Smoking cessation intervention practices in Chinese physicians: do gender and smoking status matter?

Healthcare settings provide a major arena for administering smoking cessation interventions. However, few studies have reported differences in the frequency of practice in healthcare professionals by gender and smoking status. This might also be influenced by a difference in smoking prevalence by gender, especially in China and other developing countries. This study examined factors associated with the frequency of cessation intervention practices by smoking status among Chinese physicians in men and women. A cross-sectional survey was conducted in 2006 in physicians with direct patient contact from nine hospitals in Guangzhou with a response rate of 60.8%. Significantly more female physicians who were non-smokers (79.7%) reported "initiation and/or advice" smoking cessation interventions than male physicians who were smokers (71.2%) and non-smokers (71.6%). Factors significantly associated with "initiation and/or advice" were prior smoking cessation training (OR = 4.2, 95% CI 1.8-9.6) and lack of knowledge to help patients to quit (OR = 0.4, 95% CI 0.2-0.9) among male physicians who smoked; and organisational support (OR = 1.7, 95% CI 1.3-2.2) and successful past experience (OR = 0.4, 95% CI 0.2-1.0) among male physicians who did not smoke. Among female physicians who did not smoke, significant factors were agreeing that quitting smoking is the most cost-effective way to prevent chronic disease and cancer (OR = 3.0, 95% CI 1.4-6.1), helping patients stop smoking is part of expected role and responsibility (OR = 2.0, 95% CI 1.0-3.7), lack of knowledge to help patients to quit (OR = 0.5, 95% CI 0.2-1.0) and organisational support (OR = 1.3, 95% CI 1.0-1.6) for non-smoking female physicians. This study is the first to show that male physicians were less likely to provide smoking cessation counselling regardless of their smoking status while non-smoking female physicians were more active in advising patients on quitting. The findings highlight the need for developing tailored smoking cessation training programmes for physicians according to their smoking status and gender in China.     

Effect of fiber-rich brown seaweeds on protein bioavailability of casein in growing rats

The effect of three subtropical fiber-rich brown seaweeds, Sargassum hemiphyllum (Turn.) C. Ag., Sargassum henslowianum C. Ag. and Sargassum patens Ag., on protein bioavailability of casein were evaluated by growing rats. The effect of the fiber-rich seaweeds was determined by comparing the net protein ratio (NPR), true protein digestibility (TD), nitrogen balance (NB), biological value (BV), net protein utilization (NPU), and fecal and urinary nitrogen loss of seaweed-based diet groups with those of the cellulose-based control group. There were no significant differences on NPR and urinary N loss in all diet groups. However, the values of TD (range 85.6-89.6%), BV (range 96.9-97.5%), NPU (range 83.5-86.8%) and NB (range 145-150 mg/rat/day) in all seaweed-based diet groups were significantly (p<0.05, one-way ANOVA, Tukey-HSD) lower than those of the control group. On the contrary, the fecal weight (range 5.59-6.30 g/rat/day) and fecal nitrogen (N) loss (range 31.1-41.2 mg/rat/day) of rats fed seaweed-based diets were significantly (p<0.05, one-way ANOVA, Tukey-HSD) higher than that of the control one. However, the differences on the body weight gain and weight of internal organs including liver, kidney and spleen between the seaweed-based diets and control groups were insignificant except that the weight of caecum of rats fed seaweed-based diets was significantly (p<0.05, one-way ANOVA, Tukey-HSD) higher than that of control group. The possible mechanism of fiber-rich brown seaweeds in affecting the protein bioavailability of casein and their related nutritional implications were discussed.     

Assessing psychosocial well-being of adolescents: a systematic review of measuring instruments

Background The paradigm shift from the clinically deficit‐oriented approach to that of educationally strength‐based model in assessing adolescents' psychosocial well‐being has brought about a recent increase in school‐based health promotion and prevention initiatives. This prompted this systematic review of measuring instruments designed to assess psychosocial well‐being of children and adolescents. Methods Using electronic databases on Academic Search Premier, MEDLINE, PROQUEST, PsycINFO, CINAHL Plus and Psychosocial and Health Instrument, a systematic review of literature of measuring instruments was conducted from their inception to December 2009 using the keywords of child, emotion, assessment, scale and measure. Measuring instruments from selected articles were critically appraised using a predetermined set of quality indicators which guided the rating of the psychometric properties of the instruments into grades of A, B, and C. The constructs of psychosocial well‐being from the measuring instruments were categorized into themes. Results Twenty‐nine out of the 908 articles met the inclusion criteria. Seventeen instruments identified from the selected articles were examined using preset quality indicators. In construct building, the themes identified from the strength‐based instruments distinguished the construct of psychosocial well‐being primarily into the dimensions of personal emotional competency and social functioning. In the ratings of psychometric properties, one instrument was rated 5A, five rated 4A and four rated 3A. For reliability testing, eight measures received grade A when their intraclass correlation is higher than 0.7; whereas only two instruments reported sensitivity and none investigated responsiveness. Conclusions Strength‐based measures focusing on social emotional behavioural outcomes open up a possibility to link up assessment with promotion of psychosocial well‐being, away from clinical settings and into adolescents' homes, schools and community. Future research should focus more on investigating the sensitivity and responsiveness of measuring instruments using longitudinal design in efficacy studies to assess change in adolescents' psychosocial status over extended time.     

Effects of coarse particulate matter on emergency hospital admissions for respiratory diseases: a time-series analysis in Hong Kong

Background: Many epidemiological studies have linked daily counts of hospital admissions to particulate matter (PM) with an aerodynamic diameter ≤ 10 μm (PM₁₀) and ≤ 2.5 μm (PM_2.5), but relatively few have investigated the relationship of hospital admissions with coarse PM (PM_c; 2.5–10 μm aerodynamic diameter).Objectives: We conducted this study to estimate the health effects of PM_c on emergency hospital admissions for respiratory diseases in Hong Kong after controlling for PM_2.5 and gaseous pollutants.Methods: We conducted a time-series analysis of associations between daily emergency hospital admissions for respiratory diseases in Hong Kong from January 2000 to December 2005 and daily PM_2.5 and PM_c concentrations. We estimated PM_c concentrations by subtracting PM_2.5 from PM₁₀ measurements. We used generalized additive models to examine the relationship between PM_c (single- and multiday lagged exposures) and hospital admissions adjusted for time trends, weather conditions, influenza outbreaks, PM_2.5, and gaseous pollutants (nitrogen dioxide, sulfur dioxide, and ozone).Results: A 10.9-μg/m³ (interquartile range) increase in the 4-day moving average concentration of PM_c was associated with a 1.94% (95% confidence interval: 1.24%, 2.64%) increase in emergency hospital admissions for respiratory diseases that was attenuated but still significant after controlling for PM_2.5. Adjusting for gaseous pollutants and altering models assumptions had little influence on PM_c effect estimates.Conclusion: PM_c was associated with emergency hospital admissions for respiratory diseases in Hong Kong independent of PM_2.5 and gaseous pollutants. Further research is needed to evaluate health effects of different components of PM_c.     

Most physicians were eligible for federal incentives in 2011, but few had EHR systems that met meaningful-use criteria

As more physicians adopt electronic health record systems in their practices, policy interest is focusing on whether physicians are ready to meet the federal "meaningful use" criteria--a vital threshold to qualify for financial incentives. In our analysis of a 2011 nationally representative survey of office-based physicians, we found that 91 percent of physicians were eligible for Medicare or Medicaid meaningful-use incentives. About half of all physicians intended to apply. However, only 11 percent both intended to apply for the incentives and had electronic health record systems with the capabilities to support even two-thirds of the stage 1 core objectives required for meaningful use. Although the federal Medicare incentives will be available through 2016, and Medicaid incentives through 2021, widespread gaps in readiness throughout the states illustrate the challenges physicians face in meeting the federal schedule for the incentive programs.     

Gene polymorphism in angiotensin-I-converting enzyme and physical activity among normotensive Chinese

The angiotensin-I-converting enzyme (ACE) I/D gene polymorphism has been studied for its role in determining habitual physical activity level, but there is no information from Asian populations. The objective of this study was to determine whether this ACE gene polymorphism was associated with physical activity level among Chinese in Singapore. In this cross-sectional study, 110 normotensive Chinese in Singapore, age 21-61 yr, completed the short-form version of the International Physical Activity Questionnaire and contributed buccal cell samples for genotyping of the ACE I/D gene polymorphism using polymerase chain-reaction amplification. They also provided demographic information and underwent anthropometric measurements. Physical activity level was expressed as continuous (in kcal/wk) and categorical (low, moderate, or high) data. The 3 genotypes of ACE were DD (homozygous for the deletion allele), II (homozygous for the insertion allele), and ID. Among the participants, 28.2% reported low, 49.1% moderate, and 22.7% high physical activity level. Frequencies of the genotypes were 11.8% for DD, 42.7% for ID, and 45.5% for II. ACE genotype was independently associated with physical activity level. After age, gender, and body-mass index were adjusted for, individuals with DD or ID genotypes were more likely to report insufficient or low physical activity level than those with II genotypes (odds ratio = 6.88; 95% confidence interval: 2.26, 20.94). In conclusion, the I/D polymorphism of the ACE gene is significantly associated with self-reported physical activity level in normotensive Chinese Singaporeans.     

Contents of four active components in different commercial crude drugs and preparations of Danshen （Salvia miltiorrhiza）

AIM:To detect the contents of four active components of Salvia miltiorrhiza in various commercially available danshen crude drugs and preparations.METHODS:Commercially available danshen crude drugs from different sources,as well as danshen pills and intravenous injection preparations containing danshen alone or in combination with other herbs were collected.The composition of these danshen samples was analyzed using HPLC.Specifically,the amounts of magnesium tanshinoate B(MTB),danshensu,isotanshinone IIA,and cryptotanshinone were determined.In some of these samples,the content of MTB was further confirmed by liquid chromatography-tandem mass spectrometer (LC-MS)/MS method.RESULTS:There were great variations in the amount of the four active ingredients in the commercially available danshen crude drugs and drug preparations in this study.The amount of MTB was the highest among the four components measured in the crude drugs.However,the amounts of MTB in all danshen preparations were much lower than those in crude drugs.The 2 lipophilic components,isotanshinone IIA and cryptotanshinone,were very low or not detectable in both injection and oral preparations.CONCLUSION:MTB can be used to standardize the various forms of danshen crude drugs and drug preparations from different sources.In view of the variation in the amounts of MTB and other components,improvement in the production methods of danshen preparations is essential to ensure consistent amount of its active ingredients and reproducible pharmacological actions.     

Schistosomiasis in expatriates in the Arusha region of Tanzania

BACKGROUND: In 1996 the seroprevalence of schistosomiasis in expatriates and travelers who had contact with Lake Malawi, a fresh water source thought to be schistosomiasis-free, was measured at 32%. Clinicians in Arusha, Tanzania, questioned the prevalence of Schistosoma infection in expatriates living in the Arusha region, and how schistosomiasis might relate to symptoms of chronic fatigue in Arusha expatriates. METHOD: We performed a cross-sectional survey of 80 expatriates living in the Arusha region of Tanzania to determine the seroprevalence of schistosome infection. Whole blood was analyzed by the Falcon assay screening test-enzyme-linked immunosorbent assay (FAST-ELISA) for the presence of species-specific Schistosoma mansoni and Schistosoma haematobium antibodies to microsomal antigens of adult Schistosoma worms, followed by confirmatory enzyme-linked immunoelectrotransfer blot (Western blot). Volunteers answered a questionnaire which included length of residence in Arusha, risk factors, symptoms, and previous diagnosis of schistosomiasis. RESULTS: Of the 80 expatriates sampled, 8 (10%) were positive for schistosomiasis (6 to S. mansoni only, 1 to S. haematobium, 1 to both species). Significant risk factors, elicited by questionnaire, included longer residence in the Arusha region (p =.020), history of fatigue (p =.010) and myalgias (p =.047), and previous diagnosis of schistosomiasis by stool or urine ova (p =.0007). CONCLUSION: The lower seroprevalence of schistosomiasis in Arusha expatriates, compared with expatriates and travelers to Lake Malawi, suggests a regional variation of rate of schistosomiasis infection. Although a history of fatigue and myalgias was related to seropositivity, there is no strong evidence that schistosomiasis infection is the cause of chronic fatigue in Arusha expatriates.