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he responsibility of primary care providers, referring efficiently, refilling AEDs, as well as supervising and instructing daily management of patients.
HY received the funding for this study from the "
" of the Business Development Center of the RCSC (Beijing) and UCB (Belgium). UCB provided support in the form of a salary for author DET.
HY received the funding for this study from the "Health and Hope Fund" of the Business Development Center of the RCSC (Beijing) and UCB (Belgium). UCB provided support in the form of a salary for author DET.
The aim of this study was to describe the epidemiology of prelabour rupture of membranes (PROM) in China and to assess the association between clinical practice following the guidelines and early neonatal infections.
We conducted a prospective cohort study of 15926 deliveries in ShenZhen Baoan Women's and Children's Hospital, Xibei Women's and Children's Hospital and Chengdu Women's and Children's Hospital between August 1, 2017, to March 31, 2018. Clinical data were collected for each participant. The epidemiology of PROM was described. The association between PROM with early neonatal infectious outcomes and the influence of the implementation of the guideline on early neonatal infectious outcomes were assessed.
The incidence of PROM was 18•7%. PROM was showed to be a risk factor for neonatal infectious diseases (adjusted OR 1•92, 95%CI 1•49~2•49,
<0•0001), early-onset pneumonia (EOP) (adjusted OR 1•81, 95%CI 1•29~2•53,
=0•0006) and early-onset sepsis(EOS) (adjusted OR 14•56, 95%CI 1•90~111•67,
=0•01) for term neonates. For term neonates born from mother with PROM, induction of labor according to the guideline was a protective factor for neonatal diseases(adjusted OR 0•50, 95%CI 0•25~1•00,
=0•00498) and EOP(adjusted OR 0•32, 95%CI 0•11~0•91,
=0•03). For preterm neonates born from mother with PROM, using antibiotics according to the guideline showed to be protective for neonatal infectious diseases (adjusted OR 0•14, 95%CI 0•09~0•23,
<0•0001) and EOP (adjusted OR 0•08, 95%CI 0•04~0•14,
<0•0001).
Our study showed the risk of PROM for infectious diseases (including EOP and EOS) and the benefit of the usage of antibiotics according to the guideline for infectious diseases and EOP for preterm neonates.
National Natural Science Foundation of China, Capital Medical Development Research Fund of Beijing.
National Natural Science Foundation of China, Capital Medical Development Research Fund of Beijing.
Quality care is essential for improving maternal and newborn health. Low- and middle-income Pacific Island nations face challenges in delivering quality maternal and newborn care. The aim of this review was to identify all published studies of interventions which sought to improve the quality of maternal and newborn care in Pacific low-and middle-income countries.
A scoping review framework was used. Databases and grey literature were searched for studies published between January 2000 and July 2019 which described actions to improve the quality of maternal and newborn care in Pacific low- and middle-income countries. Interventions were categorised using a four-level health system framework and the WHO quality of maternal and newborn care standards. selleck chemicals llc An expert advisory group of Pacific Islander clinicians and researchers provided guidance throughout the review process.
2010 citations were identified and 32 studies included. Most interventions focused on the clinical service or organisational level, such learnings from women and their communities.
A history of self-harm is strongly associated with future self-harm attempts. Large-scale Asian cohort studies examining risk factors for repeated self-harm are lacking. This paper reports on annual prevalence, cumulative risk, annual risk of non-fatal self-harm repetition, and risk factors among Hong Kong patients with a history of self-harm.
The Hong Kong Clinical Data Analysis and Reporting System (CDARS) provided all accident & emergency department and inpatient self-harm records between Jan 1, 2002 and Dec 31, 2016. Demographic and clinical characteristics were extracted. Annual prevalence, over-time cumulative and annual risks of non-fatal self-harm repetition were estimated, and the adjusted hazard ratios (HR; plus 95% CIs) of putative risk factors associated with repetition were estimated using Wei-Lin-Weissfeld (WLW) generalization of the Cox model for recurrent event analysis.
There were 127,801 self-harm episodes by 99,116 individuals. Annual prevalence of repeated self-harm, of all self- General Research Funding 17611619.
Research Grants Council, General Research Funding 17611619.
While strengthening primary care quality is key to China's health system reforms, evidence to guide this work has been limited, particularly for rural areas. This study provides the first nationally-representative assessment of village doctors' competence in diagnosing and managing presumptive heart disease.
A cross-sectional study of village clinics was conducted across five provinces. We presented standardized clinical vignettes to evaluate clinicians' competence in diagnosing and managing unstable angina. Enumerators accompanying mock patients documented the interaction, including questions, physical examinations, diagnoses, and management options provided by the doctor. We measured diagnostic process competence as adherence to "recommended" questions and examinations based on national clinical practice guidelines, diagnostic competence according to whether clinicians provided a correct diagnosis, and management as correct medication and/or referral. Management was assessed twice following clinicians' own diagnoses determined through questioning and examinations, and after enumerators provided doctors with the correct diagnosis.
Clinicians completed 26% (95% CI 24% to 28%) of recommended diagnostic questions and examinations; 20% (14% to 27%) arrived at a correct diagnosis. Rates of correct management were 43% (35% to 51%) following clinicians' own diagnosis and 51% (43% to 59%) after being given the correct diagnosis. When given the correct diagnosis and only asked to provide treatment, clinicians prescribed 82% fewer potentially harmful medications than in treatments based on their own (potentially incorrect) diagnosis.
The ability of village doctors to diagnose a textbook case of unstable angina is limited. Deficits in diagnostic competence led to low rates of correct management.
The ability of village doctors to diagnose a textbook case of unstable angina is limited. Deficits in diagnostic competence led to low rates of correct management.
A high prevalence of overweight and obesity has been found in adolescents of New Caledonia and other Pacific Island Countries and Territories. Although Westernization may contribute to the weight gain in populations of Oceanian, Non-European, Non-Asian ancestry (ONENA), little is known about the sociodemographic and lifestyle factors associated with overweight in the Melanesian and Polynesian adolescents of New Caledonia.
In this cross-sectional study, a pluri-ethnic sample of New Caledonian adolescents (N=954; age M=13.2 years) completed a survey to estimate sleep duration, screen time, and dietary pattern using a food frequency questionnaire. Demographic data (gender, ethnicity, socioeconomic status SES, area of residence) were collected, and anthropometric measures were used to compute weight status.
We found a higher risk for being overweight in Melanesian (OR=1.67) and Polynesian (OR=5.40) adolescents compared with European adolescents, even after controlling for age, SES, area of residence, dietary pattern, sleep duration and screen time. We also found that low SES (OR=3.43) and sleep duration (OR=0.65 per hour) were independently associated with overweight status in the European but not in ONENA adolescents.
In this study, the main contribution to being overweight was ethnic background, i.e. being Melanesian or Polynesian. The hypothesis of a genetic influence thus seems attractive and merits further analyses.
This project was funded by the University of New Caledonia and the Fondation Nestlé France.
This project was funded by the University of New Caledonia and the Fondation Nestlé France.
Neuromyelitis Optica Spectrum Disorder (NMOSD) is an inflammatory disease of the central nervous system with preferential involvement of the optic nerve and spinal cord. However, data on NMOSD incidences in China, a country encompassing 20% of the world's population and covering vast areas of Eastern Asia, are unknown.
We conducted the first nationwide survey of NMOSD, based on the database of the National Hospital Quality Monitoring System (HQMS) of China, which covers all 1665 tertiary hospitals. The "Medical Record Homepage" of all patients were consistently collected via a standard protocol across each tertiary hospital. The primary outcome was the incidence of NMOSD, diagnosed according to the 2015 International Panel for Neuromyelitis Optica Diagnosis criteria and identified by ICD-10 code (G36•0). Burden of hospitalization, comorbidities, and death were also evaluated.
We identified 33,489 hospital admissions for 17,416 NMOSD diagnosed patients from 2016 to 2018. 11,973 patients were newly diagnohina (91949208, 91642205, and 81830038); Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing.Intimate partner violence (IPV) is a serious public health issue, and nurses have the potential to screen, navigate to interventions, and provide support, but responses to IPV differ greatly in mainland China, Hong Kong, Macao, and Taiwan. We conducted a scoping review to examine the nursing literature on IPV in the above four regions in China. We conducted a comprehensive search of 11 Chinese and English databases from database inception to January 31, 2020, for eligible papers including empirical studies, reviews, reports, and expert opinion articles. We hand searched references lists and other studies published by the first and corresponding authors of included articles. Two reviewers independently screened articles and extracted data, and three reviewers cross-checked the extracted results. We also conducted quality appraisal for applicable empirical studies. A total of 58 Chinese-language and 63 English-language articles were included, 58 from Taiwan, 44 from Hong Kong, 13 from mainland China, and six fr socio-economic-political-cultural factors.
Pneumococcal pneumonia is a leading cause of childhood mortality. Pneumococcal conjugate vaccines (PCVs) have been shown to reduce hypoxic pneumonia in children. However, there are no studies from Asia examining the effectiveness of PCVs on hypoxic pneumonia. We describe a novel approach to determine the effectiveness of the 13-valent PCV (PCV13) against hypoxia in children admitted with pneumonia in the Lao People's Democratic Republic.
A prospective hospital-based, test-negative observational study of children aged up to 59 months admitted with pneumonia to a single tertiary hospital in Vientiane was undertaken over 54 months. Pneumonia was defined using the 2013 WHO definition. Hypoxia was defined as oxygen saturation <90% in room air or requiring oxygen supplementation during hospitalisation. Test-negative cases and controls were children with hypoxic and non-hypoxic pneumonia, respectively. PCV13 status was determined by written record. Vaccine effectiveness was calculated using logistic regression.
