1.Prevailing food intake, physical activity and health beliefs in a Rural Agricultural Community in the Philippines: Factors to consider prior to a Diabetes Prevention Program
Mark Anthony Sandoval ; Elizabeth Paz-Pacheco ; Edwin Cañ ; ete ; Perpetua Patal ; Monica Therese Cating-Cabral ; Frances Lina Lantion-Ang ; Elizabeth Paterno ; Noel Juban ; Cecilia Jimeno
Journal of the ASEAN Federation of Endocrine Societies 2024;39(1):37-44
		                        		
		                        			Objective:
		                        			A diabetes prevention program is being proposed in the rural agricultural town of San Juan, Batangas, Philippines. This study aims to determine the prevailing level of food intake, physical activity, and health beliefs prior to any intervention.
		                        		
		                        			Methodology:
		                        			Adults were recruited via random sampling with proportional allocation. Interviews were done to determine food intake and physical activity.  Small group discussions were held to determine prevailing health beliefs.
		                        		
		                        			Results:
		                        			The average energy intake (1,547 kcal/d) is only 72% of the recommended values for Filipinos. Only 12% of the respondents achieved the recommended energy intake. Carbohydrates comprise a large part (71%) of calorie intake. A majority (91%) already have moderate to high levels of physical activity. There are prevailing health beliefs that need to be considered when dietary modifications and physical activity interventions are to be done.
		                        		
		                        			Conclusion
		                        			Internationally recommended diabetes prevention interventions such as reducing calorie intake and increasing physical activity may not be directly applicable here. We recommend that the features of a diabetes prevention program for this locale must include the following: 1) introduction of affordable plant sources of proteins; 2) decreasing the proportion of rice as a source of carbohydrates in the diet; 3) maintaining the level of physical activity; and 4) being sensitive to the prevailing health beliefs.
		                        		
		                        		
		                        		
		                        			Culture
		                        			;
		                        		
		                        			 Diet
		                        			;
		                        		
		                        			 Life Style
		                        			;
		                        		
		                        			 Prediabetic State
		                        			;
		                        		
		                        			 Rural Population
		                        			
		                        		
		                        	
2.A Comparative Study of Blood Lead Levels in Urban Children in China: The China Nutrition and Health Survey (CNHS) 2002 and 2012.
Xiao Bing LIU ; Zhao Long GONG ; Yu ZHANG ; Hui Di ZHANG ; Jun WANG ; Hong Xing TAN ; Jian Hua PIAO ; Li Chen YANG ; Xiao Guang YANG
Biomedical and Environmental Sciences 2023;36(4):376-380
3.Current Situation and Influencing Factors of Delay in Seeking Medical Treatment Among Residents in Rural Areas of Sichuan Province.
Fang-Qun LENG ; Yi-Shan ZHOU ; Chen-Fan LIAO ; Yan DU ; Yu-Ju WU ; Rui-Qian WANG ; Zhengjie CAI ; Huan ZHOU
Acta Academiae Medicinae Sinicae 2023;45(2):193-199
		                        		
		                        			
		                        			Objective To understand the current situation and explore the influencing factors of delay in seeking medical treatment for common symptoms of residents in the rural areas of Sichuan province. Methods In July 2019,multi-stage random sampling was carried out in Zigong city,Sichuan province,and the data were collected by face-to-face questionnaire interview.The residents who had lived at hometown for more than half a year in the past year and had seen a doctor in the most recent month were surveyed.Logistic regression was adopted to predict the influencing factors of delay in seeking medical treatment. Results A total of 342 subjects were enrolled,and the incidence of delay in seeking medical treatment was 13.45%(46/342).Compared with the young and middle-aged(<65 years)people,the elderly(≥65 years)people were more likely to have delay in seeking medical treatment (OR=2.187,95%CI=1.074-4.457,P=0.031).The rural residents who gave higher score of the overall quality of township health centers were less likely to have delay in seeking medical treatment (OR=0.854,95%CI=0.735-0.992,P=0.039). Conclusions The occurrence of delay in seeking medical treatment for common symptoms of rural residents in Sichuan province is low.Age and the overall quality evaluation of township health centers affect the occurrence of delay in medical treatment among the rural residents in Sichuan province.Efforts should be made to improve the awareness of disease prevention among the elderly in rural areas.The investment in health resources in township health centers should be increased to strengthen the introduction and training of talents.These measures can improve the health services in township health centers,guide residents to make timely use of health resources,and reduce the occurrence of delay in seeking medical treatment.
		                        		
		                        		
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Surveys and Questionnaires
		                        			;
		                        		
		                        			Logistic Models
		                        			;
		                        		
		                        			Rural Population
		                        			;
		                        		
		                        			China/epidemiology*
		                        			
		                        		
		                        	
4.Characteristics and Differences of Household Fine Particulate Matter Pollution Caused by Fuel Burning in Urban and Rural Areas in China.
Yu ZHANG ; Man CAO ; Xue-Yan HAN ; Tian-Jia GUAN ; Hui-Zhong SHEN ; Yuan-Li LIU
Acta Academiae Medicinae Sinicae 2023;45(3):382-389
		                        		
		                        			
		                        			Objective To explore the overall level,distribution characteristics,and differences in household fine particulate matter (PM2.5) pollution caused by fuel burning in urban and rural areas in China. Methods The relevant articles published from 1991 to 2021 were retrieved and included in this study.The data including the average concentration of household PM2.5 and urban and rural areas were extracted,and the stoves and fuel types were reclassified.The average concentration of PM2.5 in different areas was calculated and analyzed by nonparametric test. Results The average household PM2.5 concentration in China was (178.81±249.91) μg/m3.The mean household PM2.5 concentration was higher in rural areas than in urban areas[(206.08±279.40) μg/m3 vs. (110.63±131.16) μg/m3;Z=-5.45,P<0.001] and higher in northern areas than in southern areas[(224.27±301.66) μg/m3 vs.(130.11±140.61) μg/m3;Z=-2.38,P=0.017].The north-south difference in household PM2.5 concentration was more significant in rural areas than in urban areas[(324.19±367.94) μg/m3 vs.(141.20±151.05) μg/m3,χ2=-5.06,P<0.001].The PM2.5 pollution level showed differences between urban and rural households using different fuel types (χ2=92.85,P<0.001),stove types (χ2=74.42,P<0.001),and whether they were heating (Z=-4.43,P<0.001).Specifically,rural households mainly used solid fuels (manure,charcoal,coal) and traditional or improved stoves,while urban households mainly used clean fuels (gas) and clean stoves.The PM2.5 concentrations in heated households were higher than those in non-heated households in both rural and urban areas (Z=-4.43,P<0.001). Conclusions The household PM2.5 pollution caused by fuel combustion in China remains a high level.The PM2.5 concentration shows a significant difference between urban and rural households,and the PM2.5 pollution is more serious in rural households.The difference in the household PM2.5 concentration between urban and rural areas is more significant in northern China.PM2.5 pollution in the households using solid fuel,traditional stoves,and heating is serious,and thus targeted measures should be taken to control PM2.5 pollution in these households.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Particulate Matter/analysis*
		                        			;
		                        		
		                        			Air Pollution, Indoor/analysis*
		                        			;
		                        		
		                        			Cooking
		                        			;
		                        		
		                        			Environmental Exposure/analysis*
		                        			;
		                        		
		                        			China
		                        			;
		                        		
		                        			Rural Population
		                        			
		                        		
		                        	
5.Prevalence and trends of anemia among pregnant women in eight provinces of China from 2016 to 2020.
Li Na YIN ; Wei ZHAO ; Huan Qing HU ; Ai Qun HUANG ; Si Di CHEN ; Bo SONG ; Qi YANG ; Jiang Li DI
Chinese Journal of Preventive Medicine 2023;57(5):736-740
		                        		
		                        			
		                        			This study analyzed the anemia status and change trend of 219 835 pregnant women in eight provinces from 2016 to 2020 in the Maternal and Newborn Health Monitoring Program(MNHMP). The results showed that from 2016 to 2020, the anemia rate of pregnant women in eight provinces was 41.27%, and the rates of mild, moderate and severe anemia were 28.56%, 12.59% and 0.12% respectively; the anemia rates in eastern, central and western regions were 41.87%, 36.09% and 44.63% respectively, and the anemia rates in urban and rural areas were 39.87% and 42.23%. From 2016 to 2020, the anemia rate of pregnant women decreased from 44.93% to 38.22%, with an average annual decline of 3.86% (95%CI:-5.84%, -1.85%). The anemia rate among pregnant women of the eastern region (AAPC=-6.16%, 95%CI:-9.79%, -2.38%) fell faster than that among pregnant women of the central region (AAPC=0.71%, 95%CI:-6.59%, 8.57%) and western region (AAPC=-1.53%, 95%CI:-5.19%, 2.28%). From 2016 to 2020, the moderate anemia rate in pregnant women decreased from 14.98% to 10.74%, with an average annual decline of 8.72% (95%CI:-12.90%, -4.34%), with a statistically significant difference (P<0.05); AAPC for mild and severe anemia in pregnant women was 1.56% (95%CI: 3.44%, 0.36%) and 18.86% (95%CI: 39.88%, 9.52%), respectively, without statistically significant difference (P>0.05).
		                        		
		                        		
		                        		
		                        			Infant, Newborn
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Pregnancy
		                        			;
		                        		
		                        			Pregnant Women
		                        			;
		                        		
		                        			Prevalence
		                        			;
		                        		
		                        			Anemia/epidemiology*
		                        			;
		                        		
		                        			China/epidemiology*
		                        			;
		                        		
		                        			Family
		                        			;
		                        		
		                        			Rural Population
		                        			
		                        		
		                        	
6.Analysis on trend of health examination rate and influencing factors in adults in China, 2010-2018.
Lan WANG ; Mei ZHANG ; Zhen Ping ZHAO ; Chun LI ; Zheng Jing HUANG ; Xiao ZHANG ; Li Min WANG
Chinese Journal of Epidemiology 2023;44(7):1037-1045
		                        		
		                        			
		                        			Objective: To understand the health examination rate and its changing trend in adults in China from 2010 to 2018, identify the main factors affecting the health examination rate and provide data support for decision making of health intervention. Methods: Data from China Chronic Disease and Risk Factor Surveillance in 2010, 2013, 2015 and 2018 were used. After complex weighting of the data, the rates of health examination, its changing trends and reasons for receiving health examination in adults were analyzed. Average annual percent change (AAPC) was used to describe the changing trend. Anderson model was used as the analysis framework. Multivariate logistic regression model was used to identify the influencing factors for the health examination rate. Results: From 2010 to 2018, the health examination rate in adults increased from 28.2% (95%CI: 24.8%-31.6%) to 41.0% (95%CI: 38.9%-43.1%, P for trend <0.001), the AAPC was 5.47%, the annual average increase was more obvious in those with lower education level and lower income level and in those living in rural area and in western China. In 2018, people received health examination mainly due to providing without charge by community (36.7%) and working unit (28.5%). The results of multivariate analysis showed that being women, age ≥45 years, education level of junior high school or above, living in urban areas, medical insurance, annual income ≥24 000 RMB, suffering from multiple chronic diseases, non-smoking, drinking, adequate physical activity were positive factors for receiving health examination. Conclusion: The rate of health examination in adults increased in China during 2010-2018, and the main reason for receiving health examination is free of charge.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Rural Population
		                        			;
		                        		
		                        			Risk Factors
		                        			;
		                        		
		                        			China/epidemiology*
		                        			;
		                        		
		                        			Schools
		                        			;
		                        		
		                        			Chronic Disease
		                        			
		                        		
		                        	
7.Cancer statistics in China, 2016.
Rong Shou ZHENG ; Si Wei ZHANG ; Ke Xin SUN ; Ru CHEN ; Shao Ming WANG ; Li LI ; Hong Mei ZENG ; Wen Qiang WEI ; Jie HE
Chinese Journal of Oncology 2023;45(3):212-220
		                        		
		                        			
		                        			Objective: Data for 2016 from cancer registries were used to estimate cancer incidence and mortality in China in 2016. Methods: According to the quality control process of the National Central Cancer Registry, the data from 683 cancer registries submitted by each province were evaluated, and the data of 487 cancer registries were qualified and included in the final analysis. Age-specific incidence and mortality rates were calculated by area (urban/rural), sex, age and cancer site, combined with national population data to estimate cancer incidence and mortality in China in 2016. Chinese population census in 2000 and Segi's population were used for age-standardized incidence and mortality rates. Results: Total population covered by 487 cancer registries was 381 565 422 (192 628 370 in urban and 188 937 052 in rural areas). The percentages of morphologically verified (MV%) and death certificate-only cases (DCO%) accounted for 68.31% and 1.40%, respectively, and the mortality to incidence ratio was 0.61. It was estimated about 4 064 000 new cases occurred in China in 2016, with the crude incidence rate being 293.91/100 000 (the rates of males and females were 315.52/100 000 and 271.23/100 000), age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 190.76/100 000 and 186.46/100 000, with the cumulative incidence rate (0-74 years old) being 21.42%. The crude incidence and ASIRC were 314.74/100 000 and 196.38/100 000 in urban areas, whereas in rural areas, they were 265.90/100 000 and 182.21/100 000, respectively. It was estimated about 2 413 500 cancer deaths occurred in China in 2016, the crude mortality rate was 174.55/100 000 (216.16/100 000 in males and 130.88/100 000 in females), the age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 106.00/100 000 and 105.19/100 000, and the cumulative mortality rate (0-74 years old) was 11.85%. The crude mortality and ASMRC were 180.31/100 000 and 104.44/100 000 in urban areas, whereas in rural areas, they were 166.81/100 000 and 108.01/100 000, respectively. The most common cancer cases include lung, colorectal, stomach, liver and female breast cancers. The top five cancers accounted for about 57.27% of all cancer cases. The most common cancer deaths included lung, liver, stomach, colorectal and esophageal cancers. The top five cancers accounted for about 69.25% of all cancer deaths. Conclusions: The burden of cancer shows a continuous increasing trend in China. Regional and gender differences in cancer burden are obvious. The cancer patterns still show the coexistence of cancer patterns in developed countries and developing countries. The situation of cancer prevention and control is still serious in China.
		                        		
		                        		
		                        		
		                        			Male
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Infant, Newborn
		                        			;
		                        		
		                        			Infant
		                        			;
		                        		
		                        			Child, Preschool
		                        			;
		                        		
		                        			Child
		                        			;
		                        		
		                        			Adolescent
		                        			;
		                        		
		                        			Young Adult
		                        			;
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Urban Population
		                        			;
		                        		
		                        			Breast Neoplasms
		                        			;
		                        		
		                        			Esophageal Neoplasms
		                        			;
		                        		
		                        			Rural Population
		                        			;
		                        		
		                        			China/epidemiology*
		                        			;
		                        		
		                        			Registries
		                        			;
		                        		
		                        			Incidence
		                        			;
		                        		
		                        			Colorectal Neoplasms
		                        			
		                        		
		                        	
8.Investigation of ABO and RhD blood groups in childbearing age people in rural areas of Yunnan Province.
Zheng Yuan XIE ; Guang CAO ; Tao WANG ; Cai KONG ; Yi Xiao LI ; Wei Lei ZU ; Zi Gao ZHAO ; Han Feng YE
Chinese Journal of Preventive Medicine 2023;57(1):52-57
		                        		
		                        			
		                        			The participants in this study were 20-49 years old rural childbearing age people who received the National Free Preconception Health Examination Project (NFPHEP) in Yunnan Province during 2013 to 2019. The proportion of ABO and RhD blood groups among different ethnic groups and different areas were calculated. The proportion of 2 748 131 participants with blood group A phenotype was highest (32.60%), followed by O (30.60%), B (27.33%) and AB (9.47%). In the RhD blood system, the proportion of the RhD positivity (RhD+) and RhD negativity (RhD-) group were 99.29% and 0.71% respectively. The proportions blood groups were significantly different among ethnic groups and areas (all P<0.001). Among 18 ethnic groups with more than 3 000 participants, Yao (42.75%), Bouyei (40.58%) and Dai (40.37%) ethnic groups had higher proportion of blood group O phenotype than other ethnic groups. Wa ethnic groups had highest proportion of the A (40.15%) and AB phenotypes (11.23%). Miao ethnic group (34.70%) and Lahu ethnic group (34.42%) had higher proportion of blood group B phenotype than other ethnic groups. Wa ethnic group had the highest proportion of RhD-group (1.88%). In all 16 prefectures of Yunnan, the proportion of blood group O phenotype was highest in Xishuangbanna Dai Autonomous Prefecture (40.27%). Baoshan city (36.39%), Lincang city (36.22%) and Dali Bai autonomous prefecture (36.06%) had higher proportion of blood group A phenotype than other regions. Diqing Tibetan Autonomous Prefecture (30.83%) and Qujing city (30.48%) had higher proportion of blood group B phenotype than other areas, while Zhaotong city had a highest proportion of blood group AB phenotype (11.19%). The proportion of RhD-group was highest in Honghe hani and Yi nationality autonomous prefecture(1.37%). The A RhD+(39.36%), A RhD-(0.78%), AB RhD+(11.03%), AB RhD-(0.20%) and O RhD-(0.48%) blood groups were higher proportion in Wa ethnic group than in other ethnic groups (P<0.001).
		                        		
		                        		
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Young Adult
		                        			;
		                        		
		                        			Blood Group Antigens
		                        			;
		                        		
		                        			China
		                        			;
		                        		
		                        			Ethnicity
		                        			;
		                        		
		                        			Rural Population
		                        			
		                        		
		                        	
10.Utilisation of adolescent reproductive and sexual health services in a rural area of West Bengal: A mixed-method study
Ankush Banerjee ; Bobby Paul ; Ranjan Das ; Lina Bandyopadhyay ; Madhumita Bhattacharyya
Malaysian Family Physician 2023;18(All Issues):1-10
		                        		
		                        			Introduction:
		                        			 Despite policy actions and strategic efforts for improving the reproductive and sexual health of adolescents by promoting the uptake of adolescent reproductive and sexual health (ARSH) services, the utilisation rate remains significantly low, especially in rural areas of India. This study aimed to assess the utilisation of these services by adolescents in rural West Bengal and its associated determinants.
		                        		
		                        			Methods:
		                        			 This mixed-method study was conducted from May to September 2021 in the Gosaba rural block of South 24 Parganas, West Bengal. Quantitative data were collected from 326 adolescents using a pre-tested structured questionnaire. Qualitative data were collected via four focus group discussions among 30 adolescents and key-informant interviews among six healthcare workers. Quantitative data were analysed using SPSS, while qualitative data were analysed thematically.
		                        		
		                        			Results:
		                        			 Ninety-six (29.4%) adolescents had utilised ARSH services at least once during adolescence. The factors associated with non-utilisation of ARSH services were younger age, female sex, increasing reproductive health stigma and decreasing parent–adolescent communication related to sexual health. Qualitative exploration revealed that unawareness regarding services, perceived lack of privacy and confidentiality at healthcare facilities and disruption of services post-emergence of the COVID-19 pandemic were some major barriers to ARSH service utilisation.
		                        		
		                        			Conclusion
		                        			 A multi-component strategy, including promotion of adolescent-friendly health clinics, community support interventions associated with motivation and counselling of parents regarding the importance of adolescent reproductive health, is needed to improve the utilisation of ARSH services. Necessary steps to correct the deficiencies at the facility level should also be prioritised.
		                        		
		                        		
		                        		
		                        			Adolescent
		                        			;
		                        		
		                        			 Reproductive Health Services
		                        			;
		                        		
		                        			 Sexual Health
		                        			;
		                        		
		                        			 Qualitative Research
		                        			;
		                        		
		                        			 Rural Population
		                        			
		                        		
		                        	
            

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