OBJECTIVEThis study aimed to explore the secular trends of overweight and obesity prevalence between 2007 and 2011 in children and adolescents in Guangzhou.

METHODSThe data of physical examination was collected from the routine measurements carried out by the Health Care Facilities of Primary and Secondary schools between 2007 and 2011. Random stratified cluster sampling was conducted, all the students aged 5-18 years old form 19 primary and secondary schools from 4 districts (Tianhe district, Yuexiu district, Baiyun district and Haizhu district) were included in this survey, including 27 944 students in 2007 and 38 284 students in 2011. Body mass index reference norm established by Working Group on Obesity in China (WGOC) and the WHO cut-off criteria were employed for overweight and obesity screening, and the trend was analyzed.

RESULTSPrevalence of obesity in children and adolescents (7-18 years old) significantly increased from 5.96% (1 553/26 055) in 2007 to 6.56% (2 339/35 664) in 2011, and the difference showed statistical significance (χ(2) = 9.195, P < 0.05). Overweight and obesity was more common in boys (overweight: 13.25% (1 766/13 329) in 2007 and 13.87% (2 559/18 451) in 2011; obesity: 7.82% (1 042/13 329) in 2007 and 8.63% (1 592/18 451) in 2011) than in girls (overweight: 7.43% (946/12 726) in 2007 and 8.17% (1 406/17 213) in 2011; obesity: 4.11% (523/12 726) in 2007 and 4.48% (771/17 213) in 2011), and the difference showed statistical significance (overweight:χ(2) = 236.123 in 2007 and χ(2) = 292.892 in 2011; obesity:χ(2) = 158.533 in 2007 and χ(2) = 247.794 in 2011. All P values < 0.05). Further analysis found that significant increases occurred in boys aged 16 and 17 years old and in girls aged 12 years old (boy: 16 years old,χ(2) = 6.820, P < 0.05. 17 years old, χ(2) = 4.893, P < 0.05. girl: 12 years old,χ(2) = 5.921, P < 0.05).

RESULTSof Join-point regression showed that for boys less than 10 years old the prevalence increased with age increasing (in 2007, APC = 3.75; in 2011, APC = 1.76), while over 10 years old the prevalence decreased with age increasing (in 2007, 10-18 years old's APC = -18.58; in 2011, 10-18 years old's APC = -15.95). While for girls the prevalence of obesity increased with age increasing between 7-9 years old (APC = 12.16), decreased with age increasing through 9 to 18 years old (APC = -17.23) in 2007. The prevalence decreased with age increasing for girls in 2011 (APC = -4.66).

CONCLUSIONThe prevalence of obesity is high and still increasing in children and adolescents in Guangzhou, and it is higher in boys than in girls. It is more likely to become obesity at 10 years for boys, and for girls the prevalence decrease with age increasing.

Adolescent ; Child ; Child, Preschool ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Male ; Obesity ; epidemiology ; Overweight ; epidemiology ; Prevalence

OBJECTIVETo study the effects of educational background of men who have sex with men (MSM) on their high risk sexual behaviors and the HIV/STI infection rates.

METHODSDuring July to November of 2009 and March to October of 2010, snowball and convenience sampling methods were adopted to recruit MSM from MSM venues and via the internet in Changzhou city of Jiangsu province, and finally 659 MSM were conducted a questionnaire survey and serological testing. According to the educational background of MSM, they were divided into 3 groups, that is, junior high school group (206 cases), high school group (254 cases), and university group (199 cases). The questionnaire mainly includes information on social demography, sexual behaviors, condom use, etc. Blood samples were collected for HIV and syphilis spirochete detection, and urine samples were also collected in 291 MSM who were recruited during July to November of 2009 for neisseria gonorrhoeae and chlamydia trachomatis nucleic acid detection. χ(2) test and other statistical analysis methods were used to compare the characteristics of sexual behaviors and HIV/STI infections in 3 groups.

RESULTSOf the 659 valid questionnaires returned, junior high school group, high school group, and university group accounted for 31.3% (206 cases), 38.5% (254 cases) and 30.2% (199 cases). Places where MSM of different education levels most often to seek sexual partners, were significantly different. Junior high school group and high school group mostly went to bath house/sauna club (56.3%, 116 cases) and bar (34.8%, 88 cases) for partners, respectively, while the university group sought partners mainly through the internet (41.1%, 81 cases) (χ(2) = 99.35, P < 0.05). 53.4% (109/204) of the junior high school group had anal sex with men in the last 6 months, which was higher than that of high school group (67.7%, 172/254) (χ(2) = 9.74, P < 0.05) and university group (72.7%, 144/198) (χ(2) = 16.04, P < 0.05) . A total of 54.4% (111/204) of the junior high school group had sex with women in the last 6 months, which was higher than that of university group (38.6%, 76/197) (χ(2) = 10.10, P < 0.05) , but was not statistically significantly different from that of high school group (46.9%, 119/254) (χ(2) = 2.59, P = 0.11) . The rates of condom use with men at the last anal sex in junior high school group (73.4%, 80/109) , high school group (78.0%, 131/168) and university group (73.9%, 105/142) were similar. The rates of condom use with women in the last intercourse in junior high school group, high school group and university group were 51.8% (57/110), 54.6% (65/119) and 61.8% (47/76), respectively(χ(2) = 1.88, P = 0.39) . In junior high school group, high school group and university group, the infection rates of HIV were 9.2% (19/206), 10.6% (27/254) and 5.6% (11/197) (χ(2) = 3.68, P = 0.16), the positive rates of neisseria gonorrhoeae were 3.8% (3/79), 3.4% (4/117) and 0.0% (0/95) (χ(2) = 3.85, P = 0.14), the positive rates of chlamydia trachomatis were 5.1% (4/79), 9.4% (11/117) and 4.2% (4/95) (χ(2) = 2.70, P = 0.26). The infection rate of syphilis in junior high school group was 19.9% (41/206), which was higher than high school group (12.2%, 31/254) (χ(2) = 5.11, P < 0.05) and university group (10.2%, 20/197) (χ(2) = 7.45, P < 0.05 ).

CONCLUSIONThere was no obvious correlation between education level and high risk sexual behaviors;MSM with lower education level were at higher risk of infection of syphilis.

Adult ; Cross-Sectional Studies ; Cultural Characteristics ; Educational Status ; HIV Infections ; epidemiology ; Homosexuality, Male ; Humans ; Male ; Middle Aged ; Schools ; Surveys and Questionnaires ; Syphilis ; epidemiology ; Universities ; Unsafe Sex ; Young Adult

OBJECTIVETo study resistance evolution pathway of HIV-1 CRF_BC under drug selection pressure, and compare with B subtype.

METHODSBased on the reverse transcriptase region of CRF_ 97BC HIV-1 from 588 treatment-naive and 274 treatment patients, selection pressure based method was used to select resistance-associated mutations, and Bayesian network was used to construct the resistance evolutionary pathway under antiretroviral therapy. Meanwhile, it was constructed that the resistance evolutionary pathway for B subtype with the same regimens using the data from HIV resistance database, and made a comparison with CRF_07BC.

RESULTSThe major resistance mutations for CRF_07BC were identified including K103N, Q197K, V179D and Y188L. While for B subtype, the major resistance mutations include M184V, K103N,Y181C, T69N,G190A, K238T,Y188H and P225H. Much difference was observed between these two classes. However, the classical TMA1 (41L, 210W and 215Y) and TMA2 (67N, 70R and 219E/Q) pathways exist in both pathways. As different from B subtype, the predicted major drug resistance mutations for CRF_07BC did not contain TAM-related mutations, and nucleoside reverse transcriptase inhibitor-related mutations and non-nucleoside reverse transcriptase inhibitor-related mutations were mutually depending on each other.

CONCLUSIONHIV-1 CRF_07BC showed distinctive resistance evolutionary pathway, the mutations K103N,Q197K,V179D and Y188L were the major resistance mutations, and different resistance evolutionary pathways were observed between HIV-1 CRF_07BC and B subtype.

Anti-HIV Agents ; pharmacology ; Bayes Theorem ; Drug Resistance, Viral ; genetics ; Evolution, Molecular ; HIV-1 ; drug effects ; enzymology ; genetics ; Humans ; Mutation ; RNA-Directed DNA Polymerase ; genetics

OBJECTIVETo explore the influencing factors of AIDS pathogenesis using the Bayesian network.

METHODSBased on follow-up data of 2 431 cases of HIV/AIDS from 1992-2011 in Shandong province, this study constructed the network structure by NPC algorithm, and used the EM algorithm for parameter learning to construct the Bayesian network of influencing factors and AIDS pathogenesis, then did inference by the Bayesian network.

RESULTSA total of 49.77% (1 210/2 431) were AIDS. Get a Bayesian network with 7 nodes and 11 directed arcs and the related parameters by studying the follow-up data of 2 431 cases. The area under receiver operating curve(ROC) was 0.75. There was a direct causal association among sample resource, transmission route, CD4(+)T lymphocyte count of HIV-antibody confirmed positive, antiviral therapy, opportunistic infection therapy, follow-up intervention and AIDS pathogenesis. The incidence probability was 42.83% for those who received antiviral therapy and follow-up intervention, and it was 68.96% for those who received antiviral therapy without follow-up intervention. The probability to receive follow-up intervention was 68.96% for cases transmitted by homosexual behaviors, and it was 34.00%, 42.24%, 1.06% and 22.70% respectively to be reported by medical institutions, testing and counselling, supervision institutions and special surveys.

CONCLUSIONThe Bayesian network revealed the mutual relation and effect intension among multi-factors and multi-stages by network inference. It showed that the rate of AIDS pathogenesis was lower for those who received antiviral therapy and follow-up intervention.

Acquired Immunodeficiency Syndrome ; drug therapy ; epidemiology ; pathology ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bayes Theorem ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Incidence ; Lymphocyte Count ; Male ; Middle Aged ; Young Adult

OBJECTIVETo measure related cost, effectiveness and benefit of needle and syringe exchange (NSP) in two provinces of Southwest China.

METHODSBetween September 2012 and February 2013, program files and questionnaires were used to collect the information about cost, effectiveness and benefit of NSP during three program years (July 2009 to June 2010, July 2010 to June 2011, July 2011 to June 2012 ) in 31 counties of two provinces of Southwest China. Unit cost indicators including cost of providing per syringe and cost of covering per IDU, number of new HIV infections avoided by providing needle and syringe exchange were used to evaluate the effectiveness of NSP, and the benefit indicators included the fees for ART, hospitalization cost and follow up of new HIV infection avoided by NSP. NEAR model was used to calculate the cases averted by NSP. Chi-square test was used to analyze the different percentage of allocation areas between two provinces.

RESULTSBetween July 2009 and June 2012, 25 374 041 yuan were totally used for NSP. In province A, the top investment area was management (1 848 485 yuan) while it was comprehensive intervention (5 452 355 yuan) in province B. The cost of providing per syringe was 3.67 yuan, and it decreased from 6.96 to 4.01 in province A and decreased from 3.38 to 2.17 in province B with the increasing needles distributed. The cost of covering per IDU was 712.71 yuan and the unit cost decreased from 882.85 to 574.95 in province A and decreased from 760.48 to 625.07 in province B with the growing number of IDUs intervened. A total of 1 307 new HIV infection were avoided by providing NSP, so 19 413.96 yuan would be used to avoid per IDU infecting HIV. A total of 367 507 488 yuan of HIV/AIDS related expenditure were avoided by NSP and the cost benefit ratio was 14.48.

CONCLUSIONNSP has a good cost-benefit ratio and should be promoted.

China ; Cost-Benefit Analysis ; Drug Users ; HIV Infections ; prevention & control ; Humans ; Needle-Exchange Programs ; economics ; Substance Abuse, Intravenous ; Surveys and Questionnaires ; Syringes

OBJECTIVESTo evaluate the psychological quality and its influencing factors of mine rescue staff.

METHODSA total of 310 on front line rescue staff from the mines in Tangshan were sampled by random cluster sampling method.Our own designed measurement tools for psychological quality, including Eysenck personality questionnaire (EPQ), attention test scale, willpower test scale and reactive agility test were used to investigate the psychological quality of mine rescue staff. All tests were conducted in quiet state.Other information including age, length of service for rescue, sex, education, smoking and drinking, and so on were collected at the same time. The mood and influencing factors on psychological quality of the rescue staff were also analyzed.

RESULTSThe personality traits of mine rescue staff are close to the national norm.0.6% (2/310) staff showed weak willpower.20.7% (64/310) staff had unstable mood. The E and N factor scores in 20-29 years old group (12.7 ± 4.3 and 12.1 ± 5.1) were higher than 30-39, 40-49, 50-59 years old groups (E factor scores:11.4 ± 3.9, 10.6 ± 3.7 and 10.7 ± 3.9; N factor scores:11.0 ± 5.1, 9.4 ± 4.9 and 6.3 ± 3.4, respectively) (FE = 4.28, FN = 11.35, all P < 0.01) . The L factor score in 40-49 and 50-58 years old groups (13.0 ± 4.2 and 14.8 ± 3.6) were higher than 20-29 and 30-39 years old groups (11.5 ± 3.8 and 12.2 ± 3.8) (F = 6.08, P < 0.01) . Multivariate analysis found that the psychological quality of mine rescue staff was mainly influenced by the length of service (β'E factor = -0.12, β'willpower = -0.12), the amount of participating rescue (β'P factor = 0.12, β'N factor = -0.14), alerting duty (β'L factor = 0.16, β 'error number of target tracking = -0.161) , daily training (β'attention = 0.22,β'total number of aimed at the test = -0.18) and life events (β'N factor = -0.14,β'L factor = 0.13,β'correct number of target tracking = -0.18).

CONCLUSIONThe mine rescue staff had high level psychological quality, length of service. the amount of participating rescue, and life events in the year effect the psychological quality of mine rescue staff.

Adult ; Cross-Sectional Studies ; Emergency Responders ; psychology ; Humans ; Male ; Middle Aged ; Mining ; Quality of Life ; Rescue Work ; Stress, Psychological ; Surveys and Questionnaires ; Young Adult

OBJECTIVETo explore the effect of occupational stress and related factors to the mood of speed train drivers.

METHODSBy using cluster sampling method, a cross-sectional study was conducted in 1 352 speed train drivers (including 291 passenger train drivers, 640 freight trains drivers, 342 passenger shunting train drivers, and 79 High Speed Rail drivers) from a Railway Bureau depot. The survey included mood, individual factors, occupational stress factors, personality factors and mitigating factors. The mood status was evaluated by mood scale, and the occupational stress factors, personality factors and mitigating factors were measured by the revised effort-reward imbalance (ERI) model questionnaires and occupational stress measurement scale.

RESULTSCorrelation analysis showed that the mood score was negative correlated with age(r = -0.07, P = 0.01), working age (r = -0.07, P = 0.01), ERI(r = -0.53, P < 0.01), extrinsic effort(r = -0.41, P < 0.01), intrinsic effort(r = -0.39, P < 0.01), group conflict(r = -0.12, P < 0.01), role conflict(r = -0.16, P < 0.01), role ambiguity(r = -0.08, P < 0.01), and social support(r = -0.36, P < 0.01), and was positive correlated with rewards(r = 0.42, P < 0.01), self-esteem(r = 0.20, P < 0.01), and coping strategy(r = 0.12, P < 0.01). The mood scores of passenger train drivers, passenger shunting train drivers, freight train drivers and High Speed Rail drivers were 4.88 ± 2.78, 4.72 ± 2.50, 4.28 ± 2.57 and 4.12 ± 3.02, respectively, which the differences had statistical significance(F = 4.23, P = 0.01), unrelated to age and working age. The descending sort of mood corrected mean was passenger train drivers(4.87), passenger shunting train drivers (4.69), freight train drivers (4.29) , and High Speed Rail drivers (4.17). Stepwise regression analysis indicated that ERI, social support, rewards, intrinsic effort, self-esteem, extrinsic effort and coping strategy were the predictors, which could explain the 74.36% of total variance.

CONCLUSIONMost occupational stress factors may cause negative mood, but rewards, self-esteem, social support and coping strategy were the protection factors of mood; different train drivers had different mood status, High Speed Rail drivers were the worst, and passenger train drivers were the best.

Adaptation, Psychological ; Adult ; Affect ; Cross-Sectional Studies ; Humans ; Male ; Railroads ; Regression Analysis ; Reward ; Self Concept ; Social Support ; Stress, Psychological ; Surveys and Questionnaires

OBJECTIVETo explore the effect of occupational stress and effort-reward imbalance on sleep quality of people's police.

METHODSA cluster sampling survey of sleep quality and occupational stress correlated factors was conducted on 287 police from a city public security bureau by questionnaires in May, 2011; the relationship between sleep quality and occupational stress correlated factors was analyzed by one-way ANOVA and multivariate non-conditional logistic regression using effort-reward imbalance model (ERI) and demand-control-support model (DCS). And the subjects were divided into high tension group and low tension group using the 1.0 of ERI and DCS coefficients as the boundary.

RESULTSThe sleep quality score of shift work police was higher than day work police (11.95 ± 6.54 vs 9.52 ± 6.43, t = 2.77, P < 0.05).In ERI model, the sleep quality score in high tension group was higher than low tension group (14.50 ± 6.41 vs 8.60 ± 5.53, t = -5.32, P < 0.01), and in DCS model, the sleep quality score in high tension group was also higher than low tension group (13.71 ± 6.62 vs 9.46 ± 6.04, t = -3.71, P < 0.01).For the regression analysis of ERI model as an argument, sex (OR = 3.0, 95%CI:1.16-7.73) , age for 30-39 years (OR = 3.48, 95%CI:1.32-9.16) , intrinsic effort (OR = 2.30, 95%CI:1.10-4.81) and daily hassles (OR = 2.15, 95%CI:1.06-4.33) were risk factors of low sleep quality, and reward (OR = 0.26, 95%CI:0.12-0.52) was the protective factor.For the regression analysis of DCS model as an argument , age for 30-39 years (OR = 2.55, 95%CI:1.02-6.37) , depressive symptom (OR = 2.10, 95%CI:1.14-3.89) and daily hassles (OR = 3.25, 95%CI:1.70-6.19) were risk factors of low sleep quality.While the ERI model and the DCS model were analyzed simultaneously, sex (OR = 3.03, 95%CI:1.15-7.98) , age for 30-39 years (OR = 3.71, 95%CI:1.38-9.98) and daily hassles (OR = 2.09, 95%CI:1.01-4.30) were the risk factors of low sleep quality, and reward (OR = 0.22, 95%CI:0.10-0.48) was the protective factor.

CONCLUSIONOccupational stress and effort-reward imbalance affected the sleep quality to people's policeman.

Adult ; Cross-Sectional Studies ; Female ; Humans ; Logistic Models ; Male ; Police ; Reward ; Sleep Wake Disorders ; epidemiology ; Stress, Psychological ; Surveys and Questionnaires

OBJECTIVETo explore the influencing factors of job satisfaction among enterprise workers.

METHODSBetween November, 2008 and June, 2009, 6 711 workers from 13 enterprises were recruited to this survey by cluster sampling method. Data about job satisfaction, occupational stressors, strains, coping strategy and social support were collected anonymously by using occupational stress instruments, job content questionnaire and effort-reward imbalance questionnaire.

RESULTSMedian (P25-P75) of job satisfaction scores was 40(34-46), which were separately (40.25 ± 7.59) and (38.57 ± 8.62) among female and male workers. The difference showed statistical significance (Z = 6.00, P < 0.01). The job satisfaction score was highest (41.44 ± 6.93) among administrative staff, but lowest (38.89 ± 8.79) among assistant workers. The difference showed statistical significance (χ(2) = 6.64, P < 0.01).Job satisfaction score of shift workers (38.47 ± 8.58) was significantly lower than that of non-shift workers(39.66 ± 8.10) (Z = 4.61, P < 0.01). The job satisfaction scores of workers with weekly job time ≤ 40 h, 41-50 h, 51-59 h and ≥ 60 h were separately (39.86 ± 8.25), (39.23 ± 8.20), (38.68 ± 8.44) and (37.01 ± 8.34). The difference showed statistical significance (χ(2) = 54.06, P < 0.01). Correlation analysis revealed that job satisfaction was positively related to technology utilize degree (r = 0.26, P < 0.01), free decision latitude(r = 0.32, P < 0.01), reward(r = 0.60, P < 0.01), positive affection (r = 0.45, P < 0.01), superior support(r = 0.49, P < 0.01) and coping strategy (r = 0.16, P < 0.01); however, negatively related to external effort(r = -0.33, P < 0.01), psychological demands (r = -0.34, P < 0.01), physical demands(r = -0.30, P < 0.01), negative emotions (r = -0.41, P < 0.01) and depressive symptoms (r = -0.44, P < 0.01). Multivariate logistic regression analysis showed that the risk of job dissatisfaction for workers with low reward was about three times as high as that for workers with high reward (OR = 3.44, 95%CI:2.95-4.01), risks of job dissatisfaction for workers with low negative emotions, high positive affection and social support were about two times as high as that for workers with low positive affection, high negative emotions and low social support, with the OR (95%CI) respectively at 2.42 (2.09-2.82), 2.28 (1.95-2.66) and 2.25 (1.94-2.62).

CONCLUSIONOccupational stress, individual features, health status, shiftwork system and work time had great effect on job satisfaction. The main measures of increasing job satisfaction were to improve rewards, increase superior support and decrease negative emotions.

Adult ; Cross-Sectional Studies ; Female ; Humans ; Job Satisfaction ; Male ; Middle Aged ; Occupations ; Social Support ; Stress, Psychological ; psychology ; Surveys and Questionnaires

OBJECTIVEProviding evidences for further modification of China Infectious Diseases Automated-alert and Response System (CIDARS) via analyzing the outbreak detection performance of Moving Percentile Method (MPM) by optimizing thresholds in different provinces.

METHODSWe collected the amount of MPM signals, response results of signals in CIDARS, cases data in nationwide Notifiable Infectious Diseases Reporting Information System, and outbreaks data in Public Health Emergency Reporting System of 16 infectious diseases in 31 provinces in Chinese mainland from January 2011 to October 2013. The threshold with the optimal sensitivity, the shortest time to detect outbreak and the least number of signals was considered as the best threshold of each disease in Chinese mainland and in each province.

RESULTSAmong all the 16 diseases, the optimal thresholds of 10 diseases, including dysentery, dengue, hepatitis A, typhoid and paratyphoid, meningococcal meningitis, Japanese encephalitis, scarlet fever, leptospirosis, hepatitis, typhus in country level were the 90(th) percentile (P90), which was the same as provincial level for those diseases.For the other 6 diseases, including other infectious diarrhea, influenza, acute hemorrhagic conjunctivitis, mumps, rubella and epidemic hemorrhagic fever, the nationwide optimal thresholds were the 80th percentile (P80), which was different from that by provinces for each disease. For these 6 diseases, the number of signals generated by MPM with the optimal threshold for each province was decreased by 23.71% (45 557), 15.59% (6 124), 14.07% (1 870), 9.44% (13 881), 8.65% (1 294) and 6.03% (313) respectively, comparing to the national optimal threshold, while the sensitivity and time to detection of CIDARS were still the same.

CONCLUSIONOptimizing the threshold by different diseases and provinces for MPM in CIDARS could reduce the number of signals while maintaining the same sensitivity and time to detection.

China ; Communicable Diseases ; Disease Notification ; Disease Outbreaks ; prevention & control ; Humans ; Population Surveillance ; methods