The purpose was to synthesize information gathered from the interpretation and conclusion sections of the Global Matrix of Para Report Cards on the physical activity of children and adolescents with disabilities. The synthesis was based on the strengths, weaknesses, opportunities, and threats framework. The procedure consisted of three stages: (a) the application of the International Classification of Functioning, Disability and Health as the theoretical framework; (b) identifying and aligning Global Matrix indicators and benchmarks with the International Classification of Functioning, Disability and Health components through a Delphi approach; and (c) using content analysis to identify themes from specific report cards. Outcomes reveal that further attention toward including children and adolescents with disabilities in fitness assessments is needed as well as adapted assessment methods. Program availability, equipment and facilities, and professional training emerged as strengths but need further development to overcome weaknesses. Paralympic inspiration was an opportunity, whereas extreme weather conditions presented potential threats to physical activity participation among children and adolescents with disabilities.

We analyzed the project results of preventive medicine from the National Natural Science Foundation of China (NSFC) finished in 2017 based on the project-ending reports and data on science fund sharing service network. A total of 406 projects in this field were completed in 2017. A total of 3 122 published articles supported by these projects, including 1 789 articles in science citation index (SCI) journals and 525 articles in Chinese core journals. In addition, there were 224 patent application/software copyright and 589 trained postgraduates. The top three sub-disciplines of project were non-communicable disease epidemiology, human nutrition and hygienic toxicology, accounting for 45.32% of the total number of completed projects. There were 12 institutions which had more than 10 finished projects, accounting for 41.87%. During the recent 5 years, the number of SCI articles and patents/software copyrights per project showed a general uptrend. It should be noted that the number of articles in Chinese core journals and postgraduates decreased in recent two years. Our analyses demonstrated that the project results should be guided by the new era policy of science fund to promote sustainable development of scientific research.
以国家自然科学基金委员会预防医学相关领域2017年度项目结题报告作为研究对象，并从科学基金共享服务网检索结题项目相关数据，分析该年度的结题项目成果。2017年度结题项目数为406项，发表期刊论文3 122篇，其中SCI期刊论文1 789篇，中文核心期刊论文525篇，申请专利/软件著作权224项，培养研究生589名。结题项目数前3位的分支学科是非传染病流行病学、人类营养和卫生毒理，占结题项目总数的45.32%。12家依托单位的结题项目多于10项，占总数的41.87%，是主要的科研项目承担单位。比较近5年结题项目成果，项均SCI论文数、专利/软件著作权呈上升趋势。但近两年来发表中文核心期刊论文以及培养研究生数量降低，需要引起重视。建议以新时代科学基金的资助导向为方针做好项目结题工作，促进科学研究的可持续发展。.

Noninvasive ventilation (NIV) is an increasingly used method of respiratory support. The use of NIV is expanding over the time and if properly applied, it can save patients\' lives and improve long-term prognosis. However, both knowledge and skills of its proper use as life support are paramount. This systematic review aimed to assess the importance of NIV education and training. Literature search was conducted (MEDLINE: 1990 to June, 2018) to identify randomized controlled studies and systematic reviews with the results analyzed by a team of experts across the world through e-mail based communications. Clinical trials examining the impact of education and training in NIV as the primary objective was not found. A few studies with indirect evidence, a simulation-based training study, and narrative reviews were identified. Currently organized training in NIV is implemented only in a few developed countries. Due to a lack of high-grade experimental evidence, an international consensus on NIV education and training based on opinions from 64 experts across the twenty-one different countries of the world was formulated. Education and training have the potential to increase knowledge and skills of the clinical staff who deliver medical care using NIV. There is a genuine need to develop structured, organized NIV education and training programs, especially for the developing countries.

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Much of the fear and uncertainty around Zika epidemics stem from potential association between Zika virus (ZIKV) complications on infected pregnant women and risk of their babies being born with microcephaly and other neurological abnormalities. However, much remains unknown about its mode of transmission, diagnosis and long-term pathogenesis. Worries of these unknowns necessitate the need for effective and efficient psychosocial programs and medical-legal strategies to alleviate and mitigate ZIKV related burdens. In this light, local and global efforts in maintaining fundamental health principles of moral, medical and legal decision-making policies, and interventions to preserve and promote individual and collectiveHuman Rights, autonomy, protection of the most vulnerable, equity, dignity, integrity and beneficence that should not be confused and relegated by compassionate humanitarian assistance and support. This paper explores the potential medical and ethical-legal implications of ZIKV epidemics emergency response packages and strategies alongside optimizing reproductive and mental health policies, programs and best practice measures. Further long-term cross-borders operational research is required in elucidating Zika-related population-based epidemiology, ethical-medical and societal implications in guiding evidence-based local and global ZIKV maternal-child health complications related approaches and interventions. Core programs and interventions including future Zika safe and effective vaccines for global Zika immunization program in most vulnerable and affected countries and worldwide should be prioritized.

Objective: To analyze the performance of the 5 Global Fund Malaria Programmes in China from 2003 to 2013. Methods: All of the proposals, summaries, progress reports, survey reports, Monitoring& Evaluation reports, and performance rating reports of the 5 Global Fund Malaria Programmes in China and the epidemic data of program areas were collected for statistical analysis from 2012 to 2014. Symposiums were held with relevant experts from national and provincial Centers for Disease Control and Prevention, program managers and staffs from national and provincial Global Fund Malaria Programme offices. The completion of the relevant programme indicators (including the general grant information such as program areas, beneficiaries and funding; the implementation of malaria control measures; the performance of malaria control measures; the malaria incidence in the program areas; the prevalence of malaria parasites; and program management and performance evaluation) were analyzed, and the results: of the symposiums were summarized. Results The implementation period of the 5 Global Fund Malaria Programs were as follows: Round 1 from 2003 to 2008, Round 5 from 2006 to 2010, Round 6 from 2007 to 2012, Round 10 from 2012 to 2013, and National Strategy Application (NSA) from 2010 to 2012. Under the support of all the Global Fund Malaria Programs, a total of 11 936 726 fever cases received microscopic tests, 1 485 915 confirmed and suspected malaria cases were treated, 1 579 773 Long Lasting Insecticide-treated Nets were distributed, 3 414 633 regular nets were treated by insecticide, 40 298 284 primary and middle school students received health education on malaria control. Compared with the baseline value, the completion rates of each indicator increased after the implementation of the programs. The growth value ranged from 12.83% to 83.11%, among which the biggest growth was the value of the indicator\'Percentage of households with at least one LLIN/ITN in target areas\', and it increased from 9.2% (baseline value of 2006) to 92.31% (value of 2012). The malaria incidence in program areas has dropped significantly year by year, the annual reported malaria incidence in Yunnan and Hainan provinces decreased from 1 950/100 000, 3 850/100 000 in 2002 to 3.31/100 000, 0.15/100 000 in 2012, the P. falciparum malaria incidence in target counties in Hainan province decreased from 90.6/100 000 in 2002 to 0/100 000 in 2012. As from the implementation of NSA grant in 2010 to 2012, the annual reported malaria incidence in 92% of the 75 Type 1 counties was less than 1 per 10 000, 60.00% of Type 1 counties and 98.69% of the 687 Type 2 counties reported zero locally transmitted malaria cases. The Global Fund Secretariat had conducted a total of 37 performance evaluations, of which 9 have been rated as A1, 4 rated as A2, 19 rated as B1 and 5 rated as B1. Conclusions: The Global Fund Malaria Program in China has been closely integrated with the goal and task of National Malaria Control Program, reducing malaria burden in target areas, and pushing Chinese malaria control efforts to move from control to elimination.
目的： 分析2003—2013年中国5个全球基金疟疾项目实施效果。 方法： 于2012—2014年收集中国5个全球基金疟疾项目的申请书、历年项目报表、进展报告、调查报告、督导评估报告、全球基金秘书处项目执行情况评分表等项目资料以及项目地区疫情资料。邀请国家和省级疾控机构专家、国家和省级全球基金疟疾项目办主管及工作人员座谈，比较各轮次项目相关指标完成情况（包括中国全球基金疟疾项目覆盖地区、受益人群、经费等基本情况、疟疾防治措施实施情况、疟疾防治措施实施效果、项目地区疟疾发病率、疟原虫带虫率等变化情况及项目管理与绩效考核情况），并归纳总结专题座谈讨论结果。 结果： 5个中国全球基金项目实施时间分别为：第1轮2003—2008年、第5轮2006—2010年、第6轮2007—2012年、第10轮2012—2013年、国家策略申请项目（NSA）2010—2012年。各项目累计镜检发热病例11 936 726例，治疗疟疾病例（包括疑似病例）1 485 915例，发放长效蚊帐1 579 773顶，普通蚊帐药物浸泡3 414 633顶，40 298 284名中小学生接受了疟疾防治健康教育。项目实施后相关效果指标完成值均有所提高，增加值为12.83%~83.11%，其中，\"项目地区拥有药浸蚊帐(包括长效蚊帐)的比例\"指标增加幅度最大，从9.2%（2006年基线值）增加到92.31%（2012年值）。项目地区疟疾疫情下降显著，云南、海南报告疟疾发病率分别从2002年的1 950/10万和3 850/10万分别下降至2012年的3.31/10万和0.15/10万，海南恶性疟疾发病率从2002年的90.6/10万下降至2012年无病例发现。2010年NSA项目实施以来，截至2012年，92.00%（69/75）的一类县发病率降到万分之一以下，60.00%（45/75）的一类县及98.69%（678/687）的二类县报告无本地感染病例。全球基金秘书处累计开展绩效考核37次，其中9次被评为A1级，4次评为A2级，19次评为B1，5次评为B1。 结论： 中国全球基金疟疾项目与国家疟疾防治规划目标任务紧密结合，减轻了项目地区的疟疾负担，促进了中国疟疾从控制走向消除。.

Overuse of drugs in rural areas of China has led to a growing concern regarding service quality and cost. The study found evidence of high levels of drug use in some rural health facilities in comparison with a number of other developing countries. Such a result was significantly associated with the government policy of financing health care, regulation and monitoring of health services, and users\' attitudes and behaviour. It underlines the need for measures to be taken in China to improve drug use in order to allow its population access to effective care at reasonable cost.
Excessive and inappropriate drug prescribing practices in developing countries expose patients to health risks and raise health costs. In China, the transition to a market-oriented economy has been accompanied by a largely unregulated market for drugs and drug sales represent a major source of income for rural health services. This study examined drug prescribing patterns in 3 poor rural counties in China: Donglan (Guangxi province), Shibing (Guizhou province), and Xunyi (Shaanxi province). For each month in 1993, 100 outpatient records were randomly selected from each county hospital and 50 from each health center for review. A total of 7182 prescriptions (generally for 2-3 drugs) were issued. Between one-third and one-half of all prescriptions were for antibiotics. County health bureaus do not monitor the performance of health workers in relation to drugs unless a medical accident occurs. The income of health workers is directly related to the volume of drugs they sell--a factor that, along with patient equation of drug treatment with effective care, reinforces rampant overprescription. The average cost per prescription in township health centers was equal to 5.6, 2.2, and 6.2 times the average per capita daily income in Donglan, Shibing, and Xunyi, respectively. The mark up at health facility pharmacies was 15% for Western drugs and 20% for Chinese drugs and herbs. These findings indicate an urgent need for policies to end financial incentives for health workers to prescribe drugs, limit the right to prescribe or sell drugs to those with well-defined medical training, and ensure access to effective care at a reasonable cost.

Two-thousand cases (500 women and 500 men with sterilization; 500 women and 500 men without sterilization) in two counties and two cities in Sichuan, China, were investigated between 15 September 1992 and 30 April 1993. Information was obtained about their age, parity, marriage, contraceptives, social behavior, and present psychological characteristics. CES-D, SAS, and E.P.Q. scales were used to assess the depressive symptomatology, anxiety, and personality of the subjects. The results revealed that sterilization psychologically affected the depressive symptoms and anxiety under the neutral personality. In addition, depressive symptoms and anxiety were related to the subjects\' age, educational level, income, operative doctors\' attitudes to sterilization acceptors, and subjects\' understanding of the sterilization.
A comparative study conducted in two counties and two cities in China\'s Sichuan province indicated that surgical sterilization may have long-term psychological effects. Subjects included 500 men 40-44 years of age and 500 women 35-39 years of age who underwent vasectomy or tubectomy 5 years prior to the study; 500 non-sterilized men and 500 non-sterilized women from the same site, in the same age groups, and with the same number of children were recruited as controls. Three scales measuring personality, anxiety, and depression were administered. All eight indicators of depression were significantly higher among sterilized men and women. The risk for depression was 2.34 times greater after tubal ligation and 3.97 times greater after vasectomy. Similarly, all 10 indicators of anxiety were significantly higher among sterilized subjects. The risk for anxiety was 2.88 times greater after tubal ligation and 4.79 times greater after vasectomy. The subjects\' personality type did not affect their psychological disorders. In general, sterilization acceptors of relatively older ages, higher levels of education, and higher incomes were more likely to report depression and anxiety. Depression and anxiety were also associated with a lack of adequate rest after the sterilization procedure and poor communication skills on the part of the sterilization provider. These findings suggest a need for careful pre-sterilization counseling and education as well as the option of psychotherapy for those who have undergone the procedure.

The study examined the effect of pretreatment counseling upon discontinuation of 150 mg depo-medroxyprogesterone acetate (Depo-Provera (DMPA)), given for contraception. A total of 421 Chinese women participated, 204 receiving detailed structured pretreatment and ongoing counseling on the hormonal effects and probable side effects of DMPA and 217 receiving only routine counseling. The primary study endpoint was termination rate; secondary endpoints were frequency of medical events and reasons for termination. Study termination rates were significantly lower in the intensive structured counseling group than in the routine counseling group. At one year, the total cumulative termination rates were 11% (23/204) and 42% (92/217), respectively (p < 0.0001). The most common reasons for terminating DMPA were menstrual changes. No pregnancy, serious or unexpected medical events were reported, nor were statistically or clinically significant changes in vital signs observed. We conclude that pretreatment counseling on expected side effects increases the acceptability of DMPA.
In China, 214 women aged 18-40 years at two family planning clinics in Sichuan province received structured counseling on the effects they could expect with use of the contraceptive injectable delivering depot-medroxyprogesterone acetate (DMPA) and DMPA\'s mode of action. They also viewed an educational video on DMPA and received an information booklet on DMPA. 217 women aged 19-37 years at two other family planning clinics in the same province received routine counseling. They were only told that they were in a study to study the efficacy of DMPA. No other information on DMPA was provided unless asked. Researchers aimed to determine whether or not structured counseling would affect the rate of DMPA discontinuation. They followed the women for 12 months. Overall, the women who received structured counseling had a much lower discontinuation rate than those who received routine counseling (p 0.0001). For example, three months after receiving the first DMPA dose, 3% of women in the structured counseling group did not return for the next DMPA dose compared to 25% of those in the routine counseling group. At 12 months, these figures were 11% and 42%, respectively. Regardless of the group, menstrual irregularities were the leading reasons for DMPA termination and were much more common as a reason in the routine counseling group than the structured counseling group (19.24% vs. 5.43%; p 0.0001). They were also the most commonly reported medical event for both groups (39.7% for structured counseling group and 26.3% for routine counseling group). Among breast feeding mothers, menstrual irregularities were less likely to be a reason for DMPA termination in the structured counseling group than the routine counseling group (14% vs. 37%). Increased body weight and changes in blood pressure were not found. No pregnancy or serious or unexpected side effects occurred. These findings suggest that structured counseling increases the acceptability of DMPA and that DMPA is safe and effective.