Job satisfaction and its related factors among emergency department physicians in China

BackgroundJob satisfaction is recognized as an important factor affecting the performance and quality of medical services of emergency department physicians. However, little is known about the status of job satisfaction among emergency department physicians in China. This study aimed to explore the current level of job satisfaction and its associated factors among emergency department physicians in China.MethodsA nationwide cross-sectional survey was conducted in China from July to August 2018. A total of 10,457 emergency department physicians completed the questionnaire. The structured online questionnaire collected information on socio-demographic characteristics, work-related factors, work-family conflict, and job satisfaction. Student's t-test or ANOVA were used to compare the job satisfaction scores in different characters. The generalized linear model was used to investigate the related factors of job satisfaction among emergency department physicians.ResultsThe respondents' job satisfaction average score was 12.2 ± 3.6, of which 42.01% were satisfied of which the job. The results showed that emergency department physicians over 41 years old, with a higher income and working in central and western regions were positively associated with job satisfaction. In contrast, bachelor degree and above, fixed posts, long years of service, a high frequency of night shift, perceived shortage of physicians, perceived medical errors, and higher work-family conflict scores were negatively correlated with job satisfaction among emergency department physicians.ConclusionJob satisfaction of emergency department physicians in China is low. It is suggested that hospital administrators could improve the job satisfaction of emergency department physicians by establishing an acceptable shift system, ensuring adequate emergency department staffing, increasing their income appropriately and alleviating work-family conflict

The Mediating Effects of Stigma on Depressive Symptoms in Patients With Tuberculosis: A Structural Equation Modeling Approach

Objectives: To date, the complex interrelationships between family function, doctor-patient communication, knowledge about tuberculosis (TB), stigma, and depressive symptoms among patients with TB are insufficiently understood. We explored the interrelationships between family function, doctor-patient communication, knowledge about TB, TB-related stigma, and depressive symptoms and examined whether TB-related stigma played a mediating role.Methods: A cross-sectional survey was conducted between October 1, 2013 and March 31, 2014 in Hubei province, central China. Data were collected from 1,309 patients with TB using a structured questionnaire that measured family function, doctor-patient communication, knowledge about TB, stigma, and depressive symptoms. Structural equation modeling was used to examine the interrelationships among the study variables based on the hypothesized model.Results: The proposed model provided a good fit to the obtained data. There were indirect effects between family function, doctor-patient communication, knowledge about TB, and depressive symptoms through stigma (β = −0.048, P = 0.002; β = −0.028, P = 0.001; β = −0.021, P = 0.009, respectively). Stigma partially mediated the effect of family function and knowledge about TB on depressive symptoms and fully mediated the effect of doctor-patient communication on depressive symptoms.Conclusions: This study elucidated the pathways linking family function, doctor-patient communication, and knowledge about TB to depressive symptoms and confirmed that the effect of those variables on depressive symptoms can be mediated by stigma. Those findings provide direction and information for depression interventions among patients with TB

Assessment of absorption of four lignan constituents of JingNing particles in rat gut using in situ single-pass intestinal perfusion

Purpose: To study small intestinal absorption of schisadrol A, schisandrol B, schizandrin A and schisandrin B in JingNing particles using in situ single-pass intestinal perfusion (SPIP).Methods: Absorption rate constant (Ka) and apparent permeability (Papp) of the drugs at different concentrations in various parts of rat small intestine (duodenum, jejunum and ileum) were determined using SPIP. JingNing particles were also perfused in situ at different pH in the entire rat intestine. Ethanol extract of Schisandra chinensis (standard) at low concentration was perfused in the duodenum for comparison with extract of JingNing particles.Results: The order of apparent permeability of the four lignans was schisandrol A < schisandrol B < schizandrin A < schisandrin B. Ka and Papp values of the four lignans in JingNing particles were concentration-dependent. Absorption increased in the rank order: ileum > duodenum > jejunum. Optimum absorption pH was 6.50. Polygala tenuifolia extract and volatile oil of Rhizoma acori tatarinowii significantly (p < 0.05) enhanced the absorption of the four lignans.Conclusion: The four lignans were well absorbed in the intestinal tract, particularly the ileum, probably through carrier-mediated transport. The alcohol extract of Polygala tenuifolia and volatile oil of Rhizoma acori graminei enhanced the absorption of the four lignans.Keywords: JingNing, Intestinal absorption, Polygala tenuifolia, Rhizoma acori graminei, Lignans, Schisandrol, Schisandrin, Single-pass intestinal perfusio

Prevalence of metabolic syndrome among middle-aged and elderly adults in China: current status and temporal trends

Background: Metabolic syndrome (MetS) is a cluster of major risk factors for cardiovascular diseases. We aimed to estimate prevalence and distribution of MetS among middle-aged and elderly adults in China. Methods: The present analysis used data from a national study in 2014–2015. We defined MetS by different definitions, and compared results of the present study and previous nationally representative studies to illustrate possible temporal changes in MetS prevalence. Results: The estimated prevalence of MetS was 18.4% by the ATP III criteria, 34.0% by the revised ATP III criteria, and 26.9% by IDF criteria. The prevalence was higher in women, older adults, those with lower education level, and in economically developed regions. Contrasting with previous national studies, adults in urban areas had a lower rate of MetS than those in rural areas (odds ratio 0.94; 95% CI 0.92−0.97). Rural adults had worse deterioration or less improvement in abdominal obesity, overweight, hypertension, and high fasting plasma glucose, than urban adults, which was particularly striking for women. Conclusion: While measures to prevent and control cardiovascular diseases need to be strengthened in China, rapid increasing risk factors among rural residents and women should be prioritized in making public health policy decisions

Data on prevalence of atrial fibrillation and its association with stroke in low-, middle-, and high-income regions of China

Data presented in this article are supplementary material to our research article entitled " Prevalence of Atrial Fibrillation in Different Socioeconomic Regions of China and Its Association with Stroke: Results from a National Stroke Screening Survey" (Wang et al., 2018) [1]. This data article summarizes previous studies of Atrial Fibrillation (AF) prevalence in China, and estimates the association between AF and stroke in different socioeconomic regions of China through a national survey

Data on prevalence of atrial fibrillation and its association with stroke in low-, middle-, and high-income regions of China

Data presented in this article are supplementary material to our research article entitled " Prevalence of Atrial Fibrillation in Different Socioeconomic Regions of China and Its Association with Stroke: Results from a National Stroke Screening Survey" (Wang et al., 2018) [1]. This data article summarizes previous studies of Atrial Fibrillation (AF) prevalence in China, and estimates the association between AF and stroke in different socioeconomic regions of China through a national survey

Social Determinants of Community Health Services Utilization among the Users in China: A 4-Year Cross-Sectional Study

Background To identify social factors determining the frequency of community health service (CHS) utilization among CHS users in China. Methods Nationwide cross-sectional surveys were conducted in 2008, 2009, 2010, and 2011. A total of 86,116 CHS visitors selected from 35 cities were interviewed. Descriptive analysis and multinomial logistic regression analysis were employed to analyze characteristics of CHS users, frequency of CHS utilization, and the socio-demographic and socio-economic factors influencing frequency of CHS utilization. Results Female and senior CHS clients were more likely to make 3–5 and ≥6 CHS visits (as opposed to 1–2 visits) than male and young clients, respectively. CHS clients with higher education were less frequent users than individuals with primary education or less in 2008 and 2009; in later surveys, CHS clients with higher education were the more frequent users. The association between frequent CHS visits and family income has changed significantly between 2008 and 2011. In 2011, income status did not have a discernible effect on the likelihood of making ≥6 CHS visits, and it only had a slight effect on making 3–5 CHS visits. Conclusion CHS may play an important role in providing primary health care to meet the demands of vulnerable populations in China. Over time, individuals with higher education are increasingly likely to make frequent CHS visits than individuals with primary school education or below. The gap in frequency of CHS utilization among different economic income groups decreased from 2008 to 2011

The rates and the determinants of hypertension according to the 2017 definition of hypertension by ACC/AHA and 2014 evidence-based guidelines among population aged ≥40 years old

Background : In November 2017, the American College of Cardiology/American Heart Association (ACC/AHA) updated their definition of hypertension from 140/90 mm Hg to 130/80 mm Hg. Objectives : We sought to assess the situation of hypertension and the impact of applying the new threshold to a geographically and ethnically diverse population. Methods : We analyzed selected data on 237,142 participants aged ≥40 who had blood pressure taken for the 2014 China National Stroke Screening and Prevention Project. Choropleth maps and logistic regression analyses were performed to estimate the prevalence, geographical distribution and risk factors of hypertension using both 2017 ACC/AHA guidelines and 2014 evidence-based guidelines. Results : The present cross-sectional study showed the age- and sex-standardized prevalence of hypertension was 37.08% and 58.52%, respectively, according to 2014 evidence-based guidelines and 2017 ACC/AHA guidelines. The distribution of hypertension and risk factors changed little between guidelines, with data showing a high prevalence of hypertension around Bohai Gulf and in south central coastal areas using either definition. The age- and sex-standardized prevalence of newly labeled as hypertensive was 21.44%. Interestingly, the high prevalence region of newly labeled as hypertensive was found in the north China. Conclusion : The prevalence of hypertension increased significantly on 2017 ACC/AHA guidelines compared to the prevalence when using 2014 evidence-based guidelines, with high prevalence areas of newly labeled as hypertensive now seen mainly in north China. There need to be correspondingly robust efforts to improve health education, health management, and behavioral and lifestyle interventions in the north

Prevalence of atrial fibrillation in different socioeconomic regions of China and its association with stroke: Results from a national stroke screening survey

Background: Atrial fibrillation (AF) is the most common sustained arrhythmia in clinical practice. This study aimed to estimate the prevalence of AF in different socioeconomic regions of China and identify its association with stroke, through a national survey. Methods: The study included 726,451 adults aged ≥40 years who were participants of the China National Stroke Screening and Prevention Project, a nationally representative cross-sectional study. Stepwise logistic regression analyses were conducted to investigate the association between AF and stroke. Results: The overall standardized prevalence rate of AF was 2.31%. The prevalence of AF was highest in high-income regions (2.54%), followed by middle-income regions (2.33%), and lowest in low-income regions (1.98%). Women had a higher prevalence of AF than men in all regions (low-income regions, 2.30% vs 1.65%; middle-income regions, 2.78% vs 1.89%; and high-income regions, 2.96% vs 2.12%). Compared with urban residents, the prevalence of AF among rural residents was higher in low- (2.03% vs 1.91%) and middle-income regions (2.69% vs 1.90%), but lower in high-income regions (2.44% vs 2.58%). Participants with AF were more likely to have a stroke than those without AF (9.48% vs 2.26%). After adjusting for age, sex, location, overweight or obese, smoking, drinking, physical inactivity, hypertension, diabetes, dyslipidemia, and a family history of stroke, results showed that AF was significantly associated with stroke. Conclusions: The prevalence of AF has increased in recent years, and it was positively correlated with socioeconomic status, sex (women), location (rural areas), and stroke