Microbial community study in newly established Qingcaosha Reservoir of Shanghai,China

Qingcaosha Reservoir located at Yangtze Estuary of China is a newly constructed and one of the largest tidal reservoirs in the world, which will be an important drinking water source of Shanghai. This study aims at investigating microbial community and its shifts corresponding to different water quality during the test running period of Qingcaosha Reservoir. The results showed lower concentrations of total nitrogen (TN) and total phosphorus (TP) in the reservoir than that in Yangtze Estuary. The number of total cultivable bacteria was significantly lower in the reservoir than that of Yangtze Estuary. The denaturing gradient gel electrophoresis (DGGE) analysis showed that the dominant microbes were α-Proteobacteria, β-Proteobacteria, Flavobacterium, Rheinheimera, Prochlorococcus, and Synechococcus. The quantitative PCR (q-PCR) results revealed significantly higher number of cyanobacteria and Microcystis in the reservoir during summer season. In addition, bacterial abundance positively correlated with TP concentration inside the reservoir. These results indicated that Qingcaosha Reservoir had ability to reduce the TN and TP in influent and improve the water quality overall. However, it also faced the risk of potential cyanobacteria bloom and eutrophication in Qingcaosha Reservoir where phosphorus will be the nutrient limiting factor.     

Community Based Promotion on VCT Acceptance among Rural Migrants in Shanghai,China

Objective

Voluntary counseling and testing (VCT) plays an important integral role in response to the HIV/AIDS epidemic. However, VCT service has not been effectively utilized among rural migrants, a high risk group in China. In this study, we developed a community based intervention to examine if community mobilization with comprehensive VCT is more effective than current HIV preventions with routine VCT service in promoting VCT acceptability among rural migrants in Shanghai, China.

Methods

A comprehensive intervention with community mobilization and comprehensive VCT services including community-based VCT and mobile VCT was implemented during 2007–2009. Three communities in Minhang District of Shanghai were randomly selected and were designed to receive community mobilization and comprehensive VCT, traditional VCT and none intervention, respectively. After 24 months intervention, effects were evaluated by comparing outcome indicators between the baseline (2,690 participants) and follow-up surveys (1,850 participants).

Findings

A substantial increase in VCT acceptance was observed among community mobilization group (94.9% vs. 88.5%, P<0.001), whereas the reverse effect was seen in the traditional VCT group (86.1% vs. 94.6%, P<0.001) and control group (69.0% vs. 91.7%, P<0.001). Rural migrants from community mobilization group were more likely to accept VCT (OR = 2.91, 95% CI 1.69–4.97). Rural migrants from community mobilization group also showed significant increase in HIV/AIDS knowledge, positive attitude towards HIV positive individuals and condom use.

Conclusion

Community mobilization with comprehensive VCT has significant impact on promotion of VCT acceptance and utilization among rural migrants in Shanghai. These findings provide evidence to support community mobilization as a suitable strategy for VCT promotion among rural migrants in Shanghai, China.     

多民族高校社区原发性高血压分级管理及综合干预效果评价

目的:了解多民族高校社区医院对原发性高血压患者社区分级管理及综合干预的效果,为下一步更好地开展原发性高血压患者达标工作提供依据.方法:以某民族高校教职员工原发性高血压患者作为研究对象,进行为期四年的分级管理及综合干预,采用慢病管理随访评估等的形式了解干预效果,并进行卡方检验分析.结果:通过分级管理和实施综合干预,三个管理级别患者的血压控制率均大幅提高,其中管理一级由0%上升到65.1%(x2=15.096,p=0.001),管理二级由4%上升到73.4%(x2=223.547,p<0.001),管理三级由4.5%上升到75.5%(x2=488.270,p<0.001).结论:分级管理是一种有效的管理手段,结合综合干预措施,能够有效地提高原发性高血压患者的血压控制率.     

Multifactorial assessment and targeted intervention for preventing falls and injuries among older people in community and emergency care settings: systematic review and meta-analysis

Objective To evaluate the effectiveness of multifactorial assessment and intervention programmes to prevent falls and injuries among older adults recruited to trials in primary care, community, or emergency care settings.Design Systematic review of randomised and quasi-randomised controlled trials, and meta-analysis.Data sources Six electronic databases (Medline, Embase, CENTRAL, CINAHL, PsycINFO, Social Science Citation Index) to 22 March 2007, reference lists of included studies, and previous reviews.Review methods Eligible studies were randomised or quasi-randomised trials that evaluated interventions to prevent falls that were based in emergency departments, primary care, or the community that assessed multiple risk factors for falling and provided or arranged for treatments to address these risk factors.Data extraction Outcomes were number of fallers, fall related injuries, fall rate, death, admission to hospital, contacts with health services, move to institutional care, physical activity, and quality of life. Methodological quality assessment included allocation concealment, blinding, losses and exclusions, intention to treat analysis, and reliability of outcome measurement. Results 19 studies, of variable methodological quality, were included. The combined risk ratio for the number of fallers during follow-up among 18 trials was 0.91 (95% confidence interval 0.82 to 1.02) and for fall related injuries (eight trials) was 0.90 (0.68 to 1.20). No differences were found in admissions to hospital, emergency department attendance, death, or move to institutional care. Subgroup analyses found no evidence of different effects between interventions in different locations, populations selected for high risk of falls or unselected, and multidisciplinary teams including a doctor, but interventions that actively provide treatments may be more effective than those that provide only knowledge and referral.Conclusions Evidence that multifactorial fall prevention programmes in primary care, community, or emergency care settings are effective in reducing the number of fallers or fall related injuries is limited. Data were insufficient to assess fall and injury rates.     

The impact of the 2008 cold spell on mortality in Shanghai, China

No prior studies in China have investigated the health impact of cold spell. In Shanghai, we defined the cold spell as a period of at least seven consecutive days with daily temperature below the third percentile during the study period (2001–2009). Between January 2001 and December 2009, we identified a cold spell between January 27 and February 3, 2008 in Shanghai. We investigated the impact of cold spell on mortality of the residents living in the nine urban districts of Shanghai. We calculated the excess deaths and rate ratios (RRs) during the cold spell and compared these data with a winter reference period (January 6–9, and February 28 to March 2). The number of excess deaths during the cold spell period was 153 in our study population. The cold spell caused a short-term increase in total mortality of 13 % (95 % CI: 7–19 %). The impact was statistically significant for cardiovascular mortality (RR?=?1.21, 95 % CI: 1.12–1.31), but not for respiratory mortality (RR?=?1.14, 95 % CI: 0.98–1.32). For total mortality, gender did not make a statistically significant difference for the cold spell impact. Cold spell had a significant impact on mortality in elderly people (over 65 years), but not in other age groups. Conclusively, our analysis showed that the 2008 cold spell had a substantial effect on mortality in Shanghai. Public health programs should be tailored to prevent cold-spell-related health problems in the city.     

天津于桥水库大型底栖动物群落结构及其水质生物学评价

于2010年5月-2011年5月按季度对于桥水库大型底栖动物进行了采样调查.结果表明:于桥水库底栖动物有51种,其中水生昆虫23种,占总数的45.1％;软体动物15种,占29.4％;寡毛类12种,占23.5％;其他类1种,占2.0％,优势种类为侧叶雕翅摇蚊(Glyptotendipes lobiferus)、中华圆田螺(Cipangopaludina cathayensis)、霍甫水丝蚓(Limnodrilus hoffmeisteri)、克拉泊水丝蚓(L.claparedeianus);底栖动物年均密度为159.58 ind·m-2,年均生物量为3.31 g·m-2;各季度底栖动物密度表现为春季＞冬季＞秋季＞夏季,生物量表现为冬季＞夏季＞春季＞秋季.利用Goodnight修正指数(GBI)、Shannon-Wiener多样性指数(H')、Margalef丰富度指数(d)、生物学污染指数(BPI)、科级生物指数(FBI)和综合生物污染指数(BI)对于桥水库的水质进行综合评价,结果显示,于桥水库水质整体处于轻-中污型(Ⅱ-Ⅲ),相比1999-2000年(Ⅲ)于桥水库水质污染状况有所好转.     

Reproductive health status, knowledge, and access to health care among female migrants in Shanghai, China

As the largest labour flow in human history, the recent rise in migration in China has opened up unprecedented opportunities for millions of Chinese to rearrange their lives. At the same time, this process has also posed great challenges to Chinese migrants, especially female migrants, who not only face a bias against 'outsiders' but also have a greater need for reproductive health-related services in their migratory destinations. Based on data collected via multiple sources in Shanghai, China's largest metropolis, this study profiles the changing characteristics of female migrants, presents data on self-reported symptoms of reproductive health-related problems and knowledge on reproductive health issues, compares maternal and child health measures between migrants and local residents, and examines factors related to reproductive health knowledge and migrants' access to health care in urban China. Results of this study show a relatively low level of self-reported reproductive health problems among female migrants, coupled with a relatively high level of ignorance in knowledge related to STD. Both self-reported health status and knowledge of reproductive health are related to migrants' educational attainment and length of stay in the urban destination. This study also finds ample evidence that female migrants' access to urban health care is limited by a number of institutional barriers.     

Being harmed while doing good: affective injuries in a community development programme,Medan, Indonesia

Complaints, accusations, and failures of gratitude are everyday experiences for volunteers in community‐driven development in Medan, Indonesia. In this article I develop the analytic of ‘affective injury’ to describe the force of such encounters: the sensation of having one's ethical self questioned or put at risk that manifests as an immediate force or lingering hurt. While humanitarian and development workers are all susceptible to affective injuries, I argue that they operate on a different register for developers who belong to, and have an enduring relationship with, the ‘community’. The ways local volunteers respond to, and seek to recover from, affective injuries are distinct from reflective responses to ethical dilemmas. The suppression of, or diversion from, thoughts that could derail self‐understanding is a hindrance to reflexive development practice.     

Seasonality of a forest bird community in Hong Kong, South China

We studied the composition of a secondary forest bird community in Hong Kong (22^°N) between December 1992 and June 1995, using the variable point count method. The visual detectability of each bird species had a significant positive relationship with body length. A total of 71 bird species was recorded but three resident habitat-generalists, the Great Tit Parus major, Light-vented Bulbul Pycnonotus sinensis and Japanese White-eye Zosterops japonicus, accounted for 65% of the mean total bird density of 38 per ha. The number of species seen was highest between December and April and lowest from July to September, but the total bird density was highest between December and June and lowest from August to September. The main breeding season was from March to August. Insectivores and insectivore-frugivores accounted for 80% of the species and 98% of the total bird density. The percentages of migrant species and individuals are similar to those reported at equivalent latitudes in North America. Bird community diversity and composition differed considerably from that of larger, older forest areas in South China, presumably as a result of differences in forest age, area and isolation.     

Environmental Lead Exposure among Preschool Children in Shanghai,China: Blood Lead Levels and Risk Factors

Objective

To determine blood lead levels and to identify related risk factors among children in Shanghai; to explore the lead change trend of children after industrial transformation and to provide data for policy development to control environmental lead pollution in Shanghai.

Methods

A stratified-clustered-random sampling method was used. A tungsten atomizer absorption spectrophotometer was employed to determine blood lead levels.

Results

The arithmetic mean, geometric mean and median of blood lead levels of 0- to 6-year-old children from Shanghai were 22.49 µg/L, 19.65 µg/L and 19.5 µg/L, including 0.26% (6/2291) with concentrations ≥100 µg/L and 2.7% (61/2291) with concentrations ≥50 µg/L. Boys'' levels (23.57 µg/L) were greater than those of girls (21.2 µg/L). The blood lead levels increased with age. This survey showed that the Chongming district was the highest and Yangpu district was the lowest, this result is completely opposite with the earlier survey in Shanghai. Risk factors for lead contamination included housing environment, parents'' education levels, social status, hobbies, and children''s nutritional status.

Conclusions

The blood lead levels of children in Shanghai were lower than the earlier data of Shanghai and those of published studies in China, but higher than the blood lead levels of developed countries. The blood lead levels of urban districts are higher than the central districts with the industrial transformation. Society and the government should take an active interest in childhood lead poisoning of urban areas.     

Follow up study of moderate alcohol intake and mortality among middle aged men in Shanghai,China.

OBJECTIVE: To assess the risk of death associated with various patterns of alcohol intake. DESIGN: Prospective study of mortality in relation to alcohol consumption at recruitment, with active annual follow up. SETTING: Four small, geographically defined communities in Shanghai, China. SUBJECTS: 18,244 men aged 45-64 years enrolled in a prospective study of diet and cancer during January 1986 to September 1989. MAIN OUTCOME MEASURE: All cause mortality. RESULTS: By 28 February 1995, 1198 deaths (including 498 from cancer, 269 from stroke, and 104 from ischaemic heart disease) had been identified. Compared with lifelong non-drinkers, those who consumed 1-14 drinks a week had a 19% reduction in overall mortality (relative risk 0.81; 95% confidence interval 0.70 to 0.94) after age, level of education, and cigarette smoking were adjusted for. This protective effect was not restricted to any specific type of alcoholic drink. Although light to moderate drinking (28 or fewer drinks per week) was associated with a 36% reduction in death from ischaemic heart disease (0.64; 0.41 to 0.998), it had no effect on death from stroke, which is the leading cause of death in this population. As expected, heavy drinking (29 or more drinks per week) was significantly associated with increased risks of death from cancer of the upper aerodigestive tract, hepatic cirrhosis, and stroke. CONCLUSIONS: Regular consumption of small amounts of alcohol is associated with lower overall mortality including death from ischaemic heart disease in middle aged Chinese men. The type of alcoholic drink does not affect this association.     

Prevalence and Risk Factors of Restless Legs Syndrome among Chinese Adults in a Rural Community of Shanghai in China

Aims

The primary objective of this study was to investigate the prevalence and risk factors of restless legs syndrome (RLS) in an adult Chinese population living in a rural community. We also aimed to determine the predictive diagnostic value of the 4-item screening questionnaire for RLS in this population.

Methods

This study was designed as a 2-phase survey. In phase 1 we performed a face-to-face interview of eligible individuals living in a rural community in Shanghai using a 4-item screening questionnaire. In phase 2, sleep specialists performed a phone interview of the individuals who screened positive to diagnosis RLS.

Results

Forty-one RLS cases were confirmed among 2941 eligible individuals 18 years of age or older in the study community. The prevalence of RLS was 1.4% (95% confidence interval (CI) =1.0-1.9%), with a significantly higher rate observed in females (1.9% [95%CI =1.3-2.7%]) than that in males (0.9% [95%CI =0.5-1.5%], p=0.019). The prevalence rate increased significantly with age, from 0.2% (95% CI =0.08-0.6%) in those 18-39 years old to 4.1% (95% CI =2.1-7.9%) in those ≥70 years old (p<0.001). The multivariate logistic regression analysis indicated that gastritis, anemia and hypertension were risk factors for RLS. The sensitivity and specificity of the 4-item screening questionnaire used in this study were 63.4% and 97.5%, respectively.

Conclusion

RLS prevalence is relatively low among Chinese adults living in rural Shanghai. Furthermore, population-based studies with a larger sample size and a longitudinal follow-up may help to determine the risk factors of RLS and potential interventions for RLS.     

Knowledge Levels and Training Needs of Disaster Medicine among Health Professionals,Medical Students,and Local Residents in Shanghai,China

Background

Disaster is a serious public health issue. Health professionals and community residents are main players in disaster responses but their knowledge levels of disaster medicine are not readily available. This study aimed to evaluate knowledge levels and training needs of disaster medicine among potential disaster responders and presented a necessity to popularize disaster medicine education.

Methods

A self-reporting questionnaire survey on knowledge level and training needs of disaster medicine was conducted in Shanghai, China, in 2012. A total of randomly selected 547 health professionals, 456 medical students, and 1,526 local residents provided intact information. The total response rate was 93.7%.

Results

Overall, 1.3% of these participants have received systematic disaster medicine training. News media (87.1%) was the most common channel to acquire disaster medicine knowledge. Although health professionals were more knowledgeable than community residents, their knowledge structure of disaster medicine was not intact. Medical teachers were more knowledgeable than medical practitioners and health administrators (p = 0.002). Clinicians performed better than public health physicians (p<0.001), whereas public health students performed better than clinical medical students (p<0.001). In community residents, education background significantly affected the knowledge level on disaster medicine (p<0.001). Training needs of disaster medicine were generally high among the surveyed. ‘Lecture’ and ‘practical training’ were preferred teaching methods. The selected key and interested contents on disaster medicine training were similar between health professionals and medical students, while the priorities chosen by local residents were quite different from health professionals and medical students (p<0.001).

Conclusions

Traditional clinical-oriented medical education might lead to a huge gap between the knowledge level on disaster medicine and the current needs of disaster preparedness. Continuing medical education and public education plans on disaster medicine via media should be practice-oriented, and selectively applied to different populations and take the knowledge levels and training needs into consideration.     

Relationship between oral impacts on daily performance and chewing ability among independent elders residing in Daejeon City, Korea

doi: 10.1111/j.1741‐2358.2011.00504.x
Relationship between oral impacts on daily performance and chewing ability among independent elders residing in Daejeon City, Korea Objective: The aim of this study was to assess the association between oral health‐related quality of life (OHRQoL) measured by the oral impacts on daily performances (OIDP) inventory and chewing ability. Methods: The cluster sampling method was used to select a sample of 634 socially active independent community‐dwelling elders. An oral examination was conducted and a questionnaire was implemented. After bivariate comparisons, a multivariable two‐level logistic model was developed for the dichotomous OIDP indicator using the generalised linear mixed model. Results: The mean age of the participants was 74 years and 56.6% were women. Eight percent were edentulous, and the mean number of teeth was 17.7. Overall, 39.3% of participants had one or more oral impacts on daily performance. Elders with chewing ability of 0–49, 50–74 and 75–99% were approximately 120, 20 and seven times more likely to have oral impacts compared with those with full chewing ability, respectively. Elders reporting their oral health as ‘fair’ or ‘better’ were 68% less likely to have oral impacts than those with poor or very poor self‐reported oral health. Conclusion: Among independent elders, amelioration of chewing ability including delivery of appropriate prosthodontic care might independently contribute to improving OHRQoL of elders by improving their physical, psychological and social wellbeing.     

Study on the Traffic Air Pollution inside and outside a Road Tunnel in Shanghai,China

To investigate the vehicle induced air pollution situations both inside and outside the tunnel, the field measurement of the pollutants concentrations and its diurnal variations was performed inside and outside the Xiangyin tunnel in Shanghai from 13:00 on April 24th to 13:00 on April 25th, 2013. The highest hourly average concentrations of pollutants were quantified that CO, NO, NO₂ and NO_X inside the tunnel were 13.223 mg/m³, 1.829 mg/m³, 0.291 mg/m³ and 3.029 mg/m³, respectively, while the lowest ones were 3.086 mg/m³, 0.344 mg/m³, 0.080 mg/m³ and 0.619 mg/m³. Moreover, the concentrations of pollutants were higher during the daytime, and lower at night, which is relevant to the traffic conditions inside the tunnel. Pollutants concentrations inside the tunnel were much higher than those outside the tunnel. Then in a case of slow wind, the effect of wind is much smaller than the impact of pollution sources. Additionally, the PM_2.5 concentrations climbed to the peak sharply (468.45 µg/m³) during the morning rush hours. The concentrations of organic carbon (OC) and elemental carbon (EC) in PM_2.5 inside the tunnel were 37.09–99.06 µg/m³ and 22.69–137.99 µg/m³, respectively. Besides, the OC/EC ratio ranged from 0.72 to 2.19 with an average value of 1.34. Compared with the results of other tunnel experiments in Guangzhou and Shenzhen, China, it could be inferred that the proportion of HDVs through the Xiangyin tunnel is relatively lower.     

Quantitative Risk Assessment of Trichloroethylene for a Former Chemical Works in Shanghai,China

Assessment of the potential risks posed by chlorinated solvents in groundwater is the key to establish the extent of the contamination and derive achievable remedial targets should remediation deems necessary. This article first presents the application of the American Society for Testing and Materials (ASTM) Risk Based Corrective Actions (RBCA) Guidance to quantitatively evaluate human health and environmental risk for a former chemical works in Shanghai, China. The observed maximum trichloroethylene (TCE) concentration in groundwater at the site reached 1220 mg/l that exceeded its solubility of 1070 mg/l at 10°C (Soil annual average temperature is 10°C in Shanghai). The maximum concentration for cis-1, 2-DCE (DCE) was also found to be elevated at 264 mg/l. A critical exposure pathway was considered to be indoor vapor intrusion of TCE into the buildings with excess lifetime cancer risk for children being 1.7 × 10^?3. This cancer risk exceeded regulatory limits of 1 × 10^?4 to 1 × 10^?6 for The Netherlands, the United Kingdom, and the United States. The calculated groundwater remedial targets for TCE and DCE are 7 mg/l and 904 mg/l, respectively, in order to protect child residents from inhalation of indoor vapors within the close proximity of the source area.