RESUMEN
Objective To establish macrosomia risk prediction models based on a cohort study, and to analyze and compare the results. Methods The research subjects were the pregnant women of the Chinese Pregnant Women Cohort Study. The general demographic information and clinical data of pregnant women were collected through the questionnaire and physical examination, and the related outcomes of newborns were obtained by follow-up. The dataset was divided into training set and test set by a 3:1 ratio. Multivariate logistic regression analysis (LR) and random forest algorithm (RF) were used to construct macrosomia risk prediction models in the training set, and the models were verified in the test set. The prediction efficiency of the models was evaluated by Kappa and the area under the receiver operating characteristic curve (ROC). Results Among 5544 pregnant women, 397 women delivered macrosomia, and the incidence of macrosomia was 7.16%. Among the pregnant women who delivered macrosomia, 10.08% (40/397) were over 35 years old, 27.46% (109/397) were overweight or obese, and 60.96% (242/397) were excessive gestational weight gain (GWG). LR was used to establish a macrosomia risk prediction model to predict the test set, with the accuracy of 0.716, the sensitivity of 0.719, the specificity of 0.715, the Kappa value of 0.428, the Yoden index of 0.393, and the AUC of 0.796 (95% CI: 0.777-0.815). RF was used to construct a risk prediction model to predict the test set, with the accuracy of 0.819, the sensitivity of 0.782, the specificity of 0.846, the Kappa value of 0.629, the Yoden index of 0.439, and the AUC of 0.897 (95% CI: 0.883-0.910). Conclusion The prediction effect of the two models is satisfactory. The random forest algorithm has a higher predictive effect on the risk of macrosomia in this cohort, but the multivariate logistic regression analysis can directly explain the influencing factors of the macrosomia. It is suggested to integrate the advantages of the two models in the future, so that they can play a more important role in macrosomia risk prediction.
RESUMEN
Objective To understand the current overall status of implementation on the National Demonstration Areas of Comprehensive Prevention and Control of Non-communicable Diseases.Methods According to the scheme design of the questionnaires,all the National Demonstration Areas were involved in this study.For each National Demonstration Areas,eight departments were selected to complete a total of 12 questionnaires.Results Scores related to the implementation of the National Demonstration Areas accounted for 71.8％ of the total 170 points.Based on the scores gathered from this study,the 23-items-index-system that represented the status of project implementation was classified into seven categories.Categories with higher percentile scores would include:monitoring (88.0％),safeguard measures (75.0％),health education and health promotion (75.0％).Categories with lower percentile scores would include:the national health lifestyle actions (67.7％),community diagnosis (66.7％),discovery and intervention of high-risk groups (64.7％),and patient management (60.9％).There were significant differences noticed among the eastern,central and western areas on items as safeguard measures,health education/promotion,discovery and intervention of high-risk groups.In all,the implementation programs in the eastern Demonstration Areas seemed better than in the central or western regions.As for the 23 items,five of the highest scores appeared on policy support,mortality surveillance,tumor registration,reporting system on cardiovascular/cerebrovascular events,and on tobacco control,respectively.However,the lowest five scores fell on healthy diet,patient self-management program,oral hygiene,setting up the demonstration units and promotion on basic public health services,respectively.The overall scores in the eastern region was higher than that in the central or the western regions.The scores in the central and western regions showed basically the same.Conclusions The overall status of implementation on the National Demonstration Areas was satisfactory.Future attention should be focusing on patient management as well as discovery and intervention of high-risk groups,which also presented the lowest scores,in this survey.
RESUMEN
Objective To investigate the consumption of vegetables and fruits and related influencing factors among residents from the National Demonstration Areas of Comprehensive Prevention and Control of Non-communicable Diseases.Methods From November to December,2016,a total of 4 000 residents,aged 18 or above,from ten Demonstration Areas,were selected as participants for this study by multi-stage cluster random sampling method.Information on vegetables,fruits consumption and related influencing factors was collected via questionnaire.Results A total of 3 891 residents were involved in the final analysis.Daily consumption of vegetables and fruits accounted for 72.1％ and 53.6％ of the residents under study.The residents who were aware of the National Demonstration Areas activities were more willing to have adequate intake of vegetables (OR=3.017,95％CI:2.426-3.753) and fruits (OR=1.261,95％CI:1.007-1.580).Residents with higher degree of participation activities of the demonstration areas were more likely to have adequate fruits intake (high degree:OR=1.431,95％CI:1.210-1.694;medium degree:OR=1.573,95％CI:1.315-1.882).Conclusions The implementation of the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases has improved the adequate vegetables and fruits intake among residents.Relevant activities carried out in the Demonstration Areas appeared conducive to the healthy lifestyle of the residents.
RESUMEN
Objective To assess the implementation and impact of programs carried out by the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases.Methods Both sociological and epidemiological methods were used to collect qualitative and quantitative data in November and December,2016 in order to conduct on process and outcome evaluation of the above mentioned objective.In the meantime,case study was also conducted.Results All the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases were found well implemented across the country,with health education and health promotion,surveillance and safeguard measures in particular.A government-led and inter-sector coordination and communication mechanism had been well established,with more than 16 non-health departments actively involved.28.7％ of the residents living in the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases were aware of the key messages related to chronic diseases.Among the residents,72.1％ of them consumed vegetables and 53.6％ consumed fruits daily,with another 86.9％ walked at least 10 minutes per day.Over 70％ of the patients with hypertension or diabetes reported that they were taken care of by the Community Health Centers,and above 50％ of them were under standardized management.Residents,living in the National Demonstration Areas under higher ranking of implementation scores,were more likely to be aware of relevant knowledge on chronic disease control and prevention (OR=6.591,95％CI:5.188-8.373),salt reduction (OR=1.352,95％CI:1.151-1.589),oil reduction (OR=1.477,95％CI:1.249-1.746) and recommendation on physical activities (OR =1.975,95％ CI:1.623-2.403).Conclusion The implementation of programs carried out by the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases had served a local platform for the control and prevention of non-communicable diseases,and thus become an important'carrier'for chronic disease prevention and control programs in China.
RESUMEN
Objective To understand the current overall status of implementation on the National Demonstration Areas of Comprehensive Prevention and Control of Non-communicable Diseases.Methods According to the scheme design of the questionnaires,all the National Demonstration Areas were involved in this study.For each National Demonstration Areas,eight departments were selected to complete a total of 12 questionnaires.Results Scores related to the implementation of the National Demonstration Areas accounted for 71.8％ of the total 170 points.Based on the scores gathered from this study,the 23-items-index-system that represented the status of project implementation was classified into seven categories.Categories with higher percentile scores would include:monitoring (88.0％),safeguard measures (75.0％),health education and health promotion (75.0％).Categories with lower percentile scores would include:the national health lifestyle actions (67.7％),community diagnosis (66.7％),discovery and intervention of high-risk groups (64.7％),and patient management (60.9％).There were significant differences noticed among the eastern,central and western areas on items as safeguard measures,health education/promotion,discovery and intervention of high-risk groups.In all,the implementation programs in the eastern Demonstration Areas seemed better than in the central or western regions.As for the 23 items,five of the highest scores appeared on policy support,mortality surveillance,tumor registration,reporting system on cardiovascular/cerebrovascular events,and on tobacco control,respectively.However,the lowest five scores fell on healthy diet,patient self-management program,oral hygiene,setting up the demonstration units and promotion on basic public health services,respectively.The overall scores in the eastern region was higher than that in the central or the western regions.The scores in the central and western regions showed basically the same.Conclusions The overall status of implementation on the National Demonstration Areas was satisfactory.Future attention should be focusing on patient management as well as discovery and intervention of high-risk groups,which also presented the lowest scores,in this survey.
RESUMEN
Objective To investigate the consumption of vegetables and fruits and related influencing factors among residents from the National Demonstration Areas of Comprehensive Prevention and Control of Non-communicable Diseases.Methods From November to December,2016,a total of 4 000 residents,aged 18 or above,from ten Demonstration Areas,were selected as participants for this study by multi-stage cluster random sampling method.Information on vegetables,fruits consumption and related influencing factors was collected via questionnaire.Results A total of 3 891 residents were involved in the final analysis.Daily consumption of vegetables and fruits accounted for 72.1％ and 53.6％ of the residents under study.The residents who were aware of the National Demonstration Areas activities were more willing to have adequate intake of vegetables (OR=3.017,95％CI:2.426-3.753) and fruits (OR=1.261,95％CI:1.007-1.580).Residents with higher degree of participation activities of the demonstration areas were more likely to have adequate fruits intake (high degree:OR=1.431,95％CI:1.210-1.694;medium degree:OR=1.573,95％CI:1.315-1.882).Conclusions The implementation of the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases has improved the adequate vegetables and fruits intake among residents.Relevant activities carried out in the Demonstration Areas appeared conducive to the healthy lifestyle of the residents.
RESUMEN
Objective To assess the implementation and impact of programs carried out by the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases.Methods Both sociological and epidemiological methods were used to collect qualitative and quantitative data in November and December,2016 in order to conduct on process and outcome evaluation of the above mentioned objective.In the meantime,case study was also conducted.Results All the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases were found well implemented across the country,with health education and health promotion,surveillance and safeguard measures in particular.A government-led and inter-sector coordination and communication mechanism had been well established,with more than 16 non-health departments actively involved.28.7％ of the residents living in the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases were aware of the key messages related to chronic diseases.Among the residents,72.1％ of them consumed vegetables and 53.6％ consumed fruits daily,with another 86.9％ walked at least 10 minutes per day.Over 70％ of the patients with hypertension or diabetes reported that they were taken care of by the Community Health Centers,and above 50％ of them were under standardized management.Residents,living in the National Demonstration Areas under higher ranking of implementation scores,were more likely to be aware of relevant knowledge on chronic disease control and prevention (OR=6.591,95％CI:5.188-8.373),salt reduction (OR=1.352,95％CI:1.151-1.589),oil reduction (OR=1.477,95％CI:1.249-1.746) and recommendation on physical activities (OR =1.975,95％ CI:1.623-2.403).Conclusion The implementation of programs carried out by the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases had served a local platform for the control and prevention of non-communicable diseases,and thus become an important'carrier'for chronic disease prevention and control programs in China.
RESUMEN
Objective To develop the models for predicting the reported legally notifiable diseases in China.Autoregressive integrated moving average (ARIMA) model was applied to forecast the trend of diseases.Methods Cases used for building the model were from of the records of Notifiable Infectious Diseases in China from May 2009 to July 2016 with R software and the model's predictive ability was tested by the data from August 2016 to January 2017.Results A strong seasonal nature was seen in the reported cases of notifiable communicable diseases,with the lowest point in February and highest peak in June.ARIMA (4,1,0) (1,1,1)12 model was established by the team to forecast the notifiable communicable diseases.Data showed that the biggest and lowest relative errors appeared as 9.78％ and 2.21％,respectively,with the mean of the relative error as 5.39％.Conclusion Based on the results of this study,the ARIMA (4,1,0) (1,1,1)12 model seemed to have had the sound prediction of notifiable communicable diseases in China.
RESUMEN
Objective To access the current status of folic acid supplementation in women at childbearing age in suburban area of Beijing,2016.Methods In this cross-sectional study,a total of 722 women aged 17-41 years from six hospitals in suburban areas of Beijing were selected through cluster sampling.A questionnaire survey was conducted.Results The rates of folic acid intake and regular folic acid intake among women under survey were 63.9％ (456/714) and 83.3％ (380/456).In women who remembered the duration of folic acid supplementation,the overall rate of preconceptional folic acid supplementation was 35.5％ (159/450),in whom 27.3％ (123/450) began to take folic acid 0-3 months before pregnancy;8.0％ (36/450) began to take folic acid 3 months before pregnancy.Multivariate logistic regression analysis indicated that household registering type,preparation for pregnancy or pregnancy,parity,smoking and alcohol use were the influencing factors for folic acid supplementation.Conclusions The rate of folic acid supplementation remained low in childbearing aged women in suburban area of Beijing.It is necessary to further strengthen the health education about the importance of folic acid supplementation to improve the intake rate and the regular intake rate of folic acid in pregnant women and to promote maternal infant health and reduce the related complications.
RESUMEN
Objective To analyze the association between pesticide exposure and adverse pregnancy outcomes in women from the rural areas of China.Methods Data of "National Free Preconception Health Examination Project (NFPHEP)" from January 2010 to December 2012 was used for analysis.A total of 248 501 families that were planning to deliver a baby in the next 6 months were enrolled.Data on paternal exposure to pesticides before or during pregnancy was collected through questionnaires,with related outcomes on pregnancy recorded by doctors.Results Among all the 248 501 participants,1 806 (0.74％) women and 2 653 (1.09％) men reported to have been exposed to pesticide before pregnancy,with 505 (0.21％) reported of having been exposed to pesticide during the period of pregnancy.Maternal exposure to pesticide was found a risk factor related to stillbirth (OR=3.37,95 ％ CI:2.05-5.55),peculiar smell pregnancy (OR =3.17,95％CI:1.18-8.55) and low birth weight (OR=7.56,95％ CI:5.36-10.66).Paternal exposure to pesticide was also found related to miscarriage (OR=1.37,95％ CI:1.03-1.80),low birth weight (OR=3.65,95％ CI:1.51-8.84),or giant infant (OR?=0.64,95％ CI:0.44-0.93).Maternal exposure to pesticide during pregnancy appeared a risk factor on miscarriage (OR=4.65,95％ CI:3.47-6.24).Other adverse outcomes on pregnancy would include premature birth and high birth weight.Conclusion Parental pesticide exposure appeared a risk factor on stillbirth,peculiar smell pregnancy,low birth weight and miscarriage.
RESUMEN
Objective To develop the models for predicting the reported legally notifiable diseases in China.Autoregressive integrated moving average (ARIMA) model was applied to forecast the trend of diseases.Methods Cases used for building the model were from of the records of Notifiable Infectious Diseases in China from May 2009 to July 2016 with R software and the model's predictive ability was tested by the data from August 2016 to January 2017.Results A strong seasonal nature was seen in the reported cases of notifiable communicable diseases,with the lowest point in February and highest peak in June.ARIMA (4,1,0) (1,1,1)12 model was established by the team to forecast the notifiable communicable diseases.Data showed that the biggest and lowest relative errors appeared as 9.78％ and 2.21％,respectively,with the mean of the relative error as 5.39％.Conclusion Based on the results of this study,the ARIMA (4,1,0) (1,1,1)12 model seemed to have had the sound prediction of notifiable communicable diseases in China.
RESUMEN
Objective To access the current status of folic acid supplementation in women at childbearing age in suburban area of Beijing,2016.Methods In this cross-sectional study,a total of 722 women aged 17-41 years from six hospitals in suburban areas of Beijing were selected through cluster sampling.A questionnaire survey was conducted.Results The rates of folic acid intake and regular folic acid intake among women under survey were 63.9％ (456/714) and 83.3％ (380/456).In women who remembered the duration of folic acid supplementation,the overall rate of preconceptional folic acid supplementation was 35.5％ (159/450),in whom 27.3％ (123/450) began to take folic acid 0-3 months before pregnancy;8.0％ (36/450) began to take folic acid 3 months before pregnancy.Multivariate logistic regression analysis indicated that household registering type,preparation for pregnancy or pregnancy,parity,smoking and alcohol use were the influencing factors for folic acid supplementation.Conclusions The rate of folic acid supplementation remained low in childbearing aged women in suburban area of Beijing.It is necessary to further strengthen the health education about the importance of folic acid supplementation to improve the intake rate and the regular intake rate of folic acid in pregnant women and to promote maternal infant health and reduce the related complications.
RESUMEN
Objective To analyze the association between pesticide exposure and adverse pregnancy outcomes in women from the rural areas of China.Methods Data of "National Free Preconception Health Examination Project (NFPHEP)" from January 2010 to December 2012 was used for analysis.A total of 248 501 families that were planning to deliver a baby in the next 6 months were enrolled.Data on paternal exposure to pesticides before or during pregnancy was collected through questionnaires,with related outcomes on pregnancy recorded by doctors.Results Among all the 248 501 participants,1 806 (0.74％) women and 2 653 (1.09％) men reported to have been exposed to pesticide before pregnancy,with 505 (0.21％) reported of having been exposed to pesticide during the period of pregnancy.Maternal exposure to pesticide was found a risk factor related to stillbirth (OR=3.37,95 ％ CI:2.05-5.55),peculiar smell pregnancy (OR =3.17,95％CI:1.18-8.55) and low birth weight (OR=7.56,95％ CI:5.36-10.66).Paternal exposure to pesticide was also found related to miscarriage (OR=1.37,95％ CI:1.03-1.80),low birth weight (OR=3.65,95％ CI:1.51-8.84),or giant infant (OR?=0.64,95％ CI:0.44-0.93).Maternal exposure to pesticide during pregnancy appeared a risk factor on miscarriage (OR=4.65,95％ CI:3.47-6.24).Other adverse outcomes on pregnancy would include premature birth and high birth weight.Conclusion Parental pesticide exposure appeared a risk factor on stillbirth,peculiar smell pregnancy,low birth weight and miscarriage.
RESUMEN
Objective:The paper is designed to reveal differences in stroke patients'hospitalization costs crea-ted by different socioeconomic factors , health insurance and occupational background , and analyze those differences on health outcome .Methods:18879 cases of hospitalized patients with stroke in five tertiary hospitals from four prov-inces from 2011 to 2014 were included in the database .Descriptive statistics was used to describe patients'hospitali-zation costs and health outcome .Multiple linear regression model and logistic regression were used to evaluate the im-pact of insurance and occupation .Results:After controlling for patients'social characteristics , health risks , premise during hospitalization process and clinical characteristics of patients with free healthcare costs , the socialized medi-cine was charged 19.7% higher than the private ones ( P <0.001 ), the retired people and civil servants were charged 4.2%(P<0.001) and 2.9%(P=0.049) more than farmers.The socialized medicine was also associated with health outcome.The risk of death in patients with free medical care is (OR=4.901) compared with private pa-tients (95%CI 1.652~14.537), and the retired people had increased risk of death compared with farmers (OR=2 .145 , 95%CI 1 .287 ~3 .573 ) .Conclusions: Due to the impact of social background factors , some groups are found to have a higher level of expenses than their counterparts during hospitalization , but the more hospitalization costs are not spent the better the health outcome of stroke was achieved .
RESUMEN
Objective To investigate the nutritional management level of Department of Clinical Nutrition in elderly inpatients through analyzing the actual hospital dietary intakes in elderly inpatients in Peking Union Medical College Hospital from 2013-2015.Methods Using continuous sampling, the nutrients contents and the eating rates of hospital meals ordered by the elderly inpatients on the 1st, 15th, 29th of every month from May 2013 to October 2015 were selected.The intake levels of energy, protein, calcium, vitamin A, vitamin B1 , and vitamin C were calculated and compared with the Chinese dietary reference intakes (DRIs).The nutritional in-take differences between diabetes diet and the basic hospital diet were also compared.Results A total of 90 days of hospital dietary data from 8 402 elderly inpatients were included in the study.The average eating rate was (50.1 ±4.2)%, which was lower than the general eating rate of the hospital [ (59.0 ±4.0)%, P<0.001]. Only protein intake from hospital diet reached the requirement target [male (103.1 ±47.3)%, femal (98.3 ± 33.8)%].Individual compliance rates were 63.2%and 59.8%, respectively, while the other kinds of nutrients were lower.The compliance rates of energy [ (73.3 ±26.3)%vs.(62.1 ±38.2)%, P<0.001] and ma-jor nutrient intake [ protein: ( 119.1 ±41.2 )% vs.( 93.3 ±65.1 )%, P <0.001; calcium: ( 55.5 ± 26.7)% vs.(34.3 ±34.2)%, P <0.001; vitamin A: (75.2 ±48.3)% vs.(57.4 ±97.1)%, P<0.001;vitamin B1:(76.4 ±38.2)%vs.(52.1 ±46.6)%, P<0.001;vitamin C:(92.2 ±51.4)%vs. (49.3 ±55.0)%, P<0.001) in diabetes diet group were significantly higher than those in the basic hospi-tal diet group.Conclusions The nutritional intakes from hospital diets may not meet the nutritional require-ments based on DRIs in elderly inpatients.Medical diet designed by physicians and dietitians should be ex-panded to improve the nutritional management level for these patients.
RESUMEN
Through literature study,this paper summarizes the current status ofreseareh on the relationship between maternal exposure factors and small for gestational age infant both in China and abroad.And at the same time,the relationship between pregnancy outcome of small for gestational age and maternal exposure factors was analyzed.This might contribute to reduce the incidence of small for gestational age infant and provide important guidance and references for perinatal care.
RESUMEN
Through literature study,this paper summarizes the current status ofreseareh on the relationship between maternal exposure factors and small for gestational age infant both in China and abroad.And at the same time,the relationship between pregnancy outcome of small for gestational age and maternal exposure factors was analyzed.This might contribute to reduce the incidence of small for gestational age infant and provide important guidance and references for perinatal care.