Background: About 60% of institutional births occur in the private sector in Gujarat due to limited availability of obstetricians in the government. Chiranjeevi Yojana (CY), a voucher-like program initiated in 2007, a...Background: About 60% of institutional births occur in the private sector in Gujarat due to limited availability of obstetricians in the government. Chiranjeevi Yojana (CY), a voucher-like program initiated in 2007, accredits private obstetricians who are reimbursed by the state government to provide free delivery care to eligible women i.e. below poverty line and tribal. One million women have delivered under the CY program yet there are no large community based studies of the program. Methodology of a prospective community study is described here. Methods/Designs: A prospective cohort study was done in 142 villages across 3 districts in Gujarat between July, 2013 and November, 2014. A detailed survey was done by trained researchers to ascertain maternal healthcare information including antenatal, intra-partum and post-partum care, place of delivery, birth outcomes, out of pocket expenses etc. Results: 54,955 households were surveyed. 73% of all households had poverty documentation. 4274 mothers who delivered in the study period were included. Discussion: This paper is description of the methodology of a large community based survey and household and individual level characteristics. The survey was nested in a larger project to evaluate the CY program in the state of Gujarat.展开更多
Objective To compare the characteristics of suicides in the four main demographic groups： urban males, urban females, rural males and rural females in order to help clarify the demographic pattern of suicides in Chin...Objective To compare the characteristics of suicides in the four main demographic groups： urban males, urban females, rural males and rural females in order to help clarify the demographic pattern of suicides in China. Methods A detailed psychological autopsy survey instrument was independently administered to 895 suicide victims in family members and close associates from 23 geographically representative locations from around the country. Results Pesticide ingestion accounted for 58% （519） of all suicides and 61% （3181519） of deaths were due to unsuccessful medical resuscitation. A substantial proportion （37%） of suicide victims did not have a mental illness. Among the 563 victims with mental illness, only 13% （76/563） received psychiatric treatment. Compared to other demographic groups, young rural females who died from suicide had the highest rate of pesticide ingestion （79%）, the lowest prevalence of mental illness （39%）, and the highest acute stress from precipitating life events just prior to the suicide. Contusion Many suicides in China are impulsive acts of deliberate self-harm following acute interpersonal crises. Prevention of suicides in China must focus on improving awareness of psychological problems, improving mental health services, providing alternative social support networks for managing acute interpersonal conflicts, limiting access to pesticides, and improving the resuscitation skills of primary care providers.展开更多
AIM： To assess the characteristics and quality of endoscopic ultrasonography-guided fine needle aspiration （EUS-FNA） in a large panel of endosonographers.METHODS： A survey was conducted during the 13th annual live...AIM： To assess the characteristics and quality of endoscopic ultrasonography-guided fine needle aspiration （EUS-FNA） in a large panel of endosonographers.METHODS： A survey was conducted during the 13th annual live course of endoscopic ultrasonography （EUS） held in Amsterdam, Netherlands. A 2-page question- naire was developed for the study. Content validity of the questionnaire was determined based on input by experts in the field and a review of the relevant literature. It contained 30 questions that pertained to demographics and the current practice for EUS-FNA of responders, including sampling technique, sample processing, cytopathological diagnosis and sensitivity of EUS-FNA for the diagnosis of solid mass lesions. One hundred and sixty-one endosonographers whoattended the course were asked to answer the survey. This allowed assessing the current practice of EUS-FNA as well as the self-reported sensitivity of EUS-FNA for the diagnosis of solid mass lesions. We also examined which factors were associated with a self-reported sensitivity of EUS-FNA for the diagnosis of solid mass lesions 〉 80%.RESULTS： Completed surveys were collected from 92 （57.1%） of 161 endosonographers who attended the conference. The endosonographers had been practio ing endoscopy and EUS for 22.5 4. 7.8 years and 4.8 4- 4.1 years, respectively; one third of them worked in a hospital with an annual caseload 〉 100 EUS-FNA. Endoscopy practices were located in 29 countries, in- cluding 13 countries in Western Europe that totaled 75.3% of the responses. Only one third of endosonog raphers reported a sensitivity for the diagnosis of solid mass lesions 〉 80% （interquartile range of sensitivities, 25.0%-75.0%）. Factors independently associated with a sensitivity 〉 80% were （1） 〉 7 needle passes for pancreatic lesions or rapid on-site cytopathological evaluation （ROSE） （P 〈 0.0001）, （2） a high annual hospital caseload （P = 0.024） and （3） routine isolation of microcores from EUS-FNA samples （P = 0.042）. ROSE was routinely available to 27.9% of respondents. For lymph nodes and pancreatic masses, a maximum of three needle passes was performed by approximately two thirds of those who did not have ROSE. Microcores were routinely harvested from EUS-FNA samples by approximately one third （37.2%） of survey respondents.CONCLUSION： EUS-FNA sensitivity was considerably lower than reported in the literature. Low EUS-FNA sensitivity was associated with unavailability of ROSE, few needle passes, absence of microcore isolation and low hospital caseload.展开更多
OBJECTIVE:To investigate how community residents in Beijing understood and used Traditional Chinese Medicine(TCM) in their medical practice.METHODS:This was a cross-sectional study conducted on 3410 community resident...OBJECTIVE:To investigate how community residents in Beijing understood and used Traditional Chinese Medicine(TCM) in their medical practice.METHODS:This was a cross-sectional study conducted on 3410 community residents from four large communities of Tongzhou district in Beijng,China.A validated, self-administered questionnaire comprised of three sections was used to gather the data.A systematic sampling procedure was applied to recruit the community residents.RESULTS:A total of 3410 participants completed the questionnaire survey.It showed that in highly educated residents, 33.4%(170) knew of the names of 3-10 Chinese herbals, 35.8%(182) knew of names of 3-10 traditional Chinese patent drug.Among all the respondent residents, 80.7%(2753)believed that TCM herbal therapy and TCM non-drug treatments were effective in disease treatment, health enhancement, 85.7%(2923) had taken traditional Chinese patent drug in their life,56.8%(1937) of residents had used herbal decoction, 40.0%(1365) had received non-drug treatment of TCM, such as acupuncture, massage, cupping, auricular acupuncture.Among the elderly residents, 11.4%(98) often used Chinese patent drug and 9.8%(85) often used herbal decoction.In addition, 70.8%(2415) of residents were willing to accept knowledge and information on TCM for health enhancement and disease prevention, such as medicated diet, medicinal tea, Tai Chi and Qi Gong, although 82.8%(2825) of residents had never used them.CONCLUSION:Chinese patent drug and herbal decoction are widely used in the communities in Beijing, and there existed a possible close correlation between high educational level and better understanding of TCM.Age and occupation also correlated with the attitude to TCM therapies.The characteristics of the residents should be considered seriously in the course of promoting the understanding and application of TCM.展开更多
文摘Background: About 60% of institutional births occur in the private sector in Gujarat due to limited availability of obstetricians in the government. Chiranjeevi Yojana (CY), a voucher-like program initiated in 2007, accredits private obstetricians who are reimbursed by the state government to provide free delivery care to eligible women i.e. below poverty line and tribal. One million women have delivered under the CY program yet there are no large community based studies of the program. Methodology of a prospective community study is described here. Methods/Designs: A prospective cohort study was done in 142 villages across 3 districts in Gujarat between July, 2013 and November, 2014. A detailed survey was done by trained researchers to ascertain maternal healthcare information including antenatal, intra-partum and post-partum care, place of delivery, birth outcomes, out of pocket expenses etc. Results: 54,955 households were surveyed. 73% of all households had poverty documentation. 4274 mothers who delivered in the study period were included. Discussion: This paper is description of the methodology of a large community based survey and household and individual level characteristics. The survey was nested in a larger project to evaluate the CY program in the state of Gujarat.
基金This project was supported by grants from the Ford Foundation, the Save the Children Fund, and Befrienders International.
文摘Objective To compare the characteristics of suicides in the four main demographic groups： urban males, urban females, rural males and rural females in order to help clarify the demographic pattern of suicides in China. Methods A detailed psychological autopsy survey instrument was independently administered to 895 suicide victims in family members and close associates from 23 geographically representative locations from around the country. Results Pesticide ingestion accounted for 58% （519） of all suicides and 61% （3181519） of deaths were due to unsuccessful medical resuscitation. A substantial proportion （37%） of suicide victims did not have a mental illness. Among the 563 victims with mental illness, only 13% （76/563） received psychiatric treatment. Compared to other demographic groups, young rural females who died from suicide had the highest rate of pesticide ingestion （79%）, the lowest prevalence of mental illness （39%）, and the highest acute stress from precipitating life events just prior to the suicide. Contusion Many suicides in China are impulsive acts of deliberate self-harm following acute interpersonal crises. Prevention of suicides in China must focus on improving awareness of psychological problems, improving mental health services, providing alternative social support networks for managing acute interpersonal conflicts, limiting access to pesticides, and improving the resuscitation skills of primary care providers.
文摘AIM： To assess the characteristics and quality of endoscopic ultrasonography-guided fine needle aspiration （EUS-FNA） in a large panel of endosonographers.METHODS： A survey was conducted during the 13th annual live course of endoscopic ultrasonography （EUS） held in Amsterdam, Netherlands. A 2-page question- naire was developed for the study. Content validity of the questionnaire was determined based on input by experts in the field and a review of the relevant literature. It contained 30 questions that pertained to demographics and the current practice for EUS-FNA of responders, including sampling technique, sample processing, cytopathological diagnosis and sensitivity of EUS-FNA for the diagnosis of solid mass lesions. One hundred and sixty-one endosonographers whoattended the course were asked to answer the survey. This allowed assessing the current practice of EUS-FNA as well as the self-reported sensitivity of EUS-FNA for the diagnosis of solid mass lesions. We also examined which factors were associated with a self-reported sensitivity of EUS-FNA for the diagnosis of solid mass lesions 〉 80%.RESULTS： Completed surveys were collected from 92 （57.1%） of 161 endosonographers who attended the conference. The endosonographers had been practio ing endoscopy and EUS for 22.5 4. 7.8 years and 4.8 4- 4.1 years, respectively; one third of them worked in a hospital with an annual caseload 〉 100 EUS-FNA. Endoscopy practices were located in 29 countries, in- cluding 13 countries in Western Europe that totaled 75.3% of the responses. Only one third of endosonog raphers reported a sensitivity for the diagnosis of solid mass lesions 〉 80% （interquartile range of sensitivities, 25.0%-75.0%）. Factors independently associated with a sensitivity 〉 80% were （1） 〉 7 needle passes for pancreatic lesions or rapid on-site cytopathological evaluation （ROSE） （P 〈 0.0001）, （2） a high annual hospital caseload （P = 0.024） and （3） routine isolation of microcores from EUS-FNA samples （P = 0.042）. ROSE was routinely available to 27.9% of respondents. For lymph nodes and pancreatic masses, a maximum of three needle passes was performed by approximately two thirds of those who did not have ROSE. Microcores were routinely harvested from EUS-FNA samples by approximately one third （37.2%） of survey respondents.CONCLUSION： EUS-FNA sensitivity was considerably lower than reported in the literature. Low EUS-FNA sensitivity was associated with unavailability of ROSE, few needle passes, absence of microcore isolation and low hospital caseload.
基金Supported by the Beijing Municipal Science&Technology Commission(Popularized the Technologies of Chinese Medicine for Prevention and Treatment of Hypertension,Diabetes Mellitus,and Cerebrovascular Diseases in Communities,No.Z121100000312006)Tradition Chinese Medicine National Professional Project 2012(Management Pattern of Preventing and Treating Chronic Diseases using Chinese Medicine in Communities,No.201207012)
文摘OBJECTIVE:To investigate how community residents in Beijing understood and used Traditional Chinese Medicine(TCM) in their medical practice.METHODS:This was a cross-sectional study conducted on 3410 community residents from four large communities of Tongzhou district in Beijng,China.A validated, self-administered questionnaire comprised of three sections was used to gather the data.A systematic sampling procedure was applied to recruit the community residents.RESULTS:A total of 3410 participants completed the questionnaire survey.It showed that in highly educated residents, 33.4%(170) knew of the names of 3-10 Chinese herbals, 35.8%(182) knew of names of 3-10 traditional Chinese patent drug.Among all the respondent residents, 80.7%(2753)believed that TCM herbal therapy and TCM non-drug treatments were effective in disease treatment, health enhancement, 85.7%(2923) had taken traditional Chinese patent drug in their life,56.8%(1937) of residents had used herbal decoction, 40.0%(1365) had received non-drug treatment of TCM, such as acupuncture, massage, cupping, auricular acupuncture.Among the elderly residents, 11.4%(98) often used Chinese patent drug and 9.8%(85) often used herbal decoction.In addition, 70.8%(2415) of residents were willing to accept knowledge and information on TCM for health enhancement and disease prevention, such as medicated diet, medicinal tea, Tai Chi and Qi Gong, although 82.8%(2825) of residents had never used them.CONCLUSION:Chinese patent drug and herbal decoction are widely used in the communities in Beijing, and there existed a possible close correlation between high educational level and better understanding of TCM.Age and occupation also correlated with the attitude to TCM therapies.The characteristics of the residents should be considered seriously in the course of promoting the understanding and application of TCM.
