Comprehensive Intervention Measures Research Articles

Pesticide risk behaviors and factors influencing pesticide use among farmers in Kuwait

The widespread overuse of pesticides in agriculture has generated increasing concerns about the negative effects of pesticides on human health and the environment. Understanding farmers' perceptions of risk of pesticides and the determinants of pesticide overuse is important to modifying their behavior towards reducing pesticide use. A survey of 250 randomly selected smallholder vegetable farmers in Kuwait was conducted to quantify the extent of pesticide use, their pesticide risk perceptions and factors influencing their pesticide use behaviors. The majority of the farmers perceived pesticides pose some risk to the environment (65%) and human health (70.5%), while younger farmers were more likely to perceive this risk than older farmers. When asked to rate how risky pesticides were regarding several aspects of human health and the environment on a scale of 1(not risky) to 5 (extremely risky), concern was highest for the health of applicators (x̅=4.28) and lowest for air quality (x̅=2.32). The risk perceptions of the farmers did not have a positive influence on their pesticide use practices. A total of 76 pesticide active ingredients were found in use, and 9% of these belong to the WHO toxicity class II (moderately hazardous). On average, farmers applied 12.8kg of active ingredients per hectare per year, and 58% of the farmers were found to have overused pesticides, with an average overuse rate of 2.5kg. Pesticide application frequency ranged from two times a month up to once a week, depending on the crop. A binary probit model reveals that farmers' inadequate knowledge of pesticides, the influence of pesticide retailers and lack of access to non-synthetic methods of pest control are positively associated with pesticide overuse, while the propensity to overuse decreases with higher levels of education, training in Integrated Pest Management (IPM) and the safe use and handling of pesticides, and access to extension support. Comprehensive intervention measures for reducing pesticide overuse and limit the health and environmental hazards caused by pesticides are provided in this paper.

Practices and effects of different measures for blood pressure control in hypertension patients in Beijing, 2014

Objective: To understand the practices and effects of different measures for blood pressure control in hypertension patients. Methods: Patients who have known hypertension from the subjects of "2014 Beijing adult (aged 18-79 years) chronic diseases and risk factors survey" were selected. The choices of different hypertension control measures, the relationship between the measures and demographic characteristics of hypertension patients, and the effects of different control measures were analyzed. Results: A total of 2 229 known hypertension patients were included, the analysis was conducted through a questionnaire survey. Those who answered "never taking any measures" , "taking medication according to doctor's instructions" and "taking medication when blood pressure rose" accounted for 7.0%, 79.8% and 8.3%, respectively. Those who had "diet control" , "physical exercises" and "blood pressure monitoring" accounted for 22.4%, 23.7% and 22.1%, respectively. In terms of "taking medicine according to doctor's instructions" , women (84.3%), those aged ≥60 years (87.6%), those living in urban area (81.5%), those living alone (83.8%), and Beijing local residents (82.3%) had higher compliance rates. As for "diet control" , women (24.4%), those aged ≥60 years (25.8%) and those with educational level of college or above (29.5%) had better practices. In terms of "physical exercise" , those aged ≥60 years (27.9%), those living in urban area (25.3%), those with educational level of college or above (32.5%) had better practice. Women (24.2%) and those aged ≥60 years (28.4%) had higher "blood pressure monitoring" rate. More men (9.7%), those aged 18-44 years (14.7%), those with educational level of high school (9.3%), the unmarried (18.2%), and non-Beijing local residents (14.7%) answered "never taking any measure" , and in terms of "taking medication when blood pressure rose" , non-Beijing local residents (12.8%) had higher rate. In the field survey, more patients who never took any measure (98.1%) had higher blood pressure than those who took control measures (67.1%), and those who took medicine according to doctor's instructions had lowest blood pressure rise rate (63.9%). Conclusions: Most hypertension patients could take medication according to doctor's instructions, but less patients received other comprehensive intervention measures, and there were still some patients never took any control measure, or took medication only when blood pressure rose. "Taking medication according to doctor's instructions" showed a significant effect in blood pressure control.

Surveillance for malaria outbreak on malaria-eliminating islands in Tafea Province, Vanuatu after Tropical Cyclone Pam in 2015.

The risk of malaria outbreak surfaced in Vanuatu after Tropical Cyclone (TC) Pam in March 2015. In June and July 2015 we conducted malariometric surveys on the islands of Tanna, Aneityum, and Erromango in Tafea Province, where malaria elimination had been targeted, to determine if malaria incidence had increased after TC Pam. No Plasmodium infection was detected by microscopy and PCR in 3009 survey participants. Only 6·3% (190/3007) of participants had fever. Spleen rates in children aged ⩽12 years from Aneityum and Tanna were low, at 3·6% (14/387) and 5·3% (27/510), respectively. Overall bed net use was high at 72·8% (2175/2986); however, a significantly higher (P < 0·001) proportion of participants from Aneityum (85·9%, 796/927) reported net use than those from Tanna (67·1%, 751/1119) and Erromango (66·8%, 628/940). A recent decrease in malaria incidence in Tafea Province through comprehensive intervention measures had reduced the indigenous parasite reservoir and limited the latter's potential to spur an outbreak after TC Pam. The path towards malaria elimination in Tafea Province was not adversely affected by TC Pam.

Analysis of influencing factors for doctors' prescription of essential medicines at county hospitals in Anhui province

Objective To analyze the influencing factors for doctors' prescription of essential medicines at county hospitals of Anhui province. Methods Multi-stage random sampling method was designed to conduct an investigation for doctors at nine county hospitals in Anhui province, and SPSS 16.0 was used to conduct descriptive statistical, chi-square test and binary logistic regression. Results 50.8% respondents reported that they had prescribed essential medicines with the rate of less than 60%. The factors of doctors' prescription for essential medicines are work experience, average monthly income, policy awareness, recognition, training willingness, training times, hospital support, medication preferences, and drug marketing. Conclusion The prescription rate of essential medicines in the sampled hospitals is low, and the targeted comprehensive intervention measures should be taken to promote prescription rate of essential medicines in county hospitals. Key words: Essential medicines; County hospitals; Prescription; Influencing factors

A Cross-sectional Study Assessing Predictors of Essential Medicines Prescribing Behavior Based on Information-motivation-behavioral Skills Model among County Hospitals in Anhui, China.

Background:The self-consciousness and practicality of preferentially prescribed essential medicines (EMs) are not high enough in county hospitals. The purposes of this study were to use the information-motivation-behavioral skills (IMB) model to identify the predictors of essential medicines prescribing behavior (EMPB) among doctors and to examine the association between demographic variables, IMB, and EMPB.Methods:A cross-sectional study was carried out to assess predictive relationships among demographic variables and IMB model variables using an anonymous questionnaire administered in nine county hospitals of Anhui province. A structural equation model was constructed for the IMB model to test the instruments using analysis of moment structures 17.0.Results:A total of 732 participants completed the survey. The average age of the participants was 37.7 ± 8.9 years old (range: 22–67 years old). The correct rate of information was 90.64%. The average scores of the motivation and behavioral skills were 45.46 ± 7.34 (hundred mark system: 75.77) and 19.92 ± 3.44 (hundred mark system: 79.68), respectively. Approximately half (50.8%) of respondents reported that the proportion of EM prescription was below 60%. The final revised model indicated a good fit to the data (χ2/df = 4.146, goodness of fit index = 0.948, comparative fit index = 0.938, root mean square error of approximation = 0.066). More work experience (β = 0.153, P < 0.001) and behavioral skills (β = 0.449, P < 0.001) predicted more EMPB. Higher income predicted less information (β = −0.197, P < 0.001) and motivation (β = −0.204, P < 0.001). Behavioral skills were positively predicted by information (β = 0.135, P < 0.001) and motivation (β = 0.742, P < 0.001).Conclusion:The present study predicted some factors of EMPB, and specified the relationships among the model variables. The utilization rate of EM was not high enough. Motivation and behavior skills were crucial factors affecting EMPB. The influence of demographic variables, such as income and work experience, on EMPB should be fully appreciated. Comprehensive intervention measures should be implemented from multiple perspectives.

Clinical observation and nursing care of high dose hormone therapy in patients with uveitis

Objective To explore the nursing program of large dose hormone therapy for the treatment of uveitis patients, and to provide the reference for clinical nursing program. Methods A total of 196 patients with uveitis were randomly divided into observation group and control group with 98 cases 136 eyes each group by the random number table method. All patients were treated with high-dose hormone therapy. The control group received routine nursing care, while the observation group was given comprehensive nursing intervention measures. The clinical efficacy and recurrence rate of two groups were compared. Results After treatment, the total effective rate of observation group was 90.44%, and it was 89.71% in the control group (χ2=0.041, P>0.05). Over 1 year of follow-up, the recurrence rate in the observation group was 5.15%, while it was 30.88% in the control group, and the recurrence rate of the observation group was significantly lower than that of the control group (χ2=30.381, P<0.05). Conclusions During the process of high dose hormone therapy of uveitis patients, rigorous observation and comprehensive nursing interventions can help clinical treatment effect, reduce the recurrence rate of uveitis, and is worth of further application. Key words: Uveitis; Nursing care; High dose hormone therapy

A one health framework for the evaluation of rabies control programmes: a case study from Colombo City, Sri Lanka.

BackgroundOne Health addresses complex challenges to promote the health of all species and the environment by integrating relevant sciences at systems level. Its application to zoonotic diseases is recommended, but few coherent frameworks exist that combine approaches from multiple disciplines. Rabies requires an interdisciplinary approach for effective and efficient management.Methodology/Principal FindingsA framework is proposed to assess the value of rabies interventions holistically. The economic assessment compares additional monetary and non-monetary costs and benefits of an intervention taking into account epidemiological, animal welfare, societal impact and cost data. It is complemented by an ethical assessment. The framework is applied to Colombo City, Sri Lanka, where modified dog rabies intervention measures were implemented in 2007. The two options included for analysis were the control measures in place until 2006 (“baseline scenario”) and the new comprehensive intervention measures (“intervention”) for a four-year duration. Differences in control cost; monetary human health costs after exposure; Disability-Adjusted Life Years (DALYs) lost due to human rabies deaths and the psychological burden following a bite; negative impact on animal welfare; epidemiological indicators; social acceptance of dogs; and ethical considerations were estimated using a mixed method approach including primary and secondary data. Over the four years analysed, the intervention cost US $1.03 million more than the baseline scenario in 2011 prices (adjusted for inflation) and caused a reduction in dog rabies cases; 738 DALYs averted; an increase in acceptability among non-dog owners; a perception of positive changes in society including a decrease in the number of roaming dogs; and a net reduction in the impact on animal welfare from intermediate-high to low-intermediate.ConclusionsThe findings illustrate the multiple outcomes relevant to stakeholders and allow greater understanding of the value of the implemented rabies control measures, thereby providing a solid foundation for informed decision-making and sustainable control.

An outpatient antibacterial stewardship intervention during the journey to JCI accreditation

BackgroundAntibacterial overuse, misuse and resistance have become a major global threat. The Joint Commission International (JCI) accreditation standards include quality improvement and patient safety, which is exemplified by antimicrobial stewardship. There are currently few reports on interventions to improve the quality of outpatient antibacterial prescribing.MethodsA before-after intervention study, aiming at antibacterial use in outpatients, was performed in a university-affiliated hospital with 2.8 million outpatient visits annually during the journey to JCI accreditation (March of 2012 - March of 2013). Comprehensive intervention measures included formulary adjustment, classification management, motivational, information technological, educational and organizational measures. A defined daily dose (DDD) methodology was applied. Pharmacoeconomic data and drug-related problems (DRPs) were statistically compared between the two phases.ResultsThe variety of antibacterials available in outpatient pharmacy decreased from 38 to 16. The proportion of antibacterial prescriptions significantly decreased (12.7% versus 9.9%, P < 0.01). The proportion of prescriptions containing the restricted antibacterials was 30.4% in the second phase, significantly lower than the value of 44.7% in the first phase (P < 0.01). The overall proportion of oral versus all antibacterial prescriptions increased (94.0% to 100%, P < 0.01) when measured as defined daily doses. Statistically significant increases in relative percentage of DDDs of oral antibacterials (i.e., DDDs of individual oral antibacterial divided by the sum of DDDs of all antibacterials) were observed with moxifloxacin, levofloxacin, cefuroxime axetil, ornidazole, clindamycin palmitate, cefaclor, amoxicillin and clarithromycin. Occurrence rate of DRPs decreased from 13.6% to 4.0% (P < 0.01), with a larger decrease seen in surgical clinics (surgical: 19.5% versus 5.6%; internal medicine: 8.4% versus 2.8%, P < 0.01). The total expenditure on antibacterials for outpatients decreased by 34.7% and the intervention program saved about 6 million Chinese Yuan Renminbi (CNY) annually.ConclusionThe one-year intervention program on outpatient antibacterial use during the journey to JCI accreditation reduced the expenditure on antibacterials, improved the appropriateness of antibacterial prescriptions. Quality improvements need integrated multifaceted intervention measures and long-term adherence to the antibiotic stewardship. Approach of i.v. to oral antibacterial switch, classification management, and motivational measures may play the most efficient role in changing antibacterial prescription practices.

Application of the bucket theory in evaluating the effect of the cultivation of humanistic quality of post ;90s nursing students in practice

Objective To explore the clinical teaching intervention measure and effect of the cultivation of humanistic quality of post 90s nursing students in practice .Methods One hundred and forty-eight nursing students in practice from 2012 and 152 cases from 2013 were chosen and divided into the control group and the observation group .The control group received traditional way of teaching , the observation group received the intervention study on the cultivation of humanistic quality about ten months through the bucket theory .The comprehensive intervention measures were carried out through the way of joint teaching in all clinical departments so as to improve the teaching philosophy , update the concepts of education , reform the curriculum structure, optimize teaching contents , refine teaching processes , and strengthen the model and guidance .The evaluation was carried out according to the formulation of methods and standard of evaluating the humanistic quality and professional image of nursing students in practice , and the scores of evaluation were analyzed , and the interventional effect was compared .Results The cases of nursing students in practice who respectively got 10-20, 21-30, and 31-40 were 4 cases （2.6%）, 49 cases （32.3%）, 99 cases （65.1%） in the observation group, and were significantly higher than 22 cases （14.9%）, 53 cases （35.8%）, 73 cases （49.3%） in the control group, and the difference was statistically significant （Z=-3.351, P<0.05）.The score of hospital patients on the cultivation of humanistic quality and self-evaluation of nursing students in practice in the observation group were higher than those in the control group , and the difference was statistically significant （Z=-3.202, P <0.05 ）.Conclusions The implementation of the intervention of the cultivation of humanistic quality through the bucket theory can effectively improve the nursing students ’ humanistic quality , improve the professional image , and is benefit to all-round development of the nursing students in practice . Key words: Bucket theory; Post 90s; Nursing students in practice; Humanistic quality; Interventional effect

Study on Chronic Diseases Comprehensive Intervention in Baoji of Shaanxi Province in China

Background: There is very limited data available about the epidemiology trial on chronic diseases comprehensive intervention. The aim of this study was to assess the effect of comprehensive intervention on chronic diseases in Baoji and provide basis for the improvement of chronic diseases intervention measures. Methods: Using four stages stratified random sampling method, comprehensive intervention measures were implemented on intervention group (575 individuals) respectively aimed at three crowds of whole population, high risk population and chronic diseases patients. The control group (782 individuals) did not receive special treatment. Two groups were evaluated effect after one year observation. Results: The chronic diseases prevalence rate of whole population in intervention group was lower than that in control group (P < 0.05), the blood pressure level and smoking proportion of high risk population in intervention group were lower than in control group (P < 0.05), and the blood pressure, blood glucose control rate of chronic diseases patients in intervention group were higher than in control group (P < 0.05). Conclusion: Comprehensive intervention could prevent the rise of chronic diseases prevalence. The intervention is effective in reducing or halting risk factors of high risk population, particularly in controlling blood pressure, blood glucose of patients. We should establish government leading, department cooperation, social participation, longtime and classified comprehensive intervention mechanism of chronic diseases. We believe that whole population should control the risk factors, high risk population should early diagnosis and treatment, chronic diseases patients should normalized management, and it could be applied in other counties.

Discussion on effect of comprehensive nursing intervention to blood sugar and negative emotions during gestational diabetes mellitus pregnant period

Objective To explore the effect of comprehensive nursing intervention on blood sugar levels during pregnancy and the influence of negative emotions in patients with gestational diabetes mellitus (GDM).Methods 100 cases of patients with GDM were randomly divided into observation group and control group,50 cases in each group.The control group used conventional nursing method for patients,observation group used the comprehensive nursing intervention measures based on the conventional treatment in control group.Blood sugar and negative mood changes were compared in patients of two groups.Results The blood glucose level during pregnancy in observation group patients was better than that in control group,observation group almost got close to normal,postprandial glucose in the control group increased significantly; and the incidence of negative emotions (like depression 0) more significantly decreased than the control group (such as depression 16.00％).Conclusion Adopting comprehensive nursing intervention in patients with GDM can not only control blood sugar in a stable level,but also can reduce the negative emotions of pregnant women to keep them have the optimistic point of view,showing very important application value in clinic. Key words: Comprehensive nursing intervention; Gestational diabetes mellitus (GDM); Blood sugar; Negative emotions

The efficacy appreciation of nursing intervention in the prevention of urinary retention of patients after orthopedic surgery

Objective To assess the clinical efficacy of nursing intervention in the prevention of urinary retention in patients after orthopedic surgery.Methods 116 patients undergoing orthopedic surgery were divided randomly into a study group and a control group,58 for each group.The control groups received conventional nursing,while the study group received comprehensive nursing intervention measures in addition to conventional nursing.Results The study group was superior to the control group in restoration of bladder function and satisfication (P＜0.01for both comparisons).Thehe incidence rate of urinary retention was lower in the study group than in the control group (P＜0.05).Conclusions Nursing intervention can effectively prevent the incidence of urinary retention in patients after orthopedic surgery,and enhance the quality of nursing and the degree of patient satisfaction. Key words: Nursing intervention; Urinary retention; Orthopedics; Prevention

Research progress on the nursing intervention of deep vein thrombosis of lower limb

The research progress on the nursing intervention of deep vein thrombosis of lower limb was summarized in this article,it included risk factors assessment of high-risk population,some presently common mechanical auxiliary way,venous protection,diet guidance,drug prevention and lower extremity blood circulation assessment etc.In order to strengthen the internal high-risk patients with lower extremity venous thrombosis prevention,primary screening evaluation process was should be carried out at first,according to the risk factors of thrombosis in high-risk patients,systematic and comprehensive nursing intervention measures were brought forward.The development trend of mechanical prevention nursing intervention and the concrete implementation were stated to provide the reference for clinical nurses. Key words: High-risk population; Deep Venous Thrombosis (DVT) ; Nursing intervention; Research progress

Application of the intervention mode of family treatment and nursing behaviors on children hemophilia

Objective To explore the applicable nursing intervention mode of family and nursing for children with hemophilia which was appropriate for local hemophilia center (HTC).Methods The nursing intervention group,which consisting of nurses,hemophilia patients aged 2 ～ 18 and their parents,discussed and summarized the problems in family and nursing for children with hemophilia,through literature review and expert consultation,developed comprehensive nursing intervention measures,which including individualized coagulation factors injection training,hemophilia classes,children hemophilia families sodality and follow-up visiting of the family and nursing behaviors.The effect of nursing intervention was judged through measuring and comparing the family and nursing behaviors.Results After intervention,among 22 items of family and nursing behaviors,19 items were significantly improved than that of no intervention ( x2=59.88,36.47,96.30,13.57,34.67,55.06,55.06,21.85,22.69,45.69,39.33,68.25,11.99,35.39,35.39,17.24,81.51,85.75,13.57,respectively; P＜0.01 ).Before intervention,the incidence of correctly record every bleeding and treatment among the patients was 2 cases(3.85％ ),while after intervention,that was 48 cases ( 92.31％ ),and the incidence of monthly report the bleeding and therapy nursing information to nurses was raised from 5 cases (20％) to 52 cases ( 100％ ) after intervention,and the difference was statistically significant (x2=81.51,85.75,respectively;P＜0.01).Conclusions Comprehensive nursing intervention measures can improve the families' and nursing behaviors of children with hemophilia and achieve the effective management of patients' information at the sam time,which is applicable for local hemophilia center. Key words: Children, hemophilia; Family treatment; Nursing behaviors

The influence of pharmaceutical care dominated by pharmacists on medication of community patients with hypertension

Objective: To evaluate the intervention effects of pharmaceutical care team dominated by pharmacists on medication of community patients with hypertension.Methods:The education about the knowledge of hypertension and rational drug use was carried out.Life and health care on the patients was performed combining with intervention measures such as continuous follow-up and medication guidance.Then the intervention effects were investigated by measuring the levels of blood pressure,the hypertension-related knowledge and the medication compliance of patients.Results: At the end of one-year intervention course,qualified rates of blood pressure increased from 27.59% before intervention to 93.10%,and the average decreases of systolic and diastolic pressures were 14.26 and 9.01 mm Hg,respectively.The variaties and the costs of drugs slightly decreased.The average score of the questionnaire about hypertension-related knowledge increased from 63.41 to 97.27.The medication compliance improved significantly.The unqualified rates of some biochemical indexes were decreased,and the body mass indexes(BMI) of the patients were decreased significantly(P0.05).The qualified rates of blood pressure at the 5th and 14th months after the intervention end were 89.66% and 81.48%,respectively,and the medication compliance among the patients declined,but still maintained at high level.Conclusion:The comprehensive intervention measures adopted by the pharmaceutical care team and dominated by senior pharmacists such as the education about the knowledge of hypertension and rational drug use,together with continuous follow-up and medication guidance on community patients with hypertension may substantially raise the patients' medicine knowledge level,enhance the awareness of rational drug use,and improve their medication compliance,blood pressure qualified rate and life quality.Thus continuous intervention is necessary to maintain persistent blood pressure qualified rate.

Burden of disease regarding paratyphoid fever A - based on the Syndromic Surveillance System on Fever

To evaluate the burden of paratyphoid fever A in Hongta district, Yuxi city, Yunnan province from May 1, 2008 to April 30, 2009 so as to provide information for the development of comprehensive intervention measures. Based on the Fever Syndromic Surveillance System, information as attendance rate of patients with fever, rate of patients being sampled, laboratory testing rate, sensitivity on the detection of blood culture and the rate of case reporting etc. were calculated. According to the pyramid model of food-borne disease on disease burden, the local actual incidence of paratyphoid fever A was estimated and analyzed. Under the Fever Syndromic Surveillance System, there were 6642 fever cases being detected, among whom 6570 cases were sampled and undergone testing, with the sampling rate as 98.92% and all the samples received laboratory testing. There were 354 positive cases of paratyphoid fever A reported, all from the Hongta district. Data showed that the attendance rate of the feverish patients was 73.53%, with the highest rate seen in whose under 10 years old (100%). Assumed that the sensitivity of paratyphoid fever blood culture was 70%, and the case reporting rate was 90%, we estimated that the annual incidence of paratyphoid fever A in Hongta was 220.33 (95%CI: 170.1 - 521.4) per 100 thousand, with 965 (95%CI: 745 - 2284) as new cases. Among all the age groups, the incidence in the age group from 15 to 44 years old was estimated to be at the highest (318.27 per 100 thousand). Hongta seemed to be an endemic region for paratyphoid fever A, with the highest incidence occurred in the age group of between 15 and 44 years old. These findings highlighted the urgent need to carry out further investigation on the risk factors and to implement targeted effective prevention and control measures.

Riesgo de Juego Patológico. Factores y trastornos mentales asociados en jóvenes de Medellín - Colombia

To study the risk of pathological gambling and its possible relation with mental disorders and school and family problems in a population of school pupils from the city of Medellin (Colombia), with a view to providing guidance for mental health care. Cross-sectional study; sample comprises 3486 students aged 10 to 19 years selected from all the educational institutions in the city. The sample is probabilistic and represents an estimated population of 290,000 young people from Medellin. The SOGS instrument (South Oaks Gambling Screening) was used for screening risk and likelihood of problem gambling. The analytic stage assessed possible associated factors such as mental disorders, alcohol use and drug use, with statistical significance levels of 5% and prevalence rates with 95% confidence intervals. A total of 48.6% were without problems, 37.6% were at risk and 13.8% were possible pathological gamblers. Males were more at risk than females (2.5:1), and the highest proportion of possible pathological gamblers was in the 10-14 age group (58.7%), vs. the 15-19 group (41.3%). Pathological gambling in young people is associated in this study with: anxiety OR=2.1(1.69-2.60), depression OR=1.73(1.33-2.24), suicide attempt OR=1.85(1.20-2.85), impulsivity OR=3.48(2.85-4.26), violent behavior OR=4.64(3.57-5.58), and problems at school OR=2.46(1.97-3.06); recent use of cigarettes, drunkenness and illegal drugs (use/addiction) were identified as associated risk factors, p value: <0.05. Pathological gambling risk is high in this young population, and is associated with mental disorders, use of psychoactive substances, and school and family problems. This situation suggests the need for large-scale and comprehensive preventive and therapeutic intervention measures for addressing the problem.

Analysis on the intervention services status of prevention of mother to child transmission of HIV/AIDS in China

The purpose of this study is to get to know the intervention services implementation status of prevention of mother to child transmission (PMTCT) of HIV/AIDS in China, and the trend of recent five years. We carried out relevant surveys and investigations among the areas where PMTCT work had been implemented during January 2005 to December 2009. Health providers in these fields provided routine maternal health care, HIV counseling and test for 10 360 655 pregnant women and comprehensive intervention measures to 10 123 HIV infected pregnant women which included antiretroviral (ARV) drugs usage, safety delivery, and exclusive breastfeeding, and collected relevant data and materials to analysis the ratio of main interventions and its change trend. The HIV/AIDS counseling rate was increasing year by year (χ(2)(trend) = 3184.5, P < 0.001), during 2005 to 2009 the rate was 69.8% (406 151/581 975), 84.5% (1 346 745/1 594 579), 90.3% (1 582 757/1 753 191), 93.7% (1 926 224/2 055 232), 82.3% (3 599 228/4 375 678) respectively. HIV/AIDS test rate was increasing (χ(2)(trend) = 146 194.7, P < 0.001), the rate from 2005 to 2009 was 57.8% (336 459/581 975), 80.8% (1 287 812/1 594 579), 87.0% (1 524 595/1 753 191), 89.2% (1 833 246/2 055 232), 85.5% (3 741 337/4 375 678)respectively. The total number of HIV/AIDS infected maternities was 10 123 during 2005-2009, 6156 of them delivered, the general usage rate of ARVs was 71.0% (4373/6156), and increasing to 75.3% (1554/2065) by the end of 2009, the rates of 2005 to 2008 were 64.6% (362/560), 66.9% (623/931), 66.7% (857/1284), 74.2% (977/1316) respectively. The difference was significant (χ(2)(trend) = 47.6, P < 0.001). The proportion of using ARVs during pregnant period was 58.5% (2557/4373). The proportion of using ARVs among born infants of HIV infected maternities was 83.4% (4999/5994), and increasing yearly, 77.2% (409/530) of 2005, 80.1% (720/899) of 2006, 83.8% (1053/1257) of 2007, 89.4% (1116/1249) of 2008, 82.6% (1701/2059) of 2009, the difference was significant (χ(2)(trend) = 13.0, P < 0.001). The general rate of exclusive breastfeeding was 92.9% (5276/5681) and the rate of HIV test in 18 months was 74.6% (2482/3324). The rate of HIV/AIDS counseling and test of general maternities is increasing and the proportion of mainly intervention measures have been increased year by year.

Utilisation of maternal health care in western rural China under a new rural health insurance system (New Co-operative Medical System)

To investigate factors influencing maternal health care utilisation in western rural China and its relation to income before (2002) and after (2007) introducing a new rural health insurance system (NCMS). Data from cross-sectional household-based health surveys carried out in ten western rural provinces of China in 2003 and 2008 were used in the study. The study population comprised women giving birth in 2002 or 2007, with 917 and 809 births, respectively. Correlations between outcomes and explanatory variables were studied by logistic regression models and a log-linear model. Between 2002 and 2007, having no any pre-natal visit decreased from 25% to 12% (difference 13%, 95% CI 10-17%); facility-based delivery increased from 45% to 80% (difference 35%, 95% CI 29-37%); and differences in using pre-natal and delivery care between the income groups narrowed. In a logistic regression analysis, women with lower education, from minority groups, or high parity were less likely to use pre-natal and delivery care in 2007. The expenditure for facility-based delivery increased over the period, but the out-of-pocket expenditure for delivery as a percentage of the annual household income decreased. In 2007, it was 14% in the low-income group. NCMS participation was found positively correlated with lower out-of-pocket expenditure for facility-based delivery (coefficient -1.14 P < 0.05) in 2007. Facility-based delivery greatly increased between 2002 and 2007, coinciding with the introduction of the NCMS. The rural poor were still facing substantial payment for facility-based delivery, although NCMS participation reduced the out-of-pocket expenditure on average.

Influence of nursing intervention on anxiety and depression of patients receiving α-interferon treatment

Objective To discuss effective nursing measures to reduce incidence rate of anxiety and depression caused by α-intefferen treatment,and to enable the successful completion of interferon treatment for hepatitis B patients. Methods Hepatitis B patients(220 cases) receiving α-interferon treatment were randomly divided into the intervention group(115 cases) and the control group(105 cases).The control group adopted conventional nursing,while in the intervention group,comprehensive intervention measures such as close observation,psychological intervention,symptomatic treatment intervention were used.Zung self-rating depression scale (SDS) was used to compare the incidence rate of anxiety and depression.The completion of treatment was also compared between the two groups. Results After 3,6 and 12 months of treatment incidence rate of anxiety and depression in the intervention group was significantly lower than that of the control group (P＜0.05).There were 112 cases completed treatment in the intervention group,which were higher than those of the control group,72 cases (P＜0.01). Conclusions Nursing intervention measures such as close observation,psychological intervention,symptomatic treatment can reduce incidence rate of anxiety and depression caused by a-interferon treatment. Key words: Chronic hepatitis; Interferon; Anxiety; Depression; Nursing