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Objective:To explored how medical and health institutions can improve the quality of Investigator-Initiated Trials(IIT).Methods:Strategies and measures were proposed to ensure the quality of IIT based on the combination of related literature review and IIT management experiences analysis.Results:Institutions can carry out following measurements to improve the quality of IIT, which include setting up tailored IIT management department, establish centralized management system; conducting systematic regulatory and clinical research methodology trainings; develop effective quality control system and quality assessment index, applying electronic information system and platform to optimize the management.Conclusions:Strengthen the standardized management is an effective strategy to improve the quality of IIT in medical and health institutions.
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Objective:To establish an assessment index system on the capacity of clinical medical postgraduate tutor.Methods:On the basis of "literature optimization method", the index system was initially constructed by 14 experts with "Delphi method". Then, through the survey of 109 people, the reliability and validity were tested by Cronbach's α coefficient and exploratory factor analysis. And analytic hierarchy process was used to calculate the weight coefficient of each index. SPSS 26.0 and AMOS 26.0 were applied for statistical analysis. Results:The assessment index system consisted of 2 first-level indexes, 5 second-level indexes and 27 third-level indexes. The Cronbach's α coefficient of the total index system, first-level indexes and second-level indexes ranged from 0.833 to 0.931. Five common factors were extracted by exploratory factor analysis, and the connotation of factors were basically consistent with the theoretical structure. A confirmatory factor model was established with 5 second-level indexes as the first-order factors, what's more, the theoretical model fitted well with the actual data. The combined weight values of "teaching attitude of the tutor", "medical ethics of the tutor", "scientific research projects of the tutor", "dissertation quality of the graduate students", "the quality of the scientific research and training of the graduate students", "the quality of the clinical training of the graduate students", and "disposable scientific research funds of the tutor" ranked in the top 7 weights of third-level indexes. Conclusion:This assessment index system has good reliability and validity with reasonable connotation, which could be used as a reference for tutor evaluation.
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Background: Oral health is recognized as an integral component of general health, and poor oral health is reflected in general health and quality of life (QoL). India has seen a profound shift in the elderly population and is currently home to 103.9 million elders. General Oral Health Assessment Index (GOHAI) is a self-reported oral health assessment index used in elderly population and has been tested in multiple countries. Objective: The study aimed to assess the oral health-related QoL (OHRQoL) using GOHAI and various factors affecting it, among elderly patients visiting special Sunday geriatric clinics at Delhi public hospitals. Methods: A cross-sectional study was conducted among four purposively selected special geriatric public clinics in Delhi, India, and a convenience sample of 145 elderly patients was obtained. OHRQoL was measured using a prevalidated instrument (GOHAI) along with other variables (sociodemographic factors, self-perceived oral health, utilization of medical/dental services, dental problems in the past 12 months, and prosthetic status/need). Statistical analysis was done using Statistical Package for the Social Sciences software version 21, and descriptive results were obtained. Results: The sample consisted of 66 males (45.5%) and 79 females (55.5%), and around 58% (n = 84) of the participants were illiterate. Around 39% (n = 57) of the elderly had never visited a dentist and 48% (n = 69) were financially dependent (no income) on others. The mean GOHAI score for the population was 26.69 + 4.44 (median = 25, interquartile range = 23�). GOHAI score was compared for age, oral hygiene practices, dental problems in the past 12 months, self-reported oral health, and prosthetic need, and a statistically significant difference was observed. Conclusions: The current study assessed GOHAI score and highlighted important determinants of OHRQoL in elderly population visiting the special clinics in Delhi. Thus, OHRQoL should be considered as a surrogate measure to clinical oral examination.
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Context: Oral health means more than only good teeth. It is a state-of-being-free from mouth and facial pain, oral and throat cancer, oral infections, periodontal diseases, tooth decay or loss, and other diseases/disorders. The age distribution of the world's population is changing. With advances in medicine, the proportion of older people continues to increase worldwide. Aims, Setting, Materials and Methods: A cross-sectional study was carried out among 158 elderly (>60 years) residing in a slum of Kolkata during the period from April 2017 to June 2017 to assess the impact of oral health on general health. Data were collected using a pretested predesigned schedule containing Geriatric Oral Health Assessment Index. Data analysis was performed in R software. Poisson regression was used to find the associates of the impact of oral health. Results: Mean (standard deviation) age was 68.54 (5.9) years. A total of 104 (65.8%) participants reported; foul breath as a problem and 88 (55.7%) reported gum bleeding as a problem. All participants used to clean their teeth daily but only 36.1% used to clean their teeth at least twice daily. More than half the participants reported that they have limited the kind of food they eat due to dental/gum condition and trouble chewing. Conclusion: There is a need to provide sensitive oral health services that are accessible, affordable, appropriate, and acceptable. Knowledge regarding oral health and hygiene should be provided to all elderly, especially diabetics. Further research with the broader conceptual framework, in different age groups and in different settings are warranted.
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The prevalence of malnutrition increases with old age, especially in developing countries like India, and it is the most common cause of morbidity and mortality, because of many factors out of which dentate status is one. Aim and Objective: The aim of this study is to evaluate and determine the effect of nutritional status and dietary intake on the oral health-related quality of life (OHRQOL) of elderly edentulous complete denture-wearing patients and to know whether elderly complete denture wearers have a higher risk of malnutrition. The objective was to assess the need to include dietary and nutritional counseling during prosthodontic rehabilitation of elderly edentulous patients. Materials and Methods: A cross-sectional study was conducted among 200 elderly denture-wearing patients above 60 years of age from Nagpur, Maharashtra. Mini-Nutritional Assessment (MNA) questionnaire was used to assess nutritional status, and Geriatric Oral Health Assessment Index (GOHAI) questionnaire was used to determine the OHRQOL of these patients. Descriptive statistics were used to analyze data using SPSS version 21 (SPSS Inc., Chicago, IL, USA). Results: Among the assessed participants, nearly 95% of them had total scores of GOHAI between 12 and 57 which require “needed dental care.” As per MNA, 10.5% had adequate nutrition, 70% were at risk of malnutrition, and remaining 19.5% of participants were malnourished. There was a significant correlation between GOHAI and MNA scores. Conclusion: Low nutritional status was associated with the poor OHRQOL among the elderly. A strong association was found between mean GOHAI and MNA scores and thereby nutritional status and OHRQOL. The use of conventional dentures increases the risk of malnutrition in the elderly due to inability to eat and chew food properly. Dietary analysis and counseling should be strictly incorporated into geriatric treatment planning during prosthetic rehabilitation.
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Objectives:To construct a fraud risk prediction model for basic medical insurance holders, discover the main characteristics of fraud,and then establish a risk assessment index system to provide decision support for an apposite supervision of medical insurance funds. Methods : Using the large-scale real data including more than 183 million records of basic medical insurance diagnosis and treatment in China,the integrated risk assessment model for basic medical insurance holders is constructed using XGBoost algorithm and EasyEnsemble method. On this basis, this paper further identifies and quantifies the potential characteristics of fraud enforcement, and thus constructs a fraud risk assessment index system. Results : The proposed integrated model predicted the fraud risk with the accuracy of 83％,balance predictive value of 95％,and the balance sensitivity was 85％,respectively. Most importantly, the probability of the insured fraud being correctly evaluated was 82％ in this fraud risk assessment model. Besides, the amount of various expenses incurred at each stage of assessment,and the number of various types of projects are important indicators to distinguish the fraud from the normal insurance holders. Conclusions : The fraud risk assessment index system constructed based on the XGBoost integrated model is effective for the identification of potential fraudsters among the basic medical insurance holders. Establishing a risk assessment index system and developing an apposite supervision system based on big data of medical insurance play an essential role in improving the level of medical insurance management services,which ensures the safety of medical insurance funds,and safeguards the social health insurance fairness.
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The purpose of this study was to investigate health-related habits, dietary habits, depression, stress, satisfaction of body weight, mini-dietary assessment (MDA) and dietary behaviors according to self-rated health among 255 university students in Kyungnam province. Statistical analyses were performed using the SPSS software package (version 19.0). The average ages of the subjects were 21.1 years. Participants were asked their self-rated health and 109, 105 and 41 students answered themselves as "healthy", "normal" and "unhealthy", respectively. The pocket money (P<0.05) was related with self-rated health, and meal frequency (P<0.01) of healthy group was higher than that of the unhealthy group. The self-reported depression level (P<0.01) and the score of depression (P<0.05) of the healthy group were lower than those of the unhealthy group. The self-reported stress level of the healthy group (P<0.05) was higher than that of the unhealthy group. The scores of nutritional behavior (P<0.05) and MDA (P<0.01) of the healthy group were higher than those of the unhealthy group. The scores for intakes of meat, fish, egg or beans, cereals and vegetables except kimchi, fruits, balanced diet and various foods were higher in the healthy group than in the unhealthy group. Our results suggest that pocket money, high meal frequency, low depression, satisfaction of present body weight, and good dietary behavior might influence good perception of self-rated health.
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Humans , Body Weight , Depression , Diet , Edible Grain , Feeding Behavior , Fruit , Meals , Meat , Ovum , VegetablesABSTRACT
The aim of this cross-sectional study was to evaluate the association between vasomotor symptoms (VMS) and insulin resistance, which can be postulated by the homeostatic model assessment (HOMA) index. This study involved 1,547 Korean postmenopausal women (age, 45 to 65 years) attending a routine health check-up at a single institution in Korea from January 2010 to December 2012. A menopause rating scale questionnaire was used to assess the severity of VMS. The mean age of participants was 55.22+/-4.8 years and 885 (57.2%) reported VMS in some degree. The mean HOMA index was 1.79+/-0.96, and the HOMA index increased with an increase in severity of VMS (none, mild, moderate and severe) in logistic regression analysis (beta=0.068, t=2.665, P =0.008). Insulin resistance needs to be considered to understand the linkage between VMS and cardiometabolic disorders.
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Female , Humans , Cross-Sectional Studies , Insulin Resistance , Korea , Logistic Models , MenopauseABSTRACT
Objective: The objective of this study was to translate the Geriatric Oral Health Assessment Index (GOHAI) into the Hindi language and assess its validity and reliability for use among people in India. Materials and Methods: GOHAI was translated into the Hindi language and self-administered to 420 subjects aged 55 years or above. The measures for reliability, and concurrent, convergent, and discriminant validity were assessed. The questionnaire sought information about sociodemographic details, habits related to tobacco, dental visits, tooth brushing, and self-reported perceptions of general and oral health. Results: Cronbach's alpha (0.774) showed high internal consistency and homogeneity between items. Low GOHAI scores were associated with the perceptions of poor oral and general health, low satisfaction with oral health, and a perceived need for dental care. Respondents with high socioeconomic status were likely to have high GOHAI scores. Conclusion: The Hindi version of the GOHAI demonstrated acceptable validity and reliability, and will be an important instrument to measure oral health-related quality of life (OHRQoL) for people in this region.
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The research outputs from 2010 to 2014 in clinical medicine of the top 10 universities announced by the Academic Degrees Center under Education Ministry of China in 2012 were analyzed and assessed according to the index system for assessment of research outputs in clinical medicine we established on the basis of bibliometrics.
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@#Objective To quantize the synergistic force in movement of upper limbs between shoulders and elbows. Methods The trans-verse forces of elbows and shoulders during movement were recorded in a healthy adult with an upper-limb-force-measuring plate form which comprised of 2 three-dimensional force sensors, respectively. Then he performed shoulder abduction/adduction and elbow extension/flexion at 100%, 75%, 50%and 25%of the maximum contraction force, respectively. The ratio of the active action force and the joint action force (named assessment index) was used to assess the synergistic degree of the forearm and the upper arm. Results In the shoulder abduc-tion motion, the assessment index decreased as the strength of active action decreased, meant interference of joint action increased. Howev-er, it was almost stable in the shoulder adduction, increased in the elbow extensionas, and was irregular in the elbow flexion, as the active ac-tion strength decreased, respectively. Conclusion It may be more difficult to control upper arm than the forearm.
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Objetivo: Determinar el comportamiento del Geriatric/General Oral Health Assessment Index y Oral Impacts on Daily Performances como medidas de efecto de la salud bucodental relacionada con la calidad de vida en adultos mayores en una misma población. Métodos: Muestra representativa de adultos mayores derechohabientes del Instituto Mexicano del Seguro Social del suroeste de la Ciudad de México. Se realizaron entrevistas domiciliarias para conocer las características de la muestra y aplicación de los instrumentos Geriatric/General Oral Health Assessment Index y Oral Impacts on Daily Performances. Evaluación clínica para determinar la experiencia de caries coronal y caries radicular. Resultados: Un total de 531 sujetos de 60 años y más participaron, 68.4% mujeres. La media (desviación estándar) de edad fue de 71.4 (7.0) años. El Geriatric/General Oral Health Assessment Index presentó una media de 46.8 (6.2), y 4.1 (12.4) para el Oral Impacts on Daily Performances. La escolaridad mayor de seis años, no presentar limitaciones, con deterioro cognitivo y sin depresión, presentaron una media mayor del puntaje del Geriatric/General Oral Health Assessment Index en comparación con los que no presentaban (p < 0.05). La escolaridad mayor de seis años, con una actividad laboral remunerada y sin depresión, presentaron una media menor del puntaje del Oral Impacts on Daily Performances en comparación a los que no presentaban (p < 0.05). Existe una correlación entre el Geriatric/General Oral Health Assessment Index y componentes obturados, dientes funcionales (p < 0.05). Los componentes perdidos, obturados e índice caries coronal, así como coronas sanas y dientes funcionales presentaron una correlación con el Oral Impacts on Daily Performances (p < 0.05). Conclusión: El Geriatric/General Oral Health Assessment Index tuvo mayor discriminación en las características de la población y el Oral Impacts on Daily Performances presentó mayor correlación con el estado de la dentición.
Objective: To determine the behavior of the Geriatric/General Oral Health Assessment Index as well as the Oral Impacts on Daily Performances as effective measures in oral-dental health related to quality of life in senior citizens in a given population. Methods: A representative sample of senior citizens entitled to medical services at the Instituto Mexicano del Seguro Social (Mexican Institute of Social Security) located in the southwest region of Mexico City. Home interviews were conducted in order to ascertain the sample's characteristics as well as the application of the Geriatric/General Oral Health Assessment Index and Oral Impacts on Daily Performances instruments. Clinical evaluation in order to determine experience of crown caries (CPO-D) and root caries CO-R). Results: A total of 531 subjects aged 60 years and over participated in the study, of which 68.4% were female. Age average (AA) was 71.4 years (7.0). Geriatric/General Oral Health Assessment Index exhibited a mean of 46.8 (6.2) and Oral Impacts on Daily Performances showed 4.1 (12.4). Subjects included in the sample had attended school for over 6 years, did not present limitations of cognitive deterioration, and were depression-free, exhibited a higher mean in Oral Impacts on Daily Performances score than those which did not present those characteristics (p < 0.05). Six or more years of schooling with paid work and depression-free subjects presented lesser Oral Impacts on Daily Performances scores when compared to those who did not. (p < 0.05) A correlation was found between the Geriatric/General Oral Health Assessment Index and filled components, functional teeth (p > 0.05). Filled and lost components and CPO-D index as well as healthy crowns and functional teeth exhibited a correlation with Oral Impacts on Daily Performances (p < 0.05). Conclusion: Geriatric/General Oral Health Assessment Index exhibited higher discrimination in the population's characteristics whereas Oral Impacts on Daily Performances showed higher correlation with the state of the dentition.
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Different hospital HIS suppliers were overall assessed according to the corresponding assessment index systems established with HIS suppliers as the study object based on the function demands for HIS in order to help hospitals to select their appropriate HIS suppliers .
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Objetivo: Verificar a associação entre alterações do estado nutricional, perda dentária, uso de prótese e autopercepção das condições bucais em uma coorte de idosos, segundo sexo e idade. Métodos: Foram analisados idosos (≥ 60 anos), de ambos os sexos, do Estudo SABE: Saúde, Bem-estar e Envelhecimento, epidemiológico, de base domiciliar, realizado no município de São Paulo, em 2000 e 2006. As variáveis de estudo foram: alterações no estado nutricional-segundo Índice de Massa Corporal (IMC), considerando baixo peso (≤ 23 kg/m²), peso adequado para estatura (> 23 e < 28 kg/m²) e excesso de peso (≥ 28 kg/m²), em 2000 e 2006; perda dentária (< ou ≥ 16 dentes); uso de prótese dentária (sim/não); autopercepção das condições bucais, segundo Geriatric Oral Health Assessment Index (GOHAI), considerando más condições bucais (GOHAI <50 pontos), regulares (GOHAI de 51 a 56 pontos) e boas (GOHAI de 57 a 60 pontos), sexo e grupos etários (60-74 e ≥ 75 anos), em 2000. Verificou-se a associação por meio do teste de Rao-Scotte da análise de regressão logística multinomial (p<0,05 e IC95%), utilizando o programa estatístico STATA 10.1. Resultados: De 773 idosos analisados, 59,94% eram mulheres e 80,55% do grupo 60 a 74 anos. Identificou-se diminuição da proporção de idosos com excesso de peso (37 para 29%) e aumento daquela com baixo peso (16 para 26%). Verificou-se menor risco para excesso de peso em 2006, aqueles que apresentaram peso adequado, em 2000 e referiram condições bucais regulares [RR = 0,31 (0,14-0,69)], e maior risco para peso adequado em 2006, nos homens, que apresentaram excesso de peso em 2000 [RR = 2,23 (1,09-4,55)]. Conclusão: Constatou-se associação entre alterações do estado nutricional, condições bucais regulares, segundo a autopercepção, e sexo masculino, em 2000 e 2006.
Objective: To investigate the association between changes of nutritional status and tooth loss, use of dental prost hesis and self-perceived oral health among elderly people, by gender and age. Methods: The sample consisted of 773 elderly people (≥ 60 years) community-dwelling, both genders, participants of Health, Well being and Aging Cohort Study (SABE Survey),epidemiological, home-based, from the city of São Paulo, from 2000 to 2006. The variables analyzed were: changes of nutritional status: by body mass index (BMI-kg/m²), considering underweight (≤ 23 kg/m²), appropriate weight for height (> 23 and <28 kg/m²) and overweight ( ≥ 28 kg/m²), to 2000 from 2006; tooth loss (Subject(s)
Aged
, Population Dynamics
, Dental Prosthesis
, Nutritional Status
, Oral Health
, Self Concept
, Tooth Loss
, Cohort Studies
, Logistic Models
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There are still two outstanding problems in comprehensive quality assessment index system of clinical medical undergraduates:contents of assessment is incomprehensive and every index has no quantitative research based weight.This article elaborated on a complete index framework,covering required knowledge,abilities,attitude,morality of clinical medical undergraduates and proposed a set of methods and processes,including literature research method,system analysis method,brainstorming,expert interviews,Delphi method,and some statistical methods,providing a theoretical basis for the development of comprehensive quality assessment index system for clinical medical undergraduates.
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This study was aimed to review of the selection and use of the therapeutic effect assessment indexes of randomized controlled trials ( RCTs ) on traditional Chinese medicine ( TCM ) syndrome differentiation and treatment of chronic obstructive pulmonary disease ( COPD ) based on clinical efficacy . Published studies were searched in the CBM , CNKI , VIP , Wanfang database , Cochrane Library , PubMed and Embase to identity all RCTS on TCM treatment of COPD . Two researchers selected studies and extracted data independently using a designed extraction form . The Cochrane collaboration software RevMan 5 . 1 was used for meta-analysis . The re-sults showed that a total of 40 RCTs were included . Meta-analyses showed that TCM syndrome differentiation and treatment of COPD can improve the pulmonary function and life quality , improve the clinical effect and TCM syndrome effect , reduce the number of acute exacerbation of COPD and improve clinical symptoms . Some therapeutic effect assessment indexes , such as pulmonary function , life quality , clinical comprehensive effect , the number of acute exacerbation of COPD, clinical symptoms and signs, syndrome effect and the integral of syndrome were used more frequent . Other indexes such as 6-min walk distance , BODE Index and health eco-nomic evaluation were used less frequently . It was concluded that TCM syndrome differentiation and treatment of COPD had certain therapeutic efficacy. A large number of strictly-designed, multicenter, high-quality RCTs are required because of the low quality of the included studies. The selection of therapeutic effect assessment indexes is still not standardized . The therapeutic effect assessment indexes should be selected based on differ-ent purposes of clinical studies with the clinical characteristics of TCM .
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Observed from the classroom ecology perspective,the assessment index of classroom teaching quality in higher institutes examines only the teachers' teaching behavior, but the students' behavior,the classroom's ecological media and environment,which have great impact on the teaching quality,are excluded.Ecological analyses of typical cases indicate that the assessment index of classroom teaching quality in practice are not all-sided, and there are various factors affecting the justice of the assessment result, making it very difficult to obtain objective result. Therefore, two principles in applying the assessment result are to achieve ecological harmony by aiming at improving teaching through assessment and weakening its proving function, and to create an ecologically harmonious environment on campus that may promote teacher development and improve the teaching quality.
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This study was conducted to examine the dietary behaviors with 510 high school students (260 males and 250 females) residing in Seoul. The average age of male and female students were 16.3 and 16.4 years old, respectively. Mean height and weight of male students were 174.1 cm and 65.9 kg and those of female students were 161.6 cm and 52.5 kg. The body mass index (BMI) of male and female students were 21.7 kg/m2 and 20.1 kg/m2, respectively, which were within the normal range. Students skipped breakfast more than once a week were 41.1% of males and 44.4% of females. More than 40% of the male and female students skipped breakfast frequently. The mean mini dietary assessment index score of male and female students were 30.6 and 29.6 out of total 50 index scores, respectively. Female students perceived significantly less healthy and fatter than male students. Furthermore, body image satisfaction of the female students was lower than that of male students. Female students were more significantly concerned with body image and desired a thin body shape. Only 22.7% of male students and 6.4% of female students exercised regularly, and the frequency, time, and intensity of exercise in the male students were significantly higher than those of female students.
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Female , Humans , Male , Body Image , Body Mass Index , Breakfast , Consciousness , Feeding Behavior , Reference ValuesABSTRACT
Objective To explore the association between risk factors of cardiovascular diseases (CVD) and insulin resistance in a cross-sectional study.Methods An investigation on risk factors of CVD was carried out using stratified-random sampling method among 1475 participants in Beijing.Homeostasis model assessment index(HOMA) was calculated to assess the insulin resistance in 1359 non-diabetic subjects aged 25-64 years.Insulin resistance was defined as HOMA index (fasting glucose in mmol/L×fasting insulin in mU/L/22.5) in the top quartile of the studied population.Results The degree of correlation between risk factors and natural logarithm of HOMA index in descending order were glucose,body mass index (BMI),triglyceride ( TG ),waist circumstance,high density lipoprotein- cholesterol (HDL-C),uric acid,diastolic blood pressure,systolic blood pressure and total cholesterol(TC) (all P＜0.01 ).After adjusting factors as sex and age,glucose (r=0.49),BMI(r=0.44),TG (r=0.44),waist circumstance (r=0.41),uric acid (r=0.33) and HDL-C (r=-0.32),the systolic blood pressure (r=0.20),diastolic blood pressure (r=0.18) and TC (r=0.16) were independently correlated with HOMA index (P＜0.001).Sex(OR=1.75) ,low HDL-C(OR= 1.80),hyperuricemia(OR=2.11 ),high TG(OR=2.14) and central obesity(OR=2.68)appeared to be independently correlated to insulin resistance in multiple logistic regression analysis.Conclusion The risk factors of CVD as low HDL-C,high TG,central obesity and hyperuricemia were independently correlated to insulin resistance.
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In the process of cultivating TCM clinical postgraduates of TCM clinical college in Shanxi university of Chinese medicine,we emphasized the importance of clinical application ability and innovation ability in scientific research,stressed the clinical practice and check management,to formulate the objective,effective and quantified assessment index system in keeping with the real institution of our college,so as to improve the all-round quality of TCM clinical postgraduates.