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OBJECTIVE@#To investigate the gene mutation and genotype distribution of thalassemia in the population of childbearing age in Chongzuo area of Guangxi.@*METHODS@#Six α-thalassemia and 17 β-thalassemia gene mutations common in Chinese were detected by gap-polymerase chain reaction (gap-PCR) combined with agarose gel eletrophoresis and reserve dot bolt hybridization in 29 266 cases of child-bearing age suspected of thalassemia.@*RESULTS@#A total of 19 128 (65.36%) cases were identified with thalassemia. The detection rate of α-thalassemia, β-thalassemia and α-combining β-thalassemia was 45.25% (13 242/29 266), 15.47% (4 526/29 266) and 4.65% (1 360/29 266), respectively. A total carrying rate of 8 kinds of α-thalassemia gene mutations was 26.74% (15 649/58 532), including 12.51% for --SEA, followed by 5.70% for -α3.7, and 0.24% for --Thai. Among 32 α-thalassemia genotypes, the most common five were --SEA/αα, -α3.7/αα, αCSα/αα, -α4.2/αα and αWSα/αα, accounting for 47.27%, 18.31%, 8.56%, 8.52% and 7.91%, respectively, as well as 0.97% for --Thai/αα. A total carrying rate of 13 kinds of β-thalassemia gene mutations was 10.07% (5 897/58 532), including 3.63% for CD41-42, followed by 2.55% for CD17, and 0.003% for -50 (G>A). Among 17 β-thalassemia genotypes, the most common six were CD41-42/N, CD17/N, CD71-72/N, CD26/N, 28/N and IVSI-1/N, accounting for 36.15%, 25.81%, 9.43%, 8.18%, 8.09% and 7.75%. The homozygous genotype CD26/CD26 [hemoglobin (Hb): 121 g/L] and -28/-28 (Hb: 56 g/L) were respectively detected in one case, and double heterozygous genotype were detected in 5 cases, including 3 cases of CD41-42/CD26 (Hb: 41 g/L, 51 g/L, 63 g/L, respectively), 1 case of -28/IVSI-1 (Hb: 53 g/L), and 1 case of CD71-72/CD26 (Hb: 89 g/L), in which patients with moderate or severe anemia had a history of blood transfusion. Among 104 α-combining β-thalassemia genotypes, the most common were --SEA/αα, -α3.7/αα combining CD41-42/N and --SEA/αα combining CD17/N, accounting for 12.13%, 9.63% and 9.26%, respectively. In addition, 1 case of --SEA/-α3.7 combining -28/IVSI-1 (Hb: 83 g/L) and 1 case of -α3.7/αα combining CD41-42/ CD41-42 (Hb: 110 g/L) were detected without history of blood transfusion, while 1 case of αWSα/αα combining CD41-42/CD17 (Hb: 79 g/L) and 1 case of --SEA/αα combining CD17/-28 (Hb: 46 g/L) were detected with history.@*CONCLUSIONS@#The detection rate of thalassemia genes is high and the mutations are diverse in the population of childbearing age in Chongzuo area of Guangxi. The common deletion genotype is --SEA/αα in α-thalassemia and CD41-42/N in β-thalassemia, and deletion genotype --Thai is not rare. There is a certain incidence of intermediate and severe β-thalassemia, and most patients require transfusion therapy. The results are beneficial for genetic consultation and intervention of thalassemia.
Subject(s)
Humans , beta-Thalassemia/genetics , alpha-Thalassemia/genetics , Dipeptidyl Peptidase 4/genetics , China/epidemiology , Genotype , MutationABSTRACT
Objective@#To investigate the compliance of functional exercises and identify its influencing factors among young and middle-aged stroke patients, so as to provide insights into rehabilitation management among young and middle-aged stroke patients.@*Methods@#Stroke patients at ages of 18 to 59 years were recruited from those receiving rehabilitation treatment in Tongde Hospital Affiliated to Zhejiang Chinese Medical University from January 2021 to June 2022. Participants' demographics and clinical data were collected through questionnaire surveys. The compliance of functional exercises was assessed using Stroke Functional Exercise Adherence Questionnaire, and patients' social support, exercise self-efficacy and depression were assessed using the Social Support Rating Scale, Exercise Self-efficacy Scale and Self-rating Depression Scale. The factors affecting functional exercise compliance were identified among young and middle-aged stroke patients with a multivariable linear regression model.@*Results@#A total of 230 questionnaires were allocated and 213 valid questionnaires were recovered, with an effective recovery rate of 92.61%. The respondents included 129 men (60.56%) and 84 women (39.44%) and had a mean age of (53.49±7.95) years. The total score of functional exercise compliance was (41.37±9.11) points among the participants. Multivariable linear regression analysis identified education level (β'=0.376), monthly household income per capita (β'=0.309), history of stroke onset (β'=-0.238), rehabilitation instruction (β'=0.284), depression (β'=-0.261), exercise self-efficacy (β'=0.152), and social support level (β': 0.277 to 0.415) as factors affecting the functional exercise compliance among young and middle-aged stroke patients.@*Conclusion@#Education level, income, history of stroke onset, depression, exercise self-efficacy and social support may affect the compliance of exercise compliance among young and middle-aged stroke patients.
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The current organ allocation rules prioritize elderly and urgent patients on the lung transplantation (LT) waiting list. A steady increase in the threshold at which age is taken into consideration for LT has been observed. This retrospective cohort study recruited 166 lung transplant recipients aged ≽ 65 years between January 2016 and October 2020 in the largest LT center in China. In the cohort, subgroups of patients aged 65-70 years (111 recipients, group 65-70) and ≽ 70 years (55 recipients, group ≽ 70) were included. Group D restrictive lung disease was the main indication of a lung transplant in recipients over 65 years. A significantly higher percentage of coronary artery stenosis was observed in the group ≽ 70 (30.9% vs. 14.4% in group 65-70, P = 0.014). ECMO bridging to LT was performed in 5.4% (group 65-70) and 7.3% (group ≽ 70) of patients. Kaplan-Meier estimates showed that recipients with cardiac abnormalities had a significantly increased risk of mortality. After adjusting for potential confounders, cardiac abnormality was shown to be independently associated with the increased risk of post-LT mortality (HR 6.37, P = 0.0060). Our result showed that LT can be performed in candidates with an advanced age and can provide life-extending benefits.
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Aged , Humans , East Asian People , Heart Diseases/etiology , Lung Transplantation/adverse effects , Retrospective StudiesABSTRACT
Objective@#To investigate the self-care activities and their influencing factors among young and middle-aged patients with type 2 diabetes mellitus ( T2DM ), so as to provide the basis for the care management of T2DM.@*Methods@#T2DM patients at ages of 18 to 59 years that were admitted to Department of Endocrinology, Hangzhou First People's Hospital Affiliated to Medical School of Zhejiang University were selected using the convenient sampling method from January to August 2021, and the demographic data were collected using questionnaires, including gender, age and educational levels. The self-care level was measured using the Summary of Diabetes Self-Care Activities ( SDSCA ) was used to assess self-management behaviors, and the social support level was evaluated using the Social Support Rating Scale ( SSRS ), while the coping modes were assessed using the Medical Coping Modes Questionnaire ( MCMQ ). Factors affecting the self-care activities were identified among young and middle-aged patients with T2DM using multivariable linear regression analysis.@*Results@#The 342 respondents included 185 men ( 54.07% ) and 157 women (45.93% ), and had a mean age of ( 43.76±3.82 ) years. The total score of self-care activities was ( 94.22±18.74 ), and the overall scoring rate was 72.48%, including 63 cases with high scores ( 18.42% ), 208 cases with moderate scores ( 60.82% ) and 71 cases with low scores ( 20.76% ). Multivariable linear regression analysis identified gender ( women, β'=0.213 ), educational level ( high school/technical secondary school, β'=0.187; diploma and above, β'=0.411 ), household monthly income per capita (5 000 Yuan and higher, β'=0.390), course of disease ( >5 years, β'=0.340 ), history of receiving health education targeting diabetes ( β'=0.411 ), coping mode ( avoidance, β'=0.195; confronce, β'=0.367 ) and social support level ( general, β'=0.206; high, β'=0.383 ) as factors affecting self-care activities among young and middle-aged patients with T2DM.@*Conclusions@#The overall self-care activities at a moderate level among young and middle-aged patients with T2DM, which are associated with gender, educational level, economic income, course of disease, health education targeting diabetes, coping mode and social support level.
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Background: Elderly trauma patients present unique challenges and face more significant obstacles in recovery than their younger counterparts. They usually experience higher morbidity and mortality and slower recovery trajectories and have, on average, worse functional, cognitive, and psychosocial outcomes months or years post-injury than do younger patients.Methods: Authors conducted a study of elderly head injury patients to understand the epidemiology of geriatric TBI, the impact of comorbidities and management issues and outcomes in such patients. Authors had a total of 110 patients who presented with traumatic brain injury and were admitted in this hospital over 2 years. Authors also reviewed the literatures to study the factors affecting outcome after geriatric TBI and studied the role of aggressive neurosurgical management in geriatric TBI.Results: Among 68%(n=75) of the patients were male and 32% females. Age group of 60-65 years was the highest with 60.9% patients. Patients with GCS of 8 and below had the highest mortality rates of 68 %. Overall mortality rate was 32.72% and 9.09 % of the patients survived in a vegetative condition. The proportion of injury secondary to fall was the largest single group in 50.9% patients, and Chronic SDH was the most common pathology seen in 36.45 % patients. Highest mortality was seen in patients with Diffuse Axonal Injury (69.23 %). Out of the 110 patients , 57 patients underwent surgery for various pathologies. Chronic SDH were the most common operated pathology followed by acute SDH. Glassgow outcome scale was used as the measure of outcome in these series of patients. 32.72 % patients had a GOS score of 1 and 9.09 % had a score of 2. 18.18 % patients remained severely disabled with a score of 3 and nine patients (8.18 %) had a score of 4 and thirty five patients had good recovery (GOS-5).Conclusions: Due to the better treatment options there is an increase in the number of elderly around the world. Thus, the number of eldery individuals presenting with TBI to the emergency department is also on the rise more commonly due to falls than road traffic accidents. There is a need for specific prognostic and management guidelines for the elderly which can lead to better diagnosis, care and recovery and eventual short- and long-term outcomes in the elderly.
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OBJECTIVES: To explore changes in self-reported oral health in middle-aged Koreans over a period of 9 years. METHODS: This study design was a cross-sectional analysis. This study analyzed the data of 18,845 middle-aged (45-64 years) subjects who participated in 4-6th Korea National Health and Nutrition Examination Surveys (KNHANES). A complex-sample chi-square test was used to analyze self-reported poor oral health according to sex, household income, and education. A complex-sample logistic regression analysis was used to identify the changes in the factors. SPSS 23.0 and the R ver. 3.5.1 statistical package were used for the analyses. RESULTS: Poor oral health have been decreased by 5.3% over the 9-year period. Middle-aged men were more likely to report their oral health as worse than women. The lower income and education groups reported their oral health as poor compared to the higher income and education groups. The factors affecting self-reported poor oral health over the 9-year period were sex, income, and education. CONCLUSIONS: More than half of the aged population reported their oral health as poor. Oral health policies should be established for the aged population, including the middle-aged population, for long-term plans.
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Female , Humans , Male , Cross-Sectional Studies , Education , Family Characteristics , Korea , Logistic Models , Oral HealthABSTRACT
Objective To estimate the association between high-sensitivity C-reactive protein (hs-CRP) and cardiovascular events as well as all-cause mortality events.Methods During 2009-2010,out of the 11 623 individuals,1 000 participants aged 35-64 years,were recruited and divided into 12 age-groups,to have received a study on CVD risk factors.Information on the risk factors of cardiovascular diseases was also collected.Fasting blood sample was gathered for all the participants,with hs-CRP tested.Participants in 7 out of the 12 sites were followed,with 6.21 years (36 075 personyears) as the median follow-up period.Cardiovascular and all-cause mortality events were collected.A total of 6 177 participants had been followed after excluding participants who had baseline infections,or did not take hs-CRP test/physical examination at the baseline.Finally,5 984 participants were included for analysis.Participants were categorized into three groups based on the hs-CRP (mg/L) values:＜ 1,1-3 and ＞3,respectively.Cox proportional hazards regression model was used to analyze the relationships between hs-CRP with cardiovascular events or all-cause mortality events,after adjusting for confounding factors.Results Mean age of the participants was 50.2 years.The incidence rates of cardiovascular disease events were 3.6/1 000 person-years,7.1/1 000 person-years,and 10.4/1 000 person-years among three groups and 3.0/1 000 person-years,5.7/1 000 person-years,9.1/1 000 person-years for all-cause mortality events,respectively.After adjusting for confounding factors,the hazard risks (HR) for cardiovascular events were 1.33 (95％CI:0.95-1.84) in the hs-CRP 1-3 mg/L group and 1.76 (95％CI:1.20-2.60) in the hs-CRP＞3 mg/L group when comparing with the hs-CRP＜ 1 mg/L group (trend test P=0.003).The HRs for all-cause mortality events were 1.76 (95％CI:1.23-2.54) and 2.64 (95％CI:1.74-4.01) (trend test P＜0.001),respectively.Conclusion Hs-CRP appeared an independent predictor for cardiovascular events and all-cause mortality events.
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Objective To estimate the association between high-sensitivity C-reactive protein (hs-CRP) and cardiovascular events as well as all-cause mortality events.Methods During 2009-2010,out of the 11 623 individuals,1 000 participants aged 35-64 years,were recruited and divided into 12 age-groups,to have received a study on CVD risk factors.Information on the risk factors of cardiovascular diseases was also collected.Fasting blood sample was gathered for all the participants,with hs-CRP tested.Participants in 7 out of the 12 sites were followed,with 6.21 years (36 075 personyears) as the median follow-up period.Cardiovascular and all-cause mortality events were collected.A total of 6 177 participants had been followed after excluding participants who had baseline infections,or did not take hs-CRP test/physical examination at the baseline.Finally,5 984 participants were included for analysis.Participants were categorized into three groups based on the hs-CRP (mg/L) values:＜ 1,1-3 and ＞3,respectively.Cox proportional hazards regression model was used to analyze the relationships between hs-CRP with cardiovascular events or all-cause mortality events,after adjusting for confounding factors.Results Mean age of the participants was 50.2 years.The incidence rates of cardiovascular disease events were 3.6/1 000 person-years,7.1/1 000 person-years,and 10.4/1 000 person-years among three groups and 3.0/1 000 person-years,5.7/1 000 person-years,9.1/1 000 person-years for all-cause mortality events,respectively.After adjusting for confounding factors,the hazard risks (HR) for cardiovascular events were 1.33 (95％CI:0.95-1.84) in the hs-CRP 1-3 mg/L group and 1.76 (95％CI:1.20-2.60) in the hs-CRP＞3 mg/L group when comparing with the hs-CRP＜ 1 mg/L group (trend test P=0.003).The HRs for all-cause mortality events were 1.76 (95％CI:1.23-2.54) and 2.64 (95％CI:1.74-4.01) (trend test P＜0.001),respectively.Conclusion Hs-CRP appeared an independent predictor for cardiovascular events and all-cause mortality events.
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Objective To estimate the prevalence of eight chronic non-communicable diseases ( NCDs) and associated common risk factors among Chinese middle-aged and older population . Methods The prevalence of eight NCDs and five common risk factors for NCDs among adults aged 50 years and older were estimated based on the survey data from SAGE-China wave Ⅰ.Ordinal logistic regression models were performed to examine the associated risk factors and social determinates for multiple chronic conditions . Results Adjusting for design weights and post-stratification , the proportions of insufficient vegetables and fruits intake ,low level of physical activity , current daily smoking use , obesity and frequent heavy drinker were 35.6%, 28.1%, 26.7%, 12.8% and 6.3%, respectively.And the prevalence of hypertension , arthritis, angina, chronic lung disease , diabetes, stroke, asthma and depression were 61.3%, 22.0%, 7.9%, 7.9%, 6.6%, 3.1%, 1.9%and 0.3%, separately.The proportion of multiple chronic condi-tions was 28.4%.The older elderly, women, living in the urban, more risk factors would increase the risk of multiple chronic conditions . Conclusion The prevalence of NCDs is very high and multiple chronic conditions are common among middle-aged and older population .Hence, more attentions should be paid and multiple effective control measures should be taken .
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Objective To explore the correlation between hypokalemia and sudden death in young and middle-aged people. Methods One hundred and twenty-nine young and middle-aged patients with sudden death during treatment were selected as observation group. Then 100 cases of healthy volunteers were randomly selected as control group. The incidence of cardiovascular disease, incidence of hypokalemia and intake of potassium were compared between 2 groups. Results The incidences of hypertension, arrhythmia, myocardial infarction, heart failure and hypokalemia in observation group were significantly higher than those in control group: 17.05% (22/129) vs. 5.00%(5/100), 13.18% (17/129) vs. 2.00% (2/100), 26.36% (34/129) vs. 9.00% (9/100), 9.30% (12/129) vs. 1.00% (1/100) and 55.04% (71/129) vs. 12.00% (12/100), and there were statistical differences (P<0.01). The ratios of higher, common, lower intake of potassium in observation group were 1.55%(2/129), 27.91% (36/129) and 70.54%(91/129), in control group were 15.00% (15/100), 58.00% (58/100) and 27.00% (27/100), and there was statistical difference (P<0.01). Logistic regression analysis result showed that hypertension, arrhythmia, myocardial infarction, heart failure, hypokalemia and lower intake of potassium were the risk factor for sudden death (P<0.01). The incidences of hypertension, arrhythmia, myocardial infarction and heart failure in hypokalemia patients were significantly higher than those in normokalemia patients: 28.92% (24/83) vs. 2.05% (3/146), 19.28% (16/83) vs. 2.05% (3/146), 44.58%(37/83) vs. 4.11% (6/146) and 13.25% (11/83) vs. 1.37% (2/146), and there were statistical differences (P<0.01). The incidence of hypokalemia in people with lower intake of potassium was significantly higher than that in people with higher and common intake of potassium: 56.78% (67/118) vs. 2/17 and 14.89%(14/94), and there was statistical difference (P<0.01). Conclusions There is a significant correlation between hypokalemia and sudden death in young and middle-aged people. Preventive measures of sudden death should be made according to serum potassium level in clinic. People should pay attention to the uptake of potassium in daily life.
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Objective: To study the risk factors for prevalence of acute myocardial infarction (AMI) in young and middle-aged population. Methods: A prospective cohort study was conducted in 110100 subjects at the age of (18-98) years who received physical examination in Kailuan Group from 2012-06 to 2014-10. Based on the limitations of male≤53 years and female≤63 years, a total of 62367 subjects were enrolled in our study. The subjects were followed-up for 2 years by the end point event of AMI to analyze the risk factors ofAMI occurrence. Results: According to AMI occurrence at the follow-up period, the subjects were divided into 2 groups: AMI group, n=56 and Control group, n=62152. Compared with Control group, AMI group had increased BMI, SBP, DBP and elevated blood levels of LDL-C, TG; AMI group also showed the higher ratios of subjects with the history of diabetes and taking anti-hypertension medication. Cox proportional hazard regression analysis indicated that age (RR=1.37), male (RR=60.54), LDL-C (RR=1.12), and TG (RR=5.93) were the risk factors forAMI occurrence in young and middle-aged population, allP<0.05. Conclusion: Age, male gender, blood levels of LDL-C, and TG were the risk factors for AMI occurrence in young and middle-aged population.
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Objective:To provide references for policy-making on the establishment of a sound healthcare sys-tem for China’s aged population. Methods:Based on the framework of The Behavioral Model of Health Services Use and data from China Health and Retirement Longitudinal Study in 2011 , the Tobit model of aged population’s health expenditures is built. Results: Self-rated health conditions, chronic disease, medical insurance, endowment insur-ance, self-rated living standard, age, gender, marital status and urban-rural character are the significant determi-nants. Conclusions:The healthcare system for China’s aged population should be built through simultaneously apply-ing disease prevention and access facilitation policies and the characteristic differences of different groups of aged pop-ulation should be taken into consideration.
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The reference interval for plasma total homocysteine (tHcy) and serum folate concentrations were estimated. Total of 3,154 reference individuals (1,029 men and 2,125 women) were selected based on stringent exclusion criteria. For plasma tHcy concentration (microM/L), reference values (median [5-95 percentile]) were 7.72 (5.03 to 13.80) and 6.09 (3.95-10.19) in men and women, respectively. For serum folate concentration (nM/L), reference values were 23.71 (11.73-38.44) and 28.95 (15.23-40.44) in men and women, respectively. The tHcy levels of both genders in the present study were lower than those in previous reports from other countries and Korea.
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Age Factors , Aging , Cohort Studies , Folic Acid/blood , Genotype , Homocysteine/blood , Methylenetetrahydrofolate Reductase (NADPH2)/genetics , Reference Values , Republic of Korea , Sex FactorsABSTRACT
Objetivo Evaluar el efecto que ejerce el ruido ambiental en la salud auditiva, la aparición de síntomas neuropsicológicos, el desarrollo de actividades educativas y el descanso en estudiantes de una localidad en Bogotá. Metodología Estudio transversal de prevalencia en niños y adolescentes (n=581) de 10-17 años en dos instituciones educativas distritales definidas como de mayor exposición (>65dB) y de menor exposición (<65dB) según el mapa de ruido ambiental de la localidad, clasificación verificada posteriormente. Se aplicó una encuesta de antecedentes de salud, percepción de la exposición a ruido, hábitos relacionados con salud auditiva y una audiometría tonal liminal de la vía aérea, usando criterios recomendados en la guía GATI-HNIR. Resultados El colegio más expuesto excedía la normatividad para la zona de tranquilidad (7/8 mediciones), los niveles de las dos instituciones sobrepasan la recomendación de la OMS (15/16 mediciones). El 14,8 % de los estudiantes presentaban algún grado de Hipoacusia, no se identificaron diferencias según exposición, sin embargo, al comparar los promedios de umbral auditivo, fueron mayores en el grupo de mayor exposición. Se encontró más prevalencia de hipoacusia y síntomas neuropsicológicos en la jornada mañana, y del reporte de síntomas otológicos y dificultad para dormir en estudiantes con mayor exposición. Conclusión Existe diferencia entre los umbrales auditivos de los estudiantes según la exposición, lo cual podría sugerir alguna asociación con los niveles de ruido a los que se encuentran expuestos.
Objective Evaluating the effect of environmental noise on the auditory health of a group of students from a locality in Bogotá, their educational development and leisure activities and the appearance of neuropsychological symptoms. Methods This was an observational cross-sectional prevalence study in a sample of 581, 10-17 year-old children and adolescents in two district educational institutions, defined as higher (>65 dB) and lower exposure (<65 dB) according to an environmental noise map of the locality, such ranking being subsequently verified. A survey was made regarding their health-related background, perception of being exposed to noise and auditory health-related habits; a liminal tone audiometry of the airway was taken using the criteria recommended in the Infrastructure Technical Advisory Group'snoise-induced hearing loss (ITAG-NIHL) guidelines. Results The more exposed school exceeded the regulations concerning comfortable environmental noise levels (7/8 measurements). Both institutions' levels exceeded WHO recommendations (15/16 measurements); 14.8 % of students had some degree of hearing loss. No significant differences were identified regarding exposure; however, higher thresholds were found in the more exposed group when comparing mean hearing threshold. Students attending morning sessions had a greater prevalence of hearing loss and neuropsychological symptoms and neuro-otological symptoms and difficulty in sleeping was reported amongst the more exposed students. Conclusion A difference was found between students' hearing thresholds, depending on their exposure, suggesting an association with the levels of noise to which they are exposed.
Subject(s)
Adolescent , Child , Female , Humans , Male , Hearing Loss/etiology , Mental Disorders/etiology , Nervous System Diseases/etiology , Noise/adverse effects , Colombia , Cross-Sectional Studies , Hearing Loss/epidemiology , Mental Disorders/epidemiology , Nervous System Diseases/epidemiology , Schools , Surveys and Questionnaires , Urban HealthABSTRACT
Objective To establish and verify the prediction model for ischemic cardiovascular disease(ICVD)among the elderly population who were under the current health care programs. Methods Statistical analysis on data from physical examination, hospitalization of the past years, from questionnaire and telephone interview was carried out in May, 2003. Data was from was randomly selected to generate both module group and verification group. Baseline data was induced to make the verification group into regression model of module group and to generate the predictive value. Distinguished ability with area under ROC curve and the predictive veracity were verified through comparing the predictive incidence rate and actual incidence rate of every deciles group by Hosmer- Lemeshow test. Predictive veracity of the prediction model at population level was verified through comparing the predictive 6-year incidence rates of ICVD with actual 6-year accumulative incidence rates of ICVD with error rate calculated. Results The samples included 2271 males over the age of 65 with 1817 people for modeling population and 454 for verified population.All of the samples were stratified into two layers to establish hierarchical Cox proportional hazard regression model, including one advanced age group(greater than or equal to 75 years old), and another elderly group(less than 75 years old). Data from the statically analysis showed that the risk factors in aged group were age, systolic blood pressure, serum creatinine level, fasting blood glucose level, while protective factor was high density lipoprotein; in advanced age group, the risk factors were body weight index, systolic blood pressure, serum total cholesterol level, serum creatinine level, fasting blood glucose level, while protective factor was HDL-C. The area under the ROC curve (AUC)and 95%CI were 0.723 and 0.687-0.759 respectively. Discriminating power was good. All individual predictive ICVD cumulative incidence and actual incidence were analyzed using Hosmer-Lemshow test, x 2=1.43, P=0.786, showing that the predictive veracity was good.Conclusion The stratified Cox Hazards Regression model was used to establish prediction model of the aged male population under a certain health care program. The common prediction factor of the two age groups were: systolic blood pressure, serum creatinine level, asting blood glucose level and HDL-C. Thc area under the ROWC curve of the verification group was 0.723, showing that the distinguished ability was good and the predict ability at the individual level and at the group level were also satisfactory. It was feasible to using Cox Proportional Hazards Regression Model for predicting the population groups.
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Objective This study aimed to determine the relationships between estimated glomerular filtration rate (eGFR) and cardiovascular events. Methods 2500 residents aged more than 40 years old were selected from Shougang community, Shijingshan district, in Beijing. 2315 of them took part in the survey. First morning urinary sample was collected for all the participants.Albumin and creatinine were measured and eGFR was calculated using simplified MDAD formula.Cardiovascular risk factors were also investigated. The participants were followed up for 4 years, and all-cause mortality and cardiovascular events were collected. The subjects were divided into three groups according to eGFR[ml/(min·1.73 m2)]: ＜60, 60-90,＞90.Cox regression model was used to analyze the relationships between eGFR, all events, and cardiovascular events after adjusting for confounders. Results The prevalence of eGFR ＜60 was 3.3%. The incidence rates of cardiovascular events were 43.9, 21.8 and 11.5/1000 person-years among three groups, and the incidence rates of all events (all-cause mortality and cardiovascular events) were 53.7, 28.8 and 14.6/1000 person-years,respectively. After adjusting for age, gender, smoking, body mass index, serum lipids, diabetes mellitus, cardiovascular disease, the hazard risk (HR) for cardiovascular events was 1.29 (95%CI:0.85-1.96) in eGFR＜60 group and 2.14 (95% CI: 1.02-4.50) in 60≤eGFR＜90 group, when compared with the eGFR＞90 group; the HR for all events were 1.25 (95%CI: 0.86-1.81 ) and 1.95(95% CI: 1.00-3.80) , respectively. Conclusion In the population studied, eGFR＜60 seemed an independent predictor for cardiovascular events and all-cause events.
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OBJECTIVE: The objective of this study was to evaluate the association of social support with health status and health behavior. METHODS: This study was conducted with 79 elderly people in Gunja-ri, Dongsan-myun, Chuncheon. We performed face to face interview which was composed of socio-demographic characteristics, social support, health status and health behavior. The association between social support and result variables was analysed by Chi-square test and logistic regression. We used SAS ver9.1 for statistic analysis. RESULTS: Mean age of the study population was 72.0+/-7.0, social support score was 14.3+/-4.7 with full marks of 20 and 36.25% of the total population were shown to have depression. When the social support score was changed, depression (p=0.0007) and physical exercise (p=0.0312) showed significant difference. The self-rated health status was significantly related to the relationship with family members (OR=0.25, 95% CI=0.07-0.95) and the quality of sleep was also significantly associated to the relationship with family members (OR=0.21, 95% CI=0.06-0.73). The physical exercise was done significantly less in the group 'without' close friends than in the group with 'many' close friends (OR=0.21, 95% CI=0.05-0.94) and the depression was significantly more in the group without community participation than in the group with community participation (OR=4.79, 95% CI=1.62-14.15). CONCLUSIONS: Through this study, we could conclude that the social support factors are associated with health status and health behavior. Therefore, to improve the health status of rural elderly, we need to approach to develop social support.
Subject(s)
Aged , Humans , Community Participation , Depression , Exercise , Friends , Health Behavior , Logistic Models , Phenothiazines , Rural Health , SociologyABSTRACT
Background: Anthropometry is used to survey health and nutritional situation of the population. Therefore the quality of the information that is being used must be evaluated. Aim: To estímate the agreement in weight, height and nutritional status in schoolchildren, comparing measurements made by teachers in schools and a standardized and supervised team of professionals. Material and methods: Cross sectional study including 927 schoolchildren in 31 schools from 7 counties of Santiago. Schools were randomly chosen and the universe of children attending to first grade was measured. Weight, height and nutritional status collected by teachers and researches, were compared. Results: Total agreement for nutritional status reached 0.67, random-weighted Kappa was 0.40 and weighted Kappa, 0.42. Teachers tended to over diagnose under-nutrition and under diagnose overweight and obesíty measuríng 270 grams less than the qualified team (p <0.001) and 1.7 cm more in height (p <0.001), what is reflected in a difference of less than one point in body mass index (p <0.001). Discrepancies in height and body mass índex were higher in extreme valúes. Conclusions: There is a low agreement between the measurements taken by the research team and teachers. Even though there are discrepancies between measurements, high levéis of overweight and low prevalences of stunting and underweight are kept, reílecting problems with exactitude, but not bias. Corrective actions to improve the quality of information, which should include training programs for teachers, instrument maintenance, supervisión and verification system for data entry, are needed.
Subject(s)
Child , Female , Humans , Male , Child Nutrition Disorders/diagnosis , Nutrition Assessment , Nutrition Surveys , School Health Services , Body Height , Body Mass Index , Body Weight , Child Nutrition Disorders/epidemiology , Chile/epidemiology , Cross-Sectional Studies , Malnutrition/diagnosis , Nutritional Status , Obesity/diagnosis , Schools/statistics & numerical data , StudentsABSTRACT
PURPOSE: To report the results of vision screening in the elderly and operations for the blind in 2003. METHODS: A nation-wide, indigent aged group of over 65-year-old of low-income population was surveyed. Visual acuity was tested, refractive error was measured, and ocular examination was performed to determine the group needed for operation. RESULTS: Among the indigent subjects who live in urban or rural community, 7, 750 subjects aged over 65 years old were examined by the ophthalmologists. For those screened, the most common ocular disease was cataract (4, 383 subjects, 45.4%), followed by conjunctival and scleral disease (1, 741 eyes, 18%), retinal disease (434 eyes, 4.5%), refractive errors (374 eyes, 3.9%). Surgery was performed on 1, 813 eyes of 1, 109 subjects, and these were classified by the disease category. Surgery for cataract was performed on 1, 762 eyes (97.2%), and for retinal disease on 51 eyes (2.8%). The visual acuity change after cataract surgery was 0.23 +/- 0.15 preoperatively and 0.64 +/- 0.25 postoperatively. CONCLUSIONS: Among the geriatric public health problem in eye care services, the most prevalent cause of visual impairment was senile cataract, for which the vision can be improved by surgery. Therefore, continuous vision screening and surgery for the blind among this group are important and should be performed more extensively.
Subject(s)
Aged , Humans , Cataract , Poverty , Public Health , Refractive Errors , Retinal Diseases , Rural Population , Scleral Diseases , Vision Disorders , Vision Screening , Visual AcuityABSTRACT
OBJECT: It is to evaluate the priority area for effective eye care service to the aged population of rural comniunity at present and in future. METHOD: Number of aged group surveyed on 60 and over 60 years age that, counted 531 among the total 580 patients. Visual acuity was tested and refractive error was measured by Retinornax (Nikon, Japan) . Ocular examination was performed to determine the causes of visual impairment. This survey was conducted under the auspices of the Korean Foundation for Prevention of Blindness with assistance of the Seoul National University Postgraduate School of Public Health from 1994 to 1996 at the Public Health Center of Chun-Cheon, Kang-Won Do(Province). RESULTS: Age distribution showed the sixties (60-69) 49,3%, the seventies (70-79) 33.9%, and the eighties (80) 16.8%. Proportion of visual acuity of 0.7 or upper in the better eyes constituted 32.2% and of 0.2 or worse 19.4%. Causes of visual impairnnente consisted of refractive errors 35. 9%, cataract 35. 9%, macular degeneration 7, 4%, and corneal opacity 3.9% in order. Contributed modes of care were spectacles 27.9%, surgeries 23.9% (cataract, operation, pterygium removal etc.), and medical treatment 23.9%. DISCUSSION: Surgery of the aged population in rural comrnunity of Chun-Cheon revealed the most. prevalent. causes of visual impairment as the refractive errors and cataract. It is suggested that. the most effective eye care would be provided systemically based 0 the result of the epidemiological study on the various ocular disorders.