BACKGROUNDThe World Health Organization's "Framework Convention on Tobacco Control" came into effect in China in 2006. Since then, a series of tobacco control measures has been undertaken, including the first step to establish a coordinated network of stop-smoking clinics in Chinese hospitals. Training for stop-smoking specialists has been traditionally provided via printed materials. This study evaluated the outcomes of the first two intensive 3-day courses in smoking cessation in China run in collaboration with experts who provide training to UK Specialist Stop Smoking Service.

METHODSEighty-four doctors from 38 cities in China responsible for stop-smoking treatment in 20 provinces and four autonomous regions participated in the training courses. Participants' knowledge competencies and self-efficacy were assessed before and after the authentication training.

RESULTSThe training significantly improved participants' knowledge, skills and self-efficacy across different domains. Forty-eight participants were finally certified as "smoking cessation specialist".

CONCLUSIONSThe UK model of face-to-face training was acceptable and effective in China. A relatively brief intensive training program can generate significant improvements in skills, knowledge, and readiness to engage in smoking cessation activities.

Certification ; China ; Cities ; Humans ; Physicians ; Self Efficacy ; Smoking Cessation

Objective: To evaluate gastrointestinal (GI) patient reported outcomes (PROs) in cervical cancer patients treated with definitive radiotherapy (RT), comparing 3D conformal RT (3DCRT) vs. intensity modulated/volumetric modulated arc therapy (IMRT/VMAT). Methods: An analysis of patients treated with definitive RT between 2015–2018 was performed. GI PROs were prospectively collected at baseline, during RT (acute), ≤12 weeks after RT (subacute), and >12 weeks after RT (late). GI PROs evaluated three symptom domains: bowel problems (BPs), bowel bother (BB), and abdominal problems (APs). Multiple linear regression analysis was performed to investigate associations between mean changes of symptom scores with clinical and dosimetric variables. Results: The cohort included 167 patients. A total of 100 (60%) patients were treated with IMRT/VMAT and 67 (40%) with 3DCRT. In the subacute phase, the mean change of symptom scores from baseline in 3DCRT vs. IMRT/VMAT were +0.9 vs. −1.15 (p=0.004) for BP, +2.18 vs. −0.10 (p=0.019) for BB, and +1.41 vs. −0.38 (p=0.021) for AP. Likewise, in the late phase, mean changes were +0.72 vs. −0.82 (p=0.014) for BP, +1.98 vs. −0.03 (p=0.008) for BB, and +1.29 vs. −0.31 (p<0.001) for AP. On multiple linear regression, use of 3DCRT vs. IMRT/VMAT was associated with greater mean changes in subacute BP (p=0.023) and late phase AP (p=0.019). A higher small bowel V50Gy was associated increased symptom scores in late AP (p=0.012). Conclusion 3DCRT was associated with significantly greater worsening of GI PRO symptom scores in the subacute and late phase. These data support the ongoing use of IMRT/VMAT in routine practice.

AIMCluster analysis was conducted on data from 5,169 United States (U.S.) Arizona children, age's 5-59-months with the goal of delineating patterns of caries in the primary dentition of pre-school children without a priori pattern definitions.

METHODOLOGYCluster analyses were conducted using all data for children ages 0-4 years in aggregate: (1) for all subjects, and (2) for subjects without crowned restored teeth. Each of these two sets of analyses consisted of 8 differently specified cluster analyses as a validation procedure.

RESULTSThe caries patterns identified from the clustering analysis are: (1) smooth surfaces (other than the maxillary incisor), (2) maxillary incisor, (3) occlusal surfaces of first molars, and (4) pit and fissure surfaces of second molars.

CONCLUSIONThe cluster analysis findings were consistent with results produced by multidimensional scaling. These cross-validated patterns may represent resulting disease conditions from different risks or the timing of various risk factor exposures. As such, the patterns may be useful case definitions for caries risk factor investigations in children under 60 months of age.

Arizona ; epidemiology ; Caregivers ; education ; Child, Preschool ; Cluster Analysis ; Cohort Studies ; Dental Caries ; epidemiology ; Dental Enamel ; pathology ; Dental Fissures ; epidemiology ; Educational Status ; Ethnic Groups ; statistics & numerical data ; Female ; Humans ; Incisor ; pathology ; Infant ; Male ; Mandible ; Maxilla ; Molar ; pathology ; Tooth, Deciduous ; pathology

Objective To describe the epidemiologieal features of viral encephalitis and burden of Japanese encephalitis (JE),and to identify potential strategies for effective JE control measures,using data from the Viral Encephalitis Surveillance Program (VESP) launched in Ankang,Baoji,and Weinan prefectures,Shaanxi province.Methods Data was gathered from sentinel hospitals reporting system on all the viral encephalitis (VE) eases identified between June 2005 and May 2007.County Center for Disease Control and Prevention (CDC) investigated the cases,drawing blood and cerebrospinal fluid (CSF) samples from the hospitals,and testing IgM antibody against JE using ELISA.We used Epi Data and Excel for data entry and analysis.Results A total of 1097 VEs were reported and 1053 (96.0%) had blood or CSF samples collected and tested for IgM antibody against JE.Three hundred and eleven cases (29.5%) showed JE antibody positive (JE confirmed case).Among the JE confirmed cases,numbers of those under 15 year of age accounted for 33.7%,43.9%and 88.3%in Baoji,Weinan and Ankang prefectures respectively.The rest were mainly children aged 5-14 years old (53.3%).Toddlers,farmers and children accounted for 85.2%in JE confirmed cases.About half of other VE cases (51.0%) were students of all age.Data an investigation on 398 reported VE cases at discharge,showed that 67.1%of JE confirmed cases recovered while 83.7%of the other VE cases fully recovered.The case fatality rates were 9.2%for JE confirmed cases and 3.1%for other VE cases.578 cases were followed up at 90-days after discharge,69.6%of JE confirmed cases and 90.2%of other VE cases recovered,with case fatality rates were 13.6%and 3.6%for JE confirmed cases and for other VE cases,respectively.The sequelae rates were 10.0%for JE confirmed cases and 4.5%for other VE cases.Conclusion The peak of the VE season was the sameas that of JE.There were 45.6%of reported JE cases with negative JE IgM,suggesting that it is necessary to carry out laboratory testing for clinical diagnosis cases.The fact that high risk population was different at prefectures levels suggested that more attention be paid in JE control and prevention.

Confounding effect is a critical issue in clinical research of otolaryngology because it can distort the research's conclusion. In this review, we introduce the definition of confounding effect, the methods of verifying and controlling the effect. Confounding effect can be prevented by research's design, and adjusted by data analysis. Clinicians would be aware and cautious about confounding effect in their research. They would be able to set up a research's design in which appropriate methods have been applied to prevent this effect.They would know how to adjust confounding effect after data collection. It is important to remember that sometimes it is impossible to eliminate confounding effect completely, and statistical method is not a master key. Solid research knowledge and critical thinking of our brain are the most important in controlling confounding effect.
Bias ; Humans ; Otolaryngology ; Regression Analysis ; Research Design ; Statistics as Topic

BACKGROUND: This study aimed to develop a comprehensive instrument for evaluating and ranking clinical practice guidelines, named Scientific, Transparent and Applicable Rankings tool (STAR), and test its reliability, validity, and usability. METHODS: This study set up a multidisciplinary working group including guideline methodologists, statisticians, journal editors, clinicians, and other experts. Scoping review, Delphi methods, and hierarchical analysis were used to develop the STAR tool. We evaluated the instrument's intrinsic and interrater reliability, content and criterion validity, and usability. RESULTS: STAR contained 39 items grouped into 11 domains. The mean intrinsic reliability of the domains, indicated by Cronbach's α coefficient, was 0.588 (95% confidence interval [CI]: 0.414, 0.762). Interrater reliability as assessed with Cohen's kappa coefficient was 0.774 (95% CI: 0.740, 0.807) for methodological evaluators and 0.618 (95% CI: 0.587, 0.648) for clinical evaluators. The overall content validity index was 0.905. Pearson's r correlation for criterion validity was 0.885 (95% CI: 0.804, 0.932). The mean usability score of the items was 4.6 and the median time spent to evaluate each guideline was 20 min. CONCLUSION The instrument performed well in terms of reliability, validity, and efficiency, and can be used for comprehensively evaluating and ranking guidelines.
Reproducibility of Results ; Surveys and Questionnaires ; Practice Guidelines as Topic ; Humans