Is the Mortality Trend of Ischemic Heart Disease by the GBD2013 Study in China Real? / 生物医学与环境科学（英文）

To determine the reason for the different mortality trends of ischemic heart disease (IHD) for China between Global Burden of Disease (GBD) 2010 and GBD2013, and to improve garbage code (GC) redistribution. All data were obtained from the disease surveillance points system, and two proportions for assigning chronic pulmonary heart disease (PHD) as GC to IHD were from GBD2010 and GBD2013, which were different for years before 2004. By using the GBD2013 approach, the age-standard mortality rate (ASMR) increased by 100.21% in 1991, 44.81% in 1996, and 42.47% in 2000 in comparison with the GBD2010 approach. The different methods of chronic PHD redistribution impacted the trend of IHD mortality, which elevated it in the earlier 1990s by using the GBD2013 approach. Thus, improving the redistribution of GC as a key step in mortality statistics is important.

Spatial distribution of liver cancer incidence in shenqiu county, henan province, china: a spatial analysis / 生物医学与环境科学（英文）

Liver cancer is a common and leading cause of cancer death in China. We used the cancer registry data collected from 2009 to 2011 to describe the spatial distribution of liver cancer incidence at village level in Shengqiu county, Henan province, China. Spatial autocorrelation analysis was employed to detect significant differences from a random spatial distribution of liver cancer incidence. Spatial scan statistics were used to detect and evaluate the clusters of liver cancer cases. Spatial clusters were mapped using ArcGIS 10.0 software in order to identify their physical location at village level. High cluster areas of liver cancer incidence were observed in 26 villages of 7 towns and low cluster areas were observed in 16 villages of 4 towns. High cluster areas of liver cancer incidence were distributed along the Sha Ying River which is the largest of tributary of the Huai River. Role of water pollution in Shenqiu County where the high cluster was found deserves further investigation.

Histological subtypes of lung cancer in Chinese males from 2000 to 2012 / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To characterize the histological and epidemiological features of male lung cancer patients in China.</p><p><b>METHODS</b>The demographic and histological information about male lung cancer patients identified from 2000-01-01 to 2012-12-31, was collected from the Cancer Hospital of the Chinese Academy of Medical Sciences. Relative frequencies (RF) were estimated for major histological subtypes and compared according to the years of diagnosis and birth.</p><p><b>RESULTS</b>The RF of adenocarcinoma (ADC) increased from 21.96% to 43.36% and the RF of squamous cell carcinoma (SCC) decreased from 39.11% to 32.23% from 2000 to 2012 in the 15 427 male lung cancer patients included in this study (Z=17.909, P<0.0001; Z=-6.117, P<0.0001). The RF of ADC increased from 28.72% in 2000-2004, 36.88% in 2005-2008 to 48.61% in 2009-2012 in patients born after 1960. The age-adjusted RF of ADC in 2007-2012 increased consistently in all the investigated areas.</p><p><b>CONCLUSION</b>The increased RF of ADC in male lung cancer patients highlights the need for further investigation of the etiologic factors of these tumors. Smoke-free policies rather than modifying tobacco products should be enforced.</p>

Assessment of the strength of tobacco control on creating smoke-free hospitals using principal components analysis / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the relationship between the strength of tobacco control and the effectiveness of creating smoke-free hospital, and summarize the main factors that affect the program of creating smoke-free hospitals.</p><p><b>METHODS</b>A total of 210 hospitals from 7 provinces/municipalities directly under the central government were enrolled in this study using stratified random sampling method. Principle component analysis and regression analysis were conducted to analyze the strength of tobacco control and the effectiveness of creating smoke-free hospitals.</p><p><b>RESULTS</b>Two principal components were extracted in the strength of tobacco control index, which respectively reflected the tobacco control policies and efforts, and the willingness and leadership of hospital managers regarding tobacco control. The regression analysis indicated that only the first principal component was significantly correlated with the progression in creating smoke-free hospital (P<0.001), i.e. hospitals with higher scores on the first principal component had better achievements in smoke-free environment creation.</p><p><b>CONCLUSIONS</b>Tobacco control policies and efforts are critical in creating smoke-free hospitals. The principal component analysis provides a comprehensive and objective tool for evaluating the creation of smoke-free hospitals.</p>

Cross-sectional survey on smoking and smoking cessation behaviors among Chinese adults in 2010 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To describe the prevalence of smoking and smoking cessation in Chinese adults in 2010.</p><p><b>METHODS</b>A face-to-face questionnaire survey was carried out in 162 surveillance points to collect information on non-communicable diseases related risk factors. Multi-stage stratified cluster random sampling method was used to select 98 712 individuals aged 18 and over to be interviewed and 98 526 records were included in the analysis of smoking and smoking cessation. Sample was weighted to represent the population of Chinese adults. Indicators such as current smoking and smoking cessation among different population were calculated.</p><p><b>RESULTS</b>Current smoking rate of our sample was 26.4% (26 047/98 526). With complex weighting, current smoking rate in Chinese adults aged 18 and above was 28.3% (95%CI: 27.2% - 29.4%), which is much higher among men (53.3%, 95%CI: 51.4% - 55.2%) than in women (2.5%, 95%CI: 1.9% - 3.0%) (P < 0.05). Most male current smokers (88.3%, 95%CI: 87.3% - 89.3%) smoked every day and average daily manufacture cigarettes consumption of male adults was (17.8 ± 9.3) cigarettes. Only 14.8% (95%CI: 13.8% - 15.8%) of male ever smokers quitted smoking and 10.7% (95%CI: 9.9% - 11.5%) quitted smoking. Only 38.8% (95%CI: 36.9% - 40.8%) of male current smokers intended to quit smoking. For current smokers aged from 18 to 24, proportion of those who intended to quit smoking was highest (50.5%, 95%CI: 46.1% - 54.8%), but proportion of those who quitted smoking (7.1%, 95%CI: 5.2% - 8.9%) was lowest comparing with other age groups (P < 0.05).</p><p><b>CONCLUSION</b>Prevalence of smoking in Chinese adults was high and only a few smokers quit smoking. Prevalence of smoking in Chinese male adults was still high. Fairly low proportion of male current smokers intend to quit smoking and even lower proportion of them quit smoking successfully.</p>

Body mass index and mortality from ischaemic heart disease in China:a 15-year prospective study on 220 000 adult men / 中华流行病学杂志

Objective To assess the relationship between body mass index (BMI) and ischaemic heart disease (IHD) mortality,especially in populations with low mean BMI levels.Methods We examined the data from a population-based,prospective cohort study of 220 000 Chinese men aged 40-79,who were enrolled in 1990-1991,and followed up ever since to 1/1/2006.Relative risks of the deaths from IHD by the baseline BMI were calculated,after controlling age,smoking,and the other potential confounding factors.Results The mean baseline BMI was 21.7 kg/m~2,and 2763 IHD deaths were recorded during the 15-year follow-up (6.8% of all deaths) program.Among men without prior vascular diseases at baseline,there was a J-shaped association between BMI and IHD mortality.When baseline BMI was above 20 kg/m~2,there was a strongly positive association of BMI with IHD risk,with each 5 kg/m~2 higher in BMI associated with 21%(95%CI:9%-35%,P=0.0004) higher IHD mortality.Below this BMI range,the association appeared to be reverse,with the risk ratios as 1.00,1.11,and 1.14,respectively,for men with BMI 20-21.9,18-19.9,and ＜ 18 kg/m~2.The excess IHD risk observed at low BMI levels persisted after restricting analysis to never smokers or excluding the first 3 years of follow-up.Conclusion Lower BMI was associated with lower IHD risk among people in the so-called 'normal range' of BMI values (20-25 kg/m~2).However,below that range,the association might well be reversed.

Geographical distribution of cancer mortality in China, 2004-2005 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To describe geographical distribution and its transition of mortality of cancers in China.</p><p><b>METHODS</b>The information of 2 513 949 310 person years were collected in 1973-1975 and 142 660 482 person years in 2004-2005 respectively. Being standardizing the death rates of these two survey with 2000 national census population, the changes of mortality of main cancers was observed and the geographic distribution of cancers in 2004-2005 was analyzed.</p><p><b>RESULTS</b>A total of 1 865 445 cancer deaths were collected in 1973-1975, the standardized death rate was 99.61/100 000, and 193 839 cancer deaths were collected in 2004-2005, the standardized death rate was 123.72/100 000, with growth of 24.20%. District mortality analysis showed that the provincial standardized cancer death rates varied greatly, with the highest in Heilongjiang (7443 cases, 183.34/100 000), and the lowest in Yunnan (2454 cases, 61.03/100 000). The highest standardized death rate of esophageal cancer, gastric cancer, liver cancer, colon cancer, lung cancer, nasopharyngeal cancer, leukemia, female breast cancer, cervical cancer was in Henan (3535 cases, 32.95/100 000), Gansu (1333 cases, 59.35/100 000), Heilongjiang (1640 cases, 38.63/100 000), Shanghai (390 cases, 11.58/100 000), Heilongjiang (2382 cases, 60.15/100 000), Hainan (36 cases, 7.04/100 000), Tianjin (161 cases, 5.45/100 000), Heilongjiang (179 cases, 8.09/100 000), Xinjiang (131 cases, 10.69/100 000) respectively; the lowest standardized cancer death rate of above-mentioned cancers was in Yunnan (63 cases, 1.59/100 000), Beijing (235 cases, 5.95/100 000), Tianjin (454 cases, 10.86/100 000), Tibet (3 cases, 0.82/100 000), Tibet (12 cases, 3.29/100 000), Qinghai (0 case, 0.00/100 000), Tibet (1 cases, 0.28/100 000), Tibet (6 cases, 2.88/100 000), Chongqing (27 cases, 1.02/100 000) respectively.</p><p><b>CONCLUSION</b>Comparing the two surveys, the standardized mortality of cancers was increased. Most of cancers occurred obviously in cluster by geographical distribution.</p>

Findings from 2010 Global Adult Tobacco Survey: implementation of MPOWER policy in China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To assess the implementation of five key tobacco control policies in China: protection from second-hand smoke (SHS); offering help to quit; health warnings regarding tobacco use; the enforcement of bans on tobacco advertising, promotion, and sponsorship; and increasing tobacco taxes and prices.</p><p><b>METHODS</b>Using 2010 Global Adults Tobacco Survey in China (GATS-China), 10 indicators are used to assess the implementation of five key tobacco control policies of MPOWER in China.</p><p><b>RESULTS</b>Overall, 63.3% and 72.7% of adults noticed people smoking indoor workplaces and public places, respectively. Approximately 60% of smokers were not asked about their smoking habits and approximately 67% were not advised to quit on their visit to a health worker. Sixty percent of adults noticed health warning messages on cigarette packaging and in the media in the last 30 days, 63.6% stated that they would not consider quitting. Twenty percent of respondents noticed tobacco advertising, promotion, and/or sponsorship activities in the 30 days prior to the survey. Among them, 76.3% noticed the direct advertising and 50% noticed from TV programs. Although purchasing price of one pack of cigarettes ranged from 1 to 200 RMB, 50% of current smokers (about 150 million) spent 5 RMB or less on one pack of cigarette. The expenditure on 100 packets of cigarettes represents 2% of 2009 GDP per capita.</p><p><b>CONCLUSION</b>The average score for the implementation of the 5 policies of MPOWER in China is 37.3 points, indicating tobacco control policies in China is poor and there is a large gaps from the FCTC requirements.</p>

Population-based survey of secondhand smoke exposure in China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To determine the extent of secondhand smoke exposure in China, and to explore the potential associated factors.</p><p><b>METHODS</b>This study was a nationally representative household survey examining secondhand smoke exposure of non-institutionalized men and women aged 15 and older using a global standardized geographically clustered sample design. A total of 13,354 people completed the individual questionnaire with questions on gender, age, educational level, residence, profession, potential factors associated with secondhand smoke exposure, and workplace smoking policy. The data were used to determine whole population estimates of secondhand smoke exposure.</p><p><b>RESULTS</b>Among non-smokers aged 15 years and older, it was estimated that 72.4% (556 million) were exposed to secondhand smoke, with 52.5% (292 million) exposed to secondhand smoke daily. The prevalence of secondhand smoke exposure was 74.1% for men, 71.6% for women, 70.5% for urban populations, and 74.2% for rural populations. The rates were 67.3%, 63.3%, and 72.7% respectively, within the household, indoor workplaces and public places. Secondhand smoke exposure was significantly reduced in workplaces with a smoking ban but not in workplaces with a partial smoking ban.</p><p><b>CONCLUSION</b>Although China has made some progress toward a smoke-free environment there remains a high degree of exposure to secondhand smoke.</p>

Awareness of tobacco-related health hazards among adults in China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To determine the level of awareness of the hazards of tobacco smoking and secondhand smoke inhalation among adults in China.</p><p><b>METHODS</b>Household surveys were conducted with a total of 13,354 respondents aged 15 years or over from 100 counties of 28 Chinese provinces using a stratified multi-stage geographically clustered sample design.</p><p><b>RESULTS</b>The findings revealed that 81.8% of the population was aware that smoking causes serious diseases, and 27.2% and 38.7% were aware that smoking causes stroke and heart attack, respectively. Only 64.3% of respondents were aware that secondhand smoke can cause serious diseases, and 27.5%, 51.0%, and 52.6% were aware that secondhand smoke causes heart disease in adults, lung disease in children and lung cancer in adults, respectively. Awareness regarding smoking-related hazards across all participants was significantly associated with several factors, including gender, smoking status, urban/rural residency, education level and exposure to tobacco control publicity in the last 30 days. Awareness regarding tobacco-related hazards in smokers was significantly associated with urban/rural residency, education level, exposure to tobacco control publicity in the last 30 days, and physician's advice. Awareness relating to the hazards of inhaling secondhand smoke was associated with smoking status, urban/rural residency, age, education level, and exposure to tobacco control publicity in the last 30 days. Medical professionals were found to know more about the health hazards of tobacco compared with people in other types of employment.</p><p><b>CONCLUSIONS</b>Overall awareness of the health hazards of tobacco has improved in the last 15 years in China, but is still relatively poor. Improved means of communicating information and more effective warning labels on cigarette packaging are necessary for increasing public awareness of tobacco hazards, particularly among rural residents and people with less education.</p>

What is the prevalence of smoking in China / 中华流行病学杂志

Objective To determine the accuracy of prevalence data sets on tobacco use so as to measure the risk of tobacco use and the impact of tobacco control in China.Methods Three published data sets on nation-wide survey were reviewed,and compared.Two principles were applied to determine the accuracy of the data on prevalence: ) The estimated consumption of cigarettes based on the currentprevalence rate on smokers should have been close to the actual cigarette consumption level; ii) change on the annual prevalence of male current smokers should be around 1% in China,since the international experience on the prevalence of current smokers tended to decrease at a rate of around 1% per year in the presence of comprehensive tobacco control strategies.Results The differences between the estimated cigarette consumption and the actual cigarette consumption for the three surveys were 51.07 billion through Behavior Risk Factor Surveillance System (BRFSS 2002),62.94 billion through the Chinese Citizen Nutrition & Health Survey (CCNHS 2002),and 217.11 billion through the China Health Service Survey (CHSS 2003).In comparison with the national tobacco use survey in 1996,the prevalence of male current smokers apparently dropped by 0.9% in BRFSS 2002,2.2% in CCNHS 2002 and 2.0% per year in CHSS 2003.Thus,the prevalence of current smokers in BRFSS (2002) was more reliable,comparing to the results from the other two surveys.Conclusion The prevalence of current smokers as determined by the BRFSS should be used to reflect the epidemic of tobacco use when implementing the FCTC in China.However,the reporting prevalence rates of tobacco use were different in the different surveys regarding tobacco use,suggesting that the capacity of surveillance on tobacco control should be strengthened,including the standardization of definitions on 'ever-smoker' and 'current smoker',as well as on standardized questionnaire,sampling strategy and the process of data analysis,quality of field work etc.Precise estimation of prevalence appears to be the key point for understanding how many current smokers so as to develop control policy,including setting up 'quit' clinics and evaluating the impact of tobacco control programs.There is an urgent need to establish a national standardized surveillance system to monitor the tobacco epidemics.

Using general growth balance method and synthetic extinct generations methods to evaluate the underreporting of death at disease surveillance points from 1991 to 1998 / 中华流行病学杂志

methods had some limitations. There was big difference between the results when using SEG and GGB, suggesting that we should try to combine GGB and SEG methods to get the better results.

Factors associated with attitudes toward tobacco control policy in public places among adults in three counties of China / 中华流行病学杂志

Objective To investigate the attitudes of urban and rural community members toward total banning on smoking in public places and to explore the factors associated with these attitudes, in three counties/cities in China. Methods A cross-sectional study was conducted in three counties/cities in 2004, including Xin' an county of Henan province, Anyi county of Jiangxi province, and Mianzhu city of Sichuan province. A total of 5642 residents at age of 18-69 years old were interviewed face-to-face with a uniform questionnaire by locally-trained interviewers, through a random three-stage stratified sampling in each county. Factors were assumed to be associated with attitudes, using chi-square test in univariate analysis and non-conditional logistic regression model in multivariate analysis. Results The prevalence of current smoking among respondents was 44.3%. 80.7% (1379/1709) of the current smokers reported smoking often or sometimes in public places. Only 9.6% (479/4983) of the respondents reported that their indoor workplaces had totally banned on smoking. 43.5% of the respondents supported a total smoking ban strategy in pubic venues. The results of multivariate logistic regression model showed that eight factors were significantly associated with support for the total smoking ban in public places included region, residency, age, gender, education, smoking status, awareness about passive smoking hazards, and hearing of any message on tobacco control through media differences of rates regarding the factors as: residents in urban to rural areas (OR=1.29), elderly to youngsters (30-49 vs. 18-29, OR=1.46; 50-69 vs. 18-29, OR=1.71), female to male(OR=1.27), high-educated to less-educated ones, quitters to current smokers (OR=1.90), nonsmokers to current smokers (OR=2.01). Those who know messages on health hazards of passive smoking (OR=2.26), or heard of message on tobacco control through media (OR= 1.43). Conclusion Results from our study revealed that a thorough smoke-flee policy in public places should be developed and implemented in these three counties/cities.

The current status of passive smoking in Chinese families and associated factors / 中华预防医学杂志

<p><b>OBJECTIVE</b>To understand the prevalence of passive smoking in Chinese families and discuss its associated factors, as to providing scientific evidence for establishing tobacco control measures in China.</p><p><b>METHOD</b>Cross-sectional survey: from June to September, 2004, we randomly selected six counties in three different provinces ( Mianzhu and Xichong of Sichuan Province; Anyi and Hukou of Jiangxi Province; Xinan and Yanshi of Henan Province) and performed face-to-face questionnaire survey on citizens between 18 and 69 years old. All the data were double independently input by professional data entry company to ensure data accuracy. The prevalence of home passive smoking exposure in families with different demographic characteristics was described by using prevalence, and the possible correlated factors of home passive smoking exposure as independent variables, multiple factors were analyzed using Logistic Stepwise Regression Analysis method.</p><p><b>RESULTS</b>The analysis on 8142 nonsmokers revealed that the rate of passive smoking was 28.42%, with 27.38% of male and 28.93% of female suffering from passive smoking. All 87.19% of the smokers would smoke in front of their families. As many as 42.14% of the nonsmokers would offer cigarettes to their guests, while about 46.82% of the nonsmokers would suggest smokers to smoke outdoor. Home restriction on tobacco was extremely rare and only 6.33% of all the families completely forbade smoking. Multivariate logistic regression analysis of non-conditions revealed that, there was a lower level of involuntary tobacco smoke exposure in female, older age group, lower education level, divorced, or widowed families. There was no difference in involuntary tobacco smoke exposure between town dwellers and county dwellers, but such difference did exist in different districts.</p><p><b>CONCLUSION</b>The three provinces under investigation should have severe involuntary tobacco smoking exposure. Gender, age, literacy level, occupation and region should be all factors that influence the status of involuntary tobacco smoking exposure in different families. There is a high percentile that smokers would smoke in front of their families and kids and a relative low pressure against smoking from nonsmokers. Cigarette offering is very prevalence. The knowledge and attitude about passive smoking should be separated from the situation of passive smoking exposure.</p>

Validity of diagnostic evidence for deceased cases in hospitals / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To determine the validity of the diagnostic evidence for deceased cases in hospitals.</p><p><b>METHODS</b>All information collected from medical records of the deceased cases in tertiary care health facilities was input into our database. Four diagnosis levels were determined based on level of diagnostic evidence: level I was based on autopsy, pathology or operative exploration, level II on physical and laboratory tests plus expert clinical judgment, level III on expert clinical judgment, level IV on postmortem assumptions. After the diagnostic evidence of each deceased case was reviewed by a panel of three experts, the diagnostic level of each diagnosis was determined.</p><p><b>RESULTS</b>Among the 2102 medical cases for verbal autopsy study, only 26 (1.24%) afforded diagnostic evidence for level III. Among the level III evidence-based cases of death, the major causes of death were cardiovascular diseases, respiratory diseases, and gastroenterological diseases. According to some special symptoms and medical histories, these cases could be diagnosed by comprehensive clinical judgment. Only one case met the criteria for level IV.</p><p><b>CONCLUSION</b>Level I diagnostic evidence is hard to attain in China because of the traditional concept and economic restriction. The causes for 2101 deaths can be validated by level II or III diagnostic evidence.</p>

Exploring barriers to implementation of smoking policies: a qualitative study on health professionals from three county-level hospitals / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>This study was to identify factors limiting the implementation of smoking policies in county-level hospitals.</p><p><b>METHODS</b>We conducted qualitative interviews (17 focus groups discussions and 6 one-to-one in depth interviews) involving 103 health professionals from three target county-level hospitals. A combination of purposive and convenience sampling was used to recruit subjects and gain a broad range of perspectives on issues emerging from ongoing data-analysis until data saturation occurred. The transcripts were analyzed for themes and key points.</p><p><b>RESULTS</b>The main themes that emerged suggested that both smokers and non-smokers viewed smoking very negatively. However, it was clear that, underlying this acceptance of the health risks of smoking, there was a wide range of beliefs. Most of the health professionals pointed out that, as smoking was legal, addictive, and influenced by social norms, currently it was almost unrealistic to expect all smokers to give up smoking or not to smoke in the hospitals. Furthermore, they were concerned about the potentially detrimental effects of providing counseling advice to all smokers on the interpersonal relationship among colleagues or between doctors and patients. In addition, low level of employee participation influenced the sustainable implementation of smoking policies.</p><p><b>CONCLUSIONS</b>Simply being aware of the health risks about smoking did not necessarily result in successful implementation of the smoking policies. Application of comprehensive intervention strategies such as implementing smoking policies in public places at the county level, creating supportive environments, promoting community participation, and conducting health education, may be more effective.</p>

Study on the evaluation of underreporting and the quality of death cases reporting system, from medical institutions at county level and above, in 2005 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the underreporting on death cases through web-based reporting system from medical institutions at county level and above as well as to evaluate the quality of death cases reporting through the system.</p><p><b>METHODS</b>A large-scale survey was conducted at 130 medical institutions based on stratified random sampling and to evaluate the underreporting and the quality of death cases reporting from medical institutions through data from survey and reporting system.</p><p><b>RESULTS</b>In 2005, the total reporting rates were 78.25% at the county level and 37.93% at the institutes. Comparing with the results of 2004, these rates were going down slightly. The eligibility rate of reporting was 79.62%, increased when comparing with results of 2004. The percentage of obvious coding errors among deaths reported by county level and above medical institutions was 24.68%. A total of 5226 death cases were recorded from medical (outpatient and inpatient) sources. An average underreporting rate of 33.07% was found at the selected medical institutions. Statistical difference of underreporting rate was not found at medical institutions at different levels.</p><p><b>CONCLUSION</b>Since the initiation of the web-based reporting system of death cases at medical institutes from county level and above, the timeliness of data reporting had been increasing remarkably. The system showed irreplaceable advantages. However, there still existed some problems such as the underreporting of death cases,the poor timeliness of reporting, and the poor accuracy of coding. In the meantime, it was noticed that repetitive work existed among medical institutions due to multi-systems, suggesting that it was necessary to establish a national life registration in China.</p>

Conceptual model for automatic early warning information system of infectious diseases based on internet reporting surveillance system / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To establish a conceptual model of automatic early warning of infectious diseases based on internet reporting surveillance system, with a view to realizing an automated warning system on a daily basis and timely identifying potential outbreaks of infectious diseases.</p><p><b>METHODS</b>The statistic conceptual model was established using historic surveillance data with movable percentile method.</p><p><b>RESULTS</b>Based on the infectious disease surveillance information platform, the conceptual model for early warning was established. The parameter, threshold, and revised sensitivity and specificity of early warning value were changed to realize dynamic alert of infectious diseases on a daily basis.</p><p><b>CONCLUSION</b>The instructive conceptual model of dynamic alert can be used as a validating tool in institutions of infectious disease surveillance in different districts.</p>

Passive smoking in China: contributing factors and areas for future interventions / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To reduce tobacco consumption and exposure to passive smoking in China.</p><p><b>METHODS</b>Discussion consisting of 80 focus groups and 35 interviews were held in three rural intervention counties of Jiangxi, Henan, and Sichuan Provinces. Participants came from hospitals, schools, rural areas, and urban areas.</p><p><b>RESULTS</b>Tobacco use and exposure to passive smoking were widely prevalent in the investigated schools, hospitals, county towns, and rural areas. Knowledge of the risks for passive smoking on health is lacking, especially in rural areas. Barriers to the control of tobacco use in public places include reluctance of administrators to implement tobacco control policies, lack of consistent policies, difficulties with regulations and enforcement, and reluctance of non-smokers to exercise their right to clean air.</p><p><b>CONCLUSION</b>To curb the current tobacco epidemic in China, tobacco control efforts must focus on reducing exposure to passive smoking. A strategy should be formulated to reduce the factors that contribute to tobacco use and exposure to passive smoking.</p>

Study on the quality of death-case-reporting-system in county and above levels' medical institutions in 2004 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the quality of reporting network system on death cases among county and above levels' medical institutions.</p><p><b>METHODS</b>Data on variables related to county reporting rate, unit reporting rate, timeliness of reporting, eligibility rate of reporting, auditing rate, timeliness of auditing, eligibility rate of auditing, percentage of reporting deaths of medical institutes to deaths among total population, percentage of reporting deaths of county and above levels' medical institutes to deaths among estimated deaths at these institutes were collected and distribution of common coding errors was applied to the assessment of reporting deaths.</p><p><b>RESULTS</b>The total reporting rates were: 82.58% at the county level, 42.79% at the units with auditing rate as 96.96%. The eligibility rate of reporting was 69.10% with eligibility rate of auditing as 73.58%. The percentage of reporting deaths from medical institutes to deaths among total population was 8.91%, and the percentage of reporting deaths of county and above levels' medical institutes to deaths among estimated deaths of these institutes was 30.76%. The percentage of obvious coding errors among deaths reported by county and above levels' medical institutes was as high as 22.87%.</p><p><b>CONCLUSION</b>Network reporting system of death cases among county and above levels' medical institutes had remarkably increased the timeliness of data reporting system. Network reporting of data on death was the best opportunity to expand the coverage and to improve the quality of data reporting. Based on network reporting of death cases among county and above levels' medical institutes as well as deaths accrued at the communities should also be reported via this network in the eligible areas. The quality of coding on death causes among medical institutes were commonly poor, indicating that the training on ascertainment and coding of underlying death causes were quite essential.</p>