BackgroundMigrant workers are a unique phenomenon in the process of China's economic transformation. The household registration system classifies them as temporary residents in cities, putting them in a vulnerable state with an unfair share of urban infrastructure and social public welfare. The amount of pressure inflicted by migrant workers in Beijing, as one of the major migration destinations, is currently at a threshold. This study was designed to assess the factors associated with health-seeking behavior and to explore feasible solutions to the obstacles migrant workers in China faced with when accessing health-care.MethodsA sample of 2,478 migrant workers in Beijing was chosen by the multi-stage stratified cluster sampling method. A structured questionnaire survey was conducted via face-to-face interviews between investigators and subjects. The multilevel methodology (MLM) was used to demonstrate the independent effects of the explanatory variables on health seeking behavior in migrant workers.ResultsThe medical visitation rate of migrant workers within the past two weeks was 4.8%, which only accounted for 36.4% of those who were ill. Nearly one-third of the migrant workers chose self-medication (33.3%) or no measures (30.3%) while ill within the past two weeks. 19.7% of the sick migrants who should have been hospitalized failed to receive medical treatment within the past year. According to self-reported reasons, the high cost of health service was a significant obstacle to health-care access for 40.5% of the migrant workers who became sick. However, 94.0% of the migrant workers didn't have any insurance coverage in Beijing. The multilevel model analysis indicates that health-seeking behavior among migrants is significantly associated with their insurance coverage. Meanwhile, such factors as household monthly income per capita and working hours per day also affect the medical visitation rate of the migrant workers in Beijing.ConclusionThis study assesses the influence of socio-demographic characteristics on the migrant workers' decision to seek health care services when they fall ill, and it also indicates that the current health service system discourages migrant workers from seeking appropriate care of good quality. Relevant policies of public medical insurance and assistance program should be vigorously implemented for providing affordable health care services to the migrants. Feasible measures need to be taken to reduce the health risks associated with current hygiene practices and equity should be assured in access to health care services among migrant workers.

Low-quality evidence suggested that surgical treatment is more effective than non-operative treatment in improving physical functions; no significant difference was observed in adverse events. No firm recommendation can be made due to instability of the summarized data.

Objective: To confirm the benefits of whole-body vibration exercise for pain intensity and functional disability in patients with non-specific chronic low back pain. Design: Single-blind randomized controlled trial. Setting: Outpatient. Subjects: Eighty-nine patients with non-specific chronic low back pain met the inclusion criteria, they were randomly allocated to either the intervention group ( n = 45) or the control group ( n = 44). Intervention: The intervention group received whole-body vibration exercises three times a week for 12 weeks. The control group received general exercise protocol three times a week for 12 weeks. Main outcomes: The primary outcome measures were pain intensity and functional disability measured by the visual analog scale scores and Oswestry Disability Index. The secondary outcome measures included lumbar joint position sense, quality of life (Short Form Health Survey 36) and overall treatment effect (Global Perceived Effect). Results: A total of 84 subjects completed the 12-week study program. After 12 weeks, compared with the control group, the mean visual analog scale and Oswestry Disability Index scores decreased by additional 1 point (95% confidence interval (CI) = –1.22 to −0.78; P < 0.001), 3.81 point (95% CI, −4.98, −2.63; P < 0.001) based on adjusted analysis in the intervention group. And the intervention group provided additional beneficial effects for in terms of lumbar joint position sense ( P < 0.05), quality of life ( P < 0.05), and Global Perceived Effect ( P = 0.012). Conclusion: The study demonstrated that whole-body vibration exercise could provide more benefits than general exercise for relieving pain and improving functional disability in patients with non-specific chronic low back pain.

Background and Aims The patterns of evolutionary assembly in the Sino-Japanese floristic region (SJFR) remain largely unknown due to a lack of integrative multidimensional studies throughout the region. To address this issue, we elucidated the evolutionary history of Cardiocrinum (Liliaceae), a genus containing four taxa distributed across the SJFR.Methods Fifty-four populations were sampled throughout the geographical range of Cardiocrinum to assess genetic structure, analyse phylogenetic relationships and reconstruct ancestral area based on six chloroplast DNA (cpDNA) fragments and three low copy nuclear genes (LCNG). Ecological niche modelling was used to examine the potential range shifts of Cardiocrinum in response to climatic change.Key Results The molecular data showed high genetic similarity in the cpDNA (98Á37 %) and LCNG (94Á53 %) sequences. The biogeographical analyses revealed that the ancestor of Cardiocrinum diversified during the late Miocene (approx. 7Á32 Mya) in Central China. The ancestor of the C. giganteum lineage dispersed westward to the Himalayas and south-west China with the split between C. giganteum and C. giganteum var. yunnanense occurring around 4Á11 Mya consistent with the period of orogeny of the Hengduan Mountains. Some populations of the C. cathayanum lineage dispersed eastward to south Japan via the land bridge approx. 4Á97 Mya, providing opportunities for allopatric speciation of C. cordatum. The predicted suitable habitats of Cardiocrinum have become smaller and more fragmented since the Last Glacial Maximum.Conclusions Our study provides evidence of a biogeographical pattern of dispersal from Central China to the Himalayas in the west and Japan in the east for genera distributed across the SJFR, and highlights that the orogeny of the Hengduan Mountains and fluctuations of the sea level of the East China Sea played important roles in promoting species divergence.

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