Study on Traditional Chinese Medicine Syndrome Characteristics of 1676 Heart Failure Inpatients： A Cross-Sectional Survey Based on Real-World Electronic Medical Record Information / 中医杂志

ObjectiveTo analyse the clinical characteristics of different traditional Chinese medicine （TCM） syndromes in patients with heart failure based on information from electronic medical record. MethodsA cross-sectional study was conducted to collect clinical data of all inpatients with heart failure in the Department of Cardiology， Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from January 1， 2019 to December 31， 2020. A database of clinical TCM data was established to explore the characteristics of clinical data of basic information， syndromes and syndrome element types， and biochemical indexes. The distribution of TCM syndromes and syndrome elements in heart failure patients were also analysed， and the basic information and biochemical indexes of the patients with top 7 different TCM syndrome types were compared. ResultsA total of 1676 inpatients with heart fai-lure were included. The top 7 TCM syndromes of heart failure were syndrome of phlegm turbidity and blood stasis （477 cases， 28.46%）， syndrome of qi deficiency and blood stasis （439 cases， 26.19%）， syndrome of qi deficiency and blood stasis with water retention （274 cases， 16.35%）， syndrome of yang deficiency with water retention （145 cases， 8.65%）， syndrome of qi and yin deficiency （104 cases， 6.21%）， syndrome of qi and yin deficiency with blood stasis （80 cases， 4.77%）， syndrome of heart yang deficiency （59 cases， 3.52%）. Among the 1676 patients， 6 syndrome elements accounted for more than 5%. Blood stasis accounted for the highest proportion of TCM syndrome element type （1292 cases， 77.09%）， followed by qi deficiency （919 cases， 54.83%）， phlegm （498 cases， 29.71%）， water retention （434 cases， 25.89%）， yang deficiency （215 cases， 12.82%） and yin deficiency （191 cases， 11.40%）. Among the 1676 patients， 1308 cases of acute heart failure mainly showed syndrome of phlegm turbidity and blood stasis （386 cases， 29.51%）， and 368 of chronic heart fai-lure mainly showed syndrome of qi deficiency and blood stasis （118 cases， 32.07%）. Patients with syndrome of phlegm turbidity and blood stasis had the shortest disease duration of 0.3 months， while those with syndrome of heart yang deficiency had the longest disease duration of 15 months. The proportion of syndrome of phlegm turbidity and blood stasis was the highest in patients with heart failure combined with coronary artery disease， the proportion of syndrome of qi deficiency and blood stasis with water retention was the highest in patients with heart failure combined with atrial fibrillation， and the proportion of patients with syndrome of qi deficiency and blood stasis with water retention and syndrome of yang deficiency with water retention in those applying diuretics during the hospital stay was the highest with more than 86%. The different 7 TCM syndromes showed statistically difference in patients with complications including coronary artery disease， old myocardial infarction， atrial fibrillation， pre and post-admission medication usage including intravenous vasodilators， cardiac stimulants， diuretics， and level of blood chloride， blood urea， blood creatinine， blood bicarbonate， blood albumin， and blood total bilirubin （P＜0.05）. ConclusionThe most common TCM syndromes in patients with heart failure are syndrome of phlegm turbidity and blood stasis and syndrome of qi deficiency and blood stasis. Different TCM syndromes have different characteristics in gender， disease complications， medication before and after admission， and blood indexes.

Analysis on the status quo and influencing factors of medication belief in patients with myasthenia gravis / 重庆医学

Objective To explore the status quo of medication belief in the patients with myasthenia gravis and analyze their influencing factors,so as to provide reference for health care professionals to develop targeted interventions.Methods A total of 145 patients with myasthenia gravis visiting the First Affiliated Hospital of Guangzhou University of Chinese Medicine from July 2021 to March 2022 were selected.The Be-liefs about Medicines Questionnaire(BMQ)was used to investigate.The multiple linear regression was used to analyze the relevant influencing factors.Results The scores of medication belief,necessity belief and con-cern belief in 145 patients were(4.17±1.23)points,(19.52±3.45)points and(18.29±4.26)points respec-tively.There was statistically significant difference between the scores of necessity belief and concern belief(P＜0.05).The education level,financial burden,duration of illness,length of medication,number of recur-rent hospitalizations,and inappropriate medication-induced exacerbations had influence on the medication be-lief scores of the patients with myasthenia gravis(P＜0.05).The duration of illness,length of medication and number of recurrent hospitalizations had the influence on the medication necessity scores of patients with my-asthenia gravis(P＜0.05).The financial burden had the influence on the medication concerns scores of the patients with myasthenia gravis(P＜0.05).Conclusion The medication belief in the patient swith myasthe-nia gravis is at a low level,and the number of recurrent hospitalizations and financial burden are the independ-ent risk factors affecting the medication belief scores in the patients with myasthenia gravis.The number of recurrent hospitalizations is an independent risk factor for the score of medication necessity dimension.

A cross-sectional survey on evidence-based nursing practice for pain assessment by nurses in China's class 3A hospitals / 重庆医学

Objective To explore the current situation of evidence-based nursing practice in pain assess-ment by nurses in China to provide the decision-making data for maximizing to relieve the patient pain by car-rying out the pain assessment evidence-based nursing practice.Methods The non-probability sampling meth-od was used to conduct an online anonymous survey in 63 class 3A hospitals in the whole country.The ques-tionnaire included the general information questionnaire and evidence-based nursing practice scale for pain as-sessment.The evidence-based nursing practice scale for pain assessment included the pain screening,compre-hensive pain assessment,exchange with the patients and their households in the pain assessment,pain re-as-sessment,pain assessment tool selection and record.The 5 dimensions were compared by using item equaliza-tion.The data analysis was performed by the SPSS26.0.Results A total of 1 518 questionnaires were recov-ered,in which 1 482 questionnaires were valid with an effective recovery rate of 97.62％.The evidence-based nurse practice of pain assessment by nurse was(108.40±17.96)points,the pain screening was(12.87±2.23)points,the item average score was the highest[(4.29±0.74)points],the communication with the patients and their household was(23.69±4.93)points and the item average score was the lowest[(3.94±0.82)points].The regression analysis showed that whether receiving the pain training and whether distinguishing active pain and resting pain had a positive effect on the practical behavior(P＜0.05).Conclusion The evi-dence-based nursing practice in pain assessment by nurses in the partial class 3A hospitals in China is in the upper medium level.However,the communication between the patients and their families is insufficient.Man-agers should constantly enrich the training content and methods,and guide nurses to strengthen the communi-cation between nurses and the patients.

Current status of health management (physical examination) service capacity of medical institutions in Tianjin / 中华健康管理学杂志

Objective:To investigate and analyze the current status of health management (physical examination) service capabilities of medical institutions in Tianjin in 2021.Methods:It was a cross-sectional study. Using the census method, a questionnaire survey was conducted to obtain the health management (physical examination) service capabilities of 86 medical institutions in Tianjin in 2021. The questionnaire covered the basic information of the institution, human resources and equipment, physical examination items carried out, the annual number of people receiving physical examination, the degree of informatization, and the completion of quality control indicators. In this survey, a total of 86 questionnaires were distributed and 86 valid questionnaires were collected (100%). Mann-Whitney U test and χ2 test were used to compare the differences of health management (physical examination) indicators between public and private medical institutions, and to analyze the current health management (physical examination) service capabilities of medical institutions in Tianjin. Results:Among the 86 medical institutions included in the analysis, 53 (61.6%) were public institutions and 33 (38.4%) were private medical institutions. In terms of basic information, the proportion of comprehensive hospitals and level-3 medical institutions belonging to public institutions, as well as the time of health management (physical examination) business development, were significantly higher than those of private medical institutions [62.3% vs 30.3%, 62.3% vs 0, 11 (7, 5) years vs 7 (5, 10) years], and the proportion of independent setup of the physical examination center and the business area of health management (physical examination) were significantly lower than those of private institutions[33.3% vs 98.1%, 1 011 (600, 1 000) m 2 vs 2 000 (1 395, 2 782) m 2] (all P<0.05). In terms of practitioners, there were 2 964 health management (physical examination) practitioners in Tianjin in 2021, aged 43 (35, 56) years. The proportion of male practitioners, part-time practitioners, nurses, practitioners with intermediate professional title, chief inspection physician, health management specialist in public institutions and the time engaged in health management work of employees were all significantly higher than those in private medical institutions [20.6% vs 17.5%, 20.7% vs 8.1%, 33.8% vs 23.4%, 40.7% vs 27.3%, 7.1% vs 3.9%, 13.8% vs 4.7%, 6 (3, 11) years vs 5 (3, 8) years] (all P<0.05). In terms of business development, the implementation rates of preventive medical management, mental health management, hypertension risk management, health management contract service, pulmonary nodule management, health management intervention plan, health risk assessment, and health education programs in public institutions were significantly higher than those in private medical institutions (24.5% vs 0, 28.3% vs 0, 35.8% vs 15.2%, 39.6% vs 15.2%, 41.5% vs 12.1%, 50.9% vs 18.2%, 66.0% vs 36.4%, 83.0% vs 42.4%), and the annual health physical examination person-times, group and individual physical examination person-times in public institutions were significantly lower than those in private institutions [18 625 (11 844, 27 998) to 38 384 (10 832, 46 927), 14 818 (8 803, 23 915) to 28 663 (4 982, 41 927), 2 179 (1 221, 3 588) to 5 784 (1 461, 12 156)] (all P<0.05). Among the six quality control indicators of health examination, the completion rates of waist-hip circumference measurement in both types of institutions were low (<40%). Conclusion:Compared with public institutions, the talent echelon construction and service capability of health management (physical examination) in private medical institutions in Tianjin still needs to be improved.

Lumbar puncture for neurosyphilis investigation in asymptomatic patients with HIV-syphilis coinfection: a cross-sectional study among infectious disease specialists

ABSTRACT BACKGROUND: Syphilis is a major public health issue worldwide. In people living with human immunodeficiency virus (PLHIV), there are higher incidences of both syphilis and neurosyphilis. The criteria for referring PLHIV with syphilis for lumbar puncture is controversial, and the diagnosis of neurosyphilis is challenging. OBJECTIVE: To describe the knowledge, attitudes, and practices of infectious disease specialists and residents in the context of care for asymptomatic HIV-syphilis coinfection using close-ended questions and case vignettes. DESIGN AND SETTING: Cross-sectional study conducted in three public health institutions in São Paulo (SP), Brazil. METHODS: In this cross-sectional study, we invited infectious disease specialists and residents at three academic healthcare institutions to answer a self-completion questionnaire available online or in paper form. RESULTS: Of 98 participants, only 23.5% provided answers that were in line with the current Brazilian recommendation. Most participants believed that the criteria for lumbar puncture should be extended for people living with HIV with low CD4+ cell counts (52.0%); in addition, participants also believed that late latent syphilis (29.6%) and Venereal Disease Research Laboratory (VDRL) titers ≥ 1:32 (22.4%) should be conditions for lumbar puncture in PLHIV with no neurologic symptoms. CONCLUSION: This study highlights heterogeneities in the clinical management of HIV-syphilis coinfection. Most infectious disease specialists still consider syphilis stage, VDRL titers and CD4+ cell counts as important parameters when deciding which patients need lumbar puncture for investigating neurosyphilis.

Syndrome Distribution and Characteristics of Endometriosis in 1 895 Cases / 中国实验方剂学杂志

ObjectiveTo explore the distribution and characteristics of traditional Chinese medicine （TCM） syndromes in patients with endometriosis （EMS）. MethodA cross-sectional survey was conducted to analyze the characteristics of TCM syndromes in 1 895 cases of EMS in hospitals of 19 provinces， autonomous regions， and municipalities. ResultAmong the 1 895 patients， Qistagnation and blood stasis syndrome accounted for the highest proportion， followed by Qi deficiency and blood stasis syndrome， cold coagulation and blood stasis syndrome， and kidney deficiency and blood stasis syndrome. The distribution of TCM syndrome types of patients with EMS in different regions， different treatment stages， and different disease types and with different therapeutic goals was different， and the differences were statistically significant. However， under different conditions， the Qi stagnation and blood stasis syndrome accounted for the highest proportion. Under the stratification of different regions， the cold coagulation and blood stasis syndrome in north China was relatively high， the kidney deficiency and blood stasis syndrome in south China was relatively high， and the combined phlegm and stasis syndrome was relatively high in southwest China. Different diagnosis and treatment goals corresponded to different clinical syndromes. With pelvic pain as the main manifestation， the proportion of cold coagulation and blood stasis syndrome was higher. The proportion of kidney deficiency and blood stasis syndrome was higher in married patients with infertility. Patients with the main diagnosis and treatment goals of controlling mass and inhibiting recurrence had a higher proportion of Qi deficiency and blood stasis syndrome. In different treatment stages， the proportion of Qi deficiency and blood stasis syndrome in postoperative patients and those with recurrent EMS was higher. Among different disease types， the Qi deficiency and blood stasis syndrome accounted for a higher proportion in patients with ovarian endometriosis （OEM）. The cold coagulation and blood stasis syndrome accounted for a higher proportion in patients with deep invasive endometriosis （DIE）. The kidney deficiency and blood stasis syndrome accounted for a higher proportion in patients with peritoneal EMS. There were significant differences in age， body mass index （BMI）， and course of disease among patients with different syndromes. Patients with Qi deficiency and blood stasis syndrome was relatively older， and their course of the disease was relatively long. Patients with combined phlegm and stasis syndrome had relatively high BMI. There was no significant difference in CA125 and CA199 levels among all syndrome types. ConclusionThe distribution of TCM syndromes of EMS has a certain regularity， and there are differences in regional distribution， therapeutic goals， treatment stages， and disease types（P<0.05）. However， the Qi stagnation and blood stasis syndrome accounts for a large proportion under different conditions， suggesting that Qi stagnation is the key link of EMS. In the early stage， the team took relieving depression and activating blood as the primary treatment， and created Huoxue Xiaoyi prescription， which was the core prescription for the treatment of EMS with Qi stagnation and blood stasis syndrome， achieving good clinical effect. At the same time， it is emphasized that EMS treatment should be integrated into the concept of chronic disease management and combined with health management. Through psychological counseling， cognitive behavior intervention， popular science lectures， and other methods， it is advised to adjust the emotion of patients with EMS， thereby increasing the curative effect. This study is expected to provide references for the clinical treatment of EMS.

Analysis of control status and related influencing factors of plaque in patients with periodontal disease / 新乡医学院学报

Objective To investigate the status of plaque control in patients with periodontal disease and its related in-fluencing factors.Methods A total of 350 periodontal disease patients admitted to the Hospital of Stomatological Xi'an Jiao-tong University from May 2018 to May 2022 were selected as the research subjects by the random sampling method.All patients underwent total supragingival oral prophylaxis.The total oral plaque assessment and detection,general oral examination,and a questionnaire survey on oral hygiene behavior will be conducted when patients came back for return visit at 7-10 days after operation.Single factor and multivariate logistic regression analysis were used to analyze the factors affecting the effectiveness of plaque control.Results A total of 350 questionnaires were distributed in this study,and 340 valid questionnaires(97.14％)were collected.The total plaque index of the patient was(68.42±16.93)％;the plaque index in maxillary was significantly lower than that in mandibular(P＜0.05);the plaque index in anterior tooth area was significantly lower than that in the poste-rior tooth area(P＜0.05);there was no significant difference in plaque index between the left and right halves of the mouth(P＞0.05);there was no significant difference in plaque index between zone 1 and zone 2(P＞0.05);there was no signifi-cant difference in plaque index between zone 3 and zone 4(P＞0.05);the plaque index in zone 3 and zone 4 was significantly higher than that in zone 1 and zone 2,respectively(P＜0.05).There was no significance difference in the plaque index be-tween distal and lingual surfaces(P＞0.05),while there was significance difference in the plaque index between the other dental surfaces(P＜0.05).The results of univariate analysis showed that there were significant difference in plaque index among patients with different genders,educational levels,disease severity,brushing duration,and brushing method(P＜0.05);the results of multivariate logistic regression analysis showed that the severity of the disease and brushing method were the factors affecting the plaque index(P＜0.05).Conclusion The overall control situation of plaque control in patients with periodontal disease is not ideal.The severity of the disease and the method of brushing teeth are factors affecting the effectiveness of plaque index control.Oral health education should be strengthened to promote plaque control in patients with periodontal disease.

Current situation and influencing factors of humanistic care satisfaction of Chinese patients / 中华医院管理杂志

Objective:To investigate the current situation and influencing factors of patients′ satisfaction with nursing humanistic care, and to provide reference for improving the quality of such care provided by hospitals.Methods:From July to August 2022, outpatients and inpatients in 30 provinces were selected by multi-stage stratified sampling as the survey objects. A cross-sectional survey was conducted on an online platform, using the general information questionnaire and Chinese version of methodist health care system nurse caring instrument revised by the research group. The latter instrument consists of 12 dimensions. namely care coordination, competence, teaching/learning, emotional support, respect for individuality, physical comfort, availability, helping/trusting relationship, patient/family engagement, physical environment, spiritual environment and outcomes. Descriptive analysis was performed on the data collected by the questionnaires, and independent sample t-test and one-way ANOVA were used to analyze the influencing factors of patient satisfaction. Results:A total of 107 hospitals were selected for questionnaire survey, including 86 tertiary hospitals and 21 secondary hospitals, and 29 108 valid questionnaires were recovered. The patient satisfaction with nursing humanistic care scored (5.40±0.86); the top three dimensions were competence (5.50±0.89), emotional support (5.47±0.88) and helping/trusting relationship (5.46±0.86); the lowest scoring dimensions were teaching/learning (5.38±1.01), spiritual environment (5.36±1.04) and patient/family engagement (5.11±1.28). Differences with gender, age, marital status, child status, educational level, occupation, place of residence, economic region, per capita monthly income of the family, type of medical insurance, medical department visited and surgery or not presented significant differences on the patient satisfaction with nursing humanistic care scores ( P<0.05). Conclusions:The satisfaction of patients with hospital′s nursing humanistic care in China was at the middle to upper level. In the future, health education for patients should be strengthened, and a mode of family-engaged nursing humanistic care should be constructed in line with the Chinese cultural background. In the process of nursing services, the particularity of patient groups should be considered to better meet their needs.

A Multicenter Cross-sectional Survey on the Clinical Characteristics of Patients of Ankylosing Spondylitis with Kidney Deficiency and Stasis Obstruction Syndrome and Damp-heat Stasis Obstruction Syndrome / 中医杂志

ObjectiveTo compare the differences in clinical characteristics between kidney deficiency and stasis obstruction syndrome and damp-heat stasis obstruction syndrome in patients with ankylosing spondylitis （AS）， thereby providing reference for clinical differentiation and treatment. MethodsThe clinical data of 2339 patients with AS were collected， including 1075 cases of kidney deficiency and stasis obstruction syndrome and 1264 cases of damp-heat stasis obstruction syndrome. The basic information including age， gender， course of disease， history of ophthalmia， family history and human leukocyte antigen B27 （HLA-B27） positive history， Bath ankylosing spondylitis disease activity index （BASDAI） score， Bath ankylosing spondylitis functional index （BASFI） score， Bath ankylosing spondylitis measurement index （BASMI） score， Depression Anxiety Stress Scale 21 （DASS-21） score， single symptom score in terms of spinal pain， peripheral joint pain， tendon tenderness， morning stiffness degree and morning stiffness time， patient-reported outcomes including patient global assessment （PGA） score， chronic disease therapy function-fatigue scale （FACIT-F） score and night pain visual analog scale （VAS） score， laboratory indicators including serum C-reactive protein （CRP） and erythrocyte sedimentation rate （ESR）， and CT grading of sacroiliitis were measured and compared between groups. ResultsPatients with kidney deficiency and stasis obstruction syndrome were older and had a longer course of disease （P＜0.01）. The BASDAI， BASFI and BASMI scores of the patients with kidney deficiency and stasis obstruction syndrome were 3.84±1.79， 2.78±2.00 and 3.42±2.36， respectively， while those in patients with damp-heat stasis obstruction syndrome were 4.30±1.99， 3.43±2.12， and 2.92±1.76. The BASDAI score， BASFI score， PGA score， FACIT-F score， spinal pain score， peripheral arthralgia score， tendon tenderness score， morning stiffness degree score， depression score， anxiety score， and stress score in patients with damp-heat stasis obstruction syndrome were all higher than those with kidney deficiency and stasis obstruction syndrome， with longer duration of morning stiffness and higher CRP （P＜0.05 or P＜0.01）. BASMI score and night pain VAS score were more higher in patients with kidney deficiency and stasis obstruction syndrome （P＜0.01）. There was no significant difference in the ESR level and CT grading of the sacroiliac joint between the two groups （P＞0.05）. ConclusionAS patients with kidney deficiency and stasis obstruction syndrome have poorer spinal mobility， while those with damp-heat stasis obstruction syndrome have higher disease activity， poorer physical function， and are more prone to adverse psychological reactions.

Ethanobotanical Diversity in Practices and Preparation of Punarnavadi Kwatha in Kerala Ayurveda

The Ayurvedic formulary has a long history of endogenous innovation. Its epistemic logic is best understood through the language of Oushadhayogam (polyherbal combination/ dosage forms). Punarnavadi kwatha (PUK) is an Ayurvedic polyherbal formulation, which is also known as Punarnavashtaka kwatha. It is generally used to treat diseases of respiratory system, bronchitis, liver diseases, hepatitis, joint inflammation, kidney stones, wounds, skin diseases, and gout. The present study intended to explore the Ethanobotanical diversity of Punarnavashtaka kwatha in Kerala Ayurveda market. Materials and Methods: Thorough search in classical Ayurvedic literature to collect data in PUK and cross-sectional survey to collect data of ingredients PUK used in Ayurveda industry. Results and Discussions: The ingredients of PUK along with botanical source of 5 Kerala Ayurveda manufactures were analysed and compared with AFI. The ingredients Punarnava, Nimba, Patola, Sunthi, Abhaya was common in all the manufactures. But marked variation in other ingredients were found in market samples of PUK when compared to AFI, except first sample. Conclusions: There are some ethanobotanical diversity in ingredient list of Punarnavadi kwatha (PUK) in Kerala Ayurveda market.

The current situation of the diagnosis of fibromyalgia syndrome / 中华风湿病学杂志

Objective:To investigate the currentstatus of the diagnosis of fibromyalgia syndrome (FMS), and analyze the related factors in order to improve the diagnostic level of the disease.Methods:A survey was carried out, A "FMS diagnosis table" was developed. The demographic data and past medical experience of patients were recorded. The rates of misdiagnosis and missed diagnosis were calculated. The specific misdiagnosed cases were recorded and analyzed. According to the previous diagnosis history, patients were divided into misdiagnosed group, missed diagnosis group and correct diagnosis group. The demographic characteristics, medical history and disease severity in the misdiagnosis group and missed diagnosis group were statistically analyzed, and compared with the correct diagnosis group. The reasons for missed diagnosis or misdiagnosis were explored.Results:A total of 277 patients were included in the survey. Only 19.1%(53 cases) of patients were correctly diagnosed, 22.7%(63 cases) of patients were misdiagnosed, 58.1% of patients were missed. The mean time from first symptom to disease diagnosis was (51.0±81.2) months. They were often misdiagnosed as osteoarthritis ( n=21, 33.3%), rheumatoid arthritis ( n=13, 20.6%), lumbar disease ( n=12, 19.0%), and anxiety and depression ( n=11, 17.4%). Patients' social and economic status such as age, income, educational level and the diagnosis level of pain related clinicians in medical institutions at all levels were factors that might influence misdiagnosis and missed diagnosis rate. In terms of demographic characteristics, the correctly diagnosed group had a lower average age of (44±13) years ( t=8.64/9.20, P<0.05), a higher proportion of employees, a higher monthly income ( χ2=7.10/6.87, P<0.05), and a higher education level ( χ2=7.12, P<0.05). In terms of visits, the rate of visits to other medical institutions (private hospitals) in the missed diagnosis group was higher, and the number of doctors visited was also lower. In terms of illness, the diffuse pain index (WPI) score and FMS symptom severity (SSS) score were lower in the missed diagnosis group. Conclusion:The current situation of the diagnosis of FMS in China is not optimistic, and the diagnosis should be differentiated from osteoarthritis, rheumatoid arthritis, cervical and lumbar diseases, and cardiac diseases. In order to reduce the misdiagnosis and missed diagnosis of this disease, it is necessary to strengthen the public education, improve the understanding of this disease in primary care doctors, and physicians in orthopedics, acupuncture and pain departments.

To "tell or not to tell"-Exploring disclosure about medicine use by people living with sleep disorders / 中西医结合学报

OBJECTIVE@#To explore the difference in rates and reasons for disclosure of either conventional or complementary medicine (CM) to healthcare practitioners between people living with sleep disorders (SDs) and those without SDs.@*METHODS@#A cross-sectional survey (N = 2019 adults) that measured sociodemographic characteristics, health status, health service utilisation, health literacy and health communication (medicine disclosure) of a representative sample of Australians was conducted. Data from participants reporting an SD (n = 265) were compared to those not reporting an SD to assess measures of health communication and disclosure about medicine use.@*RESULTS@#Overall, rates of medicine disclosure to both conventional and CM practitioners were high, in respondents with (70%) and without an SD (57%). Those reporting an SD had higher expectations of their conventional health practitioner's knowledge of CM, associated clinical decision-making skills, and approval of CM use, and held a higher degree of concern about drug interactions (P < 0.05). The main reasons cited for disclosing CM use to conventional health practitioners and conventional medicine use to CM practitioners were "I want them to fully understand my health status" and "I was concerned about drug interactions with the CMs used."@*CONCLUSION@#The high rate of medicine use disclosure by people with SDs is driven by an intention to inform their healthcare practitioner about their health status and concerns about potential medicine interactions. Therefore, research about the expectations that people with an SD have of their conventional healthcare practitioners' knowledge of CM and CM-drug interactions requires further examination. Likewise, further examination of CM practitioner's conventional medicine knowledge is encouraged.

Cross-sectional survey for canine leptospirosis in an Atlantic Rainforest area of the semiarid of Paraíba state, Northeastern Brazil / Estudo transversal para leptospirose canina em área de Mata Atlântica do semiárido da Paraíba, Nordeste do Brasil

Leptospirosis is a worldwide zoonosis caused by the bacteria Leptospira spp. that affects humans, domestic and wild animals. The present work aimed to conduct a cross-sectional survey for leptospirosis in the canine population of the Brejo Paraibano microregion, semiarid of Northeastern Brazil. From May to October 2017, blood samples from 414 dogs were collected in the counties of Alagoa Grande (n=100), Areia (n=79), Bananeiras (n=72), Alagoa Nova (n=73), Serrraria (n=25), Pilões (n=25), Borborema (n=20) and Matinhas (n=20). The tutors of the sampled dogs answered an epidemiological questionnaire, obtaining information about the animals, owner, residence and breeding of the dogs. Subsequently, the serum samples were subjected to the microscopic agglutination test (MAT), using a collection of 23 serovar pathogenic antigens and using the 1:50 dilution as the cutoff point. Of the 414 dogs analyzed 52 were seroreactive, resulting in an apparent prevalence of 12.6% and a real prevalence of 12.2%. Seroreactive dogs were found in the eight counties. Dogs were reactive for the serogroups Icterohaemorrhagiae (76.9%), Autumnalis (13.55%), Pomona (3.8%), Grippotyphosa (3.8%) and Serjoe (1.9%) Antibody titers ranged from 50 to 800. The statistical analysis (robust Poisson regression) detected six factors associated with seropositivity, including the rainy season (prevalence ratio; PR=1.94, P=0.013), male dogs (PR=2.10, P=0.005), animals with age greater than five years (PR=4.21, P=0.012), consumption of untreated water (PR=1.87, P=0.043), free access of dogs to street (PR=2.15, P=0.011) and contact with wildlife (PR=3.54, P=0.050). The serogroup Icterohaemorrhagiae has a high zoonotic potential and was the most frequent in seropositive animals. The high real prevalence of Leptospira spp. in a transmission region of the semiarid region of Paraíba and the occurrence of seroreactive animals in all the counties suggest wide distribution of the infection and reinforce the need for preventive measures to avoid infection in pets and, consequently, to humans. The analysis of factors associated with the prevalence suggest greater manegment cares with the dogs.(AU)

A leptospirose é uma zoonose mundial causada pela bactéria Leptospira spp. que afeta seres humanos, animais domésticos e selvagens. O presente trabalho teve como objetivo realizar um estudo transversal de leptospirose na população canina da microrregião Brejo Paraibano, semiárido do Nordeste do Brasil. No período de maio a outubro de 2017, amostras de sangue de 414 cães foram coletadas nas cidades de Alagoa Grande (n=100), Areia (n=79), Bananeiras (n=72), Alagoa Nova (n=73), Serraria (n=25), Pilões (n=25), Borborema (n=20) e Matinhas (n=20). Os tutores dos cães amostrados responderam a um questionário epidemiológico, sendo obtidas informações sobre os animais, proprietário, residência e criação dos cães. Posteriormente as amostras de soro foram submetidas à prova de soroaglutinação microscópica (SAM), utilizando-se uma coleção de 23 sorovares antígenos patogênicos e adotando como ponto de corte a diluição 1:50. Dos 414 cães analisados 52 foram sorreativos, resultando em uma prevalência aparente de 12.6% e uma prevalência real de 12,2%. Cães sororreativos foram encontrados nos oito municípios. Os cães foram reativos para o sorogrupo Icterohaemorrhagiae (76,9%), Autumnalis (13,55%), Pomona (3,8%), Grippotyphosa (3,8%) and Serjoe (1,9%) Os títulos de anticorpos variaram de 50 a 800. A análise estatística (regressão de Poisson robusta) detectou seis fatores associados à soropositividade, incluindo o período chuvoso (razão de prevalência - RP=1,94; P=0,013), cães machos (RP=2,10; P=0,005), animais com idade maior que cinco anos (RP=4,21; P=0,012), consumo de água não tratada (RP=1,87; P=0,043), cães com livre acesso à rua (RP=2,15; P=0,011) e contato com animais silvestres (RP=3,54; P=0,050). Os resultados desse estudo indicaram que há a exposição por Leptospira spp. em cães da microrregião do Brejo paraibano. O sorogrupo Icterohaemorrhagiae possui alto potencial zoonótico e foi o mais frequente nos animais soropositivos. A alta prevalência real de Leptospira spp. em uma região de transmissão da região semiárida da Paraíba e a ocorrência de animais sororreativos em todos os municípios sugerem uma ampla distribuição da infecção e reforçam a necessidade de medidas preventivas para evitar a infecção em animais de estimação e, consequentemente, em seres humanos. A análise dos fatores associados à prevalência sugere maior cuidado com os cães.(AU)

Cross-sectional survey for canine leptospirosis in an Atlantic Rainforest area of the semiarid of Paraíba state, Northeastern Brazil

ABSTRACT: Leptospirosis is a worldwide zoonosis caused by the bacteria Leptospira spp. that affects humans, domestic and wild animals. The present work aimed to conduct a cross-sectional survey for leptospirosis in the canine population of the Brejo Paraibano microregion, semiarid of Northeastern Brazil. From May to October 2017, blood samples from 414 dogs were collected in the counties of Alagoa Grande (n=100), Areia (n=79), Bananeiras (n=72), Alagoa Nova (n=73), Serrraria (n=25), Pilões (n=25), Borborema (n=20) and Matinhas (n=20). The tutors of the sampled dogs answered an epidemiological questionnaire, obtaining information about the animals, owner, residence and breeding of the dogs. Subsequently, the serum samples were subjected to the microscopic agglutination test (MAT), using a collection of 23 serovar pathogenic antigens and using the 1:50 dilution as the cutoff point. Of the 414 dogs analyzed 52 were seroreactive, resulting in an apparent prevalence of 12.6% and a real prevalence of 12.2%. Seroreactive dogs were found in the eight counties. Dogs were reactive for the serogroups Icterohaemorrhagiae (76.9%), Autumnalis (13.55%), Pomona (3.8%), Grippotyphosa (3.8%) and Serjoe (1.9%) Antibody titers ranged from 50 to 800. The statistical analysis (robust Poisson regression) detected six factors associated with seropositivity, including the rainy season (prevalence ratio; PR=1.94, P=0.013), male dogs (PR=2.10, P=0.005), animals with age greater than five years (PR=4.21, P=0.012), consumption of untreated water (PR=1.87, P=0.043), free access of dogs to street (PR=2.15, P=0.011) and contact with wildlife (PR=3.54, P=0.050). The serogroup Icterohaemorrhagiae has a high zoonotic potential and was the most frequent in seropositive animals. The high real prevalence of Leptospira spp. in a transmission region of the semiarid region of Paraíba and the occurrence of seroreactive animals in all the counties suggest wide distribution of the infection and reinforce the need for preventive measures to avoid infection in pets and, consequently, to humans. The analysis of factors associated with the prevalence suggest greater manegment cares with the dogs.

RESUMO: A leptospirose é uma zoonose mundial causada pela bactéria Leptospira spp. que afeta seres humanos, animais domésticos e selvagens. O presente trabalho teve como objetivo realizar um estudo transversal de leptospirose na população canina da microrregião Brejo Paraibano, semiárido do Nordeste do Brasil. No período de maio a outubro de 2017, amostras de sangue de 414 cães foram coletadas nas cidades de Alagoa Grande (n=100), Areia (n=79), Bananeiras (n=72), Alagoa Nova (n=73), Serraria (n=25), Pilões (n=25), Borborema (n=20) e Matinhas (n=20). Os tutores dos cães amostrados responderam a um questionário epidemiológico, sendo obtidas informações sobre os animais, proprietário, residência e criação dos cães. Posteriormente as amostras de soro foram submetidas à prova de soroaglutinação microscópica (SAM), utilizando-se uma coleção de 23 sorovares antígenos patogênicos e adotando como ponto de corte a diluição 1:50. Dos 414 cães analisados 52 foram sorreativos, resultando em uma prevalência aparente de 12.6% e uma prevalência real de 12,2%. Cães sororreativos foram encontrados nos oito municípios. Os cães foram reativos para o sorogrupo Icterohaemorrhagiae (76,9%), Autumnalis (13,55%), Pomona (3,8%), Grippotyphosa (3,8%) and Serjoe (1,9%) Os títulos de anticorpos variaram de 50 a 800. A análise estatística (regressão de Poisson robusta) detectou seis fatores associados à soropositividade, incluindo o período chuvoso (razão de prevalência - RP=1,94; P=0,013), cães machos (RP=2,10; P=0,005), animais com idade maior que cinco anos (RP=4,21; P=0,012), consumo de água não tratada (RP=1,87; P=0,043), cães com livre acesso à rua (RP=2,15; P=0,011) e contato com animais silvestres (RP=3,54; P=0,050). Os resultados desse estudo indicaram que há a exposição por Leptospira spp. em cães da microrregião do Brejo paraibano. O sorogrupo Icterohaemorrhagiae possui alto potencial zoonótico e foi o mais frequente nos animais soropositivos. A alta prevalência real de Leptospira spp. em uma região de transmissão da região semiárida da Paraíba e a ocorrência de animais sororreativos em todos os municípios sugerem uma ampla distribuição da infecção e reforçam a necessidade de medidas preventivas para evitar a infecção em animais de estimação e, consequentemente, em seres humanos. A análise dos fatores associados à prevalência sugere maior cuidado com os cães.

Attitude and Knowledge of Undergraduate Students of South Coastal Karnataka and Kerala Region towards Various Specialisations in Dentistry- A Cross Sectional Study.

Dentistry is a skill-based profession. Various specialisations are found in this field and several short-term certificate courses are also taking birth to cater to the need of newly graduated student population who want to set up practices afresh. We wanted to assess the attitude and knowledge of undergraduate dental students towards various specialisations. METHODSA cross-sectional survey of all final year dental undergraduates and house surgeons was carried out by distributing semi-structured questionnaire to 212 undergraduate dental students from various colleges in South Coastal Karnataka and Kerala region.Statistical analyses were carried out using chi‑square test and Fisher’s exact test. RESULTSThe study found that 89.6% (n= 190) respondents desired to pursue a specialisation. 91% (n=111) of the total final year students and 87.8% (n=79) of total interns desired to specialise. Majority of them were females 76.9 % (n=163). Oral surgery was the first choice of specialisation amongst final years and conservative & endodontics among interns. Least preferred was oral pathology. CONCLUSIONSAttitude and knowledge of students varied widely with respect to gender, year of study, and external influencing factors. Females were more inclined to specialisation despite the obstacles they would face.

Investigation on human hookworm infections in Anhui Province from 2014 to 2015 / 中国血吸虫病防治杂志

Objective To understand the current status and changing tendency of human hookworm infections in Anhui Province. Methods According to the unified national survey scheme, a total of 48 survey sites were sampled from 16 counties (cities) in 4 ecological regions of Anhui Province using a stratified cluster random sampling method from 2014 to 2015. The hookworm eggs were detected in the fecal samples from permanent residents at ages of over one year living in the survey sites using a modified Kato-Katz thick smear method, and the subjects’health knowledge and behaviors were investigated using questionnaire survey. Results A total of 12 300 persons were examined in the 48 survey sites from 4 ecological regions of Anhui Province between 2014 and 2015, and 259 subjects were identified with hookworm infections, with a mean prevalence of 2.11%. Among the four ecological regions, the North China Plain had the highest prevalence of human hookworm infections (3.02%) and in all survey sites, Linquan County had the highest prevalence (7.03%). Ancylostoma duodenale was the predominant hookworm species identified (62.16%), and 65.64% had mild infections. The prevalence of human hookworm infections was significantly greater in women than in men (χ2 = 4.16, P < 0.05), and showed a tendency towards a rise with ages (χ2trend = 113.36, P < 0.01). In addition, the prevalence of human hookworm infections varied in occupations (χ2 = 159.41, P < 0.01) and education levels (χ2 = 34.95, P < 0.01). Questionnaire survey showed low prevalence of human hookworm infections in subjects knowing the question“how hookworm infection occurs”and denying“using fresh stools for fertilization”(χ2 = 15.05, P < 0.01; χ2 = 4.19, P < 0.05). Conclusions The prevalence of human hookworm infections has greatly decreased in Anhui Province; however, the prevalence remains relatively high in some regions and populations. The North China Plain should be regarded as the key area for hookworm disease prevention and control, and housewives and populations with advanced ages and low educational levels are key targeted populations in Anhui Province.

Status of chronic filariasis: a cross-sectional study in Jiangxi Province, 2018 / 中国血吸虫病防治杂志

Objective To understand the status of chronic filariasis patients in Jiangxi Province in 2018, so as to provide insights into the follow-up care of the patients. Methods In 2018, a case follow-up study was conducted in all registered patients with chronic filariasis in previously endemic areas of Jiangxi Province, and a clue investigation was done for identifying the missing patients. In addition, the data of caring sites for chronic filarisis patients were collected and analyzed in the province. Results A total of 802 chronic filariasis patients were identified in 56 counties (districts) of Jiangxi Province in 2018. The patients had a male/female ratio of 1∶1, and 85.41% had ages of over 70 years. There were 58.60%, 93.89%, 17.21% and 3.62% of chronic filariasis patients with lymphangitis, lymphedema/elephantiasis, chyluria and hydrocele, respectively. A total of 273 caring sites were assigned in 56 counties (districts) of Jiangxi Province, and 306 caring activities were carried out in 2018. Conclusion The number of chronic filariasis patients has significantly decreased in Jiangxi Province; however, the care remains to be intensified for chronic filariasis patients.

Analysis of Factors Influencing Insomnia and Construction of a Prediction Model: A Cross-sectional Survey on Rescuers / 生物医学与环境科学（英文）

Objective@#To determine the factors influencing insomnia and construct early insomnia warning tools for rescuers to informbest practices for early screening and intervention.@*Methods@#Cluster sampling was used to conduct a cross-sectional survey of 1,133 rescuers from one unit in Beijing, China. Logistic regression modeling and R software were used to analyze insomnia-related factors and construct a PRISM model, respectively.@*Results@#The positive rate of insomnia among rescuers was 2.74%. Accounting for participants' age, education, systolic pressure, smoking, per capita family monthly income, psychological resilience, and cognitive emotion regulation, logistic regression analysis revealed that, compared with families with an average monthly income less than 3,000 yuan, the odds ratio ( ) values and the [95% confidence interval ( )] for participants of the following categories were as follows: average monthly family income greater than 5,000 yuan: 2.998 (1.307-6.879), smoking: 4.124 (1.954-8.706), and psychological resilience: 0.960 (0.933-0.988). The ROC curve area of the PRISM model (AUC) = 0.7650, specificity = 0.7169, and sensitivity = 0.7419.@*Conclusion@#Insomnia was related to the participants' per capita family monthly income, smoking habits, and psychological resilience on rescue workers. The PRISM model's good diagnostic value advises its use to screen rescuer early sleep quality. Further, advisable interventions to optimize sleep quality and battle effectiveness include psychological resilience training and smoking cessation.

Investigation and analysis of refraction state of primary school students in Haicheng district, Beihai city / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To understand the prevalence of refractive state of primary school students in Haicheng district, Beihai city.<p>METHODS: Cross-sectional study and cluster sampling were used. A total of 30 716 students aged 6 to 14 from 15 primary schools in Haicheng district, Beihai city, who had taken physical examination from October 2019 to January 2020, were selected for visual acuity and pupil diopter. SPSS17.0 statistical software was used for data analysis.<p>RESULTS: In the eyes of the 15 primary schools monitored in this study, 30 716 cases had mild myopia(29.62%), 0.50D < astigmatism < 2.00D(25.43%), metropia(21.05%)and mild hyperopia(15.85%). With the growth of age, the proportion of emmetropia and farsightedness declined as awhole. The proportion of myopia is on the rise. A total of 1 894 cases of wearing glasses 3 788 eyes. The rate of poor vision was 23.30%, and the rate of qualified correction of frame glasses was 64.57%. Compared with the left eye, the difference was statistically significant, and the <i>P</i>50 of the right eye was more negative than that of the left eye. The equivalent spherical mirror was compared between boys and girls. The difference was statistically significant, and the <i>P</i>50 of equivalent spherical mirror of girls was more negative than that of boys.<p>CONCLUSION: With the growth of age, the proportion of mild hyperopia and squarely eyes decreases year by year; The proportion of myopia increases year by year; Among the students with poor eyesight, the number of those who regularly wear glasses is small; However, after wearing glasses, there are still some students whose glasses are not up to standard. The refractive state of the right eye is more negative than that of the left eye; Female students tend to be more negative than male students in the refractive state.

Cognitive survey of telephone cardiopulmonary resuscitation among emergency personnel / 中华急诊医学杂志

Objectives To investigate the cognition of dispatcher-initiated telephone cardiopulmonary resuscitation (TCPR) among emergency medical system(EMS) personnel and compare the cognition of TCPR among EMS personnel in different economic status,and to understand the current situation of TCPR cognition of EMS personnel in China.Methods This study is a multicenter crosssectional survey.The method of multi-level convenient sampling was adopted,and the test reliability and split half reliability of the questionnaire was tested.Questionnaire survey and data collection were conducted from December 2018 to June 2019.The ethical approval number is M2018264.SPSS 20.0 was used for analysis.x2 test was used to analyze the differences between groups.Results A total of 1191 electronic questionnaires were collected.Of them,80.94％ respondents knew TCPR,97.82％ respondents thought that TCPR should be implemented in cardiac arrest,36.62％ respondents thought that bystander cardiopulmonary resuscitation quality monitoring was needed in TCPR,and TCPR training courses were set up in the emergency department which recruited 25.83％ respondents.Emergency personnel in developed areas had a better understanding of the criteria for judging patients' breathlessness (11.69％ vs 7.89％,P=0.048),of TCPR need ncluding guidance of chest compression (92.45％ vs 87.49％,P=0.012) and of bystander cardiopulmonary resuscitation (BCPR) quality monitoring including the frequency of artificial respiration (84.42％ vs 74.87％,P=0.029) than those in underdeveloped areas,but there was no significant difference in other indicators (P＞0.05).Conclusions TCPR knowledge of EMS personnel in China is unsatisfactory.Further training is needed to improve their understanding of the criteria for judging cardiac arrest in out-of-hospital cardiac arrest patients via telephone,TCPR content and bystander cardiopulmonary resuscitation quality monitoring.There is difference in TCPR knowledge between the EMS personnel in developed and undeveloped areas in China.