Objectives: To implement cost effective evaluation on the interventions to personality dysfunction in adolescents, so as to provide scientific evidences for extending the interventions. Methods: Cost identification, measurement of the cost, and valuing the cost were implemented to calculate the cost of the interventions. Effects of the interventions were measured based on three indicators: (1) differences of the decreasing scores of Personality Diagnostic Questionnaire-4 (PDQ-4) between intervention group and control group from grade one to three, (2) differences of the decrease number of students with personality dysfunction between intervention group and control group from grade one to three, and (3) differences of the incidence of personality dysfunction between intervention group and control group. Cost-effectiveness ratios (CERs) were calculated for the economic evaluation of the interventions. Results: The total cost of the interventions was 67, 860 Yuan. After intervention, among all of the students in intervention group, the cost of reducing one score of PDQ-4 was 9. 25 Yuan. The cost of reducing one person with personality dysfunction was 6169 Yuan. And the cost of avoiding one person developed personality dysfunction was 2714 Yuan. The cost effectiveness were not balanced among Cluster A, Cluster B and Cluster C personality dysfunction. Similar tendency was found among 10 types of personality dysfunction. Conclusion: The "Intervention Measure on Personality Dysfunction" in adolescents is easy to implement and has relative low costs. Further interventions of the specific cluster or type of personality dysfunction can be carried out based on the findings from this study.

To enhance primary and secondary stroke prevention, the Stroke Prevention and Control Project committee of the National Health Commission launched since October 2017 a nationwide training program for cerebrocardiac health advisors in the country. The authors introduced the standardized training system for such advisors, and the health management plan for stroke patients, in an effort to provide full-course health management scheme for stroke patients, and explore a stroke management model led by cerebrocardiac health advisors. Such efforts were designed to promote effective implementation of integrated prevention and control strategies for stroke, and provide a reference for the clinical practice of cerebrocardiac health advisors in a comprehensive and in-depth manner.

Stroke is one of the main causes of mortality, long-term physical and cognitive impairment in China. In order to meet the challenge, Stroke Prevention and Treatment Project of the National Health Commission(SPTPC) was established in April 2011 in the Ministry of Health. In 2016, SPTPC issued a work plan of stroke center hospital. In order to shorten the time of pre-hospital, the SPTPC established the stroke center network, stroke map and stroke green channel to create "the three 1-hour gold rescue circle" to form a hierarchical stroke diagnosis and treatment system. The current construction of the Chinese Stroke Center is divided into two levels and four layers. As of December 31, 2018, SPTPC has certified a total of 310 advanced stroke centers, including 30 demonstration advanced stroke centers and 280 advanced stroke centers, and 127 stroke prevention centers, including 85 demonstration stroke prevention centers and 42 stroke prevention centers. The median time from admission to intravenous thrombolysis (DNT) at the advanced stroke center was decreased by 13.2% (53 min vs. 46 min) in the fourth quarter of 2018 as compared with that in the first quarter of 2017.The national thrombolytic rate of acute ischemic stroke was increased 3.24 times (1.78% vs. 0.42%) in 2017 compared that in 2010. In the next step, SPTPC will vigorously promote the construction of stroke centers and graded diagnosis and treatment mechanisms, consolidate quality control and standardization, increase the scope of influence of mobile stroke and remote diagnosis and treatment, and further improve the construction of stroke center systems with Chinese characteristics.

Objective:To understand main problems existing in the construction of advanced stroke centers in China and put forward solutions, for reference in promoting the standardization construction of advanced stroke centers and improving the efficiency of acute stroke treatment.Methods:The data were derived from relevant data of on-site export guidance in the construction of advanced stroke centers at 175 tertiary hospitals from 2020 to 2021, and the scores of on-site evaluation indicators for the establishment of stroke centers and their formal approval were compared and analyzed. Based on on-site investigation and expert consultation, the common problems existing in the construction of advanced stroke centers were summarized. All data were analyzed by descriptive analysis, the scores of on-site evaluation indicators were expressed by ± s, and paired t test was used for comparison between groups. Results:Compared with the total score(693.04±72.06) of on-site evaluation at the stage of project launch, the total score(747.94±78.10) of on-site evaluation for formal approval of stroke centers of 70 hospitals was higher, and the difference was significant( P<0.01). There were seven common problems in the construction of stroke centers in 175 hospitals, including insufficient attention paid by hospitals, lack of effective performance incentive policies, imperfect treatment procedures and medical norms, and so on. Conclusions:Experts on-site guidance plays an important role in the construction of stroke centers in China. At present, there were still problems to tackle in the construction of stroke centers in hospitals. In order to promote the standardized construction of stroke centers in China and improve the efficiency of stroke treatment, the authors suggest fuorther strengthening the importance attached by hospital leadership and the coordination and organization of functional departments, establishing stroke center models conforming to the actual situation of the hospital, seting up the post of brain and heart health manager, and improving the regional prevention and treatment level of acute stroke.

Objective To investigate the association between the combination of different health?related behaviors and the risk of stroke in people with hypertension. Methods The data in this study were obtained from the China National Stroke Screening Survey (CNSSS). The case group was the people with hypertension who were also diagnosed as the first?ever stroke cases (total stroke and ischemic stroke) during 2013-2014 screening period. Their corresponding controls (1∶3 frequency?matched for age group and urban/rural ratio) were randomly selected from individuals with hypertension without stroke. The information on demographic data, stroke history, influence factors and health?related behaviors (non?smoking, normal body mass index maintenance and physical activity) was obtained using standardized face?to?face questionnaires. Univariate analysis included t?test and Chi?square test. Multivariate analysis included unconditional logistic regression. Results There were 603 total stroke cases (1 909 controls) and 536 ischemic stroke cases (1 608 controls) in men with hypertension, and 600 total stroke cases (1 800 controls) and 534 ischemic stroke cases (1 602 controls) in women with hypertension. We found that women with three health?related behaviors had lower risk of total stroke ( OR=0.29, 95%CI : 0.11-0.79) and ischemic stroke ( OR=0.28, 95%CI : 0.10-0.77). Only the combination of non?smoking and physical activity was significantly associated with the decreased risk of total stroke ( OR=0.30, 95%CI : 0.11-0.78) and ischemic stroke ( OR=0.32, 95%CI : 0.12-0.87). We had not found significant association between the combination of different health?related behaviors and risk of total stroke and ischemic stroke (P>0.05) in men. Conclusion This study indicated that health?related behavior intervention might be more effectively to prevent stroke in women with hypertension, especially the smoking control and physical activity.

Objective To explore gender?specific factors and their contributions to ischemic stroke among atrial fibrillation (AF) patients. Methods A case?control study was conducted. The relevant data were obtained from the database of China National Stroke Screening Survey. The cases were first?ever ischemic stroke cases diagnosed from September 2013 to September 2015. Frequency?matched for the age and distribution of city and country, controls were randomly selected by 1∶3 ratio from individuals with AF but without stroke in the program. Altogether, there were 85 male cases (320 controls) and 147 female cases (484 controls). Unconditional logistic regression model was applied for the analysis of relevant factors of the onset of ischemic stroke, and their population?attributable risk proportion [PARP, (95%CI) ] was calculated. Results The age of male subjects in the case group and control group were (65.26 ± 11.20) and (64.83 ± 11.08) years old, and that of females in two groups were (63.63 ± 10.40) and (63.93 ± 10.35) years old. According to the PARP (95%CI ), relevant factors of the onset of ischemic stroke in a descending sequence were hypertension history [35.63 (18.64-47.73) ], family history of stroke [28.70 (23.63-32.30) ]and physical inactivity [15.73 [5.62-23.06) ] among male AF patients,and family history of stroke (29.39 (24.21-33.08)), dyslipidemia (22.17 (2.26-36.45)) and smoking [2.09 (0.76-3.24) ] among female AF patients. Conclusion The relevant factors of ischemic stroke were different between male and female AF patients.

Objective To explore gender?specific factors and their contributions to ischemic stroke among atrial fibrillation (AF) patients. Methods A case?control study was conducted. The relevant data were obtained from the database of China National Stroke Screening Survey. The cases were first?ever ischemic stroke cases diagnosed from September 2013 to September 2015. Frequency?matched for the age and distribution of city and country, controls were randomly selected by 1∶3 ratio from individuals with AF but without stroke in the program. Altogether, there were 85 male cases (320 controls) and 147 female cases (484 controls). Unconditional logistic regression model was applied for the analysis of relevant factors of the onset of ischemic stroke, and their population?attributable risk proportion [PARP, (95%CI) ] was calculated. Results The age of male subjects in the case group and control group were (65.26 ± 11.20) and (64.83 ± 11.08) years old, and that of females in two groups were (63.63 ± 10.40) and (63.93 ± 10.35) years old. According to the PARP (95%CI ), relevant factors of the onset of ischemic stroke in a descending sequence were hypertension history [35.63 (18.64-47.73) ], family history of stroke [28.70 (23.63-32.30) ]and physical inactivity [15.73 [5.62-23.06) ] among male AF patients,and family history of stroke (29.39 (24.21-33.08)), dyslipidemia (22.17 (2.26-36.45)) and smoking [2.09 (0.76-3.24) ] among female AF patients. Conclusion The relevant factors of ischemic stroke were different between male and female AF patients.

Objective To investigate the association between the combination of different health?related behaviors and the risk of stroke in people with hypertension. Methods The data in this study were obtained from the China National Stroke Screening Survey (CNSSS). The case group was the people with hypertension who were also diagnosed as the first?ever stroke cases (total stroke and ischemic stroke) during 2013-2014 screening period. Their corresponding controls (1∶3 frequency?matched for age group and urban/rural ratio) were randomly selected from individuals with hypertension without stroke. The information on demographic data, stroke history, influence factors and health?related behaviors (non?smoking, normal body mass index maintenance and physical activity) was obtained using standardized face?to?face questionnaires. Univariate analysis included t?test and Chi?square test. Multivariate analysis included unconditional logistic regression. Results There were 603 total stroke cases (1 909 controls) and 536 ischemic stroke cases (1 608 controls) in men with hypertension, and 600 total stroke cases (1 800 controls) and 534 ischemic stroke cases (1 602 controls) in women with hypertension. We found that women with three health?related behaviors had lower risk of total stroke ( OR=0.29, 95%CI : 0.11-0.79) and ischemic stroke ( OR=0.28, 95%CI : 0.10-0.77). Only the combination of non?smoking and physical activity was significantly associated with the decreased risk of total stroke ( OR=0.30, 95%CI : 0.11-0.78) and ischemic stroke ( OR=0.32, 95%CI : 0.12-0.87). We had not found significant association between the combination of different health?related behaviors and risk of total stroke and ischemic stroke (P>0.05) in men. Conclusion This study indicated that health?related behavior intervention might be more effectively to prevent stroke in women with hypertension, especially the smoking control and physical activity.

Objective:To explore the status quo of nurse-patient communication ability in undergraduate nursing students in the early stage of clinical practice and its influencing factors, and provide a basis for clinical nursing education managers to formulate a training plan for communication skills of undergraduate nursing students in the clinical practice stage.Methods:From August to September 2019, totally 960 undergraduate nursing students engaging in clinical nursing practice for≤3 months were investigated. The survey content included demographic data, training content of nurse-patient communication ability, and clinical communication ability of nursing students. The status quo and influencing factors of communication ability of undergraduate nursing students in the early stage of clinical practice were analyzed.Results:The nurse-patient communication ability score of 960 undergraduate nursing students in the early stage of clinical practice was (2.18±0.21) , with the highest score in the dimension of acute listening (2.42±0.51) and the lowest score in the dimension of verification feeling (1.88±0.51) . Univariate analysis showed that there were statistically significant differences in the nurse-patient communication ability in the early stage of clinical practice between undergraduate nursing students with different gender, with or without training for nurse-patient communication in the early stage of clinical practice in the hospital and with different training forms ( P<0.05) . Pearson correlation analysis revealed that the nurse-patient communication ability score of undergraduate nursing students in the early stage of clinical practice was positively correlated with the number of nurse-patient communication training sessions in the hospital ( r=0.456, P<0.01) . According to multiple linear regression analysis, the number of training sessions and training forms in the hospital were main influencing factors to the nurse-patient communication ability of undergraduate nursing students in the early stage of clinical practice ( P<0.05) . Conclusions:The level of nurse-patient communication ability in undergraduate nursing students in the early stage of clinical practice is low and needs to be further improved. Clinical nursing teaching managers should formulate effective training programs based on its influencing factors to strengthen training accordingly.

Objective:To construct the teaching quality evaluation index system for clinical teachers of undergraduate nursing students based on teaching managers' perspective so as to provide a basis for clinical teaching management of undergraduate nursing students.Methods:From May 2018 to September 2019, the expert enquiry questionnaire on the teaching quality evaluation index system for clinical teachers of undergraduate nursing students based on teaching managers' perspective was developed by the literature review and expert interview. Delphi technique was used to select 20 nursing teaching management experts, 16 of them from 4 ClassⅢ Grade A teaching hospitals in Beijing, 4 of them from a nursing undergraduate university to carry out two rounds of expert enquiry.Results:The initial construction of the teaching quality evaluation index system for clinical teachers of undergraduate nursing students based on teaching managers' perspective included 5 first-level indexes and 30 second-level indexes. The valid recovery rates, expert authoritative coefficients, Kendall coordination coefficients of two rounds of expert enquiry questionnaire were 100%, 0.83 and 0.86, 0.395 and 0.554 respectively ( P<0.01) with the satisfied consistency test results and credible enquiry results. Conclusions:The construction of the teaching quality evaluation index system for clinical teachers of undergraduate nursing students based on teaching managers' perspective is scientifically rigorous. The system has definite evaluation indexes, rational administrative levels, objective and reliable system which could provide a basis for clinical teaching management of undergraduate nursing students.