Community-dwelling older adults' perspectives on health risks: a qualitative study exploring anxieties, priorities, and expectations in ageing.

BACKGROUND: With the conflict between the promise of ageing in health and longevity and the limited availability of health resources and social support, older adults in China inevitably experience anxieties surrounding health risks. This study aims to investigate how older adults perceive the health risks that come with getting older, explore the degree to which health risks affect older adults, and advocate for active engagement in practices for managing health risks. METHODS: Using purposive sampling, three districts of Beijing (Xicheng District, Fengtai District, and Daxing District, respectively) were selected for the research. Qualitative semi-structured and in-depth interviews were conducted with 70 community-dwelling older adults who participated in the study. Data were extracted and analyzed based on a thematic framework approach. RESULTS: Three main themes were identified: (i) the anxieties of older adults concerning health risks in ageing; (ii) the priorities of older adults for health risk management in ageing; (iii) the expectations of older adults for health risk management in ageing. The primary health concerns among older adults included disease incidence and function decline. It was found that basic health management emerged as a critical need for older adults to mitigate health risks. Moreover, it was observed that healthcare support for older adults from familial, institutional, and governmental levels exhibited varying degrees of inadequacy. CONCLUSIONS: The primary source of anxieties among older adults regarding health risks predominantly stems from a perceived sense of health deprivation. It is often compounded by persistent barriers to primary care of priorities in managing health risks among older adults. In addition, the expectations of older adults for health risk management emphasize the necessity for integrated care approaches. Therefore, further research should give priority to the prevention and management of health risks, aim to reduce anxieties, provide integrated care to meet the primary needs and expectations of older adults, and ultimately strive toward the overarching goal of promoting health and longevity.

Barriers and facilitators of family doctor contract services in caring for disabled older adults in Beijing, China: a mixed methods study.

OBJECTIVE: To evaluate the current state of family doctor contract services (FDCS) in Beijing, identify the roles of family doctors who have worked with disabled older adults and investigate the barriers and facilitators faced by family doctors in providing care for them. DESIGN: A convergent mixed methods study was carried out from October 2020 to January 2021 to collect and analyse both quantitative and qualitative data. The integration strategies in this study were connecting the results of the quantitative phase to data collection of the qualitative phase. SETTING: A multi-stage sampling strategy was used to select 15 community health centres (CHCs) in four districts of Beijing. Of the four districts, two were from urban areas and two were from rural areas. PARTICIPANTS: The inclusion criteria for participants were (1) family doctors, (2) contracted with disabled older adults, (3) engaged in related work for disabled older adults more than 6 months. METHODS: A cluster sampling of 283 family doctors was used in the questionnaire. A purposive sample of 30 family doctors from the same CHCs was selected during the same period. Frequency and rank, rank-sum test, Kruskal-Wallis test were conducted in qualitative data analysis, the views of the interviewees were analysed through the thematic framework method. RESULTS: Currently, family doctors provided various services to satisfy the health needs of disabled older adults, while the usage of FDCS for disabled older adults is affected by many factors. The differences of the importance of family doctors' role (p<0.001) and service satisfaction (p=0.004) were significant among four districts. Compared with contracted health senior citizens, this study has identified five unique roles of family doctors, including 'psychological consultant', 'rehabilitation physiotherapist', 'health educator', 'health manager' and 'family health guardian'. Moreover, family doctors are confronted with a myriad of barriers (including high risks in the process of home visits, a lack of supervisory and incentive mechanisms, insufficiency of time and energy, etc) and facilitators (including establishing a doctor-patient trust relationship, developing humanistic care services, etc) in the FDCS for disabled older adults. CONCLUSIONS: Family doctors play a pivotal role in the FDCS for disabled older adults, while the effect and quality of FDCS in China needs to be improved. It is suggested that further research needs to focus on solving existing barriers of FDCS to optimise the health of disabled older adults and improve the quality of their lives.

An Alternative Electro-Mechanical Finite Formulation for Functionally Graded Graphene-Reinforced Composite Beams with Macro-Fiber Composite Actuator.

With its extraordinary physical properties, graphene is regarded as one of the most attractive reinforcements to enhance the mechanical characteristics of composite materials. However, the existing models in the literature might meet severe challenges in the interlaminar-stress prediction of thick, functionally graded, graphene-reinforced-composite (FG-GRC)-laminated beams that have been integrated with piezoelectric macro-fiber-composite (MFC) actuators under electro-mechanical loadings. If the transverse shear deformations cannot be accurately described, then the mechanical performance of the FG-GRC-laminated beams with MFC actuators will be significantly impacted by the electro-mechanical coupling effect and the sudden change of the material characteristics at the interfaces. Therefore, a new electro-mechanical coupled-beam model with only four independent displacement variables is proposed in this paper. Employing the Hu-Washizu (HW) variational principle, the precision of the transverse shear stresses in regard to the electro-mechanical coupling effect can be improved. Moreover, the second-order derivatives of the in-plane displacement parameters have been removed from the transverse-shear-stress components, which can greatly simplify the finite-element implementation. Thus, based on the proposed electro-mechanical coupled model, a simple C0-type finite-element formulation is developed for the interlaminar shear-stress analysis of thick FG-GRC-laminated beams with MFC actuators. The 3D elasticity solutions and the results obtained from other models are used to assess the performance of the proposed finite-element formulation. Additionally, comprehensive parametric studies are performed on the influences of the graphene volume fraction, distribution pattern, electro-mechanical loading, boundary conditions, lamination scheme and geometrical parameters of the beams on the deformations and stresses of the FG-GRC-laminated beams with MFC actuators.

Clinical effect of off-pump coronary artery bypass grafting for the patients over 70 years with coronary artery disease / 中国胸心血管外科临床杂志

@#Objective     To evaluate the clinical efficacy of coronary artery bypass grafting in the treatment of coronary artery disease patients aged over 70 years. Methods     A total of 160 patients with coronary atherosclerotic heart disease underwent off-pump coronary artery bypass grafting from January 2013 to December 2017. There were 94 males and 66 females at age of 70–85 (76.67±2.33) years. Operations were performed by using sternal median incision with the assistance of local myocardial surface fixator and shunt plug, and the saphenous vein and internal mammary arterywere used as grafted vessels. Results     All the patients were received successful off-pump coronary artery bypass grafting without death, and the cardiac function improved significantly. There were 62 patients with the internal mammary artery bridge and 98 patients with the whole vein bridge. All the patients were followed-up for 1 to 4 years. All the patients had obvious relief of angina pectoris. Conclusion     Off-pump coronary artery bypass grafting for the treatment of elderly patients with coronary heart disease is an effective and safe operation, especially for patients with renal insufficiency, cerebrovascular disease, respiratory disease and severe left ventricular dysfunction.

[Influence of three central venous catheter biomedical materials on proliferation, apoptosis, and cell cycle of xuanwei lung cancer-05 cells].

OBJECTIVE: To explore the influence of three central venous catheter biomedical materials (polyurethane, silicone, and polyvinyl chloride) on the proliferation, apoptosis, and cell cycle of Xuanwei Lung Cancer-05 (XWLC-05) cells so as to provide the basis for clinical choice of central venous catheter. METHODS: XWLC-05 cells were cultured and subcultured, and the cells at passage 3 were cultured with polyurethane, silicone, and polyvinyl chloride (1.0 cm x 1.0 cm in size), and only cells served as a control. At 24, 48, and 72 hours after cultured, MTT assay was used to detect the cellular proliferation and flow cytometry to detect the cell cycle and apoptosis. At 72 hours after cultured, inverted microscope was used to observe the cell growth. RESULTS: Inverted microscope showed the cells grew well in control group, polyurethane group, and silicone group. In polyvinyl chloride group, the cells decreased, necrosed, and dissolved; residual adherent cells had morphologic deformity and decreased transmittance. At 24 and 48 hours, no significant difference in proliferation, apoptosis, and cell cycle was found among 4 groups (P > 0.05). At 72 hours, the proliferations of XWLC-05 cells in three material groups were significantly inhibited when compared with control group (P < 0.05), and the cells in polyvinyl chloride group had more significant proliferation inhibition than polyurethane group and silicone group (P < 0.05), but there was no signifcant difference in proliferation inhibition between polyurethane group and silicone group (P > 0.05). Compared with the control group, three material groups had significant impact on the rate of apoptosis and cell cycle: polyvinyl chloride group was the most remarkable, followed by silicone group, polyurethane group was minimum (P < 0.05). CONCLUSION: Polyvinyl chloride can significantly impact the proliferation, apoptosis, and cell cycle of XWLC-05 cells; polyurethane has better biocompatibility than polyvinyl chloride and silicone.

[Effect of Suture Lines on Lung Adenocarcinoma Cell in vitro.].

BACKGROUND: The interaction of cell and medical biomaterial is one of the significant factors to affect clinical application of medical biomaterial. This research is to investigate three of suture lines how to affect the proliferation and cell cycle of Lung Adenocarcinoma cell A549. METHODS: Three of suture lines are respectively cultivated with Lung Adenocarcinoma cell A549, after of 72 hours, to detect absorptance of each groups by MTT method in order to reflect the proliferation of Lung Adenocarcinoma cell A549 and to detect percentage of G1 period cell and S period cell of each of groups by flow cytometry. RESULTS: Different of suture lines have effect differently on the proliferation and cell cycle of Lung Adenocarcinoma cell A549 (P<0.05). The effect of absorbent suture line on the proliferation and cell cycle of Lung Adenocarcinoma cell A549 is strong, the effect of chorda serica chirurgicalis is medium, the effect of slide wire is poor. Different length of each suture line have effect differently on the proliferation and cell cycle of Lung Adenocarcinoma cell A549 (P<0.05). CONCLUSIONS: Three of suture line materials have different effect on the proliferation and cell cycle of Lung Adenocarcinoma cell A549, to reflect dose-effect relation.