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Liang W, Wang Y, Su N, Song H, Rhodes RE, Wang X, Shang B, Zhou L, Huang Q, Bu D, Baker JS, Duan Y. Associations of Reallocating Sedentary Time to Physical Activity and Sleep with Physical and Mental Health of Older Adults. Med Sci Sports Exerc 2024; 56:1935-1944. [PMID: 38934491 DOI: 10.1249/mss.0000000000003491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
INTRODUCTION Twenty-four-hour movement behaviors: moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), sedentary behavior (SB), and sleep are crucial factors affecting older adults' health. Using a compositional data analysis approach, this study examined the associations of time spent in these four movement behaviors with cardiometabolic health, physical fitness, and mental health among older adults. Furthermore, this study identified the estimated changes in aforementioned health outcomes by reallocating SB time to other movement behaviors. METHODS A population-based cross-sectional study of 4562 participants (67.68 ± 5.03 yr; 55.8% female) were implemented in Hubei China between July 25 and November 19, 2020. Measures included demographics, movement behaviors, cardiometabolic indicators (body mass index, waist circumference, waist-hip ratio, percentage body fat, systolic and diastolic blood pressure), physical fitness, and mental health outcomes (depressive symptoms and loneliness). Compositional data analyses were implemented in R. RESULTS MVPA and sleep time were associated with greater health outcomes (all P < 0.001), except blood pressure ( P = 0.13-0.83). LPA time was associated with waist circumference ( B = 0.313, P = 0.009), waist-hip ratio ( B = 0.003, P = 0.003), physical fitness ( B = 0.36, P < 0.001), and mental health indicators (both P < 0.001). Reallocating 30-min SB to MVPA and sleep was associated with predicated improvements in all health outcomes, except blood pressure, whereas reallocating 30-min SB to LPA resulted in predicted improvements in physical fitness (0.187 units), depressive symptoms (-0.264 units), and loneliness (-0.395 units). For dose-effect relationships, reallocating 5-60 min of SB to MVPA showed greatest benefits for all health outcomes. CONCLUSIONS This study provides timely empirical evidence for future interventions and policymaking on promoting healthy aging during the post-COVID-19 era. The findings underline the importance of including 24-h movement behaviors in future health promotion among older adults.
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Affiliation(s)
- Wei Liang
- School of Physical Education, Shenzhen University, Shenzhen, CHINA
| | - Yanping Wang
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, CHINA
| | - Ning Su
- School of Physical Education, Shenzhen University, Shenzhen, CHINA
| | - Huiqi Song
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, CHINA
| | - Ryan E Rhodes
- School of Exercise Science, Physical and Health Education, University of Victoria, CANADA
| | - Xiang Wang
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, CHINA
| | - Borui Shang
- Department of Social Sciences, Hebei Sports University, Shijiazhuang, CHINA
| | - Lin Zhou
- School of Physical Education, Hebei Normal University, Shijiazhuang, CHINA
| | - Qian Huang
- Fitness and Health Lab, Hubei Institute of Sport Science, Wuhan, CHINA
| | - Danran Bu
- Fitness and Health Lab, Hubei Institute of Sport Science, Wuhan, CHINA
| | - Julien S Baker
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, CHINA
| | - Yanping Duan
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, CHINA
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Cui G, Zhang S, Zhang X, Li S. Development and validation of a nomogram for predicting anorexia of aging in older people. Appetite 2024; 201:107606. [PMID: 39029530 DOI: 10.1016/j.appet.2024.107606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 06/24/2024] [Accepted: 07/16/2024] [Indexed: 07/21/2024]
Abstract
BACKGROUND Anorexia of aging (AA) is a common geriatric syndrome that seriously endangers the health of older adults. Early identification of populations at risk of AAand the implementation of appropriate intervention measures hold significant public health importance. This study aimed to develop a nomogram for predicting the risk of AA among older people. METHODS We conducted a cross-sectional study involving 2144 community-dwelling older adults to evaluate the AA using the Simplified Nutritional Appetite Questionnaire. We utilized the Least Absolute Shrinkage and Selection Operator (LASSO) and logistic regression analysis to select variables and develop a nomogram prediction model. The predictive performance of the nomogram was evaluated using the Receiver Operating Characteristic (ROC) curves, calibration curves, Decision Curve Analysis (DCA), and internal validation. RESULTS The prevalence of AA among Chinese older adults was 21.7% (95%CI: 20.0%-23.5%). Age, sex, family economic level, smoking status, dysphagia, loneliness, depressive symptoms, living alone, health literacy, life satisfaction, and body mass index have been identified as predictive factors for AA among older people. The nomogram constructed based on these predictive factors showed an area under the curve (AUC) of 0.766 (95%CI: 0.742-0.791), indicating good calibration and discrimination ability. Additionally, the results obtained from the 10-fold cross-validation process confirmed the nomogram's good predictive capabilities. Furthermore, the DCA results showed that the nomogram has clinical utility. CONCLUSION The nomogram constructed in this study serves as an effective tool for predicting anorexia of aging among community-dwelling older adults. Its implementation can help community healthcare workers evaluate the risk of AA in this population and identify high-risk groups.
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Affiliation(s)
- Guanghui Cui
- Department of Integrated Traditional Chinese and Western Medicine, Peking University First Hospital, Institute of Integrated Traditional Chinese and Western Medicine, Peking University, Beijing, China
| | - Shengkai Zhang
- Shandong University of Traditional Chinese Medicine, Jinan, 250355, China
| | - Xiaochen Zhang
- Shandong University of Traditional Chinese Medicine, Jinan, 250355, China
| | - Shaojie Li
- School of Public Health, Peking University, Beijing, China; China Center for Health Development Studies, Peking University, Beijing, China.
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Talifu Z, Guo S, Su B, Wu Y, Wang Y, Liu J, Luo Y, Zheng X. Gender disparities in multi-state health transitions and life expectancy among the ≥50-year-old population: A cross-national multi-cohort study. J Glob Health 2024; 14:04156. [PMID: 39238364 PMCID: PMC11377966 DOI: 10.7189/jogh.14.04156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2024] Open
Abstract
Background Understanding how disability progresses with ageing is important for shaping policies aimed at improving older adults' quality of life, especially when considering the global trends in ageing, life expectancy (LE), and gender disparity. We aimed to assess the health transition probabilities of daily living activities and their implications on LE and gender gaps in global middle-aged and elderly populations. Methods In this multi-cohort study with a sample of 74 101 individuals aged ≥50 years, we analysed data from six international cohorts: the China Health and Retirement Longitudinal Study (CHARLS), the English Longitudinal Study of Ageing (ELSA), the Health and Retirement Study (HRS) in the USA, the Mexican Longitudinal Study of Ageing (MHAS), the Korean Longitudinal Study of Ageing (KLoSA), and the Survey of Health, Ageing and Retirement in Europe (SHARE). We estimated probabilities between robust health; disabilities related to instrumental activities of daily living (IADL) and basic activities of daily living (BADL); and mortality through multi-state Markov models. We included gender as a covariate in the models to calculate hazard ratios (HRs), while we calculated LE within the distinct health states of robust health, IADL disabilities, BADL disabilities, and mortality using the stochastic population analysis for complex events (SPACE) microsimulation. Results Women had higher progressions to disability (IADL: HR = 1.392; BADL: HR = 1.356) compared to men, who conversely showed lesser progression from IADL to BADL disability (HR = 0.856) and lower mortality rates (span of HRs = 0.232-0.692). LE at age 50 favoured women (32.16-38.22 years) over men (28.99-33.58 years), yet they spent more time in states of disability. We otherwise observed significant regional and gender disparities in healthy LE. Conclusions We identified ageing patterns in which longer lives are often coupled with extended periods of disability. Pronounced gender and regional differences indicate a need for targeted health interventions to address inequities and improve seniors' quality of life. Our findings highlight the necessity for policy interventions focussed on health equity to more completely respond to the demographic shift towards older populations.
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Affiliation(s)
- Zuliyaer Talifu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Shuai Guo
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Binbin Su
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yu Wu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yunhe Wang
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Jufen Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Yanan Luo
- Department of Global Health, School of Public Health, Peking University, Beijing, China
| | - Xiaoying Zheng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- APEC Health Science Academy, Peking University, Beijing, China
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Zheng K, Qian Y, Wang H, Song D, You H, Hou B, Han F, Zhu Y, Feng F, Lam SM, Shui G, Li X. Combinatorial lipidomics and proteomics underscore erythrocyte lipid membrane aberrations in the development of adverse cardio-cerebrovascular complications in maintenance hemodialysis patients. Redox Biol 2024; 76:103295. [PMID: 39159596 PMCID: PMC11378344 DOI: 10.1016/j.redox.2024.103295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 07/21/2024] [Accepted: 07/31/2024] [Indexed: 08/21/2024] Open
Abstract
Age-associated deterioration of physiological functions occur at heterogeneous rates across individual organs. A granular evaluation of systemic metabolic mediators of aging in a healthy human cohort (n = 225) identified prominent increases in circulating uremic toxins that were recapitulated in mice, on which we further characterized the aging phenome across five peripheral organs. Our multi-omics analyses connected systemic aging profiles primarily to kidney metabolism, uncovering a metabolic association between localized glucosylceramide (GluCer) accretion and renal functional decline. Elevated GluCers were also associated with higher risk of deaths in an independent cohort of aged individuals (n = 271). We report GluCer-mTOR signaling commencing at late middle-age that disrupts mitophagy and undermines mitochondrial respiration in kidney. Conserved between human and mice, GluCer-mediated renal dysfunction is female-biased and modulated by intracellular purines. Our work provides molecular basis for the sexually disparate effects of mTOR inhibition on mammalian lifespan, possibly ascribed to the evolutionary cost of female reproduction.
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Affiliation(s)
- Ke Zheng
- Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yujun Qian
- Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China; Department of Nephrology, Jiangsu Province Hospital/The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Haiyun Wang
- Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Dan Song
- Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Hui You
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Bo Hou
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Fei Han
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yicheng Zhu
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Feng Feng
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Sin Man Lam
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China.
| | - Guanghou Shui
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China.
| | - Xuemei Li
- Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
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He S, Bian Y. Older adults 's hospitalizational costs and burden study in China--analysis from CHARLS data 2018. Front Public Health 2024; 12:1418179. [PMID: 39118974 PMCID: PMC11306026 DOI: 10.3389/fpubh.2024.1418179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 06/19/2024] [Indexed: 08/10/2024] Open
Abstract
Objective The aging Chinese population is driving up health care costs, with hospitalizational accounting for a large portion of total health care costs. By 2012, hospitalization costs for people over 60 years of age exceeded outpatient costs, marking a change in the allocation of medical resources. Further research is needed on the factors influencing changes in hospitalizational costs and burden. This paper examines the costs and burden of hospitalization for older adults from a micro perspective, providing new evidence to explain how social, medical, family, personal, and geographic factors affect them. Methods Utilizing data from the 2018 China Health and Retirement Longitudinal Study (CHARLS), a linear regression model was constructed to investigate the impact of various factors on the hospitalization costs and burden among the older adult in China. To ensure the heterogeneity of the results, the sample was divided into subgroups based on different regions for comparative analysis. Additionally, collinearity among the variables was examined. Results The average hospitalization costs for the older adult are $1,199.24, with a burden score of 0.5. Residence, type of chronic diseases, region, family size, type of health service facility, received distance, smoke and alcoholic significantly affect the out-of-pocket expenses for older adult hospitalizations. In terms of the burden of hospitalization for the older adult, Residence, health insurance, education, type of chronic diseases, region, family size, ethnic, type of health service facility, received distance, smoke, alcoholic and pension significantly impact the hospitalization burden for the older adult. Conclusion This paper provides a new perspective to explain the factors influencing hospitalizational costs and burden in China. The policy recommendations include expanding health insurance coverage and promoting commercial insurance to enhance the accessibility and financial security of healthcare services. Strengthening primary care is suggested to reduce the burden on hospitals and lower the overall cost of hospitalization. Policies aimed at addressing regional healthcare disparities are proposed, along with targeted support for vulnerable groups, including subsidies and culturally sensitive services.
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Affiliation(s)
- Shanheng He
- Institute of Chinese Medical Sciences, University of Macau, Macau, China
- State Key Laboratory of Quality Research in Chinese Medicine, University of Macau, Macau, China
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macau, China
| | - Ying Bian
- Institute of Chinese Medical Sciences, University of Macau, Macau, China
- State Key Laboratory of Quality Research in Chinese Medicine, University of Macau, Macau, China
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macau, China
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Ding M, Yan J, Chen Y, Liu J, Chao G, Zhang S. Changes in M6A methylation: A key factor in the vicious cycle of flora -gut aging. Ageing Res Rev 2024; 98:102351. [PMID: 38820855 DOI: 10.1016/j.arr.2024.102351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 05/16/2024] [Accepted: 05/27/2024] [Indexed: 06/02/2024]
Abstract
The aging process significantly impacts the gastrointestinal tract and various bodily systems, exacerbating age-related diseases. Research suggests a correlation between an imbalance in intestinal flora and gut aging, yet the precise mechanism remains incompletely elucidated. Epigenetic modifications, particularly m6A methylation, play a pivotal role in driving aging and are closely associated with gut aging. Maintaining a healthy balance of intestinal microbes is contingent upon m6A methylation, which is believed to be crucial in the vicious cycle of gut aging and intestinal flora. This article highlights the importance of m6A methylation in the nexus between gut aging and flora. It proposes the potential for targeted m6A methylation to break the vicious cycle of gut aging and flora imbalance, offering novel perspectives on attenuating or reversing gut aging.
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Affiliation(s)
- Menglu Ding
- The Second Affiliated Hospital of Zhejiang Chinese Medical University (The Xin Hua Hospital of Zhejiang Province), Hangzhou, PR China; Department of General Practice, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou 310000, PR China
| | - Junbin Yan
- The Second Affiliated Hospital of Zhejiang Chinese Medical University (The Xin Hua Hospital of Zhejiang Province), Hangzhou, PR China; Department of General Practice, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou 310000, PR China
| | - Yuxuan Chen
- The Second Affiliated Hospital of Zhejiang Chinese Medical University (The Xin Hua Hospital of Zhejiang Province), Hangzhou, PR China; Department of General Practice, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou 310000, PR China
| | - Jinguo Liu
- The Second Affiliated Hospital of Zhejiang Chinese Medical University (The Xin Hua Hospital of Zhejiang Province), Hangzhou, PR China; Department of General Practice, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou 310000, PR China
| | - Guanqun Chao
- The Second Affiliated Hospital of Zhejiang Chinese Medical University (The Xin Hua Hospital of Zhejiang Province), Hangzhou, PR China; Department of General Practice, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou 310000, PR China.
| | - Shuo Zhang
- The Second Affiliated Hospital of Zhejiang Chinese Medical University (The Xin Hua Hospital of Zhejiang Province), Hangzhou, PR China; Department of General Practice, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou 310000, PR China.
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Song M, Zheng L, Chen L, Zhang C, Chen X, Zhao C. Epidemiological characteristics of chronic non-communicable diseases in Dongfang, China, 2021: a cross-sectional survey. BMJ Open 2024; 14:e081710. [PMID: 38803260 PMCID: PMC11129020 DOI: 10.1136/bmjopen-2023-081710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 05/03/2024] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVES The study aimed to understand the composition, epidemiological characteristics and disease burden of chronic non-communicable diseases and to evaluate the association between sociodemographic factors and chronic non-communicable diseases. DESIGN A cross-sectional study. SETTING AND PARTICIPANTS Medical records of 196 761 residents were collected from Dongfang disease surveillance system from January to December 2021. PRIMARY OUTCOME Prevalence and disability burden were recorded. Logistic regression was used to investigate the relationship between sociodemography factors and diseases. RESULTS Cardiovascular diseases, chronic lower respiratory diseases and other upper respiratory tract diseases were the main chronic non-communicable diseases. In multivariable analysis, men were associated with increased risk of cardiovascular diseases (OR=1.210, 95% CI 1.162 to 1.261) and chronic lower respiratory diseases (OR=1.128, 95% CI 1.079 to 1.180). Older age was associated with increased risk of cardiovascular diseases (OR=83.952, 95% CI 58.954 to 119.550), whereas was associated with decreased risk of chronic lower respiratory diseases (OR=0.442, 95% CI 0.415 to 0.471) and other upper respiratory tract diseases (OR=0.450, 95% CI 0.411 to 0.493). The unemployed and poor household were associated with decreased risk of cardiovascular diseases (OR=0.463, 95% CI 0.412 to 0.521 and OR=0.390, 95% CI 0.342 to 0.444, respectively), whereas were associated with increased risk of chronic lower respiratory diseases (OR=12.219, 95% CI 6.343 to 23.539 and OR=10.954, 95% CI 5.666 to 21.177, respectively) and other upper respiratory tract diseases (OR=2.246, 95% CI 1.719 to 2.936 and OR=3.035, 95% CI 2.308 to 3.991, respectively). Gender and age moderated the association between personnel category and major diseases. CONCLUSIONS The spectrum and epidemiological characteristics of chronic diseases observed in Dongfang is good evidence for developing prevention guides and health policies for region.
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Affiliation(s)
- Meixuan Song
- Department of Nursing, Tongji University School of Medicine, Shanghai, China
- Research Center for Translational Medicine, Tongji University Affilliated East Hospital, Shanghai, China
| | - Liang Zheng
- Research Center for Translational Medicine, Tongji University Affilliated East Hospital, Shanghai, China
| | - Lan Chen
- Department of Internal Medicine, Dongfang People's Hospital, Dongfang, Hainan, China
| | - Chunmei Zhang
- Dongfang Municipal Health Commission, Dongfang, Hainan, China
| | - Xingyi Chen
- Department of Medical, Tongji University Affilliated East Hospital, Shanghai, China
| | - Chunyan Zhao
- Department of Nursing, Tongji University Affilliated East Hospital, Shanghai, China
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Liu R, Zhao Q, Dong W, Guo D, Shen Z, Li Y, Zhang W, Zhu D, Zhang J, Bai J, Ren R, Zhen M, Zhang J, Cui J, Li X, Miao Y. Assessing public health service capability of primary healthcare personnel: a large-scale survey in Henan Province, China. BMC Health Serv Res 2024; 24:627. [PMID: 38745226 PMCID: PMC11094852 DOI: 10.1186/s12913-024-11070-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 05/02/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND The public health service capability of primary healthcare personnel directly affects the utilization and delivery of health services, and is influenced by various factors. This study aimed to examine the status, factors, and urban-rural differences of public health service capability among primary healthcare personnel, and provided suggestions for improvement. METHODS We used cluster sampling to survey 11,925 primary healthcare personnel in 18 regions of Henan Province from 20th to March 31, 2023. Data encompassing demographics and public health service capabilities, including health lifestyle guidance, chronic disease management, health management of special populations, and vaccination services. Multivariable regression analysis was employed to investigate influencing factors. Propensity Score Matching (PSM) quantified urban-rural differences. RESULTS The total score of public health service capability was 80.17 points. Chronic disease management capability scored the lowest, only 19.60. Gender, education level, average monthly salary, professional title, health status, employment form, work unit type, category of practicing (assistant) physician significantly influenced the public health service capability (all P < 0.05). PSM analysis revealed rural primary healthcare personnel had higher public health service capability scores than urban ones. CONCLUSIONS The public health service capability of primary healthcare personnel in Henan Province was relatively high, but chronic disease management required improvement. Additionally, implementing effective training methods for different subgroups, and improving the service capability of primary medical and health institutions were positive measures.
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Affiliation(s)
- Rongmei Liu
- Henan Key Laboratory for Health Management of Chronic Diseases, Central China Fuwai Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Qiuping Zhao
- Henan Key Laboratory for Health Management of Chronic Diseases, Central China Fuwai Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Wenyong Dong
- Department of Hypertension, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan, China
| | - Dan Guo
- Department of Health Management, College of Public Health, Zhengzhou University, No.100 Kexue Road, Zhongyuan District, Zhengzhou, Henan, 450001, China
- Department of Neurology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan, China
| | - Zhanlei Shen
- Department of Health Management, College of Public Health, Zhengzhou University, No.100 Kexue Road, Zhongyuan District, Zhengzhou, Henan, 450001, China
| | - Yi Li
- Department of Health Management, College of Public Health, Zhengzhou University, No.100 Kexue Road, Zhongyuan District, Zhengzhou, Henan, 450001, China
| | - Wanliang Zhang
- Department of Health Management, College of Public Health, Zhengzhou University, No.100 Kexue Road, Zhongyuan District, Zhengzhou, Henan, 450001, China
| | - Dongfang Zhu
- Department of Health Management, College of Public Health, Zhengzhou University, No.100 Kexue Road, Zhongyuan District, Zhengzhou, Henan, 450001, China
| | - Jingbao Zhang
- Department of Health Management, College of Public Health, Zhengzhou University, No.100 Kexue Road, Zhongyuan District, Zhengzhou, Henan, 450001, China
| | - Junwen Bai
- Department of Health Management, College of Public Health, Zhengzhou University, No.100 Kexue Road, Zhongyuan District, Zhengzhou, Henan, 450001, China
| | - Ruizhe Ren
- Department of Health Management, College of Public Health, Zhengzhou University, No.100 Kexue Road, Zhongyuan District, Zhengzhou, Henan, 450001, China
| | - Mingyue Zhen
- Department of Health Management, College of Public Health, Zhengzhou University, No.100 Kexue Road, Zhongyuan District, Zhengzhou, Henan, 450001, China
| | - Jiajia Zhang
- Department of Health Management, College of Public Health, Zhengzhou University, No.100 Kexue Road, Zhongyuan District, Zhengzhou, Henan, 450001, China
| | - Jinxin Cui
- Department of Health Management, College of Public Health, Zhengzhou University, No.100 Kexue Road, Zhongyuan District, Zhengzhou, Henan, 450001, China
| | - Xinran Li
- Department of Health Management, College of Public Health, Zhengzhou University, No.100 Kexue Road, Zhongyuan District, Zhengzhou, Henan, 450001, China
| | - Yudong Miao
- Department of Health Management, College of Public Health, Zhengzhou University, No.100 Kexue Road, Zhongyuan District, Zhengzhou, Henan, 450001, China.
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Du S, Yang Y, Zheng M, Zhang H, Li T, Cai F. Health inequality of rural-to-urban migrant workers in eastern China and its decomposition: a comparative cross-sectional study. Front Public Health 2024; 12:1365241. [PMID: 38803809 PMCID: PMC11128589 DOI: 10.3389/fpubh.2024.1365241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 04/30/2024] [Indexed: 05/29/2024] Open
Abstract
Objectives As a specific group with high health inequality, it is crucial to improve the health status and health inequalities of rural-to-urban migrant workers. This study aimed to evaluate the health inequality of migrant and urban workers in China and decompose it. Methods A cross-sectional study was carried out, using a standardized questionnaire to obtain basic information, self-rated health to evaluate health status, concentration index to measure health inequalities, and WDW decomposition to analyze the causes of health inequalities. Results The concentration index of health for migrants was 0.021 and 0.009 for urban workers. The main factors contributing to health inequality among rural-to-urban migrant workers included income, exercise, and age. In contrast, the main factors of health inequality among urban workers included income, the number of chronic diseases, social support, and education. Conclusion There were health inequalities in both rural-to-urban migrant and urban workers. The government and relevant authorities should formulate timely policies and take targeted measures to reduce income disparities among workers, thereby improving health inequality.
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Affiliation(s)
- Sisi Du
- College of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Yufan Yang
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Miaomiao Zheng
- College of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Haiyan Zhang
- College of Nursing, Wenzhou Medical University, Wenzhou, China
- Cixi Biomedical Research Institute, Wenzhou Medical University, Wenzhou, China
| | - Tingting Li
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Fuman Cai
- College of Nursing, Wenzhou Medical University, Wenzhou, China
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Chen C, Zhao Y, Wu Y, Zhong P, Su B, Zheng X. Socioeconomic, Health Services, and Multimorbidity Disparities in Chinese Older Adults. Am J Prev Med 2024; 66:735-743. [PMID: 38123028 DOI: 10.1016/j.amepre.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 12/14/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION As one of the world's most populous countries, China persistently confronts a significant multimorbidity burden. This study aimed to elucidate the multimorbidity burden experienced by Chinese older adults, explore its interplay with socioeconomic disparity, and investigate potential correlations between these provincial disparities and health services availability. METHODS The fourth wave of China's national Urban and Rural Elderly Population study, conducted in 2015, was used to construct a multimorbidity index and elucidate the geographic differences in the multimorbidity burden. Incorporating macrolevel indicators about socioeconomic and health services availability, quantile regression and Spearman correlation analyses were employed to investigate the relationship between multimorbidity and socioeconomic disparities and examine the potential linkages between these provincial disparities and health services availability. Analyses were performed in 2023. RESULTS The final analysis included a total of 213,857 older adults. At the provincial level, significant geographic disparities in multimorbidity burden were identified. After adjusting for individual social determinants of health, an independent association was found between the human development index and a higher multimorbidity index (coefficient= -0.22; 95% CI= -0.24, -0.19). Furthermore, a significant positive correlation emerged between human development index and both population and geographic densities of health services availability. Notably, geographic density displayed greater inequality (Gini coefficients=0.45-0.48) than population density (Gini coefficients=0.03-0.10). CONCLUSIONS This study demonstrates that multimorbidity burden in China is linked to provincial socioeconomic disparities and that inequality in health services availability may account for this, which would advocate for a need to reduce disparities in health services availability.
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Affiliation(s)
- Chen Chen
- Department of Population Health and Aging Science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - Yihao Zhao
- Department of Chronic Diseases and Multimorbidity, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - Yu Wu
- Department of Population Health and Aging Science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - Panliang Zhong
- Department of Population Health and Aging Science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| | - Binbin Su
- Department of Health Economics, School of Population Medicine and Public Health, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China.
| | - Xiaoying Zheng
- Department of Population Health and Aging Science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; APEC Health Science Academy, Peking University, Beijing, China.
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Pang L, He K, Zhang Y, Li P, Lin Y, Yue J. Predicting environmental risks of pharmaceutical residues by wastewater surveillance: An analysis based on pharmaceutical sales and their excretion data. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 916:170204. [PMID: 38262535 DOI: 10.1016/j.scitotenv.2024.170204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/23/2023] [Accepted: 01/14/2024] [Indexed: 01/25/2024]
Abstract
Pharmaceutical residues are increasingly becoming a significant source of environmental water pollution and ecological risk. This study, leveraging official national pharmaceutical sales statistics, predicts the environmental concentrations of 33 typical pharmaceuticals in the Tianjin area. The results show that 52 % of the drugs have a PEC/MEC (Predicted Environmental Concentration/Measured Environmental Concentration) ratio within the acceptable range of 0.5-2, including atenolol (1.21), carbamazepine (1.22), and sulfamethoxazole (0.91). Among the selected drugs, tetracycline, ciprofloxacin, and acetaminophen had the highest predicted concentrations. The EPI (Estimation Programs Interface) biodegradation model, a tool from the US Environmental Protection Agency, is used to predict the removal efficiency of compounds in wastewater treatment plants. The results indicate that the EPI predictions are acceptable for macrolide antibiotics and β-blockers, with removal rates of roxithromycin, spiramycin, acetaminophen, and carbamazepine being 14.1 %, 61.2 %, 75.1 %, and 44.5 %, respectively. However, the model proved to be less effective for fluoroquinolone antibiotics. The ECOSAR (Ecological Structure-Activity Relationships) model was used to supplement the assessment of the potential impacts of drugs on aquatic ecosystems, further refining the analysis of pharmaceutical environmental risks. By combining the concentration and detection frequency of pharmaceutical wastewater, this study identified 9 drugs with significant toxicological risks and marked another 24 drugs as substances of potential concern. Additionally, this study provides data support for addressing pharmaceutical residues of priority concern in subsequent research.
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Affiliation(s)
- Lihao Pang
- College of Environmental Science and Safety Engineering, Tianjin University of Technology, Tianjin 300384, China
| | - Kai He
- College of Civil Engineering, Sun Yat-Sen University, Guangzhou 51000, China.
| | - Yuxuan Zhang
- College of Civil Engineering, Sun Yat-Sen University, Guangzhou 51000, China
| | - Penghui Li
- College of Environmental Science and Safety Engineering, Tianjin University of Technology, Tianjin 300384, China
| | - Yingchao Lin
- College of Environmental Science and Engineering, Nankai University, Tianjin 300350, China.
| | - Junjie Yue
- College of Environmental Science and Safety Engineering, Tianjin University of Technology, Tianjin 300384, China.
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Liu H, Zhang M, Zhang X, Zhao X. Exposure to early-life adversity and long-term trajectories of multimorbidity among older adults in China: analysis of longitudinal data from the China Health and Retirement Longitudinal Study. BMJ Open 2024; 14:e075834. [PMID: 38485180 PMCID: PMC10941172 DOI: 10.1136/bmjopen-2023-075834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 02/27/2024] [Indexed: 03/17/2024] Open
Abstract
OBJECTIVES This study aimed to identify long-term distinct trajectories of multimorbidity with ageing from 50 to 85 years among Chinese older adults and examine the relationship between exposure to early-life adversity (ELA; including specific types of adversity and accumulation of different adversities) and these long-term multimorbidity trajectories. DESIGN The group-based trajectory models identified long-term multimorbidity trajectories. Multinomial logistic regression models were used to examine the relationship between ELA and the identified multimorbidity trajectories. SETTING This study used data from the China Health and Retirement Longitudinal Study (CHARLS, 2011-2018) and the 2014 Life History Survey. PARTICIPANTS We used data from 9112 respondents (aged 60 and above) of the 2018 wave of CHARLS. OUTCOME MEASURES Each respondent's history of chronic conditions and experiences of ELA were collected from the 2011-2018 waves of CHARLS and the 2014 Life History Survey. RESULTS Four heterogeneous long-term trajectories of multimorbidity development were identified: 'maintaining-low' (19.1%), 'low onset-rapidly increasing' (23.3%), 'middle onset-moderately increasing' (41.5%) and 'chronically-high' (16.2%). Our findings indicated that the heterogeneity can be explained by ELA experiences. Across various types of different ELA experiences, exposure to food insufficiency (relative risk ratios from 1.372 (95% CI 1.190 to 1.582) to 1.780 (95% CI 1.472 to 2.152)) and parental quarrel/divorce (relative risk ratios from 1.181 (95% CI 1.000 to 1.394) to 1.262 (95% CI 1.038 to 1.536)) had the most prominent associations with health deterioration. The accumulation of more different ELA experiences was associated with a higher relative risk of developing more severe multimorbidity trajectories (relative risk ratio for five to seven ELAs and chronically high trajectory: 7.555, 95% CI 4.993 to 11.431). CONCLUSIONS There are heterogeneous long-term trajectories of multimorbidity in Chinese older adults, and the risk of multimorbidity associated with ELA accumulates over the lifespan. Our findings highlight the role of a supportive early-life family environment in promoting health development across the lifespan, advocating for the integration of life-course approaches to implementing health disparity interventions.
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Affiliation(s)
- Huiying Liu
- Department of Sociology, Central South University, Changsha, China
| | - Mi Zhang
- Department of Sociology, Central South University, Changsha, China
| | - Xinyan Zhang
- Department of Sociology, Central South University, Changsha, China
| | - Xinyi Zhao
- School of Health Humanities, Peking University, Beijing, China
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Yang S, Zhao H, Zhang H, Wang J, Jin H, Stirling K, Ge X, Ma L, Pu Z, Niu X, Yu D. Current status and continuing medical education need for general practitioners in Tibet, China: a cross-sectional study. BMC MEDICAL EDUCATION 2024; 24:265. [PMID: 38459539 PMCID: PMC10924353 DOI: 10.1186/s12909-024-05143-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 02/07/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND The Tibetan area is one of China's minority regions with a shortage of general practice personnel, which requires further training and staffing. This research helps to understand the current condition and demand for general practitioner (GP) training in Tibetan areas and to provide a reference for promoting GP education and training. METHODS We conducted a cross-sectional survey using stratified sampling targeting 854 GPs in seven cities within the Tibetan Autonomous Region, utilizing an online questionnaire. Achieving a high response rate of 95.1%, 812 GPs provided invaluable insights. Our meticulously developed self-designed questionnaire, available in both Chinese and Tibetan versions, aimed to capture a wide array of data encompassing basic demographics, clinical skills, and specific training needs of GPs in the Tibetan areas. Prior to deployment, the questionnaire underwent rigorous development and refinement processes, including expert consultation and pilot testing, to ensure its content validity and reliability. In our analysis, we employed descriptive statistics to present the characteristics and current training needs of GPs in the Tibetan areas. Additionally, chi-square tests were utilized to examine discrepancies in training needs across various demographic groups, such as age, job positions, and educational backgrounds of the participating GPs. RESULTS The study was completed by 812 (812/854, 95.1%) GPs, of whom 62.4% (507/812) were female. The top three training needs were hypertension (81.4%, 661/812), pregnancy management (80.7%, 655/812), and treatment of related patient conditions and events (80.5%, 654/812). Further research shows that the training required by GPs of different ages in "puncturing, catheterization, and indwelling gastric tube use" (64.6% vs. 54.8%, p = 9.5 × 10- 6) varies statistically. GPs in various positions have different training needs in "community-based chronic disease prevention and management" (76.6% vs. 63.9%, p = 0.009). The training needs of GPs with different educational backgrounds in "debridement, suturing, and fracture fixation" (65.6% vs. 73.2%, p = 0.027) were also statistically significant. CONCLUSIONS This study suggests the need for targeted continuing medical education activities and for updating training topics and content. Course developers must consider the needs of GPs, as well as the age, job positions, and educational backgrounds of GPs practicing in the Tibetan Plateau region. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Sen Yang
- Department of General Practice, Research Center for General Practice, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue Road, Yangpu District, Shanghai, 200090, PR China
- Department of General Practice, Lazi County Health Service Center, Xigatse, Tibet, 858100, PR China
| | - Huaxin Zhao
- Department of Oncology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, PR China
| | - Hanzhi Zhang
- Department of General Practice, Research Center for General Practice, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue Road, Yangpu District, Shanghai, 200090, PR China
| | - Junpeng Wang
- Medical Administration Affiliationision, Yangpu Hospital, Tongji University School of Medicine, Shanghai, 200090, PR China
| | - Hua Jin
- Department of General Practice, Research Center for General Practice, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue Road, Yangpu District, Shanghai, 200090, PR China
- Shanghai General Practice and Community Health Development Research Center, Shanghai, 200090, PR China
| | - Kyle Stirling
- Crisis Technologies Innovation Lab, Luddy School of Informatics, Computing and Engineering, Indiana University, Bloomington, IN, 47408, USA
| | - Xuhua Ge
- Department of General Practice, Research Center for General Practice, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue Road, Yangpu District, Shanghai, 200090, PR China
| | - Le Ma
- Department of General Practice, Research Center for General Practice, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue Road, Yangpu District, Shanghai, 200090, PR China
| | - Zhen Pu
- Department of General Practice, Lazi County Health Service Center, Xigatse, Tibet, 858100, PR China
| | - Xiaomin Niu
- Department of Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, 241 Huaihai West Road, Shanghai, 200030, PR China.
| | - Dehua Yu
- Department of General Practice, Research Center for General Practice, Yangpu Hospital, School of Medicine, Tongji University, 450 Tengyue Road, Yangpu District, Shanghai, 200090, PR China.
- Shanghai General Practice and Community Health Development Research Center, Shanghai, 200090, PR China.
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14
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Zhang X, Yu SL, Qi LM, Xia LN, Yang QT. Association of educational attainment with hypertension and type-2 diabetes: A Mendelian randomization study. SSM Popul Health 2024; 25:101585. [PMID: 38283548 PMCID: PMC10821170 DOI: 10.1016/j.ssmph.2023.101585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/17/2023] [Accepted: 12/13/2023] [Indexed: 01/30/2024] Open
Abstract
BACKGROUNDDue to the long time interval between exposure and outcome, it is difficult to infer the causal relationship between educational attainment (EA) and common chronic diseases. Therefore, we utilized Mendelian randomization (MR) to predict the causal relationships of EA with hypertension and type-2 diabetes (T2DM). METHODSA two-sample MR analysis was conducted using genome-wide association studies (GWASs) combined with inferential measurements. A GWAS meta-analysis including 1,131,881 European individuals was used to identify instruments for EA. Hypertension and T2DM data were obtained from a Finnish database. MR analyses were performed using inverse-variance weighted meta-analysis (IVW), weighted median regression, MR‒Egger regression, simple mode regression, weighted mode regression and the MR-Pleiotropy RESidual Sum and Outlier test. Sensitivity analyses were further performed using the leave-one-out method to test the robustness of our findings. RESULTSUsing the MR approach, our results showed that EA was significantly associated with a reduced risk of hypertension (OR = 0.63; P = 2.94 × 10-47; [95% CI: 0.59, 0.67]) and type-2 diabetes (OR = 0.59; P = 1.25 × 10-16; [95% CI: 0.52, 0.67]). CONCLUSIONSThis study showed that EA is causally linked to the risk of chronic diseases, including high blood pressure and T2DM.
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Affiliation(s)
- Xin Zhang
- Rehabilitation Traditional Chinese Medicine Department, Nanping First Hospital Affiliated to Fujian Medical University, Nanping, Fujian, 353000, China
| | - Shi-liang Yu
- Rehabilitation Traditional Chinese Medicine Department, Nanping First Hospital Affiliated to Fujian Medical University, Nanping, Fujian, 353000, China
| | - Lu-ming Qi
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, China
| | - Li-na Xia
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, China
- State Administration of Traditional Chinese Medicine Key Laboratory of Traditional Chinese Medicine, Regimen and Health, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, China
| | - Qing-tang Yang
- Rehabilitation Traditional Chinese Medicine Department, Nanping First Hospital Affiliated to Fujian Medical University, Nanping, Fujian, 353000, China
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Lin J, Yang D, Zhao X, Xie L, Xiong K, Hu L, Xu Y, Yu S, Huang W, Gong N, Liang X. The action logic of the older adults about health-seeking in South Rural China. BMC Public Health 2023; 23:2487. [PMID: 38087231 PMCID: PMC10714459 DOI: 10.1186/s12889-023-17314-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The Chinese government has invested significant resources to build many rural healthcare stations. However, in the face of convenient medical paths and accessible medical resources, the utilization rate of health services for older adults in rural areas is surprisingly low. This study explored why health-seeking behavior among older adults in rural China was not active. METHODS Data were collected through participatory rural appraisal (PRA) with 108 participants in 12 villages in southern China. Daily schedule and social and resource mapping were employed to outline the range of activities and the routine of the older adults, as well as in-depth interviews to understand the logic of their healthcare choices. Data collected were analyzed by content analysis. RESULTS Three themes were generated: (1) perceptions of health status (being healthy or sick): the rural older adults used the ability to handle routine chores as a measure of health status; (2) prioritization of solving symptoms over curing diseases: the older adults preferred the informal self-medication to cope with diseases, as long as there were no symptoms and no pain; (3) 'unpredictable' troubles: they tended to favor the 'optimal' solution of keeping their lives in order rather than the best medical treatment options. CONCLUSION This study showed that the medical practices of the rural elderly were profoundly influenced by their perceptions of health and their life experiences. In the face of diseases, they tended to keep their lives in order, preferring self-treatment practices that address symptoms or selectively following medical advice rather than medical and science-based clinical solutions. In the future, the construction of rural health care should focus on changing the 'inaccessibility' of healthcare resources at the subjective level of the rural elderly and develop culturally adaptable health education.
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Affiliation(s)
- Jianqiang Lin
- State Key laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
- Department of Ophthalmology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Dan Yang
- Department of Endodontics, Stomatological Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xinyu Zhao
- State Key laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Liqiong Xie
- State Key laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Kun Xiong
- State Key laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Lei Hu
- School of Nursing, Jinan University, Guangzhou, China
| | - Yue Xu
- State Key laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - ShanShan Yu
- State Key laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Wenyong Huang
- State Key laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
| | - Ni Gong
- School of Nursing, Jinan University, Guangzhou, China.
| | - Xiaoling Liang
- State Key laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
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Ba Z, Li Y, Ma J, Qin Y, Tian J, Meng Y, Yi J, Zhang Y, Chen F. Reflections on the dynamic zero-COVID policy in China. Prev Med Rep 2023; 36:102466. [PMID: 38116286 PMCID: PMC10728318 DOI: 10.1016/j.pmedr.2023.102466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/07/2023] [Accepted: 10/07/2023] [Indexed: 12/21/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has posed a serious threat to global healthcare and economy. In order to curb its spread, China adopted the dynamic zero-COVID policy, aiming to diagnose and isolate cases and close contacts as soon as possible. However, there is a controversy about the impact of isolation measures on social order, including the economy, personal employment and public mental health. Therefore, this review discusses and analyzes in detail the advantages and challenges of implementing dynamic zero-COVID policy. Although this public health policy might cause a shock to the economy in the short term, China still achieved a continued healthy economic performance with stable unemployment and strong export growth. Moreover, the rates of infection and mortality in China were lower than those in the United States and the European Union. However, due to the high transmissibility and low pathogenicity of the Omicron variant and prolonged lockdown-induced psychological damage, people questioned the effectiveness and necessity of this policy. Now that China has adjusted its policy in a timely manner, but many problems still remain unsolved. Some practical suggestions in terms of mental health, vaccine development, drugs supply, and economic recovery are put forward at the end of our paper to minimize negative impacts and provide a reference for future efforts.
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Affiliation(s)
- Zaihua Ba
- Jining Medical University, 133 Hehua Rd, Jining 272067, China
| | - Yuqi Li
- Jining Medical University, 133 Hehua Rd, Jining 272067, China
| | - Jiao Ma
- Jining Medical University, 133 Hehua Rd, Jining 272067, China
| | - Yining Qin
- Jining Medical University, 133 Hehua Rd, Jining 272067, China
| | - Jinzhu Tian
- Jining Medical University, 133 Hehua Rd, Jining 272067, China
| | - Yixiang Meng
- Jining Medical University, 133 Hehua Rd, Jining 272067, China
| | - Jiarong Yi
- Jining Medical University, 133 Hehua Rd, Jining 272067, China
| | - Yingze Zhang
- Jining Medical University, 133 Hehua Rd, Jining 272067, China
| | - Fei Chen
- Jining Medical University, 133 Hehua Rd, Jining 272067, China
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Zhou X, Yang F, Gao Y. A meta-analysis of the association between loneliness and all-cause mortality in older adults. Psychiatry Res 2023; 328:115430. [PMID: 37647699 DOI: 10.1016/j.psychres.2023.115430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 08/19/2023] [Accepted: 08/20/2023] [Indexed: 09/01/2023]
Abstract
Despite the well-established association between loneliness and all-cause mortality in older adults, it remains unknown whether this association holds for older adults of different sex and whether it is influenced by different samples and study characteristics. Thus, this meta-analysis aims to examine moderators of the association between loneliness and all-cause mortality in older adults. To this end, relevant literature was retrieved from the PubMed, Embase, PsycINFO, Web of Science, Chinese National Knowledge Infrastructure, Weipu, and Wanfang databases (inception to May 2023) and was processed in the Comprehensive Meta-Analysis 3.3 software. Moreover, subgroup analysis was performed to explore the sources of heterogeneity and further explore potential moderators. Funnel plots, Begg's test, and Egger's linear regression test were used to examine the publication bias, and sensitivity analysis was used to test the robustness of the results. Thirty-six studies involving 128,927 older adults were included in this meta-analysis. In general, loneliness was related to an increase in all-cause mortality in older adults (HR = 1.09, 95% CI = 1.06-1.12, I2 = 63.31%, p < 0.001). The overall effect size for older men was 1.18 (95% CI = 1.04-1.33, p = 0.010). The association between loneliness and all-cause mortality was found to be significantly influenced by the source country of the data, follow-up length, and covariates for chronic disease as moderators. In conclusion, loneliness among older adults deserves more attention, and services are needed to improve their mental health.
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Affiliation(s)
- Xiang Zhou
- Department of Social Work, School of Sociology and Political Science, Shanghai University, Nanchen Road, Baoshan District, Shanghai, 200444, China
| | - Fang Yang
- Department of Social Work, School of Sociology and Political Science, Shanghai University, Nanchen Road, Baoshan District, Shanghai, 200444, China.
| | - Yourong Gao
- Department of Social Work, School of Sociology and Political Science, Shanghai University, Nanchen Road, Baoshan District, Shanghai, 200444, China
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Zhang Y, Liu X, Ma Y, Li X. Physical Activity, Sedentary Behavior, Fruit and Vegetable Consumption, and Sarcopenia in Older Chinese Adults: A Cross-Sectional Study. Nutrients 2023; 15:3417. [PMID: 37571354 PMCID: PMC10420903 DOI: 10.3390/nu15153417] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/20/2023] [Accepted: 07/28/2023] [Indexed: 08/13/2023] Open
Abstract
PURPOSE The purpose of this study was to investigate the association between moderate to vigorous physical activity (MVPA), sedentary behavior, fruit and vegetable intake, and the risk of sarcopenia among older Chinese adults. METHODS This cross-sectional study enrolled 5418 older Chinese adults who participated in the Study on Global Aging and Adult Health (SAGE). Participants reported information about their physical activity, sedentary behavior, and dietary habits (fruit and vegetable intake). Sarcopenia was defined as the presence of low skeletal muscle mass and either a slow gait speed or weak handgrip strength. A multiple logistic regression model was employed to determine the relationship between MVPA, sedentary behavior, fruit and vegetable intake, and the risk of sarcopenia. RESULTS Only 32.63% of participants met all three recommendations (for MVPA, sedentary behavior, and fruit and vegetable intake). Compared with meeting none of the recommendations, meeting all three recommendations was associated with a lower risk of sarcopenia (OR = 0.63, 95% CI = 0.41-0.98). Moreover, meeting the recommendation for sufficient fruit and vegetable intake (OR = 0.69, 95% CI = 0.58-0.83), MVPA and fruit/vegetable intake (OR = 0.67, 95% CI = 0.52-0.86), and sedentary behavior and fruit/vegetable intake (OR = 0.69, 95% CI = 0.48-0.98) was associated with a lower risk of sarcopenia. CONCLUSION Our findings indicate that in this large representative sample of older Chinese adults, meeting lifestyle recommendations for MVPA, sedentary behavior, and fruit and vegetable intake protected against sarcopenia.
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Affiliation(s)
- Yanjie Zhang
- Physical Education Unit, School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Shenzhen 518172, China;
| | - Xiaolei Liu
- Chinese Traditional Regimen Exercise Intervention Research Center, Beijing Sport University, Beijing 100084, China;
| | - Yongzhi Ma
- Martial Arts Culture Research Center, Tsinghua University, Beijing 100084, China;
| | - Xinxing Li
- Department of Physical Education, Seoul National University, Seoul 08826, Republic of Korea
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Su B, Liu C, Chen L, Wu Y, Li J, Zheng X. Long-term exposure to PM 2.5 and O 3 with cardiometabolic multimorbidity: Evidence among Chinese elderly population from 462 cities. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 255:114790. [PMID: 36948004 DOI: 10.1016/j.ecoenv.2023.114790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 03/12/2023] [Accepted: 03/14/2023] [Indexed: 06/18/2023]
Abstract
Cardiometabolic multimorbidity (CMM) refers to the presence of multiple cardiovascular and metabolic diseases (CMDs), such as hypertension, diabetes, and cardio-cerebrovascular diseases (CCVD), in the same individual, and has emerge as a significant global health concern due to population aging. Although previous research has demonstrated the association between cardiovascular and metabolic diseases and air pollutants, evidence on the link between CMM and air pollution exposure among Chinese older adults is limited. To address this research gap, we conducted a national representative survey of 222,179 adults aged 60 and older to investigate the epidemiology of CMM and its association with long-term exposure to PM2.5 and O3 in China's elderly population. We found that the prevalence of CMM among Chinese older adults was 16.9%, and hypertension and CCVD were the most common CMM cluster (10.8%). After adjusting for confounding variables, we observed a significant positive association between PM2.5 exposure and the prevalence of hypertension, diabetes, and CCVD, with a respective excess risk increase of 3.2%, 3.6%, and 5.5% for every 10-unit increase. Moreover, every 10-unit increase in PM2.5 was linked to a higher risk of hypertension and diabetes (2.2%), hypertension and CCVD (5.4%), diabetes and CCVD (5.6%), and hypertension, diabetes, and CCVD combined (7.6%). We also found a U-shaped curve relationship between O3 exposure and the occurrence of hypertension, diabetes, and CCVD, as well as different subtypes of CMM, with the lowest risk of O3 exposure was observed near 75-80 μg/m3. Furthermore, we identified that female and rural residents are more vulnerable to the health risks of air pollution than male and urban residents. Given the increasing aging of the population and rising prevalence of multimorbidity, policymakers should focus more attention on the female and rural elderly population to prevent and control CMM. This study provides compelling evidence that reducing air pollution levels can be an effective strategy to prevent and manage CMM among older adults.
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Affiliation(s)
- Binbin Su
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, People's Republic of China
| | - Chen Liu
- Peking University Third Hospital, Beijing, People's Republic of China
| | - Li Chen
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, People's Republic of China
| | - Yu Wu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, People's Republic of China
| | - Jun Li
- Institute of Quantitative and Technological Economics, Chinese Academy of Social Sciences, Beijing, People's Republic of China
| | - Xiaoying Zheng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, People's Republic of China.
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