by Michael Woodhead
1. Beijing will start to enforce new anti-smoking laws with 200 yuan on-the-spot fines (up from 10 yuan) for people who smoke in public indoor shared areas, and institutional fines of 30,000 yuan (up from 5000 yuan). Cameras will be used to compensate for the lack of enforcement officers, especially after hours, the city government says.
2. The Chinese government has been accused of withholding medical care from dissidents. An article by Sophie Richardson in the WSJ says civil rights campaigner Cao Shunli is now in intensive care because she was denied access to medical care while detained for her efforts to promote a civil society.
3. A link has been found between damp housing in Shanghai and rates of asthma in children. Researchers from the University of Shanghai for Science and Technology say asthma symptoms could be reduced by 25% by simply keeping a child's window open at night.
4. A vaccine against enterovirus 71 developed by Sinovac Biotech has proved effective against EV71-associated hand, foot, and mouth disease or herpangina in infants and young children, according to a study in 5000 children done by the Jiangsu Provincial Center for Disease Control and Prevention, published in the New England Journal of Medicine.
5. Eating shark fin is not only cruel and bad for the environment, it is also a health hazard because of high mercury levels in the product, researchers from Zhejiang have shown. After testing samples of shark fin they found that up to 33% contained toxic levels of mercury.
6. Antibiotics are widely overused by parents in rural China, with more than 60% dosing their children with antibiotics bought over the counter, Shanghai researchers have found. Most parents were ignorant about how antibiotics worked and had little idea hat they do not help viral infections.
7. Migrant workers have little access to healthcare and many of them put off seeing a doctor for illness, a survey in Shanghai has found. Two thirds of migrant workers said they had never had a medical check up and nearly 40% said they had ignored symptoms because they couldn't get to see a doctor.
8. Health workers in Guangdong have completed a successful pilot trial of a cervical cancer screening program using the ThinPrep cytological system. The program offered Pap test cancer screening to more than 40,000 women, and found that improvements are needed in basic education regarding cervical cancer screening for young and poorly educated women.
Showing posts with label food safety. Show all posts
Showing posts with label food safety. Show all posts
Monday, 3 March 2014
Wednesday, 26 February 2014
3 medical tales from China: the good, bad and the fake
by Michael Woodhead
Hospital performance pay system revealed
Hospitals in China are adopting performance-bonus schemes for their staff based on a concept called the balanced scorecard (BSC) according to an academic paper in the Health Policy and Planning. Researchers from Jinan in Shandong did a literature search and found details of 90 hospitals that had adopted the scorecards for staff as a way of improving performance, staff motivation and patient satisfaction. The hospitals typically compiled the score cards on a monthly basis at a department level and the score systems were usually linked to increasing hospital revenue. A scorecard might also measure parameters such as operations management (eg bed utilisation), patient satisfaction, learning and attitude to work. The score card-based bonuses were generally well accepted and had become an important part of the staff income, the study found.
(Some interesting facts revealed in the study: China has around 20,000 hospitals, but hospitals receive only about 10% of their operating costs through government subsidies. And medical salaries are low, only about 12% above average earnings.)
Shanxi Hospital swindling exposed
A hospital in Taiyuan, Shanxi is under investigation for swindling women through 'special offers' for treatments including abortion. The provincial Price Bureau started an investigation of the Yellow River Hospital after receiving complaints from women who said they had been charged much more than advertised and had not received the services promised. In one case, the hospital held a special 'Women's Health Week', during which time they offered a special price of 480 yuan to perform painless abortion and IUD insertion. However, women who used the hospital services said they were charged 4288 yuan, not 402 yuan. Part of the excess fee was for 'educational materials' that were widely available elsewhere and cost just a few yuan. The hospital also offered ultrasound scans for for 10 yuan, but women said they were forced to pay 120 yuan. One woman was told she needed magnetotherapy and microwave therapy, for which she was charged almost 10,000 yuan, but no doctor had recommended them. A spokesman for the hospital said the women's health price offer was only available during a certain period and the women in question had treatment outside those dates.
Rat poison kebab death: the fake hospital rumour
A story doing the rounds on Weibo claims that a 12-year-boy has died in a Hangzhou hospital after eating a rat poison-tainted meat kebab bought from a street stall. The post purports to come from a doctor at the hospital, who said the boy had a massively increased prothrombin time (known as an INR) of 150. The usual range is around 2-3. The post has been widely circulated, with many netizens commenting that it shows yet again that food in China was unsafe. However, when a reporter contacted the hospital he found there had been no such patient. A doctor said he had heard the rumour being attributed to many hospitals in China, most of which proved to be fake. However, he said there had once been a genuine case of rat poison-tainted food ingestion at the 301 PLA Hospital, but had not been fatal. It was true that rat poison could cause bleeding problems because it was based on the blood thinner warfarin. His general advice was that truth or rumour, it was best to be prudent about eating food from street stalls.
Hospital performance pay system revealed
Hospitals in China are adopting performance-bonus schemes for their staff based on a concept called the balanced scorecard (BSC) according to an academic paper in the Health Policy and Planning. Researchers from Jinan in Shandong did a literature search and found details of 90 hospitals that had adopted the scorecards for staff as a way of improving performance, staff motivation and patient satisfaction. The hospitals typically compiled the score cards on a monthly basis at a department level and the score systems were usually linked to increasing hospital revenue. A scorecard might also measure parameters such as operations management (eg bed utilisation), patient satisfaction, learning and attitude to work. The score card-based bonuses were generally well accepted and had become an important part of the staff income, the study found.
(Some interesting facts revealed in the study: China has around 20,000 hospitals, but hospitals receive only about 10% of their operating costs through government subsidies. And medical salaries are low, only about 12% above average earnings.)
Shanxi Hospital swindling exposed
A hospital in Taiyuan, Shanxi is under investigation for swindling women through 'special offers' for treatments including abortion. The provincial Price Bureau started an investigation of the Yellow River Hospital after receiving complaints from women who said they had been charged much more than advertised and had not received the services promised. In one case, the hospital held a special 'Women's Health Week', during which time they offered a special price of 480 yuan to perform painless abortion and IUD insertion. However, women who used the hospital services said they were charged 4288 yuan, not 402 yuan. Part of the excess fee was for 'educational materials' that were widely available elsewhere and cost just a few yuan. The hospital also offered ultrasound scans for for 10 yuan, but women said they were forced to pay 120 yuan. One woman was told she needed magnetotherapy and microwave therapy, for which she was charged almost 10,000 yuan, but no doctor had recommended them. A spokesman for the hospital said the women's health price offer was only available during a certain period and the women in question had treatment outside those dates.
Rat poison kebab death: the fake hospital rumour
A story doing the rounds on Weibo claims that a 12-year-boy has died in a Hangzhou hospital after eating a rat poison-tainted meat kebab bought from a street stall. The post purports to come from a doctor at the hospital, who said the boy had a massively increased prothrombin time (known as an INR) of 150. The usual range is around 2-3. The post has been widely circulated, with many netizens commenting that it shows yet again that food in China was unsafe. However, when a reporter contacted the hospital he found there had been no such patient. A doctor said he had heard the rumour being attributed to many hospitals in China, most of which proved to be fake. However, he said there had once been a genuine case of rat poison-tainted food ingestion at the 301 PLA Hospital, but had not been fatal. It was true that rat poison could cause bleeding problems because it was based on the blood thinner warfarin. His general advice was that truth or rumour, it was best to be prudent about eating food from street stalls.
Monday, 16 December 2013
Clinical news round-up from China
From the medical journals .... by Michael Woodhead
Trends in HIV treatment in Shanghai: antiretroviral treatment has been increasingly used in patients with higher CD4 counts since 2006 and stavudine regimens are prescribed less frequently.
“Strategies to facilitate early access to antiretroviral treatment and further reduction in stavudine use are needed,” says Dr Lu Hongzhou and co-researchers from the Department of Infectious Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China .
Source: International Journal of STD and AIDS
Why do Chinese consumers opt for more expensive branded drugs over cheaper generics? Because they don’t trust cheaper drugs and the stores that provide them, according to a survey of 250 consumers by Dr Zhou Zhiliang of the China Pharmaceutical University, Nanjing.
Source: Health Marketing Quarterly
Pertussis is still circulating in China, and the reported incidence might be underestimated, according to a study of children in a regional town in Hebei by Dr Zhao Shuzhun of the Department of Respiratory Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Beijing.
Source: Epidemiology and Infection
How does the composition of surgical teams in the operating room affect surgical team performance and procedure times? Interesting results from Dr He Wenjing and co-researchers at the Department of Minimally Invasive Surgery, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong.
Source: Surgical Endoscopy
Nontyphoidal Salmonella pathogens are a common cause of serious gastrointestinal infections in children, and there is a worrying level of antibiotic resistance, according to a study by Dr Wang Xiaohong and co-researchers at the Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai. “Ongoing surveillance for Nontyphoidal Salmonella infection and antibiotic resistance is needed to control this pathogen in Shanghai,” they conclude.
Source: Foodborne Pathogens and Diseases
Human enterovirus 71 (EV71) was the major pathogen of Hand, Foot and Mouth Disease in Guangdong during the 2010 epidemic, a study from the Guangdong Provincial Centrr for Disease Control and Prevention, Guangzhou has found. The infection occurs mostly in children less than 3 years of age, who should have first priority to receive an EV71 vaccine, the researchers say.
Source: PLOS One
Syphilis is still an important cause of pregnancy loss and infant disability in China, particularly among women who do not receive prenatal care or have late or inadequate treatment, a study from Shenzhen has shown. Researchers from the School of Public Health, Central South University, Hunan, screened 279,334 pregnant women and identified 838 (0.3%) women infected with syphilis. About 8% of infants born to syphilitic mothers were diagnosed as having congenital syphilis and 25% of women had adverse pregnancy outcomes.
“These study results can inform antenatal programs on the importance of early syphilis testing and prompt and appropriate treatment,” the study authors said.
Source: Sexually Transmitted Diseases
Trends in HIV treatment in Shanghai: antiretroviral treatment has been increasingly used in patients with higher CD4 counts since 2006 and stavudine regimens are prescribed less frequently.
“Strategies to facilitate early access to antiretroviral treatment and further reduction in stavudine use are needed,” says Dr Lu Hongzhou and co-researchers from the Department of Infectious Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China .
Source: International Journal of STD and AIDS
Why do Chinese consumers opt for more expensive branded drugs over cheaper generics? Because they don’t trust cheaper drugs and the stores that provide them, according to a survey of 250 consumers by Dr Zhou Zhiliang of the China Pharmaceutical University, Nanjing.
Source: Health Marketing Quarterly
Pertussis is still circulating in China, and the reported incidence might be underestimated, according to a study of children in a regional town in Hebei by Dr Zhao Shuzhun of the Department of Respiratory Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Beijing.
Source: Epidemiology and Infection
How does the composition of surgical teams in the operating room affect surgical team performance and procedure times? Interesting results from Dr He Wenjing and co-researchers at the Department of Minimally Invasive Surgery, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong.
Source: Surgical Endoscopy
Nontyphoidal Salmonella pathogens are a common cause of serious gastrointestinal infections in children, and there is a worrying level of antibiotic resistance, according to a study by Dr Wang Xiaohong and co-researchers at the Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai. “Ongoing surveillance for Nontyphoidal Salmonella infection and antibiotic resistance is needed to control this pathogen in Shanghai,” they conclude.
Source: Foodborne Pathogens and Diseases
Human enterovirus 71 (EV71) was the major pathogen of Hand, Foot and Mouth Disease in Guangdong during the 2010 epidemic, a study from the Guangdong Provincial Centrr for Disease Control and Prevention, Guangzhou has found. The infection occurs mostly in children less than 3 years of age, who should have first priority to receive an EV71 vaccine, the researchers say.
Source: PLOS One
Syphilis is still an important cause of pregnancy loss and infant disability in China, particularly among women who do not receive prenatal care or have late or inadequate treatment, a study from Shenzhen has shown. Researchers from the School of Public Health, Central South University, Hunan, screened 279,334 pregnant women and identified 838 (0.3%) women infected with syphilis. About 8% of infants born to syphilitic mothers were diagnosed as having congenital syphilis and 25% of women had adverse pregnancy outcomes.
“These study results can inform antenatal programs on the importance of early syphilis testing and prompt and appropriate treatment,” the study authors said.
Source: Sexually Transmitted Diseases
Friday, 18 January 2013
One in six Chinese people have food poisoning every year
 |
| New food safety regulations are in place in China, but the problem lies in enforcing them |
Food safety has become one of the most challenging social issues in China that needs to be addressed.
Domestic issues concerning food safety occur more frequently in China than in other countries; there are loopholes in all the aspects of the food chain—from the farm to the table; public concerns over food safety are growing. A severe scandal related to food safety was recently exposed with regards to the production and extensive use of banned cooking oil which shows that China faces a grave situation in ensuring food safety. In contrast with the different major food safety issues in developed countries, China is dealing with recurrent instances of foodborne diseases, not due to micro-organisms or environmental pollutants, but due to the illegal use of pesticides and veterinary drugs as well as adulterated materials.
In October 2011, the China National Center for Food Safety Risk Assessment was established; it is responsible for risk surveillance, risk assessment, early warning and risk communication, as well as scientific support for national food safety standards. This is the first professional body that aims to offer national-level risk assessment to policy makers and the public, and is one of the few interdepartmental centres in the world, indicating an important step by the Chinese government to strengthen food safety capability building. In June 2012, the State Council issued the 12th Five Year Plan for the National Food Safety Regulation System, highlighting the Chinese government's efforts towards food safety. The plan pointed out that the government needed to comprehensively promote the development of the system in 10 areas: regulations and standards, monitoring and assessment, inspection, process control, supervision of the import and export, food safety, emergency management, comprehensive coordination, science and technology support for research and development, food safety information integrity and missionary training. Key projects will be built that aim to address the urgent outstanding issues with the weak link of the food safety regulatory system need, including food safety risk assessment, the traceability system and the national food safety information exchange platform. In future, China will still need to strengthen development and application of new technologies such as the exposome characterisation of hazards occurring in Chinese food, and particularly risk-benefit techniques for exposure assessment and translational toxicology, to provide technological support for the food safety basic research programme.
As in other countries, although the main problem lies in enforcing food-safety regulations, the largest food safety issues in China are still foodborne diseases, most of which are characterised by acute gastrointestinal illness (AGI). There is a lack of practical means to ensure the implementation of foodborne disease surveillance system improvement. Since only a few cases with AGI seek medical care or submit a specimen for laboratory testing which is then not routinely cultured for pathogens, the true burden of foodborne diseases in China is not clear. During 2010 and 2011, the Center for Food Safety Risk Assessment launched the foodborne diseases active surveillance pilot work in some provinces in China, and the results highlight the substantial burden of AGI cases. It is estimated that there were 202 million cases of foodborne disease in China in 1 year, which means that about 1 in 6.6 people experienced at least one episode of foodborne disease annually (unpublished data). China also needs to establish a foodborne disease active surveillance and traceability system from patients about food-originated pathogens by laboratory-based PULSENET (ChinaFoodNet). One objective is to enhance the ability to deal with emergencies like the outbreak of Escherichia coli O104:H4 in Germany. The rapid expansion of swine production and its potential role as a source of plasmid-mediated quinolone resistance (PMQR) genes in the environment highlights the importance of international co-operation to promote the prudent use of antibiotics in medical therapy, agriculture and animal husbandry, and supports the need for effective treatment of husbandry wastewater before its release into the environment. Our results imply that the correlation of PMQR genes between wastewater and paired farm soil is a valuable first step in the environmental risk assessment of PMQR genes, but further research is needed to better understand transfer mechanisms. We also recommend the establishment of programmes to monitor antibiotic resistance genes in the environment on a global scale in order to clarify the extent of potential risks to public health.
The common challenges faced by the world, such as environmental degradation and global foodborne disease outbreaks, together with the food safety issues manifested at the particular social stage of development, constitute the theme of food safety in China. Besides those listed above, there are many reasons for concern about food safety in China and for informing the public that the government is actively addressing these issues. There is still a lot of work to be done to solve the food safety problems in China and to address people's concerns.
Read the full article (subscription only): Journal of Epidemiology and Community Health
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