Effects of Continuity of Care on Diabetes-Related Avoidable Hospitalizations among Middle- and Old-Aged Patients: Analysis of National Health Insurance Claims Data / 보건행정학회지

BACKGROUND: Diabetes is known as one of the most important ambulatory care sensitive conditions. This study purposed to assess the status of continuity of care (COC) and diabetes-related avoidable hospitalizations (DRAHs) of a group of middle- and old-aged patients and to observe the relationship of the two elements by the two age groups. METHODS: This study utilized the National Health Insurance Service's National Sample Cohort data and the subjects are diabetes patients of 45 and over, classified into two groups of ‘middle-aged’(45–64 years) and ‘old-aged’(≥65 years) patients. The dependent variable was DRAHs, which was defined in accordance with the definition of the Organization for Economic Cooperation and Development “Health Care Quality Indicators” project. COC, as an independent variable, is measured by the COC index in this study. Two-part model (multi-variate and multi-level analyses) was utilized. RESULTS: Factors associated with the status and the number of DRAHs differed by each age group. Meanwhile, the two-part model showed that higher COC was associated with a lower risk of preventable hospitalizations in both middle- and old-aged groups. CONCLUSION: Study findings can provide health policy insights and implications in order to strengthen the primary care system for further improvement of diabetes management, especially for middle- and old-aged groups.

lllness Perceptions of Breast Cancer in Japanese Middle-and Early Old-Aged Women: Psychometric Properties of the Brief lllness Perception Questionnaire for Use in Diagnosing Breast Cancer in Japan.

Objectives: The present study was aimed at constructing the Japanese version of the Brief Illness Perception Questionnaire for breast cancer (Brief IPQ-JBC), for use with Japanese middle- and early old-aged women who had not previously undergone mammography. We also examined the psychometric properties of the translated instrument. Methods: Patients were 824 middle- and early old-aged women living in all parts of Japan, who completed surveys on the Internet in January 2014. Of these, 282 had not previously undergone mammography and were included in this study, completing the Internet survey again, six months later, in July 2014.The participants were evaluated on the basis of a battery of questionnaires comprising demographic details, the tentative version of the Brief IPQ-JBC, the Japanese version of the Illness Perception Questionnaire (J-IPQ), Self-Directedness subscale from the Japanese version of the Temperament and Character Inventory-125 items, perceived breast cancer risk, and anticipated worry about breast cancer. Results: The Brief IPQ-JBC was found to have good long-term test-retest reliability, as well as concurrent validity with the J-IPQ. The scale also showed good construct validity, based on the results of a path model using structural equation modeling, thus supporting the theoretical perspective of the common-sense model of self-regulation. Conclusion: We have validated the Brief-JBC in a sample of Japanese middle- and earlyold-aged women and believe our results will be useful for subsequent research.

Yishi Oral Liquid Treat Middle and Old Aged Asthenopia 65 Cases / 浙江中医药大学学报

[Objective] To observe Yishi Oral Liquid effect on treating middle and old aged asthenopia. [Method] Choose 125 cases of middle and old aged asthenopia, and randomly divide them into observation group 65 cases treated wutg Yishi Oral Liquid, and control group 60 cases with Mingmu Rehmannia Pil;meanwhile both groups reduced the time with the eye and made massage on the acupoints around the eyes. [Result] With 2~4 weeks of treatment, in the observation group, 23 cases were cured, 25 had marked effect, 13 effective, 11 had no effect, the total effective rate was 93.85%;for the control one, they were respectively 14,19,16,11 and 81.67%. The comparison showed the observation group was better than control one. [Conclusion] Yishi Oral Liquid treating middle and old aged asthenopia has good clinical effect, can obviously relieve the symptoms of blurred vision, phengophobia, lacrimation and aningerestling eyes, helpful to recovering eyesight.

Vitamin D status and its effect on bone mineral density of the middle and old aged women in the urban area of Guiyang / 中华内分泌代谢杂志

Objective To evaluate vitamin D status of the middle and old aged women in the urban area of Guiyang,and to explore the impact of vitamin D status on the bone mineral density.Methods A total of 511 healthy women,aged 40 to 79 years old,living in one of the urban communities in Guiyang,were selected by means of stratified cluster sampling.The levels of serum 25-hydroxyvitamin D [25 (OH) D] and intact parathyroid hormone (iPTH) were detected by radioimmunoassay.In addition,the bone mineral density (BMD) of hip,lumbar vertebrae 1-4 (L1-4),and neck of left femur were detected by Dual energy X ray absorptiometry.Results The average serum level of 25(OH)D in all subjects was (21.3 ± 7.9) ng/ml and that of iPFH was (29.3 ± 16.5) pg/ml.Severe deficiency [25 (OH) D＜ 10 ng/ml],deficiency [10 ≤ 25 (OH) D＜20 ng/ml],insufficiency [20 ≤ 25 (OH) D ≤ 30ng/ml],and sufficiency [25 (OH) D＞ 30 ng/ml] of vitamin D were ascertained in 5.3％,42.3％,37.9％,and 14.5％ of the total cases respectively.The morbidity of secondary hyperparathyroidism was 4.7％.The level of 25 (OH) D was positively correlated with the BMD of L1-4 and neck of left femur (both P＜0.01).The level of iPTH was negatively correlated with BMD of neck of left femur and L1-4 (both P＜0.05).Conclusion The majority of middle and old aged women in the urban area of Guiyang city were found to be of vitamin D deficiency and insufficiency.Vitamin D status is positively correlated with BMD at lumbar spine and proximal femur.Serum 25 (OH) level below 20 ng/ml is associated with raised parathyroid hormone,which increases the risk of osteoporosis.

The influence of two transfusion triggers on middle-and old-aged patients during tumorectomy / 中国输血杂志

0.05].Conclusion To the middle-and old-aged GI cancer patients without organ dysfunction,lowering blood transfusion trigger from Hb 100 g/L to Hb 80 g/L during operation can meet the requirement of oxygen,reduce blood transfusion,and do not increase the rates of wound infection or delay wound healing.

Mobile Vehicle Exhaust Exposure and Impacts of Cardiovascular System in Middle and Old Aged People:a panel Study in a Community of Guangzhou / 环境与健康杂志

Objective To explored the effects of vehicle exhaust on the cardiovascular system in a panel of 32 middle and old aged people,to discover the sensitive effect indicators of vehicle exhaust. Methods Thirty-two middle and old aged people living near a main road were followed-up,The health-related indicators and individual time-weighted outdoor exposure concentration of air pollutants were determined;The mixed model was used to evaluate association between vehicle exhaust and health indicators of cardiovascular system. Results In single-pollutant models,TNF-? was positively associated with PM10,SO2,NO2 and FVC,IL-6 was negative. The indicators of heart rate variability(HRV) in SDNN(?:-0.57,SE:0.18) ,SDNN index(?:-0.74,SE:0.20) had a strong association with PM10,and NO2 related indicators was SDNN index(?:-0.66,SE:0.17) . In the multi-pollutant model,after adjusting the effect of other pollutants,IL-6 had a positive correlation with PM10;And TNF-? was positively correlated to NO2,SO2;FVC had a negative correlation with PM10. Conclusion The air pollutants of this location show a vehicle exhausts characteristic,and the pollution is serious;TNF-?,IL-6,FVC,SDNN,SDNN index are closely related to exposure of the vehicle exhaust,and can be used to evaluate the effects of vehicle exhaust pollution on the cardiovascular system of the elderly.

A Evaluation Study on Nutrient Intake Status and Diet Quality of Middle and Old Aged Vegetarian Women in Korea / 대한지역사회영양학회지

The purpose of this study was to evaluate on nutrient intake status and diet quality of middle and old aged vegetarian women in Korea. The research group was composed of vegetarian women (n = 91), all of them were Seven Day Adventists, who had been on vegetarian diets, over 20 yrs. Their anthropometric measurements, dietary intakes, and diet quality indices were compared to omnivores (n = 122). The average age of vegetarians and omnivores were 61.8 yrs and 60.3 yrs, respectively. The mean daily energy intakes of vegetarians and omnivores were 1428.8 kcal and 1424.5 kcal, respectively and there was no significant difference. The vegetarians consumed significantly lower intakes of protein (p<0.05), zinc (p<0.001) and vitamin B2 (p<0.05) compared to omnivores. In the diet quality, zinc and vitamin B2 nutrient adequacy ratio (NAR) of vegetarians were significantly lower than those of omnivores. Mean adequacy ratio (MAR) of vegetarians and omnivores were 0.80 and 0.77, respectively and there was no significant difference. The KDDS (Korean's Dietary Diversity Score) of vegetarians and omnivores were 3.7 and 4.0, respectively, and there was significant difference (p<0.01). The KDQI (Korean's Diet Quality Index) of vegetarians (1.5) was significantly lower than that (2.1) of omnivores (p<0.001). In conclusion, vegetarian women have low intake status of protein, zinc and vitamin B2, and partly low diet quality. Therefore it was needed that well planed diets to replace the nutrients supplied from excluded food groups in middle and old aged vegetarian women.

Prevalence and correlated factors of hyperuricemia in the middle-and-old aged inhabitants of Nanjing / 肠外与肠内营养

Objective:To learn the prevalence and correlated factors of hyperuricemia in the middle-and-old aged inhabitants of Nanjing. Methods:5 423 inhabitants in the districts of Nanjing were selected by random cluster sampling. The levels of uric acid, creatine, total cholesterol, triglycerides, blood glucose in the serum were measured,and the diet was also investigated. Results:The prevalence of hyperuricemia in the middle-and-old aged inhabitants was 15.0%, with 20.1% for males and 10.6% for females. The prevalence for males and females increased after 50 years old, and maintained at a high level afterwards. The concentration of uric acid, creatine, total cholesterol, triglycerides, blood glucose, the blood pressure and BMI in the inhabitants with hyperuricemia were higher than those in the inhabitants without hyperuricemia. The risk factors for hyperuricemia included higher BMI and hypertension, while the protective factor was favorite for hot-food. Conclusion:For the inhabitants over 45 years old in Nanjing, hyperuricemia was common among the adults over 50 years old. Higher BMI and hypertension were the risk factors, while favorite for hot food was the protective factor.

Relationship Between Physical Fitness and Ability to Coordinate Exertion of Force with Reference to Sex Difference in Healthy Middle- and Old-Aged People / 体力科学

The purpose of this study was to examine the relationship between physical fitness and ability to coordinate exertion of force (ACEF) in 82 healthy middle and old-aged people aged 54 to 78 years (male 41, female 41), and to examine its sex differences. The ACEF test was conducted with the subject fitting the exertion value of grip strength to a changing demand value appearing on the display of a personal computer. The variable estimating ACEF was the total sum of the differences between the demand value and the produced strength value. The physical fitness items measured were : grip strength, shoulder arm strength (push and pull), vertical jump, vital capacity, foot balance with eyes open, trunk flexion, trunk rotation, whole body reaction time, finger tapping, and stepping. To clarify the relationship between the ACEF and physical fitness, multiple regression analysis was used after age-controlled partial correlations were computed. No sex difference was found in nervous function based on the exertion of maximal ability, but there was with the ACEF based on the exertion of sub-maximal strength. Also the relationship between the ACEF and age differed in men and women. The tests of nervous function and grip strength had little relation to the ACEF test. Each physical fitness factor and the fundamental physical fitness had low relation to the ACEF. It was inferred that ability measured by the ACEF test differs from that measured by general physical fitness tests based on the exertion of maximal ability. It is necessary to examine the relationship between the ACEF test and a similar test based on the exertion of sub-maximal strength.