaction with Life Scale (SWLS), and the Social Capital Questionnaire (SCQ)., Results: The overall mental health, satisfaction with life, and social capital of the CG were better than the NCG (P <  0.05). The nutritional status of these two groups did not show a significant difference. Participants in the CG with financial support from local government and donations from an enterprise with a better dietary diversity exhibited a better nutritional status (P <  0.05); the average satisfaction with diet and self-evaluation of food nutrition of the CG were higher than the NCG (P < 0.05); the ratio of having a diet on time in the CG was higher than that of the NCG (P < 0.05)., Conclusion: The free canteen services provided by the government can improve older adults' satisfaction with life and diet, and mental health status and also enrich their social capital, but this still needs to be future evidenced. More financial support for canteen services is an essential component in promoting successful aging in China.

Background: Lymphedema is the most common complication after breast cancer treatment, but management of lymphedema remains a clinical challenge. Several studies have reported the beneficial effect of acupuncture for treating breast cancer-related lymphedema (BCRL). Our objective is to verify the effectiveness of warm acupuncture on BCRL and compare the effectiveness of a local distribution acupoint combination with a local-distal acupoint combination for BCRL., Methods: This is a study protocol for a multicenter, three-arm parallel, assessor blinded, randomized controlled trial. A total of 108 participants diagnosed as BCRL will be randomly allocated in equal proportions to a local distribution acupoint (LA) group, a local-distal acupoint (LDA) group, or a waiting-list (WL) group. The LA and LDA groups will receive 20 acupuncture treatment over 8 weeks with local distribution acupoint combination and local-distal acupoint combination, respectively. The WL group will receive acupuncture treatment after the study is concluded. The primary outcome is the mean change in inter-limb circumference difference from baseline to week 8. The secondary outcomes include volume measurement, skin hardness, common terminology criteria for adverse events 4.03 (edema limbs criteria), stages of lymphedema from the International Society of Lymphology, Disabilities of the Arm, Shoulder and Hand questionnaire, and the Medical Outcome Study 36-item Short-form Health Survey., Discussion: This study aims to provide data on warm acupuncture as an effective treatment for BCRL and at the same time compare the effectiveness of different acupoint combinations., Trial Registration: ClinicalTrials.gov: Identifier NCT03373474 . Registered on 14th December 2017.

Objective: This study aimed to investigate the association between auricular reflective points and the status of lower urinary tract symptoms (LUTS) among Chinese aging males., Methods: A total of 113 male participants, with 69 having LUTS (LUTS+ve) and 44 having no LUTS (LUTS-ve), were recruited for this case-control study. Ear diagnosis was conducted in three ways: inspection, electrical skin resistance measurement, and tenderness testing., Results: Quality of life was lower among the LUTS+ve cases than among the LUTS-ve cases. The tenderness and electrical conductivity of a number of auricular points, including the "angle of superior concha", the "urinary bladder", the "ureter", the "kidney", the "urethra", and the "internal genitals" were associated with LUTS in the Chinese aging males. In terms of electrical conductivity, the "angle of superior concha" on both ears exhibited the highest sensitivity among the other auricular points under testing. This auricular point also demonstrated considerable sensitivity, specificity, and positive/negative predictive values for both ears during the tenderness testing., Conclusions: Auricular diagnosis has a pre-diagnostic value and could be considered as a screening method for the aging population with relatively high LUTS risk.

Fatigue, rated by adolescents as the most distressing symptom experienced during cancer treatment, is essential to the successful clinical care of patients of every culture and nationality. Efforts to provide relief from such symptom, in any area of the world, have been hampered by the lack of reliable and valid instruments used to measure fatigue. Our aims were to examine the semantic, conceptual, and normative equivalence of the Chinese version of the Fatigue Scale-Adolescent (FS-A-C) to the original Fatigue Scale-Adolescent (FS-A) and to estimate the reliability and validity of the FS-A-C. We recruited 51 Taiwanese adolescents in various stages of different types of cancer in this cross-sectional study. Results indicated that the initial panel estimates of semantic, conceptual, and normative equivalence of the FS-A-C with the original instrument (FS-A) were positive. The FS-A-C had acceptable internal consistency (Cronbach alpha =.89) and moderate-to-high content validity (content validity index ranges from 87% to 100%). In addition, the FS-A-C achieved known-groups validity (anemic adolescents reporting higher fatigue than nonanemic adolescents do) and initial construct validity (a significant association between the FS-A-C and the Anxious/Depressed subscale). Its use in measuring the intensity of fatigue in adolescents is likely to yield accurate assessments of their fatigue that could prompt clinical efforts to relieve their fatigue-related distress.

This study aimed to investigate Chinese children's perceptions of self-competence and the coping strategies based on gender and weight status using the Terror Management Theory. A total of 331 Chinese children completed body mass index (BMI), Self-Perception Profile for Children, and Schoolagers' Coping Strategies Inventory. Mothers completed demographic information and the Family Assessment Device. Results indicated that better behavioral conduct competence contributed to better global self-worth in boys; in girls, better behavioral conduct competence and physical appearance competence contributed to better global self-worth. Higher BMI was related to lower athletic competency in boys and lower social competence in girls. Eating and drinking were reported as one of the most frequently used coping strategies by children, but the children felt that this strategy was not effective. Results of this study suggest that culture plays an important role in children's perceived self-competence and coping strategies. Health care providers and educators should incorporate assessment of self-competence and coping strategies into patient care and education.

A longitudinal study design was used to examine factors related to change of body mass index (BMI) over a 1-year period in 307 Chinese children, aged 7 and 8 years, in Taiwan. Standardized instruments were used to measure the children's food intake, physical activity/inactivity, and physical fitness, as well as maternal BMI. Results suggested that a high baseline BMI, poor aerobic capacity, and a high maternal BMI were significantly correlated with increased BMI at 12 months' follow-up. A higher baseline BMI, an overweight mother, increased television viewing and computer time, and poorer aerobic capacity were identified as predictors for weight gain in children (F=207.67; P<.001; adjusted R(2)=0.752). These findings suggest that health care providers need to include the family in children's health care visits and incorporate an assessment of maternal weight status and children's BMI status, activity levels, and aerobic capacity into patient care and education.

Four-day, non-brushing studies have been used successfully to demonstrate the anti-plaque efficacy of triclosan-containing dentifrices. The treatment effects observed are variable, likely due to differences in formulation, study design and measurement techniques. This randomized, double-blind crossover study was conducted to evaluate the anti-plaque efficacy of an experimental, multiple-benefit, triclosan-containing dentifrice versus two currently marketed sodium fluoride dentifrices in a four-day, lingual-brushing model on subjects in Beijing. People's Republic of China. Subjects brushed the lingual surfaces for 30 seconds, and before expectorating, swished the saliva/dentifrice slurry over the buccal surfaces for an additional 30 seconds. This procedure was repeated. Subjects performed their assigned brushing regimen twice daily for four days under supervision. On Day 5, plaque was measured using the Turesky Modification of the Quigley-Hein Plaque Index. There were highly significant treatment effects in favor of the experimental triclosan-containing dentifrice for whole mouth, buccal and lingual sites when compared to either of the sodium fluoride dentifrices (p < 0.0001).