Prediction of all-cause and cardiovascular mortality using central hemodynamic indices among elderly people: systematic review and meta-analysis

ABSTRACT BACKGROUND: Despite widespread usage of central blood pressure assessment its predictive value among elderly people remains unclear. OBJECTIVE: To ascertain the capacity of central hemodynamic indices for predicting future all-cause and cardiovascular hard outcomes among elderly people. DESIGN AND SETTING: Systematic review and meta-analysis developed at the Del Cuore cardiology clinic, in Antonio Prado, Rio Grande do Sul, Brazil. METHODS: 312 full-text articles were analyzed, from which 35 studies were included for systematic review. The studies included needed to report at least one central hemodynamic index among patients aged 60 years or over. RESULTS: For all-cause mortality, aortic pulse wave velocity (aPWV) and central systolic blood pressure (SBP) were significant, respectively with standardized mean difference (SMD) 0.85 (95% confidence interval, CI 0.69-1.01; I2 96%; P < 0.001); and SMD 0.27 (95% CI 0.15-0.39; I2 77%; P 0.012). For cardiovascular mortality brachial-ankle PWV (baPWV), central SBP and carotid-femoral PWV (cfPWV) were significant, respectively SMD 0.67 (95% CI 0.40-0.93; I2 0%; P 0.610); SMD 0.65 (95% CI 0.48- 0.82; I2 80%; P 0.023); and SMD 0.51 (95% CI 0.32-0.69; I2 85%; P 0.010). CONCLUSIONS: The meta-analysis results showed that aPWV was promising for predicting all-cause mortality, while baPWV and central SBP demonstrated consistent results in evaluating cardiovascular mortality outcomes. Thus, the findings support usage of central blood pressure as a risk predictor for hard outcomes among elderly people. REGISTRATION NUMBER IN PROSPERO: RD42018085264

Construction of Traditional Chinese Medicine preventive health care service system in Changning District / 上海预防医学

Under the guidance of State Administration of Traditional Chinese Medicine, Shanghai Municipal Commission of Health and Family Planning and Shanghai Municipal Office for Development of Traditional Chinese Medicine, Traditional Chinese Medicine( TCM) preventive health care service system was started to construct in 2011 in Changning District of Shanghai.The system was residents'needs orien-ted.After five years of effort, TCM preventive health care service system characterized with integration of prevention and treatment, multicultural atmosphere, supported by TCM featured services was formed.The new model of community health management provided a positive and beneficial practice for the Healthy City construction with Chinese and Shanghai characteristics.

Study on preventive health care service in Traditional Chinese Medicine and policies under the concept of disease prevention theory / 中国卫生政策研究

The concept of “disease prevention theory” contains a wealth of preventive medicine thought. Pre-ventive health care service in Traditional Chinese Medicine( TCM) is an important measure for enhancing health qual-ity and improving the quality of living. This contributes to the building of a harmonious society and suits the changing medical model. Despite a series of achievements, there are also some problems in preventative health care service. Based on an analysis of influencing factors on policy implementation, the problems are discussed in the paper. The study provides some suggestions on preventive health care services, including the perfection of operations and man-agement mechanisms, the improvement of awareness on preventive health care service, the strengthening of the talent team, an increase in funding, and an evaluation of policy implementation.

Association between Perceived Social Support and Postpartum Depression in Turkey.

Aims: The purpose of this study was to find out the association between perceived social support and postpartum depression. Study Design: This study was a cross-sectional study. Place and Duration of Study: The cross-sectional study was carried out in Manisa, a city in western part of Turkey. Methodology: Two hundred eighty seven postpartum women were included in the study using stratified sampling from the records of 11 primary health care centers in Manisa city centre. Depression and social support were measured using, Edinburgh Postnatal Depression Scale and Multidimensional Scale of Perceived Social Support. Results: It was found that the point prevalence of post partum depression (Edinburgh Postnatal Depression Scale total score >12) was 13.5%. Smoking, pregnancy number, social support from family and from a significant other predicted postpartum depression, but baby’s gender, family type, perceived family income, educational level, occupation, having a health insurance, antenatal care, unwanted pregnancy and social support from friends did not. Conclusion: Postpartum depression is a public health problem in Turkey and social support from family and from a significant other is associated with postpartum depression. This finding highlights that there is a need to address this unmet need in planning interventions. But prevalence rate of postpartum depression and differential effects of risk factors on postpartum depression vary substantially among countries and regions, this should be taken into consideration when planning interventions for postpartum depression.