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To assess risk factors of childhood obesity, we carried out a case-control study in ten kindergartens in Changsha, the capital city in the Chinese province of Hunan, between July 1 and December 31, 2007. Height and weight measurements were obtained from annual physical examinations for children attending these kindergartens. Obesity was defined according to the International Obesity Task Force cutoff for body mass index (BMI). For each obese child, one child with normal BMI, matched by kindergarten class, sex, age (within 3 months), and height (within 3 cm) were chosen as controls. The parents of the study subjects were asked to complete a questionnaire about their children, including perinatal factors, infant feeding, and current lifestyle factors. Univariate analysis was performed first to compare the distribution of risk factors between cases and controls. Conditional logistic regression analysis was used to assess independent risk factors of childhood obesity. A total of 162 subjects (81 pairs of cases and controls) were included in the final analysis. The results showed that the adjusted odds ratios and 95% confidence intervals for childhood obesity were 8.88 (2.41-32.70), 5.23 (1.24-22.04), 10.96 (2.08-21.64), and 6.72 (1.55-29.12), respectively, for macrosomia, cesarean delivery, early solid foods initiation (<4 months), and fetal musical education. We conclude that macrosomia, cesarean delivery, early initiation of solid foods, and fetal musical education are associated with increased risk of obesity in preschool children in urban China.

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BackgroundResearch into evidence-based practice has been extensively explored in nursing and there is strong recognition that the organizational context influences implementation. A range of barriers has been identified; however, the research has predominantly taken place in Western cultures, and there is little information about factors that influence evidence-based practice in China. The purpose of this study was to explore barriers and facilitators to evidence-based practice in Hunan province, a less developed region in China.MethodsA descriptive qualitative methodology was employed. Semi-structured interviews were conducted with staff nurses, head nurses and directors (n = 13). Interviews were translated into English and verified for accuracy by two bilingual researchers. Both Chinese and English data were simultaneously analyzed for themes related to factors related to the evidence to be implemented (Innovation), nurses’ attitudes and beliefs (Potential Adopters), and the organizational setting (Practice Environment).ResultsBarriers included lack of available evidence in Chinese, nurses’ lack of understanding of what evidence-based practice means, and fear that patients will be angry about receiving care that is perceived as non-traditional. Nurses believed evidence-based practice was to be used when clinical problems arose, and not as a routine way to practice. Facilitators included leadership support and the pervasiveness of web based social network services such as Baidu (百度) for easy access to information.ConclusionWhile several parallels to previous research were found, our study adds to the knowledge base about factors related to evidence-based practice in different contextual settings. Findings are important for international comparisons to develop strategies for nurses to provide evidence-based care.Electronic supplementary materialThe online version of this article (10.1186/s12912-018-0295-x) contains supplementary material, which is available to authorized users.

Background:  Inadequate social support is an important determinant of postpartum depression (PPD). Social support for pregnant women consists of supports from various sources and can be measured at different gestation periods. Differentiating the effects of social support from different sources and measured at different gestation periods may have important implications in the prevention of PPD. In the family centred Chinese culture, family support is likely to be one of the most important components in social support. Aims:  The aim of this study was to assess the association of prenatal family support and postnatal family support with PPD. Methods:  A prospective cohort study was conducted between February and September 2007 in Hunan, China. Family support was measured with social support rating scale at 30–32 weeks of gestation (prenatal support) and again at 2 weeks of postpartum visit (postnatal support). PPD was defined as Edinburgh Postnatal Depression Scale (EPDS) score ≥13. Results:  A total of 534 pregnant women were included, and among them, 103 (19.3%) scored 13 or more on the EPDS. PPD was 19.4% in the lowest tertile versus 18.4% in the highest quartile (adjusted odds ratio: 1.04, 95% confidence interval 0.60, 1.80) for prenatal support from all family members, and PPD was 39.8% in the lowest tertile versus 9.6% in the highest tertile (adjusted odds ratio: 4.4, 95% confidence interval 2.3, 8.4) for postnatal support from all family members. Among family members, support from husband had the largest impact on the risk of developing PPD. Conclusions:  Lack of postnatal family support, especially the support from husband, is an important risk factor of PPD.

There has been a resurgence of congenital syphilis in Shanghai, China, especially in the migrating population and other populations with a lower socioeconomic status.

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Objective:To examine the impact of prenatal and postnatal social support on the association between fetal sex and postpartum depression (PPD). Method:We conducted a prospective cohort study in Changsha, China, between February and September 2007. We first compared the sociodemographic and obstetric characteristics, and the prenatal and postnatal social support between women who gave birth to a female infant and those who gave birth to a male infant. We then examined the association between fetal sex and PPD by following logistic regression models: fetal sex as the independent variable; with adjustment for sociodemographic and obstetric factors; with adjustment for sociodemographic, obstetric factors, and prenatal social support; and with adjustment for sociodemographic, obstetric factors, and postnatal social support.Results: Postnatal social support scores were much lower in women who gave birth to a female infant than in those who gave birth to a male infant. The odds ratio of PPD for women who gave birth to a female infant, as compared with those who gave birth to a male infant, was 3.67 (95% CI 2.31 to 5.84). The increased risk of PPD for women who gave birth to a female infant remained after adjustment for sociodemographic and obstetric factors and prenatal social support, but disappeared after adjustment for postnatal social support score. Conclusion:We conclude that increased risk of PPD in Chinese women who give birth to a female infant is caused by lack of social support after childbirth. Can J Psychiatry. 2009;54(11):750-756. Clinical Implications· Lack of social support after childbirth is an important determinant of PPD. · To maximize cost-effectiveness, interventions aiming at reducing the risk of PPD should focus on the postpartum period. · Cultural factors should be taken into consideration in the development of preventive strategies for PPD. Limitations· Our study sample is not sufficiently large, especially for stratified analysis, to assess potential effect modification. · Patients at either end of the emotional spectrum might not have been inclined to participate. · PPD and postnatal Social Support Rating Scale were measured at the same time and they might have interacted with each other. · The Edinburgh Postnatal Depression Scale was used to classify women as depressed or not. It should be noted that this is a screening measure, and it does not constitute a diagnosis of depression.