The demand for knowledge of productive health and the current status of productive health services provided by relevant governmental institutions were qualitatively and quantitatively studied. The study identified the key factors that influenced the demand for the productive health services and results of the services. It also discussed the effective approaches to control, planning and sustainable development of the reproductive health services for the floating populations.
Attitude to Health ; China ; Health Services Accessibility ; Health Services Needs and Demand/*statistics & numerical data ; Questionnaires ; *Reproductive Health Services/supply & distribution ; Sampling Studies ; Transients and Migrants ; Travel ; Urban Health Services/*organization & administration ; Urban Health Services/standards ; Young Adult

Child ; Child Health Services ; trends ; Delivery of Health Care ; organization & administration ; Education, Medical ; Hospitals, Pediatric ; economics ; organization & administration ; Humans ; Pediatrics ; trends ; Specialization ; Urban Population

OBJECTIVETo explore a suitable model regarding community-based case management of hypertension in the urban areas.

METHODSBased on the guidelines set by the Chinese Hypertension League (CHL), the goal of case management of hypertension was set as: to maintain blood pressure at the normal range. Family doctors were guided to take care of case management. Hypertension patients who had been contracted to the family doctors were followed by a team of family doctors for half a year.

RESULTSAfter the 6-month intervention, the rate of hypertension under control had increased from 50.44% to 69.84% (P < 0.0001) while the means of systolic blood pressure decreased by 3.72 mm Hg and diastolic blood pressure decreased by 2.67 mm Hg (P < 0.0001) respectively. The means of SBP decreased by 8.59 mm Hg and diastolic blood pressure decreased by 5.26 mm Hg in patients whose baseline blood pressure were not under control. The rates of smoking, higher salt intake and no physical exercise had significantly decreased (P < 0.05). The mean number of hospital visits in the six-month follow-up period was 7.69 +/- 2.37. The "rate of control" among those who had followed schedule was higher than that of those who were not on schedule (P < 0.0001). The rate among those who had followed the schedule tended to have increased with aging and the level of education (P < 0.001).

CONCLUSIONThe community-based case management program on hypertension played an important and effective role in the control of hypertension in urban areas. Patients received great benefit when following the guidance from their doctors.

Aged ; Case Management ; organization & administration ; China ; epidemiology ; Community Health Services ; organization & administration ; Evaluation Studies as Topic ; Female ; Humans ; Hypertension ; epidemiology ; Male ; Middle Aged ; Urban Health

INTRODUCTIONDepression affects more women than men in Malaysia. The objective of this paper was to determine the prevalence of depression and its associated factors among women attending a government primary care clinic.

METHODSA cross-sectional study was conducted in a government-funded primary care clinic in Malaysia. Consecutive adult female patients attending the clinic during the data collection period were invited to participate. The participants completed self-administered questionnaires (including the validated Patient Health Questionnaire [PHQ-9], which was translated into the Malay language).

RESULTSA total of 895 female patients participated in the study (response rate 87.5%). The prevalence of depression (PHQ-9 scores ≥ 10) was 12.1%. Based on multiple logistic regression analysis, certain stressful life events were found to be associated with depression (p < 0.05). These factors, arranged from highest to lowest risk, were financial problems (odds ratio [OR] 3.7, 95% confidence interval [CI] 2.2-6.2), unhappiness in the parent-child relationship (OR 3.0, 95% CI 1.2-7.5), history of serious illness (OR 2.4, 95% CI 1.1-5.2), unhappiness in family relationships (OR 2.3, 95% CI 1.1-4.7) and unhappiness at work (OR 2.2, 95% CI 1.1-4.3) (p < 0.05).

CONCLUSIONThe prevalence of depression among participants in this study was clinically significant and corresponded with the findings of other international studies. Factors associated with depression need to be highlighted and addressed accordingly. Clinicians in Malaysia should be aware of this prevalence when making diagnoses in primary care.

Adolescent ; Adult ; Aged ; Cross-Sectional Studies ; Depression ; diagnosis ; epidemiology ; etiology ; Female ; Humans ; Malaysia ; Middle Aged ; Parent-Child Relations ; Prevalence ; Primary Health Care ; organization & administration ; Regression Analysis ; Risk ; Sex Factors ; Social Class ; Surveys and Questionnaires ; Urban Health Services ; Urban Population

In a real-world running of cancer screening programs or intervention strategies, multiple influencing factors need to be considered other than the effectiveness and cost-effectiveness. The articles in this special issue summarize the main findings related to sustainability of cancer screening program in urban China from four perspectives of cancer screening service, including actual supplier, potential supplier, actual demander and potential demander. These evidences are expected to provide references for decision-making on suitable strategies and running mechanism for large-scale cancer screening program in local populations.
China ; Cost-Benefit Analysis ; Early Detection of Cancer/methods* ; Health Services Administration ; Humans ; Mass Screening/organization & administration* ; Neoplasms/prevention & control* ; Urban Population

OBJECTIVETo evaluate the community-based intervention on reduction of hypertension and stroke in different age groups and subtypes hypertension.

METHODSIn 6 cities, 2 geographically separated communities with a registered population about 10 000 of each were selected as either intervention or control communities. A cohort containing 2 700 subjects, 35 years or older, and free of stroke were sampled from each community. The baseline survey was conducted to screen the subjects for intervention. In each city, a program for control of hypertension, heart diseases and diabetes was initiated in the intervention cohort and health education was provided to the whole intervention community. A follow-up survey was conducted 3 years later.

RESULTSWithin 3 years, the prevalence of hypertension increased in both intervention and control cohorts, as well as in the middle and elderly cohorts, especially in the middle aged in control group. Among hypertensives in the intervention cohort, the rates of awareness, treatment and control of hypertension got improved. The incidence of stroke was 29% lower (HR = 0.71, 95% CI: 0.58 - 0.87) and mortality of stroke was 40% lower (HR = 0.60, 95% CI: 0.42 - 0.86) in the intervention cohort than the control cohort. The intervention was most effective in reduction of stroke for those with isolated systolic hypertension and combined systolic and diastolic hypertension (All P < 0.05). Meanwhile, all-cause mortality was 11% lower (HR = 0.89, 95% CI: 0.78 - 0.99) in the intervention cohort than in the control cohort.

CONCLUSIONThe community-based intervention was effective in controlling the development of hypertension and stroke, while the elderly people benefit more than the middle aged people from the intervention.

China ; epidemiology ; Cohort Studies ; Community Health Services ; organization & administration ; Female ; Follow-Up Studies ; Health Knowledge, Attitudes, Practice ; Humans ; Hypertension ; complications ; prevention & control ; Incidence ; Male ; Mass Screening ; Middle Aged ; Risk Factors ; Stroke ; epidemiology ; mortality ; prevention & control ; Urban Health