ObjectiveTo study the effect of new bundle interventions on medical staff’s cognition of occupational exposure protection and exposure rate, and provide evidence for reducing medical staff’s occupational exposure.MethodsThe 1 435 medical practitioners in 37 clinical/technical departments of Nanchong Central Hospital were selected as the research objects. Bundle intervention strategies about occupational exposure for whole population and high risk population were implemented, and the medical staff’s cognition of occupational exposure, occurrence of occupational exposure, and post-exposure reporting in 2017 (before intervention) and 2018 (after intervention) were investigated and compared to evaluate the intervention effects.ResultsThe numbers of valid survey forms collected before intervention and after intervention were 1 160 and 1 421, respectively. The total awareness rate increased from 91.10% before intervention to 96.10% after intervention (P<0.001). The exposure rate and average rank of exposure frequency after intervention were lower than those before intervention (10.98% vs. 17.50%, 1 250.74 vs. 1 340.32), the reporting rate of initial exposure after intervention (69.23%) was higher than that before intervention (57.64%), and the differences were all statistically significant (P<0.05).ConclusionThrough gradually implementing the new bundle interventions, medical staff can improve the cognition of occupational exposure, reduce the occurrence of occupational exposure, improve the enthusiasm of reporting, and create a safe atmosphere.
ObjectiveTo systematically review the impact of school breakfast on children's nutrition and health. MethodsThe PubMed, Web of Science, The Cochrane Library, EMbase, CNKI, CBM, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) on the impact of school breakfast on children's nutrition and health from inception to June 2022. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.4 software. ResultsA total of 8 RCT, involving 8 208 children were included. The results of meta-analysis showed that compared with non-school breakfast, the school breakfast could significantly improve the rate of school attendance (RR=1.38, 95%CI 1.26 to 1.51, P<0.000 1). However, there was no statistically significant difference in height, weight, weight-for-age, height for age, energy, protein, iron, or incidence of nutritional disease between the groups. ConclusionThe current evidence suggests that school breakfast has no impact on children's nutrition and health. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo systematically review the efficacy of different non-pharmacological interventions for smoking cessation. MethodsPubMed, EMbase, The Cochrane Library, Web of Science, CBM, WanFang Data, VIP and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) of different non-pharmacological interventions for smoking cessation from inception to November, 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, network meta-analysis was performed by using Stata 15.1 software. ResultsA total of 27 RCTs involving 14 interventions were included. The results of the network meta-analysis showed that compared with conventional advice, video counseling (OR=2.34, 95%CI 1.32 to 4.15), mobile phone text message (OR=1.82, 95%CI 1.03 to 3.20), motivational interview (OR=2.00, 95%CI 1.11 to 3.59) and health education (OR=3.40, 95%CI 1.52 to 7.57) were higher in quitting rate (P<0.05). The sort results showed that health education was the most likely to be the best intervention (86.20%), followed by video consultation (74.10%). ConclusionCurrent evidence shows that the smoking cessation effects of health education, video counseling, telephone counseling, mobile phone text message and motivational interview. Among them, health education may be the best. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo systematically review the research issues related to evidence quality grading methods for public health decision making. MethodsPubMed, Web of Science, CNKI, WanFang Data, CBM and VIP databases were electronically searched to collect studies related to the application of evidence quality grading methods for public health decision making from inception to December 2022. The questions were constructed according to the SPIDER model. The quality of the included literature was evaluated by using the CASP checklist, and a three-level interpretation analysis of the questions on the application of quality rating methods for public health decision making was conducted using the thematic synthesis method to establish a pool of question entries. ResultsA total of 14 papers were included, covering seven countries. GRADE was the commonly used method for grading the quality of evidence. CASP evaluation results showed eight high quality studies, four medium quality studies and two low quality studies. The thematic synthesis method summarized 13 question entries in 7 categories. ConclusionThe existing methodology for grading the quality of evidence for public health decision making suffers from the diversity of evidence sources and the underestimation of the level of evidence from complex intervention studies.
ObjectiveTo overview the systematic reviews of dominant diseases of acupuncture in clinical efficacy.MethodsPubMed, The Cochrane Library, Web of Science, CNKI, CBM, VIP and WanFang Data databases were electronically searched to collect systematic reviews or meta-analyses of dominant diseases of acupuncture in clinical efficacy from inception to December 2020. Two reviewers independently screened literature, extracted data and assessed the quality of the included studies. Then, Excel 2010 and VOS viewer were used for data analysis.ResultsA total of 263 systematic reviews were included. Acupuncture techniques involved electroacupuncture (n=29), point thread-embedding (n=25), dermal needle (n=15), acupoint injection (n=12), spoon needle (n=12), fire needle (n=8), laser (n=8), intradermal needle (n=5), filiform needle (n=4), pricking blood therapy (n=2) and round-sharp needle (n=1). A total of 94 kinds of diseases were identified, and their total effective rate ranged from 4% (bladder cancer) to 98% (bladder stones, renal colic), 72 kinds of which were above 85%.ConclusionsAcupuncture is currently widely used in clinical practice. Based on the clinical effectiveness evidence, this study finally identifies 94 types of dominant diseases. However, the total sample size and total effective rate vary considerably, and the types of acupuncture are not yet specified in this study, which requires to be focused in future research.
In response to the specific requirements of nutrition research, Schwingshackl’s research group developed the NutriGrade grading system, which independently assessed the quality of evidence in randomized controlled trials and cohort studies in nutrition, aiming to summarize the associations or effects between different nutritional factors and outcomes and meet the specific needs of evidence users. It has the advantages of novel classification, quantifiability, independence and pertinence, and it has better consistency, fairness, reliability and feasibility. Well-designed prospective cohort studies are more feasible in the field of nutrition than randomized controlled trials. The grading of the evidence quality for cohort studies included the following eight items: a) risk of bias, study quality, and study limitations; b) precision; c) heterogeneity; d) directness; e) publication bias; f) funding bias; g) effect size; and h) dose-response. Based on the evaluation results of the above items, the evidence quality could be divided into four grades: high (8-10), moderate (<8), low (<6), and very low (<4). The purpose of this paper was to introduce the basic principles, specific contents, and application methods of the NutriGrade grading system for cohort studies and cite examples to provide references for relevant researchers.