Evaluation of the hygiene status of teaching environment in primary and secondary schools in Beijing City from 2016 to 2020 / 中国学校卫生

Objective@#To understand the trend of changes of hygiene status in the teaching environment among primary and secondary schools in Beijing City during 2016-2020, so as to provide basis for further improving the teaching environment and campus hygiene conditions in primary and secondary schools.@*Methods@#A proportional systematic sampling method covered over 50% of schools selected annually in Beijing from 2016 to 2019, and 34% were selected in 2020. Two representative classrooms were selected from each selected school for testing based on their structure and other factors, with 6 196 classrooms supervised, from 2016 to 2020,1 330,1 312,1 384,1 322,848 classrooms were monitored for each year.@*Results@#From 2016 to 2020, the overall lighting qualification rate of classrooms (lighting coefficient 72.8%, window to floor area ratio 41.8%, rear wall reflectance ratio 42.2%, blackboard reflection ratio 37.4%), the overall qualification rate of average blackboard illumination and uniformity (50.6%, 34.9 %), and the overall qualification rate of desk and chair allocation (58.6%) were all below 80%. The overall qualification rate of per capita classroom area (87.5%), blackboard size (83.2%), average desk illumination ( 80.1% ), average desk illumination and uniformity (82.9%), the distance between lamp and desk (99.1%), carbon dioxide ( 86.6% ), temperature (84.9%), and noise (96.6%) were all above 80%. The following indicators, blackboard size, the distance between lamp and desk, average blackboard illumination, lighting coefficient, blackboard reflectance, rear wall reflectance, carbon dioxide, temperature, and noise ( χ 2=78.38, 9.71, 11.76, 320.59, 37.63, 58.45, 236.45, 1 347.56, 101.97), had statistically significance between years. Among those indicators, the qualified rates of blackboard size, blackboard reflectance, lighting coefficient, and noise had been increasing year by year ( χ 2 trend =69.98, 15.82, 240.02, 5.77) ( P <0.05). The qualified rates of per capita classroom area, window to floor area ratio, and blackboard reflection ratio in primary schools (81.6%, 39.8%, 36.3%) were all lower than those in secondary schools (94.9%, 44.5%, 40.3%) ( χ 2=246.32, 12.03, 10.51, P <0.05). The qualified rates of blackboard size, average blackboard illumination, average blackboard illumination and uniformity, and desk and chair allocation (89.3%, 55.6% , 36.0%, and 60.2%) were all higher than those in secondary schools (75.4%, 44.1%, 33.3%, and 56.5%) ( χ 2=209.33, 78.41, 4.44, 8.22) ( P <0.05). The qualified rates of average desk illumination and uniformity, average blackboard illumination, rear wall reflectance ratio, desk and chair allocation, carbon dioxide, temperature, and noise indicators in urban area (82.9%, 84.1% , 51.9%, 45.0%, 60.9%, 91.2%, 89.5%, 97.8%) were all higher than those in suburban area (77.3%, 81.7%, 49.2%, 39.5%, 56.3%, 82.3%, 80.4%, 95.5%) ( χ 2=31.16, 6.28, 4.36, 16.40, 13.39, 105.29, 98.23, 24.66， P <0.05). The qualified rates of the distance between lamp and desk, lighting coefficient, window to floor area ratio, blackboard size, blackboard reflection ratio, average blackboard illumination and uniformity, and per capita classroom area in urban areas (98.8%, 65.2%, 34.3%, 76.7%, 35.9%, 30.1%, 84.6%) were all lower than those in suburban areas (99.4%, 81.4%, 49.8%, 89.7%, 40.2%, 39.6%, 90.3%) ( χ 2=6.80, 171.67, 132.43, 188.46 , 12.45, 60.28, 44.82) ( P <0.05).@*Conclusions@#The main problems in the teaching environment of schools in Beijing are classroom lighting, as well as desk and chair allocation. The findings suggest technical rationality and operability of relevant standard should be considered when under revision, and standard training and supervision management should be strengthened, with the aim of teaching environment improvement.

Improving Identification of Medicaid Eligible Community-Dwelling Older Adults in Major Household Surveys with Limited Income or Asset Information.

Analysis of public policy affecting dual eligibles requires accurate identification of survey respondents eligible for both Medicare and Medicaid. Doing so for Medicaid is particularly challenging given the complex eligibility rules tied to income and assets. In this paper we provide guidance on how to best identify eligible respondents in household surveys that have limited income or asset information, such as the National Health Interview Survey (NHIS), American Community Survey (ACS), Current Population Survey (CPS), and Medical Expenditure Panel Survey (MEPS). We show how two types of errors-false negative and false positive errors-are impacted by incorporating limited income or asset information, relative to the commonly-used approach of solely comparing total income to the income threshold. With the 2018 Health and Retirement Study (HRS), which has detailed income and asset information, we mimic the income and asset information available in those other household surveys and quantify how errors change when imposing income or asset tests with limited information. We show that incorporating all available income and asset data results in the lowest number of errors and the lowest overall error rates. We recommend that researchers adjust income and impose the asset test to the fullest extent possible when imputing Medicaid eligibility for Medicare enrollees.

Quality of referrals to specialist palliative care and remote patient triage - a cross-sectional study.

PURPOSE: Choosing the optimal moment for admission to palliative care remains a serious challenge, as it requires a systematic identification of persons with supportive care needs. Despite the screening tools available for referring physicians, revealing the essential information for preliminary admission triage is crucial for an undisturbed qualification process. The study was aimed at analysing the eligibility criteria for specialist palliative care disclosed within provided referrals, expanded when necessary by documentation and/or interview. METHODS: Referral forms with the documentation of 300 patients consecutively referred to the non-profit in-patient ward and home-care team in Poland were analysed in light of prognosis, phase of the disease and supportive needs. RESULTS: Half of the referrals had the sufficient information to make a justified preliminary qualification based solely on the delivered documentation. The majority lacked performance status or expected prognosis. Where some information was revealed, two-thirds were in a progressing phase of the disease, with a within-weeks life prognosis. In 53.7%, no particular reason for admission was given. Social problems were signalled as the only reason for the admission in 7.7%. Twenty-eight percent were labelled as "urgent"; however, 52.4% of them were triaged as "stable" or disqualified. Patients referred to a hospice ward received complete referral forms more often, containing all necessary information. CONCLUSIONS: General physicians need practical tips to facilitate timely referrals and unburden the overloaded specialist palliative care. Dedicated referral forms extended by a checklist of typical patients' concerns should be disseminated for better use of these resources.

Examining Exclusion Criteria in Advanced Prostate Cancer Clinical Trials: An Assessment of recommendations From the American Society Of Clinical Oncology and Friends of Cancer Research.

PURPOSE: Eligibility criteria illustrate the characteristics of the study population and promote the safety of participants. However, overreliance on restrictive eligibility criteria may limit the generalizability of outcomes. As a result, the American Society of Clinical Oncology (ASCO) and Friends of Cancer Research (Friends) issued statements to curtail these challenges. In this study, we aimed to assess restrictiveness in eligibility criteria across advanced prostate cancer clinical trials. MATERIALS AND METHODS: We identified all phase I, II, and III advanced prostate cancer clinical trials between June 30, 2012, and June 30, 2022, through Clinicaltrials.gov. We evaluated whether a clinical trial excluded, conditionally included, or did not report 4 common criteria: brain metastases, prior or concurrent malignancies, HIV infection, and hepatitis B virus (HBV)/hepatitis C virus (HCV) infection. Performance status (PS) criteria were recorded based on the Eastern Cooperative Oncology Group (ECOG) scale. RESULTS: Out of 699 clinical trials within our search strategy, 265 (37.9%) trials possessed all the required data and were included in our analysis. The most common excluded condition of our interest was brain metastases (60.8%), followed by HIV positivity (46.4%), HBV/HCV positivity (46.0%), and concurrent malignancies (15.5%). Additionally, 50.9% of clinical trials only included patients with ECOG PS 0 to 1. HIV and HBV/HCV infection were exclusion criteria of 22 (80.8%) and 19 (73.1%) immunotherapy trials, respectively. CONCLUSION: Patients with brain metastases, prior or concurrent malignancies, HIV infection, HBV/HCV infection, or low-functioning PS were overly restricted from participating in advanced prostate clinical trials. Advocating for broader criteria may ameliorate generalizability.

Women with large intact abdominal aortic aneurysms remain untreated.

OBJECTIVE: A lower elective repair rate among women with abdominal aortic aneurysms (AAAs) has been a consistent finding. Reasons behind this gender gap have not been thoroughly outlined. METHODS: This was a retrospective multicenter cohort study (ClinicalTrials.gov: NCT05346289) at three European vascular centers in Sweden, Austria and Norway. Patients in surveillance with AAAs were consecutively identified starting from January 1, 2014, until reaching a total sample size of 200 women and 200 men. All individuals were followed for 7 years through medical records. Final treatment distributions and the proportion of "truly untreated" (surgically untreated despite reaching guideline-directed thresholds: 50 mm for women and 55 mm for men) were determined. In a complementary analysis, a universal 55-mm threshold was used. Gender-specific primary reasons behind untreated statuses were clarified. Eligibility for endovascular repair among the truly untreated was assessed in a structured computed tomography analysis. RESULTS: Women and men had similar median diameters at inclusion (46 mm; P = .54) and at treatment decisions (55 mm; P = .36). After 7 years, the repair rate was lower among women (47% vs 57%). More women were truly untreated (26% vs 8%; P < .001) despite similar mean ages as for male counterparts (79.3 years; P = .16). With the 55-mm threshold, 16% women still classified as truly untreated. Similar reasons for nonintervention were captured for women and men (50% due to comorbidities alone, 36% morphology and comorbidity). The endovascular repair imaging analysis revealed no gender differences. Among truly untreated women, ruptures were common (18%), and mortality was high (86%). CONCLUSIONS: Surgical AAA management differed between women and men. Women could be underserved in terms of elective repairs: one in every four women was untreated with over-the-threshold AAAs. The lack of obvious gender differences in eligibility analyses could imply unmeasured discrepancies (eg, in disease extent or patient frailty).

Anatomical feasibility of fenestrated stent graft to treat complex abdominal aortic aneurysms from a Korean single institute database.

Purpose: This study aims to investigate the feasibility of Zenith Fenestrated AAA Endovascular Graft (Z-FEN, Cook Medical) from a single Korean institution database by evaluating the vascular anatomy of Korean abdominal aortic aneurysm (AAA) patients with hostile aortic neck. Methods: This is a retrospective study on patients with AAA who underwent endovascular aortic repair (EVAR) and open surgery repair between January 2012 and December 2021 (n = 211). The anatomic characteristics of the aortic neck were evaluated using 3-dimensional reconstructed computed tomographic scans. For the juxtarenal AAA patients (n = 39), feasibility of fenestrated stent graft was evaluated under the protocol of fenestrated EVAR. For those who were not suitable for the application of Z-FEN, the reasons for unsuitability were analyzed. Results: Among 211 AAA patients, 108 patients (51.2%) had complex aortic neck, and 39 (18.5%) had insufficient aortic neck length (<15 mm) for conventional EVAR. Of the 39 patients with juxtarenal AAAs, 13 (33.3%) were determined feasible for Z-FEN. Twenty-six patients (66.7%) were noncandidate for Z-FEN due to severe neck angulation, short aortic neck length, inadequate iliac artery anatomy, large aortic neck diameter, and severe calcification and thrombosis. Proximal aortic neck length of the non-feasible group was significantly shorter than that of the feasible group (P = 0.002). Conclusion: Z-FEN was applicable to 33.3% of the juxtarenal AAA patients. As recent studies confirm, the effectiveness and safety of fenestrated EVAR, Z-FEN can be an option for AAA patients with short aortic neck.

Comparison of disinfection quality in nurseries of Nanjing during 2019-2021 / 中国学校卫生

Objective@#To analyze the disinfection quality and influencing factors of nurseries in Nanjing during 2019-2021, so as to provide a scientific basis for optimizing preventive disinfection strategies and measures in nurseries.@*Methods@#Environmental samples from 389 nurseries in Nanjing from January 2019 to December 2021 were tested, and the change of disinfection quality qualification rate was compared.@*Results@#The overall disinfection qualification rate of nurseries of year 2019-2021 were 96.32%, 95.85% and 94.60%, respectively, showing a downward trend ( χ 2 trend =8.67, P <0.05). Specifically, disinfection qualification rate of object surfaces, staff hands and tableware showed a downward trend, while the disinfection qualification rate of dynamic air showed an upward trend, and the differences were statistically significant ( χ 2 trend =23.17, 12.32, 5.37, 21.48, P <0.05). The total qualification rate of disinfection in Jiangning and Liuhe districts increased during 2019-2021( χ 2 trend =21.46, 24.05, P <0.05).@*Conclusion@#Disinfection quality of nurseries in Nanjing has declined by year during 2019-2021, especially the object surfaces and staff hands. It is urgent to optimize and refine the strategies and measures for preventive disinfection in nurseries, strengthen the training of personnel on disinfection knowledge, and ensure the quality of disinfection in nurseries.

Teaching environmental health in primary and secondary schools in Shanghai and its association with screening myopia applying multilevel models / 中国学校卫生

Objective@#To understand the status of teaching environmental health in primary and secondary schools and explore its association with myopia, so as to provide a basis for precision myopia prevention and control.@*Methods@#From September to October 2020, a stratified cluster sampling method was used in 16 districts of Shanghai. After matching the teaching environment testing classrooms with the classrooms where the students were surveyed, totally 470 classrooms and 14 624 students were monitored. Trained professional technicians used laser range finder, luxmeter to measure parameters about teaching environmental health. Students were subject vision testing and questionnaires. Multilevel models was used to analyze the association between teaching environment and screening myopia.@*Results@#The qualified rates of each indicators of teaching environmental health were as follows: window to floor area ratio (93.0%), classroom area per capita (82.1%), uniformity ratio of illuminance of blackboard ( 79.7% ), blackboard size (68.7%), daylight factor (67.0%), blackboard hanging height (66.9%), average illuminance on desk (66.4%), uniformity ratio of illuminance of desk (63.6%), reflectance of blackboard (46.8%), average illuminance on blackboard (41.4%), reflectance of wall (33.2%), desk and chair allocation compliance rate (19.8%). The results of two level Logistic model analysis showed that unqualified average illuminance on blackboard was positively associated with screening myopia ( OR =1.24, 95% CI = 1.05 -1.47, P <0.05).@*Conclusion@#Teaching environmental health of primary and secondary schools in Shanghai is not optimistic, teaching environment especially the desk and chair allocation compliance rate need to be improved. The average illumination on blackboard is positively correlated with screening myopia, suggesting that myopia prevention and control can focus on improving the illuminance on blackboard.

Physical fitness evaluation results among students in Yunnan Province in 2019 / 中国学校卫生

Objective@#To analyze physical fitness of students aged 6-22 years old from seven ethnic groups in Yunnan Province, and to provide reference for physical fitness intervention measures.@*Methods@#The nationality, gender, grade, body shape, vital capacity, exercise quality of students were derived from the 2019 Yunnan Student Physical Health Survey Database. Comprehensive physical fitness score was calculated according to the National Student Physical Fitness Standards(revised in 2014). t test, ANOVA, and χ 2 test were used to analyze physical fitness score and level among students with different ethnic groups, gender, and school stages.@*Results@#The average comprehensive score of physical fitness among students from 7 ethnic groups in Yunnan Province was (70.02±9.69）, with the pass rate being 88.91%. The proportion of excellent was 0.93%, good was 17.90%, pass 70.09 %, and failed was 11.09%. Physical fitness score was highest in BMI (94.99 points), followed by 50 meter running (74.13 points), sitting forward bend (72.63 points), endurance running (70.43 points), standing long jump (67.77 points), sit ups ( 65.71 points) , 1 minute skipping rope (65.25 points), vital capacity (62.97 points), pull up (29.04 points). Physical fitness score and pass rate and evaluation level varied significantly by ethnicity and school stage( F =293.53，452.85， χ 2/ χ 2 trend =466.65， 412.57 ； 1 553.22 ，1 045.36， P <0.01).@*Conclusion@#The excellent rate of physical fitness among students in Yunnan Province is relatively low. Physical fitness promotion requires specific guidance and training based on ethnicity and school stage.

Surveillance and control of infectious disease in primary and middle schools in Hebei Province from 2019 to 2021 / 中国学校卫生

Objective@#To understand the infectious disease prevention and control among primary and secondary schools in Hebei Province from 2019 to 2021 and to provide a scientific basis for promoting epidemic prevention and control in schools.@*Methods@#Relevant indicators of infectious disease prevention and control in primary and secondary schools were collected and screened from the on site supervision and inspection data uploaded from various places, and analyzed with SPSS 22.0 software.@*Results@#The qualified rates of infectious disease prevention and control in primary and secondary schools in Hebei Province from 2019 to 2021 were 77.11%, 89.74% and 96.24%, respectively, the difference was statistically significant( χ 2=455.45, P <0.01). The qualified rates of infectious disease prevention and control in primary schools, middle schools and high schools from 2019 to 2021 increased by year, the difference was statistically significant( χ 2=319.49, 118.74, 25.73, P <0.05). The qualified rates of six infectious disease prevention and control indicators such as morning inspection record, special person responsible for epidemic report, registration record of absence due to illness increased by year, the difference was statistically significant( χ 2=140.34, 9.10, 113.55 , 163.71 , 286.74, 329.18, P <0.05).@*Conclusion@#Steady improvement in school infectious disease prevention and control has been observed, while qualification rate in primary school and rural area still need to be improved, with missing or late report. Government support and talent policy, hardware and sofeware construction, as management level should be strengthened.

Coincidence rate of adjustable and non adjustable desks and chairs in primary and secondary schools in Shanghai / 中国学校卫生

Objective@#To understand the coincidence rate of adjustable and non adjustable desks and chairs in primary and secondary schools in Shanghai, so as to provide a reference for the effective management of desks and chairs in schools.@*Methods@#Stratified random cluster sampling was applied to measure 1 091 sets of desks and chairs in 33 classrooms of 7 primary and secondary schools in 4 districts of Shanghai including Huangpu, Hongkou, Yangpu and Jiading districts. The height examination data of seated students in the same semester were also collected to evaluate the matching type of functional size of desks and chairs and students height according to Functional Sizes and Technical Requirements of Chairs and Tables for Educational Institutions.@*Results@#The matching coincidence rate of desk and chair distribution in primary and secondary schools was 22.5%, and the matching coincidence rates of primary, middle and high schools were 11.7%, 27.1% and 40.9% respectively ( χ 2=83.23, P <0.01); the matching coincidence rate of adjustable desks and chairs (28.2%) was significantly higher than that of fixed (18.2%) ( χ 2=14.49, P <0.01). The type of distribution of desks and chairs that do not correspond to national standards, from elementary school to high school, showing a trend of high desks with high chairs, low desks with high chairs to high desks with low chairs.@*Conclusion@#The coincidence rate of desk and chair distribution in primary and secondary schools is low, and the adjustable desks and chairs has improved the problems to a certain extent, but has not significantly improved the coincidence rate. It is necessary to further explore the effective management mode in the use of adjustable desks and chairs and improve the current situation of the use of desks and chairs in schools.

Physical health status and influencing factors of preschool children in Tibet / 中国学校卫生

Objective@#To explore physical health status and influencing factors of preschool children in Tibet, so as to provide a scientific reference and theoretical basis for the healthy development of physical fitness.@*Methods@#Data were collected from children (3-6 years old) of Xizang national physical fitness monitoring, and a total of 1 521 preschool children were recruited who received questionnaire survey and physical fitness test. Independent sample t-test and one-way ANOVA were used to compare the differences in physical fitness indexes of preschool children in different groups. Chi square test and binary Logistic regression model were used to analyze the factors affecting physical health of preschool children.@*Results@#The total qualified rate of physical fitness was 79.75%, among which the excellent rate was 3.16%, the good rate was 15.12%, the qualified rate was 61.47% and the unqualified was 20.25%. From the perspective of BMI, the excellent physical fitness rate (3.74%) and good physical fitness rate ( 17.47% ) were highest in healthy weight preschool children, and the qualified physical fitness rate of overweight preschool children (69.03%) was higher than that of obese (55.88%) and healthy weight preschool children (60.68%)( χ 2=53.56, P <0.01). From the perspective of ethnic, Tibetan children s physique proficiency (3.69%), good rate ( 17.13% ) than with the elevation of the Han nationality (0.74%, 5.88%), fraction defective (16.97%), lower than that of Han nationality (35.29%) ( χ 2=53.71, P <0.01); The results of chest circumference, skinfold thickness, body fat percentage, tennis throw distance, continuous jump of both feet, sitting forward bend and balance beam walking of Tibetan children were higher than those of Han children, and the results of quiet heart rate and standing long jump were lower than those of Han children ( t = 2.72 , 10.95, 9.66, 3.68, 3.88, 8.04, 3.56, 8.70, -4.39 , -4.40, P <0.01). Binary Logistic regression analysis showed that Tibetans ( OR =2.29), breastfeeding ( OR =1.51), body dynamics outdoor daily exercise duration 30-90 min (30-<60 min ;OR = 2.03 ; 60-90 min: OR =2.22) were positively correlated with physical health of preschool children ( P <0.05).@*Conclusions@#The total physical qualification rate of preschool children aged 3-6 years old in Tibet is lower than the national average. Ethnic group, feeding pattern during infancy, and physical activity are all factors that affected the physical fitness of preschool children in Tibet. It is of great significance to improve the physique of preschool children in Tibet to promote their sustainable and healthy development.

Accuracy of Simulated Research Tasks by Community Hospitals Participating in a Multicenter Telemedicine Trial.

Background/Aims: Clinical trials evaluating facility-to-facility telemedicine may include sites that have limited research experience. For the trial to be successful, these sites must correctly perform research-related tasks. This study aimed to determine whether health care professionals at community hospitals could accurately identify simulated study eligible patients and submit data to a research coordinating center. Methods: Twenty-seven community hospitals in the United States and Canada participated in this study. An electronic survey was sent to one designated health care professional at each site. The survey included a description of trial eligibility criteria and five written neonatal resuscitation scenarios. For each scenario, the participant determined whether the neonate was study eligible. One scenario required participants to submit 14 data elements to the coordinating center. Accuracy of study eligibility and data submission was summarized using standard descriptive statistics. Results: The survey response rate was 100% (27/27). Overall accuracy in determining study eligibility was 89% (120/135), and accuracy varied across the five scenarios (range 82-93%). Overall accuracy of data submission was 92% (310/336). Data were >95% accurate for 9 of the 14 data elements, with 100% accuracy achieved for 6 data elements. These results were used to clarify eligibility criteria, inform database design, and improve training materials for the subsequent clinical trial. Conclusions: Health care professionals at community hospitals accurately determined trial eligibility and submitted study data based on written clinical scenarios. Research teams conducting telemedicine trials with community hospitals should consider completing pre-trial simulation activities to identify opportunities for improving trial processes and materials.

Cochlear implant eligibility in an adult hearing aid population: a multi-perspective service evaluation of a patient referral pathway at a British district general hospital.

OBJECTIVES: To quantify patient eligibility for cochlear implantation following National Institute for Health and Care Excellence 2019 guidelines (TA566) over five years at our institution, and identify factors influencing patients' decisions surrounding cochlear implantation referral. METHODS: A multi-perspective service evaluation was conducted at a district general hospital, comprising cochlear implantation eligible patients. The main outcome measures were: eligibility numbers for 2014-2019, comparing application of TA566 versus 2009 (TA166) guidelines; and patient interview transcripts and questionnaires. RESULTS: There was a 259 per cent average increase in cochlear implantation eligibility from 2014 to 2019. Most patients' thresholds were 80 dB HL or more at 3 kHz and 4 kHz. There are several cochlear implantation barriers, including patient-centred issues (e.g. health-related anxieties, implantation misperceptions) and external barriers (difficulty getting to regional implant centres). Motivating factors for cochlear implantation include improved quality of life and access to local cochlear implantation services. CONCLUSION: The TA566 guidelines have increased cochlear implantation eligibility, putting pressure on cochlear implantation centres and referring hospitals. Current referral systems have external and patient-centred implantation barriers. British cochlear implantation delivery may need rethinking to meet increasing populational demands and improve accessibility for those most vulnerable to these barriers.

Transitions Between Preexposure Prophylaxis Eligibility States and HIV Infection in the Lisbon Cohort of HIV-Negative Men Who Have Sex With Men: A Multistate Model Analysis.

We aimed to describe transitions between preexposure prophylaxis (PrEP) eligibility and human immunodeficiency virus (HIV) infection among HIV-negative men who have sex with men (MSM). We used data from 1,885 MSM, who had not used PrEP, enrolled in the Lisbon Cohort of MSM, with at least 2 consecutive measurements of PrEP eligibility from 2014-2020. A time-homogeneous Markov multistate model was applied to describe the transitions between states of PrEP eligibility-eligible and ineligible-and from these to HIV infection (HIV). The intensities of the transitions were closer for ineligible-to-eligible and eligible-to-ineligible transitions (intensity ratio, 1.107, 95% confidence interval (CI): 1.080, 1.176), while the intensity of the eligible-to-HIV transition was higher than that for ineligible-to-HIV transition (intensity ratio, 9.558, 95% CI: 0.738, 65.048). The probabilities of transitions increased with time; for 90 days, the probabilities were similar for the ineligible-to-eligible and eligible-to-ineligible transitions (0.285 (95% CI: 0.252, 0.319) vs. 0.258 (95% CI: 0.228, 0.287)), while the eligible-to-HIV transition was more likely than ineligible-to-HIV (0.004 (95% CI: 0.003, 0.007) vs. 0.001 (95% CI: 0.001, 0.008)) but tended to become closer with time. Being classified as ineligible was a short-term indicator of a lower probability of acquiring HIV. Once an individual moved to eligible, he was at a higher risk of seroconversion, demanding a timely delivery ofPrEP.

Associated factors of environmental health in primary and secondary schools in Beijing from 2017 to 2020 / 中国学校卫生

Objective@#To understand the current situation of teaching and living environment in primary and secondary schools in Beijing and to provide basis for further intervention.@*Methods@#According to the national plan, an annual average of 92 schools in 16 districts of Beijing were investigated from 2017 to 2020, including school drinking water, canteen, toilet, dormitory management and equipment allocation. Classroom environment of some schools were tested,including the per capita area of classrooms, the agreement rate of desks and chairs distribution, blackboard reflectance, the average illumination and uniformity of desks, the average illumination and uniformity of blackboards, and noise.@*Results@#From 2017 to 2020,most of schools provided water purifiers and direct drinking water, accounting for 85.1% of all investigated schools. The proportion of students canteens in urban schools was increasing,accounting for 90.5% of all schools in 2020. And there was little change in suburban schools,reaching 85.1% in 2020. The proportion of school toilets equipped with soap increased significantly, 92.0% of school toilets were equipped with soap in 2020. The proportion of student dormitories with a per capita area of less than 3 m 2 decreased by year, and all reached the standard in 2020. The qualified rates of various classroom testing indicators, including per capita area in classroom, desk illumination uniformity, and noises, were higher than 80%, while the qualified rates of the blackboard illumination uniformity, desk allotment were lower than 80%.@*Conclusion@#The teaching and living environment in Beijing has improved in recent years, but there are still some problems need to be solved.

Analysis of health monitoring results in the teaching environment of primary and secondary schools in Sichuan Province from 2017 to 2021 / 中国学校卫生

Objective@#To analyze the current situation of teaching environmental sanitation in primary and secondary schools in Sichuan Province from 2017 to 2021, and to provide basis for the development of teaching environmental sanitation intervention measures in Sichuan Province.@*Methods@#A total of 7 510 primary and secondary schools were supervised and sampled from 2017 to 2021 according to the unified questionnaire. Descriptive statistical analysis method was used to analyze the monitoring results.@*Results@#The overall pass rate from 2017 to 2021 is only 51.70% (3 883), a total of 2 282 were sampled in 2017 and 1 414 were qualified, with the pass rate was the highest (61.96%),a total of 1 768 were sampled in 2019 and 750 were qualified, with the lowest pass rate (42.42%). The pass rate of different testing items in each year from 2017 to 2021 and the pass rate of the same test item in different years from 2017 to 2021 were statistically significant ( P <0.05). A total of 2 095 samples were inspected in rural areas in five years, and 1 177 were qualified, with the highest pass rate (56.18%). In urban areas, a total of 2 124 samples were inspected in five years, and 1 040 were qualified, with the lowest pass rate (48.96%). In the five year period of primary school, a total of 4 867 schools were sampled, and 2 626 were qualified, with the highest pass rate (53.93%). There were statistically significant differences in the qualification rate of desks and chairs, classroom lighting, blackboard illumination, per capita area of classrooms, and per capita area of student dormitories in different regions ( χ 2=9.87, 17.51, 37.69, 75.43, 11.22, P ＜0.05), and there were statistically significant differences in the pass rates of classroom lighting, per capita area of classrooms, per capita area of student dormitories, and ventilation of classrooms and student dormitories between different school sections ( χ 2=9.16, 39.37, 79.56 , 31.37, P <0.05).@*Conclusion@#The teaching environment of primary and secondary schools in Sichuan Province needs to be improved continuously, the qualified rate of classroom lighting and desks and chairs is low, and the investment in weak links should be increased.

Evaluation of school lunch recipes based on digital platform / 中国学校卫生

Objective@#To understand levels of various foods and nutrients in school lunch based on digital platform and to provide reference for food preparation and serving.@*Methods@#A total of 13 018 school lunch recipes in Binhai New Area of 96 schools in Tianjin from November 2020 to April 2021 were collected by using digital management platform for food safety and nutritional health.Food types including cereals and tubers, vegetables, fruits, livestock and poultry meat, fish and shrimp, eggs, milk and dairy products, legumes and their products/nuts and others energy, and nutrients including protein, fat, carbohydrate, calcium, iron, zinc, selenium, vitamin A, vitamin B 1, vitamin B 2, vitamin C and dietary fiber were evaluated.@*Results@#The qualified rate of all kinds of food for students lunch from high to low were 96.8% (116.4 g) of livestock and poultry meat, 92.3% (179.5 g) of cereal and potato, 65.0% (170.6 g) of vegetables, 47.7% (21.4 g) of soybeans and their products/nuts, 33.4% (18.0 g) of eggs, 14.4% (8.5 g) of fish and shrimp, 14.1% (19.6 g) of fruits, 0.3% (35.4 g) of milk and dairy products. There were significant differences in the qualified rate of various food intake among different grades( P <0.05). The qualified rate of students lunch energy was 76.9%(932.6 kcal). The qualified rates of various nutrients from high to low were iron 96.9%(9.7 mg), zinc 96.8%(5.9 mg), protein 96.4%(43.8 g), carbohydrate 87.6%(130.8 g) and selenium 82.9%(23.5 μg), vitamin C 78.5%(48.8 mg), vitamin B 1 75.9%(0.5 mg), fat 74.3%(28.5 g), vitamin A 74.1%(327.1 μ g) vitamin B 2 49.9%(0.5 mg), dietary fiber 19.5%(5.9 g) and calcium 13.4%(246.1 mg). There were significant differences in the qualified rates of energy and nutrients among different grades( P <0.05).@*Conclusion@#The digital platform basically meets school lunch requirments on food types and nutrients, but still with problems regarding insufficient fish and shrimp, fruits, milk and dairy products, vitamin B 2, dietary fiber and calcium. It is suggested to optimize school lunch recipes or increase corresponding nutrients content in other meals.

Analysis of teaching environment of primary and middle schools in Zhengzhou City from 2014 to 2018 / 中国学校卫生

Objective@#To understand the changing trend of the teaching environment of the elementary and secondary schools in Zhengzhou, and to provide data for further improving the teaching environment of the elementary and secondary schools.@*Methods@#A survey of teaching facilities and teaching aids in 534 secondary and primary schools in Zhengzhou was conducted from 2014 to 2018 by using a stratified random sampling method.@*Results@#Teaching facilities: the qualified rate of the railings in the outer corridor of the teaching building was 88.8% (474), the qualified rate of classroom lighting was 79.6% (425), the qualified rate of the light desk distance was 82.8% (442), and the qualified rate of black plate lights 86.1% (460), the qualified rate of each year was statistically significant ( χ 2=9.97, 23.74, 80.10, 53.33, P <0.05); the qualified rate of classroom area per capita was 52.8% (282), the qualified rate of the outer corridor width of the teaching building was 64.0% (342), the qualified rate of each year showed no statistical difference( χ 2=7.38, 8.71, P >0.05). Teaching ancillary facilities: the proportion of centralized water supply was 65.0% (347), toilet with hand washing facilities was 81.6% (436), these two indicators showed an increasing trend, hand washing facilities in campus was 70.6% (377), showed a decreasing trend, the rate of each year differed significantly( χ 2=88.62, 42.71 , 123.53, P <0.05).@*Conclusion@#The overall situation of teaching environment in Zhengzhou primary and secondary schools is relatively good, the qualified rate of most indicators of teaching facilities increased from 2014 to 2018. However, there are still some indicators to be strengthened.