Integrating Community Care for the Prevention and Treatment of Diabetes.

Introduction: This paper describes 'Project 8', a campaign that aims to reduce glycated haemoglobin (HbA1c) to 8% or more among patients with diabetes mellitus, utilising healthcare professionals and local community residents and focusing on education and support. The study is based in Uonuma-a small rural city in Japan with a declining population and an increased number of older people. Description: 'Project 8' began in Uonuma's Koide Hospital in 2008. The Uonuma School for Community Health and Social Care was established in 2011 with the cooperation of a clinic's general practitioner. Medical students, trainees, doctors, and health care professionals have been holding 'open schools' (daytime lectures) and 'night schools' (evening lectures) to educate the community residents about various health issues. Through repeated lectures, the residents have been made aware of lifestyle-related diseases, including diabetes, and the meaning of 'Project 8'. Discussion: Over the last decade, the hospital's campaign has expanded within the community, showing a statistically significant reduction of diabetic patients with HbA1c ≥ 8%, which successfully deferred the start of dialysis for many of them. Conclusion: Well-integrated community care requires interprofessional education, collaborative practice, and the participation of community residents in health education.

Association of altitude and frailty in Chinese older adults: using a cumulative frailty index model.

Objective: The population is aging exponentially and the resulting frailty is becoming increasingly evident. We aimed to explore the association between altitude and frailty, and to identify associated factors for frailty. Methods: This is a community-based cross-sectional survey. 1,298 participants aged ≥60 years from three different altitudes were included in the study. To quantify frailty, we constructed a frailty index (FI) and a frailty score (FS). The FI was divided into non-frailty, prefrailty, and frailty. The Odds Ratios and confidence intervals (ORs, 95%CIs) were used to evaluate the association between altitude and FI and FS in multivariate ordinal logistic regression and linear regression. Results: There were 560 (53.1%) participants in the prefrailty and 488 (37.6%) in the frailty group. The FS increased with higher altitude (P for trend <0.001). Multivariate ordinal logistic regression analysis revealed an association between altitude and frailty, OR = 1.91 (95% CI: 1.38-2.64) in mid-high altitude and 2.49 (95% CI:1.40-4.45) in high altitude. The same trend of association was found in the univariate analysis. The FS increased by 1.69 (95% CI: 0.78-2.60) at mid-high altitude and 3.24 (95%CI:1.66-4.81) at high altitude compared to medium altitude. Conclusion: The study indicates that high altitude exposure is an associated factor for frailty in older adults. This association become stronger with higher altitudes. As a result, it is essential to conduct early frailty screening for residents living at high altitudes.

[Effect of information-knowledge-attitude-practice theory-based health education on clonorchiasis control among community residents and primary school students in Zhongshan City].

OBJECTIVE: To evaluate the effect of information-knowledge-attitude-practice (IKAP) theory-based health education interventions on clonorchiasis control among community residents and primary school students in Torch High-tech Development Zone of Zhongshan City, so as to provide insights into formulation of clonorchiasis control strategies among different types of populations. METHODS: Residents were randomly sampled from two communities and students from two primary schools using a random cluster sampling method in Torch High-tech Development Zone, Zhongshan City from 2019 to 2021, and health education pertaining to clonorchiasis control was performed based on the IKAP theory. The changes in the awareness of basic clonorchiasis control knowledge and belief, self-reported risk of Clonorchis sinensis infections and dietary behaviors were compared among community residents and primary school students before and after health education interventions. RESULTS: The participants included 146 male and 151 female community residents and 158 male and 153 female primary school students, with no significant difference detected in gender distribution (χ2 = 0.16, P > 0.05). The mean awareness of basic clonorchiasis control knowledge increased by 44.71% and 43.28% among primary school students and community residents 6 months following health education, and there were significant differences in the awareness of each item of basic clonorchiasis control knowledge before and after health education (χ2 = 41.53 to 284.44, all P values < 0.05). The proportions of primary school students and community residents thinking very high and high risks of C. sinensis infections increased from 9.35% and 6.71% before health education to 22.15% and 37.75% after health education, but only the difference of the attitudes in community residents achieve statistical significance (χ2 = 92.18, P < 0.05). The frequency of separation of raw and cooked foods with chopping board and knife significantly increased among community residents and primary school students following health education (χ2 = 16.04 to 62.65, all P values < 0.05). The frequency of eating raw freshwater fish (χ2 = 32.85, P < 0.05), fish congee (χ2 = 7.02, P < 0.05) and fish fillet hot pot (χ2 = 4.88, P < 0.05) significantly reduced among primary school students following health education, while only the frequency and proportions of eating raw freshwater fish have significantly reduced in community residents (χ2 = 11.77, P < 0.05). CONCLUSIONS: Health education interventions based on the IKAP theory are effective to increase the awareness of clonorchiasis control knowledge and improve dietary behaviors associated with C. sinensis infections among community residents and primary school students in Zhongshan City.

[Promoting Appropriate Use of Medications by "Lectures and Practices Regarding Medicine" for the Regional Community Residents].

We held lectures and practices for the regional community residents with the aim of promoting appropriate use of medications. To evaluate the usefulness of our activity, we conducted medicine-related questionnaire surveys (pre- and post-questionnaires) before and after the lectures and practices, and satisfaction with the activity questionnaire surveys (post-questionnaires) after them. We also evaluated the effect of age difference on the results by dividing the participants into elderly (age ≥65) and non-elderly (age <65), before the analysis. In the both (elderly and non-elderly) groups, the ratio of positive answers in several items of post-questionnaire regarding appropriate use of medications was higher than that of pre-questionnaire. These results suggest that the basic medicine-related knowledge improved by attending the lectures and practices, and indicate that the knowledge of the regional community residents is higher than we imagined. Furthermore, there was no difference in the ratio of positive answers between the both groups, suggesting that our activity is applicable to a wide range of age groups. Our activity benefitted the participants, and not only provided education to the regional community residents regarding appropriate drug use, but also lead to the development of regional community activity, by the coming together of the regional community residents of various age.

Public awareness, specific knowledge, and worry about mpox (monkeypox): A preliminary community-based study in Shenzhen, China.

Background: The mpox (monkeypox) outbreak has been declared to be a public health emergency of international concern by the Director-General of World Health Organization in July 2022. However, evidence regarding the awareness, knowledge, and worry about mpox in the general population remains scant. Methods: A community-based survey targeting community residents was preliminarily conducted in Shenzhen, China in August 2022 by using a convenience sampling method. Information on mpox-related awareness, knowledge, and worry was collected from each participant. Binary logistic regression analyses with the stepwise procedure were applied to explore the factors associated with awareness, knowledge, and worry about mpox. Results: A total of 1028 community residents were included in the analysis (mean age: 34.70 years). Among these participants, 77.9% had ever heard of mpox, and 65.3% were aware of the global outbreak of mpox. However, only about half of them had a high level of knowledge regarding mpox (56.5%) and related symptoms (49.7%). More than one-third of them (37.1%) expressed a high level of worry about mpox. Having high knowledge levels of mpox and related symptoms were positively associated with a high level of worry (OR: 1.79, 95%CI: 1.22~2.63 for a single high knowledge level; OR: 1.98, 95%CI: 1.47~2.66 for both high knowledge levels). Conclusions: This study identified the gaps in public awareness and specific knowledge of mpox in Chinese people, providing scientific evidence for the prevention and control network of mpox at the community level. Targeted health education programs are of urgent need, which should be implemented along with psychological interventions to release public worry if necessary.

[Sub-staff training program for community residents to provide community-based care services at day-care facilities].

Objectives　As the birthrate declines and the population ages, increase in the number of older adults certified as requiring long-term care and shortage of care staff are important issues to be considered. This study developed a sub-staff training program that trains community residents as sub-staff (paid auxiliary staff who possess knowledge and skills in care prevention and confidentiality) to provide care for enhancing independence of older adults with the support of staff in day-care facilities. The study also examined the program's feasibility and key factors, through the introduction of practical examples and surveys, for implementation in care prevention projects of local governments.Methods　The four-month training program included lectures on care prevention and provided job training to ensure participants understood the goals and contents of the care plan and learnt to provide care services with the assistance of facility staff. The training program was conducted at 14 facilities in Tokyo and Chiba from 2015 to 2017. The evaluation focused on the completion rate, change in understanding of care prevention and confidence regarding activities at the facility and in the community, participation in community activities after program completion, the psychological impact on care service recipients, and the perception of workload reduction by the facility staff.Results　A total of 96 out of 104 participants completed the training program (completion rate of 92.3%). The survey results showed that participants' confidence in activities at the facilities and understanding of care prevention increased significantly; 65.3% participated in new community activities after program completion, including activities at the facilities. The results of the survey of care service recipients showed that negative psychological effects did not increase among those who received care services from the participants compared to those who did not receive care from participants. Among the facility staff, 85.7% indicated that their workload had reduced after the community residents' participation in care services.Conclusion　The training program improved participants' confidence in care-related activities and their understanding of care prevention. More than half of them engaged in new community activities afterwards. Participants' provision of care services had a less negative impact on the service recipients and led to a reduction in workload for the facility staff. These results suggest high feasibility of the training program for care prevention projects.

Effect of information-knowledge-attitude-practice theory-based health education on clonorchiasis control among community residents and primary school students in Zhongshan City / 中国血吸虫病防治杂志

OBJECTIVE@#To evaluate the effect of information-knowledge-attitude-practice (IKAP) theory-based health education interventions on clonorchiasis control among community residents and primary school students in Torch High-tech Development Zone of Zhongshan City, so as to provide insights into formulation of clonorchiasis control strategies among different types of populations.@*METHODS@#Residents were randomly sampled from two communities and students from two primary schools using a random cluster sampling method in Torch High-tech Development Zone, Zhongshan City from 2019 to 2021, and health education pertaining to clonorchiasis control was performed based on the IKAP theory. The changes in the awareness of basic clonorchiasis control knowledge and belief, self-reported risk of Clonorchis sinensis infections and dietary behaviors were compared among community residents and primary school students before and after health education interventions.@*RESULTS@#The participants included 146 male and 151 female community residents and 158 male and 153 female primary school students, with no significant difference detected in gender distribution (χ2 = 0.16, P > 0.05). The mean awareness of basic clonorchiasis control knowledge increased by 44.71% and 43.28% among primary school students and community residents 6 months following health education, and there were significant differences in the awareness of each item of basic clonorchiasis control knowledge before and after health education (χ2 = 41.53 to 284.44, all P values < 0.05). The proportions of primary school students and community residents thinking very high and high risks of C. sinensis infections increased from 9.35% and 6.71% before health education to 22.15% and 37.75% after health education, but only the difference of the attitudes in community residents achieve statistical significance (χ2 = 92.18, P < 0.05). The frequency of separation of raw and cooked foods with chopping board and knife significantly increased among community residents and primary school students following health education (χ2 = 16.04 to 62.65, all P values < 0.05). The frequency of eating raw freshwater fish (χ2 = 32.85, P < 0.05), fish congee (χ2 = 7.02, P < 0.05) and fish fillet hot pot (χ2 = 4.88, P < 0.05) significantly reduced among primary school students following health education, while only the frequency and proportions of eating raw freshwater fish have significantly reduced in community residents (χ2 = 11.77, P < 0.05).@*CONCLUSIONS@#Health education interventions based on the IKAP theory are effective to increase the awareness of clonorchiasis control knowledge and improve dietary behaviors associated with C. sinensis infections among community residents and primary school students in Zhongshan City.

Stroke 120 or FAST (Face, Arm, Speech, Time): Which is Better in Stroke Awareness Promotion for Older Residents Living in Shanghai?

BACKGROUND: To make a parallel comparison regarding the effectiveness of Stroke 120 and FAST (Face, Arm, Speech, Time) in stroke knowledge promotion among community-living older residents in Shanghai. METHODS: This is a prospective community-based study. Between 1 February 2021 and 31 July 2021, we conducted a community-based stroke education program among older residents living in two communities in Minhang district, Shanghai. Residents aged over 60 years were educated with FAST and Stroke 120 separately. We defined the community educated with FAST as FAST-Community, the other one educated with Stroke 120 as Stroke 120-Community. Pre- and post-education survey were collected. The ability to recall the meanings of FAST and Stroke 120 in pre- and post-education survey was compared. The awareness of stroke risk factors and symptoms was also compared. RESULTS: There were 466 responders in pre-education survey (231 from FAST-community, 235 from Stroke 120-community) and 456 responders in post-education survey (230 from FAST-community, 226 from Stroke 120-community). The mean age of responders in Stroke 120-community was 76 years (40% male) and in FAST-community was 71 years (52% male). Of the common stroke symptoms, we only found significant improvement in the awareness of Face drop (61.7% versus 34.6%, P<0.001) and Dizziness (45.7% versus 27.7%, P<0.001) in post-education survey for responders living in FAST-community. However, for responders living in Stroke 120-community, significant improvement was observed in all stroke symptoms (all P<0.05). As for the ability to recall the meanings of stroke awareness tools, the number of responders who can recall all the meanings of Stroke 120 increased from 0 in pre-education survey to 44 (21.5%) in post-education survey (P<0.001) for responders living in Stroke 120-community. However, among responders living in FAST-community, only 4 (5%) can recall all the meanings of FAST in post-education survey (5% versus 0%, P = 0.47). In the meantime, the proportion of responders who can recall part or all the meanings of them was also higher in Stroke 120-community in post-education survey. CONCLUSION: Among community-living older residents in Shanghai, Stroke 120 seems to be more suitable than FAST in stroke knowledge promotion.

The correlation between electronic cigarette use and environmental exposure to electronic cigarette among residents in Guangzhou City / 预防医学

Objective@#To evaluate the correlation between electronic cigarette (e-cigarette) use and environmental e-cigarette exposure among residents living in Guangzhou City, so as to provide the evidence for the development of the e-cigarette control policy.@*Methods@#Permanent university students living in Guangzhou City were recruited as investigators from July to October 2021, and the permanent adult residents in communities where the university students lived were randomly selected as participants. Subjects' demographic features, e-cigarette use, passive viewing of e-cigarette use and exposure to e-cigarette advertising were collected using both online and offline questionnaire surveys, and the association of e-cigarette use with passive viewing of e-cigarette use and exposure to e-cigarette advertising were examined using a multivariable logistic regression model.@*Results@# A total of 948 questionnaires were allocated, and 874 valid questionnaires were recovered, with an effective recovery rate of 92.19%. The respondents had a mean age of ( 34.96±13.76 ) years. There were 420 men ( 48.05% ), and 426 married residents ( 48.80% ). The prevalence of e-cigarette use was 14.99%, and the rate of e-cigarette use was 23.81% in men and 6.83% in women. In addition, 27.27% of respondents at ages of 35 to 44 years used e-cigarette, 479 respondents viewed e-cigarette advertising ( 54.81% ) and 510 respondents had at least once passive viewing of e-cigarette use ( 58.35% ). Multivariable logistic regression analysis revealed that a higher frequency of exposure to e-cigarette advertising ( OR: 3.064-5.784, 95%CI: 1.683-12.620 ) and a higher frequency of passive viewing of e-cigarette use ( OR: 2.182-2.349, 95%CI: 1.094-4.526 ) led to a higher rate of e-cigarette use.@*Conclusions@#E-cigarette use is affected by passive viewing of e-cigarette use and exposure to e-cigarette advertising among community residents in Guangzhou City. Supervision and restriction is recommended for e-cigarette advertising, marketing, and use in public places.

Lifetime and 1-Month Prevalence of Mental Disorders in Hebei Province, China: A Community-Based Cross-Sectional Study.

Background: The prevalence of mental disorders is an important topic, which has been reported in different countries in the world. In China, some studies were also conducted to get the prevalence of mental disorders at the national level and in some metropolitan cities. However, the prevalence of mental disorders in Chinese underdeveloped provinces has not been reported internationally in recent decades. Due to the discrepancy in the social-economic development of different Chinese provinces, we also have reasons to believe the different prevalence of mental disorders between underdeveloped provinces and other provinces. Method: A community-based cross-sectional study was conducted among community residents aged 18 years and older in Hebei province, China. We screened 20,884 community residents in this study, and a Structured Clinical Interview for Diagnostic and Statistical Manual (DSM-IV) Axis I disorders was used to make the diagnoses of mental disorders. Results: The weighted lifetime prevalence of mental disorders was 15.87% (95% CI 15.38-16.38%), and the 1-month prevalence was 10.79% (95% CI 10.37-11.22%). Anxiety disorder ranked first in the classification of mental disorders for both lifetime (6.56%) and 1-month prevalence (6.25%). The weighted lifetime and 1-month region-gender-age-specific prevalence of mental disorders was also analyzed in this study. Conclusions: Mental disorders have been an important issue in Chinese economically underdeveloped regions, and the prevalence was at a high level compared with the results in the 2000s. There are several serious challenges in the work of Chinese mental disorders, which should be paid more attention to.

Poor awareness of stroke educational tools among older adults in China.

BACKGROUND: Stroke 1-2-0 and FAST (Face, Arm, Speech, Time) are two popular stroke educational tools that have been used in many stroke promotion campaigns. However, few researchers have investigated awareness of these tools among older adults in communities. METHODS: This study was a cross-sectional survey of community-living older adults. Two family physicians conducted face-to-face interviews with older adults living in Minhang district, Shanghai, between October 1, 2020 and November 31, 2020. The survey comprised three parts: basic information, prior medical history, and stroke awareness knowledge. We focused on the awareness of FAST and Stroke 1-2-0 and investigated factors associated with awareness of these stroke educational tools. RESULTS: The sample of this study was 466 older adults. Their mean age was 73.45 years. Male respondents accounted for 46.14% of the total sample. More than half of the older adults surveyed had an educational background of less than 6 years. Over 90% of the older adults surveyed had never heard about Stroke 1-2-0 or FAST. The awareness rate of Stroke 1-2-0 and FAST was 7.94%, with awareness of Stroke 1-2-0 being higher than that of FAST (6.01% vs. 0.43%, p < .05). None of the respondents who had heard about the two stroke educational tools could explain the utility of either tool fully. Having a background in higher education was associated with awareness of stroke educational tools independently, with an odds ratio (OR) of 10.07, 95% confidence interval (CI) of 3.7-27.4, p < .001. In addition, Wechat (OR 6.57, 95%CI 2.65-16.27, p < .001) and the community bulletin board (OR 2.95, 95%CI 1.37-6.33, p = .005) were found to be important sources for acquiring knowledge of stroke awareness tools. CONCLUSION: The limited awareness of Stroke 1-2-0 and FAST displayed among older adults in the community indicates that we must take action to improve education on stroke among the elderly.

Age-Related Disparities in Stroke Knowledge Among Community Older Adults.

Background: This study aimed to investigate the disparities in stroke knowledge between older adults and the oldest old. Methods: Family physicians conducted a cross-sectional survey through face-to-face interviews with the older and oldest old adults of two suburban communities in the Minhang district, Shanghai between October 1, 2020, and November 30, 2020. All participants were classified as oldest old (age ≥80 years) and older adults (age 60-79 years). Between-group differences in stroke knowledge were investigated by multivariate logistic regression analysis. Results: Overall, 466 older adults including 101 (21.67%) oldest old persons were qualified. Older adults were more familiar with the risk factors and symptoms of stroke than the oldest old. By multivariable logistic regression analysis, older adults were more familiar with the following risk factors: smoking [odds ratio (OR) 0.32, 95% confidence interval (CI) 0.16-0.61], alcohol abuse (OR 0.45, 95% CI 0.23-0.87), dyslipidemia (OR 0.51, 95% CI 0.31-0.85), and obesity (OR 0.30, 95% CI 0.17-0.53) than the oldest old. Regarding stroke symptoms, older adults were more aware regarding vision alteration (OR 0.42, 95% CI 0.25-0.69) and face-drop (OR 0.57, 95% CI 0.35-0.95) than the oldest old. The oldest old were less aware of acute stroke therapy (OR 0.11, 95% CI 0.02-0.48) and calling the emergency medical service (OR 0.30, 95% CI 0.12-0.70) than older adults. Finally, the older adults used television (OR 0.53, 95% CI 0.28-1.0), WeChat (OR 0.21, 95% CI 0.05-0.89), and the community bulletin board (OR 0.43, 95% CI 0.23-0.80) as knowledge sources more than the oldest old. Conclusion: The older adults and the oldest old had significantly high disparities in stroke knowledge. Given the aging population across China, the life expectancy is expected to be longer in future decades. These differences should be addressed in stroke educational campaigns targeting the oldest old.

[Incidence and Prognosis of Infections in the Elderly and Non-elderly Residents in a Community of Beijing].

Objective To compare the incidence and prognosis of infections between elderly and non-elderly residents in a community of Beijing. Method Adult inpatients during the study period(from July 1,2012 to June 30,2014)living in Yuetan Subdistrict of Beijing were screened for infections,and patients with infections were included into the analysis. Results A total of 19 472 patients were screened,and infections were found in 3449 patients(17.7%).The incidence was significantly higher in the elderly than that in the non-elderly patients(21.5%vs.10.5%,χ 2=362.202,P<0.001).Lower respiratory tract was the most commonly affected site,followed by genitourinary system.The mortalsity rate of the elderly patients with infections was significantly higher than that of the non-elderly patients with infections(13.6%vs.3.4%,χ 2=56.829,P<0.001)and increased with age.Logistic regression analysis found that older age,emergency surgery,comorbid cancer,chronic cardiac insufficiency,higher Charlson comorbidity index,intra-abdominal infection,gastrointestinal infection,bloodstream infection,lower respiratory infection,and hospital-acquired infection were independent risk factors of death for the elderly patients. Conclusion The incidence of infections in the elderly patients living in Yuetan Subdistrict of Beijing is much higher than that of the non-elderly patients,and elderly infected patients had longer hospital length of stays and higher mortality rates than non-elderly infected patients.

Relationship between neck circumference and metabolic syndrome in over 40 years old community residents / 中国医师进修杂志

Objective@#To investigate the relationship between neck circumference and metabolic syndrome (MS) in ≥ 40 years old community residents.@*Methods@#A total of 5 017 Dalian community residents who participated in "the risk evaluation of cancers in Chinese diabetic individuals: a longitudinal study" from July to December 2014 were selected, with 1 256 male cases and 3 761 female cases, aged ≥ 40 years old. The basic information was selected by questionnaire. The neck circumference, waist circumference (WC), body height, weight, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting plasma glucose (FPG), 2 h-postprandial plasma glucose (2 h PG), glycosylated hemoglobin (HbA1c) and blood fat were measured; the body mass index (BMI) was calculated.@*Results@#The age, neck circumference, WC, FPG, 2 h PG, SBP, DBP, incidence of obesity, incidence of hypertension and incidence of type 2 diabetes mellitus in male were significantly higher than those in female: (63.5 ± 8.4) years vs. (60.8 ± 8.0) years, (38.6 ± 3.0) cm vs. (34.4 ± 2.6) cm, (92.3 ± 9.1) cm vs. (87.3 ± 9.6) cm, 5.59 (5.20, 6.42) mmol/L vs. 5.43 (5.09, 5.99) mmol/L, 7.67 (6.06, 11.08) mmol/L vs. 7.20 (5.97, 9.64) mmol/L, (135.3 ± 18.8) mmHg (1 mmHg = 0.133 kPa) vs. (129.8 ± 19.5) mmHg, (79.8 ± 10.7) mmHg vs. (74.8 ± 10.0) mmHg, 53.0% (666/1 256) vs. 48.9% (1 841/3 761), 49.9% (627/1 256) vs. 40.6% (1 528/3 761) and 29.8% (374/1 256) vs. 22.5% (846/3 761); the total cholesterol, triacylglycerol, high density lipoprotein cholesterol, low density lipoprotein cholesterol and incidence of central obesity in male were significantly lower than those in female: (5.04 ± 0.94) mmol/L vs. (5.58 ± 1.03) mmol/L, 1.35 (0.97, 1.95) mmol/L vs. 1.45 (1.06, 2.04) mmol/L, (1.18 ± 0.27) mmol/L vs. (1.32 ± 0.29) mmol/L, (2.99 ± 0.78) mmol/L vs. (3.27 ± 0.85) mmol/L and 63.7% (800/1 256) vs. 79.7% (2 998/3 761), and there were statistical differences (P<0.01 or <0.05). There were no statistical differences in BMI, HbA1c and incidence of MS between male and female (P>0.05). After adjustment for age, smoking, drinking, menopausal status (female), BMI and WC, Logistic regression analysis result showed that increased neck circumference in male increased the risk of type 2 diabetes mellitus (OR = 1.075, 95% CI 1.012 to 1.142, P = 0.019); increased neck circumference in female increased the risks of type 2 diabetes mellitus (OR = 1.143, 95% CI 1.096 to 1.192, P = 0.000), hypertension (OR = 1.112, 95% CI 1.071 to 1.156, P = 0.000), hypertriacylglyceremia (OR = 1.099, 95% CI 1.060 to 1.139, P = 0.000), low HDL-C (OR = 1.104, 95% CI 1.064 to 1.144, P = 0.000) and MS (OR = 1.167, 95% CI 1.120 to 1.217, P = 0.000). Taking neck circumference as detection variable and MS as outcome variable, the receiver operating characteristic curve was analyzed. In male, the area under curve was 0.733, the optimal cut-off value of neck circumference was 37.9 cm, with a sensitivity of 77.9%, and a specificity of 55.9%. In female, the area under curve was 0.720, the optimal cut-off value of neck circumference 33.3 cm, with a sensitivity of 76.7%, and a specificity of 56.0%.@*Conclusions@#Neck circumference is associated with MS in ≥ 40 years old community residents. Male neck circumference >37.9 cm and female neck circumference>33.3 cm are the optimal cut-off value for forecasting MS.

Incidence and Prognosis of Infections in the Elderly and Non-elderly Residents in a Community of Beijing / 中国医学科学院学报

To compare the incidence and prognosis of infections between elderly and non-elderly residents in a community of Beijing. Adult inpatients during the study period(from July 1,2012 to June 30,2014)living in Yuetan Subdistrict of Beijing were screened for infections,and patients with infections were included into the analysis. A total of 19 472 patients were screened,and infections were found in 3449 patients(17.7%).The incidence was significantly higher in the elderly than that in the non-elderly patients(21.5%10.5%,=362.202,<0.001).Lower respiratory tract was the most commonly affected site,followed by genitourinary system.The mortalsity rate of the elderly patients with infections was significantly higher than that of the non-elderly patients with infections(13.6%3.4%,=56.829,<0.001)and increased with age.Logistic regression analysis found that older age,emergency surgery,comorbid cancer,chronic cardiac insufficiency,higher Charlson comorbidity index,intra-abdominal infection,gastrointestinal infection,bloodstream infection,lower respiratory infection,and hospital-acquired infection were independent risk factors of death for the elderly patients. The incidence of infections in the elderly patients living in Yuetan Subdistrict of Beijing is much higher than that of the non-elderly patients,and elderly infected patients had longer hospital length of stays and higher mortality rates than non-elderly infected patients.

Screening for Depression among Community-dwelling Elders: Usefulness of the Center for Epidemiologic Studies Depression Scale.

CONTEXT: Though common, depressive disorders often remain undetected in late life. AIM: To examine the usefulness of Center for Epidemiologic Studies Depression (CES-D) for identifying depression among older people. SETTINGS AND DESIGN: Community resident older people (aged 65 years or more), were evaluated by clinicians trained in psychiatry, as part of a cross-sectional study of late-life depression. Assessments were done in the community. METHODS AND MATERIAL: The participants were assigned ICD-10 diagnoses and assessed using Montgomery-Asberg Depression Rating Scale (MADRS) and CES-D. A short version of CES-D with 10 items, translated to the local language Malayalam, was used. STATISTICAL ANALYSIS: The sensitivity and specificity of CES-D was evaluated against ICD-10 clinical diagnosis of depression. The correlation of CES-D and MADRS was assessed using Pearson correlation coefficient. RESULTS: 220 consenting adults from 3 wards of the Panchayath were assessed. On analysis of the Receiver Operating Characteristic (ROC) curve of CES-D scores in relation to clinical diagnosis, the large Area Under Curve (AUC) showed efficient screening and a cut off score of 4 in CES-D had a sensitivity of 97.7% and a specificity of 79.1% for depression. There was also good correlation between the MADRS and CES-D scores (0.838). CONCLUSION: CES-D is a short simple scale which can be used by health care professionals for detecting depression in older people in primary care settings.

Prevalence and risk factors for depression among community resident older people in Kerala.

BACKGROUND: Depression is the most common mental health problem in late-life. We need more information about the incidence and prevalence of major and minor syndromes of depression in older people. This will help in service development. AIMS: To estimate the prevalence of depressive disorders among community resident older people in Kerala, India and to identify factors associated with late-life depression. MATERIALS AND METHODS: Two hundred and twenty community resident older subjects were assessed for depression by clinicians trained in psychiatry. They used a symptom checklist based on International Classification of Diseases Tenth Revision (ICD-10) Diagnostic criteria for research for Depression and Montgomery Asberg Depression Rating Scale for assessment of symptoms. A structured proforma was used to assess sociodemographic characteristics and medical history. The point prevalence of depression was estimated. Univariate analysis and subsequent binary logistic regression were carried out to identify factors associated with depression. RESULTS: Prevalence of any ICD-10 (World Health Organization, 1992) depressive episode was 39.1% (95% confidence interval [CI] 32.6-45.9). There was significant correlation between depression and female gender (odds ratio [OR] 2.33; 95% CI 1.07-5.06) and history of a significant life event in the previous year (OR 2.39; 95% CI 1.27-4.49). CONCLUSION: High prevalence rate of late-life depression is indicative of high burden due to depression among older people in the community. Better awareness among primary care clinicians can result in better detection and management of late-life depression.

A cross -sectional study on prevalence of hypertension among community residents / 预防医学

Objective To explore the prevalence and risk factors of hypertension among the residents aged over the 35 years old in Pinghu City.Methods A total of 3 300 residents aged over 35 years old from 1 0 villages (communities)in Pinghu City were selected by multi -stage stratified cluster sampling method,and were investigated via questionnaire survey, physical examination and laboratory tests.Results The prevalence rate of hypertension was 32.1 5%,and the standardized rate was 28.30%.Multi -variable logistic regression analysis showed that the major risk factors of hypertension included high age(OR =38.93),overweight(OR =1 .94)and obesity(OR =4.49),family history of hypertension(OR =5.61 ), hypertriglyceridemia(OR =1 .76),Normal weight(OR =0.54)and high education level (OR =0.40)were the protective factors.Conclusion The prevalence of hypertension among the residents aged over 35 years old in Pinghu City is at a high level.It is possible to take comprehensive intervention for hypertension focus on the different risk factors.

Status quo and correlated influential factors of ability for health practice of elderly people / 现代临床护理

To investigate the status quo of health capability of old people as well as the influential factors.Method The self-rated abilities for health practices scale(SRAHP)was used for the investigation among 300 elderly healthy people.Results The total score by SRAHP was(54.29±22.80).The major influential factors included age,residence site,education,economy and health condition was age,education,economical conditions,self-evaluated health conditions(P<0.001).Conclusions SRAHP among old persons is below the medium and low was at a few lower level.The nursing intervention is good for the improvement of old persons' level of SRAHP.The nursing strategy is good for the improvement of SRAHP so as to raise the quality of life of old people.

Practice of health-promoting volunteers in the promotion of community health activities / 现代临床护理

Objective To investigate the role of health-promoting volunteers in the promotion of community health activities. Methods Fifty health volunteers were trained and went to take part in health-promoting activities together with community medical workers.Results After health-promoting activities,the rate of archive-establishment for hypertensive and diabetic patients,the rate of standardized management over the patients with archives,the rate of disease control were all significantly higher than that before the health promotion(all P<0.05).Conclusion The health-promoting volunteers are surely effective for the improvement of health knowledge and the formation of healthy behaviors.